Scand J Trauma Resus
-
Scand J Trauma Resus · Oct 2017
Multicenter Study Observational StudyUse of intrathoracic pressure regulation therapy in breathing patients for the treatment of hypotension secondary to trauma.
Intrathoracic pressure regulation (IPR) therapy has been shown to increase blood pressure in hypotensive patients. The potential value of this therapy in patients with hypotension secondary to trauma with bleeding is not well understood. We hypothesized that IPR would non-invasively and safely enhance blood pressure in spontaneously breathing patients with trauma-induced hypotension. ⋯ These findings support the use of IPR to treat trauma-induced hypotension as long as bleeding has been controlled.
-
Scand J Trauma Resus · Oct 2017
Randomized Controlled Trial Multicenter StudyEMT-led laryngeal tube vs. face-mask ventilation during cardiopulmonary resuscitation - a multicenter prospective randomized trial.
Laryngeal tube (LT) application by rescue personnel as an alternate airway during the early stages of out-of-hospital cardiac arrest (OHCA) is still subject of debate. We evaluated ease of handling and efficacy of ventilation administered by emergency medical technicians (EMTs) using LT and bag-valve-mask (BVM) during cardiopulmonary resuscitation of patients with OHCA. ⋯ EMTs preferred LT ventilation to BVM ventilation during pre-study training, but on-site there was no difference with regard to efficacy, ventilation safety, or outcome. The results indicate that LT ventilation by EMTs during OHCA is not superior to BVM and cannot substitute for BVM training. We assume that the main benefit of the LT is the provision of an alternative airway when BVM ventilation fails. Training in BVM ventilation remains paramount in EMT apprenticeship and cannot be substituted by LT ventilation.
-
Scand J Trauma Resus · Oct 2017
Multicenter Study Observational StudyCommon intensive care scoring systems do not outperform age and glasgow coma scale score in predicting mid-term mortality in patients with spontaneous intracerebral hemorrhage treated in the intensive care unit.
Intensive care scoring systems are widely used in intensive care units (ICU) around the world for case-mix adjustment in research and benchmarking. The aim of our study was to investigate the usefulness of common intensive care scoring systems in predicting mid-term mortality in patients with spontaneous intracerebral hemorrhage (ICH) treated in intensive care units (ICU). ⋯ The common intensive care scoring systems did not outperform a simpler model based on only age and GCS score. Thus, the use of previous intensive care scoring systems is not warranted in ICH patients.
-
Scand J Trauma Resus · Oct 2017
Observational StudySpecialist advice may improve patient selection for decompression therapy following diving accidents: a retrospective observational study.
Even in a landlocked country like Switzerland recreational diving is becoming more and more popular. Smaller lakes in the Alps are located at an altitude of 2500 m above sea level. The incidence of diving accidents among all helicopter emergency service missions and the consecutive medical knowledge about decompression injuries is low. Thus, a collaboration between the Swiss Air-Ambulance (Rega) and the divers alert network (DAN) was initiated to improve patient treatment and identification of decompression injury and necessity of hyperbaric oxygen therapy (HBO). ⋯ For diving accidents among HEMS missions, specialist advice by diving medicine specialists (DAN) appears mandatory to accurately identify and transport patients with decompression injury, as exposure of emergency physicians towards diving accidents and the diagnosis of DCI is low.