Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Ensuring free passage of air is the first priority in emergency care of patients. Removing obstruction to softtissue, dislodging obstructing foreign bodies and positioning the patient correctly usually secure open airways and respiration in trauma patients. ⋯ Correct control of airways may reduce morbidity and mortality. The author discusses the practical aspects of control of airways and unobstructed respiration.
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Tidsskr. Nor. Laegeforen. · Feb 1992
[Treatment at the site of the accident and transport of patients with multiple injuries].
In the event of an accident it is the responsibility of the public health service to attempt to save lives, and to reduce pain and permanent disability. This is done by a complex chain of actions by persons ranging from the provider of first aid to the rehabilitation team. ⋯ Paramedics, primary care doctors and specialized emergency care teams are all important collaborators in this field. The specific decisions that are made at the various stages of treating a patient with multiple injuries will always be of fundamental importance for the patient.
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Tidsskr. Nor. Laegeforen. · Feb 1992
Comparative Study[Emergency helicopters--health services in the grey zone? Description of a one-year activity in Troms].
In 1988 a nation-wide aeromedical emergency service (AES) (12 helicopters and five fixed wing aircraft) was introduced in Norway. An important objective was equity--to offer equal access to treatment for the same need irrespective of age and geographical location. In 1989 cardiovascular disease accounted for 34% of the 282 missions in the county of Troms in Northern Norway, but the use of the helicopters did not reflect the age-related increase in the incidence of this disease. ⋯ We believe that the key determinant of the use of helicopters may be varying attitudes among the doctors to the use of AES. The findings indicate that AES does not meet the objective of equity. Stricter medical guidelines for use of AES are called for.
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Tidsskr. Nor. Laegeforen. · Feb 1992
Comparative Study[Emergency helicopters and transport of patients with acute myocardial infarction].
In order to assess the effectiveness of an emergency helicopter in a rural area of Norway we compared all patients with acute myocardial infarction who were transported by helicopter (N = 29) in 1989 with a group of patients transported by ground ambulance (N = 58). There was no difference in terms of distance to hospital or short-term course of the disease (complications or death by seven days after onset of infarction). It seems that the general practitioners had very different practices when choosing between ground and air transport for patients with acute myocardial infarction.
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Mortality from severe multitrauma is 25-30%. Haemorrhage is the cause of one third of the deaths, either directly or indirectly as the cause of organ failure. Many trauma victims will not present alarming symptoms shortly after the accident. ⋯ Due to risk of overlooking injuries, patients should not be sorted by surgical specialty in the field. Obstructed airways are more acutely life-threatening than inadequate respiration, which is more serious than decreased circulation, which is again more dangerous than impaired consciousness. In general, thoracic injuries take priority over abdominal, cerebral and orthopaedic injuries, in that order.