Articles

Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Severe accidental hypothermia is associated with high morbidity and mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides an efficient rewarming method with complete cardiopulmonary s...

Authors: Aurélien Ledoux and Piehr Saint Leger

Longitudinal analysis of health status the first year after trauma in severely injured patients

While survival rates after a trauma are increasing a considerable part of the trauma population are still at risk for both short and long term disabilities. Little is known about prognostic factors over time a...

Authors: Roos Johanna Maria Havermans, Mariska Adriana Cornelia de Jongh, Leonie de Munter and Koen Willem Wouter Lansink

What clinical crew competencies and qualifications are required for helicopter emergency medical services? A review of the literature

Patients served by Helicopter Emergency Medical Services (HEMS) tend to be acutely injured or unwell and in need of stabilisation followed by rapid and safe transport. It is therefore hypothesised that a parti...

Authors: Siobhán Masterson, Conor Deasy, Mark Doyle, David Hennelly, Shane Knox and Jan Sorensen

A novel ECG-biomarker for cardiac arrest during hypothermia

Treatment of arrhythmias evoked by accidental or therapeutic hypothermia and rewarming remains challenging. We aim to find an ECG-biomarker that can predict ventricular arrhythmias at temperatures occurring in...

Authors: Erik Sveberg Dietrichs, Torkjel Tveita, Rachel Myles and Godfrey Smith

Including oxygen supplement in the early warning score: a prediction study comparing TOKS, modified TOKS and NEWS in a cohort of emergency patients

Early warning scores (EWS) are widely used in emergency departments and on general wards to detect critical illness and deterioration. TOKS (“Tidlig Opsporing af Kritisk Sygdom”) is an early warning score used...

Authors: Maj Juhl Skov, Jacob Dynesen, Marie K. Jessen, Janet Yde Liesanth, Julie Mackenhauer and Hans Kirkegaard

Template for documenting and reporting data in physician-staffed pre-hospital services: a consensus-based update

Physician-staffed emergency medical services (p-EMS) are resource demanding, and research is needed to evaluate any potential effects of p-EMS. Templates, designed through expert agreement, are valuable and fe...

Authors: Kristin Tønsager, Andreas Jørstad Krüger, Kjetil Gorseth Ringdal and Marius Rehn

Patient experience of severe acute dyspnoea and relief during treatment in ambulances: a prospective observational study

Acute dyspnoea is common among ambulance patients, but little is known of the patients’ experience of symptom. We aimed to investigate ambulance patients initial perceived intensity of acute dyspnoea, and whet...

Authors: Tim Alex Lindskou, Ulla Møller Weinreich, Kenneth Lübcke, Torben Anders Kløjgaard, Birgitte Schantz Laursen, Søren Mikkelsen and Erika Frischknecht Christensen

Correction to: Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: retrospective analysis of prospectively collected prehospital data

Following the publication of the original article [1], the authors unfortunately became aware of some typesetting and resolution problems in Figs. 1 and 2.

Authors: Dong Keon Lee, Yu Jin Kim, Giwoon Kim, Choung Ah. Lee, Hyung Jun Moon, Jaehoon Oh, Hae Chul Yang, Han Joo Choi, Young Taeck Oh and Seung Min Park

Septic shock: ECMO beyond ARDS? Introducing the Simon two-stage protocol when randomisation is considered unethical

Authors: Alexander Buia, Hans-Bernd Hopf, Eva Herrmann, Thomas Schmandra and Ernst Hanisch

Impact of blunt chest trauma on outcome after traumatic brain injury– a matched-pair analysis of the TraumaRegister DGU®

Traumatic brain injury (TBI) is associated with high rates of long-term disability and mortality. Our aim was to investigate the effects of thoracic trauma on the in-hospital course and outcome of patients wit...

Authors: Mark Schieren, Frank Wappler, Arasch Wafaisade, Rolf Lefering, Samir G. Sakka, Jost Kaufmann, Hi-Jae Heiroth, Jerome Defosse and Andreas B. Böhmer

Trauma research in the Nordic countries, 1995–2018 – a systematic review

Trauma is a major cause of mortality and reduced quality of life. Most trauma-related research originates from trauma centres, and there are limited available data regarding the treatment of trauma patients th...

Authors: Elisabeth Jeppesen, Valdemar Vea Iversen, Ingrid Schrøder Hansen, Eirik Reierth and Torben Wisborg

Influence of physical strain at high altitude on the quality of cardiopulmonary resuscitation

High quality cardiopulmonary resuscitation is a key factor in survival with good overall quality of life after out-of-hospital cardiac arrest. Current evidence is predominantly based on studies conducted at lo...

Authors: Alexander Egger, Maximilian Niederer, Katharina Tscherny, Josef Burger, Verena Fuhrmann, Calvin Kienbacher, Dominik Roth, Wolfgang Schreiber and Harald Herkner

The volume-outcome relationship among severely injured patients admitted to English major trauma centres: a registry study

Many countries have centralized and dedicated trauma centres with high volumes of trauma patients. However, the volume-outcome relationship in severely injured patients (Injury Severity Score (ISS) > 15) remai...

Authors: Charlie A. Sewalt, Eveline J. A. Wiegers, Fiona E. Lecky, Dennis den Hartog, Stephanie C. E. Schuit, Esmee Venema and Hester F. Lingsma

London Trauma Conference 2019

Authors:

Artificial intelligence algorithm to predict the need for critical care in prehospital emergency medical services

In emergency medical services (EMSs), accurately predicting the severity of a patient’s medical condition is important for the early identification of those who are vulnerable and at high-risk. In this study, ...

Authors: Da-Young Kang, Kyung-Jae Cho, Oyeon Kwon, Joon-myoung Kwon, Ki-Hyun Jeon, Hyunho Park, Yeha Lee, Jinsik Park and Byung-Hee Oh

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

If transport under ongoing cardiopulmonary resuscitation (CPR) from an upper floor is indicated, the ideal CPR-method and evacuation route is unknown hitherto. We aimed to elaborate a strategy for evacuation o...

Authors: Hendrik Drinhaus, Sebastian Nüsgen, Niels Adams, Wolfgang A. Wetsch and Thorsten Annecke

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

To determine the prevalence and characteristics of prechiasmatic visual system injuries (VSI) among seriously injured patients with concomitant head trauma in Europe by means of a multinational...

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

Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review

Autoresuscitation describes the return of spontaneous circulation after termination of resuscitation (TOR) following cardiac arrest (CA). We aimed to identify phenomena that may lead to autoresuscitation and t...

Authors: Les Gordon, Mathieu Pasquier, Hermann Brugger and Peter Paal

Swedish emergency hospital surgical surge capacity to mass casualty incidents

In Sweden the surgical surge capacity for mass casualty incidents (MCI) is managed by county councils within their dedicated budget. It is unclear whether healthcare budget constraints have affected the region...

Authors: Magnus Blimark, Per Örtenwall, Hans Lönroth, Peter Mattsson, Kenneth D. Boffard and Yohan Robinson

Intubation in acute alcohol intoxications at the emergency department

Guidelines recommend endotracheal intubation in trauma patients with a Glasgow coma scale (GCS) < 9 because of the loss of airway reflexes and consequential risk of airway obstruction. However, in patients wit...

Authors: Thomas C. Sauter, Katharina Rönz, Trevor Hirschi, Beat Lehmann, Christopher Hütt, Aristomenis K. Exadaktylos and Martin Müller

Comparison of adverse events between video and direct laryngoscopes for tracheal intubations in emergency department and ICU patients–a systematic review and meta-analysis

This systematic review and meta-analysis was designed to determine whether video laryngoscope (VL) compared with direct laryngoscope (DL) could reduce the occurrence of adverse events associated with tracheal ...

Authors: Jia Jiang, Na Kang, Bo Li, An-Shi Wu and Fu-Shan Xue

Outcomes following resuscitative thoracotomy for abdominal exsanguination, a systematic review

Resuscitative thoracotomy is a damage control procedure with an established role in the immediate treatment of patients in extremis or cardiac arrest secondary to cardiac tamponade however Its role in resuscit...

Authors: Michael Hughes and Zane Perkins

Emergency department non-invasive cardiac output study (EDNICO): an accuracy study

There is little published data investigating non-invasive cardiac output monitoring in the emergency department (ED). We assess here the accuracy of five non-invasive methods in detecting fluid responsiveness ...

Authors: David McGregor, Shrey Sharma, Saksham Gupta, Shanaz Ahmed and Tim Harris

Towards definitions of time-sensitive conditions in prehospital care

Prehospital care has changed in recent decades. Advanced assessments and decisions are made early in the care chain. Patient assessments form the basis of a decision relating to prehospital treatment and the l...

Authors: Kristoffer Wibring, Carl Magnusson, Christer Axelsson, Peter Lundgren, Johan Herlitz and Magnus Andersson Hagiwara

Nonspecific complaints in the emergency department – a systematic review

Nonspecific complaint (NSC) is a common presenting complaint in the emergency setting, especially in the elderly population. Individual studies have shown that it is associated with significant morbidity and m...

Authors: Kirsi Kemp, Reija Mertanen, Mitja Lääperi, Leila Niemi-Murola, Lasse Lehtonen and Maaret Castren

A retrospective register study comparing fibrinogen treated trauma patients with an injury severity score matched control group

Fibrinogen concentrate (FC) is frequently used to treat bleeding trauma patients, although the clinical effects are not well known. In this study we describe demographic and clinical outcome data in a cohort o...

Authors: Lou M. Almskog, Ulf Hammar, Agneta Wikman, Anders Östlund, Jonas Svensson, Michael Wanecek and Anna Ågren

Developing a tool for measuring the disaster resilience of healthcare rescuers: a modified Delphi study

Disaster resilience is an essential personal characteristics of health rescue workers to respond to disasters in an effective manner, and maintain a state of adaptation after deployment. It is essential for di...

Authors: Xiaorong MAO, Alice Yuen LOKE and Xiuying HU

Associations of therapeutic hypothermia with clinical outcomes in patients receiving ECPR after cardiac arrest: systematic review with meta-analysis

Therapeutic hypothermia has been recommended for eligible patients after cardiac arrest (CA) in order to improve outcomes. Up to now, several comparative observational studies have evaluated the combined use o...

Authors: Xi Chen, Zhen Zhen, Jia Na, Qin Wang, Lu Gao and Yue Yuan

Clinical guided computer tomography decisions are advocated in potentially severely injured trauma patients: a one-year audit in a level 1 trauma Centre with long pre-hospital times

The International Commission on Radiological Protection’s (ICRP) justification principles state that an examination is justified if the potential benefit outweighs the risk for radiation harm. Computer tomogra...

Authors: Anna Bågenholm, Trond Dehli, Stig Eggen Hermansen, Kristian Bartnes, Marthe Larsen and Tor Ingebrigtsen

Spontaneous trigger words associated with confirmed out-of-hospital cardiac arrest: a descriptive pilot study of emergency calls

According to the International Liaison Committee on Resuscitation (ILCOR), the trigger words used by callers that are associated with cardiac arrest constitute a scientific knowledge gap. This study was design...

Authors: Joonas Tamminen, Erik Lydén, Jan Kurki, Heini Huhtala, Antti Kämäräinen and Sanna Hoppu

Impact of a goal-directed factor-based coagulation management on thromboembolic events following major trauma

A factor-based coagulation management following major trauma is recommended as standard of care by the European Trauma Treatment Guidelines. However, concerns about the thromboembolic risk of this approach are...

Authors: Anais L. Stein, Julian Rössler, Julia Braun, Kai Sprengel, Patrick E. Beeler, Donat R. Spahn, Alexander Kaserer and Philipp Stein

Open-chest cardiopulmonary resuscitation versus closed-chest cardiopulmonary resuscitation in patients with cardiac arrest: a systematic review and meta-analysis

Cardiopulmonary resuscitation is the most urgent and critical step in the rescue of patients with cardiac arrest. However, only about 10% of patients with out-of-hospital cardiac arrest survive to discharge. S...

Authors: Mao Wang, Xiaoguang Lu, Ping Gong, Yilong Zhong, Dianbo Gong and Yi Song

Impact of gender on post- traumatic intensive care and outcomes

Several reports indicate gender disparities in health care provision. There is a well-documented male patient dominance in intensive care unit (ICU) admittance. It is not established if this difference reflect...

Authors: Emma Larsson, Ann-Charlotte Lindström, Mikael Eriksson and Anders Oldner

Development, validation and assessment of the test on knowledge about basic life support and use of automated external defibrillator among schoolchildren

Educating lay public can significantly strengthen the Chain of Survival after out of hospital cardiac arrest. Schoolchildren are an accessible population for learning basic life support (BLS) and use of an aut...

Authors: Vesna Borovnik Lesjak, Andrej Šorgo and Matej Strnad

Intra-patient potassium variability after hypothermic cardiac arrest: a multicentre, prospective study

To date, the decision to set up therapeutic extra-corporeal life support (ECLS) in hypothermia-related cardiac arrest is based on the potassium value only. However, no information is available about how the an...

Authors: M. Pasquier, M. Blancher, S. Buse, B. Boussat, G. Debaty, M. Kirsch, M. de Riedmatten, P. Schoettker, T. Annecke and P. Bouzat

First-response treatment after out-of-hospital cardiac arrest: a survey of current practices across 29 countries in Europe

In Europe, survival rates after out-of-hospital cardiac arrest (OHCA) vary widely. Presence/absence and differences in implementation of systems dispatching First Responders (FR) in order to arrive before Emer...

Authors: Iris Oving, Siobhan Masterson, Ingvild B.M. Tjelmeland, Martin Jonsson, Federico Semeraro, Mattias Ringh, Anatolij Truhlar, Diana Cimpoesu, Fredrik Folke, Stefanie G. Beesems, Rudolph W. Koster, Hanno L. Tan and Marieke T. Blom

National early warning score (NEWS) and the new alternative SpO₂ scale during rapid response team reviews: a prospective observational study

The national early warning score (NEWS) enables early detection of in-hospital patient deterioration and timely activation of hospital’s rapid response team (RRT). NEWS was updated in 2017 to include a separat...

Authors: Joonas Tirkkonen, Sari Karlsson and Markus B. Skrifvars

The cost-effectiveness of upfront point-of-care testing in the emergency department: a secondary analysis of a randomised, controlled trial

Time-saving is constantly sought after in the Emergency Department (ED), and Point-of-Care (POC) testing has been shown to be an effective time-saving intervention. However, when direct costs are compared, the...

Authors: Lara Nicole Goldstein, Mike Wells and Craig Vincent-Lambert

Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: retrospective analysis of prospectively collected prehospital data

The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone adminis...

Authors: Dong Keon Lee, Yu Jin Kim, Giwoon Kim, Choung Ah. Lee, Hyung Jun Moon, Jaehoon Oh, Hae Chul Yang, Han Joo Choi, Young Taeck Oh and Seung Min Park

Nonoperative management of splenic injury in closely monitored patients with reduced consciousness is safe and feasible

Treatment of blunt splenic injury has changed over the past decades. Nonoperative management (NOM) is the treatment of choice. Adequate patient selection is a prerequisite for successful NOM. Impaired mental s...

Authors: Michel Teuben, Roy Spijkerman, Taco Blokhuis, Roman Pfeifer, Henrik Teuber, Hans-Christoph Pape and Luke Leenen

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

The aim of this Letter to the Editor was to report some important biases in a recently published Article. We agreed with the notion by Yamamoto et al. that the effects of epinephrine regarding was limited with...

Authors: Makoto Aoki and Toshikazu Abe

Outcome, quality of life and direct costs after out-of-hospital cardiac arrest in an urban region of Switzerland

Considering the significant morbidity and mortality of out-of-hospital cardiac arrest, only little data on survival or quality of life after successful resuscitation is available in Europe. Additionally, econo...

Authors: Raphael Ruch, Laura Stoessel, Philipp Stein, Michael Thomas Ganter and Daniel Anthony Button

Impact of rewarming rate on the mortality of patients with accidental hypothermia: analysis of data from the J-Point registry

Accidental hypothermia (AH) is defined as an involuntary decrease in core body temperature to < 35 °C. The management of AH has been progressing over the last few decades, and numerous techniques for rewarming...

Authors: Makoto Watanabe, Tasuku Matsuyama, Sachiko Morita, Naoki Ehara, Nobuyoshi Miyamae, Yohei Okada, Takaaki Jo, Yasuyuki Sumida, Nobunaga Okada, Masahiro Nozawa, Ayumu Tsuruoka, Yoshihiro Fujimoto, Yoshiki Okumura, Tetsuhisa Kitamura and Bon Ohta

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