Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Chasing time targets in pre-hospital emergency anaesthesia: is it time to rethink?","authors":"Mark Hodkinson, David Zideman","doi":"10.1186/s13049-026-01694-2","DOIUrl":"10.1186/s13049-026-01694-2","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931614","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":"Modelling eCPR eligibility after out-of-hospital cardiac arrest: a 10-year retrospective temporospatial analysis from a mixed urban-rural region in Germany.","authors":"Clemens Grimm, Hanna Illian, Nils Kunze-Szikszay, Hanna Haus, Claudius Balzer, Markus Roessler","doi":"10.1186/s13049-026-01681-7","DOIUrl":"https://doi.org/10.1186/s13049-026-01681-7","url":null,"abstract":"<p><strong>Background: </strong>Survival with good neurological function after out-of-hospital cardiac arrest (OHCA) remains low. Extracorporeal cardiopulmonary resuscitation (eCPR) may benefit selected patients, but it is unclear how many patients in a mixed urban-rural European region would be eligible, whether regional case volumes justify dedicated eCPR programmes, and whether an in-hospital strategy after intra-arrest transport can meet a 60-minute low-flow target.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of OHCA cases in the city and county of Göttingen, Germany (January 2015-February 2025). eCPR eligibility was assessed using a local protocol and a stricter modified ELSO definition. Eligibility was first determined at emergency medical services (EMS) arrival and then re-evaluated for three hypothetical intra-arrest transport strategies in which transport was initiated after 10, 15, or 20 minutes of on-scene conventional cardiopulmonary resuscitation (cCPR). Scene-to-hospital travel times were modelled and patients were classified according to whether they would be eligible for eCPR upon hospital arrival. A complementary analysis estimated time from collapse to hypothetical eCPR initiation under an on-scene scenario, split into simultaneous dispatch of a dedicated eCPR team (S1a) and delayed dispatch after 10 minutes of on-scene evaluation by the primary EMS team (S1b), and an in-hospital scenario following intra-arrest transport (S2), incorporating documented timing of sustained return of spontaneous circulation (ROSC).</p><p><strong>Results: </strong>Of 2,218 OHCA cases, 1,696 registry-documented patients were analysed (median age 71.5 years; 67.5% male; shockable rhythm 20.5%). At EMS arrival, 348 patients (20.5%) met local and 149 (8.8%) modified ELSO criteria. With transport initiated after 10/15/20 minutes of on-scene cCPR, 11.1%/9.8%/8.8% (local) and 3.8%/3.1%/2.8% (modified ELSO) would have been eligible at hospital arrival. Extrapolated regional case volume was approximately 46 (local) and 20 (modified ELSO) eligible patients per year at EMS arrival. In patients who met local eCPR criteria the number of patients with sustained ROSC exceeded those without at 13.4 minutes after EMS arrival. Median estimated time from collapse to eCPR was 37 minutes under S1a (94.8% within 60 minutes) and 54 minutes under S1b (71.6% within 60 minutes) versus 75 minutes under S2 (<1% within 60 minutes). After excluding patients with ROSC before hypothetical eCPR initiation, 47.4% (S1a) and 31.6% (S1b) in the local cohort and 36.9% (S1a) and 24.8% (S1b) in the modified ELSO cohort would both still have required and could have received on-scene eCPR within 60 minutes.</p><p><strong>Conclusions: </strong>A substantial number of OHCA patients in our region met eCPR eligibility criteria, but hospital arrival did not equate to eCPR initiation. Given realistic procedural time intervals, in-hospital eCPR following intra-arrest ","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117392","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":"Correction: Identifying research priorities for post-collision care in the United Kingdom: outcomes and methodological adaptations from the final prioritisation workshop.","authors":"Tim Nutbeam, Laura Cottey, Kerry Dungay, Lauren R Rodgers, Emily Foote, Caroline Leech, Claire E Baker, Elizabeth Box, Louise Johnson, Brian Lee, Marilyn MacQueen, Rob Fenwick, Nigel Lang, Ianto Guy, Ian Marritt, Ian Dunbar, Ed B G Barnard","doi":"10.1186/s13049-026-01671-9","DOIUrl":"10.1186/s13049-026-01671-9","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876410","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":"Blunt versus penetrating trauma: differences in early physiology, coagulopathy, and outcomes in a Scandinavian trauma centre.","authors":"Erik von Oelreich, Jesper Eriksson, Bjarni Arnason, Daniel Ohlén, Axel Hedin, Anders Gille, Malin Jonsson Fagerlund, Magnus Hedberg","doi":"10.1186/s13049-026-01683-5","DOIUrl":"10.1186/s13049-026-01683-5","url":null,"abstract":"<p><strong>Background: </strong>Blunt and penetrating trauma differ in injury patterns, management, and outcomes, but data comparing early physiological and haemostatic responses within Scandinavian trauma systems remain limited. We aimed to investigate differences in clinical characteristics, early physiology, and outcomes between blunt and penetrating trauma patients at a major Swedish trauma centre.</p><p><strong>Methods: </strong>This registry-based observational cohort study included adult trauma patients admitted to the Karolinska University Hospital, Stockholm, between November 2022 and December 2024. Detailed prospective data were collected for patients receiving blood transfusion within two hours of arrival. Patients were categorised by injury type (blunt vs. penetrating). Clinical outcomes included 30-day mortality, hospital length of stay, and functional outcome. Secondary analyses compared physiological, metabolic, and coagulation parameters. Multivariable logistic regression was used to compare 30-day mortality between groups, adjusted for age, sex, Injury Severity Score, and preinjury comorbidity.</p><p><strong>Results: </strong>A total of 2,193 patients were included, of whom 353 (16%) sustained penetrating trauma. Patients with penetrating trauma were younger (median 34 vs. 49 years, p < 0.001), more often male (78% vs. 66%, p < 0.001), and more frequently presented in shock (5.9% vs. 2.2%, p < 0.001), with a greater need for emergency surgery (53% vs. 30%, p < 0.001) and early blood transfusion (20% vs. 4.5%, p < 0.001). Blunt trauma patients had higher injury severity (median ISS 10 vs. 4, p < 0.001), longer hospital stays (> 7 days: 26% vs. 18%, p = 0.001), and worse functional outcomes at discharge (Glasgow Outcome Scale 2 or 3: 40% vs. 12%, p < 0.001). In the early transfusion subgroup (n = 152), blunt trauma patients exhibited lower fibrinogen levels (median 2.1 vs. 2.5 g/L, p = 0.027), lower platelet counts (median 239 vs. 271 10⁹/L, p = 0.011), and prolonged activated partial thromboplastin time (median 26 vs. 23 s, p < 0.001) compared with penetrating trauma patients, despite similar rates of trauma-induced coagulopathy defined by INR > 1.2 (23% vs. 16%, p = 0.32). After exclusion of non-trauma-related deaths, 30-day mortality did not differ significantly between groups in unadjusted or adjusted analyses.</p><p><strong>Conclusions: </strong>Within this Scandinavian trauma system, blunt and penetrating trauma represent distinct clinical entities with differing injury patterns, physiological responses, and management needs. Despite these differences, adjusted mortality was comparable. These findings may support mechanism-specific assessment and prioritisation in trauma management.</p><p><strong>Trial registration: </strong>This study is a secondary analysis of a prospectively registered observational trauma cohort (ClinicalTrials.gov NCT05573841, registered 6 October, 2022).</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876416","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":"Operational assumptions underlying extracorporeal resuscitation eligibility models.","authors":"Alexis Cournoyer, Alexandros Cavayas, Lawrence Leroux","doi":"10.1186/s13049-026-01686-2","DOIUrl":"10.1186/s13049-026-01686-2","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851840","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":"Workplace violence from the ambulance personnel's perspective, a qualitative study.","authors":"Magnus Viking, Karin Hugelius, Erik Höglund, Lisa Kurland","doi":"10.1186/s13049-026-01680-8","DOIUrl":"10.1186/s13049-026-01680-8","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing interest in the occurrence of workplace violence in ambulance services, few studies have explored the phenomenon from the perspective of the ambulance personnel. While previous studies have identified its incidence and risk factors, this study aimed to explore ambulance personnel's understanding of why workplace violence occurs.</p><p><strong>Methods: </strong>An inductive, qualitative study was conducted using digital focus group interviews. The inclusion criteria were as follows - having worked in ambulance services for a minimum of two years and having personally experienced workplace violence. Reflexive thematic analysis was employed in this study.</p><p><strong>Results: </strong>Three focus group interviews with 10 Swedish ambulance personnel were included in the study. Three themes were identified: (I) ambulance personnel's lack of competence and willingness to adapt can lead to workplace violence; (II) ambulance personnel's inability to cope with their emotional response to provocation can lead to workplace violence; and (III) experiencing limited control in unpredictable situations. Workplace violence occurred when the ambulance personnel lacked empathy and compassion for the patient, acted disrespectfully, or when the power imbalance between ambulance personnel and the patient became apparent. If ambulance personnel felt provoked by the patient's behaviour, it triggered workplace violence. Furthermore, if they could not read the situation and lost control of it or if the patient's behaviour was unpredictable (e.g. if the patient was under the influence of drugs or alcohol), workplace violence ensued.</p><p><strong>Conclusions: </strong>Ambulance personnel need to acknowledge their own contributions to the risk of workplace violence and identify situations and actions that could both increase and decrease the risk of exposure. Future studies should focus on implementing interventions to identify potential high-risk situations and train ambulance personnel to deescalate risky situations.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867530","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":"Thoracic injuries in elderly trauma patients epidemiology, injury characteristics, in-hospital care and outcome.","authors":"Andrea Lundin, Katarina E Göransson, Anders Enocson","doi":"10.1186/s13049-026-01676-4","DOIUrl":"10.1186/s13049-026-01676-4","url":null,"abstract":"<p><strong>Purpose: </strong>The aim was to describe epidemiology, injury characteristics, in-hospital care and outcome for elderly trauma patients with thoracic injuries within the context of a large national register study.</p><p><strong>Methods: </strong>Trauma patients aged ≥ 60 years from 2022 to 2024 were identified through the national Swedish Trauma Registry (SweTrau). The Abbreviated Injury Scale (AIS) was used to identify thoracic and other injuries. Data on patient and injury demographics, in-hospital care and outcome in terms of discharge destination and mortality was collected for each patient.</p><p><strong>Results: </strong>A total of 11,624 patients were included. The median age for all patients was 76 years (range 60-106), and 4617 (40%) were females. A total of 3644 (31%) patients had a thoracic injury registered (TI group). Compared with patients without thoracic injury (NTI), the TI group had higher injury severity (ISS and NISS) and were more physiologically compromised on arrival (lower systolic blood pressure and a higher proportion of patients presenting with circulatory shock (SBP < 90 mmHg). TI patients had more injuries, longer hospital length of stay, required more intensive care and were less often discharged to their home, while 30day mortality did not differ between groups.</p><p><strong>Conclusion: </strong>Elderly trauma patients with thoracic injuries were more severely injured, required more in-hospital care and could less often be discharged directly to their home, compared to patients without thoracic injury.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800586","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":"Clinical outcomes and opportunities for improvement across modified trauma quality improvement cohorts: a registry-based cohort study.","authors":"Jonatan Attergrim, Lovisa Strömmer, Olof Brattström, Martin Jacobsson, Josef Al-Khalili, Elin Sun Cao, Kelvin Szolnoky, Johanna Berg, Martin Gerdin Wärnberg","doi":"10.1186/s13049-026-01674-6","DOIUrl":"https://doi.org/10.1186/s13049-026-01674-6","url":null,"abstract":"<p><strong>Background: </strong>The American College of Surgeons Trauma Quality Improvement Program (TQIP) relies primarily on risk-adjusted mortality benchmarking, yet mortality alone may overlook non-fatal morbidity and care-process failures, particularly in cohorts where outcomes are driven by injury severity. This study aimed to analyse and compare 30-day mortality, cause of death, functional outcomes as measured by the Glasgow Outcome Scale (GOS), and opportunities for improvement (OFIs) identified through peer review across modified TQIP cohorts.</p><p><strong>Methods: </strong>Registry-based cohort study of 8,298 trauma patients at Karolinska University Hospital (2013-2023), classified into four modified TQIP cohorts: isolated severe TBI, blunt multisystem with TBI, blunt multisystem without TBI, and penetrating truncal injury. Remaining patients, of lower severity on average, formed a non-TQIP reference cohort. Cohort associations with mortality, unfavourable GOS, and OFI were assessed using cumulative sequential logistic regression (reference: non-TQIP cohort), progressively adjusting for patient characteristics, physiological status, and care processes, pooled across 20 imputed datasets. Cause of death, GOS levels, and OFI categories were compared using multinomial logistic regression.</p><p><strong>Results: </strong>All TQIP cohorts had elevated odds of mortality and unfavourable GOS. The blunt multisystem cohorts had the highest OFI rates (10.6% with TBI, 16.9% without) and were the only cohorts with elevations across all OFI categories, including potentially preventable deaths and clinical judgement errors. Care-process adjustment (e.g. emergency interventions, time to radiology, care level) reduced their mortality ORs, suggesting potentially modifiable processes. Isolated severe TBI had the highest mortality (52.8%) but no OFI excess, suggesting outcomes driven by primary injury rather than care-process failures. Penetrating truncal injury showed high, potentially preventable, haemorrhage-related mortality but favourable functional recovery in survivors after care-process adjustment.</p><p><strong>Conclusions: </strong>Outcome profiles differed across TQIP cohorts and were not captured by mortality alone: isolated severe TBI had the highest mortality but no OFI excess, while the blunt multisystem cohorts had the greatest OFI burden and potentially preventable deaths despite lower mortality. Penetrating truncal injury showed high haemorrhage-related mortality but favourable functional recovery in survivors. Integrating functional outcomes and structured peer review alongside mortality identifies cohorts amenable to quality improvement and reveals cohort-specific processes to target.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800583","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":"Fitting in or standing out: a scoping review of gender-related findings in Nordic EMS through an organizational socialization lens.","authors":"Lindström Veronica, R C Ericsson, R Sinisalo, A Venesoja","doi":"10.1186/s13049-026-01677-3","DOIUrl":"10.1186/s13049-026-01677-3","url":null,"abstract":"<p><strong>Objective: </strong>To explore and map research on workplace culture, occupational health, exposure to violence, and organizational dynamics among Emergency Medical Service (EMS) professionals in Nordic countries, focusing on studies reporting gender-related findings between 2010 and 2025.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with the JBI methodological guidance and reported using the PRISMA-ScR framework. Searches were performed in CINAHL, PubMed, Scopus, Web of Science, and Google Scholar covering the period 2010-2025. Studies focusing on EMS professionals and workplace experiences related to gender, workplace culture, discrimination, leadership, or organizational factors were eligible. Data were charted descriptively, using an inductive content analysis approach.</p><p><strong>Results: </strong>Seven peer-reviewed studies and five master's theses met the inclusion criteria, comprising cross-sectional, prospective cohort, and observational designs. Three explicitly examined gender/equality; other gender-related differentiated findings were reported as secondary observations. Women reported higher physical and psychosocial work demands (43% vs. 22%; 41% vs. 20%), greater concerns about threats and violence (58% vs. 38%), and higher levels of mental health problems (29% vs. 8%) and sleep disturbances (60% vs. 39%). Despite this, women demonstrated higher physical capacity, while men had higher cardiovascular disease risk factors. Men reported greater exposure to certain critical incidents, whereas stress levels were similar between genders. Workplace violence was common, with differences between men and women observed in exposure, perception, and support-seeking behaviors.</p><p><strong>Conclusion: </strong>This scoping review found that gender-related patterns are present across workplace demands, health outcomes, exposure to violence, and critical incidents, but are rarely explicitly addressed in Nordic EMS research. Rather than isolated findings, these patterns appear to be embedded in organizational processes that shape norms, expectations, and professional identities. For example, women reported higher work demands, greater concern about workplace risks, and poorer mental health outcomes, despite demonstrating high physical capacity, while men reported greater exposure to certain critical incidents. Interpreted through the lens of organizational socialization, these findings suggest unequal access to legitimacy, well-being, and career opportunities, with implications for workforce sustainability. Addressing these issues through organizational and educational strategies may improve working conditions, reduce workplace risks, and support a more equitable and sustainable Nordic EMS workforce.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800611","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":"Effect of an app-guided advanced cardiac life support algorithm on teamwork, non-technical skills, and workload in simulated in-hospital cardiac arrest: a randomized controlled feasibility trial.","authors":"Anne Kamphausen, Maximilian Pilz, Matthias Baumgärtel, Jens Christian Kubitz, Christian Engelen","doi":"10.1186/s13049-026-01673-7","DOIUrl":"10.1186/s13049-026-01673-7","url":null,"abstract":"<p><strong>Background: </strong>In-hospital cardiac arrest carries high mortality despite advances in monitoring, rapid response systems, and adherence to advanced life support (ALS) guidelines. Digital decision-support tools, including mobile applications, are increasingly explored to improve guideline adherence, yet their impact on cognitive workload, team performance, and ALS performance remains uncertain.</p><p><strong>Methods: </strong>We conducted a prospective, randomized, simulation-based controlled feasibility trial with 40 interprofessional teams (80 participants) comparing ALS performance with and without the use of the 'CPR Leader' app. Two-person teams were randomized 1:1 to intervention or control and followed standardized in-hospital cardiac arrest scenarios (asystole and ventricular fibrillation). Primary outcomes included team performance (TEAM), non-technical skills (ANTS), and subjective workload (NASA-TLX). Secondary outcomes comprised objective resuscitation metrics, including time to rhythm analysis, defibrillation, medication administration, and chest compression quality.</p><p><strong>Results: </strong>Overall NASA-TLX scores were high but comparable between intervention and control group (mean 49.2 ± 13.6 vs. 54.1 ± 14.6; p = 0.2), with higher effort reported in the app group and higher frustration in the control group. TEAM and ANTS scores showed no evidence of meaningful between-group differences. Across the two scenarios types, ALS performance metrics-including rhythm analysis, defibrillation, medication administration, and chest compression quality-were similar between groups, with the exception of earlier chest compression initiation in the control group during ventricular fibrillation.</p><p><strong>Conclusions: </strong>In this exploratory randomized simulation study involving predominantly experienced in-hospital healthcare professionals, the use of a resuscitation support application did not demonstrate a clear improvement in adherence to guideline-recommended ALS algorithms or resuscitation performance compared with standard practice. These findings likely reflect the high level of participants' clinical experience and should not be generalized to novice providers, mixed-experience teams, prehospital settings, or training environments. Further studies are warranted to evaluate the potential benefits of cognitive aids in less experienced populations and in real-world clinical practice.</p><p><strong>Trial number: </strong>None.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759845","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}