Scand J Trauma Resus
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Scand J Trauma Resus · Jun 2021
Protocol for a cohort study of the impact of the COVID-19 pandemic on the rate and incidence of bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest.
Survival after out-of-hospital cardiac arrest (OHCA) is dependent on early recognition, early cardiopulmonary resuscitation (CPR) and early defibrillation. The purpose of CPR is to maintain some blood flow until the arrival of the emergency medical services (EMS). Our concern is that the COVID-19 pandemic has had a negative effect on the number of patients who get CPR before EMS arrival. The aim of this study is to compare the incidence of bystander CPR during the pandemic with data from before the pandemic. ⋯ This study does not present the prospect of direct benefit to the patient, but does provide an opportunity to gain a better understanding of the epidemiology of bystander CPR for OHCA patients during a pandemic. By comparing data during the pandemic with already collected information in established registries we believe we can gain valuable information about changes in public response to out-of-hospital cardiac arrest.
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Scand J Trauma Resus · Jun 2021
The ROX index as a predictor of standard oxygen therapy outcomes in thoracic trauma.
Thoracic trauma is commonplace and accounts for 50-70% of the injuries found in severe trauma. Little information is available in the literature as to timing of endotracheal intubation. The main objective of this study was to assess the accuracy of the ROX index in predicting successful standard oxygen (SO) therapy outcomes, and in pre-empting intubation. ⋯ We have shown that a ROX index greater than 12.85 at 24 h was linked to successful standard oxygen therapy outcomes in critical thoracic trauma patients. It is our belief that an early low ROX index in the initial phase of trauma should heighten vigilance on the part of the attending intensivist, who has a duty to optimize management.
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Scand J Trauma Resus · Jun 2021
Penetrating injuries in Germany - epidemiology, management and outcome an analysis based on the TraumaRegister DGU®.
The management of penetrating wounds is a rare challenge for trauma surgeons in Germany and Central Europe as a result of the low incidence of this type of trauma. In Germany, penetrating injuries are reported to occur in 4-5 % of the severely injured patients who are enrolled in the TraumaRegister DGU® (trauma registry of the German Trauma Society). They include gunshot injuries, knife stab injuries, which are far more common, and penetrating injuries of other origin, for example trauma caused by accidents. The objective of this study was to assess the epidemiology and outcome of penetrating injuries in Germany, with a particular focus on the level of care provided by the treating trauma centre to gain more understanding of this trauma mechanism and to anticipate the necessary steps in the initial treatment. ⋯ In Germany, gunshot and stab wounds have a low incidence and are mostly caused by violent crime or attempted suicides. Depending on the site of injury, they have a high mortality and are often associated with major haemorrhage. As a result of the low incidence of these types of trauma, further data and analyses are required in order to provide the basis for evaluating the long-term quality of the management of patients with stab or gunshot wounds.
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Scand J Trauma Resus · Jun 2021
Standardized post-resuscitation damage assessment of two mechanical chest compression devices: a prospective randomized large animal trial.
Mechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances. Current devices lack prospective and comparative data on their specific cardiovascular effects and potential for severe thoracic injuries. ⋯ The LUCAS 2 device shows superior resuscitation outcomes and less thoracic injuries compared to Corpuls cpr when used for experimental CPR in juvenile pigs. Researchers should be aware that different mCCDs for experimental studies may significantly influence the respective outcome of resuscitation studies and affect comparability of different trials. Controlled human and animal CPR studies and a standardised post-resuscitation injury evaluation could help to confirm potential hazards.
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Scand J Trauma Resus · Jun 2021
Letter ReviewPrioritizing health care workers and first responders for access to the COVID19 vaccine is not unethical, but both fair and effective - an ethical analysis.
The Nordic countries have differed in their approach as to how much priority for COVID19 vaccine access should be given to health care workers. Two countries decided not to give health care workers highest priority, raising some controversy. ⋯ Likewise, when considering whether to prioritize health care workers for the vaccine, their crucial role in keeping the health care system operational, and right to a safe work environment need to be factored in. Below we review several ethical arguments for why frontline health care workers and first responders should receive priority access to the COVID19 vaccine.