Scand J Trauma Resus
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Scand J Trauma Resus · Sep 2017
Multicenter StudyIntoxication with GHB/GBL: characteristics and trends from ambulance-attended overdoses.
Overdoses from so-called "club drugs" (GHB/GBL) have become a more frequent cause of overdoses attended by ambulance services. Given its availability, affordability, and lack of awareness of risks, there is a common misconception among users that the drug is relatively safe. ⋯ The review of ambulance records on the prehospital treatment of overdoses can be beneficial in monitoring, preparing, and prevention efforts aimed to benefit this vulnerable group.
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Scand J Trauma Resus · Sep 2017
Multicenter Study Observational StudyFactors influencing on-scene time in a rural Norwegian helicopter emergency medical service: a retrospective observational study.
Critically ill patients need to be immediately identified, properly managed, and rapidly transported to definitive care. Extensive prehospital times may increase mortality in selected patient groups. The on-scene time is a part of the prehospital interval that can be decreased, as transport times are determined mostly by the distance to the hospital. Identifying factors that affect on-scene time can improve training, protocols, and decision making. Our objectives were to assess on-scene time in the Helicopter Emergency Medical Service (HEMS) in our region and selected factors that may affect it in specific and severe conditions. ⋯ The most important factors associated with increased on-scene time were the severity of the patient's condition, the need for intubation or intravenous analgesic, helicopter transport, and trauma missions.
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Scand J Trauma Resus · Sep 2017
Barriers and facilitators towards implementing the Sepsis Six care bundle (BLISS-1): a mixed methods investigation using the theoretical domains framework.
The 'Sepsis 6', a care bundle of basic, but vital, measures (e.g. intravenous fluid, antibiotics) has been implemented to improve sepsis treatment. However, uptake has been variable. Tools from behavioral sciences, such as the Theoretical Domains Framework (TDF) may be used to understand and address such implementation issues. This study used a behavioral science approach to identify barriers and facilitators towards Sepsis Six implementation at a case study hospital. ⋯ A range of barriers and facilitators towards Sepsis Six performance across different staff groups were systematically identified using a theoretically-informed approach. This can inform development of targeted performance improvement interventions.
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Scand J Trauma Resus · Sep 2017
Neurological outcomes and duration from cardiac arrest to the initiation of extracorporeal membrane oxygenation in patients with out-of-hospital cardiac arrest: a retrospective study.
We investigated the relationship between neurological outcomes and duration from cardiac arrest (CA) to the initiation of extracorporeal membrane oxygenation (ECMO) (CA-to-ECMO) in patients with out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR) and determined the ideal time at which ECPR should be performed. ⋯ The duration from CA-to-ECMO was significantly associated with good neurological outcomes. The indication for patients with OHCA should include a criterion for the ideal time to initiate ECPR.
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Scand J Trauma Resus · Sep 2017
Physician-staffed helicopter emergency medical service has a beneficial impact on the incidence of prehospital hypoxia and secured airways on patients with severe traumatic brain injury.
After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. ⋯ The introduction of a physician-staffed HEMS unit resulted in decreased incidence of prehospital hypoxia and increased the number of secured airways. This may have contributed to the observed improved neurological outcome during the HEMS period.