Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"The impact of concurrency conflicts on optimal location of air ambulance bases in Norway.","authors":"Jo Røislien, Pieter L van den Berg, J Theresia van Essen, Oddvar Uleberg, Caroline Jagtenberg","doi":"10.1186/s13049-025-01324-3","DOIUrl":"10.1186/s13049-025-01324-3","url":null,"abstract":"<p><strong>Background: </strong>Helicopter emergency medical services (HEMS) are important in many health care systems. In order to best utilize this expensive healthcare service, the location of HEMS bases is key. Concurrency conflicts is a prominent deviation for not completing missions, yet is often overlooked in mathematical modelling. The aim of the present study was to calculate optimal air ambulance base locations when accounting for the potential unavailability of helicopters due to concurrency conflicts.</p><p><strong>Methods: </strong>We used incident data for Norway from 2015. Optimal helicopter base locations were estimated using the Maximum Expected Covering Location Problem (MEXCLP) optimization model, allowing for estimation of the impact of concurrency conflicts by introducing a busy fraction parameter in the model. We explored busy fractions of 0, 0.10, 0.20 and 0.30, representing helicopters on the HEMS bases being busy 0, 10, 20 and 30% of the time, respectively. Both greenfield scenarios and simulations conditioned on the existing base structure were explored.</p><p><strong>Results: </strong>The 428 municipalities had a median (5-95 percentile) of 10 (2-38) incidents. Assuming a helicopter is always available, the existing bases cover an estimated 73.6% of the incidents within 30 min. Increasing the busy fraction in the calculations resulted in a significant decrease in estimated coverage. Re-arranging the currently available 14 helicopters in a greenfield analysis increases coverage to 91.9%. Increasing the busy fraction in the models, the mathematically optimal solutions put increasingly more emphasis on the more densely populated greater Oslo area, removing helicopters from northern Norway and the coastal areas, where population is more spread.</p><p><strong>Conclusion: </strong>The busy fraction significantly impacts the optimal location of air ambulance bases, with higher busy fractions resulting in more helicopters being placed in the more densely populated areas where demand is higher. However, the actual busy fractions reported in the Norwegian HEMS system seem to be of a magnitude small enough to have little impact on the optimal location of HEMS bases and helicopters. To determine the impact of adjusting for non-homogeneous busy fractions across the country more refined busy fraction models are needed.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"57"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789109","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":"Creation and validation of a roadside rescue skills scale for training pre-hospital medical teams: the RoadRes-Q scale.","authors":"Lavabre Killien, Marjanovic Nicolas, Oriot Denis, Chenu Mathilde, Gransagne Adrien, Gentilleau Michel, Moreau Anthony, Contal Paul, Mimoz Olivier, Drugeon Bertrand","doi":"10.1186/s13049-025-01370-x","DOIUrl":"10.1186/s13049-025-01370-x","url":null,"abstract":"<p><strong>Background: </strong>Road traffic injuries are the leading cause of death among young people worldwide. While advances in vehicle safety have reduced some of the risks, the speed and quality of pre-hospital care are critical to prevent fatalities. In France, patients are cared for by medical teams and firefighters who must work together as closely as possible to ensure the best possible survival rate. However, there is a lack of standardised scales to assess the performance of these multidisciplinary teams. This study aimed to create and validate a roadside rescue skills assessment scale, the RoadRes-Q scale, for healthcare teams.</p><p><strong>Methods: </strong>We used a two-round Delphi method to develop the RoadRes-Q scale. A panel of 9 international roadside rescue experts, including 7 firefighters and 2 engineers in road rescue equipment, agreed to participate. The scale covers five key areas: healthcare provider protection, site securing, vehicle securing, first aid delivery, and patient extrication. The final version was tested during two one-day simulation-based training sessions, each involving 22 participants: 6 healthcare staff, 14 firefighters, and 2 simulated victims. Assessors completed the scale during and after each scenario, focusing on internal consistency and inter-observer reliability.</p><p><strong>Results: </strong>The RoadRes-Q scale consists of 60 items. Internal consistency was excellent (Cronbach's alpha of 0.86), indicating that items were non-redundant and consistently measured the required competencies. However, inter-observer reliability was low (intra-class correlation coefficient of 0.48), suggesting variability between assessors. Satisfaction among participants to the simulation-based training courses was high, and their knowledge increased.</p><p><strong>Conclusions: </strong>The RoadRes-Q scale proved to be a valid and reliable scale for evaluating both technical and non-technical skills. While internal consistency was strong, improvements are needed in inter-observer reliability. Structured training for assessors and video-based assessments could enhance reproducibility. The RoadRes-Q scale has the potential for assessing the quality and safety of care provided by healthcare teams in roadside rescue situations.</p><p><strong>Registration: </strong>As the study did not involve interventional research or patient participation, ethics committee approval was not required, but it received approval from the scientific referents of the Faculty of Medicine of Poitiers, and participants provided informed consent for using their anonymised data.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"56"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781869","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 full response chain surge capacity test of a small rural hospital, prehospital resources and collaborating organisations.","authors":"Kristina Stølen Ugelvik, Kristina Lennquist Montán, Øyvind Thomassen, Geir Sverre Braut, Thomas Geisner, Silje Longva Todnem, Ove Njå, Elin Seim, Torunn Oveland Apelseth, Janecke Engeberg Sjøvold, Geir Arne Sunde, Sølvi Kasin, Carl Montán","doi":"10.1186/s13049-025-01372-9","DOIUrl":"https://doi.org/10.1186/s13049-025-01372-9","url":null,"abstract":"<p><strong>Background: </strong>Increased surge capacity is key in mass casualty incidents. Rural hospitals face other challenges in terms of transport capacity and available resources. The aim was to examine if a simulation system previously used to test surge capacity at large hospitals, could be used to test surge capacity at a small rural hospital.</p><p><strong>Method: </strong>A qualitative study was conducted to assess surge capacity at a small rural hospital using a previously validated simulation system. The simulation system was adopted to the Norwegian trauma system and local context. New simulated patient cards were developed, inspired by traffic victims. A tunnel accident scenario involving a bus, a heavy goods vehicle and a motorcyclist was used. Test staff ensured that real consumption of time and resources were followed. 98 persons representing 16 organisations, participated. A post-test survey was collected.</p><p><strong>Results: </strong>Access to the scene and transport resources were bottlenecks in the initial phase. The emergency department and lack of surgeons and anaesthetic doctors in the trauma team became the first and most prominent in-hospital surge capacity limiting factors. Operating theatre reached surge capacity, but never exceeded. The intensive care unit avoided depletion of beds/staff/ventilators due to transfer of patients to the trauma centre. Surge capacity was enhanced by obtaining staff, blood and equipment from the trauma centre. Water lock systems and replenishment routines for chest tube trays was inadequate. Blood supply was insufficient in the initial phase and a lack of overview of blood products was identified. Some communication gaps and deficiencies in victim identification were detected. The hospital participants evaluated the method as useful in assessing hospital surge capacity. Half of the participants requested increased time to learn the system pre-test. The inclusion of several organisations in the mass casualty incident exercise was appreciated and ranked high as a simulation training.</p><p><strong>Conclusion: </strong>The simulation system provided detailed data to determine surge capacity and capacity-limiting factors in the mass casualty incidents response at a rural hospital and performed as a training tool for staff. Methods to improve pre-test simulation system knowledge should be examined. Broad inclusion of cooperating organisations was found beneficial.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"55"},"PeriodicalIF":3.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743857","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-led interprofessional pre-hospital teams: does the science hold up?","authors":"Ryan Glendwyr Davis, Pieter Francsois Fouche, Belinda Flanagan","doi":"10.1186/s13049-025-01368-5","DOIUrl":"10.1186/s13049-025-01368-5","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"54"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732749","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":"POCUS vs. CT in acute cholecystitis: are we really reducing ED length of stay?","authors":"Caglar Kuas, Volkan Ercan, Mustafa Emin Canakci","doi":"10.1186/s13049-025-01367-6","DOIUrl":"10.1186/s13049-025-01367-6","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"53"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722081","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 head-to-head comparison of S100B and GFAP/UCH-L1 for detection of traumatic intracranial lesions in a Scandinavian trauma cohort.","authors":"Thea Overgaard Wichmann, Ayad Babaee, Kirsten Duch, Mikkel Mylius Rasmussen, Maj Lesbo, Ole Brink, Lars C Borris, Claus V B Hviid","doi":"10.1186/s13049-025-01364-9","DOIUrl":"10.1186/s13049-025-01364-9","url":null,"abstract":"<p><strong>Background: </strong>Few countries recommend glial fibrillary protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) as a substitute for S100 astroglial calcium-binding protein B (S100B) in early detection of traumatic intracranial lesions in mild TBI (mTBI). This study aims to evaluate the classification agreement between S100B and GFAP/UCH-L1 in a Scandinavian trauma cohort, to evaluate the performance characteristics of S100B and GFAP/UCH-L1 for detection of traumatic intracranial lesions, and lastly to evaluate the laboratory performance of the GFAP/UCH-L1 assay.</p><p><strong>Methods: </strong>Prospectively collected data from an unselected cohort of 379 adult trauma patients admitted to a level I trauma center at Aarhus University Hospital, Denmark, were retrospectively analyzed. Analyses were performed in the unselected cohort, in sub-cohort 1 (n = 218) i.e. patients with any evidence of TBI in their chart as well as in sub-cohort 2 (n = 105) i.e. patients with mTBI defined as Glasgow Coma Scale score ≥ 14, an injury severity score ≤ 15, and blood sampling within 6 h or 12 h after trauma. Plasma-samples were used for GFAP/UCH-L1 measurement and serum-samples were used for S100B measurement. Data analysis involved agreement analysis using Cohens kappa and sensitivity, specificity, positive predictive value and negative predictive value for each biomarker in each of the three cohorts. Lastly, levels of GFAP/UCH-L1 measured by the Alinity-I platform and the Simoa platform were compared.</p><p><strong>Results: </strong>Classification agreement between GFAP/UCH-L1 and S100B was high in all three cohorts, but Cohens kappa improved with increasing proximity to clinical biomarker use and reached an almost perfect identity in sub-cohort 2 (0.70, 95% CI 0.62-0.92). S100b had a sensitivity and negative predictive value of 100% in sub-cohort 2, while GFAP/UCH-L1 reached 100% across all three cohorts. The specificities for both S100B and GFAP/UCH-L1 were relatively low. Comparing GFAP/UCH-L1 levels between platforms revealed a low concordance with the Alinity-I platform measuring GFAP levels on average 65% lower and UCH-L1 levels 84% higher than the Simoa platform.</p><p><strong>Conclusions: </strong>In this study, S100B and GFAP/UCH-L1 had an almost perfect agreement for classification of mTBI patients and comparable diagnostic performances for detecting traumatic intracranial lesions. Our results therefore support GFAP/UCH-L1 as a feasible alternative to S100B for detecting traumatic intracranial lesions in mTBI.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"52"},"PeriodicalIF":3.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711890","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":"Management of traumatic spinal cord injury in the Nordic countries: a multidisciplinary survey.","authors":"Anders C Feyling, Johan Undén, Niklas Marklund, Ilke Malak, Ramona Åstrand, Jussi P Posti, Tor Brommeland","doi":"10.1186/s13049-025-01349-8","DOIUrl":"10.1186/s13049-025-01349-8","url":null,"abstract":"<p><strong>Background: </strong>Management of traumatic spinal cord injury is complex and depends on a multidisciplinary approach involving pre-hospital services, spinal surgery, intensive care unit treatment and specialized rehabilitation. International clinical practice guidelines for the handling of these patients offer specific recommendations regarding transportation, radiological investigations, timing of surgery, intensive care management and rehabilitation. We performed a comprehensive multicenter survey to assess the agreement between the Nordic countries on the different aspects of traumatic spinal cord injury management.</p><p><strong>Methods: </strong>Sequential, cross-sectional, structured survey comprising the key clinical domains (pre-hospital services, spinal surgery, intensive care management and rehabilitation) in all tertiary spine trauma centers in Sweden, Denmark, Norway, Iceland and Finland. Data are presented descriptively.</p><p><strong>Results: </strong>A total of 109 respondents from 22 Nordic centers were invited to take the survey, with a response rate of 90% (98/109). Overall, clinical practices were comparable within the domains. Prehospital services had similar practices for airway management, clinical spine clearance and patient transport. Preoperative magnetic resonance imaging was available to 33/35 of the spine surgeons (94%) on a 24/7 basis. This examination was considered mandatory prior to surgery by 66% (23/35) of the surgeons. Surgery was defined as early if performed within 24 h of the injury by all surveyed surgeons. Augmented blood pressure regimens were widely applied in the intensive care units, with mean arterial pressure targets varying between > 80 and > 90 mmHg. Postoperative thromboprophylaxis was administered within 48 h by all centers and rehabilitation policies were similar overall. Notable variations in practice were the occasional steroid administration and the use of lumbar drains in 54% (14/26) of intensive care units.</p><p><strong>Conclusion: </strong>Although there is some variability in the current management of traumatic spinal cord injury in the Nordic countries at the center- and country-level, practices in most key clinical domains are similar and follow established international guidelines.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"51"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701925","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":"Echoes of precision: feedback, governance and ultrasound in prehospital care.","authors":"Marco Tartaglione, Luca Carenzo","doi":"10.1186/s13049-025-01362-x","DOIUrl":"10.1186/s13049-025-01362-x","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"50"},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677322","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":"Comment: Prolonged critical avalanche burial for nearly 23 h with severe hypothermia and severe frostbite with good recovery: a case report.","authors":"Ian J Cohen","doi":"10.1186/s13049-025-01366-7","DOIUrl":"10.1186/s13049-025-01366-7","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"49"},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677294","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":"Temperature should not be ignored when analyzing the factors affecting trauma outcomes.","authors":"Yuliu Li, Tian Gu, Hongbing Yin","doi":"10.1186/s13049-025-01363-w","DOIUrl":"10.1186/s13049-025-01363-w","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"48"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665172","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}