Scand J Trauma Resus
-
Scand J Trauma Resus · Apr 2024
Development of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care.
Emergency Medical Services (EMS) are a unique setting because care for the chief complaint is given across all ages in a complex and high-risk environment that may pose a threat to patient safety. Traditionally, a reporting system is commonly used to raise awareness of adverse events (AEs); however, it could fail to detect an AE. Several methods are needed to evaluate patient safety in EMS. In this light, this study was conducted to (1) develop a national ambulance trigger tool (ATT) with a guide containing descriptions of triggers, examples of use, and categorization of near misses (NMs), no harm incidents (NHIs), and harmful incidents (HIs) and (2) use the ATT on randomly selected ambulance records. ⋯ This study shows that a trigger tool together with a retrospective record review can be used as a method to measure the frequency of harmful incidents, no harm incidents, and near misses in the EMS, thus complementing the traditional reporting system to realize increased patient safety.
-
In the European Union alone, more than 100 million people present to the emergency department (ED) each year, and this has increased steadily year-on-year by 2-3%. Better patient management decisions have the potential to reduce ED crowding, the number of diagnostic tests, the use of inpatient beds, and healthcare costs. ⋯ The SEM cohort provides a platform for CDSS research, and we welcome collaboration. In addition, SEM's large amount of real-world patient data with almost complete short-term follow-up will allow research in epidemiology, patient management, diagnostics, prognostics, ED crowding, resource allocation, and social medicine.
-
Scand J Trauma Resus · Apr 2024
A retrospective analysis of mission reports in the national Swedish Police Registry on mountain rescue 2018-2022: here be snowmobiles.
Increasing mountain activity and decreasing participant preparedness, as well as climate change, suggest needs to tailor mountain rescue. In Sweden, previous medical research of these services are lacking. The aim of the study is to describe Swedish mountain rescue missions as a basis for future studies, public education, resource allocation, and rescuer training. ⋯ These baseline data suggest snowmobiling, cardiac events, drownings, multi-casualty incidents, and backcountry internal medicine merit future study and intervention.
-
Scand J Trauma Resus · Apr 2024
Randomized Controlled TrialEffect of a vapor barrier in combination with active external rewarming for cold-stressed patients in a prehospital setting: a randomized, crossover field study.
Use of a vapor barrier in the prehospital care of cold-stressed or hypothermic patients aims to reduce evaporative heat loss and accelerate rewarming. The application of a vapor barrier is recommended in various guidelines, along with both insulating and wind/waterproof layers and an active external rewarming device; however, evidence of its effect is limited. This study aimed to investigate the effect of using a vapor barrier as the inner layer in the recommended "burrito" model for wrapping hypothermic patients in the field. ⋯ The use of a vapor barrier as the innermost layer in combination with an active external heat source leads to higher mean skin rewarming rates in patients wearing wet clothing who are at risk of accidental hypothermia.
-
Scand J Trauma Resus · Apr 2024
ReviewPrevalence of airway patency and air pocket in critically buried avalanche victims - a scoping review.
Survival of critically buried avalanche victims is directly dependent on the patency of the airway and the victims' ability to breathe. While guidelines and avalanche research have consistently emphasized on the importance of airway patency, there is a notable lack of evidence regarding its prevalence. ⋯ The present study found that in critically buried avalanche victims patent airways were more than three times more prevalent than obstructed, with the airway status reported only in half of the cases. This high rate of airway patency supports the ongoing development and the effectiveness of avalanche rescue systems which oppose asphyxiation in critically buried avalanche victims. Further effort should be done to improve the documentation of airway patency and the presence of an air pocket in avalanche victims and to identify factors affecting the rate of airway obstruction.