Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Prehospital measurement and treatment of ionised hypocalcaemia by UK helicopter emergency medical services in trauma patients: a survey of current practice.","authors":"O Hibberd, C Leech, N Lang, J Price, Ebg Barnard","doi":"10.1186/s13049-025-01379-2","DOIUrl":"https://doi.org/10.1186/s13049-025-01379-2","url":null,"abstract":"<p><strong>Background: </strong>In the United Kingdom (UK), an increasing number of Helicopter Emergency Medical Services (HEMS) carry blood products for the resuscitation of patients with suspected haemorrhage. Ionised hypocalcaemia can occur due to calcium chelation from citrate-containing blood products or in response to traumatic injury. Therefore, many HEMS administer calcium alongside prehospital blood product transfusion. There are no national guidelines for prehospital calcium replacement. This study aimed to explore current UK HEMS protocols for calcium replacement associated with prehospital blood product transfusion and to report point-of-care testing (POCT) availability. The survey also sought to identify clinicians' opinions on the measurement, significance, and management of trauma-induced ionised hypocalcaemia in the prehospital setting.</p><p><strong>Methods: </strong>A cross-sectional survey with single-staged purposive sampling was conducted between 26th September and 15th November 2024. The survey explored standard operating procedures (SOPs) for calcium replacement, the incidence of POCT, and clinicians' opinions on the measurement and treatment of ionised hypocalcaemia. The survey was sent to the medical director, research lead, or a nominated clinician at the 21 HEMS in the UK on the 26th September 2024. These services were also invited to participate via a post on X (formerly Twitter) and a presentation delivered at the National HEMS Research and Audit Forum (NHRAF) on 26th September 2024.</p><p><strong>Results: </strong>21 HEMS responded to the survey (100% response rate), and all carried prehospital blood products and calcium replacement therapy. Eleven different combinations of blood products were carried. 20/21 (95%) had a SOP for calcium replacement during prehospital blood product transfusion. POCT of ionised calcium (iCa²⁺) was available at 6/21 (29%) of services. None had an SOP outlining the use of POCT for trauma patients, nor did any SOP specify the timing for measuring iCa²⁺. Clinicians' opinions on the definition, measurement, and treatment of ionised hypocalcaemia varied widely.</p><p><strong>Conclusion: </strong>Blood products and calcium replacement therapy are now carried by all UK HEMS, but POCT is not in widespread use. Significant variation exists in the combination of products carried, protocols for calcium replacement, and opinions on the management of trauma-induced hypocalcaemia during prehospital transfusion, which suggests a need for further evidence.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"63"},"PeriodicalIF":3.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: matters arising to impact of a POCUS-first versus CT-first approach on emergency department length of stay and time to surgical consultation in patients with acute cholecystitis: a retrospective study.","authors":"Chien-Tai Huang, Wan-Ching Lien","doi":"10.1186/s13049-025-01375-6","DOIUrl":"https://doi.org/10.1186/s13049-025-01375-6","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"61"},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992491","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":"Competence expected from advanced-level paramedics by emergency medical services managers in Finland: a modified Delphi study.","authors":"Antti Tanninen, Anne Kouvonen, Hilla Nordquist","doi":"10.1186/s13049-025-01384-5","DOIUrl":"https://doi.org/10.1186/s13049-025-01384-5","url":null,"abstract":"<p><strong>Background: </strong>Competence is a critical attribute for paramedics in emergency medical services (EMSs) because of the complex and diverse demands of the prehospital environment. This study aimed to identify and rank the key competencies expected of advanced-level paramedics as perceived by EMS managers.</p><p><strong>Methods: </strong>The modified Delphi study included three rounds conducted between October 2022 and June 2023. The panel consisted of 44 EMS managers, all working as superiors in EMS organizations across Finland.</p><p><strong>Results: </strong>In Round 1, 44 experts (100% response rate) evaluated 43 claims, with a consensus (≥ 75%) reached on five claims. The open-ended responses generated seven additional claims. In Round 2, 45 claims were reviewed; however, no consensus was reached. In Round 3, the top 15 claims from previous rounds were reevaluated (95% response rate), with assessment of patient conditions via the ABCDE protocol ranking highest. The experts also emphasized patient-centered care, safe environments, and systematic approaches in EMS.</p><p><strong>Conclusions: </strong>This study used the Delphi method to identify essential competencies for advanced-level paramedics, emphasizing patient assessment via the ABCDE protocol. This highlights the importance of core skills and nontechnical competencies such as supervision and well-being, stressing the need for continuous updates in paramedic training.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"62"},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044568","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 care pathways of patients conveyed by emergency medical services (EMS) through electronic health records.","authors":"Jani Paulin, Teijo I Saari, Heikki Riihimäki, Mari Koivisto, Laura-Maria Peltonen","doi":"10.1186/s13049-025-01378-3","DOIUrl":"https://doi.org/10.1186/s13049-025-01378-3","url":null,"abstract":"<p><strong>Background: </strong>Emergency Medical Services (EMS) and Emergency Departments (ED) have reported increased patient volumes in the last decades. Despite high rates of non-conveyance decisions, unnecessary conveyances by EMS still occur. The aim of this study was to explore care pathways of conveyed patients by EMS through registry data.</p><p><strong>Methods: </strong>This was a retrospective cohort study of EMS patients in Finland. The primary outcomes were EMS recontacts and visits to a primary health care facility or ED within seven days. The secondary outcome was mortality within one week. Univariate and multivariable associations between the outcome variables and categorical variables were analysed with logistic regression. Results are presented with odds ratios (ORs) together with 95% confidence intervals (CIs) and p-values.</p><p><strong>Results: </strong>The conveyed patients' visits to health care facilities were mainly brief. EMS arrival during night-time (20:00-08:00) (OR 1.69; 95% CI 1.59 to 1.80), in urban area (OR 1.21; 95% CI 1.13 to 1.29) and alcohol use (OR 2.55; 95% CI 2.26 to 2.86) predicted short ED visits (< 24 h). 77% of the patients were discharged from primary health care within one hour (median 22 min, IQR 18-60). After EMS conveyance and visit to the ED or primary health care facility, 10.5% of the patients were readmitted within one week. Non-urgent patients (OR 1.26; 95% CI 1.14 to 1.39), an EMS mission at night (OR 1.36; 95% CI 1.24 to 1.50), and based on univariate analyses, the usage of alcohol (OR 1.26; 95% CI 1.09 to 1.45) increased the likelihood of a readmission. 449 patients of all conveyed EMS patients (n = 20376) died within one week (2.2%).</p><p><strong>Conclusions: </strong>EMS non-conveyance reduces patient flow in EDs, but there is a possibility that more could be done related to unnecessary conveyances to health care facilities, especially in urban areas and at night. The pathway analyses of post conveyance re-contacts show that a small number of patients burden the system. Further in-depth studies are needed to understand of unnecessary conveyances, find solutions, and provide repeated users the appropriate care.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"60"},"PeriodicalIF":3.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009784","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":"Concrete silo collapse: emergency medical services response to a mass casualty incident.","authors":"Peter Martin Hansen, Marius Rehn, Rasmus Peter Jakobsen, Jesper Byrdorf, Simon Hestbech Lundorff, Søren Mikkelsen","doi":"10.1186/s13049-025-01376-5","DOIUrl":"10.1186/s13049-025-01376-5","url":null,"abstract":"<p><strong>Background: </strong>Major incidents evolving from occupational accidents are very infrequent in Scandinavia and therefore, case reports are called for. On 26 November, 2024, a fatal occupational accident took place during the construction of a concrete silo in the small rural town of Flemløse (population 574), Denmark. Three people died and six were injured as the result of a collapsing concrete roof during construction. We aim to describe the incident response by the emergency medical services (EMS), to identify areas of improvement, and to evaluate the adherence to current national major incident guidelines and communication grids.</p><p><strong>Case presentation: </strong>The initial call to the emergency medical dispatch center described an accident comprising fifteen injured persons, all of whom were migrant workers. Seventeen EMS units including two helicopter EMS units were dispatched to scene. Three critically injured patients were admitted to a nearby trauma center, whereas three lightly injured were taken to a regional trauma hospital. The initial reports overestimated the number of possible casualties and therefore, the available resources were ample. The very construction of the silo resulted in challenging conditions for evacuation of the injured patients. Chemical, biological, radiological, nuclear, and explosive (CBRNE) aspects of the incident added to the inherent complexity in major incident management. Although potentially detrimental to the patients, the prolonged extrication of the patients enabled the prehospital services to procure a timely organization of the incident site according to guidelines and an organized transport prioritization of the victims. The communication within EMS and between authorities was generally as per national guideline.</p><p><strong>Conclusions: </strong>The EMS response to this major incident generally adhered to the national guidelines and, furthermore, the communication within and between authorities was established according to guidelines. Important findings included the use of local resources by the incident command and improvised means for the evacuation of victims from a highly hostile environment. The triage of patients adhered to local and national major incident guidelines. Migrant workers have increased risk for occupational accidents.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"58"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early initiated noradrenaline versus fluid therapy for hypotension and shock in the emergency department (VASOSHOCK): a protocol for a pragmatic, multi-center, superiority, randomized controlled trial.","authors":"Lasse Paludan Bentsen, Thomas Strøm, Jakob Lundager Forberg, Gerhard Tiwald, Peter Biesenbach, Malik Kalmriz, Jens Henning Rasmussen, Nikolaj Raaber, Sören Möller, Mette Løkke, Gitte Boier Tygesen, Hanne Nygaard, Josephine Hyldgaard Brok, Julie Westergaard Andersen, Nikolett Bajusz, Mikkel Brabrand","doi":"10.1186/s13049-025-01369-4","DOIUrl":"10.1186/s13049-025-01369-4","url":null,"abstract":"<p><strong>Background: </strong>Shock is a condition with high mortality even with early intervention and treatment. Usual care for shock and hypotension in the Emergency Department (ED) is intravenous fluid resuscitation which can lead to fluid overload and other complications. When fluid therapy fails or risk of complications are high, the next treatment step is the use of vasopressors for stabilisation. Noradrenaline therapy for hypotension and shock are commonly used in ED's outside Scandinavia, but the evidence on the optimal initiation time is sparse. The lack of noradrenaline therapy in Scandinavia provides a unique environment to investigate the possible implications of early initiation. The aim of this trial is to investigate whether the use of early initiated noradrenaline compared to ED fluid therapy can improve blood pressure goals and by that, reduce the need for ICU admittance.</p><p><strong>Methods: </strong>This protocol describes a pragmatic, multi-center, superiority randomized controlled trial, randomizing patients with hypotension to intervention or control. Eligible patients are ≥ 18-year-old who have received at least 500 ml intravenous fluids (including prehospital administration), and without suspected cardiogenic, haemorrhagic, anaphylactic, or neurogenic causes, or require direct ICU admittance due to non-hemodynamic severe organ failure. The intervention group receives noradrenaline initiated at 0.05 mcg/kg/min with a maximum of 0.15 mcg/kg/min through a peripheral venous catheter for up to 24 h. The control group receives usual care. Treatment is targeted for a systolic blood pressure ≥ 100 mmHg, a mean arterial pressure ≥ 65 mmHg or a clinician defined blood pressure target. We require a sample size of 320 patients to show a significant difference in proportion of patients achieving shock control within 90 min (primary endpoint). Key secondary outcomes include ICU free days alive within 30-days and 30-day all-cause mortality.</p><p><strong>Discussion: </strong>Previous prospective randomized trials on early peripheral noradrenaline treatment for shock are sparse and are investigated in settings where noradrenaline use is already usual care. Since noradrenaline are not used as standard treatment for shock in Scandinavian EDs, this provides a unique opportunity not only to investigate the early initiation of noradrenaline for shock, but also comparing it directly to ED fluid only approach.</p><p><strong>Trial registration: </strong>EU CT ID 2023-504584-16-00.</p><p><strong>Clinicaltrials: </strong>gov NCT05931601. URL: https://classic.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT05931601.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"59"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804529","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 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":"Killien Lavabre, Nicolas Marjanovic, Denis Oriot, Mathilde Chenu, Adrien Gransagne, Michel Gentilleau, Anthony Moreau, Paul Contal, Olivier Mimoz, Bertrand Drugeon","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":"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}