Scand J Trauma Resus
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Scand J Trauma Resus · Jun 2020
Multicenter Study Comparative Study Observational StudyComparing complications of small-bore chest tubes to large-bore chest tubes in the setting of delayed hemothorax: a retrospective multicenter cohort study.
Previous studies have provided initial data suggesting that small-bore (SB, ≤ 14Fr) chest tubes have the same efficacy as large-bore (LB, > 14 Fr) chest tubes for acute hemothorax (HTX), but data continue to be lacking in the setting of delayed HTX. This study compared complications of SB chest tubes to LB tubes in patients with delayed HTX. ⋯ There was no clearly superior chest tube diameter size; both chest tube sizes demonstrated risks and benefits. Clinicians must be aware of these potential tradeoffs when deciding on the diameter of chest tube for the treatment of delayed HTXs.
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Scand J Trauma Resus · Jun 2020
ReviewStrategies to measure and improve emergency department performance: a scoping review.
Over the last two decades, Emergency Department (ED) crowding has become an increasingly common occurrence worldwide. Crowding is a complex and challenging issue that affects EDs' capacity to provide safe, timely and quality care. This review aims to map the research evidence provided by reviews to improve ED performance. ⋯ ED performance measurement is complex, involving automated information technology mechanisms and manual data collection, reflecting the multifaceted nature of ED care. Interventions to improve ED performance address a broad range of ED processes and disciplines.
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Scand J Trauma Resus · Jun 2020
Clinical experience of whole-body computed tomography as the initial evaluation tool after extracorporeal cardiopulmonary resuscitation in patients of out-of-hospital cardiac arrest.
The routine application of whole-body CT after extracorporeal cardiopulmonary resuscitation (ECPR) in out-of-hospital cardiac arrest (OHCA) has not been extensively investigated. We aimed to evaluate the benefit of CT in this context. ⋯ Routine whole-body CT after ECPR in OHCA patients appears to have a limited role, as the majority is caused by ACS. However, it may be a useful tool when CPR-related injury or non-ACS causes of OHCA are suspected, as well as in cases where the cause of OHCA is unknown. On the contrary, routine brain CT may be a valuable tool in guiding anticoagulant therapy during ECMO and in aiding outcome prediction.
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Scand J Trauma Resus · Jun 2020
Self-rated worry is associated with hospital admission in out-of-hours telephone triage - a prospective cohort study.
Telephone triage manages patient flow in acute care, but a lack of visual cues and vague descriptions of symptoms challenges clinical decision making. We aim to investigate the association between the caller's subjective perception of illness severity expressed as "degree-of-worry" (DOW) and hospital admissions within 48 h. ⋯ Patients' self-assessment of illness severity as DOW was associated with subsequent hospital admission. Further, it may be beneficial in supporting clinical decision making in telephone triage. Finally, it might be useful as a measure to facilitate patient participation in the triage process.