Scand J Trauma Resus
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Scand J Trauma Resus · Feb 2019
Observational StudyAirway Management in the Emergency Department (The OcEAN-Study) - a prospective single centre observational cohort study.
Emergency airway management (AM) is a major key for successful resuscitation of critically ill non-traumatic (CINT) patients. Details of the AM of these patients in German emergency departments (ED) are unknown. This observational study describes epidemiology, airway techniques, success rates and complications of AM in CINT ED patients in the resuscitation room (RR). ⋯ OcEAN demonstrates the challenges of AM in CINT patients in a German ED RR. We propose a nation-wide ED airway registry to better track outcomes in the future.
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Scand J Trauma Resus · Feb 2019
Challenges of helicopter mountain rescue missions by human external cargo: need for physicians onsite and comprehensive training.
Human external cargo (HEC) extrication during helicopter rescue missions is commonly used in mountain emergency medical services. Furthermore, longline or winch operations offer the opportunity to deliver professional medical care onsite. As the safety and quality of emergency medical care depends on training and experience, we aimed to investigate characteristics of mountain rescue missions with HEC. ⋯ As these interventions have to be performed in challenging terrain, with reduced personnel resources, and limited monitoring, our results point out the need for physicians onsite who are clinically experienced in these procedures and specially and intensively trained for the specific characteristics and challenges of HEC rescue missions.
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Scand J Trauma Resus · Feb 2019
Comparative StudyComparison of two different intraosseous access methods in a physician-staffed helicopter emergency medical service - a quality assurance study.
Intravenous access in critically ill and injured patients can be difficult or impossible in the field. Intraosseous access is a well-established alternative to achieve access to a noncollapsible vascular network. We wanted to compare the use of a sternal and tibial/humeral intraosseous device in a physician-staffed helicopter emergency medical service. ⋯ Intraosseous access seems to be a reliable rescue technique in our helicopter emergency medical service, with high insertion success rates. EZ-IO was a more rapid method in gaining vascular access compared to FAST-Responder. However, FAST-Responder may be a better method when high-flow infusion is needed. Few complications were registered with both techniques in our service.
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Scand J Trauma Resus · Feb 2019
Does injury pattern among major road trauma patients influence prehospital transport decisions regardless of the distance to the nearest trauma centre? - a retrospective study.
Prehospital undertriage occurs when the required level of care for a major trauma patient is underestimated and the patient is transported to a lower-level emergency care facility. One possible reason is that the pattern of injuries exceeding a certain severity threshold is not easily recognizable in the field. The present study aims to examine whether the injury patterns of major road trauma patients are associated with trauma centre transport decisions in Sweden, controlling for the distance from the crash to the nearest trauma centre and other patient characteristics. ⋯ These results highlight that there is considerable prehospital undertriage in Sweden and suggest that distance to nearest TC is more influential in transport decisions than injury pattern. These results can be used to further develop prehospital transportation guidelines and designation of trauma centres.
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Scand J Trauma Resus · Feb 2019
Is there an association between female gender and outcome in severe trauma? A multi-center analysis in the Netherlands.
Little evidence suggest that female gender is associated with a lower risk of mortality in severely injured patients, especially in premenopausal women. Previous clinical studies have shown contradictory results regarding protective effects of gender on outcome after severe trauma. The objective of this study was to determine the association between gender and outcome (mortality and Intensive Care Unit (ICU) admission) among severely injured patients in the Netherlands. ⋯ The current study shows that in this population of severely injured patients, female sex is associated with a lower in-hospital mortality rate among those aged 16- to 44-years. Furthermore, female sex is independently associated with an overall decreased likelihood for ICU admission. More research is needed to examine the physiologic background of this protective effect of female sex in severe trauma.