Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Risk assessment reasoning and decision-making by ambulance professionals in patients with a transient loss of consciousness: a qualitative study.","authors":"Lucia G Uit Het Broek-Creemers, Lilian C M Vloet, Hester Vermeulen, Sivera A A Berben","doi":"10.1186/s13049-026-01598-1","DOIUrl":"https://doi.org/10.1186/s13049-026-01598-1","url":null,"abstract":"<p><strong>Background: </strong>Patients with a transient loss of consciousness (T-LOC) present a complex clinical situation for ambulance professionals. The challenge arises from the complexity of the diverse aetiologies associated with T-LOC and the demanding nature of the pre-hospital work environment. Insights into the experiences, dilemmas, and challenges faced by ambulance professionals in the risk assessment and decision-making in this patient category could help to understand the support they need. Our study aimed to explore the risk assessment reasoning and decision-making process of ambulance professionals in patients with a T-LOC in current practice.</p><p><strong>Methods: </strong>We conducted a qualitative study with focus group interviews in an emergency medical services (EMS) organisation in the Netherlands. Through purposive sampling, ambulance professionals were recruited for two online focus group interviews. An interview guide, based on literature and preliminary individual interviews, was used. The focus group interviews were transcribed verbatim and analysed using thematic analysis.</p><p><strong>Results: </strong>A total of eleven participants participated in two focus group interviews. Three main themes emerged: (1) Clinical reasoning covering the (initial) approach of ambulance professionals on scene, the T-LOC specific assessment, complexity of the aetiology of T-LOC, and the medical conveyance decision, (2) Collaboration describing the difficulties and facilitating factors in the interprofessional collaboration with other healthcare professionals in the chain of emergency care (e.g., general practitioners, emergency physicians, etc.) and the involvement of patients and relatives, (3) Professionalism describing the influence of professionals' experiences (e.g. professional maturity), the sense of responsibility and accountability of the ambulance professional, and their subsequent need for reflection.</p><p><strong>Conclusion: </strong>Ambulance professionals follow a structured approach for the clinical assessment of a patient with a T-LOC. In addition to their professional experience, the complexity of the symptom and the patient's context play a crucial role in the risk assessment reasoning and decision-making process. Ambulance professionals collaborate with other healthcare professionals to enhance their process, with varying experiences. There is a delicate balance between professionals' sense of responsibility and accountability. A non-conveyance decision is considered precarious by professionals, and adequate support from management, education and interprofessional collaboration is required to feel confident in their decision-making.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640392","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":"Collaboration among emergency first responders at major incidents - an explorative focus group study.","authors":"Andreas Rantala, Anna Conradsson, Jonathan Adamsson, Lena Forsell, Jonas Wihlborg","doi":"10.1186/s13049-026-01606-4","DOIUrl":"10.1186/s13049-026-01606-4","url":null,"abstract":"<p><strong>Background: </strong>In the event of a major incident, collaboration between the ambulance service, fire brigade and police is common. Effective collaboration requires teamwork, with communication between the three organisations being crucial. Leadership functions should be integrated in a way that leverages organisation-specific capabilities, enabling interprofessional collaboration where diverse professional roles complement each other. The aim of this study is to explore the experiences of collaboration among emergency first responders during major incidents.</p><p><strong>Methods: </strong>Data were collected through four focus group interviews involving ambulance nurses, firefighters and police officers, each with a minimum of one year of operational experience. The data were analysed using content analysis inspired by Krueger and Casey.</p><p><strong>Results: </strong>Three categories emerged from the analysis; Coordinated communication as a foundation for collaboration, Structured interprofessional collaboration through leadership and shared understanding and Relational conditions for sustained interprofessional collaboration. Each category comprises two subcategories that reflect the participants' experiences.</p><p><strong>Conclusion: </strong>The findings highlight that collaboration among emergency first responders during major incidents is shaped by coordinated communication, structured leadership and mutual understanding of organisational roles. Communication challenges, leadership demands and safety considerations in complex incidents were described as influencing collaboration. Joint training and interprofessional interaction may support preparedness and strengthen collaboration across emergency service organisations.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595863","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":"Exploring enablers and barriers to the use of chest compression feedback devices in advanced life support: a qualitative study.","authors":"Øystein Myrlund Hansen, Charlotte Björk Ingul, Benjamin Stage Storm, Rita Solbakken","doi":"10.1186/s13049-026-01607-3","DOIUrl":"https://doi.org/10.1186/s13049-026-01607-3","url":null,"abstract":"<p><strong>Background: </strong>In sudden cardiac arrest, high-quality chest compressions are crucial for survival with favorable neurological outcomes. Chest compression feedback devices improve chest compression quality and the likelihood of achieving return of spontaneous circulation. However, implementation remains challenging. Understanding enablers and barriers is essential to inform implementation strategies and device design.</p><p><strong>Methods: </strong>We conducted a qualitative exploratory study using semi-structured interviews with 15 healthcare professionals from pre- and in-hospital advanced life support settings in Norway and Denmark. Data were analyzed using reflexive thematic analysis to identify patterns of meaning related to enablers and barriers to device use.</p><p><strong>Results: </strong>Data analysis led to the construction of four themes: (1) The CPR sensor-a key physical interaction point, where usability was shaped by ergonomics, as well as challenges related to sensor positioning and detachment. The sensor created a physical buffer that reduced the discomfort of feeling rib and sternum fractures and skin damage during compressions, helping providers maintain focus and perform compressions consistently. (2) Feedback-Device-to-rescuer communication, where visual feedback was preferred and considered informative, while audio feedback was often seen as disruptive and difficult to perceive during compressions. (3) Organizing cardiac arrest treatment, where team structure, leadership roles and protocol integration influenced device use. Clear assignment of responsibility and predefined equipment layout supported consistent use. (4) Perceived usefulness-an important enabling factor, where feedback was especially valued in supervisory roles, supporting clinical oversight and decision-making, leading to device integration into team workflows. In the pre-hospital setting, the device supported effective guidance for bystanders. The device's inability to provide physiological feedback raised questions about its future relevance.</p><p><strong>Conclusions: </strong>Successful implementation of chest compression feedback devices in advanced life support depends on user-centered design, role-sensitive feedback, and integration into clinical protocols. Key enablers included sensor ergonomics, visual feedback, and structured team roles, while barriers such as sensor detachment and disruptive audio feedback hindered sustained use. Future development should focus on multimodal feedback tailored to team functions and support physiology-guided resuscitation.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595978","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":"Helicopter versus GROUND emergency medical services in mountainous trauma care: a comparative cohort study on time efficiency, golden hour achievement, and clinical outcomes in the Qinba region.","authors":"Yong Bai, Kai Yang, Jing Gao, Wenping Guo","doi":"10.1186/s13049-026-01604-6","DOIUrl":"https://doi.org/10.1186/s13049-026-01604-6","url":null,"abstract":"<p><strong>Objective: </strong>To compare the time efficiency and clinical outcomes of helicopter emergency medical services (HEMS) versus ground emergency medical services (GROUND) for severe trauma in the mountainous Qinba region, with a focus on achieving the \"golden hour\" and its impact on patient prognosis.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included severe trauma patients (Injury Severity Score [ISS] ≥ 16) transported by HEMS or GROUND between January 2018 and September 2025. Propensity score matching (1:1) was performed using age, sex, APACHE II, and ISS scores to control for confounding. The primary outcome was a composite of major in-hospital complications. \"Golden hour\" compliance was defined as completion of critical imaging (FAST/CT) and admission to the operating room or intensive care unit within 60 min of the emergency call. Time metrics, mortality, organ dysfunction (SOFA), length of stay, and discharge neurological status (GOS) were compared.</p><p><strong>Results: </strong>After matching, 77 well-balanced pairs were formed. HEMS achieved a significantly higher golden hour compliance rate than GROUND (71.43% vs. 2.60%, p < 0.001). HEMS significantly reduced transport time (median 15 vs. 105 min, p < 0.001) and total call-to-hospital arrival time (46 vs. 158 min, p < 0.001). Clinically, HEMS was associated with lower 24-h mortality (1.30% vs. 10.39%, p = 0.039), lower composite major complication rate (7.88% vs. 26.33%, p = 0.026), lower SOFA scores (median 12 vs. 20, p < 0.001), shorter ICU (5.62 vs. 9.78 days, p < 0.001) and hospital stays (13.44 vs. 21.34 days, p < 0.001), and higher GOS scores at discharge (4.0 vs. 2.64, p < 0.001). Multivariable Cox regression identified HEMS as an independent protective factor for better outcomes. ROC analysis showed perfect discrimination of HEMS vs. GROUND by transport time and total arrival time (AUC = 1.000).</p><p><strong>Conclusion: </strong>In mountainous regions, HEMS markedly improves golden hour attainment, translating into reduced early mortality, fewer complications, milder organ dysfunction, shorter hospitalizations, and better neurological recovery. These findings support the integration of HEMS into trauma systems in geographically challenging areas.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582863","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 and diagnostic accuracy of paramedic-performed prehospital point-of-care ultrasound: a retrospective observational study.","authors":"Adrian Boehm, Tobias Bexten, Michael Stanley, Dieter Westphal, Robert Buder, Ferdinand Konrad-Borgstaedt, Peter Benoehr","doi":"10.1186/s13049-026-01595-4","DOIUrl":"10.1186/s13049-026-01595-4","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) is increasingly being used in prehospital emergency medicine. While physician-performed prehospital ultrasound is well established, evidence regarding the feasibility and diagnostic accuracy of paramedic-performed POCUS in real-world settings remains limited.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study evaluating paramedic-performed POCUS following a structured, multimodal training program. Twenty-one certified paramedics performed handheld ultrasound examinations in prehospital emergencies using standardized protocols with an observation period of 24 months, starting from March 2023. Feasibility, utilization patterns, diagnostic accuracy, and perceived clinical impact were assessed using standardized documentation. Hospital diagnoses served as the reference standard, based on radiological, sonographic, and/or clinical documentation.</p><p><strong>Results: </strong>A total of 169 ultrasound examinations were performed on 144 patients. The overall diagnostic performance achieved a sensitivity of 87.9% and specificity of 92.7%. Diagnostic accuracy, defined as the concordance between prehospital POCUS-based working diagnoses and final in-hospital diagnoses, was particularly strong for lung ultrasound (pneumothorax, pulmonary edema, pneumonia and pleural effusion; sensitivity 91.7%, specificity 100%) and eFAST (sensitivity 100%, specificity 96.5%), while for the abdominal ultrasound examinations, the specificity was 70% and sensitivity was 71.43%. Ultrasound findings influenced logistical and clinical decision-making in a substantial proportion of missions, including changes in transport urgency (36.1%) and hospital destination (18.1%), whereas emergency room prealerts were avoided in 9.7% of cases. Training resulted in significantly more positive attitudes regarding feasibility, clinical relevance, and image of paramedic-performed ultrasound. Concerns regarding time delay and workload were markedly reduced.</p><p><strong>Conclusions: </strong>Paramedic-performed prehospital POCUS is feasible after structured training and can be integrated into routine prehospital care. Prospective studies should further assess the diagnostic accuracy, reliability, and clinical impact of paramedic-performed POCUS in the prehospital setting.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575919","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":"BMI is independently associated with ARDS, sepsis and multiorgan failure after major trauma-results of a high-volume retrospective observational cohort study.","authors":"B Erdle, J Mangold, J Kalbhenn, T D Diallo, F C Wagner, J Maier, H Schmal, N Mühlenfeld","doi":"10.1186/s13049-026-01603-7","DOIUrl":"10.1186/s13049-026-01603-7","url":null,"abstract":"<p><strong>Background: </strong>Obesity is increasingly prevalent among trauma patients and has been proposed to influence post-injury inflammatory responses and organ dysfunction. However, evidence on the independent effect of body mass index (BMI) on in-hospital complications after major trauma remains conflicting. This study aimed to determine whether BMI is an independent predictor of specific adverse clinical outcomes in a large cohort of adult trauma patients.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed associations between BMI and adverse clinical outcomes (ARDS, pneumonia, sepsis, multiorgan failure (MOF) and mortality) among adult trauma patients at a German level-I trauma center between 2018 and 2024. Inclusion criteria were trauma leading to an Injury Severity Score (ISS) ≥ 9 and/or admission to the intensive care unit. Multivariable logistic regression adjusted for BMI, age, sex, ASA and ISS.</p><p><strong>Results: </strong>A total of 1514 patients were included. Adjusted multivariate regression revealed BMI as being independently associated with an increased risk of ARDS (aOR 1.09 per kg/m², 95% CI 1.01-1.16; p = 0.025), sepsis (aOR 1.05, 95% CI 1.00-1.10; p = 0.048) and MOF (aOR 1.10, 95% CI 1.04-1.17; p < 0.001), but not with pneumonia or mortality. Categorical BMI analysis identified obesity (> 30 kg/m²) as a clinically relevant non-linear cut-off point.</p><p><strong>Conclusions: </strong>A higher BMI was independently associated with ARDS, sepsis and MOF, but no independent association with mortality was detected in this cohort of adult trauma patients. This suggests that BMI may function as a clinically relevant risk marker.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534001","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":"Video-assisted versus telephone-only pediatric emergency calls: a predefined substudy of the cluster randomized CAM-VISION trial.","authors":"N H Bohnstedt-Pedersen, T B Gehrt, R A Blauenfeldt, U Væggemose, M F Gude","doi":"10.1186/s13049-026-01602-8","DOIUrl":"10.1186/s13049-026-01602-8","url":null,"abstract":"<p><strong>Background: </strong>Assessment of pediatric emergencies by telephone is challenging and may be associated with uncertainty and overtriage. Video streaming has been introduced in emergency medical dispatch, but evidence regarding its impact in pediatric emergency calls remains limited. We evaluated associations between video-assisted dispatch assessment and urgency allocation, EMS resource use, and patient safety in pediatric calls.</p><p><strong>Methods: </strong>This predefined substudy of the cluster-randomized CAM-VISION trial included emergency calls concerning children ≤ 15 years handled at the Emergency Medical Dispatch Center in the Central Denmark Region between January 1 and April 30, 2023. Dispatchers were randomized to video-assisted or telephone-only communication. Prespecified pediatric outcomes were the proportion of children assigned the lowest urgency level (response E), hospital admission within 24 h after response E, and the distribution of all urgency levels (A-E). Additional analyses included EMS resource allocation, urgency changes between dispatch and scene, non-conveyance, time intervals, ICU admission, and 30-day mortality. Analyses followed an intention-to-treat approach using clustered regression models.</p><p><strong>Results: </strong>Among 1,303 pediatric emergency calls, 586 were allocated to video-assisted dispatch and 717 to telephone-only communication. Video was successfully established in 74.7% of calls in the video group. Among predefined outcomes, the lowest urgency level (response E) was assigned more frequently in the video-assisted group (34.8% vs 28.0%; absolute difference 6.8 percentage points, 95% CI 0.1 to 13.4). No hospital admissions within 24 h occurred among children dispatched at response E in either group. The highest urgency level (response A) was less frequent in the video-assisted group (37.9% vs 45.0%; absolute difference - 7.2 percentage points, 95% CI - 14.0 to - 0.3). Additional analyses showed that physician-staffed vehicles arrived less often in the video-assisted group (35.3% vs 44.2%; absolute difference - 8.9 percentage points, 95% CI - 16.8 to - 0.9). Median time from call to dispatch was one minute longer in the video-assisted group, while on-scene time and hospital length of stay were similar between groups.</p><p><strong>Conclusion: </strong>Video-assisted dispatch in pediatric emergency calls was associated with more frequent assignment of the lowest urgency level and reduced use of physician-staffed vehicles without evidence of compromised patient safety.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT05742412.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522494","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 times and outcomes for hypotensive trauma patients in Sweden.","authors":"Axel Limbäck, Oscar Lapidus, Denise Bäckström","doi":"10.1186/s13049-026-01597-2","DOIUrl":"10.1186/s13049-026-01597-2","url":null,"abstract":"<p><strong>Background: </strong>The influence of EMS transport time on trauma patient survival has previously been examined. Studies have shown conflicting results, and some studies have been unable to prove any association between prehospital times and outcomes for trauma patients. In the context of Swedish trauma systems, the impact of prehospital time remains unclear.</p><p><strong>Aim: </strong>The aim of the present study was to investigate the correlation between prehospital time and outcomes for hypotensive trauma patients in Sweden.</p><p><strong>Methods: </strong>A total of 3,740 hypotensive trauma patients treated during the years 2013-2022 were identified through the Swedish Trauma Registry (SweTrau). The study included both ground ambulance patients and helicopter emergency medical services patients. A binary logistic regression model was used to analyse the correlation between total prehospital time and mortality while controlling for confounding factors. The primary study endpoint of this study was 30-day mortality after the initial traumatic event.</p><p><strong>Results: </strong>After adjusting for potentially confounding factors, including RTS, NISS, patient age, sex, and methods of injury, a longer total prehospital time was found to be associated with increased odds of mortality in the study population. In the present study, a one-minute increase in total prehospital time was found to have an adjusted odds ratio (AOR) of 1.005 for mortality (95% CI 1.000-1.009; P = 0.046) for undifferentiated hypotensive trauma patients.</p><p><strong>Conclusion: </strong>In this nationwide study aimed at investigating the correlation between prehospital time and survival among hypotensive trauma patients in Sweden, a longer total prehospital time was found to be associated with increased odds of mortality for undifferentiated hypotensive trauma patients, with the odds of mortality increasing by 5.1% per 10-min increase in total prehospital time.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505063","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":"Sex and gender bias in major trauma care: a scoping review.","authors":"A Ghika-Nanchen, L Marzorati, A Merra, C Girardello, P Truong, P N Carron, T Nutbeam, C Clair, F X Ageron","doi":"10.1186/s13049-026-01596-3","DOIUrl":"10.1186/s13049-026-01596-3","url":null,"abstract":"<p><strong>Background: </strong>Sex/gender bias have been well-documented in clinical medicine. However, few studies have assessed sex/gender disparities specifically in major trauma care. This scoping review aims to explore sex and gender-based differences in the emergency management of severely injured patients.</p><p><strong>Methods: </strong>A systematic literature review was conducted in the following electronic databases: Medline Ovid ALL, Embase, CINAHL with Full Text, Web of Science Core Collection, Cochrane Central Register of Controlled Trials with search criteria including keywords and mesh terms: gender, sex, major trauma, wounds and injuries. Three reviewers conducted the article selection.</p><p><strong>Results: </strong>Seventy-four full-text articles were included in the study. Main themes of sex/gender-based differences were mechanism of injury, severity of trauma, trauma triage, trauma care, mortality, and complications. Women were older with more low-energy trauma than men. Women were more likely to suffer from pelvic and spinal cord injuries. Women were more likely to be under-triaged and under-treated. Sex/gender-based differences in mortality were inconsistent across studies. Adjusted mortality appeared similar between women and men, with conflicting evidence of increased mortality in men in some studies.</p><p><strong>Conclusion: </strong>Women received less trauma care and were less likely to be transported to a trauma centre. These disparities are not fully explained by differences in injury mechanism or severity and instead appear to reflect modifiable features of trauma systems, particularly triage and transfer practices. Addressing these inequities will require system-level changes to ensure that access to specialist trauma care is based on clinical need rather than sex or gender.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516066","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 Ten Second Triage Tool - a multi-disciplinary simulation-based field test to determine its speed, accuracy and practical on scene application.","authors":"Claire Louise Park, James Vassallo, Philip Cowburn, Sean Brayford-Harris, Bryony Louise Dunne, Christopher G Moran, Jason Edward Smith","doi":"10.1186/s13049-026-01588-3","DOIUrl":"10.1186/s13049-026-01588-3","url":null,"abstract":"<p><strong>Background: </strong>Triage at major incidents has traditionally relied on assessing physiology, and in the UK, this role has usually been performed by healthcare responders. However, recent major incidents have shown that this approach, particularly in the initial phases, may be inappropriate due to potential delays in the delivery of key life-saving interventions (LSIs).The Ten Second Triage (TST) tool has been developed to expedite the triage process and the delivery of key LSIs. The aim of this study was to determine the performance characteristics of the TST, including the time to deliver LSIs, in a simulated major incident setting, by both healthcare and non-healthcare responders.</p><p><strong>Methods: </strong>A prospective observational study was conducted as part of a simulated major incident exercise, incorporating a variety of trauma pathologies. Responders from all three emergency services - Police, Fire, and Ambulance - participated. Eight simulations were conducted, each involving ten responders and a team leader from the respective single service groups. The NHS Major Incident Triage Tool (MITT), the TST alone, and a combination of both were assessed. Quantitative assessments for each simulation included overall triage time, time to delivery of LSI, and accuracy of triage tool categorisation.</p><p><strong>Results: </strong>Using the TST alone, the mean overall triage time was 377 s (10.2 s per casualty). In comparison, the mean overall triage time of the MITT alone was 1500 s (40.5 s per casualty). However, when the MITT was applied following the TST, it was completed more quickly, with a mean time of 960 s (25.9 s per casualty). When the TST was used, we observed a clinically significant reduction in the time to deliver key LSIs (491 s) compared to the MITT (1377 s). Overall triage accuracy was comparable between TST (80.3%) and MITT (79.3%), and TST performance was similar between healthcare and non-healthcare responders.</p><p><strong>Conclusion: </strong>This simulation study demonstrated that the TST is a rapid and accurate early scene triage method that enables the timely delivery of key lifesaving interventions. It facilitates the administration of these LSIs faster than existing physiological triage methods. These findings support the NHS England endorsement of the TST.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500267","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}