Scand J Trauma Resus
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Scand J Trauma Resus · Dec 2017
Therapeutic hypothermia in patients with coagulopathy following severe traumatic brain injury.
Coagulopathy in traumatic brain injury (TBI) has been associated with poor neurological outcomes and higher in-hospital mortality. In general principle of trauma management, hypothermia should be prevented as it directly worsens coagulopathy. Therefore, we examined the safety of mild therapeutic hypothermia (MTH) in patients with coagulopathy following severe TBI. ⋯ Our study suggests that in comparison to control, MTH does not worsen the outcome of patients with coagulopathy following severe TBI.
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Scand J Trauma Resus · Dec 2017
Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services.
Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS). A second objective was to identify any occupational hearing loss amongst prehospital personnel. ⋯ We found that the exposure levels exceeded the recommendations described in the European Regulative for Noise, which requires further protective initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.
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Scand J Trauma Resus · Dec 2017
Impact of systolic blood pressure limits on the diagnostic value of triage algorithms.
Major incidents are characterized by a lack of resources compared to an overwhelming number of casualties, requiring a prioritization of medical treatment. Triage algorithms are an essential tool for prioritizing the urgency of treatment for patients, but the evidence to support one over another is very limited. We determined the influence of blood pressure limits on the diagnostic value of triage algorithms, considering if pulse should be palpated centrally or peripherally. ⋯ As a consequence, it might be important in which location pulses are palpated according to the algorithm at hand during triage of patients.
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Scand J Trauma Resus · Dec 2017
Comment LetterPre-hospital advanced airway management in children: a challenge that training can handle.
We respond to the Tarpgaard et al. article reporting on pre-hospital endotracheal intubation (PHETI) success and complications by Danish critical care teams including critical care anaesthetists. We compare the authors' results with previously published results from our service's experience with PHETI in a similar patient population, also with physician and paramedic medical teams. ⋯ A recently published study of 82 patients that we completed revealed the following results: 100, 91 and 14%, respectively. We propose training and operating protocols we believe contribute to this relative success in paediatric PHETI.
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Scand J Trauma Resus · Nov 2017
Observational StudyThe effect on the patient flow in local health care services after closing a suburban primary care emergency department: a controlled longitudinal follow-up study.
It has not been studied what happens to patient flow to EDs and other parts of local health care system if distances to ED services are manipulated as a part of health policy in urban areas. ⋯ Manipulating distances to ED services can be used to direct patient flows to different parts of the health care system. The correlation between distance to ED and the tendency to use ED by inhabitants is negative. If secondary care ED was available there were no life-threatening side-effects at the level of general public health when a minor ED was closed in a primary care ED system.