Scand J Trauma Resus
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Scand J Trauma Resus · Nov 2018
Comment LetterComment to: non-specific complaints at emergencydepartment presentation result in uncleardiagnoses and lengthened hospitalization: a prospective observational study.
Abstract
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Scand J Trauma Resus · Nov 2018
Observational StudyThe role of a checklist for assessing the quality of basic life support performance: an observational cohort study.
Training lay rescuers in Basic Life Support (BLS) is essential to improve bystander cardiopulmonary resuscitation (CPR) rates; in addition, simple methods are needed to provide feedback on CPR performance. This study evaluated whether a simple observational checklist can be used by BLS instructors to adequately measure the quality of BLS performance as an alternative to other feedback devices. ⋯ The observational checklist adequately distinguished sufficient from insufficient BLS performances and offered an assessment of items not incorporated by SkillReporting software such as the initial assessment or undressing the chest. Although its usefulness was reduced for scaling intermediate performance groups, the checklist may be overall a useful rating tool in BLS-training if objective feedback devices are not available, for example, due to large groups of participants or limited training time.
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Scand J Trauma Resus · Nov 2018
Bone marrow-derived mononuclear cell therapy can attenuate systemic inflammation in rat heatstroke.
This study was performed to gain insights into novel therapeutic approaches for acute systemic inflammation in heatstroke. Bone marrow-derived mononuclear cells (BMMNCs) secrete anti-inflammatory proteins and have protective effects against acute inflammation. Recent evidence suggested that transplantation of BMMNCs can reduce the acute tissue injury caused by regional myocardial reperfusion and the lung dysfunction induced by lipopolysaccharides. We evaluated whether BMMNCs attenuate systemic inflammatory response induced by severe heatstroke. ⋯ Transplantation of BMMNCs attenuated acute systemic inflammation and vascular endothelial injury, reduced organ dysfunction, and improved survival in a rat heatstroke model. These findings provide a possible therapeutic strategy against critical heatstroke.
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Scand J Trauma Resus · Nov 2018
Identification and internal validation of models for predicting survival and ICU admission following a traumatic injury.
Measures to improve the accuracy of determining survival and intensive care unit (ICU) admission using the International Classification of Injury Severity Score (ICISS) are not often conducted on a population-wide basis. The aim is to determine if the predictive ability of survival and ICU admission using ICISS can be improved depending on the method used to derive ICISS and incremental inclusion of covariates. ⋯ The inclusion of comorbid conditions, injury mechanism and nature of injury, improved discrimination for both 90-day mortality and ICU admission. Moves to routinely use ICD-based injury severity measures, such as ICISS, should be considered for hospitalisation data replacing more resource-intensive injury severity classification measures.
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It is a challenge to dispatch Emergency medical Services (EMS) appropriately with limited resources and maintaining patient safety; this requires accurate dispatching systems. The objective of the current systematic review was to examine the evidence, according to GRADE, for medical dispatching systems to accurately dispatch EMS according to level of acuity and in recognition of specific conditions. A systematic search was performed trough PubMed, Web of Science, Embase (free text in all fields), Centre for Reviews and Dissemination (CRD), and Cochrane Central Register of Controlled Trials up to 16th of May, 2017. A combination of keywords and Medical Subject Heading (MeSH) terms relevant to "emergency medical dispatch criteria" were used, to search for articles published between 2012 and 2017. Publications were included according to the inclusion/exclusion criteria using the Systematic Reviews and Meta-Analyses (PRISMA) protocol. Level of evidence was evaluated in accordance with Grading of Recommendations Assessment, Development and Evaluation (GRADE). Articles included were those that provided evidence for at least one of the measures of dispatch system accuracy; i.e. sensitivity, specificity, positive and negative predictive and/or over- and under-triage. The search identified 1445 articles. After the removal of duplicates, 382 titles were reviewed for relevance and an additional 359 articles were excluded based on manuscript title and abstract. An additional five articles were excluded after review of the full text versions of the remaining articles. The current review included 18 publications which all were based on primary research. ⋯ The 18 articles addressed the identification of cardiac arrest, stroke, medical priority and major trauma using different dispatching systems. The results of the current review show that there is a very low to low overall level of evidence for the accuracy of medical dispatching systems. We suggest that it is necessary to create a consensus on common standards for reporting before consensus can be reached for the level of accuracy in medical dispatching systems.