Scand J Trauma Resus
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Scand J Trauma Resus · Mar 2016
Continuous venovenous hemofiltration decreases mortality and ameliorates acute lung injury in canine model of severe salt water drowning.
Pulmonary edema is an important cause of complications and death in severe drowning. Continuous veno-venous hemofiltration (CVVH) may reduce pulmonary edema and thus may be a treatment modality for severe sea water drowning resuscitation. ⋯ CVVH decreased mortality and pulmonary injury and largely maintained hemodynamic and acid-base balance in animals with severe sea water drowning and thus, may be added as a new measure to aid in resuscitation from severe sea water drowning.
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Scand J Trauma Resus · Mar 2016
Geographic information system data from ambulances applied in the emergency department: effects on patient reception.
Emergency departments (ED) recognize crowding and handover from prehospital to in-hospital settings to be major challenges. Prehospital Geographical Information Systems (GIS) may be a promising tool to address such issues. In this study, the use of prehospital GIS data was implemented in an ED in order to investigate its effect on 1) wait time and unprepared activations of Trauma Teams (TT) and Medical Emergency Teams (MET) and 2) nurses' perceptions regarding patient reception, workflow and resource utilization. ⋯ A comparison of the use of prehospital GIS data in the ED with the control period showed no effect on median wait time for TT and MET, however, the number of waits of >10 min was reduced. On the other hand, nurses perceived implementation of GIS data as improving workflow, resource utilization and quality of all patients' reception, critically as well as non-critically ill. There were no substantial disadvantages to the GIS application.
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Scand J Trauma Resus · Mar 2016
Analysis of death in major trauma: value of prompt post mortem computed tomography (pmCT) in comparison to office hour autopsy.
To analyze diagnostic accuracy of prompt post mortem Computed Tomography (pmCT) in determining causes of death in patients who died during trauma room management and to compare the results to gold standard autopsy during office hours. ⋯ PmCT is useful in traumatic death allowing for an immediate identification of causes of death and providing detailed information on bony lesions, brain injuries and gas formations. It is advisable to conduct pmCT especially in cases without consent to autopsy to gain information about possible causes of death and to rule out possible clinical errors.
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Scand J Trauma Resus · Mar 2016
Randomized Controlled TrialRandomized controlled trial of multidisciplinary team stress and performance in immersive simulation for management of infant in shock: study protocol.
Human error and system failures continue to play a substantial role in adverse outcomes in healthcare. Simulation improves management of patients in critical condition, especially if it is undertaken by a multidisciplinary team. It covers technical skills (technical and therapeutic procedures) and non-technical skills, known as Crisis Resource Management. The relationship between stress and performance is theoretically described by the Yerkes-Dodson law as an inverted U-shaped curve. Performance is very low for a low level of stress and increases with an increased level of stress, up to a point, after which performance decreases and becomes severely impaired. The objectives of this randomized trial are to study the effect of stress on performance and the effect of repeated simulation sessions on performance and stress. ⋯ We will concomitantly evaluate technical and non-technical performance, and the impact of stress on both. This is the first randomized trial studying repetition of simulation sessions and its impact on both clinical performance and stress, which is explored by objective and subjective assessments. We expect that stress decreases team performance and that repeated simulation will increase it. We expect no variation of stress parameters regardless of the level of performance.