Scand J Trauma Resus
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Scand J Trauma Resus · Apr 2018
Primary mass casualty incident triage: evidence for the benefit of yearly brief re-training from a simulation study.
Triage is a mainstay of early mass casualty incident (MCI) management. Standardized triage protocols aim at providing valid and reproducible results and, thus, improve triage quality. To date, there is little data supporting the extent and content of training and re-training on using such triage protocols within the Emergency Medical Services (EMS). The study objective was to assess the decline in triage skills indicating a minimum time interval for re-training. In addition, the effect of a one-hour repeating lesson on triage quality was analyzed. ⋯ To improve disaster preparedness, triage skills should be refreshed yearly by a brief re-education of all EMS providers.
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Scand J Trauma Resus · Apr 2018
Simple modification of trauma mechanism alarm criteria published for the TraumaNetwork DGU® may significantly improve overtriage - a cross sectional study.
No consensus exists in the literature on the use of uniform emergency room trauma team activation criteria (ERTTAC). Today excessive over- or undertriage rates continue to be a challenge for most trauma centres. Application of ERTTAC, published for use in the German TraumaNetwork DGU®, at a Swiss trauma centre resulted in a high overtriage rate. The aim of the investigation was to analyse the ERTTAC in detail with the intention of possible improvement. ⋯ Application of ERTTAC as published for TraumaNetwork DGU® resulted in a lower undertriage but higher overtriage rate than recommended by the American College of Surgeons. Omitting the criterion 'passenger of car or truck' markedly improved overtriage with only a minimal increase in undertriage.
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Scand J Trauma Resus · Apr 2018
Haemodynamic outcomes during piston-based mechanical CPR with or without active decompression in a porcine model of cardiac arrest.
Experimental active compression-decompression (ACD) CPR is associated with increased haemodynamic outcomes compared to standard mechanical chest compressions. Since no clinically available mechanical chest compression device is capable of ACD-CPR, we modified the LUCAS 2 (Physio-Control, Lund, Sweden) to deliver ACD-CPR, hypothesising it would improve haemodynamic outcomes compared with standard LUCAS CPR on pigs with cardiac arrest. ⋯ Cardiac output and brain blood flow improved with mechanical ACD-CPR and CPP trended towards higher during end-diastole compared to standard LUCAS CPR.
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Scand J Trauma Resus · Apr 2018
Traumatic cardiac arrest in Sweden 1990-2016 - a population-based national cohort study.
Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to describe characteristics and 30-day survival following a TCA as compared with a medical out-of-hospital cardiac arrest (medical CA). ⋯ In a medical CA registry like ours, prevalence of TCAs is low and survival is poor. Registries like ours might not capture the true incidence. However, many individuals do survive and resuscitation in TCAs should not be seen futile.
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Scand J Trauma Resus · Apr 2018
Risk factors associated with short term mortality changes over time, after arrival to the emergency department.
Preventing death is the most important outcome pursued in the Emergency Department. Prompt accurate assessment, followed by competent and efficient investigation and treatment is the recipe sought. Abnormal physiological measurements are common antecedents to deterioration and therefore a cornerstone in many risk stratification tools. Some risk factors have their impact during the first few days after admittance, others have higher impact on 30 day mortality. Understanding the variance in impact of risk factors is relevant for future composition of risk stratification models. ⋯ The over-all 30-day mortality was 4%. Physiology-related risk factors varied in strength of association throughout different mortality outcome measures.