Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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The 14 anaesthesiologist-manned ambulance helicopters in Norway are administratively placed under the head of the nearest anaesthetic department. Routines for quality assurance vary considerably. In 1995, a total of 6,850 patients were treated by air ambulance anaesthesiologists. ⋯ A review of all 162 medical records for one year at one air ambulance base indicates that a thorough review of one third of all records would identify all major areas of improvement. The selection of records has to be based on local experience concerning both patients and personnel. When areas of improvement are identified, the quality assurance process can be simplified without increasing the risk of not addressing serious problems.
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Tidsskr. Nor. Laegeforen. · Oct 1999
[Specialized positions, time allocation and clinical research at the Haukeland hospital].
An aim for Norwegian health care is to improve clinical medical research. Special positions for junior doctors are designated for research, quality control projects or subspecialization. In addition, four hours per week for all doctors at Haukeland University Hospital have recently been allocated to theoretical study. ⋯ There was general agreement that other aspects of department organisation was more important for promotion of research. Clinical research positions for junior doctors should be used for research, but even in an ambitious university hospital they are not fully used for such work. Most of the department heads have a clear ambition to improve the conditions for research in their departments.
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Since January 1996, mammography screening every second year has been offered to women aged 50 to 69 in four counties in Norway. As an input to the evaluation of the programme, medical authorities commissioned an analysis of the cost-efficacy of screening. The results are presented in this paper. ⋯ Using an estimate of a 40% higher costs nation-wide, we find that the total cost of one year of nation-wide (population 4.5 m) screening would amount to NOK 83 m, cost per life saved to NOK 950,000, and per year-of-life saved to NOK 41,000. Estimated cost per life saved by traffic safety measures has been NOK 10 m. On this basis, mammography screening in Norway seems to be a highly cost-effective measure.
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Tidsskr. Nor. Laegeforen. · Oct 1999
[Ultrasound guidance for placement of central venous catheters].
Central venous cannulation is associated with a number of serious complications like arterial punction and pneumothorax and with discomfort for the awake patient when repeated attempts are made. Ultrasound guidance during cannulation has been shown to reduce complications, increase the success rate and thus reduce the need for multiple catheter placement attempts. We describe two methods using ultrasound for central venous cannulation and we recommend the use of ultrasound guidance, particularly in high-risk patients.