Scand J Trauma Resus
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Scand J Trauma Resus · Nov 2024
Predictors of care home resident conveyance to hospital or referral to community pathways by a regional ambulance service attending medical emergencies: a retrospective cross sectional study.
Care home residents are at higher risk compared with community dwelling elders for medical emergencies, often resulting in ambulance attendance and conveyance to hospital. We aimed to determine the factors predicting care home resident conveyance to hospital or referral to community pathways by an ambulance service. ⋯ Various factors significantly predicted conveyance of care home residents to hospital by ambulance. These included HCP referral and a higher NEWS2 score confirming that severity of clinical condition of the patient significantly increased conveyance. Future interventions to prevent or address certain conditions such as falls or provide enhanced care in care homes may prevent some emergencies or reduce the likelihood of conveyance to hospital.
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Scand J Trauma Resus · Nov 2024
Trauma team activation and triage of severely injured patients at one non-trauma-center hospital in Stockholm.
In 2017 the Swedish public insurance company Löf published national guidelines for in-hospital trauma team activation (TTA), which are now widely adopted in Sweden. No studies have examined triage accuracy at non-trauma-center hospitals in the Stockholm trauma system since the implementation of the new TTA criteria. ⋯ Undertriage of severely injured trauma patients was 98% according to the definition specified by Swedish trauma triage guidelines, higher than reasonably acceptable. There is considerable overtriage with non-severely injured patients prompting TTA. However, the suitability of using NISS > 15 to retrospectively define the need for TTA is debatable as this does not always correlate with the fulfillment of the TTA criteria. Further investigation of adherence to trauma triage guidelines in clinical practice may be of value to improve triage accuracy in organized regional trauma systems.
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Scand J Trauma Resus · Nov 2024
Characteristics of helicopter hoist operations with intubated patients: a retrospective analysis of a Norwegian physician staffed SAR helicopter service.
Timely medical management and evacuation of critically ill or injured patients from austere environments or maritime vessels is often achieved by helicopter hoist operations. When indicated, intubation is performed onsite to restore and sustain patient physiology and to facilitate safe transport. We aimed to describe the characteristics of helicopter hoist operations (HHOs) with intubated patients in a physician staffed SAR helicopter service and to identify learning points for future missions. ⋯ HHOs with intubated patients are rare but increasingly occurring events in our service. Owing to the infrequency, complexity and risk factors involved, these operations should be governed by specific operating procedures and trained regularly to be performed safely. HHOs with intubated patients represents a favourable alternative in situations where terrestrial transport is associated with significant time delay or additional risk to the patient or the rescuers.
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Scand J Trauma Resus · Nov 2024
Randomized Controlled TrialA randomized clinical trial of intranasal dexmedetomidine versus inhaled nitrous oxide for procedural sedation and analgesia in children.
Procedural sedation and analgesia is an important part of pediatric emergency care, safe and clinically useful alternatives for adequate management are necessary. The objective of this clinical trial was to evaluate the non-inferiority of intranasal dexmedetomidine to nitrous oxide with respect to analgesia for a painful procedure in children 3-15 years of age. ⋯ The results of this trial support that intranasal dexmedetomidine is not inferior to 50% nitrous oxide in providing analgesia for a painful procedure in children 3-15 years of age and can be considered as an alternative to 50% nitrous oxide for procedural sedation and analgesia.