Articles

Subjective safety and self-confidence in prehospital trauma care and learning progress after trauma-courses: part of the prospective longitudinal mixed-methods EPPTC-trial

Prehospital trauma care is stressful and requires multi-professional teamwork. A decrease in the number of accident victims ultimately affects the routine and skills and underlines the importance of effective ...

Authors: David Häske, Stefan K. Beckers, Marzellus Hofmann, Rolf Lefering, Paul A. Grützner, Ulrich Stöckle, Vassilios Papathanassiou and Matthias Münzberg

Characteristics and outcome of rapid response team patients ≥75 years old: a prospective observational cohort study

Rapid response teams (RRTs) attend severely ill general ward patients whose average 30-day mortality is near 30%. A major part of RRT patients are over 75 years old, but there are no studies on the characteris...

Authors: Joonas Tirkkonen, Piritta Setälä and Sanna Hoppu

The Anticoagulated trauma patient in the age of the direct oral anticoagulants: a Canadian perspective

The anticoagulated trauma patient presents a particular challenge to the critical care physician. Our understanding of these patients is defined and extrapolated by experience with patients on warfarin pre-inj...

Authors: Brendan Wood, Barto Nascimento, Sandro Rizoli, Michelle Sholzberg, Amanda McFarlan, Andrea Phillips and Alun D. Ackery

Exploring how nurses assess, monitor and manage acute pain for adult critically ill patients in the emergency department: protocol for a mixed methods study

Many critically ill patients experience moderate to severe acute pain that is frequently undetected and/or undertreated. Acute pain in this patient cohort not only derives from their injury and/or illness, but...

Authors: Wayne Varndell, Margaret Fry and Doug Elliott

Computed tomography during initial management and mortality among hemodynamically unstable blunt trauma patients: a nationwide retrospective cohort study

Although many hemodynamically unstable trauma patients undergo computed tomography (CT) to identify a source of bleeding, this practice is currently only recommended by a few guidelines. To clarify whether CT ...

Authors: Yusuke Tsutsumi, Shingo Fukuma, Asuka Tsuchiya, Tatsuyoshi Ikenoue, Yosuke Yamamoto, Sayaka Shimizu, Miho Kimachi and Shunichi Fukuhara

A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyanc...

Authors: Remco H.A. Ebben, Lilian C.M. Vloet, Renate F. Speijers, Nico W. Tönjes, Jorik Loef, Thomas Pelgrim, Margreet Hoogeveen and Sivera A.A. Berben

The use of non-uniform drowning terminology: a follow-up study

In 2002, the World Congress on Drowning developed a uniform definition for drowning. The aim of this study is to determine the prevalence of “non-uniform drowning terminology” (NUDT) and “non-uniform drowning ...

Authors: Andrew C. Schmidt, Justin R. Sempsrott, David Szpilman, Ana Catarina Queiroga, Matt S. Davison, Ryan J. Zeigler and Sean J. McAlister

Swedish-Norwegian co-operation in the treatment of three hypothermia victims: a case report

Accidental hypothermia with cardiac arrest represents a challenge for pre-hospital rescuers as well as in-hospital staff. For pre-hospital personnel, the main focus is to get the patient to the correct destina...

Authors: Anders Wetting Carlsen, Nils K. Skjaervold, Nils Johan Berg, Øystein Karlsen, Eli Gunnarson and Alexander Wahba

Demographic and clinical characteristics of carbon monoxide poisoning: nationwide data between 1999 and 2012 in Taiwan

Carbon monoxide poisoning (COP) is not uncommon, but nationwide epidemiological data are limited. We conducted a study in Taiwan to fill the data gaps.

Authors: Chien-Cheng Huang, Chung-Han Ho, Yi-Chen Chen, Hung-Jung Lin, Chien-Chin Hsu, Jhi-Joung Wang, Shih-Bin Su and How-Ran Guo

Serum lactate is an independent predictor of hospital mortality in critically ill patients in the emergency department: a retrospective study

Elevated lactate has been found to be associated with a higher mortality in a diverse patient population. The aim of the study is to investigate if initial serum lactate level is independently associated with ...

Authors: Ralphe Bou Chebl, Christopher El Khuri, Ali Shami, Eva Rajha, Nagham Faris, Rana Bachir and Gilbert Abou Dagher

National consensus on communication in prehospital trauma care, the DENIM study

In the Netherlands prehospital trauma care is provided by emergency medical services (EMS) nurses. This care is extended by Physician staffed Helicopter Emergency Medical Services (P-HEMS) for the more severel...

Authors: Annelieke Maria Karien Harmsen, Leo Maria George Geeraedts Jr., Georgios Fredericus Giannakopoulos, Maartje Terra, Herman M. T. Christiaans, Lidwine Brigitta Mokkink and Frank Willem Bloemers

Hypothermia induced alteration of repolarization - impact on acute and long-term outcome: a prospective cohort study

The effects of target temperature management (TTM) on the heart aren’t thoroughly studied yet. Several studies showed the prolongation of various ECG parameters including Tpeak-Tend-time under TTM. Our study’s...

Authors: Sophie von Ulmenstein, Christian Storm, Thomas G. K. Breuer, Sebastian Lask, Philipp Attanasio, Andreas Mügge and Alexander Wutzler

Controlled automated reperfusion of the whole body after 120 minutes of Cardiopulmonary resuscitation: first clinical report

Cardiopulmonary resuscitation (CPR) is associated with a high mortality rate. Furthermore, the few survivors often have severe, persistent cerebral dysfunction. A potential cause for this unsatisfactory outcom...

Authors: Georg Trummer, Alexander Supady, Friedhelm Beyersdorf, Christian Scherer, Tobias Wengenmayer, Markus Umhau and Christoph Benk

Effect of dextran-70 on outcome in severe sepsis; a propensity-score matching study

Albumin may be beneficial in patients with septic shock but availability is limited and cost is high. The objective of the present study was to investigate if the use of dextran-70 in addition to albumin and c...

Authors: Peter Bentzer, Marcus Broman and Thomas Kander

Anatomical landmarks for safely implementing resuscitative balloon occlusion of the aorta (REBOA) in zone 1 without fluoroscopy

Resuscitative balloon occlusion of the aorta (REBOA) can maintain hemodynamic stability during hemorrhagic shock after a following torso injury, although inappropriate balloon placement may induce brain or vis...

Authors: Yohei Okada, Hiromichi Narumiya, Wataru Ishi and Ryoji Iiduka

Two cases of low birth weight infant survival by prehospital emergency hysterotomy

During maternal cardiac arrest, emergency hysterotomy (EH) is recommended after four minutes of resuscitation, if no signs of spontaneous circulation are detected. This extreme procedure is believed to be pote...

Authors: Miretta Tommila, Mikko Pystynen, Hanna Soukka, Fatih Aydin and Matias Rantanen

Mortality due to traumatic spinal cord injuries in Europe: a cross-sectional and pooled analysis of population-wide data from 22 countries

Traumatic spinal cord injuries (TSCI) pose a significant burden globally, while existing epidemiological data–especially on population mortality–are limited. The aim of this study was to calculate the age-stan...

Authors: Marek Majdan, Dominika Plancikova, Eva Nemcovska, Lenka Krajcovicova, Alexandra Brazinova and Martin Rusnak

Risk score to predict false-positive ST-segment elevation myocardial infarction in the emergency department: a retrospective analysis

The best treatment approach for ST-segment elevation myocardial infarction (STEMI) is prompt primary percutaneous coronary intervention (PCI). However, some patients show ST elevation on electrocardiography (E...

Authors: Ji Hoon Kim, Yun Ho Roh, Yoo Seok Park, Joon Min Park, Bo Young Joung, In Cheol Park, Sung Phil Chung and Min Joung Kim

Ultrasonography helps emergency physician identify the best lumbar puncture site under the conus medullaris

Ultrasonography – assisted lumbar puncture helps physicians identify traditional anatomical landmarks. However, it could help to overcome the anatomical dogmas and thus identify the best interspinous space und...

Authors: Line Dussourd, Batistin Martinon, Clara Candille, Carole Paquier, Claire Wintenberger, Perrine Dumanoir, Anais Plazanet, Damien Viglino and Maxime Maignan

Performance of point-of-care international normalized ratio measurement to diagnose trauma-induced coagulopathy

Trauma-induced coagulopathy (TIC) is a common feature after severe trauma. Detection of TIC is based upon classic coagulation tests including international normalized ratio (INR) value. Point-of-care (POC) dev...

Authors: Thomas Mistral, Yvonnick Boué, Jean-Luc Bosson, Pauline Manhes, Jules Greze, Julien Brun, Pierre Albaladejo, Jean-François Payen and Pierre Bouzat

Community first responders and responder schemes in the United Kingdom: systematic scoping review

Community First Responder (CFR) schemes support lay people to respond to medical emergencies, working closely with ambulance services. They operate widely in the UK. There has been no previous review of UK lit...

Authors: Viet-Hai Phung, Ian Trueman, Fiona Togher, Roderick Orner and A. Niroshan Siriwardena

Comparison of transportation related injury mechanisms and outcome of young road users and adult road users, a retrospective analysis on 24,373 patients derived from the TraumaRegister DGU^®

Most young people killed in road crashes are known as vulnerable road users. A combination of physical and developmental immaturity as well as inexperience increases the risk of road traffic accidents with a h...

Authors: Thomas Brockamp, Uli Schmucker, Rolf Lefering, Manuel Mutschler, Arne Driessen, Christian Probst, Bertil Bouillon and Paola Koenen

Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality – a prospective study of patients admitted with infection to the emergency department

We aimed to evaluate the clinical usefulness of qSOFA as a risk stratification tool for patients admitted with infection compared to traditional SIRS criteria or our triage system; the Rapid Emergency Triage a...

Authors: Åsa Askim, Florentin Moser, Lise T. Gustad, Helga Stene, Maren Gundersen, Bjørn Olav Åsvold, Jostein Dale, Lars Petter Bjørnsen, Jan Kristian Damås and Erik Solligård

The danish regions pediatric triage model has a limited ability to detect both critically ill children as well as children to be sent home without treatment – a study of diagnostic accuracy

The Danish Regions Pediatric Triage model (DRPT) was introduced in 2012 and subsequent implemented in most Danish acute pediatric departments. The aim was to evaluate the validity of DRPT as a screening tool t...

Authors: Lotte Høeg Hansen, Christian Backer Mogensen, Lena Wittenhoff and Helene Skjøt-Arkil

The golden hour of acute ischemic stroke

Acute Ischemic Stroke (AIS) treatment has been revolutionised in the last two decades with the increasing use of Intravenous Thrombolysis (IVT) and with the advent of Endovascular therapy (EVT). AIS treatment ...

Authors: Rajiv Advani, Halvor Naess and Martin W. Kurz

Pre-hospital triage performance after standardized trauma courses

The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in ...

Authors: Maria Lampi, Johan Junker, Peter Berggren, Carl-Oscar Jonson and Tore Vikström

Under-triage in telephone consultation is related to non-normative symptom description and interpersonal communication: a mixed methods study

Telephone consultation and triage are used to limit the workload on emergency departments. Lack of visual cues and clinical tests put telephone consultations to a disadvantage compared to face-to-face consulta...

Authors: Hejdi Gamst-Jensen, Freddy K. Lippert and Ingrid Egerod

Dispatch and prehospital transport for acute septic patients: an observational study

In order to dispatch ambulances with the correct level of urgency, the dispatch center has to balance the perceived urgency and traffic safety considerations with the available resources. As urgency is not cle...

Authors: Peter Bank Pedersen, Daniel Pilsgaard Henriksen, Søren Mikkelsen and Annmarie Touborg Lassen

Risk for intracranial pressure increase related to enclosed air in post-craniotomy patients during air ambulance transport: a retrospective cohort study with simulation

Post-craniotomy intracranial air can be present in patients scheduled for air ambulance transport to their home hospital. We aimed to assess risk for in-flight intracranial pressure (ICP) increases related to ...

Authors: Helge Brändström, Anna Sundelin, Daniela Hoseason, Nina Sundström, Richard Birgander, Göran Johansson, Ola Winsö, Lars-Owe Koskinen and Michael Haney

A novel scoring system for predicting the neurologic prognosis prior to the initiation of induced hypothermia in cases of post-cardiac arrest syndrome: the CAST score

The aim of this study was to develop a scoring system for identifying the post-cardiac arrest syndrome (PCAS) patients with a good potential for recovery prior to the initiation of induced therapeutic hypother...

Authors: Mitsuaki Nishikimi, Naoyuki Matsuda, Kota Matsui, Kunihiko Takahashi, Tadashi Ejima, Keibun Liu, Takayuki Ogura, Michiko Higashi, Hitoshi Umino, Go Makishi, Atsushi Numaguchi, Satoru Matsushima, Hideki Tokuyama, Mitsunobu Nakamura and Shigeyuki Matsui

Do pre-hospital poisoning deaths differ from in-hospital deaths? A retrospective analysis

Most fatal poisonings occur outside the hospital and the victims found dead. The purpose of this study was to determine the general pattern and patient demographics of fatal poisonings in Northern Finland. In ...

Authors: Lauri Koskela, Lasse Raatiniemi, Håkon Kvåle Bakke, Tero Ala-Kokko and Janne Liisanantti

Clinical course and prognostic factors of patients in severe accidental hypothermia with circulatory instability rewarmed with veno-arterial ECMO - an observational case series study

Recently, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become the rewarming treatment of choice in hypothermic cardiac arrest. The detailed indications for extracorporeal rewarming in non-ar...

Authors: Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksander Zeliaś, Mirosław Ziętkiewicz, Paweł Podsiadło, Tomasz Sanak, Kinga Sałapa, Jacek Piątek, Janusz Konstany-Kalandyk, Robert Gałązkowski, Paweł Krawczyk, Łukasz Krzych and Rafał Drwiła

Sex-based differences in outcomes after severe injury: an analysis of blunt trauma patients in China

Experimental research suggests that females have a higher survival rate after trauma, although this claim is controversial. This study sought to determine the role of sex on mortality among trauma patients in ...

Authors: Ziqiang Zhu, Xiaoping Shang, Peiyi Qi and Shengli Ma

Treatment-limiting decisions in patients with severe traumatic brain injury in a Norwegian regional trauma center

Treatment-limiting decisions (TLD) for severe traumatic brain injury (sTBI) have been sparsely studied. This study determine prevalence, main reason for, categories and timing of TLDs in a Norwegian regional t...

Authors: Annette Robertsen, Reidun Førde, Nils Oddvar Skaga and Eirik Helseth

In-hospital airway management training for non-anesthesiologist EMS physicians: a descriptive quality control study

Pre-hospital airway management is a major challenge for emergency medical service (EMS) personnel. Despite convincing evidence that the rescuer’s qualifications determine efficacy of tracheal intubation, in-ho...

Authors: Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger and Wolfgang G. Voelckel

Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors

Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia...

Authors: Frédéric Lapostolle, James Couvreur, François Xavier Koch, Dominique Savary, Armelle Alhéritière, Michel Galinski, Jean-Luc Sebbah, Karim Tazarourte and Frédéric Adnet

Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients—still a relevant problem?

Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome o...

Authors: Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A. Schmid and Gregor J. Kocher

The association of patient and trauma characteristics with the health-related quality of life in a Dutch trauma population

It is suggested in literature to use the Health Related Quality of Life (HRQoL) as an outcome indicator for evaluating trauma centre performances. In order to predict HRQoL, characteristics that could be of in...

Authors: Amy Gunning, Mark van Heijl, Karlijn van Wessem and Luke Leenen

The use of viscoelastic haemostatic assays in goal-directing treatment with allogeneic blood products – A systematic review and meta-analysis

Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopath...

Authors: Mathilde Fahrendorff, Roberto S. Oliveri and Pär I. Johansson

Merger of two dispatch centres: does it improve quality and patient safety?

Dispatch centres (DCs) are considered an essential but expensive component of many highly developed healthcare systems. The number of DCs in a country, region, or state is usually based on local history and of...

Authors: Alexandre Moser, Annette Mettler, Vincent Fuchs, Walter Hanhart, Claude-François Robert, Vincent Della Santa and Fabrice Dami

The challenges of military medical education and training for physicians and nurses in the Nordic countries - an interview study

Development and use of e-learning has not taken place to the same extent in military medicine in the Nordic countries. The aim was to explore the similarities and differences in education and training in milit...

Authors: Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark and Klas Karlgren

PreHospital Ambulance Stroke Test - pilot study of a novel stroke test

There is a need for a prehospital stroke test that in addition to high sensitivity for stroke, also is able to communicate stroke severity similar to the National Institute of Health Stroke Scale (NIHSS).

Authors: Gunnar Andsberg, Magnus Esbjörnsson, Arne Olofsson, Arne Lindgren, Bo Norrving and Mia von Euler

Effect of an interactive cardiopulmonary resuscitation assist device with an automated external defibrillator synchronised with a ventilator on the CPR performance of emergency medical service staff: a randomised simulation study

The present study evaluates whether the quality of advanced cardiac life support (ALS) is improved with an interactive prototype assist device. This device consists of an automated external defibrillator linke...

Authors: Rainer Nitzschke, Christoph Doehn, Jan F. Kersten, Julian Blanz, Tobias J. Kalwa, Norman A. Scotti and Jens C. Kubitz

Termination of prehospital resuscitative efforts: a study of documentation on ethical considerations at the scene

Discussions on ethical aspects of life-and-death decisions within the hospital are often made in plenary. The prehospital physician, however, may be faced with ethical dilemmas in life-and-death decisions when...

Authors: Søren Mikkelsen, Caroline Schaffalitzky de Muckadell, Lars Grassmé Binderup, Hans Morten Lossius, Palle Toft and Annmarie Touborg Lassen

Blood transfusion and coagulopathy in geriatric trauma patients

Trauma resuscitation has undergone a paradigm shift with new emphasis on the early use of blood products and increased proportions of plasma and platelets. However, it is unclear how this strategy is applied o...

Authors: Brett Mador, Bartolomeu Nascimento, Simon Hollands and Sandro Rizoli

External validation of the ROSC after cardiac arrest (RACA) score in a physician staffed emergency medical service system

The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score exte...

Authors: Petteri Kupari, Markus Skrifvars and Markku Kuisma

We need to include bystander first aid in trauma research

The chain of trauma survival is a concept that originated in the area of out-of-hospital cardiac arrest (OHCA) and was adapted to the treatment of trauma. In out-of-hospital cardiac arrest research into bystan...

Authors: Håkon Kvåle Bakke and Torben Wisborg

Meeting abstracts from the 7th Danish Emergency Medicine Conference

Authors: Osama Bin Abdullah, Johannes Grand, Astha Sijapati, Petrine Nimskov, Finn Erland Nielsen, Jens Christian Schmidt, Noel Pérez, Tanja Kirkegaard, Marianne Fløjstrup, Mikkel Brabrand, Mathias Galthen-Sørensen, Rasa Ramoskiene, Arman Arshad, Annmarie Lassen, Lars Stubbe Teglbjærg, O. Andersen…

Targeted temperature management in cardiac arrest: survival evaluated by propensity score matching

Targeted temperature management in cardiac arrest was introduced following evidence of increased survival from two controlled trials published in 2002. We wanted to investigate whether the introduction of targ...

Authors: Eirik A. Buanes, Karl O. Hufthammer, Jørund Langørgen, Anne-Berit Guttormsen and Jon-Kenneth Heltne

Prothrombin time is predictive of low plasma prothrombin concentration and clinical outcome in patients with trauma hemorrhage: analyses of prospective observational cohort studies

Fibrinogen and prothrombin have been suggested to become rate limiting in trauma associated coagulopathy. Administration of fibrinogen is now recommended, however, the importance of prothrombin to patient outc...

Authors: Clare A. Balendran, Ann Lövgren, Kenny M. Hansson, Karin Nelander, Marita Olsson, Karin J. Johansson, Karim Brohi, Dietmar Fries and Anders Berggren