Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2013
Impact of a physician-staffed helicopter on a regional trauma system: a prospective, controlled, observational study.
This study aims to compare the trauma system before and after implementing a physician-staffed helicopter emergency medical service (PS-HEMS). Our hypothesis was that PS-HEMS would reduce time from injury to definitive care for severely injured patients. ⋯ Implementation of a PS-HEMS was associated with significant reduction in time to the trauma centre for severely injured patients. We also observed significantly reduced proportions of secondary transfers and 30-day mortality.
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Acta Anaesthesiol Scand · May 2013
Comparative StudySevere community-acquired pneumonia treated with β-lactam-respiratory quinolone vs. β-lactam-macrolide combination.
This study aimed to compare the outcome of patients with severe community-acquired pneumonia (SCAP) treated with the combination of either β-lactam-quinolone (βQ) or β-lactam-macrolide (βM) antibiotics. ⋯ Thirty-day mortality rate of SCAP patients did not differ whether they were treated with either βQ or βM combination.
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Acta Anaesthesiol Scand · May 2013
Avoiding bladder catheterisation in total knee arthroplasty: patient selection criteria and low-dose spinal anaesthesia.
Bladder catheterisation may be inconvenient for patients, delay mobilisation and risk complications. We hypothesised that by excluding pre-operatively patients at high risk of post-operative urinary retention, the majority of patients could avoid perioperative catheterisation during low-dose spinal anaesthesia. ⋯ Low-dose spinal anaesthesia combined with simple selection criteria allowed for early mobilisation (96%) and avoidance of bladder catheterisation in the vast majority (88%) of patients undergoing total knee arthroplasty, and the rest (12%) only needed a single temporary catheterisation.
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Acta Anaesthesiol Scand · May 2013
Case ReportsIntra-arrest formation of right-heart thrombi -- a case illustrated by real-time ultrasonography.
The presence of free-floating right-heart thrombus has been reported in a cardiac arrest patient in the periarrest period. Free-floating right atrial thrombus is a rare phenomenon seen in patients developing severe pulmonary embolism, and is associated with increased mortality. However, there have been no previously reported cases of right-heart thrombus formation during a resuscitated cardiac arrest. ⋯ Recent implementation of ultrasonography into the regional pre-hospital care protocol enabled sonographic investigation before and during cardiac arrest. This allowed detection of right atrial septal thrombus formation in the course of advanced life support and its migration through the tricuspid valve. The pathophysiological consequences, clinical significance and potential therapeutic options are discussed.
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Acta Anaesthesiol Scand · May 2013
Pre-hospital airway management by non-physicians in Northern Finland -- a cross-sectional survey.
Airway management is an important skill in pre-hospital emergency medicine. The most optimal method depends on the resources and experience of the emergency medical service (EMS) providers. We wanted to study the frequency of occurrence, equipment used, problems experienced and maintenance of skills in pre-hospital airway management by non-physicians. ⋯ Advanced airway management procedures are uncommon for most EMS providers in Northern Finland. Procedures, training in and maintenance of airway management skills should be re-evaluated.