Scand J Trauma Resus
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Scand J Trauma Resus · Dec 2024
Observational StudyHelicopter emergency medical services demonstrate reduced time to emergency anaesthesia in an undifferentiated trauma population: a retrospective observational analysis across three major trauma networks.
Early rapid sequence induction of anaesthesia (RSI) and tracheal intubation for patients with airway or ventilatory compromise following major trauma is recommended, with guidance suggesting a 45-min timeframe. Whilst on-scene RSI is recommended, the potential time benefit offered by Helicopter Emergency Medical Services (HEMS) has not been studied. We compared the time from 999/112 emergency call to delivery of RSI between patients intubated either in the Emergency Department or pre-hospital by HEMS. ⋯ Major trauma patients who had a pre-hospital RSI received this time-critical intervention sooner after their injury than those who received an emergency anaesthetic after conveyance to a specialist hospital. Patient outcome benefit of HEMS delivered early RSI should be explored.
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Scand J Trauma Resus · Dec 2024
ReviewThe use and impact of prehospital blood lactate measurements in acute non-traumatic patients: a systematic review.
The prehospital use of blood lactate measurements is increasing. However, the test's benefits have not been methodically evaluated in non-trauma patients. This study had three aims: (1) To assess the evidence of prehospital blood lactate measurements' prognostic value in non-trauma patients, (2) to investigate to what extent the test changed early patient treatment, and (3) to evaluate the healthcare personnel's attitude towards the test. ⋯ Most acute non-trauma patients with elevated prehospital lactate levels had increased risks of short-term mortality, except OHCA patients. Few studies suggested that measuring prehospital lactate levels could change early patient care, particularly in patients with suspected sepsis. The certainty of the evidence is low in this systematic review. The included studies were heterogeneous, and many had high risks of bias. Further studies are needed to investigate the impact of prehospital lactate measurements on patient care.
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Scand J Trauma Resus · Dec 2024
The extent of physical and psychological workplace violence experienced by prehospital personnel in Denmark: a survey.
Workplace violence against healthcare workers has been a well-known problem for more than 40 years. This problem is also relevant for prehospital personnel who are at risk of physical and/or psychological violence during work. Violence and threats of violence can have physical and psychological consequences, including personal challenges in their everyday life, use of sick days, reports, and the need for professional help. Therefore, this study aimed to describe the extent of and subsequent reporting of physical and psychological workplace violence toward the prehospital healthcare workers in Denmark in a two-year period. Moreover, we wanted to elucidate any possible effect of workplace violence on the private and professional lives of the prehospital healthcare personnel. ⋯ We suggest that the prehospital organisations emphasise reporting future episodes of physical and/or psychological violence. Knowing the extent of the problem is a prerequisite for addressing, debriefing, and/or other psychological follow-up.
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Scand J Trauma Resus · Dec 2024
Conventional versus task-based package organization for out-of-hospital emergency kits: an emergency medical services simulation study.
Emergency Medical Service crews are equipped with comprehensive emergency kits for routine care and to provide life-saving interventions in severely ill patients. While guidelines on contents and packing strategies of emergency kits for specific tasks and specialized situations exist, data for the design of out-of-hospital emergency kits in a general urban population is lacking. It may be possible to transfer the promising results of modern in-hospital packing strategies such as task-based package organization (TPO) to an Emergency Medical Service setting. ⋯ TPO has been previously investigated in an in-hospital setting using participants with low exposure to medical emergencies, and with promising results. In our prehospital simulation setting with paramedics, equipment retrieval was neither faster nor more complete compared to non-TPO kits.