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Prevalence of airway patency and air pocket in critically buried avalanche victims - a scoping review Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-23 Frederik Eisendle, Simon Rauch, Bernd Wallner, Hermann Brugger, Giacomo Strapazzon
Survival of critically buried avalanche victims is directly dependent on the patency of the airway and the victims’ ability to breathe. While guidelines and avalanche research have consistently emphasized on the importance of airway patency, there is a notable lack of evidence regarding its prevalence. The aim of this review is to provide insight into the prevalence of airway patency and air pocket
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Development and internal validation of an algorithm for estimating mortality in patients encountered by physician-staffed helicopter emergency medical services Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-23 Emil Reitala, Mitja Lääperi, Markus B. Skrifvars, Tom Silfvast, Hanna Vihonen, Pamela Toivonen, Miretta Tommila, Lasse Raatiniemi, Jouni Nurmi
Severity of illness scoring systems are used in intensive care units to enable the calculation of adjusted outcomes for audit and benchmarking purposes. Similar tools are lacking for pre-hospital emergency medicine. Therefore, using a national helicopter emergency medical services database, we developed and internally validated a mortality prediction algorithm. We conducted a multicentre retrospective
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Acute patients discharged without an established diagnosis: risk of mortality and readmission of nonspecific diagnoses compared to disease-specific diagnoses Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-19 Rasmus Gregersen, Marie Villumsen, Katarina Høgh Mottlau, Cathrine Fox Maule, Hanne Nygaard, Jens Henning Rasmussen, Mikkel Bring Christensen, Janne Petersen
Nonspecific discharge diagnoses after acute hospital courses represent patients discharged without an established cause of their complaints. These patients should have a low risk of adverse outcomes as serious conditions should have been ruled out. We aimed to investigate the mortality and readmissions following nonspecific discharge diagnoses compared to disease-specific diagnoses and assessed different
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A national multi centre pre-hospital ECPR stepped wedge study; design and rationale of the ON-SCENE study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-17 Samir Ali, Xavier Moors, Hans van Schuppen, Lars Mommers, Ellen Weelink, Christiaan L. Meuwese, Merijn Kant, Judith van den Brule, Carlos Elzo Kraemer, Alexander P. J. Vlaar, Sakir Akin, Annemiek Oude Lansink-Hartgring, Erik Scholten, Luuk Otterspoor, Jesse de Metz, Thijs Delnoij, Esther M. M. van Lieshout, Robert-Jan Houmes, Dennis den Hartog, Diederik Gommers, Dinis Dos Reis Miranda
The likelihood of return of spontaneous circulation with conventional advanced life support is known to have an exponential decline and therefore neurological outcome after 20 min in patients with a cardiac arrest is poor. Initiation of venoarterial ExtraCorporeal Membrane Oxygenation (ECMO) during resuscitation might improve outcomes if used in time and in a selected patient category. However, previous
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Optimizing remote and rural prehospital resources using air transport of thrombectomy candidates Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-16 Pauli Vuorinen, Piritta Setälä, Sanna Hoppu
In Finland, the yearly number of mechanical thrombectomies for acute stroke is increasing and more patients are transported over 100 km to the comprehensive stroke centre (CSC) for definitive care. This leaves the rural townships without immediate emergency medical services (EMS) for hours. In this study we compare the EMS’ estimated return times to own station after the handover of a thrombectomy
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Mortality rates in Norwegian HEMS—a retrospective analysis from Central Norway Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-16 Stian Lande Wekre, Oddvar Uleberg, Lars Eide Næss, Helge Haugland
Helicopter Emergency Medical Services (HEMS) provide rapid and specialized care to critically ill or injured patients. Norwegian HEMS in Central Norway serves an important role in pre-hospital emergency medical care. To grade the severity of patients, HEMS uses the National Advisory Committee for Aeronautics’ (NACA) severity score. The objective of this study was to describe the short- and long term
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Letter to the editor Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-15 Dag Ferner Netteland, Pål Aksel Næss, Christine Gaarder, Eirik Helseth
Dear Editor, We read the meta-analysis on tranexamic acid (TXA) in traumatic brain injury (TBI) by Song et al. with great interest [1]. Whether TBI patients benefit from TXA has been a matter of controversy since CRASH-3, the largest study to date addressing this question [2]. In CRASH-3, the primary outcome was defined as head-injury-related mortality at 28 days post trauma and was revised during
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Impact of delayed mobile medical team dispatch for respiratory distress calls: a propensity score matched study from a French emergency communication center Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-12 Léo Charrin, Nicolas Romain-Scelle, Christian Di-Filippo, Eric Mercier, Frederic Balen, Karim Tazarourte, Axel Benhamed
Shortness of breath is a common complaint among individuals contacting emergency communication center (EMCCs). In some prehospital system, emergency medical services include an advanced life support (ALS)-capable team. Whether such team should be dispatched during the phone call or delayed until the BLS-capable paramedic team reports from the scene is unclear. We aimed to evaluate the impact of delayed
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A wrong conclusion Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-09 Hadi Mirfazaelian
Dear Editor, I read the study published by Nikula et al. [1] with interest. As provided by the authors, “the objective of this study was to evaluate whether intranasal dexmedetomidine could provide more effective analgesia and sedation during a painful procedure than intranasal ketamine” [1]. As depicted in the statistical analysis section, it is a superiority trial and hence the null (H0) hypothesis
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Non-technical skills needed by medical disaster responders– a scoping review Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-04-02 Anja Westman, Lisa Kurland, Karin Hugelius
There is no universal agreement on what competence in disaster medicine is, nor what competences and personal attributes add value for disaster responders. Some studies suggest that disaster responders need not only technical skills but also non-technical skills. Consensus of which non-technical skills are needed and how training for these can be provided is lacking, and little is known about how to
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Characteristics of traumatic major haemorrhage in a tertiary trauma center Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-25 Pieter van Wyk, Marcus Wannberg, Anna Gustafsson, Jane Yan, Agneta Wikman, Louis Riddez, Carl-Magnus Wahlgren
Major traumatic haemorrhage is potentially preventable with rapid haemorrhage control and improved resuscitation techniques. Although advances in prehospital trauma management, haemorrhage is still associated with high mortality. The aim of this study was to use a recent pragmatic transfusion-based definition of major bleeding to characterize patients at risk of major bleeding and associated outcomes
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Prognostic value of arterial carbon dioxide tension during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients receiving extracorporeal resuscitation Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-21 Pei-I Su, Min-Shan Tsai, Wei-Ting Chen, Chih-Hung Wang, Wei-Tien Chang, Matthew Huei-Ming Ma, Wen-Jone Chen, Chien-Hua Huang, Yih-Sharng Chen
Current guidelines on extracorporeal cardiopulmonary resuscitation (ECPR) recommend careful patient selection, but precise criteria are lacking. Arterial carbon dioxide tension (PaCO2) has prognostic value in out-of-hospital cardiac arrest (OHCA) patients but has been less studied in patients receiving ECPR. We studied the relationship between PaCO2 during cardiopulmonary resuscitation (CPR) and neurological
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Firefighters and police search dog handlers’ experiences working closely with paramedics in urban search and rescue incidents: a qualitative focus group study from Oslo Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-19 Erik Westnes, Magnus Hjortdahl
Rescue operations are in Norway defined as situations where patients are difficult to access or that more resources are needed than the health services alone possess and can put in operation (Bull A, Redningshåndboken er endelig her! [Internet]. Hovedredningssentralen. 2018 [cited 2023 May 15]. Available from: https://www.hovedredningssentralen.no/redningshandboken-er-endelig-her/ ). Rescue operations
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Evaluation of the offset static rope evacuation procedure: insights from a safe job analysis Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-18 Eirik Bjorheim Abrahamsen, Håvard Mattingsdal, Håkon Bjorheim Abrahamsen
Recently, the Norwegian Helicopter Emergency Medical Service (HEMS) has developed a procedure for a special type of static rope rescue operation, referred to as the offset technique. In this technique, the helicopter is offset from the accident site, and the HEMS technical crew member uses an offset throw line to gain access to the scene. Today, there is little practical experience of such operations
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Prehospital invasive arterial blood pressure monitoring in critically ill patients attended by a UK helicopter emergency medical service– a retrospective observational review of practice Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-12 Emma D. Butterfield, James Price, Marco Bonsano, Kate Lachowycz, Zachary Starr, Christopher Edmunds, Jon Barratt, Rob Major, Paul Rees, Ed B. G. Barnard
Accurate haemodynamic monitoring in the prehospital setting is essential. Non-invasive blood pressure measurement is susceptible to vibration and motion artefact, especially at extremes of hypotension and hypertension: invasive arterial blood pressure (IABP) monitoring is a potential solution. This study describes the largest series to date of cases of IABP monitoring being initiated prehospital. This
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The diagnostic accuracy of cardiac ultrasound for acute myocardial ischemia in the emergency department: a systematic review and meta-analysis Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-11 Virginia Zarama, María Camila Arango-Granados, Ramiro Manzano-Nunez, James P. Sheppard, Nia Roberts, Annette Plüddemann
Chest pain is responsible for millions of visits to the emergency department (ED) annually. Cardiac ultrasound can detect ischemic changes, but varying accuracy estimates have been reported in previous studies. We synthetized the available evidence to yield more precise estimates of the accuracy of cardiac ultrasound for acute myocardial ischemia in patients with chest pain in the ED and to assess
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Therapeutic efficacy of tranexamic acid on traumatic brain injury: a systematic review and meta-analysis Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-07 Jia-Xing Song, Jian-Xiang Wu, Hai Zhong, Wei Chen, Jian-Chun Zheng
Tranexamic acid (TXA) demonstrates therapeutic efficacy in the management of traumatic brain injury (TBI). The objective of this systematic review and meta-analysis was to evaluate the safety and effectiveness of TXA in patients with TBI. The databases, namely PubMed, Embase, Web of Science, and Cochrane Library databases, were systematically searched to retrieve randomized controlled trials (RCTs)
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Characteristics and critical care interventions in drowning patients treated by the Danish Air Ambulance from 2016 to 2021: a nationwide registry-based study with 30-day follow-up Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-06 Niklas Breindahl, Signe A. Wolthers, Thea P. Møller, Stig N. F. Blomberg, Jacob Steinmetz, Helle C. Christensen
Improving oxygenation and ventilation in drowning patients early in the field is critical and may be lifesaving. The critical care interventions performed by physicians in drowning management are poorly described. The aim was to describe patient characteristics and critical care interventions with 30-day mortality as the primary outcome in drowning patients treated by the Danish Air Ambulance. This
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A randomized double-blind trial of intranasal dexmedetomidine versus intranasal esketamine for procedural sedation and analgesia in young children Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-03-04 Anna Nikula, Stefan Lundeberg, Malin Ryd Rinder, Mitja Lääperi, Katri Sandholm, Maaret Castrén, Lisa Kurland
Procedural sedation and analgesia are commonly used in the Emergency Departments. Despite this common need, there is still a lack of options for adequate and safe analgesia and sedation in children. The objective of this study was to evaluate whether intranasal dexmedetomidine could provide more effective analgesia and sedation during a procedure than intranasal esketamine. This was a double-blind
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Impact of emergency physician performed ultrasound in the evaluation of adult patients with acute abdominal pain: a prospective randomized bicentric trial Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-02-26 François Brau, Mathilde Papin, Eric Batard, Emeric Abet, Eric Frampas, Aurélie Le Thuaut, Emmanuel Montassier, Quentin Le Bastard, Philippe Le Conte
Abdominal pain is common in patients visiting the emergency department (ED). The aim of this study was to assess the diagnostic contribution of point-of-care ultrasound (POCUS) in patients presenting to the ED with acute abdominal pain. We designed an interventional randomized, controlled, open label, parallel-group, trial in two French EDs. We included adult patients presenting to the ED with acute
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Correction: Trauma patient transport to hospital using helicopter emergency medical services or road ambulance in Sweden: a comparison of survival and prehospital time intervals Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-02-19 Oscar Lapidus, Rebecka Rubenson Wahlin, Denise Bäckström
Correction: Scand J Trauma Resusc Emerg Med (2023) 31:101 https://doi.org/10.1186/s13049-023-01168-9 After publication of this article [1], the authors reported that in Fig. 3 the text along the y-axis is incorrect; the figure should have appeared as shown below. Fig. 3 Injury severity distribution for patients transported by HEMS vs EMSFull size image The original article [1] has been corrected. Lapidus
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Correction: The implication of a translational triage tool in mass casualty incidents: part three: a multinational study, using validated patient cards Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-02-19 Amir Khorram-Manesh, Eric Carlström, Frederick M. Burkle, Krzysztof Goniewicz, Lesley Gray, Amila Ratnayake, Roberto Faccincani, Dinesh Bagaria, Phatthranit Phattharapornjaroen, Mohammed A. S. Sultan, Carl Montán, Johan Nordling, Shailly Gupta, Carl Magnusson
Correction to: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2023) 31:88 https://doi.org/10.1186/s13049-023-01128-3 Author Amir Khorram‑Manesh’s affiliation with the “Center for Disaster Medicine, Gothenburg University, Sweden” was inadvertently omitted from the original publication. This is re-inserted to the article as affiliation #4 and subsequent co-authors’ affiliations
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Cardiorespiratory consequences of attenuated fentanyl and augmented rocuronium dosing during protocolised prehospital emergency anaesthesia at a regional air ambulance service: a retrospective study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-02-12 Sarah Morton, Zoey Spurgeon, Charlotte Ashworth, James Samouelle, Peter B Sherren
Pre-Hospital Emergency Anaesthesia (PHEA) has undergone significant developments since its inception. However, optimal drug dosing remains a challenge for both medical and trauma patients. Many prehospital teams have adopted a drug regimen of 3 mcg/kg fentanyl, 2 mg/kg ketamine and 1 mg/kg rocuronium (‘3:2:1’). At Essex and Herts Air Ambulance Trust (EHAAT) a new standard dosing regimen was introduced
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Prolonged critical avalanche burial for nearly 23 h with severe hypothermia and severe frostbite with good recovery: a case report Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-02-12 Elisabeth Gruber, Rosmarie Oberhammer, Hermann Brugger, Elisa Bresadola, Matteo Avogadri, Julia Kompatscher, Marc Kaufmann
Accidental hypothermia with severe frostbite is a rare combination of injuries with a high risk for long-term sequelae. There are widely accepted recommendations for the management of avalanche victims and for frostbite treatment, but no recommendation exists for the treatment of frostbite in severe hypothermic patients, specifically for the management of hypothermic avalanche victims presenting with
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Clinical features and outcomes of orthopaedic injuries after the kahramanmaraş earthquake: a retrospective study from a hospital located in the affected region Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-30 Murat Gök, Mehmet Ali Melik
The purpose of this retrospective, single-institutional study was to report the clinical features and outcomes of orthopaedic injuries after the Kahramanmaraş earthquake. An institutional database review was conducted to evaluate the results of patients who applied to our hospital’s emergency department after the Kahramanmaraş earthquake. Trauma patients referred to orthopaedics and traumatology were
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Unmanned aerial vehicles and pre-hospital emergency medicine Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-29 Katy Surman, David Lockey
Unmanned aerial vehicles (UAVs) are used in many industrial and commercial roles and have an increasing number of medical applications. This article reviews the characteristics of UAVs and their current applications in pre-hospital emergency medicine. The key roles are transport of equipment and medications and potentially passengers to or from a scene and the use of cameras to observe or communicate
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Favourable neurological outcome following paediatric out-of-hospital cardiac arrest: authors’ reply Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-26 Alexander Fuchs, Roland Albrecht, Robert Greif, Martin Mueller, Urs Pietsch
We thank Benjamin Stretch [1] for commenting on our article[2] in which we investigated factors associated with favourable neurological outcome in paediatric patients sustaining out-of-hospital cardiac arrest (CA). Considering all helicopter emergency service system (HEMS) missions in Switzerland, paediatric out-of-hospital CA is a very rare condition [3]. We agree that traumatic CA substantially differs
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The SEE-IT Trial: emergency medical services Streaming Enabled Evaluation In Trauma: a feasibility randomised controlled trial Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-26 Cath Taylor, Lucie Ollis, Richard M. Lyon, Julia Williams, Simon S. Skene, Kate Bennett, Matthew Glover, Scott Munro, Craig Mortimer
Use of bystander video livestreaming from scene to Emergency Medical Services (EMS) is becoming increasingly common to aid decision making about the resources required. Possible benefits include earlier, more appropriate dispatch and clinical and financial gains, but evidence is sparse. A feasibility randomised controlled trial with an embedded process evaluation and exploratory economic evaluation
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Ambulance nurses’ experiences as the sole caregiver with critical patients during long ambulance transports: an interview study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-23 Jenny Wästerhed, Erika Ekenberg, Magnus Andersson Hagiwara
Working in rural areas involves tackling long distances and occasional lack of supportive resources. Ambulance nurses are faced with the responsibility of making immediate autonomous decisions and providing extended care to critically ill patients during prolonged ambulance transport to reach emergency medical facilities. This study aims to expose the experiences of ambulance nurses acting as primary
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Machine learning for risk stratification in the emergency department (MARS-ED) study protocol for a randomized controlled pilot trial on the implementation of a prediction model based on machine learning technology predicting 31-day mortality in the emergency department Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-23 Paul M.E.L. van Dam, William P.T.M. van Doorn, Floor van Gils, Lotte Sevenich, Lars Lambriks, Steven J.R. Meex, Jochen W.L. Cals, Patricia M. Stassen
Many prediction models have been developed to help identify emergency department (ED) patients at high risk of poor outcome. However, these models often underperform in clinical practice and their actual clinical impact has hardly ever been evaluated. We aim to perform a clinical trial to investigate the clinical impact of a prediction model based on machine learning (ML) technology. The study is a
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Severe trauma associated cardiac failure Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-22 Maximilian Dietrich, Frank Weilbacher, Stephan Katzenschlager, Markus A. Weigand, Erik Popp
Although significant efforts have been made to enhance trauma care, the mortality rate for traumatic cardiac arrest (TCA) remains exceedingly high. Therefore, our institution has implemented special measures to optimize the treatment of major trauma patients. These measures include a prehospital Medical Intervention Car (MIC) and a ‘code red’ protocol in the trauma resuscitation room for patients with
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Paediatric cardiac arrest prognostication in the context of a HEMS service Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-22 Benjamin Stretch
Many thanks to Fuchs et al. for publishing their retrospective study looking at neurological outcome following out of hospital paediatric cardiac arrest, which showed a high rate of positive neurological outcome (19%) [1]. Firstly, when looking at prognostic factors, I believe traumatic and non-traumatic cardiac arrest should be analysed separately. This is emphasised by the significant difference
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Imposter or knight in shining armor? Pelvic circumferential compression devices (PCCD) for severe pelvic injuries in patients with multiple trauma: a trauma-registry analysis Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-16 H. Trentzsch, R. Lefering, U. Schweigkofler
Pelvic Circumferential Compression Devices (PCCD) are standard in hemorrhage-control of unstable pelvic ring fractures (UPF). Controversial data on their usefulness exists. Aim of the study was to investigate whether prehospital application of PCCD can reduce mortality and transfusion requirements in UPF. Retrospective cohort study. From 2016 until 2021, 63,371 adult severely injured patients were
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Investigating the effects of frailty on six-month outcomes in older trauma patients admitted to UK major trauma centres: a multi-centre follow up study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2024-01-04 Elaine Cole, Robert Crouch, Mark Baxter, Chao Wang, Dhanupriya Sivapathasuntharam, George Peck, Cara Jennings, Heather Jarman
Pre-injury frailty is associated with adverse in-hospital outcomes in older trauma patients, but the association with longer term survival and recovery is unclear. We aimed to investigate post discharge survival and health-related quality of life (HRQoL) in older frail patients at six months after Major Trauma Centre (MTC) admission. This was a multi-centre study of patients aged ≥ 65 years admitted
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A classification system for identifying patients dead on ambulance arrival: a prehospital medical record review Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-21 Markus Petersen, Fredderick Georg Kjeldtoft, Erika Frischknecht Christensen, Henrik Bøggild, Tim Alex Lindskou
Patients dead before arrival of the ambulance or before arrival at hospital may be in- or excluded in mortality analyses, making comparison of mortality difficult. Often only physicians are allowed to declare death, thereby impeding uniform registration of prehospital death. Many studies do not report detailed definitions of prehospital mortality. Our aim was to define criteria to identify and categorize
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Favourable neurological outcome following paediatric out-of-hospital cardiac arrest: a retrospective observational study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-21 Alexander Fuchs, Deliah Bockemuehl, Sabrina Jegerlehner, Christian P. Both, Evelien Cools, Thomas Riva, Roland Albrecht, Robert Greif, Martin Mueller, Urs Pietsch
Out-of-hospital cardiac arrest (OHCA) in children is rare and can potentially result in severe neurological impairment. Our study aimed to identify characteristics of and factors associated with favourable neurological outcome following the resuscitation of children by the Swiss helicopter emergency medical service. This retrospective observational study screened the Swiss Air-Ambulance electronic
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Automated and app-based activation of first responders for prehospital cardiac arrest: an analysis of 16.500 activations of the KATRETTER system in Berlin Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-20 C. Pommerenke, S. Poloczek, F. Breuer, J. Wolff, J. Dahmen
Bystander CPR is one of the main independent factors contributing to better survival after out-of-hospital cardiac arrest. Simultaneously, the rate of bystander CPR in Germany is below the European average. First responder applications (apps) contribute to reducing the time period without CPR (no-flow time) until professional help can arrive on-scene. The KATRETTER app was introduced in Berlin as one
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Critical hypertension in trauma patients following prehospital emergency anaesthesia: a multi-centre retrospective observational study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-20 Liam Sagi, James Price, Kate Lachowycz, Zachary Starr, Rob Major, Chris Keeliher, Benjamin Finbow, Sarah McLachlan, Lyle Moncur, Alistair Steel, Peter B. Sherren, Ed B G Barnard
Critical hypertension in major trauma patients is associated with increased mortality. Prehospital emergency anaesthesia (PHEA) is performed for 10% of the most seriously injured patients. Optimising oxygenation, ventilation, and cerebral perfusion, whilst avoiding extreme haemodynamic fluctuations are the cornerstones of reducing secondary brain injury. The aim of this study was to report the differential
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The association between geospatial and temporal factors and pre-hospital response to major trauma: a retrospective cohort study in the North of England Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-19 Ryan D McHenry, Christopher A Smith
Major trauma is a leading cause of premature death and disability worldwide, and many healthcare systems seek to improve outcomes following severe injury with provision of pre-hospital critical care. Much research has focussed on the efficacy of pre-hospital critical care and advanced pre-hospital interventions, but less is known about how the structure of pre-hospital critical care services may influence
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Prehospital blood gas analyses in acute patients treated by a ground-based physician-manned emergency unit: a cohort study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-19 Louise Houlberg Walther, Annmarie Touborg Lassen, Christian Backer Mogensen, Erika Frischknecht Christensen, Søren Mikkelsen
The prehospital patients treated by ambulances and mobile emergency care units (MECU) are potentially critically ill or injured. Knowing the risks of serious outcomes in these patients is important for guiding their treatment. Some settings allow for prehospital arterial blood gas analyses. This study aimed to assess the outcomes of prehospital patients in relation to their prehospitally measured lactate
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Trauma patient transport to hospital using helicopter emergency medical services or road ambulance in Sweden: a comparison of survival and prehospital time intervals Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-16 Oscar Lapidus, Rebecka Rubenson Wahlin, Denise Bäckström
The benefits of helicopter emergency medical services (HEMS) transport of adults following major trauma have been examined with mixed results, with some studies reporting a survival benefit compared to regular emergency medical services (EMS). The benefit of HEMS in the context of the Swedish trauma system remains unclear. To investigate differences in survival and prehospital time intervals for trauma
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Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-13 S. A. C. Richardson, D. Anderson, A. J. C. Burrell, T. Byrne, J. Coull, A. Diehl, D. Gantner, K. Hoffman, A. Hooper, S. Hopkins, J. Ihle, P. Joyce, M. Le Guen, E. Mahony, S. McGloughlin, Z. Nehme, C. P. Nickson, P. Nixon, J. Orosz, B. Riley, J. Sheldrake, D. Stub, M. Thornton, A. Udy, V. Pellegrino, S. Bernard
Survival from refractory out of hospital cardiac arrest (OHCA) without timely return of spontaneous circulation (ROSC) utilising conventional advanced cardiac life support (ACLS) therapies is dismal. CHEER3 was a safety and feasibility study of pre-hospital deployed extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) for refractory OHCA in metropolitan Australia.
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Response to ‘Chest compressions at altitude are of decreased quality, require more effort and cannot reliably be self-evaluated’ Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-12 Maximilian Niederer, Dominik Roth, Alexander Egger
To the editor, We thank van Veelen and colleagues for their interest in our article on an ascent to high altitude on physical exhaustion during cardiopulmonary resuscitation (CPR) [1]. We wholeheartedly concur with the assessment that performing CPR under such unique circumstances requires greater effort and impairs providers’ ability to adhere to resuscitation guidelines at high altitudes. Whether
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Invited commentary: “Identifying traumatic significant haemorrhage is challenging for patient with low and intermediate risk, not when bleeding is obvious” Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-12 Joanne E Griggs, Richard M Lyon, Martyn Sherriff, Jack W Barrett, Gary Wareham, Ewoud Ter Avest
We would like to thank the authors for their valuable comments on our study, wherein we investigated how pre-hospital lactate (P-LACT) measurements could be used to predict the need for (ongoing) in-hospital blood product transfusion in patients attended by HEMS with major traumatic haemorrhage. As mentioned in our article, the algorithm we developed is a decision support tool, which means that it
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Selective aortic arch perfusion: a first-in-human observational cadaveric study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-12 Max Marsden, Jon Barratt, Helen Donald-Simpson, Tracey Wilkinson, Jim Manning, Paul Rees
Selective aortic arch perfusion (SAAP) is a novel endovascular technique that combines thoracic aortic occlusion with extracorporeal perfusion of the brain and heart. SAAP may have a role in both haemorrhagic shock and in cardiac arrest due to coronary ischaemia. Despite promising animal studies, no data is available that describes SAAP in humans. The primary aim of this study was to assess the feasibility
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Frostbite treatment: a systematic review with meta-analyses Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-11 Ivo B. Regli, Rosmarie Oberhammer, Ken Zafren, Hermann Brugger, Giacomo Strapazzon
Our objective was to perform a systematic review of the outcomes of various frostbite treatments to determine which treatments are effective. We also planned to perform meta-analyses of the outcomes of individual treatments for which suitable data were available. We performed a systematic review and meta-analyses in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
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Suspension syndrome: a scoping review and recommendations from the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-09 Simon Rauch, Raimund Lechner, Giacomo Strapazzon, Roger B. Mortimer, John Ellerton, Sven Christjar Skaiaa, Tobias Huber, Hermann Brugger, Mathieu Pasquier, Peter Paal
Suspension syndrome describes a multifactorial cardio-circulatory collapse during passive hanging on a rope or in a harness system in a vertical or near-vertical position. The pathophysiology is still debated controversially. The International Commission for Mountain Emergency Medicine (ICAR MedCom) performed a scoping review to identify all articles with original epidemiological and medical data to
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“Calling for help: i need you to listen’’: a qualitative study of callers’ experience of calls to the emergency medical communication centre Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-07 Trine Berglie Spjeldnæs, Kristine A. Vik Nilsen, Lars Myrmel, Jan-Oddvar Sørnes, Guttorm Brattebø
The Emergency Medical Communications Center (EMCC) is essential in emergencies and often represents the public’s first encounter with the healthcare system. Previous research has mainly focused on the dispatcher’s perspective. Therefore, there is a lack of insight into the callers’ perspectives, the attainment of which may contribute significantly to improving the quality of this vital public service
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Ambulance deployment without transport: a retrospective difference analysis for the description of emergency interventions without patient transport in Bavaria Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-06 Florian Dax, Heiko Trentzsch, Marc Lazarovici, Kathrin Hegenberg, Katharina Kneißl, Florian Hoffmann, Stephan Prückner
Not all patients who call the ambulance service are subsequently transported to hospital. In 2018, a quarter of deployments of an emergency ambulance in Bavaria were not followed by patient transport. This study describes factors that influence patient transport rates. This is a retrospective cross-sectional study based on data from all Integrated Dispatch Centres of the Free State of Bavaria in 2018
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Chest compressions at altitude are of decreased quality, require more effort and cannot reliably be self-evaluated Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-04 Michiel J. van Veelen, Hermann Brugger, Marika Falla, Giacomo Strapazzon
To the Editor, We read with interest the recent study by Niederer et al. about the influence of altitude (3454 m) on physical exhaustion during cardiopulmonary resuscitation (CPR) [1]. The authors analyze a secondary objective of a previous study that showed a reduction of chest compression (CC) depth at altitude [2] and show that heart rates are significantly higher at altitude before and after CPR
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The MeSH heading “Call Center” is due for an update: why we recommend the more precise heading “Emergency Medical Communication Center” Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-04 Astrid K. V. Harring, Jesper Blinkenberg, Guttorm Brattebø, Magnus Hjortdahl, Siri Idland, Emil Iversen, Ann-Chatrin. L. Leonardsen, Erik Zakariassen, Trine M. Jørgensen
Call centers can be found in various industries. However as a Medical Subject Heading (MeSH) the term “Call centers” does not reflect the critical purpose of handling emergency calls. We recommend “emergency medical communication center(s)”, as this provides clarity and precision regarding the primary function and purpose of the center.
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A data-driven algorithm to support the clinical decision-making of patient extrication following a road traffic collision Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-04 Eyston Vaughan-Huxley, Joanne Griggs, Jasmit Mohindru, Malcolm Russell, Richard Lyon, Ewoud ter Avest
Some patients involved in a road traffic collision (RTC) are physically entrapped and extrication is required to provide critical interventions. This can be performed either in an expedited way, or in a more controlled manner. In this study we aimed to derive a data-driven extrication algorithm intended to be used as a decision-support tool by on scene emergency service providers to decide on the optimal
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The effect of restrictive versus liberal selection criteria on survival in ECPR: a retrospective analysis of a multi-regional dataset Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-04 Arne Diehl, Andrew C. Read, Timothy Southwood, Hergen Buscher, Mark Dennis, Vinodh Bhagyalakshmi Nanjayya, Aidan J. C. Burrell
Extracorporeal cardiopulmonary resuscitation (ECPR) is an established rescue therapy for both out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA). However, there remains significant heterogeneity in populations and outcomes across different studies. The primary aim of this study was to compare commonly used selection criteria and their effect on survival and utilisation in an
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Oslo HEMS Conference 2023 Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-12-04
Sole Lindvåg Lie1, Hans Morten Lossius1, Marius Rehn1 1Norwegian Air Ambulance Foundation, Oslo, Norway Correspondence: Sole Lindvåg Lie (sole.lindvaag.lie@norskluftambulanse.no) Scand J Trauma Resusc Emerg Med 2023, 31(Suppl 2):I1 In a historic first, the European HEMS community gathered for the Oslo HEMS Conference (O-HEMS-C) December 4 to 6, 2023, in Oslo, Norway. This event serves as a nexus for
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The implication of a translational triage tool in mass casualty incidents: part three: a multinational study, using validated patient cards Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-11-28 Amir Khorram-Manesh, Eric Carlström, Frederick M. Burkle, Krzysztof Goniewicz, Lesley Gray, Amila Ratnayake, Roberto Faccincani, Dinesh Bagaria, Phatthranit Phattharapornjaroen, Mohammed A. S. Sultan, Carl Montán, Johan Nordling, Shailly Gupta, Carl Magnusson
Mass casualty incidents (MCI) pose significant challenges to existing resources, entailing multiagency collaboration. Triage is a critical component in the management of MCIs, but the lack of a universally accepted triage system can hinder collaboration and lead to preventable loss of life. This multinational study uses validated patient cards (cases) based on real MCIs to evaluate the feasibility
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Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-11-27 Hussein Albaaj, Jonatan Attergrim, Lovisa Strömmer, Olof Brattström, Martin Jacobsson, Gunilla Wihlke, Liselott Västerbo, Elias Joneborg, Martin Gerdin Wärnberg
Trauma is one of the leading causes of morbidity and mortality worldwide. Morbidity and mortality review of selected patient cases is used to improve the quality of trauma care by identifying opportunities for improvement (OFI). The aim of this study was to assess how patient and process factors are associated with OFI in trauma care. We conducted a registry-based study using all patients between 2017
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Psychoactive substances and previous hospital admissions, triage and length of stay in rural injuries: a prospective observational study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-11-27 Thomas Wilson, Torben Wisborg, Vigdis Vindenes, Ragnhild Elèn Gjulem Jamt, Stig Tore Bogstrand
Patients admitted to hospital after an injury are often found to have used psychoactive substances prior to the injury. The aim of this study was to investigate the associations between psychoactive substances (alcohol, psychoactive medicinal drugs and illicit drugs) and previous hospital admissions, triage and length of stay in the arctic Norwegian county of Finnmark. Patients ≥ 18 years admitted
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Prehospital and emergency department airway management of severe penetrating trauma in Sweden during the past decade Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-11-24 Mattias Renberg, Martin Dahlberg, Mikael Gellerfors, Elham Rostami, Mattias Günther
Prehospital tracheal intubation (TI) is associated with increased mortality in patients with penetrating trauma, and the utility of prehospital advanced airway management is debated. The increased incidence of deadly violence in Sweden warrants a comprehensive evaluation of current airway management for patients with penetrating trauma in the Swedish prehospital environment and on arrival in the emergency
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Randomised controlled trial of analgesia for the management of acute severe pain from traumatic injury: study protocol for the paramedic analgesia comparing ketamine and morphine in trauma (PACKMaN) Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-11-24 F. Michelet, M. Smyth, R. Lall, H. Noordali, K. Starr, L. Berridge, J. Yeung, G. Fuller, S. Petrou, A. Walker, J. Mark, A. Canaway, K. Khan, G. D. Perkins
Prehospital analgesia is often required after traumatic injury, currently morphine is the strongest parenteral analgesia routinely available for use by paramedics in the United Kingdom (UK) when treating patients with severe pain. This protocol describes a multi-centre, randomised, double blinded trial comparing the clinical and cost-effectiveness of ketamine and morphine for severe pain following
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Electronic field protocols for prehospital care quality improvement in Lithuania: a randomized simulation-based study Scand. J. Trauma Resusc. Emerg. Med. (IF 3.3) Pub Date : 2023-11-21 Ieva Paliokaite, Zilvinas Dambrauskas, Paulius Dobozinskas, Evelina Pukenyte, Aida Mankute-Use, Dinas Vaitkaitis
Prehospital emergency care is complex and influenced by various factors, leading to the need for decision-support tools. Studies suggest that cognitive aids improve provider performance and patient outcomes in clinical emergencies. Electronic cognitive aids have rarely been investigated in prehospital care. Therefore, this study aimed to evaluate the effects of the electronic field protocol (eFP) module