Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2014
Observational StudyAnaerobic metabolism associated with traumatic hemorrhagic shock monitored by microdialysis of muscle tissue is dependent on the levels of hemoglobin and central venous oxygen saturation: a prospective, observational study.
Traumatic hemorrhagic shock resulting in tissue hypoxia is a significant cause of morbidity and mortality in polytraumatized patients. Early identification of tissue hypoxia is possible with microdialysis. The aim of this study was to determine the correlation between a marker of tissue hypoxia (L/P; lactate to pyruvate ratio) and selected parameters of systemic oxygen delivery (Hb; hemoglobin) and oxygen extraction (ScvO2; central venous oxygen saturation). We also investigated the severity of tissue hypoxia over the course of care. ⋯ The L/P ratio is useful to identify tissue ischemia and can estimate the effectiveness of fluid resuscitation. An increase in the L/P ratio is an early warning sign of inadequate tissue oxygenation and should lead to more detailed hemodynamic and laboratory monitoring. This information cannot usually be obtained from global markers.
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The Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine-which received its first Impact Factor in 2013-is extremely grateful for the time, hard work and support of its highly-qualified peer reviewers. The editors of the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, the Norwegian Air Ambulance Foundation and BioMed Central would like to show our appreciation by thanking the following people for their assistance reviewing manuscripts for the journal in 2013.
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Scand J Trauma Resus · Jan 2014
Review Meta AnalysisComparison of whole-body computed tomography vs selective radiological imaging on outcomes in major trauma patients: a meta-analysis.
The purpose of this meta-analysis was to explore the value of whole-body computed tomography (WBCT) in major trauma patients (MTPs). ⋯ The present meta-analysis suggests that the application of whole-body CT significantly reduces the mortality rate of MTPs and markedly reduces the time spent in the emergency department.
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Scand J Trauma Resus · Jan 2014
Review Meta AnalysisThe impact of direct admission to a catheterisation lab/CCU in patients with ST-elevation myocardial infarction on the delay to reperfusion and early risk of death: results of a systematic review including meta-analysis.
For each hour of delay from fist medical contact until reperfusion in ST-elevation myocardial infarction (STEMI) there is a 10% increase in risk of death and heart failure. The aim of this review is to describe the impact of the direct admission of patients with STEMI to a Catheterisation laboratory (cath lab) as compared with transport to the emergency department (ED) with regard to delays and outcome. ⋯ An overview of available studies of the impact of a protocol-based pre-hospital clinical pathway with direct admission to a cath lab as compared with the standard transport to the ED in ST-elevation AMI suggests the following. The delay to the start of revascularisation will be reduced. The clinical benefit is not clearly evidence based. However, the documented association between system delay and outcome defends the use of the pathway.
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Scand J Trauma Resus · Jan 2014
Multicenter StudyVariations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres - a cross-sectional study.
The 19 Norwegian Emergency medical communication centres (EMCCs) use Norwegian Index for medical emergency assistance (Index) as dispatch guidelines. Little is known about the use of Index, nor its validity. We aimed to document the epidemiology of contacts made to the public emergency medical phone number and the operators' self-reported use of Index as a first step towards a validation study. ⋯ There is a large variation between the EMCCs with regard to both contact patterns and use of Index. There is a relatively high overall self-reported use of Index by the operators, with variations on both individual and EMCC level.