Articles

Regional hypothermia attenuates secondary-injury caused by time-out application of tourniquets following limb fragments injury combined with hemorrhagic shock

Tourniquet is the most widely used and effective first-aid equipment for controlling hemorrhage of injured limb in battlefield. However, time-out application of tourniquets leads to ischemic-necrosis of skelet...

Authors: Changmei Weng, Kai Lan, Tao Li, Liangchao Zhang, Jianmin Wang and Xinan Lai

Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study

Severe accidental hypothermia (AH) is life threatening. Thus, prognostic prediction in AH is essential to rapidly initiate intensive care. Several studies on prognostic factors for AH are known, but none have ...

Authors: Kenji Kandori, Yohei Okada, Tasuku Matsuyama, Sachiko Morita, Naoki Ehara, Nobuhiro Miyamae, Takaaki Jo, Yasuyuki Sumida, Nobunaga Okada, Makoto Watanabe, Masahiro Nozawa, Ayumu Tsuruoka, Yoshihiro Fujimoto, Yoshiki Okumura, Tetsuhisa Kitamura and Ryoji Iiduka

Characteristics of patients treated by the Danish Helicopter Emergency Medical Service from 2014-2018: a nationwide population-based study

A national Helicopter Emergency Medical Service (HEMS) was introduced in Denmark in 2014 to ensure the availability of physician-led critical care for all patients regardless of location.

Authors: Karen Alstrup, Thea Palsgaard Møller, Lars Knudsen, Troels Martin Hansen, Jens Aage Kølsen Petersen, Leif Rognås and Charlotte Barfod

Causes of brain dysfunction in acute coma: a cohort study of 1027 patients in the emergency department

Coma of unknown etiology (CUE) is a major challenge in emergency medicine. CUE is caused by a wide variety of pathologies that require immediate and targeted treatment. However, there is little empirical data ...

Authors: Wolf Ulrich Schmidt, Christoph J. Ploner, Maximilian Lutz, Martin Möckel, Tobias Lindner and Mischa Braun

The Danish prehospital emergency healthcare system and research possibilities

The emergency medical healthcare system outside hospital varies greatly across the globe - even within the western world. Within the last ten years, the demand for emergency medical service systems has increas...

Authors: Tim Alex Lindskou, Søren Mikkelsen, Erika Frischknecht Christensen, Poul Anders Hansen, Gitte Jørgensen, Ole Mazur Hendriksen, Hans Kirkegaard, Peter Anthony Berlac and Morten Breinholt Søvsø

Application of NICE or SNC guidelines may reduce the need for computerized tomographies in patients with mild traumatic brain injury: a retrospective chart review and theoretical application of five guidelines

Traumatic brain injuries continue to be a significant cause of mortality and morbidity worldwide. Most traumatic brain injuries are classified as mild, with a low but not negligible risk of intracranial hemorr...

Authors: Sebastian Svensson, Tomas Vedin, Linus Clausen, Per-Anders Larsson and Marcus Edelhamre

The impact of the Sepsis-3 definition on ICU admission of patients with infection

Sepsis is defined as a life-threatening organ dysfunction due to a dysregulated inflammation following an infection. However, the impact of this definition on patient care is not fully clear. This study invest...

Authors: Jenny Klimpel, Lorenz Weidhase, Michael Bernhard, André Gries and Sirak Petros

Dispatcher-assisted cardiopulmonary resuscitation for traumatic patients with out-of-hospital cardiac arrest

Resuscitation efforts for traumatic patients with out-of-hospital cardiac arrest (OHCA) are not always futile. Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) during emergency calls could increase t...

Authors: Chien-Hsin Lu, Pin-Hui Fang and Chih-Hao Lin

The boundaries of our imagination are not restricted by limits, but by lack of knowledge

Authors: Kristi G. Bache and Marius Rehn

Prehospital administration of surfactant to a premature neonate in respiratory distress

The population of the Kingdom of Bhutan is scattered in small villages throughout the eastern Himalaya. Infants born prematurely in villages have no access to neonatal intensive care until they are transported...

Authors: Charles Haviland Mize, Lhab Dorji and Ken Zafren

Variation in accessibility of the population to an Emergency Medical Communication Centre: a multicentre observational study

Access to an Emergency Medical Communication Centre is essential for the population in emergency situations. Handling inbound calls without delay requires managing activity, process and outcome measures of the...

Authors: Yann Penverne, Brice Leclere, Eric Lecarpentier, Jean-Sébastien Marx, Benjamin Gicquel, Laurent Goix and Paul-Georges Reuter

Ventilation feedback device for manual ventilation in simulated respiratory arrest: a crossover manikin study

Studies have shown that providing adequate ventilation during CPR is essential. While hypoventilation is often feared by most caregivers on the scene, the most critical problem remains hyperventilation. We dev...

Authors: Abdo Khoury, Alban De Luca, Fatimata S. Sall, Lionel Pazart and Gilles Capellier

Predicting acute coronary syndrome in males and females with chest pain who call an emergency medical communication centre

Chest pain is a frequent reason for calls in emergency medical communication centre (EMCC). Detecting a coronary origin by phone is a challenge. This is especially so as the presentations differ according to g...

Authors: Paul-Georges Reuter, Catherine Pradeau, Samantha Huo Yung Kai, Thibault Lhermusier, Arnaud Bourdé, Eric Tentillier, Xavier Combes, Vanina Bongard, Jean-Louis Ducassé and Sandrine Charpentier

A Delphi consensus study for teaching “Basic Trauma Management” to third-year medical students

The Basic-Trauma Management (BTM) course has been taught to third-year medical students in small groups for many years without substantial changes. With the introduction of a new curriculum for Swiss medical s...

Authors: Joana Berger-Estilita, Sabine Nabecker and Robert Greif

Determining optimal needle size for decompression of tension pneumothorax in children – a CT-based study

For neonates and children requiring decompression of tension pneumothorax, specific recommendations for the choice of needle type and size are missing. The aim of this retrospective study was to determine opti...

Authors: Georg Leonhard, Daniel Overhoff, Lucas Wessel, Tim Viergutz, Marcus Rudolph, Michael Schöler, Holger Haubenreisser and Tom Terboven

Limitation of treatment in prehospital care – the experiences of helicopter emergency medical service physicians in a nationwide multicentre survey

Making ethically sound treatment limitations in prehospital care is a complex topic. Helicopter Emergency Medical Service (HEMS) physicians were surveyed on their experiences with limitations of care orders in...

Authors: Heidi Kangasniemi, Piritta Setälä, Heini Huhtala, Antti Kämäräinen, Ilkka Virkkunen, Joonas Tirkkonen, Arvi Yli-Hankala and Sanna Hoppu

Palliative care in the emergency department as seen by providers and users: a qualitative study

Much effort has been made to explore how patients with advanced chronic illness and their families experience care when they attend the Emergency Department, and many studies have investigated how healthcare p...

Authors: Silvia Di Leo, Sara Alquati, Cristina Autelitano, Massimo Costantini, Gianfranco Martucci, Francesco De Vincenzo, Beata Kuczynska, Alessandra Morini, Laura Trabucco, Raffaella Ursicelli, Gianluca Catania and Luca Ghirotto

The management of unanticipated difficult airways in children of all age groups in anaesthetic practice - the position paper of an expert panel

Children form a specific group of patients, as there are significant differences between children and adults in both anatomy and physiology. Difficult airway may be unanticipated or anticipated. Difficulties e...

Authors: Wojciech Walas, Dawid Aleksandrowicz, Maria Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska and Zenon P. Halaba

Presence of a pre-hospital enhanced care team reduces on scene time and improves triage compliance for stab trauma

A reduction in pre-hospital scene time for patients with penetrating trauma is associated with reduced mortality, when combined with appropriate hospital triage. This study investigated the relationship betwee...

Authors: Alan Cowley, Mark Durham, Duncan Aldred, Richard Crabb, Paul Crouch, Adam Heywood, Andy McBride, Julia Williams and Richard Lyon

Impact of traumatic events incurred by asylum-seekers on mental health and utilization of medical services

Asylum-seekers from Africa immigrate to Israel through the Sinai desert and are often exposed to traumatic events.

Authors: Maya Siman-Tov, Moran Bodas, Alex Wang, Michael Alkan and Bruria Adini

Chest pain in the ambulance; prevalence, causes and outcome - a retrospective cohort study

Chest pain is common in acute ambulance transports. This study aims to characterize and compare ambulance-transported chest pain patients to non-chest pain patients and evaluate if patient characteristics and ...

Authors: Claus Kjær Pedersen, Carsten Stengaard, Kristian Friesgaard, Karen Kaae Dodt, Hanne Maare Søndergaard, Christian Juhl Terkelsen and Morten Thingemann Bøtker

Implementation of new guidelines in the prehospital services: a nationwide survey of Norway

A debate regarding the potential harmful effects of rigid neck collar and backboard usage among prehospital and hospital care providers in Norway provoked the development of an evidence-based guideline. “The N...

Authors: Nina Øye Thorvaldsen, Lars Didrik Flingtorp, Torben Wisborg and Elisabeth Jeppesen

Extracorporeal membrane oxygenation mitigates myocardial injury and improves survival in porcine model of ventricular fibrillation cardiac arrest

Despite decades of improved strategy in conventional cardiopulmonary resuscitation (CCPR), survival rates of favorable neurological outcome after cardiac arrest (CA) remains poor. It is indicated that the surv...

Authors: Bo Liu, Qiang Zhang, Yong Liang, Yun Zhang, Xiaoli Yuan, Jiyang Ling and Chunsheng Li

Neurocritical care physicians’ doubt about whether to withdraw life-sustaining treatment the first days after devastating brain injury: an interview study

Multilevel uncertainty exists in the treatment of devastating brain injury and variation in end-of-life decision-making is a concern. Cognitive and emotional doubt linked to making challenging decisions have n...

Authors: Annette Robertsen, Eirik Helseth, Jon Henrik Laake and Reidun Førde

Postponing intubation in spontaneously breathing major trauma patients upon emergency room admission does not impair outcome

Pre-hospital emergency anaesthesia and tracheal intubation are life-saving interventions in trauma patients. However, there is evidence suggesting that the risks associated with both procedures outweigh the be...

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

Prehospital cardiopulmonary resuscitation duration and neurological outcome after out-of-hospital cardiac arrest among children by location of arrest: a Nationwide cohort study

Little is known about the associations between the duration of prehospital cardiopulmonary resuscitation (CPR) by emergency medical services (EMS) and outcomes among paediatric patients with out-of-hospital ca...

Authors: Haruka Shida, Tasuku Matsuyama, Kosuke Kiyohara, Tetsuhisa Kitamura, Takefumi Kishimori, Takeyuki Kiguchi, Chika Nishiyama, Daisuke Kobayashi, Satoe Okabayashi, Tomonari Shimamoto, Takashi Kawamura and Taku Iwami

Prehospital management provided by medical on-scene commanders in tunnel incidents in Oslo, Norway – an interview study

High demands are placed on the emergency medical services to handle rescue operations in challenging environments such as tunnels. In Oslo, Norway a specialised management function within the emergency medical...

Authors: Johan Hylander, Britt-Inger Saveman, Ulf Björnstig and Lina Gyllencreutz

New clinical guidelines on the spinal stabilisation of adult trauma patients – consensus and evidence based

Traumatic spinal cord injury is a relatively rare injury in Denmark but may result in serious neurological consequences. For decades, prehospital spinal stabilisation with a rigid cervical collar and a hard ba...

Authors: Christian Maschmann, Elisabeth Jeppesen, Monika Afzali Rubin and Charlotte Barfod

Clinical reasoning in the emergency medical services: an integrative review

Clinical reasoning is the process of gathering and understanding information conducted by clinicians in the emergency medical services (EMS) so as to make informed decisions. Research on clinical reasoning spa...

Authors: Ulf Andersson, Hanna Maurin Söderholm, Birgitta Wireklint Sundström, Magnus Andersson Hagiwara and Henrik Andersson

Single mission workload and influencing factors in German prehospital emergency medicine - a nationwide prospective survey of 1361emergency missions

Workload is a major determinant of system performance and human well-being. This study aims to evaluate workload in prehospital emergency medicine on a single mission level and investigates influencing factors...

Authors: Johannes Prottengeier, Johann Georg Keunecke, Christine Gall, Christian Eiche, Andreas Moritz and Torsten Birkholz

Epinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study

The beneficial effect of epinephrine during resuscitation from out-of-hospital cardiac arrest (OHCA) has been inconclusive, and potential harm has been suggested, particularly in trauma victims. Although no si...

Authors: Ryo Yamamoto, Masaru Suzuki, Kei Hayashida, Jo Yoshizawa, Atsushi Sakurai, Nobuya Kitamura, Takashi Tagami, Taka-aki Nakada, Munekazu Takeda and Junichi Sasaki

The use of HEAVEN criteria to predict difficult laryngeal view and intubation failure with direct and video laryngoscopy

Authors: Liu-Jia-Zi Shao, Shao-Hua Liu and Fu-Shan Xue

Value of copeptin and the S-100b protein assay in ruling out the diagnosis of stroke-induced dizziness pattern in emergency departments

Dizziness is a frequent reason for visiting emergency departments (EDs). Differentiating stroke from other causes is challenging for physicians. The role of biomarkers has been poorly assessed. We evaluated wh...

Authors: N. Deboevere, N. Marjanovic, M. Sierecki, M. Marchetti, M. Dubocage, E. Magimel, O. Mimoz and J. Guenezan

Correlation between field triage criteria and the injury severity score of trauma patients in a French inclusive regional trauma system

In France, the pre-hospital field triage of trauma patients is currently based on the Vittel criteria algorithm. This algorithm was originally created in 2002 before the stratification of trauma centers and, a...

Authors: Arnaud Cassignol, Julien Marmin, Jean Cotte, Mickael Cardinale, Julien Bordes, Vanessa Pauly, François Kerbaul, Didier Demory and Eric Meaudre

Patient experience of spinal immobilisation after trauma

Spinal immobilisation of blunt trauma victims with potential spinal cord injury is considered standard of care. The traditional management has, however, been increasingly questioned and concerns about harm hav...

Authors: Camilla Ikast Ottosen, Jacob Steinmetz, Mo Haslund Larsen, Josefine S. Baekgaard and Lars S. Rasmussen

Spinal injury in alpine winter sports: a review

Alpine winter sports have become increasingly popular over recent decades, with a similar increase in accident incidence. This review provides an overview of the most recent literature concerning spinal injury...

Authors: Sebastian Frederick Bigdon, Jan Gewiess, Sven Hoppe, Aristomenis K. Exadaktylos, Lorin M. Benneker, Paul Gilbert Fairhurst and Christoph E. Albers

Meeting Abstracts: London Trauma Conference, London Cardiac Arrest Symposium, London Pre-hospital Care Conference 2018

Authors:

Fluid resuscitation with preventive peritoneal dialysis attenuates crush injury-related acute kidney injury and improves survival outcome

In-hospital renal replacement therapy (RRT) is widely used for the treatments of acute kidney injury (AKI) in crush injury (CI) victims. This study was designed to investigate whether preventive peritoneal dia...

Authors: Xian-Long Zhou, Shao-Zhou Ni, Dan Xiong, Xue-Qi Cheng, Peng Xu and Yan Zhao

Derivation and internal validation of the screening to enhance prehospital identification of sepsis (SEPSIS) score in adults on arrival at the emergency department

Prehospital recognition of sepsis may inform case management by ambulance clinicians, as well as inform transport decisions. The objective of this study was to develop a prehospital sepsis screening tool for u...

Authors: Michael A. Smyth, Daniel Gallacher, Peter K. Kimani, Mark Ragoo, Matthew Ward and Gavin D. Perkins

Accuracy of low-weight versus standard syringe infusion pump devices depending on altitude

Intravenous drug infusions in critically ill patients require accurate syringe infusion pumps (SIPs). This is particularly important during transportation of critically ill patients by helicopter emergency med...

Authors: Marc Blancher, Maxence Repellin, Maxime Maignan, Cyrielle Clapé, Arnaud Perrin, José Labarère, Guillaume Debaty and Damien Viglino

Road bike accidents involving cervical fractures presenting as cardiac arrest: a report of two cases

We present two cases in which elderly male recreational cyclists suffered from cervical fractures and coinciding injuries of the spinal cord that subsequently led to cardiac arrest.

Authors: Anne Marie Kabell Nissen, Louise Gramstrup Nielsen, Søren Mikkelsen and Anne Craveiro Brøchner

Defining a mission-based method to determine a HEMS unit’s actual service area

Geographical service areas are used as descriptive system indicators in Emergency Medical Service (EMS) related studies and reporting templates. The actual service area may differ significantly from administra...

Authors: Jukka Pappinen, Anna Olkinuora and Päivi Laukkanen-Nevala

Letter to the editor: in response to Alstrup et. al.

Authors: Cor Slagt, Amon Heijne and Geert-Jan van Geffen

Pre-hospital emergent intubation in trauma patients: the influence of etomidate on mortality, morbidity and healthcare resource utilization

Due to its favorable hemodynamic characteristics and by providing good intubation conditions etomidate is often used for induction of general anesthesia in trauma patients. It has been linked to temporary adre...

Authors: Michael Gäßler, Matthias Ruppert, Rolf Lefering, Bertil Bouillon and Arasch Wafaisade

An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature

The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia and guide the management of hypothermic patients. The proposed temperature range for clinical stage 1 is < 35–32 °C, for st...

Authors: M. Pasquier, P. N. Carron, A. Rodrigues, F. Dami, V. Frochaux, C. Sartori, T. Deslarzes and V. Rousson

Response to letter to the editor: “comment on unplanned out-of-hospital birth and risk factors of adverse perinatal outcome: findings from a prospective cohort”

The aim of this Letter to the Editor was to respond to a comment highlighting potential statistical biases in an analysis of our recently published article. We therefore specified the method for selecting the ...

Authors: François Javaudin, Arnaud Legrand, Philippe Pes, Emmanuel Montassier and Christelle Volteau

Acute Dysnatremias - a dangerous and overlooked clinical problem

Dysnatremias are common electrolyte disturbances with significant morbidity and mortality. In chronic dysnatremias a slow correction rate (<10 mmol/L/24 h) is indicated to avoid neurological complications. In ...

Authors: David Joergensen, Kiarash Tazmini and Dag Jacobsen

The effect of a terrorist attack on emergency department inflow: an observation study using difference-in-differences methodology

The objective of this study was to investigate how the terrorist attack in Stockholm, Sweden affected patient inflow to the general emergency departments (EDs) in close proximity of the attack. The study analy...

Authors: Andreas Ekström, Fredrik Eng-Larsson, Olov Isaksson, Lisa Kurland and Martin Nordberg

A prospective pilot study using metabolomics discloses specific fatty acid, catecholamine and tryptophan metabolic pathways as possible predictors for a negative outcome after severe trauma

We wanted to define metabolomic patterns in plasma to predict a negative outcome in severe trauma patients.

Authors: Luis Servià, Mariona Jové, Joaquim Sol, Reinald Pamplona, Mariona Badia, Neus Montserrat, Manuel Portero-Otin and Javier Trujillano

Live video footage from scene to aid helicopter emergency medical service dispatch: a feasibility study

Obtaining accurate information from a 112 caller is key to correct tasking of Helicopter Emergency Medical Services (HEMS). Being able to view the incident scene via video from a mobile phone may assist HEMS d...

Authors: E. ter Avest, E. Lambert, R. de Coverly, H. Tucker, J. Griggs, M. H. Wilson, A. Ghorbangholi, J. Williams and R. M. Lyon