Scand J Trauma Resus
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Scand J Trauma Resus · Sep 2011
A national survey on temporary and delayed abdominal closure in Norwegian hospitals.
Temporary abdominal closure (TAC) is included in most published damage control (DC) and abdominal compartment (ACS) protocols. TAC is associated with a range of complications and the optimal method remains to be defined. The aim of the present study was to describe the experience regarding TAC after trauma and ACS in all acute care hospitals in a sparsely populated country with long transportation distances. ⋯ This study shows that most Norwegian hospitals have limited experience with TAC and ACS. However, the long distances between hospitals mandate all acute care hospitals to implement formal treatment protocols including monitoring of IAP, diagnosing and decompression of ACS, and the use of TAC. Assuming experience leads to better care, the subsequent treatment of these patients might benefit from centralization to one or a few regional centers.
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Scand J Trauma Resus · Sep 2011
The appropriateness of single page of activation of the cardiac catheterization laboratory by emergency physician for patients with suspected ST-segment elevation myocardial infarction: a cohort study.
The early use of reperfusion therapy has a significant effect on the prognosis of patients with ST-segment elevation myocardial infarction (STEMI), and it is recommended that emergency department (ED) physicians activate the cardiac catheterization laboratory (CCL) as soon as possible to treat these patients. The aim of this study was to examine the appropriateness of emergency physician activation of the CCL for patients with suspected STEMI. Inappropriate activations (i.e., false positive activations) were identified according to a variety of criteria. ⋯ CCL activation was appropriate for most patients and was unnecessary in a relatively small percentage of cases. This result supports the current recommendation for CCL activation by emergency physicians. Such early activation is a key strategy in the reduction of door-to-balloon time.
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Scand J Trauma Resus · Sep 2011
Comparative StudyUnderstanding of and adherence to advice after telephone counselling by nurse: a survey among callers to a primary emergency out-of-hours service in Norway.
To investigate how callers understand the information given by telephone by registered nurses in a casualty clinic, to what degree the advice was followed, and the final outcome of the condition for the patients. ⋯ Medical and communicative training must be an important part of the continuous improvement strategy within the out-of-hour services.
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Scand J Trauma Resus · Aug 2011
Comparative StudyAcute referral of patients from general practitioners: should the hospital doctor or a nurse receive the call?
Surprisingly little is known about the most efficient organization of admissions to an emergency hospital. It is important to know, who should be in front when the GP requests an acute admission. The aim of the study was to analyse how experienced ED nurses perform when assessing requests for admissions, compared with hospital physicians. ⋯ We found no differences in the frequency of admitted patients or unnecessary admissions, but the nurses redirected significantly more patients to the right hospital according to the catchment area, and used only half the time for the assessment. We find, that nurses, trained for the assignment, are able to handle referrals for emergency admissions, but also advise the subject to be explored in further studies including other assessment models and GP satisfaction.
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Scand J Trauma Resus · Jul 2011
ReviewA systematic review of triage-related interventions to improve patient flow in emergency departments.
Overcrowding in emergency departments is a worldwide problem. A systematic literature review was undertaken to scientifically explore which interventions improve patient flow in emergency departments. ⋯ Introducing fast track for patients with less severe symptoms results in shorter waiting time, shorter length of stay, and fewer patients leaving without being seen. Team triage, with a physician in the team, will probably result in shorter waiting time and shorter length of stay and most likely in fewer patients leaving without being seen. There is only limited scientific evidence that streaming of patients into different tracks, performing laboratory analysis in the emergency department or having nurses to request certain x-rays results in shorter waiting time and length of stay.