Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Racing against time: Emergency ambulance dispatches and response times, a register-based study in Region Zealand, Denmark, 2013-2022.","authors":"Josefine Tangen Jensen, Thea Palsgaard Møller, Stig Nikolaj Fasmer Blomberg, Annette Kjær Ersbøll, Helle Collatz Christensen","doi":"10.1186/s13049-024-01284-0","DOIUrl":"10.1186/s13049-024-01284-0","url":null,"abstract":"<p><strong>Background: </strong>The global strain on Emergency Medical Services (EMS) is reflected in the increasing number of emergency ambulance dispatches. Shorter EMS response times have demonstrated some effect on very specific and rare conditions. It is unknown if the increased number of ambulance dispatches compromises response times. This study aimed to describe trends in emergency ambulance dispatches and response times from 2013 to 2022 in Region Zealand, Denmark. Additionally, it aimed to outline the demographic profile of emergency ambulance patients, including age and comorbidities.</p><p><strong>Methods: </strong>Using administrative data from the Region Zealand emergency medical dispatch center, a register-based study spanning from January 1, 2013, to December 31, 2022, was conducted. Data were linked with nationwide registries and priority A (emergency), or B (urgent) ambulance dispatches were included. Trends were examined overall and stratified by catchment areas corresponding to the hospitals with emergency departments in the region. Poisson and ordinal logistic regressions were used to analyze data.</p><p><strong>Results: </strong>The study encompassed 678,789 emergency ambulance dispatches, with 55.0% priority A and 45.0% priority B. Among these, 667,788 had a valid personal identification number allowing for further analysis. Within the study population, females comprised 48.5%, while 49.1% of patients were 65 years or more. Overall, 47.5% of patients had no comorbidities, while 7.7% and 44.8% had mild and severe comorbidities, respectively. Emergency ambulance dispatches increased from 56,867 in 2013 to 81,080 in 2022 (143%). Correspondingly, the dispatch incidence rate per 1,000 residents per year increased from 69.2 to 95.5. Stratification by catchment areas revealed significant disparities. The median response time for priority A dispatches increased from 7 min:14 s in 2013 to 8 min:20 s in 2022 and for priority B dispatches from 12 min:23 s to 15 min:6 s.</p><p><strong>Conclusions: </strong>From 2013 to 2022, emergency ambulance dispatches both priorities A and B increased in absolute numbers and per 1000 residents per year. Ambulance response times also increased for both priorities during the study period. The study shows regional disparities regarding to the rate of emergency ambulance dispatches and response times indicating challenges in resource distribution in the future for maintaining emergency care standards.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-energy, high risk: unveiling the undertriage crisis in geriatric trauma.","authors":"Adem Az","doi":"10.1186/s13049-024-01285-z","DOIUrl":"10.1186/s13049-024-01285-z","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-hospital care for children: a descriptive study from Central Norway.","authors":"Martine Myhre, Lars Eide Næss, Eirik Skogvoll, Helge Haugland","doi":"10.1186/s13049-024-01279-x","DOIUrl":"10.1186/s13049-024-01279-x","url":null,"abstract":"<p><strong>Background: </strong>Pre-hospital incidents involving pediatric and neonatal patients are infrequent, and clinical characteristics and care for these patients differ from the adult population. Lack of knowledge, guidelines, and experience can make pre-hospital pediatric care challenging, and there is limited research on the epidemiology and best practice of care for this population. We examined the pre-hospital pediatric population in the county of Sør-Trøndelag, Norway, to improve our understanding of this population in our region.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study of emergency incidents involving children under twelve years of age with dispatch of Emergency Medical Services (EMS) in Sør-Trøndelag between 2018 and 2022. Incidents and patient characteristics were extracted from the Emergency Medical Communication Center (EMCC) database. In addition, data on patient characteristics and interventions for more serious incidents seen by the Helicopter Emergency Medical Service (HEMS) were included from the database LABAS. We provided descriptive statistics and estimated population incidences using Poisson regression.</p><p><strong>Results: </strong>The catchment area of EMCC Sør-Trøndelag has a population of approximately 43,000 children under the age of twelve years. During the five-year study period, there were 7005 emergency calls concerning this patient population, representing 6% of all emergency calls (total no. 108,717). Of these, 3500 (50%) resulted in the dispatch of an ambulance and/or HEMS, yielding an annual incidence of EMS dispatches of 17 per 1000 children. The three most common primary medical problems were respiratory distress, altered consciousness, and trauma. Among the 309 HEMS patients, 131 (42%) received advanced interventions from the HEMS physician. Assisted ventilation was the most frequent intervention.</p><p><strong>Conclusions: </strong>Pediatric and neonatal patients make up a small proportion of pre-hospital patient dispatches in Sør-Trøndelag. Consequently, each EMS provider infrequently encounters children in the pre-hospital environment, resulting in less experience with pediatric advanced medical interventions. This study identifies some clinical characteristics and interventions regarding pediatric and neonatal patients that have been pointed out as focus areas for pediatric pre-hospital research.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of odontoid fractures with associated cardiac arrest: retrospective bi-center case series and systematic literature review.","authors":"S F Schaible, S Häckel, N Rutsch, F C Aregger, S F Bigdon, V Schoenborn, I Broger, C E Albers, C Tinner","doi":"10.1186/s13049-024-01277-z","DOIUrl":"10.1186/s13049-024-01277-z","url":null,"abstract":"<p><strong>Background: </strong>Odontoid fractures from high-energy trauma are associated with significant morbidity and mortality, including spinal cord injury, neurological damage, and cardiac arrest. The literature on odontoid fractures leading to cardiac arrest is limited to isolated case reports. This study aims to conduct a retrospective bi-center case series and a systematic review of existing literature.</p><p><strong>Methods: </strong>We conducted a retrospective bi-center case series on patients with odontoid fractures from high-energy trauma who experienced post-traumatic cardiac arrest with return of spontaneous circulation (ROSC) after CPR from two Level 1 Trauma Centers (2008-2024). The primary outcome was in-hospital mortality; secondary outcomes included epidemiological, pre-hospital, and in-hospital data, and CT and MRI findings. Additionally, we performed a systematic literature review to summarize existing evidence.</p><p><strong>Results: </strong>The study included 25 patients (mean age 71.1 ± 12.3 years, SD; 8 females). The mortality rate was 92% (23 patients). Median downtime before CPR was 5.0 min (IQR: 7.0), with CPR lasting 17.0 min (IQR: 13.0), primarily initiated by professionals (60%). All patients were quadriplegic. Type II Anderson d'Alonzo fractures were most common (88%), with all patients showing myelopathy on MRI. Only three patients (12%) underwent surgical intervention due to favorable prognosis. Our literature review identified seven case reports, with two patients surviving and one achieving full recovery.</p><p><strong>Conclusions: </strong>In this case series, patients experiencing cardiac arrest after odontoid fractures exhibited high mortality rates despite comprehensive management at Level 1 trauma centers. Survivors faced significant and enduring morbidity.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulating the methodological bias in the ATLS classification of hypovolemic shock: a critical reappraisal of the base deficit renaissance.","authors":"M L A Heldeweg, T T R Heldeweg, J A H Stohlmann, P Freire Jorge, R Boer, L A Schwarte, P Schober","doi":"10.1186/s13049-024-01276-0","DOIUrl":"10.1186/s13049-024-01276-0","url":null,"abstract":"<p><strong>Background: </strong>The Advanced Trauma Life Support classification (ATLS) of hypovolemic shock is a widely used teaching and treatment reference in emergency medicine, but oversimplifies clinical reality. A decade ago, a landmark study compared vital parameters to base deficit (BD) in trauma patients. The investigators concluded that BD had higher accuracy to detect the need for early blood product administration. BD was subsequently introduced in the ATLS shock classification and has since been widely accepted as a laboratory standard for hypovolemia. The aim of this study is to investigate whether a methodological bias may have inadvertently contributed to the study's results and interpretation.</p><p><strong>Methods: </strong>In the current study, we replicate the original study by simulating a cohort of trauma patients with randomly generated data and applying the same methodological strategies. First, a predefined correlation between all predictor variables (vital parameters and BD) and outcome variable (transfusion) was set at 0.55. Then, in accordance with the methods of the original study we created a composite of ATLS parameters (highest class amongst heart rate, systolic blood pressure, and Glasgow Coma Scale) and compared it with BD for resulting transfusion quantity. Given the preset correlations between predictors and outcome, no predictor should exhibit a stronger association unless influenced by methodological bias.</p><p><strong>Results: </strong>Applying the original imbalanced grouping and composite allocation strategies caused a systematic overestimation of shock class for traditional ATLS parameters, favoring the association between BD and transfusion. This effect persisted when the correlation between BD and transfusion was set substantially worse (rho = 0.3) than the correlation between ATLS parameters and transfusion (rho = 0.8).</p><p><strong>Conclusions: </strong>In this fully reproducible simulation, we confirm the inadvertent presence of methodological bias. It is physiologically reasonable to include a metabolic parameter to classify hypovolemic shock, but more evidence is needed to support widespread and preferred use of BD.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prehospital management of mass casualty incidents: limitations of using START in simulations and awareness of START fusion.","authors":"Ömerul Faruk Aydın","doi":"10.1186/s13049-024-01274-2","DOIUrl":"https://doi.org/10.1186/s13049-024-01274-2","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequent callers contacting the Norwegian national emergency medical number 113: a retrospective study.","authors":"Sara Naess Viken, Lars Myrmel, Guttorm Brattebø","doi":"10.1186/s13049-024-01275-1","DOIUrl":"https://doi.org/10.1186/s13049-024-01275-1","url":null,"abstract":"<p><strong>Background: </strong>Calling for help is the first link in the chain of survival; however, few studies have investigated the challenges faced by frequent callers (FCs) to emergency medical communication centres (EMCCs). This study aimed to explore the characteristics of FCs and the nature of their calls to the Bergen EMCC, Norway.</p><p><strong>Methods: </strong>This was a retrospective analysis of all emergency calls to the Bergen EMCC over three consecutive years (2019-2021). Bergen is the second-largest city in Norway, and the Bergen EMCC and ambulance services are part of the specialist medical service, covering a population of 460,000. The Bergen EMCC receives approximately 60,000 emergency calls per year. The study population comprised all adults identified during emergency medical calls. FCs were defined as individuals who registered five or more calls over 12 consecutive months during the three-year period.</p><p><strong>Results: </strong>The analysis included approximately 50,000 individuals, who made > 90,000 calls during the study period. Of those, 1,594 (3.2%) were FCs, accounting for approximately one in four (21,339 of 90,085, 23.7%) calls. The FCs included more men (882 of 1,594 (55.3%) vs. 24,204 of 47,564 (50.9%)) and registered a lower proportion of calls with an acute degree of urgency (6,051 of 21,339 calls (28.4%) vs. 30,276 of 68,746 calls (44.0%)). Calls from FCs showed an even occurrence throughout the week, peaking between 19:00 h and 20:00 h. Compared with calls from non-FCs, calls from FCs had a higher proportion of 'no response/verbal referral to local emergency medical department' and involved a lower proportion of hospital transfers. The EMCC most frequently used the medical criterion 'Mental health problems/suicide' for calls from FCs.</p><p><strong>Conclusions: </strong>FCs were common, and more often men. The EMCC dispatched ambulances or admitted patients to hospitals less frequently following these calls. Many of these situations could be handled in other parts of the healthcare system, reducing the burden on EMCCs, and providing more suitable services for FCs. Thus, EMCCs should identify and adjust patient management to match their actual needs.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the psychobiological demands of high-fidelity training in pre-hospital emergency medicine.","authors":"Mark A Wetherell, Glenn Williams, Jeff Doran","doi":"10.1186/s13049-024-01272-4","DOIUrl":"10.1186/s13049-024-01272-4","url":null,"abstract":"<p><strong>Background: </strong>Individuals who provide critical emergency care mount rapid psychobiological responses when faced with an incident. These responses are adaptive and ensure resources at time of demand; however, frequent activation with minimal opportunity for recovery can have negative consequences for health and wellbeing. Monitoring individuals in real emergency situations would provide an understanding of their stress responses during the provision of critical care; however, this presents logistical challenges. An alternative is to assess individuals during high-fidelity training scenarios. This is the first comprehensive assessment of psychobiological responding during continuous high-fidelity training in pre-hospital emergency medicine.</p><p><strong>Methods: </strong>A sample of doctors and paramedics (N = 27) participated during 10 days of training and a weekend of no activities. Training involved the acquisition of human factors, non-technical and surgical skills, and their application in complex high-fidelity scenarios including road-traffic accidents, firearms incidents, and swift water rescue operations. On each day participants reported levels of state, cognitive, and somatic anxiety, and self-confidence following waking and before sleep, and their anticipated (at wake) and experienced (before sleep) demands of the day. Saliva samples were obtained each day for assessment of diurnal cortisol indices and the Cortisol Awakening Response (CAR). Garmin smartwatches were worn throughout for the collection of heart rate and HRV-derived stress.</p><p><strong>Results: </strong>There were significant (p < 0.001) differences across days for state, cognitive, and somatic anxiety; self-confidence; anticipated and experienced demands; aggregated measures of heart rate and HRV-derived stress; levels of cortisol at waking (p = 0.002) and for the CAR (p < 0.001). Measures of psychobiological responding during training were distinct from the weekend and the highest levels of psychobiological responding occurred on days characterised by greater anticipated and experienced demands.</p><p><strong>Discussion: </strong>This high-fidelity training is typical of the day-to-day requirements of emergency services and these observations are representative of functioning during real-life critical care emergencies. Increased responding during times of demand is adaptive; however, frequent and sustained responding increases allostatic load and is a contributor to burnout. As burnout is a significant concern in emergency medicine, this study identifies patterns of responding and recovery that may impact upon longer-term health and wellbeing.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital undertriage of older injured patients in western Switzerland: an observational cross-sectional study.","authors":"Clément Poncet, Pierre-Nicolas Carron, Vincent Darioli, Tobias Zingg, Francois-Xavier Ageron","doi":"10.1186/s13049-024-01271-5","DOIUrl":"10.1186/s13049-024-01271-5","url":null,"abstract":"<p><strong>Background: </strong>The ageing of the population is leading to an increase in the number of traumatic injuries and represents a major challenge for the future. Falls represent the leading cause of Emergency department admission in older people, with injuries ranging from minor to severe multiple injuries. Older injured patients are more likely to be undertriaged than younger patients. The aim of this study was to investigate the extent of undertriage in older patients with particular emphasis on access to trauma centres and resuscitation rooms.</p><p><strong>Methods: </strong>Retrospective observational cross-sectional study based on data prospectively collected from prehospital electronic records including all patients ≥ 18 years for whom an ambulance or helicopter was dispatched between 1 January 2018 and 31 April 2023 due to a trauma. The primary outcome, admission to the resuscitation room of the regional trauma centre with trauma team activation, was assessed by age. Multivariate logistic regression was used to control for known confounders and to test for plausible effect modifiers.</p><p><strong>Results: </strong>Emergency Medical Services treated 37,906 injured patients. Older patients ≥ 75 years represented 17,719 patients (47%). Admission to trauma centre with trauma team activation was lower in older patients, N = 121 (1%) compared to N = 599 (5%) in younger patients, p < 0.001; adjusted odds ratio: 0.33 (0.24-0.45); p < 0.001. Undertriage increased by twofold with age ≥ 75; OR: 1.81 (1.04-3.15); p value < 0.001. Undertriaged patients were older, more likely to be female, to have low energy trauma and to be located farther from the regional trauma centre.</p><p><strong>Conclusion: </strong>Older injured patients were at increased risk of undertriage and non-trauma team activation admission, especially if they were older, female, had head injury without altered consciousness and greater distance to regional trauma centre.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus on innovations and future directions of community first responder schemes in United Kingdom: a national nominal group technique study.","authors":"Gupteswar Patel, Vanessa Botan, Viet-Hai Phung, Ian Trueman, Mehrshad Parvin Hosseini, Murray D Smith, Roderick Ørner, Julie Pattinson, Zahid Asghar, Elise Rowan, Robert Spaight, Craig Mortimer, Amanda Brewster, Pauline Mountain, Joshua Miller, Martina Brown, Aloysius Niroshan Siriwardena","doi":"10.1186/s13049-024-01254-6","DOIUrl":"10.1186/s13049-024-01254-6","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to achieve consensus among NHS and community stakeholders to identify and prioritise innovations in Community First Responder (CFR) schemes.</p><p><strong>Methods: </strong>We conducted a mixed-methods study, adopting a modified nominal group technique with participants from ambulance services, CFR schemes and community stakeholders. The 1-day consensus workshop consisted of four sessions: introduction of innovations derived from primary research; round-robin discussions to generate new ideas; discussion and ranking of innovations; feedback of ranking, re-ranking and concluding statements. Innovations were ranked on a 5-point Likert scale and descriptive statistics of median and interquartile range calculated. Discussions were recorded, transcribed, and analysed thematically.</p><p><strong>Results: </strong>The innovations found were classified into two categories: process innovations and technological innovations. The process innovations included six types of innovations: roles, governance, training, policies and protocols, recruitment, and awareness. The technological innovations included three aspects: information and communication; transport; and health technology. The descriptive statistics revealed that innovations such as counselling and support for CFRs (median: 5 IQR 5,5), peer support [5 (4,5)], and enhanced communication with control room [5 (4,5)] were essential priorities. Contrastingly, innovations such as the provision of dual CFR crew [1.5 (1,3)], CFR responsibilities in patient transport to hospital [1 (1,2)], and CFR access to emergency blue light [1 (1,1.5)] were deemed non-priorities.</p><p><strong>Conclusions: </strong>This article established consensus on innovations in the CFR schemes and their ranking for improving the provision of care delivered by CFRs in communities. The consensus-building process also informed policy- and decision-makers on the potential future change agenda for CFR schemes.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}