Articles

Seven years since defining the top five research priorities in physician-provided pre-hospital critical care – what did it lead to and where are we now?

Authors: Kristi G. Bache, Marius Rehn and Julian Thompson

Mortality of civilian patients with suspected traumatic haemorrhage receiving pre-hospital transfusion of packed red blood cells compared to pre-hospital crystalloid

Major haemorrhage is a leading cause of mortality following major trauma. Increasingly, Helicopter Emergency Medical Services (HEMS) in the United Kingdom provide pre-hospital transfusion with blood products, ...

Authors: J. E. Griggs, J. Jeyanathan, M. Joy, M. Q. Russell, N. Durge, D. Bootland, S. Dunn, E. D. Sausmarez, G. Wareham, A. Weaver and R. M. Lyon

Comment to: non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study

Authors: Roland Bingisser and Christian H Nickel

Factors determining level of hospital care and its association with outcome after resuscitation from pre-hospital pulseless electrical activity

Patients resuscitated from out-of-hospital cardiac arrest (OHCA) with pulseless electrical activity (PEA) as initial cardiac rhythm are not always treated in intensive care units (ICUs): some are admitted to h...

Authors: Sini SAARINEN, Ari SALO, James BOYD, Päivi LAUKKANEN-NEVALA, Catharina SILFVAST, Ilkka VIRKKUNEN and Tom SILFVAST

Bone marrow-derived mononuclear cell therapy can attenuate systemic inflammation in rat heatstroke

This study was performed to gain insights into novel therapeutic approaches for acute systemic inflammation in heatstroke. Bone marrow-derived mononuclear cells (BMMNCs) secrete anti-inflammatory proteins and ...

Authors: Yutaka Umemura, Hiroshi Ogura, Hiroshi Matsuura, Takeshi Ebihara, Kentaro Shimizu and Takeshi Shimazu

The role of a checklist for assessing the quality of basic life support performance: an observational cohort study

Training lay rescuers in Basic Life Support (BLS) is essential to improve bystander cardiopulmonary resuscitation (CPR) rates; in addition, simple methods are needed to provide feedback on CPR performance. Thi...

Authors: Johanna van Dawen, Lina Vogt, Hanna Schröder, Rolf Rossaint, Lina Henze, Stefan K. Beckers and Saša Sopka

Identification and internal validation of models for predicting survival and ICU admission following a traumatic injury

Measures to improve the accuracy of determining survival and intensive care unit (ICU) admission using the International Classification of Injury Severity Score (ICISS) are not often conducted on a population-...

Authors: Rebecca J. Mitchell, Hsuen P. Ting, Tim Driscoll and Jeffrey Braithwaite

The accuracy of medical dispatch - a systematic review

It is a challenge to dispatch Emergency medical Services (EMS) appropriately with limited resources and maintaining patient safety; this requires accurate dispatching systems. The objective of the current syst...

Authors: K. Bohm and L. Kurland

A prediction model for good neurological outcome in successfully resuscitated out-of-hospital cardiac arrest patients

In the initial hours after out-of-hospital cardiac arrest (OHCA), it remains difficult to estimate whether the degree of post-ischemic brain damage will be compatible with long-term good neurological outcome. ...

Authors: Ward Eertmans, Thao Mai Phuong Tran, Cornelia Genbrugge, Laurens Peene, Dieter Mesotten, Jo Dens, Frank Jans and Cathy De Deyne

Treat me nice! –a cross-sectional study examining support during the first year in the emergency medical services

Working in the emergency medical service (EMS) can be extremely varying and sometimes physically and psychologically demanding. Being new in this context can be a great challenge. This study aim to describe wh...

Authors: Anna Hörberg, Susanne Kalén, Maria Jirwe, Max Scheja and Veronica Lindström

A retrospective comparison between non-conveyed and conveyed patients in ambulance care

Not all patients where an ambulance is dispatched are conveyed to an emergency department. Although non-conveyance is a substantial part of ambulance care, there is limited insight in the non-conveyance patien...

Authors: Lilian C. M. Vloet, Arjan de Kreek, Emmelieke M. C. van der Linden, Jori J. A. van Spijk, Vince A. H. Theunissen, Maud van Wanrooij, Pierre M. van Grunsven and Remco H. A. Ebben

Best practice guidelines for blunt cerebrovascular injury (BCVI)

Blunt cerebrovascular injury (BCVI) is a non-penetrating injury to the carotid and/or vertebral artery that may cause stroke in trauma patients. Historically BCVI has been considered rare but more recent publi...

Authors: Tor Brommeland, Eirik Helseth, Mads Aarhus, Kent Gøran Moen, Stig Dyrskog, Bo Bergholt, Zandra Olivecrona and Elisabeth Jeppesen

Airway management in pre-hospital critical care: a review of the evidence for a ‘top five’ research priority

The conduct and benefit of pre-hospital advanced airway management and pre-hospital emergency anaesthesia have been widely debated for many years. In 2011, prehospital advanced airway management was identified...

Authors: K. Crewdson, M. Rehn and D. Lockey

Initial assessment, level of care and outcome among children who were seen by emergency medical services: a prospective observational study

The assessment of children in the Emergency Medical Service (EMS) is infrequent representing 5.4% of the patients in an urban area in the western part of Sweden. In Sweden, patients are assessed on scene by an...

Authors: Carl Magnusson, Johan Herlitz, Thomas Karlsson and Christer Axelsson

Structured analysis, evaluation and report of the emergency response to a terrorist attack in Wuerzburg, Germany using a new template of standardised quality indicators

Until now there has been a reported lack of systematic reports and scientific evaluations of rescue missions during terror attacks. This however is urgently required in order to improve the performance of emer...

Authors: T Wurmb, N Schorscher, P Justice, S Dietz, R Schua, T Jarausch, U Kinstle, J Greiner, G Möldner, J Müller, M Kraus, S Simon, U Wagenhäuser, J Hemm, N Roewer and M Helm

The effect of bystander cardiopulmonary resuscitation on the survival of out-of-hospital cardiac arrests: a systematic review and meta-analysis

For many years, bystander cardiopulmonary resuscitation (BCPR) has been considered as a favorable factor to improve survival of out-of-hospital cardiac arrests (OHCAs). To examine the effect of BCPR on the sur...

Authors: Jianting Song, Wenxiu Guo, Xiaoguang Lu, Xin Kang, Yi Song and Dianbo Gong

Cardiac arrest teams perspectives on communication and ethical conflicts related to awareness during CPR, a focus group study protocol

Awareness during Cardio Pulmonary Resuscitation (CPR) also called CPR induced consciousness (CPRIC) is a rare, but increasingly reported condition with significant clinical implications. Health professionals l...

Authors: Rune Sarauw Lundsgaard and Kristine Sarauw Lundsgaard

A novel method of non-clinical dispatch is associated with a higher rate of critical Helicopter Emergency Medical Service intervention

Helicopter Emergency Medical Services (HEMS) are a scarce resource that can provide advanced emergency medical care to unwell or injured patients. Accurate tasking of HEMS is required to incidents where advanc...

Authors: Scott Munro, Mark Joy, Richard de Coverly, Mark Salmon, Julia Williams and Richard M. Lyon

A socio-economic analysis of increased staffing in the Norwegian helicopter emergency medical service

The European Aviation Safety Agency (EASA) is preparing a new set of regulations that will cover working and resting periods for crew members engaged in emergency medical services with helicopters (HEMS) and a...

Authors: Eirik Bjorheim Abrahamsen, Jon Tømmerås Selvik, Anders Nordgaard Dahle, Frank Asche and Håkon Bjorheim Abrahamsen

Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load

We examined the effect of advanced preparation and organisation of equipment and drugs for Pre-hospital Emergency Anaesthesia (PHEA) and tracheal intubation on procedural time, error rates, and cognitive load.

Authors: Paul Swinton, Alasdair R. Corfield, Chris Moultrie, David Percival, Jeffrey Proctor, Neil Sinclair and Zane B. Perkins

Independent determinants of prolonged emergency department length of stay in a tertiary care centre: a prospective cohort study

Emergency department (ED) overcrowding is a potential threat for patient safety. We searched for independent determinants of prolonged ED length of stay (LOS) with the aim to identify factors which can be targ...

Authors: Daniël van der Veen, Claudia Remeijer, Anne J. Fogteloo, Christian Heringhaus and Bas de Groot

First establishment of a new table-rotated-type hybrid emergency room system

The hybrid emergency room (hybrid ER) system was first established in 2011 in Japan. It is defined as an integrated system including an ER, emergency computed tomography (CT) and interventional radiology (IVR)...

Authors: Hiroaki Watanabe, Yoshihide Shimojo, Eiji Hira, Shunsuke Kuramoto, Tomohiro Muronoi, Kazuyuki Oka and Akihiko Kidani

Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study

After on-scene examination and /or treatment, emergency medical services (EMS) nurses must decide whether the patient requires further assessment or treatment, most frequently in a hospital. The primary object...

Authors: Wim Breeman, Nathan A. Poublon, Michael H. J. Verhofstad and Esther M. M. Van Lieshout

The satisfaction regarding handovers between ambulance and emergency department nurses: an observational study

A thorough handover in the emergency department (ED) is of great importance for improving the quality and safety in the chain of care. The satisfaction of handover may reflect the quality of handover. Research...

Authors: Gijs Thomas Hovenkamp, Tycho Joan Olgers, Remco Robert Wortel, Milou Esmée Noltes, Bert Dercksen and Jan Cornelis ter Maaten

How does the length of cardiopulmonary resuscitation affect brain damage in patients surviving cardiac arrest? A systematic review

Brain injury can occur after cardiac arrest due to the effects of ischaemia and reperfusion. In serious cases this can lead to permanent disability. This risk must be considered when making decisions about ter...

Authors: Clare Welbourn and Nikolaos Efstathiou

Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015

Peripheral nerve injury (PNI) as an adjunct lesion in patients with upper extremity trauma has not been investigated in a Central European setting so far, despite of its devastating long-term consequences. Thi...

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

Peripheral measurements of venous oxygen saturation and lactate as a less invasive alternative for hemodynamic monitoring

Peripheral measurement of venous oxygen saturation and lactate is a less invasive alternative to monitor tissue oxygenation as compared to measurements from a central venous catheter. However, there is a lack ...

Authors: Raphaelle Avigael Chemtob and Hasse Møller-Sørensen

Lightning accidents in the Austrian alps – a 10-year retrospective nationwide analysis

Lightning strikes are rare but potentially lethal. The risk for suffering a lightning strike in a mountain environment is unknown. The aim of this nationwide study was to analyse all lightning accidents in the...

Authors: Mathias Ströhle, Bernd Wallner, Michael Lanthaler, Simon Rauch, Hermann Brugger and Peter Paal

Assessment of laypersons’ paediatric basic life support and foreign body airway obstruction management skills: a validity study

Standardised courses for laypeople in Paediatric Basic Life Support (PBLS) and Foreign Body Airway Obstruction Management (FBAOM) teach essential skills for the initiation of resuscitation by bystanders. Perfo...

Authors: Asbjørn Hasselager, Doris Østergaard, Tim Kristensen, Claus Sønderskov, Cathrine Bohnstedt, Torsten L. B. Lauritsen, Lars Konge and Martin G. Tolsgaard

Linking the severity of illness and the weekend effect: a cohort study examining emergency department visits

Despite extensive research on the “weekend effect” i.e., the increased mortality associated with hospital admission during weekend, knowledge about disease severity in previous studies is limited. The aim of t...

Authors: Iben Duvald, Anders Moellekaer, Mathias A. Boysen and Betina Vest-Hansen

Prehospital infection control and prevention in Denmark: a cross-sectional study on guideline adherence and microbial contamination of surfaces

Prehospital acute care and treatment have become more complex, and while invasive procedures are standard procedures, focus on infection control and prevention is scarce. We aimed to evaluate guideline adheren...

Authors: Heidi Storm Vikke, Matthias Giebner and Hans Jørn Kolmos

Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a randomised controlled feasibility trial (COMPRESS-RCT)

Mechanical chest compression devices consistently deliver high-quality chest compressions. Small very low-quality studies suggest mechanical devices may be effective as an alternative to manual chest compressi...

Authors: Keith Couper, Tom Quinn, Ranjit Lall, Anne Devrell, Barry Orriss, Kate Seers, Joyce Yeung and Gavin D. Perkins

Use of the prognostic biomarker suPAR in the emergency department improves risk stratification but has no effect on mortality: a cluster-randomized clinical trial (TRIAGE III)

Risk stratification of patients in the emergency department can be strengthened using prognostic biomarkers, but the impact on patient prognosis is unknown. The aim of the TRIAGE III trial was to investigate w...

Authors: Martin Schultz, Line Jee Hartmann Rasmussen, Malene H. Andersen, Jakob S. Stefansson, Alexander C. Falkentoft, Morten Alstrup, Andreas Sandø, Sarah L. K. Holle, Jeppe Meyer, Peter B. S. Törnkvist, Thomas Høi-Hansen, Erik Kjøller, Birgitte Nybo Jensen, Morten Lind, Lisbet Ravn, Thomas Kallemose…

Prehospital treatment of patients with acute intracranial pathology: adherence to guidelines and blood pressure recommendations by the Danish Air Ambulance

Hypoxia and hypotension may be associated with secondary brain injury and negative outcomes in patients with traumatic and non-traumatic intracranial pathology. Guidelines exist only for the prehospital manage...

Authors: Joachim Juelsgaard, Leif Rognås, Lars Knudsen, Troels Martin Hansen and Mads Rasmussen

The long-term outcomes and health-related quality of life of patients following blunt thoracic injury: a narrative literature review

Major Trauma remains a leading cause of mortality and morbidity worldwide. Blunt Thoracic Injury (BTI) accounts for > 15% of United Kingdom (UK) trauma admissions and is consistently associated with respirator...

Authors: Edward Baker, Andreas Xyrichis, Christine Norton, Philip Hopkins and Geraldine Lee

How do external factors contribute to the hypocoagulative state in trauma-induced coagulopathy? – In vitro analysis of the lethal triad in trauma

External factors following trauma and iatrogenic intervention influence blood coagulation and particularly clot formation. In particular, three external factors (in detail dilution via uncritical volume replac...

Authors: Michael Caspers, Nadine Schäfer, Matthias Fröhlich, Ursula Bauerfeind, Bertil Bouillon, Manuel Mutschler and Marc Maegele

EHAC medical working group best practice advice on the role of air rescue and pre hospital critical care at major incidents

Helicopter EMS (HEMS) teams may perform a variety of clinical, managerial and transport functions during major incident management. Despite national and international variations in HEMS systems, the rapid deli...

Authors: Julian Thompson, Marius Rehn and Stephen J. M. Sollid

Undertriage of major trauma patients at a university hospital: a retrospective cohort study

Studies show increased mortality among severely injured patients not met by trauma team. Proper triage is important to ensure that all severely injured patients receive vital trauma care. In 2017 a new nationa...

Authors: Terje Nordgarden, Peter Odland, Anne Berit Guttormsen and Kristina Stølen Ugelvik

Evaluating the ability of a trauma team activation tool to identify severe injury: a multicentre cohort study

Sensitive decision making tools should assist prehospital personnel in the triage of injured patients, identifying those who require immediate lifesaving interventions and safely reducing unnecessary under- an...

Authors: Ole-Petter Vinjevoll, Oddvar Uleberg and Elaine Cole

Mortality, risk factors and causes of death in Swedish patients with open tibial fractures - a nationwide study of 3, 777 patients

Open tibial fractures are serious, complicated injuries. Previous studies suggested an increased risk of death, however, this has not been studied in large population-based settings. We aimed to analyze mortal...

Authors: Ulrika Tampe, Lukas W. Widmer, Rüdiger J. Weiss and Karl-Åke Jansson

Streptococcal M1 protein induces hyporesponsiveness and cytokine release from human arteries in a fibrinogen-dependent manner: a translational study

Streptococcus pyogenes is a Gram positive bacterial species commonly involved in sepsis. Invasive strains express virulence factors such as the M1 protein. M1 protein forms complexes with fibrinogen leading to a ...

Authors: Viveka Björck, Lisa I. Påhlman, Johan Törnebrant and Mikael Bodelsson

Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study

Up to 20% of patients admitted to an emergency department present with non-specific complaints. Retrospective studies suggest an increased risk of misdiagnosis and hospital admission for these patients, but pr...

Authors: Thomas C. Sauter, Giuliana Capaldo, Michele Hoffmann, Tanja Birrenbach, Stefanie C. Hautz, Juliana E. Kämmer, Aristomenis K. Exadaktylos and Wolf E. Hautz

Neurologic outcome after out-of-hospital cardiac arrest could be predicted with the help of bispectral-index during early targeted temperature management

Outcome prediction is crucial for out-of-hospital cardiac arrest (OHCA) survivors. Several attempts have been made to use the bispectral index (BIS) for this purpose. We aimed to investigate the prognostic pow...

Authors: Jeong Ho Park, Jae Hun Oh, Seung Pill Choi and Jung Hee Wee

Association between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients – a retrospective Analysis

Deranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various c...

Authors: Janett Kreutziger, Stefan Schmid, Nikolaus Umlauf, Hanno Ulmer, Maarten W. Nijsten, Daniel Werner, Thomas Schlechtriemen and Wolfgang Lederer

Repeated vital sign measurements in the emergency department predict patient deterioration within 72 hours: a prospective observational study

More than one in five patients presenting to the emergency department (ED) with (suspected) infection or sepsis deteriorate within 72 h from admission. Surprisingly little is known about vital signs in relatio...

Authors: Vincent M. Quinten, Matijs van Meurs, Tycho J. Olgers, Judith M. Vonk, Jack J. M. Ligtenberg and Jan C. ter Maaten

Head-to-head comparison of qSOFA and SIRS criteria in predicting the mortality of infected patients in the emergency department: a meta-analysis

Recently, the concept of sepsis was redefined by an international task force. This international task force of experts recommended using the quick Sequential Organ Failure Assessment (qSOFA) criteria instead o...

Authors: Jianjun Jiang, Jin Yang, Jing Mei, Yongmei Jin and Youjin Lu

Modelling the association between fibrinogen concentration on admission and mortality in patients with massive transfusion after severe trauma: an analysis of a large regional database

The relationship between fibrinogen concentration and traumatic death has been poorly explored after severe trauma. Existing studies analysed this relationship in unselected trauma population, often considerin...

Authors: Pierre Bouzat, François-Xavier Ageron, Jonathan Charbit, Xavier Bobbia, Pauline Deras, Jennifer Bas Dit Nugues, Etienne Escudier, Guillaume Marcotte, Marc Leone and Jean-Stéphane David

Identification of the technical and medical requirements for HEMS avalanche rescue missions through a 15-year retrospective analysis in a HEMS in Switzerland: a necessary step for quality improvement

Avalanche rescues mostly rely on helicopter emergency medical services (HEMS) and include technical rescue and complex medical situations under difficult conditions. The adequacy of avalanche victim management...

Authors: Alexandre Kottmann, Pierre-Nicolas Carron, Lorenz Theiler, Roland Albrecht, Mario Tissi and Mathieu Pasquier

Acute pain in the prehospital setting: a register-based study of 41.241 patients

Acute pain is a frequent symptom, but little is known about the frequency and causes of acute pain in the prehospital population. The objectives of this study were to investigate the frequency of moderate to s...

Authors: Kristian D. Friesgaard, Ingunn S. Riddervold, Hans Kirkegaard, Erika F. Christensen and Lone Nikolajsen

“Reality rarely looks like the guidelines”: a qualitative study of the challenges hospital-based physicians encounter in war wound management

Globally, armed conflict is a major contributor to mortality and morbidity. The treatment of war-associated injuries is largely experience-based. Evidence is weak due to difficulty in conducting medical resear...

Authors: Andreas Älgå, Karin Karlow Herzog, Murad Alrawashdeh, Sidney Wong, Hamidreza Khankeh and Cecilia Stålsby Lundborg