Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Need-standardised comparisons are required before inferring sex and gender bias in major trauma care.","authors":"Pieter Fouche","doi":"10.1186/s13049-026-01624-2","DOIUrl":"https://doi.org/10.1186/s13049-026-01624-2","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of carotid artery Doppler ultrasound for resuscitation outcomes in patients with cardiac arrest.","authors":"Shuaishuai Zhou, Sa Wang, Shurong Xu, Jue Fang, Rui Zhang, Danping Yan, Yajie Liu, Meiling Wang, Yuwei Wang","doi":"10.1186/s13049-026-01620-6","DOIUrl":"https://doi.org/10.1186/s13049-026-01620-6","url":null,"abstract":"<p><strong>Objective: </strong>Carotid artery Doppler ultrasound, as a non-invasive monitoring method, offers higher clinical utility during cardiopulmonary resuscitation (CPR) compared to invasive techniques. This study aimed to investigate the application of real-time carotid Doppler ultrasound in CPR patients and analyze the predictive efficacy of waveform-derived parameters for return of spontaneous circulation (ROSC).</p><p><strong>Methods: </strong>This prospective observational study consecutively enrolled adult patients who underwent CPR in the emergency department of a tertiary hospital in Zhejiang Province between March 2024 and March 2025. ROSC was defined as the first documented confirmation at a scheduled pulse/rhythm check, independent of Doppler findings. Patients were divided into ROSC and non-ROSC groups based on whether ROSC was obtained. Baseline characteristics and carotid Doppler parameters were analyzed to evaluate their prognostic value. Univariate analysis compared baseline characteristics, CPR data, and carotid Doppler parameters between groups. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of statistically significant indicators for ROSC.</p><p><strong>Results: </strong>Among 51 patients (23 in the ROSC group, 28 in the non-ROSC group). Significant differences were observed in carotid blood flow parameters between groups, including VTI、Vmax、Vmin、TAV、MD*、RI、dv.MAX (all P < 0.05). ROC analysis showed AUC values of 0.811 (VTI), 0.758 (Vmax), 0.727 (Vmin), 0.751 (cMD*) and 0.72 (dv.MAX), with optimal cutoffs of 18.8 87.1,19, 2318 and 8.75, respectively. Because ROSC was adjudicated at scheduled pulse/rhythm checks, the prespecified 60-second Doppler window before documented ROSC may have partially overlapped with spontaneous rather than purely compression-generated flow.</p><p><strong>Conclusion: </strong>Carotid Doppler parameters (VTI、Vmax、Vmin、TAV、MD*、RI、dv.MAX) significantly differ between ROSC and non-ROSC groups. These parameters may provide objective hemodynamic insights during CPR. However, these findings should be interpreted cautiously because the Doppler window preceding documented ROSC may have partially included ROSC-transition flow; therefore, the results are exploratory and require prospective multicenter validation.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylaxis of opioid-induced nausea in helicopter emergency medical service: a prospective quasi-experimental study.","authors":"Jürgen Knapp, Robin Strohm, Markus Huber, Roland Albrecht, Urs Pietsch","doi":"10.1186/s13049-026-01626-0","DOIUrl":"https://doi.org/10.1186/s13049-026-01626-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In prehospital emergency medicine, opioids are usually used to treat acute traumatic pain. A common side effect of opioids is nausea. To prevent this, the prophylactic administration of 5-HT&lt;sub&gt;3&lt;/sub&gt; antagonists such as ondansetron has become established in clinical practice, even though there is currently no evidence to support its use. Aromatherapy is also used as an alternative non-pharmacological method for the treatment of nausea. We therefore investigated whether the prophylactic administration of ondansetron or prophylactic aromatherapy after opioid administration is beneficial to the patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients over the age of 16 who received opioid therapy due to acute traumatic pain by the crews of a total of six HEMS bases between February 2024 and April 2025 were prospectively included. Nausea prophylaxis after opioid-based pain therapy was performed according to a fixed rotating 7-day schedule: no nausea prophylaxis, medication-based nausea prophylaxis with ondansetron 4 mg intravenously, and aromatherapy-based nausea prophylaxis by inhalation of isopropanol. A nausea score was evaluated at the time of opioid administration and upon handover at the destination hospital, using a numeric rating scale (NRS) between 0 (no nausea) and 10 (maximum nausea). Primary endpoint was the change in NRS between the time before opioid administration and the time of patient handover at the emergency department. Secondary endpoints were incidence of moderate and severe nausea (defined as an NRS &gt; 3), the incidence of vomiting during prehospital patient care and need of rescue medication (ondansetron for therapeutic use).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 205 patients were included in the analysis. Eighty-six in the \"no prophylaxis\" group, 64 in the ondansetron group, and 55 in the aromatherapy group. We found a median change in NRS of 0 (interquartile range 0-0) points across all groups. An increase in NRS was observed in 15% of patients in the no prophylaxis group, 14% in the ondansetron group, and 15% in the aromatherapy group. An NRS &gt; 3 was observed in 14% of patients in the no prophylaxis group and in 11% of patients in both the ondansetron and aromatherapy groups. Vomiting occurred in 4% of patients in the no prophylaxis group, 2% in the ondansetron group, and in none of the aromatherapy group. Therapeutic administration of ondansetron was necessary in 4 patients in the \"no prophylaxis\" group and in one patient in the aromatherapy group. None of the patients experienced any improvement in nausea as a result, three of these patients from the \"no prophylaxis\" group vomited after ondansetron administration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Neither the prophylactic administration of ondansetron nor aromatherapy seem to be beneficial for the prevention of opioid-induced nausea in unselected patients in the setting of prehospital emergency medicine. Larger randomized controlled trials ","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Civilian penetrating traumatic brain injury in South-East Norway.","authors":"Mads Aarhus, Dag Ferner Netteland, Cathrine Tverdal, Vidar Stenset, Pål Rønning, Eirik Helseth","doi":"10.1186/s13049-026-01623-3","DOIUrl":"https://doi.org/10.1186/s13049-026-01623-3","url":null,"abstract":"<p><strong>Background: </strong>Civilian penetrating traumatic brain injury (cpTBI) is a rare entity associated with severe and often devastating consequences. Guidelines recommend CT angiography (CTA), prophylactic antibiotics (AB) and antiseizure medication (ASM), early surgical revision with dural closure whenever feasible, and intracranial pressure (ICP)-guided therapy. The study aimed to investigate guideline compliance, as well as outcome after cpTBI for patients admitted to Oslo University Hospital (OUH).</p><p><strong>Methods: </strong>We identified and included cpTBI patients admitted to OUH between 2015 and 2023 through the Oslo TBI Registry - Neurosurgery. Guideline adherence was assessed and variables associated with 30-day mortality and Glasgow Outcome Scale (GOS) were examined using standard uni- and multivariable techniques.</p><p><strong>Results: </strong>The incidence of cpTBI was 1.9/1.000.000 with a 30-day mortality rate of 42.3%. Among the survivors, 70% achieved a favourable outcome (GOS 4 and 5) at 6 months. CTA was obtained at an acceptable rate (81%) in concordance with guidelines, but the guideline compliance for AB (12%) and ASM (29%) was substantially lower-than-expected. Surgery started within 12 h after injury in 58%, and ICP was monitored in 53.5% of patients with GCS < 9.</p><p><strong>Conclusions: </strong>Despite high mortality in cpTBI, most survivors achieved favourable outcome. We found a lower-than-expected guideline compliance for prophylactic AB and ASM, ICP monitoring, and surgical revision within 12 h. Thus, we identified several key factors that can improve cpTBI treatment at our institution. For patients considered potential survivors, management should be aggressive and aligned with established TBI treatment principles, including early vascular imaging with CTA, prompt wound debridement with dural closure, and prophylactic administration of AB and ASM.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preserving patient safety in Nordic emergency care: concerns from Nordic anaesthesiology societies regarding development goals of emergency medicine.","authors":"","doi":"10.1186/s13049-026-01584-7","DOIUrl":"10.1186/s13049-026-01584-7","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845095","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 role of tactical police medics in the prehospital environment: results from an interview study.","authors":"Lova Widman, Magnus Andersson Hagiwara, Felix Lindell, Claes Wildar, Denise Bäckström","doi":"10.1186/s13049-026-01621-5","DOIUrl":"10.1186/s13049-026-01621-5","url":null,"abstract":"<p><strong>Background: </strong>The Swedish tactical police unit is a highly trained team specialized in managing complex situations and tactically demanding operations. Each tactical police group includes a designated medic who completes a 10-week basic training program in tactical medicine, followed by various forms of additional training. The medical aspects of police work are strictly regulated by medical authorities, and among other restrictions, the medics' authorizations apply only when providing care to fellow officers. The purpose of this study was to explore tactical police medics' perceptions of their work in relation to training, competencies, tactics, and the provision of practical medical care.</p><p><strong>Method: </strong>The study employed a qualitative design in which 13 medics from the tactical police unit were interviewed using a semi-structured interview protocol. They were asked questions about their perceived preparedness for the role, their training, and real-life situations in which they had acted as medics. All interviews were digitally recorded and transcribed verbatim. The transcripts were then coded and analysed thematically following Braun and Clarke's model of thematic analysis.</p><p><strong>Result: </strong>The results indicated that the medics were generally satisfied with their training and education in tactical medicine. However, there was a clear discrepancy between what they had been trained to do and the tasks they actually performed in their roles. They also expressed frustration about how their mission is defined by medical authorities, particularly the restriction that prevents them from applying their medical authorizations to injured third parties. Collaboration with civilian healthcare was described as inconsistent; cooperation with prehospital physicians was generally viewed positively, whereas the relationship with ambulance personnel was perceived as more challenging.</p><p><strong>Conclusions: </strong>The tactical police medics represent a highly trained and competent group that is not being utilized to its full potential. They could be deployed more extensively in situations requiring tactical medical care and rescue operations. Achieving this would require stronger and more effective collaboration with civilian healthcare services.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845143","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 impact of advanced pre-hospital interventions on scene time.","authors":"Miles Gandolfi, Flora Bird, Christine L Henry, Jonathan Bestwick, David J Lockey, Zane B Perkins","doi":"10.1186/s13049-026-01613-5","DOIUrl":"https://doi.org/10.1186/s13049-026-01613-5","url":null,"abstract":"<p><strong>Background: </strong>Pre-hospital trauma care has evolved with the introduction of increasingly advanced interventions. While these procedures may offer clinical benefit, they may also prolong pre-hospital times, a critical determinant of outcome, particularly in patients with non-compressible haemorrhage. This study examined whether expanding pre-hospital capability has affected scene time over the past two decades.</p><p><strong>Methods: </strong>We conducted a retrospective, observational study of injured patients treated by a physician-led air ambulance service. Data from July of each year between 2005-2010 (Group 1) and 2017-2021 (Group 2) were compared. Advanced interventions including blood transfusion, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), arterial and central venous cannulation were introduced between these periods. Univariate and multivariable analyses were performed to identify factors associated with scene time.</p><p><strong>Results: </strong>Among 1,357 eligible patients, 26% received at least one advanced intervention, with uptake increasing over time (24% vs 29%; p = 0.02). The proportion of penetrating trauma also increased (24% vs 34%; p < 0.001), and these patients had consistently shorter scene times than those with blunt trauma (10 [6-17] vs 25 [17-36] minutes; p < 0.001). Median scene time remained similar between study periods. In multivariable analysis, scene time was independently associated with mechanism of injury, age, and number of advanced interventions performed. Each additional intervention increased scene time by 41% (p < 0.001).</p><p><strong>Conclusion: </strong>Advanced pre-hospital interventions have become more frequent, and scene time increases in direct proportion to the number of interventions performed, independent of temporal, operational, patient, and injury factors. Scene times have remained similar over two decades, reflecting opposing trends of increasing intervention frequency and more penetrating trauma. These findings highlight the need to balance the potential benefit of advanced pre-hospital interventions against their time cost, ensuring procedural efficiency, judicious patient selection, and timely transfer to definitive care in time-critical trauma.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No delayed intracranial hemorrhage in head injury patients on oral anticoagulants and with normal CT: a retrospective study of 215 patients.","authors":"Martin Aase Bahr, Håvard Visnes, Tor Brommeland","doi":"10.1186/s13049-026-01617-1","DOIUrl":"https://doi.org/10.1186/s13049-026-01617-1","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of portable telemedicine devices for ambulance-based prehospital triage: a comparative simulation study.","authors":"Sophia L Kingma, Robert Croese, Marcel Durieux, Jan Bosch, Matthijs de Visser, Sandra Timmermans, Loet M H Kloos, Els L L M de Schryver, Nyika D Kruyt, Geert H Groeneveld","doi":"10.1186/s13049-026-01612-6","DOIUrl":"https://doi.org/10.1186/s13049-026-01612-6","url":null,"abstract":"<p><strong>Background: </strong>Video-based telemedicine can improve prehospital triage. However, it is unclear which portable device enabling a real-time specialist consultation via two-way video and audio connection in dynamic emergency medical service environments should be used. This feasibility study identified the most suitable portable telemedicine device for prehospital triage.</p><p><strong>Methods: </strong>Four simulated stroke-like scenarios were conducted with ambulance professionals and remote vascular neurologists. Three portable telemedicine devices were tested: two head-mounted assisted-reality devices (RealWear Navigator ™ 520, Vuzix M400) and a smartphone using Siilo Messenger application. Feasibility was evaluated through structured surveys from both user groups and a patient actor. Quantitative data were analysed using Multi-Criteria Decision Analysis with stakeholder-derived criterion weights to generate overall value scores and device ranking.</p><p><strong>Results: </strong>Out of 47 analysed surveys, the Vuzix head-mounted device achieved the highest overall value score (0.80), followed by Siilo Messenger smartphone application (0.77) and RealWear head-mounted device (0.73). Ambulance professionals prioritised usability, favouring the smartphone application, whereas neurologists emphasised video quality, favouring Vuzix head-mounted device. Qualitative feedback highlighted trade-offs: head-mounted devices offered hands-free use but required peripherals and hindered patient interaction, while smartphones were intuitive but limited by video quality and image stability.</p><p><strong>Conclusions: </strong>Device suitability for prehospital telemedicine depends on balancing technical performance with usability. The smartphone-based application provides practical solution for early implementation, while head-mounted devices may be preferable when hands-free operation and video quality are critical. Future research should assess their clinical and operational impact to enable safe and scalable implementation.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diamond minutes: rethinking the earliest link of the trauma chain of survival.","authors":"Guglielmo Imbriaco, Sonia D'Arrigo, Francesco Limonti, Tim Nutbeam, Alberto Cucino","doi":"10.1186/s13049-026-01611-7","DOIUrl":"https://doi.org/10.1186/s13049-026-01611-7","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787295","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}