Scand J Trauma Resus
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Scand J Trauma Resus · Apr 2016
Coma of unknown origin in the emergency department: implementation of an in-house management routine.
Coma of unknown origin is an emergency caused by a variety of possibly life-threatening pathologies. Although lethality is high, there are currently no generally accepted management guidelines. ⋯ Our SOP may provide an appropriate tool for efficient management of patients with non-traumatic coma. Our results justify the assignment of the initial diagnostic workup to neurologists and internal specialists in collaboration with anaesthesiologists.
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Scand J Trauma Resus · Apr 2016
Observational StudyIncidence and outcome of cardiac injury in patients with severe head trauma.
Although cardiac injury has been reported in patients with various neurological conditions, few data report cardiac injury in patients with traumatic brain injury (TBI). The aim of this work is to report the incidence of cardiac injury in patients with TBI and its impact on patient outcome. ⋯ Cardiac injury is common in patients with TBI and is associated with increased mortality. The association of high NCIS and poor outcome in these patients warrants a further larger study.
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Scand J Trauma Resus · Apr 2016
An exploration of the views of paramedics regarding airway management.
Paramedics are a skilled group of clinicians with expertise in airway management. Our research group has completed a trial comparing supraglottic airway devices with tracheal intubation during out of hospital cardiac arrest. This is a contentious topic amongst paramedics in the United Kingdom (UK). We explored the customs and beliefs of UK paramedics in relation to airway management, and whether tracheal intubation contributes to and sustains paramedic professional identity. ⋯ We have demonstrated that UK paramedics have a wide range of views regarding airway management, and that these are based on evidence and experience rather than dogma. Airway management contributes to paramedics' professional identity, but is not reliant on this.
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Scand J Trauma Resus · Apr 2016
The impact of occupational hazards and traumatic events among Belgian emergency physicians.
Emergency Physicians (EPs) are regularly confronted with work related traumatic events and hectic work conditions. Several studies mention a high incidence of post-traumatic stress disorder (PTSD) and psychosomatic complaints in EP. The main objective of this study is to examine the contribution of demographics, traumatic events, life events, the occurrence of occupational hazards and social support to post-traumatic stress symptoms (PTSS), psychological distress, fatigue, somatic complaints and job satisfaction in Emergency Physicians. ⋯ Emergency Physicians are particularly vulnerable to post-traumatic stress and chronic stress consequences due to repetitive exposure to work related traumatic events. Training in dealing with violence and situations that can increase the risk of burnout can reduce detrimental consequences in emergency physicians. In addition, it is suggested that emergency units are screened systematically on determinants of burnout, in view of interventions. Finally, creating a supportive work environment and training the medical staff in supportive skills with backup by experts may also reduce adverse consequences of confrontation with traumatic work events.
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Scand J Trauma Resus · Apr 2016
LetterRevision for the Rapid Emergency Triage and Treatment System Adult (RETTS-A) needed?
The study highlights the prognostic role of patient's vital signs at presentation to the emergency department (ED): The predictive role of vital signs in ED triage has been controversially discussed probably due to a paucity of data on the value of vital signs in ED at presentation. However, the authors did not find a suitable way to adjust for the inherent influence of triage decision and medical treatment on mortality. We have discussed that ambiguity concerning the assessment of vital signs criteria in RETTS-A Red priority may threaten any association between patient acuity and fatal outcome.