Scand J Trauma Resus
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Scand J Trauma Resus · Dec 2014
Multicenter StudyPreventable deaths following emergency medical dispatch ¿ an audit study.
Call taker triage of calls to the 112 emergency number, can be error prone because rapid decisions must be made based on limited information. Here we investigated the preventability and common characteristics of same-day deaths among patients who called 112 and were not assigned an ambulance with lights and sirens by the Emergency Medical Communication Centre (EMCC). ⋯ Same-day death rarely occurred among 112 callers whose situations were assessed as not highly urgent. No same-day deaths were found to be definitively preventable by a different EMCC call assessment, but a minority of same-day deaths could potentially have been prevented with more accurate triage. Better adherence with dispatch protocol could improve the safety of the dispatch process.
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Scand J Trauma Resus · Dec 2014
Multicenter StudyIncidence of traumatic cervical spine fractures in the Norwegian population: a national registry study.
The incidence of cervical spine fractures (CS-fx) in the general population is sparingly assessed. The aim of the current study was to estimate the incidence of traumatic CS-fx and of open surgery of cervical spine injuries in the Norwegian population. ⋯ Between 2009 and 2012, a total of 3 248 patients met our criteria for severe traumatic cervical spine injury. A total of 2 963 patients had one or more CS-fx, and 285 had severe non-fracture cervical spine injuries. The median age was 54 years, and 69% of the patients were male. The incidence of CS-fx and severe non-fracture injuries in the total Norwegian population was 16.5/100 000/year, and the incidence of CS-fx was 15.0/100 000/year. A total of 18% of the patients were treated with open surgery, resulting in an estimated incidence of surgery for acute traumatic cervical spine injury of 3.0/100 000/ year in the Norwegian population. The 1- and 3-month mortality rates were 4% and 6%, respectively.
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Scand J Trauma Resus · Dec 2014
Correction of hypothermic and dilutional coagulopathy with concentrates of fibrinogen and factor XIII: an in vitro study with ROTEM.
Fibrinogen concentrate treatment can improve coagulation during massive traumatic bleeding. The aim of this in vitro study was to determine whether fibrinogen concentrate, or a combination of factor XIII and fibrinogen concentrates, could reverse a haemodilution-induced coagulopathy during hypothermia. ⋯ Fibrinogen improved in vitro haemodilution-induced coagulopathy at both 33°C and 37°C, though more efficiently after crystalloid than HES haemodilution. Factor XIII had an additional effect on FIBTEM-MCF, but only after crystalloid dilution.
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Scand J Trauma Resus · Dec 2014
Multicenter StudyA Thailand case study based on quantitative assessment: does a national lead agency make a difference in pre-hospital care development in middle income countries?
Emergency Medical Institute of Thailand (EMIT) has been established as a national lead agency to improve emergency medical service systems since December 2008. However up to now, there has not been any published systematic assessment of its performance to guide further policy decisions. ⋯ This national data assessment shows progression in certain basic pre-hospital care requirements in Thailand. However, it needs regular systematic evaluation and there is still room for improvement of pre-hospital care systems such as increasing coverage, more equitable distribution of the coverage, faster response times, especially for patients with critical code, information system, cost-effectiveness study as well as further specific qualitative researches to guide further development of policy and intervention.
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Scand J Trauma Resus · Dec 2014
Observational StudyExtracorporeal membrane oxygenation in near-drowning patients with cardiac or pulmonary failure.
The aim of this study was to determine the early outcomes of using extracorporeal membrane oxygenation (ECMO) in near-drowning patients with cardiac or pulmonary failure. ⋯ ECMO was safe and effective for patients with ongoing cardiac arrest or ARDS after a near-drowning incident and can be used as a resuscitative strategy in near-drowning patients with cardiac or pulmonary failure resistant to conventional ventilator therapy.