Scand J Trauma Resus
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Scand J Trauma Resus · Oct 2020
Emergency department crowding and hospital transformation during COVID-19, a retrospective, descriptive study of a university hospital in Stockholm, Sweden.
COVID-19 presents challenges to the emergency care system that could lead to emergency department (ED) crowding. The Huddinge site at the Karolinska university hospital (KH) responded through a rapid transformation of inpatient care capacity together with changing working methods in the ED. The aim is to describe the KH response to the COVID-19 crisis, and how ED crowding, and important input, throughput and output factors for ED crowding developed at KH during a 30-day baseline period followed by the first 60 days of the COVID-19 outbreak in Stockholm Region. ⋯ It is possible to avoid ED crowding, even during extreme and quickly changing conditions by leveraging previously known input, throughput and output factors. One key factor was the change in working methods in the ED with higher competence, less diagnostics and increased focus on rapid clinical admission decisions. Another important factor was the reduction in bed occupancy in emergency wards that enabled a timely admission to inpatient care. A key limitation was the retrospective study design.
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Scand J Trauma Resus · Oct 2020
Multicenter StudyExploiting an early warning Nomogram for predicting the risk of ICU admission in patients with COVID-19: a multi-center study in China.
Novel coronavirus disease 2019 (COVID-19) is a global public health emergency. Here, we developed and validated a practical model based on the data from a multi-center cohort in China for early identification and prediction of which patients will be admitted to the intensive care unit (ICU). ⋯ We established an early prediction model incorporating clinical characteristics that could be quickly obtained on hospital admission, even in community health centers. This model can be conveniently used to predict the individual risk for ICU admission of patients with COVID-19 and optimize the use of limited resources.
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Scand J Trauma Resus · Oct 2020
Correction to: Is prehospital use of active external warming dangerous for patients with accidental hypothermia: a systematic review.
An amendment to this paper has been published and can be accessed via the original article.
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Scand J Trauma Resus · Oct 2020
Letter ReviewResilience in a prehospital setting - a new focus for future research?
Handling and initiating of treatment in a prehospital setting are complex processes that involve many treatment options and include several parts of the chain of survival. Capacity to adapt to unexpected changes in the patients' conditions or in the surroundings is a prerequisite for patient safety. Outside the healthcare sector, safety science is moving from an approach focused on the analysis and management of error (Safety I) to instead understanding the inherent properties of safety systems (Safety II). In healthcare the attention to why service providers are able to succeed under challenging conditions remains sparse. The aim of this commentary is to give a better understanding of how the concept and inclusion of resilience can inspire a new approach for future research in prehospital settings. So far, most resilience studies have been conducted in emergency departments while the role of contextual factors and adaptations in a prehospital setting has remained unexplored. ⋯ Empirical research is of crucial importance to build and support resilient systems and processes in a prehospital setting. We need a new framework and a new approach to how research on this topic is conducted and to support resilient performance. This should involve identifying factors that promote resilience, both on individual-, team- and system- levels.
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Scand J Trauma Resus · Oct 2020
ReviewDescription of Emergency Medical Services, treatment of cardiac arrest patients and cardiac arrest registries in Europe.
Variation in the incidence, survival rate and factors associated with survival after cardiac arrest in Europe is reported. Some studies have tried to fill the knowledge gap regarding the epidemiology of out-of-hospital cardiac arrest in Europe but were unable to identify reasons for the reported differences. Therefore, the purpose of this study was to describe European Emergency Medical Systems, particularly from the perspective of country and ambulance service characteristics, cardiac arrest identification, dispatch, treatment, and monitoring. ⋯ Throughout Europe there are important differences in Emergency Medical Service systems and the response to out-of-hospital cardiac arrest. Explaining these differences is complicated due to significant variation in how variables are reported to and used in registries.