Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Preselection of stable children limits inference about DA-PEWS transport safety.","authors":"Ercan Yılmaz, Nezihe Koker Özer, Erdem Topal","doi":"10.1186/s13049-026-01707-0","DOIUrl":"https://doi.org/10.1186/s13049-026-01707-0","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185554","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":"Chasing time targets in pre-hospital emergency anaesthesia: the case identification system is crucial.","authors":"Alan A Garner","doi":"10.1186/s13049-026-01708-z","DOIUrl":"10.1186/s13049-026-01708-z","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117405","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":"Physician-staffed HEMS: triage accuracy beyond diagnostic agreement in paediatric trauma.","authors":"Urs Pietsch, Julian Klug, Christian P Both, Alexander Fuchs","doi":"10.1186/s13049-026-01706-1","DOIUrl":"https://doi.org/10.1186/s13049-026-01706-1","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117373","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":"Reply to \"Why should more than two reliability coefficients be reported in triage studies?\"","authors":"Louise Deshayes, Magnus Andersson Hagiwara, Denise Bäckström","doi":"10.1186/s13049-026-01698-y","DOIUrl":"https://doi.org/10.1186/s13049-026-01698-y","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117411","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":"Diagnostic agreement does not establish triage accuracy in paediatric HEMS trauma.","authors":"Ercan Yılmaz, Zeynep Yamancan Yılmaz","doi":"10.1186/s13049-026-01704-3","DOIUrl":"10.1186/s13049-026-01704-3","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076401","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":"Daily emergency department volume and in-hospital mortality: the importance of temporal alignment.","authors":"Mert Gültekin","doi":"10.1186/s13049-026-01703-4","DOIUrl":"10.1186/s13049-026-01703-4","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031901","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 missing sex and gender lens in artificial-intelligence-enabled resuscitation.","authors":"Andi Wahyu Irawan, Mohamad Ahmad Saleem Khasawneh, Muhammad Ibnu Sa'ad","doi":"10.1186/s13049-026-01699-x","DOIUrl":"10.1186/s13049-026-01699-x","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018590","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":"A multinational cross-sectional survey on the use of AI-based voice assistance systems in emergency medical services.","authors":"Clemens Möllenhoff, Oddvar Uleberg, Matthias Bender, Thomas Neumuth, Max Rockstroh","doi":"10.1186/s13049-026-01695-1","DOIUrl":"10.1186/s13049-026-01695-1","url":null,"abstract":"<p><strong>Background: </strong>Emergency medical services (EMS) worldwide face increasing demands that require improvements in efficiency and quality of care. Voice assistance systems (VAS) based on Artificial Intelligence (AI) can support staff in prehospital settings through contactless, intuitive operation. However, evidence regarding their application in EMS is limited but desired. To date, no large-scale study has systematically explored potential functions, user acceptance, or implementation challenges of voice assistance systems in prehospital emergency medicine. This study aimed to explore the possibilities and challenges of designing and implementing a VAS tailored for EMS from a user perspective. Emergency medical personnel from three European countries were invited to share their requirements, expectations, and anticipated obstacles across different systems and countries.</p><p><strong>Methods: </strong>An exploratory, cross-sectional online survey was conducted in Germany, Norway, and Switzerland during the summer of 2024 using a 34-item self-administered questionnaire. Eligible participants were EMS professionals, including physicians, paramedics, emergency medical technicians, and students. Collected data were analyzed using descriptive statistics and a large language model. The reporting of this study adhered to the CROSS checklist.</p><p><strong>Results: </strong>A total of 587 responses were received, of which 186 (32%) were excluded, leaving 401 responses for final analysis. Participants reported occasional use of AI applications and voice assistants in personal or work settings and demonstrated a high level of technical proficiency. In EMS, several digital tools are in use today, mainly concerning documentation, knowledge access, hospital pre-notification and occupancy checks. Most respondents reported a rather positive attitude towards the use of voice assistants during missions, expecting reduced workload and improved quality of care; however, none were aware of an EMS-specific voice assistant to date. Desired features included language translation, patient history summarization, hospital pre-notification, medical information retrieval, and case documentation. Key requirements for adoption were reliability, usability, and fast system response times, while major implementation challenges involved staff acceptance, funding, and data protection.</p><p><strong>Conclusion: </strong>Developing AI-based voice assistants with emergency medical service-specific functionalities is desirable and likely to be well accepted if user requirements are addressed. Future steps include prototype-based field testing and evaluating measurable improvements in care delivery.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031869","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":"Gelatin 4% and hydroxyethyl starch (130/0.42) impair clot formation in a human ex vivo whole-blood resuscitation model.","authors":"Marco Mannes, Doreen Tabea Spiegelburg, Thomas Datzmann, Anke Schultze, Andreas Bauer, Gerhard Achatz, Markus Huber-Lang, Christian Karl Braun","doi":"10.1186/s13049-026-01690-6","DOIUrl":"10.1186/s13049-026-01690-6","url":null,"abstract":"<p><strong>Background: </strong>Colloid solutions provide effective intravascular volume expansion but can impair hemostasis, which is particularly critical after trauma-associated hemorrhagic shock. The differential effects of specific colloids on plasmatic coagulation, platelet function and complement activation, especially when used alongside crystalloids, are still underexplored. We therefore examined graded hemodilution with gelatin or hydroxyethyl starch, alone and in combination with a balanced crystalloid, in an ex vivo human whole-blood model over time.</p><p><strong>Methods: </strong>We used a citrate- and heparin-free human ex vivo whole-blood model to assess the effects of volume dilution with a balanced crystalloid (Jonosteril), gelatin solution (Gelafundin 4%) and hydroxyethyl starch (HES 130/0.42, 6%; Tetraspan). Whole-blood was diluted at increasing ratios up to 4:6 (diluent:blood), incubated for 30 minutes at 37 °C and analyzed for blood gases, standard coagulation tests, platelet activation (CD62P), von Willebrand factor (vWF), thrombin-antithrombin complexes, complement activation and viscoelastic parameters by ROTEM (EXTEM, INTEM, FIBTEM).</p><p><strong>Results: </strong>At high dilution ratios, colloid-diluted samples exhibited more frequent macroscopic clotting and significantly lower pH with more pronounced base deficit than Jonosteril. Gelafundin, but not Jonosteril or Tetraspan, increased vWF levels over time, while CD62P expression, thrombin-antithrombin complexes and complement markers remained unchanged. ROTEM revealed a clearly hypocoagulable profile after dilution with Gelafundin or Tetraspan, most pronounced with HES, with prolonged clotting time and clot formation time, reduced a-angle and maximum clot firmness. When combining Jonosteril with increasing colloid fractions at fixed dilution, these changes followed a non-linear, ratio-dependent pattern.</p><p><strong>Conclusion: </strong>Balanced colloids, particularly HES 130/0.42, exert intrinsic, ratio-dependent adverse effects on clot formation beyond simple dilution, suggesting that hemostatic safety may depend not only on fluid type but also on the tolerated proportion of colloid within resuscitation strategies.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983829","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":"Early clinical predictors of amputation in frostbite: injury depth and extent for admission risk stratification.","authors":"İbrahim Doğan, Ali Rıza Karayıl, Serpil Sevimli Deniz, Sıdkı Arşad Narçin, Berk Topaloğlu, Serdar Çoban, Ezgi Sönmez, Mehmet Kadir Bartın, Meltem Ceylan Delice, Sebahattin Çelik","doi":"10.1186/s13049-026-01696-0","DOIUrl":"10.1186/s13049-026-01696-0","url":null,"abstract":"<p><strong>Background: </strong>Early identification of patients at high risk of amputation remains a major challenge in frostbite management, particularly in resource-limited settings where advanced imaging may not be readily available. We aimed to identify admission predictors of amputation in a predominantly migrant frostbite cohort and secondarily evaluated the prognostic value of the Prognostic Nutritional Index (PNI) and neutrophil-to-lymphocyte ratio (NLR).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of consecutive patients admitted with frostbite to a tertiary referral hospital in eastern Turkey between January 2020 and December 2025. Demographic, clinical, and laboratory variables recorded at admission were compared between patients with and without amputation. Predictive performance was evaluated using receiver operating characteristic (ROC) analysis and multivariable logistic regression. Because frostbite degree demonstrated quasi-complete separation with the outcome, its independent effect was assessed using Firth penalized logistic regression.</p><p><strong>Results: </strong>A total of 128 patients were included, of whom 126 (98.4%) were foreign nationals. Amputation was performed in 54 patients (42.2%). Frostbite degree was the strongest admission predictor of amputation, with 53 of 65 patients (81.5%) with third-degree frostbite requiring amputation compared with only 1 of 63 patients (1.6%) with first- or second-degree injuries (AUC 0.910, 95% CI 0.864-0.956). Frostbite extent (%TBSA) remained independently associated with amputation in multivariable analysis (adjusted OR 2.23, 95% CI 1.59-3.32; p < 0.001), and combining frostbite degree with %TBSA achieved the highest predictive performance (AUC 0.948, 95% CI 0.910-0.985). Although CRP, NLR, albumin, and PNI differed significantly between groups in univariable analyses, none remained independent predictors after adjustment for injury severity.</p><p><strong>Conclusions: </strong>In patients with frostbite, admission risk of amputation is primarily determined by injury depth and extent. Simple bedside assessment of frostbite degree and %TBSA provides robust early risk stratification, whereas inflammatory and nutritional biomarkers offer limited additional prognostic value beyond clinical evaluation. These findings may facilitate early identification of patients at high risk of amputation, particularly in resource-limited emergency settings and regions managing migration-related cold injuries.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041513","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}