Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2015
Review Meta AnalysisIs the supine position associated with loss of airway patency in unconscious trauma patients? A systematic review and meta-analysis.
Airway compromise is a leading cause of death in unconscious trauma patients. Although endotracheal intubation is regarded as the gold standard treatment, most prehospital providers are not trained to perform ETI in such patients. Therefore, various lateral positions are advocated for unconscious patients, but their use remains controversial in trauma patients. We conducted a systematic review to investigate whether the supine position is associated with loss of airway patency compared to the lateral position. ⋯ Although concerns other than airway patency may influence how a trauma patient is positioned, our systematic review provides evidence supporting the long held recommendation that unconscious trauma patients should be placed in a lateral position.
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Scand J Trauma Resus · Jan 2015
Randomized Controlled Trial Comparative StudyThe C-MAC videolaryngoscope compared with conventional laryngoscopy for rapid sequence intubation at the emergency department: study protocol.
Especially in the emergency setting, rapid and successful airway management is of major importance. Conventional endotracheal intubation is challenging and requires high level of individual skills and experience. Videolaryngoscopes like the C-MAC are likely to offer better glottis visualization and serve as alternatives to conventional endotracheal intubation. The aim of this study is to compare clinical performance and feasibility of the C-MAC videolaryngoscope compared to conventional endotracheal intubation in the emergency setting. ⋯ In the clinical setting, the ultimate success rate of endotracheal intubation ranges between 97% and 99%. Unexpected difficulties during laryngoscopy and poor glottis visualization occur in up to 9% of all cases. In these cases, videolaryngoscopes may increase success rate of initial intubation attempt and thereby patient safety.
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Scand J Trauma Resus · Jan 2015
Review Case ReportsTension gastrothorax: acute life-threatening manifestation of late onset congenital diaphragmatic hernia (CDH) in children.
Tension gastrothorax in children is a life-threatening condition and presents dramatically with acute and severe respiratory distress. It develops when an intra-thoracic stomach herniated through a diaphragmatic defect is massively distended by trapped air and/or fluid causing mediastinal displacement. ⋯ We present a child with tension gastrothorax and a literature review of this phenomenon. Immediate clinical and radiographic evaluation should lead to accurate diagnosis followed by emergency decompression of the stomach before laparotomy with reduction of herniated viscera and repair of the diaphragmatic defect.
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Scand J Trauma Resus · Jan 2015
Observational StudyPoint of care coagulometry in prehospital emergency care: an observational study.
Haemostatic impairment can have a crucial impact on the outcome of emergency patients, especially in cases of concomitant antithrombotic drug treatment. In this prospective observational study we used a point of care (POC) coagulometer in a prehospital physician-based emergency medical system in order to test its validity and potential value in the treatment of emergency patients. ⋯ Assessment of INR through a POC coagulometer is feasible in prehospital emergency care and provides valuable information on haemostatic parameters in patients. Questionnaire results suggest that POC INR testing may present a valuable technique in selected patients. Whether this information translates into an improved management of respective patients has to be evaluated in further studies.
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Scand J Trauma Resus · Jan 2015
Randomized Controlled TrialFunctional outcome, cognition and quality of life after out-of-hospital cardiac arrest and therapeutic hypothermia: data from a randomized controlled trial.
To study functional neurologic and cognitive outcome and health-related quality of life (HRQoL) in a cohort of patients included in a randomised controlled trial on glucose control following out-of-hospital cardiac arrest (OHCA) from ventricular fibrillation (VF) treated with therapeutic hypothermia. ⋯ Functional outcome six months after OHCA and therapeutic hypothermia was good in the great majority of the survivors, and half of them were cognitively intact. Of note, the HRQoL of CA survivors did not differ from that of age- and gender matched population.