Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Teaching triage in disaster medicine - same subject, but different approach.","authors":"Amir Khorram-Manesh","doi":"10.1186/s13049-025-01322-5","DOIUrl":"10.1186/s13049-025-01322-5","url":null,"abstract":"<p><strong>Background: </strong>Disaster management is an inter-, intra-, and cross-disciplinary task in which different specialties partake. Triage is a crucial part of disaster education. A synchronized approach and mutual understanding of triaging and agreement on priorities are essential for saving lives.</p><p><strong>Case study: </strong>Educational initiatives in disaster medicine aim to address issues that highlight the differences between more routine multi-casualty incidents and rarer mass casualty incidents. These differences are characterized by the number of victims, available resources, and environmental factors that may jeopardize the safety of victims and healthcare providers. While routine triage algorithms are often used in multiple casualty emergencies, considering environmental factors in mass casualty incidents caused by natural or human-made hazards should be equally important.</p><p><strong>Conclusions: </strong>The impacts of environmental factors are usually not discussed in disaster medicine education, resulting in professionals having difficulties understanding the limitations of implementing routine triage algorithms during disaster response.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"9"},"PeriodicalIF":3.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015029","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":"Peripheral oxygen saturation levels as a guide to avoid hyperoxia: an observational study.","authors":"Renate Stolmeijer, Jan C Ter Maaten, Jack Ligtenberg, Ewoud Ter Avest","doi":"10.1186/s13049-025-01323-4","DOIUrl":"10.1186/s13049-025-01323-4","url":null,"abstract":"<p><strong>Background: </strong>As iatrogenic hyperoxia has been related to adverse outcomes in critically ill patients, guidelines advise to titrate oxygen to physiological levels. In the prehospital setting where partial arterial oxygen (PaO₂) values are often not readily available, titration of oxygen is based on peripheral oxygen saturations (SpO2). In this study we aimed to investigate the efficacy of SpO₂ guided oxygen titration in the prevention of hyperoxia.</p><p><strong>Methods: </strong>In a retrospective observational cohort study of patients included in the Acutelines data- and biobank of the University Medical Center Groningen between September 2020 and March 2023, we collected blood gas samples and triage data of sequentially included patients who received oxygen at the moment they were presented in the emergency department (ED). PaO₂ values were compared to (concurrently measured) SpO₂ values, and to patient- and treatment characteristics and P/F ratios were calculated in order to investigate the efficacy of SpO₂ based oxygen titration for various subgroups.</p><p><strong>Results: </strong>Blood gas samples were obtained for 1042 patients, of which 178 (17.1%) had hyperoxia (PaO₂ levels > 13.5 kPa). SpO₂ readings were available for 170 of these, 68 of which (40%) had SpO₂ values above the recommended target range (94-98%; 88-92% for patients with COPD) whereas 102 patients (60%) had SpO2 values within- or even below the recommended target range. Many of these patients (44.1%) received oxygen through a low-flow device (nasal canula), and these patients almost invariably (84.4%) were not compromised in their ventilation (P/F ratio's > 300).</p><p><strong>Conclusion: </strong>When oxygen is titrated based on SpO₂ levels, this results in hyperoxemia in a significant proportion of the patients. Health care providers should especially be reluctant to administer (low flow) oxygen as a standard of care to patients who do not have clear respiratory compromise, as these patients are at a high risk of developing (occult) hyperoxia.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"8"},"PeriodicalIF":3.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015023","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":"Definition and developmental goals for Nordic emergency medicine.","authors":"Hjalti Már Björnsson, Ari Palomäki, Christian Baaner Skjærbæk, Frederik Pors Klinting, Frida Meyer, Jørn Einar Rasmussen, Lars Petter Bjørnsen","doi":"10.1186/s13049-025-01319-0","DOIUrl":"10.1186/s13049-025-01319-0","url":null,"abstract":"<p><p>Although Emergency Medicine is now globally an established specialty, the Nordic countries have been relatively slow to implement it into their health care systems. To facilitate the development of EM in the Nordic area, a working group was formed with representation from all national EM societies; DASEM (Danish Society for Emergency Medicine), FiSEM (Finnish Society of Emergency Medicine), ISEM (Icelandic Society for Emergency Medicine), NCEM (Norwegian College of Emergency Medicine), and SWESEM (Swedish Society for Emergency Medicine). This group was tasked with creating a Nordic EM manifesto-to create a definition and developmental goals for Nordic Emergency Medicine. The commentary provides an overview of the current status and challenges facing EM in the Nordic countries.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"7"},"PeriodicalIF":3.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984110","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":"Factors affecting communication time in an emergency medical communication centers.","authors":"Melisande Bensoussan, Mathilde Vannier, Thomas Loeb, Jérémie Boutet, Frédéric Lapostolle, Paul-Georges Reuter","doi":"10.1186/s13049-024-01315-w","DOIUrl":"10.1186/s13049-024-01315-w","url":null,"abstract":"<p><strong>Background: </strong>Emergency Medical Communication Centres (EMCCs) play a crucial role in emergency care by ensuring timely responses through telephone triage. However, extended communication times can impede accessibility, patient triage, and decision-making. Identifying the factors influencing communication duration is essential for improving EMCC efficiency.</p><p><strong>Objective: </strong>This study aims to identify temporal, human, and contextual factors associated with prolonged communication times in an EMCC where decision-making is conducted by physicians.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of all calls received at a French EMCC between March 1 and December 31, 2019. A total of 108,548 patient medical files were analyzed, excluding calls from medical personnel or hospitals. We examined the total communication time (from call initiation to decision) and the medical communication time (physician involvement). Bivariate and multivariate logistic regressions were used to identify factors associated with prolonged communication times.</p><p><strong>Results: </strong>The median total communication time was 7 min [IQR 5-11], and the median medical communication time was 3 min [IQR 2-4]. Psychiatric reasons for calling (OR = 1.75) and elderly patients (OR = 1.58) were associated with longer communication times. Calls leading to medical advice (OR = 1.48) and calls during weekends or nighttime were also significant factors. Conversely, calls for trauma or from nursing homes, and those handled by emergency physicians, were associated with shorter durations.</p><p><strong>Conclusion: </strong>Several factors influence communication times in EMCCs, including patient demographics, reason for the call, and time of day.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"6"},"PeriodicalIF":3.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980460","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":"\"They were sort of in the room with me\": a qualitative study about callers' experience of video streaming during medical emergency calls.","authors":"Siri Idland, Kristin Häikiö, Jo Kramer-Johansen, Magnus Hjortdahl","doi":"10.1186/s13049-024-01317-8","DOIUrl":"10.1186/s13049-024-01317-8","url":null,"abstract":"<p><strong>Background: </strong>During the recent years, emergency services in several countries have integrated video streaming into medical emergency calls, and research on the topic has gained increased focus. Video streaming during medical emergency calls may change dispatcher's perspective of the call and can be a helpful tool for supervising bystanders' first aid. Little research exists, however, about the caller's perspective of video streaming during a medical emergency call. With this study, we explore the caller's experiences with video streaming.</p><p><strong>Methods: </strong>The study is a qualitative interview study. During a period of five weeks, we recruited respondents from the region of Oslo who had called the medical emergency number 113 and where video streaming had been used by the dispatcher during the call. We conducted 14 semi-structured individual interviews, in-person or digitally on Zoom/Teams, from October to December 2023. The interviews were transcribed verbatim, and we analyzed them drawing on Malterud's systematic text condensation.</p><p><strong>Results: </strong>Our material was sorted into three category headings: Increased sense of safety, the unexpected option of video streaming, and emotional discomfort. Most respondents felt comforted knowing that the dispatcher could see and assess the situation visually. Several were also positively surprised that video streaming was an option during the call. Some respondents however felt increased stress during the call due to video streaming. Other respondents reflected on the societal taboo of filming ill or injured persons.</p><p><strong>Conclusion: </strong>Most respondents experienced video streaming as a positive addition to the medical emergency call and felt comforted knowing that the dispatcher could see the situation. Knowledge of the integration between video streaming and basic communication in a call is nonetheless of great importance, as to not increase stress experienced by the caller. The dispatcher should be sensitive for how the caller will handle video streaming for each call.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"5"},"PeriodicalIF":3.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957659","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":"Extrication following a motor vehicle collision: a consensus statement on behalf of The Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh.","authors":"Tim Nutbeam, Rob Fenwick, Charlotte Haldane, Caroline Leech, Emily Foote, Simon Todd, David Lockey","doi":"10.1186/s13049-024-01312-z","DOIUrl":"https://doi.org/10.1186/s13049-024-01312-z","url":null,"abstract":"<p><strong>Background: </strong>Road traffic injury is the leading cause of death among young people globally, with motor vehicle collisions often resulting in severe injuries and entrapment. Traditional extrication techniques focus on limiting movement to prevent spinal cord injuries, but recent findings from the EXIT project challenge this approach. This paper presents updated recommendations from the Faculty of Pre-Hospital Care (FPHC) that reflect the latest evidence on extrication practices.</p><p><strong>Methods: </strong>A systematic scoping review identified 170 relevant articles from 7083 records. Findings, together with EXIT project data, informed the development of 12 core and supplemental statements on extrication. In April 2024, 43 subject matter experts from diverse backgrounds participated in a consensus process. Statements were discussed, voted on, and synthesised into the updated statement, ratified by FPHC.</p><p><strong>Results: </strong>Consensus was achieved for all 12 statements, emphasising self-extrication as a preferred, primary approach, reducing extrication time, and moving away from absolute movement minimisation. The U-STEP OUT algorithm was endorsed as a decision-making tool. Key themes included interdisciplinary collaboration, use of operational and clinical decision aids, and enhanced training.</p><p><strong>Conclusions: </strong>This consensus statement marks a paradigm shift in extrication practice, moving away from traditional movement minimisation to a focus on time-sensitive, patient-centred care. The findings advocate for empowering both clinical and non-clinical responders and improving interdisciplinary training and communication. Further research is needed to assess the broader implementation of this statement and to explore the psychological impacts of entrapment and extrication on patients.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"3"},"PeriodicalIF":3.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957638","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 development of a decision support tool in the prehospital setting for acute chest pain - a study protocol for an observational study (BRIAN2).","authors":"Elin Lökholm, Carl Magnusson, Johan Herlitz, Annica Ravn-Fischer, Ola Hammarsten, Magnus Johansson, Kristoffer Hallin, Kristoffer Wibring","doi":"10.1186/s13049-024-01314-x","DOIUrl":"https://doi.org/10.1186/s13049-024-01314-x","url":null,"abstract":"<p><strong>Introduction: </strong>Chest pain is one of the most common reasons for contacting the emergency medical services (EMS). It is difficult for EMS personnel to distinguish between patients suffering from a high-risk condition in need of prompt hospital care and patients suitable for non-conveyance. A vast majority of patients with chest pain are therefore transported to the emergency department (ED) for further investigation even if hospital care is not necessary. Improved prehospital assessment and risk stratification, thus accurately and safely identifying patients suitable for non-conveyance, could prevent unnecessary transport to the ED. This would reduce ED crowding and overburdening sparse EMS resources. It would thus also probably reduce healthcare costs. Little is known about the prehospital use of the 5th generation, i.e. high-sensitivity troponin analyses. The aim of this project is to develop an EMS decision support tool using high-sensitivity troponin I for risk assessment of chest pain patients.</p><p><strong>Methods and analysis: </strong>This is a prospective, multicentre, cohort study including adult unselected EMS patients with chest pain. Data is being collected from 20 May 2023 to 31 December 2025, aiming to include at least 2,000 patients. High-sensitivity troponin I is being analysed bedside using Siemens Healthineers Atellica VTLi. In addition to prehospital troponin I, data is being collected on patient medical history, onset, vital signs, symptoms, ECG and diagnosis at hospital discharge. Several statistical analyses (random forest, logistic regression, gradient boosting) will be conducted to identify the best model for identifying patients with low-risk conditions suitable for non-conveyance.</p><p><strong>Ethics and dissemination: </strong>The study has been approved by the Swedish Ethical Review Authority (Dnr 2022-01066-01 and 2022-06846-02). Patients are being informed about the study both orally and in writing. The results of the study will be published in a peer-reviewed journal and will be presented at national and/or international conferences.</p><p><strong>Registration details: </strong>The study is registered at ClinicalTrials.gov (NCT05767619).</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"4"},"PeriodicalIF":3.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957639","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":"Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis.","authors":"Matthew D Lavery, Arshbir Aulakh, Michael D Christian","doi":"10.1186/s13049-024-01298-8","DOIUrl":"10.1186/s13049-024-01298-8","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past three decades, more advanced pre-hospital systems have increasingly integrated physicians into targeted roles, forming interprofessional teams. These teams focus on providing early senior decision-making and advanced interventions while also ensuring rapid transport to hospitals based on individual patient needs. This paper aims to evaluate the benefits of an inter-professional care model compared to a model where care is delivered solely by paramedics.</p><p><strong>Methodology: </strong>A meta-analysis and systematic review were conducted using the guidelines of PRISMA 2020. Articles were identified through a systematic search of three databases and snowballing references. A systematic review was conducted of articles that met the inclusion criteria, and a suitable subset was included in a meta-analysis. The survival and mortality outcomes from the studies were then pooled using the statistical software Review Manager (RevMan) Version 8.2.0.</p><p><strong>Results: </strong>Two thousand two hundred ninety-six articles were found from the online databases and 86 from other sources. However, only 23 articles met the inclusion criteria of our study. A pooled analysis of the outcomes reported in these studies indicated that the mortality risk was significantly reduced in patients who received pre-hospital care from interprofessional teams led by physicians compared with those who received care from paramedics alone (AOR 0.80; 95% CI [0.68, 0.91] p = 0.001). The survival rate of critically ill or injured patients who received pre-hospital care from interprofessional teams led by physicians was increased compared to those who received care from paramedics alone (AOR 1.49; 95% CI [1.31, 1.69] P < 0.00001).</p><p><strong>Conclusions: </strong>The results of our analysis indicate that the targeted deployment of interprofessional teams led by physicians in the pre-hospital care of critically ill or injured patients improves patient outcomes.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933237","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: A regional modification to the Revised Swiss System for clinical staging of hypothermia including confusion.","authors":"Duncan Gray, Mathieu Pasquier, Hermann Brugger, Martin Musi, Peter Paal","doi":"10.1186/s13049-024-01303-0","DOIUrl":"10.1186/s13049-024-01303-0","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"2"},"PeriodicalIF":3.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928561","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":"Pre-hospital management of traumatic cardiac arrest 2024 position statement: Faculty of Prehospital Care, Royal College of Surgeons of Edinburgh.","authors":"Celestine Weegenaar, Zane Perkins, David Lockey","doi":"10.1186/s13049-024-01304-z","DOIUrl":"10.1186/s13049-024-01304-z","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"139"},"PeriodicalIF":3.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911010","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}