Scand J Trauma Resus
-
Scand J Trauma Resus · Jan 2015
Are the current MRI criteria using the DWI-FLAIR mismatch concept for selection of patients with wake-up stroke to thrombolysis excluding too many patients?
Up to 25% of stroke patients wake up with a neurological deficit, so called wake-up stroke (WUS). Different imaging approaches that may aid in the selection of patients likely to benefit from reperfusion therapy are currently under investigation. The magnetic resonance imaging (MRI) diffusion weighted imaging - fluid attenuated inversion recovery (DWI-FLAIR) mismatch concept is one proposed method for identifying patients presenting within 4.5 hours of the ischemic event. ⋯ In this small series DWI-FLAIR mismatch was not associated with worse outcome or ICH. This suggests that selecting WUS patients using DWI-FLAIR mismatch in clinical trials may exclude a large group of patients who might benefit.
-
Scand J Trauma Resus · Jan 2015
Observational StudyDoes point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?
This study aimed to assess the patient-rated level of discomfort during point-of-care ultrasonography (POCUS) of the heart, lungs and deep veins in a population of patients admitted to an ED with respiratory symptoms and to what extent the patients would accept being assessed by the use of POCUS if they had to be examined for possible disease. ⋯ The patient-rated level of discomfort during POCUS of the heart, lungs and deep veins is very low and the vast majority of patients would accept being assessed by the use of POCUS if the patients once again had to be examined for possible disease.
-
Scand J Trauma Resus · Jan 2015
Maxillofacial fractures and craniocerebral injuries - stress propagation from face to neurocranium in a finite element analysis.
Severe facial trauma is often associated with intracerebral injuries. So it seemed to be of interest to study stress propagation from face to neurocranium after a fistlike impact on the facial skull in a finite element analysis. ⋯ As patients presenting with facial fractures have a risk for craniocerebral injuries attention should be paid to this and the indication for a CT-scan should be put widely. Efforts have to be made to generate more precise finite element models for a better comprehension of craniofacial and brain injury.
-
Scand J Trauma Resus · Jan 2015
Patients presenting at the emergency department with acute abdominal pain are less likely to be admitted to inpatient wards at times of access block: a registry study.
Also known as access block, shortage of inpatient beds is a common cause of emergency department (ED) boarding and overcrowding, which are both associated with impaired quality of care. Recent studies have suggested that access block not simply causes boarding in EDs, but may also result in that patients are less likely to be admitted to the hospital from the ED. The present study's aim was to investigate whether this effect remained for patients with acute abdominal pain, for which different management strategies have emerged. Access block was defined in terms of hospital occupancy and the appropriateness of ED discharges addressed as 72 h revisits to the ED. ⋯ Study findings indicate that patients with acute abdominal pain are less likely to be admitted to the hospital from the ED at times of access block and that other management strategies are employed instead. No association with 72 h revisits was seen, but future studies need to address more granular outcomes in order to clarify the safety aspects of the effect.
-
Scand J Trauma Resus · Jan 2015
LetterAirplane transport isolators may loose leak tightness after rapid cabin decompression.
Air medical transport of patients suffering of highly infectious diseases is typically performed employing portable isolation chambers. Although the likelihood of decompression flight emergencies is low, sustainability of the devices used is crucial. When a standard isolation unit was subjected to an explosive cabin decompression of 493 hPa, simulating a 32808 ft flight level accident, leak tightness of the unit was lost due to rupture of the bag caused by over expansion. When the pressure chamber experiment was repeated with a modified unit, distension was minimized by an additional compensation air bag, thus ensuring leak tightness.