Scand J Trauma Resus
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Scand J Trauma Resus · Jul 2014
How do bacteraemic patients present to the emergency department and what is the diagnostic validity of the clinical parameters; temperature, C-reactive protein and systemic inflammatory response syndrome?
Although blood cultures are often ordered based on the presence of fever, it is a clinical challenge to identify patients eligible for blood cultures. Our aim was to evaluate the diagnostic value of temperature, C-reactive-protein (CRP), and Systemic Inflammatory Response Syndrome (SIRS) to identify bacteraemic patients in the Medical Emergency Department (MED). ⋯ One third of the acute medical bacteraemic patients had a normal temperature at arrival to the MED. A normal temperature combined with a CRP < 100 mg/L and no SIRS criteria, ruled out bacteraemia.
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Scand J Trauma Resus · Jun 2014
Multicenter StudyEvaluation of clinical efficacy and safety of cervical trauma collars: differences in immobilization, effect on jugular venous pressure and patient comfort.
Concern has been raised that cervical collars may increase intracranial pressure in traumatic brain injury. The purpose of this study was to compare four types of cervical collars regarding efficacy of immobilizing the neck, effect on jugular venous pressure (JVP), as a surrogate for possible effect on intracranial pressure, and patient comfort in healthy volunteers. ⋯ Stifneck and Miami J collars offered the most efficient immobilization of the neck with the least effect on JVP. Vista and Miami J were the most comfortable ones. The methodology used in this study may offer a new approach to evaluate clinical efficacy and safety of neck collars and aid their continued development.
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Scand J Trauma Resus · May 2014
Editorial ReviewQuality improvement in pre-hospital critical care: increased value through research and publication.
Pre-hospital critical care is considered to be a complex intervention with a weak evidence base. In quality improvement literature, the value equation has been used to depict the inevitable relationship between resources expenditure and quality. ⋯ A QI system for pre-hospital critical care includes leadership involvement, multi-disciplinary buy-in, data collection infrastructure and long-term commitment. Further, integrating process control with governance systems allows evidence-based change of practice and publishing of results.
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Scand J Trauma Resus · May 2014
Full-text publication of abstracts in emergency medicine in Denmark.
Abstracts presented at medical conferences or scientific meetings should ideally be published as full-text articles in peer-reviewed journals after initial presentation and feedback regardless of the findings. The aim of this survey was to determine the publication rate of papers presented at the Danish Emergency Medicine Conferences in 2009, 2010 and 2011. ⋯ When comparing full-text publication rates from DEMC to previous international studies in EM Danish EM research community has similar publication rates. However, other more established specialties have higher publication levels. Knowledge of reasons for non-publication could lead to efforts to promote publication like funding; the possibility of discussion between authors and editors at conferences; "publication mentors"; and/or research courses provided by the Danish Society of Emergency Medicine.
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Scand J Trauma Resus · Apr 2014
Symptoms and signs in interpreting Gamma-hydroxybutyrate (GHB) intoxication - an explorative study.
Acute poisoning with gamma-hydroxybutyrate (GHB) has been a serious medical and social problem in different parts of the world including Sweden. GHB is a drug of abuse which acts primarily as central nervous system (CNS) depressants. GHB has serious toxicity, although many young users do not recognise GHB as a dangerous drug. The aim of this pilot study was to explore how symptoms with risk of failure in vital functions would be valued among professionals that encounter GHB intoxication in the emergency phase. ⋯ Despite the professionals' different levels of training in GHB intoxication, all of them were relatively well aware of and in accordance regarding the most risky symptoms. The interpretation score for the less risky symptoms and signs of GHB intoxication varied depending on their degree of training. The results should be viewed cautiously, as the size of the professional groups and their general knowledge of critical symptoms of GHB poisoning varied.