Articles

Difficulty of the ethical decision–making process in withholding and withdrawing life-sustaining treatments in French EDs during COVID pandemic

Authors: Marion Douplat, Laurent Jacquin, Soizic Frugier, Karim Tazarourte and Pierre Le Coz

Is prehospital use of active external warming dangerous for patients with accidental hypothermia: a systematic review

Optimal prehospital management and treatment of patients with accidental hypothermia is a matter of frequent debate, with controversies usually revolving around the subject of rewarming. The rule of thumb in p...

Authors: Sigurd Mydske and Øyvind Thomassen

Re-assessment of re-warming for out-of-hospital births

Therapeutic controlled cooling is routinely practiced on neonates with core temperatures of 33–34 °C attained during cooling for birth related hypoxic-ischaemia encephalopathy (HIE). Rewarming after therapeuti...

Authors: Peter Jones, Camille Joly and Benoît Vivien

Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan

There is limited information on the predictive accuracy of commonly used predictors, such as lactate, pH or serum potassium for the survival among out-of-hospital cardiac arrest (OHCA) patients with hypothermi...

Authors: Yohei Okada, Takeyuki Kiguchi, Taro Irisawa, Kazuhisa Yoshiya, Tomoki Yamada, Koichi Hayakawa, Kazuo Noguchi, Tetsuro Nishimura, Takuya Ishibe, Yoshiki Yagi, Masafumi Kishimoto, Hiroshi Shintani, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Haruko Sakamoto…

Serious conditions among patients with non-specific chief complaints in the pre-hospital setting: a retrospective cohort study

Emergency Medical Services (EMS) are faced daily with patients presenting with a non-specific chief complaints (NSC); i.e. decreased general condition, general malaise, sense of illness, or just being unable t...

Authors: Robert Ivic, Lisa Kurland, Veronica Vicente, Maaret Castrén and Katarina Bohm

Hospital incident command groups’ performance during major incident simulations: a prospective observational study

Hospital incident command groups’ (HICG) performance may have a profound impact on hospital response to major incidents. Previous research has assessed hospital incident command group capacity as opposed to pe...

Authors: Jason P. Murphy, Lisa Kurland, Monica Rådestad and Anders Rüter

Computer tomographic assessment of gastric volume in major trauma patients: impact of pre-hospital airway management on gastric air

Gastric dilation is frequently observed in trauma patients. However, little is known about average gastric volumes comprising food, fluids and air. Although literature suggests a relevant risk of gastric insuf...

Authors: Thomas Mitteregger, Philipp Schwaiger, Janett Kreutziger, Herbert Schöchl, Daniel Oberladstätter, Helmut Trimmel and Wolfgang G. Voelckel

Mechanical chest compression devices in the helicopter emergency medical service in Switzerland

Over the past years, several emergency medical service providers have introduced mechanical chest compression devices (MCDs) in their protocols for cardiopulmonary resuscitation (CPR). Especially in helicopter...

Authors: Urs Pietsch, David Reiser, Volker Wenzel, Jürgen Knapp, Mario Tissi, Lorenz Theiler, Simon Rauch, Lorenz Meuli and Roland Albrecht

The accuracy of preliminary diagnoses made by paramedics – a cross-sectional comparative study

Clinical decision-making skills of paramedics have been emphasized because of the growing complexity of emergency medicine nursing. A preliminary diagnosis made by a paramedic has an essential role in directin...

Authors: Outi Koivulahti, Miretta Tommila and Elina Haavisto

Non-specific diagnoses are frequent in patients hospitalized after calling 112 and their mortality is high – a register-based Danish cohort study

The number of patients calling for an ambulance increases. A considerable number of patients receive a non-specific diagnosis at discharge from the hospital, and this could imply less serious acute conditions,...

Authors: Frederikke Vestergaard Nielsen, Mette Rønn Nielsen, Jesper Amstrup, Ida Lund Lorenzen, Torben A. Kløjgaard, Emil Færk, Henrik Bøggild and Erika Frischknecht Christensen

Quality indicators for a geriatric emergency care (GeriQ-ED) – an evidence-based delphi consensus approach to improve the care of geriatric patients in the emergency department

In emergency care, geriatric requirements and risks are often not taken sufficiently into account. In addition, there are neither evidence-based recommendations nor scientifically developed quality indicators ...

Authors: Susanne Schuster, Katrin Singler, Stephen Lim, Mareen Machner, Klaus Döbler and Harald Dormann

The association of partial pressures of oxygen and carbon dioxide with neurological outcome after out-of-hospital cardiac arrest: an explorative International Cardiac Arrest Registry 2.0 study

Exposure to extreme arterial partial pressures of oxygen (PaO₂) and carbon dioxide (PaCO₂) following the return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) is common and may affe...

Authors: Florian Ebner, Richard R. Riker, Zana Haxhija, David B. Seder, Teresa L. May, Susann Ullén, Pascal Stammet, Karen Hirsch, Sune Forsberg, Allison Dupont, Hans Friberg, John A. McPherson, Eldar Søreide, Josef Dankiewicz, Tobias Cronberg and Niklas Nielsen

National Early Warning Score 2 (NEWS2) on admission predicts severe disease and in-hospital mortality from Covid-19 – a prospective cohort study

There is a need for validated clinical risk scores to identify patients at risk of severe disease and to guide decision-making during the covid-19 pandemic. The National Early Warning Score 2 (NEWS2) is widely...

Authors: Marius Myrstad, Håkon Ihle-Hansen, Anders Aune Tveita, Elizabeth Lyster Andersen, Ståle Nygård, Arnljot Tveit and Trygve Berge

Pelvic circumferential compression devices for prehospital management of suspected pelvic fractures: a rapid review and evidence summary for quality indicator evaluation

Pelvic fractures, especially when unstable, may cause significant haemorrhage. The early application of a pelvic circumferential compression device (PCCD) in patients with suspected pelvic fracture has establi...

Authors: Robin Pap, Rachel McKeown, Craig Lockwood, Matthew Stephenson and Paul Simpson

Cabin temperature during prehospital patient transport – a prospective observational study

Few studies have investigated the patient compartment temperatures during ambulance missions or its relation to admission hypothermia. Still hypothermia is a known risk factor for increased mortality and morbi...

Authors: Tuva Svendsen, Inger Lund-Kordahl and Knut Fredriksen

The rate of short-term revisits after diagnosis of non-specific abdominal pain is similar for surgeons and emergency physicians - results from a single tertiary hospital emergency department

Acute abdominal pain can be a diagnostic challenge even for experienced surgeons. Delayed diagnosis can lead to higher morbidity, mortality and increased costs. While readmission rate has been used to evaluate...

Authors: Leena Saaristo, Mika T. Ukkonen, Johanna M. Laukkarinen and Satu-Liisa K. Pauniaho

Resuscitative endovascular balloon occlusion of the aorta may contribute to improved survival

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an increasingly used trauma resuscitation procedure, however, there are no reports of whether or not the survival of patients treated with R...

Authors: Makoto Aoki, Toshikazu Abe, Shuichi Hagiwara, Daizoh Saitoh and Kiyohiro Oshima

Efficacy and efficiency of indoor nighttime human external cargo mission simulation in a high-fidelity training Centre

The human external cargo (HEC) operations conducted by Helicopter Emergency Medical Services (HEMS) rarely take place at night, making it difficult for crew members to attain and maintain the level of expertis...

Authors: Urs Pietsch, Volker Lischke, Stephen J. M. Sollid, Stephan Prückner, Lorenz Theiler, Robert Greif and Roland Albrecht

Identifying the relative importance of predictors of survival in out of hospital cardiac arrest: a machine learning study

Studies examining the factors linked to survival after out of hospital cardiac arrest (OHCA) have either aimed to describe the characteristics and outcomes of OHCA in different parts of the world, or focused o...

Authors: Nooraldeen Al-Dury, Annica Ravn-Fischer, Jacob Hollenberg, Johan Israelsson, Per Nordberg, Anneli Strömsöe, Christer Axelsson, Johan Herlitz and Araz Rawshani

The predictive value of variables measurable in the ambulance and the development of the Predict Sepsis screening tools: a prospective cohort study

Despite sepsis being a time critical condition with a high mortality, it is often not identified in a timely fashion. The aim of the current study was to create a screening tool based on bedside measurable var...

Authors: Ulrika Margareta Wallgren, Jan Sjölin, Hans Järnbert-Pettersson and Lisa Kurland

Can we predict patient outcome before extracorporeal membrane oxygenation for refractory cardiac arrest?

Refractory cardiac arrest resistant to conventional cardiopulmonary resuscitation (C-CPR) has a poor outcome. Although previous reports showed that extracorporeal cardiopulmonary resuscitation (E-CPR) can impr...

Authors: Fu-Yuan Siao, Chun-Wen Chiu, Chun-Chieh Chiu, Yu-Jun Chang, Ying-Chen Chen, Yao-Li Chen, Yung-Kun Hsieh, Chu-Chung Chou and Hsu-Hen Yen

The effect of COVID-19 on trauma system in one city of China

Authors: Fenglu Yang and Xiao Lu

Comparing complications of small-bore chest tubes to large-bore chest tubes in the setting of delayed hemothorax: a retrospective multicenter cohort study

Previous studies have provided initial data suggesting that small-bore (SB, ≤ 14Fr) chest tubes have the same efficacy as large-bore (LB, > 14 Fr) chest tubes for acute hemothorax (HTX), but data continue to b...

Authors: A. Orlando, J. Cordero, M. M Carrick, A. H. Tanner II, K. Banton, R. Vogel, M. Lieser, D. Acuna and D. Bar-Or

Strategies to measure and improve emergency department performance: a scoping review

Over the last two decades, Emergency Department (ED) crowding has become an increasingly common occurrence worldwide. Crowding is a complex and challenging issue that affects EDs’ capacity to provide safe, tim...

Authors: Elizabeth E. Austin, Brette Blakely, Catalin Tufanaru, Amanda Selwood, Jeffrey Braithwaite and Robyn Clay-Williams

Clinical experience of whole-body computed tomography as the initial evaluation tool after extracorporeal cardiopulmonary resuscitation in patients of out-of-hospital cardiac arrest

The routine application of whole-body CT after extracorporeal cardiopulmonary resuscitation (ECPR) in out-of-hospital cardiac arrest (OHCA) has not been extensively investigated. We aimed to evaluate the benef...

Authors: Kelvin Jeason Yang, Chih-Hsien Wang, Yu-Cheng Huang, Li-Jung Tseng, Yih-Sharng Chen and Hsi-Yu Yu

Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study

Telephone triage manages patient flow in acute care, but a lack of visual cues and vague descriptions of symptoms challenges clinical decision making. We aim to investigate the association between the caller’s...

Authors: Hejdi Gamst-Jensen, Erika Frischknecht Christensen, Freddy Lippert, Fredrik Folke, Ingrid Egerod, Linda Huibers, Mikkel Brabrand, Janne Schurmann Tolstrup and Lau Caspar Thygesen

Management of decision of withholding and withdrawing life-sustaining treatments in French EDs

Decisions of withholding or withdrawing life sustaining-treatments in emergency department are part of current practice but the decision-making process remains poorly described in the literature.

Authors: Marion Douplat, Laurie Fraticelli, Clement Claustre, Alexandra Peiretti, Patrice Serre, Magali Bischoff, Laurent Jacquin, Julie Freyssenge, Anne-Marie Schott, Karim Tazarourte, Soizic Frugier and Carlos E. L. Khoury

Barriers and challenges in the process of including critically ill patients in clinical studies

Clinical research in severely ill or injured patients is required to improve healthcare but may be challenging to perform in practice. The aim of this study was to analyse barriers and challenges in the proces...

Authors: Jørgen Dahlberg, Camilla Eriksen, Annette Robertsen and Sigrid Beitland

Assessment of rewarming methods in unplanned out-of-hospital births from a prospective cohort

Mobile intensive care units frequently manage unplanned out-of-hospital births (UOHB). Rewarming methods during pre-hospital management of UOHB have not yet been compared. The aim was to compare rewarming meth...

Authors: François Javaudin, Mélodie Roche, Lucile Trutt, Isabelle Bunker, Valérie Hamel, Sybille Goddet, François Templier, Christine Potiron, Quentin Le Bastard, Philippe Pes, Gilles Bagou, Jean-Louis Chabernaud, Emmanuel Montassier and Brice Leclère

Championing survival: connecting the unknown network of responders to address out-of-hospital cardiac arrest

Early intervention for out-of-hospital cardiac arrest (OHCA) presents a challenge for Emergency Medical Services (EMS) across Europe. Strategies designed to address this include education and training initiati...

Authors: Ronan McBride, Chantal F. Ski, David R. Thompson, Tom Quinn and Mark H. Wilson

The selection of an optimal transportation strategy in urgent stroke missions: a simulation study

Stroke causes death, disability and increases the use of healthcare resources worldwide. The outcome of intravenous thrombolysis and mechanical endovascular thrombectomy highly depends on the delay from sympto...

Authors: Jukka Pappinen, Tuuli Miettinen, Päivi Laukkanen-Nevala, Pekka Jäkälä, Anne-Mari Kantanen, Pekka Mäntyselkä and Jouni Kurola

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

The first seven years of nationally organized helicopter emergency medical services in Finland – the data from quality registry

Helicopter Emergency Medical Services (HEMS) play an important role in prehospital care of the critically ill. Differences in funding, crew composition, dispatch criteria and mission profile make comparison be...

Authors: Anssi Saviluoto, Johannes Björkman, Anna Olkinuora, Ilkka Virkkunen, Hetti Kirves, Piritta Setälä, Ilkka Pulkkinen, Päivi Laukkanen-Nevala, Lasse Raatiniemi, Helena Jäntti, Timo Iirola and Jouni Nurmi

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