Scand J Trauma Resus
-
Scand J Trauma Resus · Oct 2015
Diversity in clinical management and protocols for the treatment of major bleeding trauma patients across European level I Trauma Centres.
Uncontrolled haemorrhage is still the leading cause of preventable death after trauma and the primary focus of any treatment strategy should be related to early detection and control of blood loss including haemostasis. ⋯ Diversity in the management of bleeding trauma patients such as pre-hospital blood administration and routinely performed viscoelastic tests exists even among level I trauma centres. The paucity of consensus among these centres highlights the need for further primary research followed by clinical trials to improve the evidence for sophisticated guidelines and strategies.
-
Scand J Trauma Resus · Sep 2015
Comparative Study Observational StudyThe impact of environmental factors in pre-hospital thermistor-based tympanic temperature measurement: a pilot field study.
Few pre-hospital services have the possibility to accurately measure core temperature (T core). Non-invasive estimation of T core will improve pre-hospital decision-making regarding the triage and management of hypothermic patients. Thermistor-based tympanic temperature (T tymp) correlates well with T core in controlled studies; however, little is known about the feasibility of using T tymp under field conditions. This study assessed the impact of pre-hospital environmental factors on the accuracy of T tymp . Deep rectal temperature (T rect) was used as a substitute for T core . ⋯ After surface cooling of head and neck, T tymp did not accurately reflect core temperature within the first 10 min of measurement. The variation of ∆T rect-tymp was low after 10 min, regardless of the initial degree of cooling. With the risk of over-triage, T tymp may at this point provide an indication of T core and also exhibit a trend.
-
Scand J Trauma Resus · Sep 2015
Multicenter Study Comparative Study Observational StudyThe accuracy and timeliness of a Point Of Care lactate measurement in patients with Sepsis.
The aims of this study were to a) compare the lactate measurement of a Point of Care (POC) handheld device to near patient blood gas analysers, and b) determine the differential reporting times between the analysers. ⋯ The POC handheld device produced accurate, efficient and timely lactate measurements with the potential to influence clinical decision making sooner.
-
Scand J Trauma Resus · Sep 2015
Development and validation of a score to identify in the Emergency Department patients who may benefit from a time-critical intervention: a cohort study.
Risk stratification methods developed on the basis of predicting illness severity are often used to prioritise patients on the basis of urgency. Illness severity and urgency may not be interchangeable. Severe illness places patients at risk of adverse outcome, but treatment is only urgent if adverse outcome can be prevented by time-sensitive treatment. We aimed to develop a score to identify patients in need of urgent treatment, on the basis of potential to benefit from time-sensitive intervention, and to compare this with a severity score identifying patients at high risk of death. ⋯ A score developed to predict the need for urgent treatment has a different composition to a score developed to predict illness severity, suggesting that triage methods based on predicting severity could lead to inappropriate prioritisation on the intended basis of urgency.
-
Scand J Trauma Resus · Aug 2015
Multicenter Study Comparative StudyPost resuscitation care of out-of-hospital cardiac arrest patients in the Nordic countries: a questionnaire study.
Aim of this study was to compare post resuscitation care of out-of-hospital cardiac arrest (OHCA) patients in Nordic (Denmark, Finland, Iceland, Norway, Sweden) intensive care units (ICUs). ⋯ Since 2012, TTM at 36 °C has been implemented in some ICUs, but TTM at 33 °C is used in majority of the ICUs. TTM at 33 or 36 °C and primary CAG are not routinely provided for all OHCA survivors and the criteria for these and ICU admission are variable. Best practices as a uniform approach to the optimal care of the resuscitated patient should be sought in the Nordic Countries.