Articles

Establishment of an extracorporeal cardio-pulmonary resuscitation program in Berlin – outcomes of 254 patients with refractory circulatory arrest

Optimal management of out of hospital circulatory arrest (OHCA) remains challenging, in particular in patients who do not develop rapid return of spontaneous circulation (ROSC). Extracorporeal cardiopulmonary ...

Authors: Jens Nee, Roland Koerner, Daniel Zickler, Tim Schroeder, Philipp Enghard, Lutz Nibbe, Dietrich Hasper, Robert Buder, Christoph Leithner, Christoph J. Ploner, Kai-Uwe Eckardt, Christian Storm and Jan M. Kruse

Prediction of mortality in critically-ill elderly trauma patients: a single centre retrospective observational study and comparison of the performance of trauma scores

Trauma in the elderly (≥ 65 years) population is increasing. This study compares the performance of trauma scoring systems in predicting 30-day mortality among the traumatised elderly patients admitted to the ...

Authors: Rebecca Egglestone, David Sparkes and Ahilanandan Dushianthan

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services—particularl...

Authors: Peter Hilbert-Carius, Jörg Braun, Fikri Abu-Zidan, Jörn Adler, Jürgen Knapp, Didier Dandrifosse, Désirée Braun, Urs Pietsch, Patrick Adamczuk, Leif Rognås and Roland Albrecht

Real-time AI prediction for major adverse cardiac events in emergency department patients with chest pain

A big-data-driven and artificial intelligence (AI) with machine learning (ML) approach has never been integrated with the hospital information system (HIS) for predicting major adverse cardiac events (MACE) in...

Authors: Pei-I Zhang, Chien-Chin Hsu, Yuan Kao, Chia-Jung Chen, Ya-Wei Kuo, Shu-Lien Hsu, Tzu-Lan Liu, Hung-Jung Lin, Jhi-Joung Wang, Chung-Feng Liu and Chien-Cheng Huang

Massive hemothorax due to bleeding from thoracic spinal fractures: a case series and systematic review

Massive hemothorax secondary to thoracic spinal fractures is rare, and its clinical characteristics, treatment, and prognosis are unknown. We present two cases of thoracic spinal fracture-induced massive hemot...

Authors: Kohei Ninomiya, Akira Kuriyama and Hayaki Uchino

Consistency and variability in human performance during simulate infant CPR: a reliability study

Positive outcomes from infant cardiac arrest depend on the effective delivery of resuscitation techniques, including good quality infant cardiopulmonary resuscitation (iCPR) However, it has been established th...

Authors: Debora Almeida, Carol Clark, Michael Jones, Phillip McConnell and Jonathan Williams

Evolution and current state of global research on paediatric resuscitation: a systematic scientometric analysis

Paediatric resuscitation is rare but potentially associated with maximal lifetime reduction. Notably, several nations experience high infant mortality rates even today. To improve clinical outcomes and promote...

Authors: Sean S. Scholz, Rainer Borgstedt, Leoni C. Menzel, Sebastian Rehberg and Gerrit Jansen

Intubation during a medevac flight: safety and effect on total prehospital time in the helicopter emergency medical service system

The Helicopter Emergency Medical Service (HEMS) commonly intubates patients who require advanced airway support prior to takeoff. In-flight intubation (IFI) is avoided because it is considered difficult due to...

Authors: Hiroki Maeyama, Hiromichi Naito, Francis X. Guyette, Takashi Yorifuji, Yuki Banshotani, Daisaku Matsui, Tetsuya Yumoto, Atsunori Nakao and Makoto Kobayashi

High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study

To evaluate the associations between glycated hemoglobin (HbA1c) at admission and 6-month mortality and outcomes after out-of-hospital cardiac arrest (OHCA) treated by hypothermic targeted temperature manageme...

Authors: Junhaeng Lee, Joo Suk Oh, Jong Ho Zhu, Sungyoup Hong, Sang Hyun Park, Ji Hoon Kim, Hyungsoo Kim, Mingu Seo, Kiwook Kim, Doo Hyo Lee, Hyun Ho Jung, Jungtaek Park, Young Min Oh, Semin Choi and Kyoung Ho Choi

Cutaneous impact location: a new tool to predict intracranial lesion among the elderly with mild traumatic brain injury?

Mild traumatic brain injury is the leading cause of arrivals to emergency department due to trauma in the 65-year-old population and over. Recent studies conducted in ED suggested a low intracranial lesion pre...

Authors: Xavier Dubucs, Frederic Balen, Eric Schmidt, Mathieu Houles, Sandrine Charpentier, Charles-Henri Houze-Cerfon and Dominique Lauque

Residents working with Médecins Sans Frontières: training and pilot evaluation

Well-prepared humanitarian workers are now more necessary than ever. Essential to the preparation process are: clearly defined learning objectives, curricula tailored to the nuances of humanitarian settings, s...

Authors: Alba Ripoll-Gallardo, Luca Ragazzoni, Ettore Mazzanti, Grazia Meneghetti, Jeffrey Michael Franc, Alessandro Costa and Francesco della Corte

Pediatric hypothermic submersion incident – should we do chest compressions on a beating heart?

Drowning is the third leading cause of unintentional injury death worldwide, with the highest rates of fatality among young children. To decide how to treat these patients prehospitally could be challenging in...

Authors: Steinar Einvik, Andreas Jorstad Kruger and Sven Erik Gisvold

Prehospital management of burns requiring specialized burn centre evaluation: a single physician-based emergency medical service experience

Emergency medical services regularly encounter severe burns. As standards of care are relatively well-established regarding their hospital management, prehospital care is comparatively poorly defined. The aim ...

Authors: Ludovic Maudet, Mathieu Pasquier, Olivier Pantet, Roland Albrecht and Pierre-Nicolas Carron

Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2)

The measurement of lactate in emergency medical services has the potential for earlier detection of shock and can be performed with a point-of-care handheld device. Validation of a point-of-care handheld devic...

Authors: Anette Raa, Geir Arne Sunde, Bjørn Bolann, Reidar Kvåle, Christopher Bjerkvig, Håkon S. Eliassen, Tore Wentzel-Larsen and Jon-Kenneth Heltne

Elevated admission lactate levels in the emergency department are associated with increased 30-day mortality in non-trauma critically ill patients

Elevated blood lactate levels were reported as useful predictors of clinical outcome and mortality in critically ill patients. To identify higher-risk patients, this investigation evaluated the relationship be...

Authors: Michael Bernhard, Stephanie Döll, Andre Kramer, Lorenz Weidhase, Thomas Hartwig, Sirak Petros and André Gries

Pre-hospital triage performance and emergency medical services nurse’s field assessment in an unselected patient population attended to by the emergency medical services: a prospective observational study

In Sweden, the rapid emergency triage and treatment system (RETTS-A) is used in the pre-hospital setting. With RETTS-A, patients triaged to the lowest level could safely be referred to a lower level of care. T...

Authors: Carl Magnusson, Johan Herlitz and Christer Axelsson

Impact of two-level filtering on emergency medical communication center triage during the COVID-19 pandemic: an uncontrolled before-after study

Rapid access to emergency medical communication centers (EMCCs) is pivotal to address potentially life-threatening conditions. Maintaining public access to EMCCs without delay is crucial in case of disease out...

Authors: Y. Penverne, B. Leclere, J. Labady, F. Berthier, J. Jenvrin, F. Javaudin and E. Montassier

Pre-hospital blood transfusion – an ESA survey of European practice

Blood products are a lifesaving commodity in the treatment of major trauma.

Authors: Karl-Christian Thies, Anatolij Truhlář, Damian Keene, Jochen Hinkelbein, Kurt Rützler, Luca Brazzi and Benoît Vivien

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

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