Articles

Point-of-care ultrasound induced changes in management of unselected patients in the emergency department - a prospective single-blinded observational trial

Point-of-Care ultrasound (POCUS) changes the management in specific groups of patients in the Emergency Department (ED). It seems intuitive that POCUS holds an unexploited potential on a wide variety of patien...

Authors: Jesper Weile, Christian A. Frederiksen, Christian B. Laursen, Ole Graumann, Erik Sloth and Hans Kirkegaard

Changing role of EMS –analyses of non-conveyed and conveyed patients in Finland

Emergency Medical Services (EMS) and Emergency Departments (ED) have seen increasing attendance rates in the last decades. Currently, EMS are increasingly assessing and treating patients without the need to co...

Authors: Jani Paulin, Jouni Kurola, Sanna Salanterä, Hans Moen, Nischal Guragain, Mari Koivisto, Niina Käyhkö, Venla Aaltonen and Timo Iirola

Prediction of in-hospital mortality in patients with post traumatic brain injury using National Trauma Registry and Machine Learning Approach

The use of machine learning techniques to predict diseases outcomes has grown significantly in the last decade. Several studies prove that the machine learning predictive techniques outperform the classical mu...

Authors: Ahmad Abujaber, Adam Fadlalla, Diala Gammoh, Husham Abdelrahman, Monira Mollazehi and Ayman El-Menyar

Decision support tool and suggestions for the development of guidelines for the helicopter transport of patients with COVID-19

The novel coronavirus SARS-CoV2 emerged in December 2019 and is now pandemic. Initial analysis suggests that 5% of infected patients will require critical care, and that respiratory failure requiring intubatio...

Authors: Per P. Bredmose, Monica Diczbalis, Emma Butterfield, Karel Habig, Andrew Pearce, Svein Are Osbakk, Ville Voipio, Marcus Rudolph, Alistair Maddock and John O’Neill

Possible advantages of early stabilization of spinal fractures in multiply injured patients with leading thoracic trauma - analysis based on the TraumaRegister DGU®

Major trauma often comprises fractures of the thoracolumbar spine and these are often accompanied by relevant thoracic trauma. Major complications can be ascribed to substantial simultaneous trauma to the ches...

Authors: Sven Hager, Helge Eberbach, Rolf Lefering, Thorsten O. Hammer, David Kubosch, Christoph Jäger, Norbert P. Südkamp and Jörg Bayer

Clinical outcomes of extracorporeal membrane oxygenation in acute traumatic lung injury: a retrospective study

Therapeutic extracorporeal membrane oxygenation (ECMO) is a challenging procedure in patients who have experienced severe trauma. Particularly, patients with traumatic lung injury and posttraumatic acute respi...

Authors: Hong Kyu Lee, Hyoung Soo Kim, Sang Ook Ha, Sunghoon Park, Hee Sung Lee, Soo Kyung Lee and Sun Hee Lee

Transport of COVID-19 and other highly contagious patients by helicopter and fixed-wing air ambulance: a narrative review and experience of the Swiss air rescue Rega

The current COVID-19 pandemic highlights the challenges air ambulance services are facing when transporting highly infectious patients for several hours in enclosed spaces. This overview provides an example of...

Authors: Roland Albrecht, Jürgen Knapp, Lorenz Theiler, Marcus Eder and Urs Pietsch

A potential method of identifying stroke and other intracranial lesions in a prehospital setting

Identifying stroke and other intracranial lesions in patients with a decreased level of consciousness may be challenging in prehospital settings. Our objective was to investigate whether the combination of sys...

Authors: Anssi Saviluoto, Heini Harve-Rytsälä, Mitja Lääperi, Hetti Kirves, Helena Jäntti and Jouni Nurmi

Radiologic discrepancies in diagnosis of fractures in a Dutch teaching emergency department: a retrospective analysis

Missed fractures in the emergency department (ED) are common and may lead to patient morbidity.

Authors: Laura Mattijssen-Horstink, Judith Joëlle Langeraar, Gert Jan Mauritz, William van der Stappen, Maarten Baggelaar and Edward Camillus Thwan Han Tan

Lausanne medical dispatch centre’s response to COVID-19

The COVID-19 crisis is an unprecedented event. It is therefore essential for dispatch centres to share their experiences while the crisis is underway, similar to hospitals, so that we will all benefit from fee...

Authors: Fabrice Dami and Vincent Berthoz

Nitrous oxide/oxygen plus acetaminophen versus morphine in ST elevation myocardial infarction: open-label, cluster-randomized, non-inferiority study

Studies have shown disparate results on the consequences of morphine use in ST-segment elevation myocardial infarction (STEMI). No study has evaluated alternative treatments that could be at least non-inferior...

Authors: Sandrine Charpentier, Michel Galinski, Vincent Bounes, Agnès Ricard-Hibon, Carlos El-Khoury, Meyer Elbaz, François-Xavier Ageron, Stéphane Manzo-Silberman, Louis Soulat, Frédéric Lapostolle, Alexandre Gérard, Delphine Bregeaud, Vanina Bongard and Eric Bonnefoy-Cudraz

Association of helicopter transportation and improved mortality for patients with major trauma in the northern French Alps trauma system: an observational study based on the TRENAU registry

Prompt prehospital triage and transportation are essential in an organised trauma system. The benefits of helicopter transportation on mortality in a physician-staffed pre-hospital trauma system remains unknow...

Authors: Francois-Xavier Ageron, Guillaume Debaty, Dominique Savary, Frederic Champly, Francois Albasini, Pascal Usseglio, Cécile Vallot, Samuel Galvagno and Pierre Bouzat

Undertriage in trauma: an ignored quality indicator?

Early identification of life-threatening injuries is essential to reduce morbidity and mortality in trauma patients. Failure to detect severe injury may cause delayed diagnosis and therapeutic interventions an...

Authors: Elisabeth Jeppesen, Mathias Cuevas-Østrem, Cathrine Gram-Knutsen and Oddvar Uleberg

Performance of pre-hospital evaluations in ruling out invasive chest stab wounds

Some guidelines advocate for managing patients with penetrating thoracic wounds in trauma centres with cardiothoracic surgery. This systematic approach is questionable. Only 15% of these patients require surge...

Authors: Pascal Augustin, Elise Guivarch, Quentin Pellenc, Yves Castier, Sandrine Boudinet, Sebastien Tanaka, Philippe Montravers and Alexy Tran-Dinh

Top five research priorities in physician-provided pre-hospital critical care – appropriate staffing, training and the effect on outcomes

Authors: Marius Rehn, Kristi G. Bache, Hans Morten Lossius and David Lockey

The ticking clock: does actively making an enhanced care team aware of the passage of time improve pre-hospital scene time following traumatic incidents?

Pre-hospital enhanced care teams like Helicopter Emergency Medical Services (HEMS) are often dispatched to major trauma patients, including patients with traumatic brain injuries and those with major haemorrha...

Authors: L. Curtis, E. ter Avest, J. Griggs, J. Wiliams and R. M. Lyon

Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Severe accidental hypothermia is associated with high morbidity and mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides an efficient rewarming method with complete cardiopulmonary s...

Authors: Aurélien Ledoux and Piehr Saint Leger

Longitudinal analysis of health status the first year after trauma in severely injured patients

While survival rates after a trauma are increasing a considerable part of the trauma population are still at risk for both short and long term disabilities. Little is known about prognostic factors over time a...

Authors: Roos Johanna Maria Havermans, Mariska Adriana Cornelia de Jongh, Leonie de Munter and Koen Willem Wouter Lansink

What clinical crew competencies and qualifications are required for helicopter emergency medical services? A review of the literature

Patients served by Helicopter Emergency Medical Services (HEMS) tend to be acutely injured or unwell and in need of stabilisation followed by rapid and safe transport. It is therefore hypothesised that a parti...

Authors: Siobhán Masterson, Conor Deasy, Mark Doyle, David Hennelly, Shane Knox and Jan Sorensen

A novel ECG-biomarker for cardiac arrest during hypothermia

Treatment of arrhythmias evoked by accidental or therapeutic hypothermia and rewarming remains challenging. We aim to find an ECG-biomarker that can predict ventricular arrhythmias at temperatures occurring in...

Authors: Erik Sveberg Dietrichs, Torkjel Tveita, Rachel Myles and Godfrey Smith

Including oxygen supplement in the early warning score: a prediction study comparing TOKS, modified TOKS and NEWS in a cohort of emergency patients

Early warning scores (EWS) are widely used in emergency departments and on general wards to detect critical illness and deterioration. TOKS (“Tidlig Opsporing af Kritisk Sygdom”) is an early warning score used...

Authors: Maj Juhl Skov, Jacob Dynesen, Marie K. Jessen, Janet Yde Liesanth, Julie Mackenhauer and Hans Kirkegaard

Template for documenting and reporting data in physician-staffed pre-hospital services: a consensus-based update

Physician-staffed emergency medical services (p-EMS) are resource demanding, and research is needed to evaluate any potential effects of p-EMS. Templates, designed through expert agreement, are valuable and fe...

Authors: Kristin Tønsager, Andreas Jørstad Krüger, Kjetil Gorseth Ringdal and Marius Rehn

Patient experience of severe acute dyspnoea and relief during treatment in ambulances: a prospective observational study

Acute dyspnoea is common among ambulance patients, but little is known of the patients’ experience of symptom. We aimed to investigate ambulance patients initial perceived intensity of acute dyspnoea, and whet...

Authors: Tim Alex Lindskou, Ulla Møller Weinreich, Kenneth Lübcke, Torben Anders Kløjgaard, Birgitte Schantz Laursen, Søren Mikkelsen and Erika Frischknecht Christensen

Correction to: Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: retrospective analysis of prospectively collected prehospital data

Following the publication of the original article [1], the authors unfortunately became aware of some typesetting and resolution problems in Figs. 1 and 2.

Authors: Dong Keon Lee, Yu Jin Kim, Giwoon Kim, Choung Ah. Lee, Hyung Jun Moon, Jaehoon Oh, Hae Chul Yang, Han Joo Choi, Young Taeck Oh and Seung Min Park

Septic shock: ECMO beyond ARDS? Introducing the Simon two-stage protocol when randomisation is considered unethical

Authors: Alexander Buia, Hans-Bernd Hopf, Eva Herrmann, Thomas Schmandra and Ernst Hanisch

Impact of blunt chest trauma on outcome after traumatic brain injury– a matched-pair analysis of the TraumaRegister DGU®

Traumatic brain injury (TBI) is associated with high rates of long-term disability and mortality. Our aim was to investigate the effects of thoracic trauma on the in-hospital course and outcome of patients wit...

Authors: Mark Schieren, Frank Wappler, Arasch Wafaisade, Rolf Lefering, Samir G. Sakka, Jost Kaufmann, Hi-Jae Heiroth, Jerome Defosse and Andreas B. Böhmer

Trauma research in the Nordic countries, 1995–2018 – a systematic review

Trauma is a major cause of mortality and reduced quality of life. Most trauma-related research originates from trauma centres, and there are limited available data regarding the treatment of trauma patients th...

Authors: Elisabeth Jeppesen, Valdemar Vea Iversen, Ingrid Schrøder Hansen, Eirik Reierth and Torben Wisborg

Influence of physical strain at high altitude on the quality of cardiopulmonary resuscitation

High quality cardiopulmonary resuscitation is a key factor in survival with good overall quality of life after out-of-hospital cardiac arrest. Current evidence is predominantly based on studies conducted at lo...

Authors: Alexander Egger, Maximilian Niederer, Katharina Tscherny, Josef Burger, Verena Fuhrmann, Calvin Kienbacher, Dominik Roth, Wolfgang Schreiber and Harald Herkner

The volume-outcome relationship among severely injured patients admitted to English major trauma centres: a registry study

Many countries have centralized and dedicated trauma centres with high volumes of trauma patients. However, the volume-outcome relationship in severely injured patients (Injury Severity Score (ISS) > 15) remai...

Authors: Charlie A. Sewalt, Eveline J. A. Wiegers, Fiona E. Lecky, Dennis den Hartog, Stephanie C. E. Schuit, Esmee Venema and Hester F. Lingsma

London Trauma Conference 2019

Authors:

Artificial intelligence algorithm to predict the need for critical care in prehospital emergency medical services

In emergency medical services (EMSs), accurately predicting the severity of a patient’s medical condition is important for the early identification of those who are vulnerable and at high-risk. In this study, ...

Authors: Da-Young Kang, Kyung-Jae Cho, Oyeon Kwon, Joon-myoung Kwon, Ki-Hyun Jeon, Hyunho Park, Yeha Lee, Jinsik Park and Byung-Hee Oh

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

If transport under ongoing cardiopulmonary resuscitation (CPR) from an upper floor is indicated, the ideal CPR-method and evacuation route is unknown hitherto. We aimed to elaborate a strategy for evacuation o...

Authors: Hendrik Drinhaus, Sebastian Nüsgen, Niels Adams, Wolfgang A. Wetsch and Thorsten Annecke

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

To determine the prevalence and characteristics of prechiasmatic visual system injuries (VSI) among seriously injured patients with concomitant head trauma in Europe by means of a multinational...

Authors: Torge Huckhagel, Jan Regelsberger, Manfred Westphal, Jakob Nüchtern and Rolf Lefering

Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review

Autoresuscitation describes the return of spontaneous circulation after termination of resuscitation (TOR) following cardiac arrest (CA). We aimed to identify phenomena that may lead to autoresuscitation and t...

Authors: Les Gordon, Mathieu Pasquier, Hermann Brugger and Peter Paal

Swedish emergency hospital surgical surge capacity to mass casualty incidents

In Sweden the surgical surge capacity for mass casualty incidents (MCI) is managed by county councils within their dedicated budget. It is unclear whether healthcare budget constraints have affected the region...

Authors: Magnus Blimark, Per Örtenwall, Hans Lönroth, Peter Mattsson, Kenneth D. Boffard and Yohan Robinson

Intubation in acute alcohol intoxications at the emergency department

Guidelines recommend endotracheal intubation in trauma patients with a Glasgow coma scale (GCS) < 9 because of the loss of airway reflexes and consequential risk of airway obstruction. However, in patients wit...

Authors: Thomas C. Sauter, Katharina Rönz, Trevor Hirschi, Beat Lehmann, Christopher Hütt, Aristomenis K. Exadaktylos and Martin Müller

Comparison of adverse events between video and direct laryngoscopes for tracheal intubations in emergency department and ICU patients–a systematic review and meta-analysis

This systematic review and meta-analysis was designed to determine whether video laryngoscope (VL) compared with direct laryngoscope (DL) could reduce the occurrence of adverse events associated with tracheal ...

Authors: Jia Jiang, Na Kang, Bo Li, An-Shi Wu and Fu-Shan Xue

Outcomes following resuscitative thoracotomy for abdominal exsanguination, a systematic review

Resuscitative thoracotomy is a damage control procedure with an established role in the immediate treatment of patients in extremis or cardiac arrest secondary to cardiac tamponade however Its role in resuscit...

Authors: Michael Hughes and Zane Perkins

Emergency department non-invasive cardiac output study (EDNICO): an accuracy study

There is little published data investigating non-invasive cardiac output monitoring in the emergency department (ED). We assess here the accuracy of five non-invasive methods in detecting fluid responsiveness ...

Authors: David McGregor, Shrey Sharma, Saksham Gupta, Shanaz Ahmed and Tim Harris

Towards definitions of time-sensitive conditions in prehospital care

Prehospital care has changed in recent decades. Advanced assessments and decisions are made early in the care chain. Patient assessments form the basis of a decision relating to prehospital treatment and the l...

Authors: Kristoffer Wibring, Carl Magnusson, Christer Axelsson, Peter Lundgren, Johan Herlitz and Magnus Andersson Hagiwara

Nonspecific complaints in the emergency department – a systematic review

Nonspecific complaint (NSC) is a common presenting complaint in the emergency setting, especially in the elderly population. Individual studies have shown that it is associated with significant morbidity and m...

Authors: Kirsi Kemp, Reija Mertanen, Mitja Lääperi, Leila Niemi-Murola, Lasse Lehtonen and Maaret Castren

A retrospective register study comparing fibrinogen treated trauma patients with an injury severity score matched control group

Fibrinogen concentrate (FC) is frequently used to treat bleeding trauma patients, although the clinical effects are not well known. In this study we describe demographic and clinical outcome data in a cohort o...

Authors: Lou M. Almskog, Ulf Hammar, Agneta Wikman, Anders Östlund, Jonas Svensson, Michael Wanecek and Anna Ågren

Developing a tool for measuring the disaster resilience of healthcare rescuers: a modified Delphi study

Disaster resilience is an essential personal characteristics of health rescue workers to respond to disasters in an effective manner, and maintain a state of adaptation after deployment. It is essential for di...

Authors: Xiaorong MAO, Alice Yuen LOKE and Xiuying HU

Associations of therapeutic hypothermia with clinical outcomes in patients receiving ECPR after cardiac arrest: systematic review with meta-analysis

Therapeutic hypothermia has been recommended for eligible patients after cardiac arrest (CA) in order to improve outcomes. Up to now, several comparative observational studies have evaluated the combined use o...

Authors: Xi Chen, Zhen Zhen, Jia Na, Qin Wang, Lu Gao and Yue Yuan

Clinical guided computer tomography decisions are advocated in potentially severely injured trauma patients: a one-year audit in a level 1 trauma Centre with long pre-hospital times

The International Commission on Radiological Protection’s (ICRP) justification principles state that an examination is justified if the potential benefit outweighs the risk for radiation harm. Computer tomogra...

Authors: Anna Bågenholm, Trond Dehli, Stig Eggen Hermansen, Kristian Bartnes, Marthe Larsen and Tor Ingebrigtsen

Spontaneous trigger words associated with confirmed out-of-hospital cardiac arrest: a descriptive pilot study of emergency calls

According to the International Liaison Committee on Resuscitation (ILCOR), the trigger words used by callers that are associated with cardiac arrest constitute a scientific knowledge gap. This study was design...

Authors: Joonas Tamminen, Erik Lydén, Jan Kurki, Heini Huhtala, Antti Kämäräinen and Sanna Hoppu

Impact of a goal-directed factor-based coagulation management on thromboembolic events following major trauma

A factor-based coagulation management following major trauma is recommended as standard of care by the European Trauma Treatment Guidelines. However, concerns about the thromboembolic risk of this approach are...

Authors: Anais L. Stein, Julian Rössler, Julia Braun, Kai Sprengel, Patrick E. Beeler, Donat R. Spahn, Alexander Kaserer and Philipp Stein

Open-chest cardiopulmonary resuscitation versus closed-chest cardiopulmonary resuscitation in patients with cardiac arrest: a systematic review and meta-analysis

Cardiopulmonary resuscitation is the most urgent and critical step in the rescue of patients with cardiac arrest. However, only about 10% of patients with out-of-hospital cardiac arrest survive to discharge. S...

Authors: Mao Wang, Xiaoguang Lu, Ping Gong, Yilong Zhong, Dianbo Gong and Yi Song

Impact of gender on post- traumatic intensive care and outcomes

Several reports indicate gender disparities in health care provision. There is a well-documented male patient dominance in intensive care unit (ICU) admittance. It is not established if this difference reflect...

Authors: Emma Larsson, Ann-Charlotte Lindström, Mikael Eriksson and Anders Oldner

Development, validation and assessment of the test on knowledge about basic life support and use of automated external defibrillator among schoolchildren

Educating lay public can significantly strengthen the Chain of Survival after out of hospital cardiac arrest. Schoolchildren are an accessible population for learning basic life support (BLS) and use of an aut...

Authors: Vesna Borovnik Lesjak, Andrej Šorgo and Matej Strnad