Articles

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

The role of point of care ultrasound in prehospital critical care: a systematic review

In 2011, the role of Point of Care Ultrasound (POCUS) was defined as one of the top five research priorities in physician-provided prehospital critical care and future research topics were proposed; the feasib...

Authors: Morten Thingemann Bøtker, Lars Jacobsen, Søren Steemann Rudolph and Lars Knudsen

Predictive factors of intracranial bleeding in head trauma patients receiving antiplatelet therapy admitted to an emergency department

In head trauma cases involving antiplatelet agent treatment, the French Society of Emergency Medicine recommends performing computed tomography (CT) scans to detect brain lesions, 90% of which are normal. The ...

Authors: Farès Moustafa, Jean Roubin, Bruno Pereira, Alain Barres, Jennifer Saint-Denis, Christophe Perrier, Marine Mondet, Frederic Dutheil and Jeannot Schmidt

Prehospital point-of-care emergency ultrasound: a cohort study

In the prehospital situation, the diagnostic armamentarium available to the rescue physician is limited. Emergency ultrasound has proven to be a useful diagnostic tool, providing crucial information for the ma...

Authors: Maximilian Scharonow and Christian Weilbach

Does the prehospital National Early Warning Score predict the short-term mortality of unselected emergency patients?

The prehospital research field has focused on studying patient survival in cardiac arrest, as well as acute coronary syndrome, stroke, and trauma. There is little known about the overall short-term mortality a...

Authors: Marko Hoikka, Tom Silfvast and Tero I. Ala-Kokko

Capillary and venous lactate measurements with a handheld device compared to venous blood-gas analysis for emergency patients

Early identification of lactate levels may have a large impact on triage classification and assist in identifying critically ill patients. A handheld device provides a rapid and timesaving measurement of lacta...

Authors: David Stoll, Erling Englund, Helene Hillborg, Stefan Vedin and Agneta Larsson

Standardised data reporting from pre-hospital advanced airway management – a nominal group technique update of the Utstein-style airway template

Pre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients. To improve pre-hospital critical care and develop evidence-based guideline...

Authors: G. A. Sunde, A. Kottmann, J. K. Heltne, M. Sandberg, M. Gellerfors, A. Krüger, D. Lockey and S. J. M. Sollid

Critcomms: a national cross-sectional questionnaire based study to investigate prehospital handover practices between ambulance clinicians and specialist prehospital teams in Scotland

Poor communication during patient handover is recognised internationally as a root cause of a significant proportion of preventable deaths. Improving the accuracy and quality of handover may reduce associated ...

Authors: David Fitzpatrick, Michael McKenna, Edward A. S. Duncan, Colville Laird, Richard Lyon and Alasdair Corfield

Quality of life and level of post-traumatic stress disorder among trauma patients: A comparative study between a regional and a university hospital

The aim of this study was to assess outcome in long-term quality of life (QoL) and post-traumatic stress disorder (PTSD) among adult survivors of trauma. Secondary aim was to compare levels of the outcome with...

Authors: F. B. Danielsson, M. Schultz Larsen, B. Nørgaard and J. M. Lauritsen

Electrical injury – a dual center analysis of patient characteristics, therapeutic specifics and outcome predictors

Electrical injuries represent life-threatening emergencies. Evidence on differences between high (HVI) and low voltage injuries (LVI) regarding characteristics at presentation, rhabdomyolysis markers, surgical...

Authors: Jochen Gille, Thomas Schmidt, Adrian Dragu, Dimitri Emich, Peter Hilbert-Carius, Thomas Kremer, Thomas Raff, Beate Reichelt, Apostolos Siafliakis, Frank Siemers, Michael Steen and Manuel F. Struck

Comparing population and incident data for optimal air ambulance base locations in Norway

Helicopter emergency medical services are important in many health care systems. Norway has a nationwide physician manned air ambulance service servicing a country with large geographical variations in populat...

Authors: Jo Røislien, Pieter L. van den Berg, Thomas Lindner, Erik Zakariassen, Oddvar Uleberg, Karen Aardal and J. Theresia van Essen

Development and implementation of a geographical area categorisation method with targeted performance indicators for nationwide EMS in Finland

In Finland, hospital districts (HD) are required by law to determine the level and availability of Emergency Medical Services (EMS) for each 1-km² sized area (cell) within their administrative area. The cells are...

Authors: Jukka Pappinen, Päivi Laukkanen-Nevala, Pekka Mäntyselkä and Jouni Kurola

Nerve trauma of the lower extremity: evaluation of 60,422 leg injured patients from the TraumaRegister DGU® between 2002 and 2015

Nerve lesions are well known reasons for reduced functional capacity and diminished quality of life. By now only a few epidemiological studies focus on lower extremity trauma related nerve injuries. This study...

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

Ventilation of intubated patients during HEMS hoisting operations

In response to the review “Advanced airway management in hoist and longline operations in mountain HEMS - considerations in austere environments: a narrative review.” by Pietsch et al. we refer to recently pub...

Authors: John Hollott

Emergency management of patients with ST-segment elevation myocardial infarction in Eastern Austria: a descriptive quality control study

Myocardial infarction is a time-critical condition and its outcome is determined by appropriate emergency care. Thus we assessed the efficacy of a supra-regional ST-segment elevation myocardial infarction (STE...

Authors: Helmut Trimmel, Thomas Bayer, Wolfgang Schreiber, Wolfgang G. Voelckel and Lukas Fiedler

Apples to apples: can differences in out-of-hospital cardiac arrest incidence and outcomes between Sweden and Ireland be explained by core Utstein variables?

Variation in reported incidence and outcome based on aggregated data is a persistent feature of out-of-hospital cardiac arrest (OHCA) epidemiology.

Authors: Siobhán Masterson, Anneli Strömsöe, John Cullinan, Conor Deasy and Akke Vellinga

Implementation of a mechanical CPR device in a physician staffed HEMS – a prospective observational study

In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR d...

Authors: Simon Rauch, Giacomo Strapazzon, Monika Brodmann, Ernst Fop, Christian Masoner, Lydia Rauch, Alessandro Forti, Urs Pietsch, Peter Mair and Hermann Brugger

Primary mass casualty incident triage: evidence for the benefit of yearly brief re-training from a simulation study

Triage is a mainstay of early mass casualty incident (MCI) management. Standardized triage protocols aim at providing valid and reproducible results and, thus, improve triage quality. To date, there is little ...

Authors: Michael S. Dittmar, Philipp Wolf, Marc Bigalke, Bernhard M. Graf and Torsten Birkholz

The epidemiology of mild traumatic brain injury: the Trondheim MTBI follow-up study

Mild traumatic brain injury (MTBI) is a frequent medical condition, and some patients report long-lasting problems after MTBI. In order to prevent MTBI, knowledge of the epidemiology is important and potential...

Authors: Toril Skandsen, Cathrine Elisabeth Einarsen, Ingunn Normann, Stine Bjøralt, Rune Hatlestad Karlsen, David McDonagh, Tom Lund Nilsen, Andreas Nylenna Akslen, Asta Kristine Håberg and Anne Vik

Temporal phenotyping of circulating microparticles after trauma: a prospective cohort study

After severe polytrauma the dynamic process of coagulation may deteriorate towards a trauma-induced coagulopathy (TIC) promoting a dramatic increase in morbidity and mortality. Recent evidence suggests that mi...

Authors: Matthias Fröhlich, Nadine Schäfer, Michael Caspers, Julia K. Böhm, Ewa K. Stürmer, Bertil Bouillon and Marc Maegele

Simple modification of trauma mechanism alarm criteria published for the TraumaNetwork DGU^® may significantly improve overtriage – a cross sectional study

No consensus exists in the literature on the use of uniform emergency room trauma team activation criteria (ERTTAC). Today excessive over- or undertriage rates continue to be a challenge for most trauma centre...

Authors: Philipp Braken, Felix Amsler and Thomas Gross

Haemodynamic outcomes during piston-based mechanical CPR with or without active decompression in a porcine model of cardiac arrest

Experimental active compression-decompression (ACD) CPR is associated with increased haemodynamic outcomes compared to standard mechanical chest compressions. Since no clinically available mechanical chest com...

Authors: Mikkel T. Steinberg, Jan-Aage Olsen, Morten Eriksen, Andres Neset, Per Andreas Norseng, Jo Kramer-Johansen, Bjarne Madsen Hardig and Lars Wik

Traumatic cardiac arrest in Sweden 1990-2016 - a population-based national cohort study

Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to descri...

Authors: T. Djarv, C. Axelsson, J. Herlitz, A. Stromsoe, J. Israelsson and A. Claesson

Risk factors associated with short term mortality changes over time, after arrival to the emergency department

Preventing death is the most important outcome pursued in the Emergency Department. Prompt accurate assessment, followed by competent and efficient investigation and treatment is the recipe sought. Abnormal ph...

Authors: Camilla Nørgaard Bech, Mikkel Brabrand, Søren Mikkelsen and Annmarie Lassen

One-year and three-year mortality prediction in adult major blunt trauma survivors: a National Retrospective Cohort Analysis

Survivors of trauma are at increased risk of dying after discharge. Studies have found that age, head injury, injury severity, falls and co-morbidities predict long-term mortality. The objective of our study w...

Authors: Ting Hway Wong, Nivedita Vikas Nadkarni, Hai V. Nguyen, Gek Hsiang Lim, David Bruce Matchar, Dennis Chuen Chai Seow, Nicolas K. K. King and Marcus Eng Hock Ong

Change in the profile of traumatic spinal cord injury over 15 years in Spain

Traumatic spinal cord injury remains a serious public health and social problem. Although incidence rates are decreasing in our environment, it is a high cost condition that is associated with great disability...

Authors: Enrique Bárbara-Bataller, José Luis Méndez-Suárez, Carolina Alemán-Sánchez, Jesús Sánchez-Enríquez and Manuel Sosa-Henríquez

Admission rates in a general practitioner-based versus a hospital specialist based, hospital-at-home model: ACCESS, an open-labelled randomised clinical trial of effectiveness

Hospital at home (HaH) is an alternative to acute admission for elderly patients. It is unclear if should be cared for a primarily by a hospital intern specialist or by the patient’s own general practitioner (...

Authors: Christian Backer Mogensen, Ejnar Skytte Ankersen, Mats J. Lindberg, Stig L. Hansen, Jørgen Solgaard, Pia Therkildsen and Helene Skjøt-Arkil

Prehospital triage of patients diagnosed with perforated peptic ulcer or peptic ulcer bleeding: an observational study of patients calling 1-1-2

Triage systems are used in emergency medical services to systematically prioritize prehospital resources according to individual patient conditions. Previous studies have shown cases of preventable deaths in e...

Authors: Kasper Bonnesen, Kristian D. Friesgaard, Morten T. Boetker and Lone Nikolajsen

Decreased risk adjusted 30-day mortality for hospital admitted injuries: a multi-centre longitudinal study

The interpretation of changes in injury-related mortality over time requires an understanding of changes in the incidence of the various types of injury, and adjustment for their severity. Our aim was to inves...

Authors: Robert Larsen, Denise Bäckström, Mats Fredrikson, Ingrid Steinvall, Rolf Gedeborg and Folke Sjoberg

Advanced airway management in hoist and longline operations in mountain HEMS – considerations in austere environments: a narrative review This review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Providing sufficient oxygenation and ventilation is of paramount importance for the survival of emergency patients. Therefore, advanced airway management is one of the core tasks for every rescue team. Endotra...

Authors: Urs Pietsch, Jürgen Knapp, Oliver Kreuzer, Ludwig Ney, Giacomo Strapazzon, Volker Lischke, Roland Albrecht, Patrick Phillips and Simon Rauch

Trauma facilities in Denmark - a nationwide cross-sectional benchmark study of facilities and trauma care organisation

Trauma is a leading cause of death among adults aged < 44 years, and optimal care is a challenge. Evidence supports the centralization of trauma facilities and the use multidisciplinary trauma teams. Because k...

Authors: Jesper Weile, Klaus Nielsen, Stine C. Primdahl, Christian A. Frederiksen, Christian B. Laursen, Erik Sloth, Ole Mølgaard, Lars Knudsen and Hans Kirkegaard

Pre-hospital extra-corporeal cardiopulmonary resuscitation

Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extra-corporeal cardiopulmonary resuscitation (ECPR) is a novel use of an establis...

Authors: Ben Singer, Joshua C. Reynolds, David J. Lockey and Ben O’Brien

The impact of direct oral anticoagulants in traumatic brain injury patients greater than 60-years-old

Traumatic brain injury (TBI) is the leading cause of death among trauma patients. Patients under antithrombotic therapy (ATT) carry an increased risk for intracranial haematoma (ICH) formation. There is a pauc...

Authors: Oliver Prexl, Martin Bruckbauer, Wolfgang Voelckel, Oliver Grottke, Martin Ponschab, Marc Maegele and Herbert Schöchl

Review of 14 drowning publications based on the Utstein style for drowning

The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to generate an inventory of the use of the US...

Authors: Allart M. Venema, Anthony R. Absalom, Ahamed H. Idris and Joost J. L. M. Bierens

Response to: pre-hospital advanced airway management in children: a challenge that training can handle

Authors: Mona Tarpgaard

First installation of a dual-room IVR-CT system in the emergency room

Computed tomography (CT) embedded in the emergency room has gained importance in the early diagnostic phase of trauma care. In 2011, we implemented a new trauma workflow concept with a sliding CT scanner syste...

Authors: Daiki Wada, Yasushi Nakamori, Shuji Kanayama, Shuhei Maruyama, Masahiro Kawada, Hiromu Iwamura, Koichi Hayakawa, Fukuki Saito and Yasuyuki Kuwagata

Bedside analysis of the sublingual microvascular glycocalyx in the emergency room and intensive care unit – the GlycoNurse study

Deterioration of the endothelial glycocalyx (eGC), a protective carbohydrate-rich layer lining the luminal surface of the endothelium, plays a key role in vascular barrier dysfunction and eventually organ-fail...

Authors: Alexandros Rovas, Alexander-Henrik Lukasz, Hans Vink, Marc Urban, Jan Sackarnd, Hermann Pavenstädt and Philipp Kümpers

Effect of gelatin-polysuccinat on cerebral oxygenation and microcirculation in a porcine haemorrhagic shock model

During early treatment of haemorrhagic shock maintenance of cerebral and end-organ oxygen supply by fluid resuscitation is mandatory. Gelatin-polysuccinat (GP) recently regained attention despite a still uncle...

Authors: Alexander Ziebart, Christian Möllmann, Andreas Garcia-Bardon, Jens Kamuf, Moritz Schäfer, Rainer Thomas and Erik K. Hartmann

Predictors of hospital mortality in adult trauma patients receiving extracorporeal membrane oxygenation for advanced life support: a retrospective cohort study

Using extracorporeal membrane oxygenation (ECMO) to provide advanced life support in adult trauma patients remains a controversial issue now. The study was aimed at identifying the independent predictors of ho...

Authors: Meng-Yu Wu, Pin-Li Chou, Tzu-I Wu and Pyng-Jing Lin

Perceptions and experiences of community first responders on their role and relationships: qualitative interview study

Community First Responders (CFRs) are lay volunteers who respond to medical emergencies. We aimed to explore perceptions and experiences of CFRs in one scheme about their role.

Authors: Viet-Hai Phung, Ian Trueman, Fiona Togher, Roderick Ørner and Aloysius Niroshan Siriwardena

Hypoglycaemia without diabetes encountered by emergency medical services: a retrospective cohort study

The current study investigates the incidence, aetiology, and outcome of hypoglycaemia of patients without diabetes in the EMS.

Authors: Hanna Vihonen, Markku Kuisma and Jouni Nurmi

suPAR is associated with risk of future acute surgery and post-operative mortality in acutely admitted medical patients

Acutely admitted medical patients are often fragile and in risk of future surgery. The biomarker soluble urokinase plasminogen activator receptor (suPAR) is a predictor of readmission and mortality in the acut...

Authors: Jeppe Meyer, Morten Alstrup, Line J. H. Rasmussen, Martin Schultz, Steen Ladelund, Thomas H. Haupt, Jens Tingleff, Kasper Iversen and Jesper Eugen-Olsen

Sensemaking in the formation of basic life support teams - a proof-of-concept, qualitative study of simulated in-hospital cardiac arrests

The formation of critical care teams is a complex process where team members need to get a shared understanding of a serious situation. No previous studies have focused on how this shared understanding is achi...

Authors: Peter Hallas, Johnny Lauridsen and Mikkel Brabrand

What should be included in the assessment of laypersons’ paediatric basic life support skills? Results from a Delphi consensus study

Assessment of laypersons’ Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for l...

Authors: Asbjørn Børch Hasselager, Torsten Lauritsen, Tim Kristensen, Cathrine Bohnstedt, Claus Sønderskov, Doris Østergaard and Martin Grønnebæk Tolsgaard

Patient and case characteristics associated with ‘no paramedic treatment’ for low-acuity cases referred for emergency ambulance dispatch following a secondary telephone triage: a retrospective cohort study

Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study ...

Authors: Kathryn Eastwood, Amee Morgans, Johannes Stoelwinder and Karen Smith

Danish first aid books compliance with the new evidence-based non-resuscitative first aid guidelines

The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current ma...

Authors: Theo Walther Jensen, Thea Palsgaard Møller, Søren Viereck, Jens Roland, Thomas Egesborg Pedersen and Freddy K. Lippert

Severe thoracic trauma – still an independent predictor for death in multiple injured patients?

Over the past, the severe thoracic trauma has had decisive influence on the outcome of multiple injured patients. Today, new therapies (e.g. extracorporeal membrane oxygenation (ECMO), protective ventilation m...

Authors: Michael Grubmüller, Maximilian Kerschbaum, Eva Diepold, Katharina Angerpointner, Michael Nerlich and Antonio Ernstberger

Long-term mortality of acetaminophen poisoning: a nationwide population-based cohort study with 10-year follow-up in Taiwan

The long-term mortality of acetaminophen (APAP) poisoning has not yet been well studied; hence, we conducted this study to gain understanding of this issue.

Authors: Hung-Sheng Huang, Chung-Han Ho, Shih-Feng Weng, Chien-Chin Hsu, Jhi-Joung Wang, Shih-Bin Su, Hung-Jung Lin and Chien-Cheng Huang

Comparison of two different coagulation algorithms on the use of allogenic blood products and coagulation factors in severely injured trauma patients: a retrospective, multicentre, observational study

At the University Hospital Zurich (USZ) and the Cantonal Hospital of Lucerne (LUKS) an individualized goal-directed coagulation and transfusion algorithm was introduced and implemented before 2012 (Coagulation...

Authors: Alexander Kaserer, Mattias Casutt, Kai Sprengel, Burkhardt Seifert, Donat R. Spahn and Philipp Stein