Scand J Trauma Resus
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Scand J Trauma Resus · Jul 2019
Fluid resuscitation with preventive peritoneal dialysis attenuates crush injury-related acute kidney injury and improves survival outcome.
In-hospital renal replacement therapy (RRT) is widely used for the treatments of acute kidney injury (AKI) in crush injury (CI) victims. This study was designed to investigate whether preventive peritoneal dialysis (PPD) is useful for renal protection in CI. ⋯ The use of PPD at the onset of compression release is beneficial for renal protection and survival outcome in a rabbit model of CI.
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Scand J Trauma Resus · Jul 2019
Derivation and internal validation of the screening to enhance prehospital identification of sepsis (SEPSIS) score in adults on arrival at the emergency department.
Prehospital recognition of sepsis may inform case management by ambulance clinicians, as well as inform transport decisions. The objective of this study was to develop a prehospital sepsis screening tool for use by ambulance clinicians. ⋯ This is the first screening tool developed to identify NICE high risk of severe illness or death from sepsis. The SEPSIS score is significantly associated with high risk of severe illness or death from sepsis on arrival at the Emergency Department. It may assist ambulance clinicians to identify those patients with sepsis in need of antibiotic therapy. However, it requires external validation, in clinical practice by ambulance clinicians, in an independent population.
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Scand J Trauma Resus · Jul 2019
Comparative StudyAccuracy of low-weight versus standard syringe infusion pump devices depending on altitude.
Intravenous drug infusions in critically ill patients require accurate syringe infusion pumps (SIPs). This is particularly important during transportation of critically ill patients by helicopter emergency medical services (HEMS), where altitude may influence device performance. Because weight is a real concern in HEMS, new low-weight devices are very appealing. The aim of this study was to compare infusion flow rates delivered by low-weight versus standard SIP devices, in the prehospital emergency medicine setting, at different altitudes. ⋯ Despite satisfactory normative tests, low-weight SIPs deliver discontinuous flow with potential clinical implications for critically ill patients receiving vasoactive drugs. This study also highlights a thus far unknown negative impact of altitude on SIP function. We believe that normative requirements for SIP approval should be revised accordingly.
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Scand J Trauma Resus · Jul 2019
Case ReportsRoad bike accidents involving cervical fractures presenting as cardiac arrest: a report of two cases.
We present two cases in which elderly male recreational cyclists suffered from cervical fractures and coinciding injuries of the spinal cord that subsequently led to cardiac arrest. Based on reports from eye witnesses and due to the low impact nature of the crashes, the two patients were initially considered as having cardiac arrest before falling of their bikes. The spinal cord injuries triggering cardiac arrest were acknowledged with delay, as the primary eliciting cause was considered cardiac disease in conjunction with all-out exercise. We suggest that increased focus should be made on possible cervical injuries even following low energy crashes in road cycling.
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Scand J Trauma Resus · Jul 2019
Defining a mission-based method to determine a HEMS unit's actual service area.
Geographical service areas are used as descriptive system indicators in Emergency Medical Service (EMS) related studies and reporting templates. The actual service area may differ significantly from administrative areas; this may lead to inaccuracy in determining indicator values, such as population or mission density, thus making it biased when comparing results between different areas and organizations. The aim of this study was to introduce a univocal, repeatable and easily adaptable method to determine the actual service area of a helicopter emergency medical service (HEMS) unit for statistical, quality measurement and research purposes using widely available geographical information (GIS) and statistical analysis tools. ⋯ Administrative areas do not correspond to the actual service areas of HEMS units. The service area of a HEMS unit defined by administrative boundaries may differ significantly from actual operations. Using historical mission data to create a convex hull that incorporates mission locations could offer a standardized and comparable solution for determining actual HEMS unit service areas, which can be used for statistical comparison, quality measurement and system development.