Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Development of novel thoracic retractor for resuscitative thoracotomy.","authors":"Shoichiro Urabe, Junya Shimazaki, Tomohisa Izutani, Tsuyoshi Hata, Mamoru Uemura, Hidetoshi Eguchi, Yuichiro Doki, Kiyokazu Nakajima","doi":"10.1186/s13049-025-01423-1","DOIUrl":"10.1186/s13049-025-01423-1","url":null,"abstract":"<p><strong>Background: </strong>Resuscitative thoracotomy (RT) is a critical intervention for patients in traumatic cardiac arrest or hemorrhagic shock, where survival is highly dependent on the time required to perform the procedure. Despite its urgency, RT is still conducted using traditional thoracic retractors originally designed for scheduled surgeries, which pose challenges in emergency settings. To address these limitations, we developed a novel thoracic retractor optimized for RT and evaluated its performance compared to a conventional model.</p><p><strong>Methods: </strong>The novel retractor was designed with an arrow-shaped hook for improved intercostal insertion and a continuously rotatable handle to enhance procedural efficiency. A comparative study using excised porcine thoraxes was conducted to assess its performance. Six cm incisions were made in the intercostal spaces bilaterally before retractor insertion. Evaluators inserted the device, performed three handle rotations, and repeated the procedure using the other retractor on the contralateral side. The primary outcome was the time required for three rotations, while secondary outcomes included ease of insertion, ease of rotation, and hook stability, rated on a 6-point scale by evaluators.</p><p><strong>Results: </strong>Ten surgeons (n = 10) performed thoracotomy using both the novel and conventional retractors. Comparison of the time required for three handle rotations between the novel and conventional retractors demonstrated a statistically significant reduction with the novel retractor. The median time to complete three rotations was 16.0 [11.7-19.1] seconds with the novel retractor, compared to 7.0 [5.3-8.5] seconds with the conventional model (P < 0.01). The ease of insertion was rated significantly higher with the novel retractor compared to the conventional model (6.0 [5.5-6.0] vs. 2.5 [2.0-3.0], P < 0.01). The ease of rotation was also rated significantly higher with the novel retractor than with the conventional model (5.5 [5.0-6.0] vs. 2.5 [1.0-3.5], P < 0.01). In the evaluation of the hook stability, no significant difference was observed between the novel and conventional retractors (P = 1.0).</p><p><strong>Conclusions: </strong>The novel thoracic retractor enables faster and easier thoracotomy compared to conventional model. Given the strong association between time and RT prognosis, this device is well-suited for RT procedures requiring rapid execution.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"106"},"PeriodicalIF":3.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318472","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":"Unplanned transfers from wards to intensive care units: how well does NEWS identify patients in need of urgent escalation of care?","authors":"Marianne Ask Torvik, Stig Haugset Nymo, Ståle Haugset Nymo, Eirik Hugaas Ofstad","doi":"10.1186/s13049-025-01371-w","DOIUrl":"10.1186/s13049-025-01371-w","url":null,"abstract":"<p><strong>Background: </strong>The National Early Warning Score (NEWS) is implemented internationally for in-hospital monitoring. It has been superior to other predictive scores, but its preventive abilities are still unclear. Additionally, data on patients who experience critical events but are not identified by NEWS as being at risk are scarce. We aimed to explore the National Early Warning Score (NEWS) as an actionable trigger to flag high-risk patients for unplanned transfers from a ward to an intensive care unit (ICU).</p><p><strong>Methods: </strong>Single-centre, retrospective study with case record reviews of all adult, unplanned ICU admissions from a ward to an ICU (level 2 and/ or level 3 ICU) for one year in a Norwegian, 200-bed, urban hospital. We examined the portion of patients flagged by a NEWS of five or seven within 24 h of an ICU transfer, if there was a change in NEWS from the previous 48 h, and how NEWS findings in this patient population differed from a general ward population.</p><p><strong>Results: </strong>Among 264 unplanned transfers from a ward to an ICU, 164 (62%) and 121 (46%) were flagged by a NEWS of five or seven, respectively. Up to 31% had a change in their NEWS, crossing the five-threshold from the previous 48 h. In contrast, nearly one in five (2077 of 11,310) of all adult admissions to the wards had at least one NEWS of five or higher, though with large variations between departments.</p><p><strong>Conclusion: </strong>NEWS did not predictably identify patients who were urgently transferred to an ICU from a ward. Less than one-third could have been identified by a recent change in their NEWS, and more than one-third did not meet the criteria of a moderately high NEWS (of five). In addition, a large portion of the ward population have NEWS of five or higher during their hospital stay. Our study emphasizes the vital role of clinical judgment in interaction with early warning scores.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"105"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295192","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":"Emergency surgical airway experience from an Australian major trauma centre emergency department.","authors":"Christopher Groombridge, Amit Maini, Dries Helsloot, Carl Luckhoff, Mark Fitzgerald","doi":"10.1186/s13049-025-01413-3","DOIUrl":"10.1186/s13049-025-01413-3","url":null,"abstract":"<p><strong>Background: </strong>Emergency front of neck access (eFONA) may be life-saving in the can't intubate can't oxygenate scenario but the frequency with which an individual emergency department (ED) or emergency physician (EP) will be required to perform this intervention is very low.</p><p><strong>Objective: </strong>Identify and describe all eFONA cases from the Alfred Airway Registry and to estimate the per clinician incidence of the procedure.</p><p><strong>Methods: </strong>Retrospective case series of all eFONA cases from the Alfred Airway Registry. Data on all intubations undertaken in the ED were collected prospectively from February 2017 to January 2025. Data on individual clinician experience of eFONA was captured by an electronic survey.</p><p><strong>Results: </strong>Of the 1805 patients intubated during the 8 years study period, 4 cricothyroidotomies were performed (0.22%) with a scalpel-finger-bougie-tube technique. All were performed outside daytime hours (08:00-18:00) and all were successfully completed by clinicians who had previously practiced the procedure on a cadaver. 75% were in trauma patients, 75% were male and 75% were performed by emergency medicine doctors. From the survey data EPs performed 24 surgical airways in 768 years of consultant-level experience.</p><p><strong>Conclusions: </strong>eFONA is a rare intervention occurring approximately once every 2 years in this trauma centre ED, and once every 32 years of consultant-level experience for the centre's EPs. The scalpel-finger-bougie-tube technique reliable achieved a secure airway in these patients.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"104"},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286971","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":"Demography, emergency interventions and outcome after severe pelvic injuries: a two-decade registry study from South- Western Norway.","authors":"Kenneth Thorsen, Pieter Oord, Jon K Narvestad, Andreas Reite, Kjell E Tjosevik","doi":"10.1186/s13049-025-01399-y","DOIUrl":"10.1186/s13049-025-01399-y","url":null,"abstract":"<p><strong>Background: </strong>Severe pelvic injuries with ISS > 15 is associated with a high degree of morbidity and mortality. We aimed to describe the demography, emergency interventions and outcome of patients with these injuries and analyze changes in practice occurring in this timeframe.</p><p><strong>Methods: </strong>Stavanger University Hospital (SUH) is located in South-Western Norway. All patients registered in the Stavanger University Hospital Trauma registry between 2004-2022 with a pelvic injury and concomitant ISS > 15 were included in this study.</p><p><strong>Results: </strong>In total 2283 patients with a pelvic injury were included in the trauma registry between 2004-2022. There were 160 patients with an ISS > 15, with 115 (72%) men and 45 (28%) women. Median age of men was 45 years, while women were slightly older at 52 years of age. The 30-day mortality in men (25/115) and women (10/45) was identical at 22%. Emergency intervention was performed in 33/160 (20.1%%) patients. In 27 patients a laparotomy, an EPP or an angioembolization was the primary hemostatic emergency procedure. All but one pelvic packing were done in the years 2010-2014, with one packing also performed in 2021. A significant decline both in number of patients receiving crystalloids and the amount of crystalloids administered, both prehospitally and in the ER were seen when comparing period 1-3. The mortality in the EPP group was very high at 6/8 (75%) while only 1/9 in the laparotomy group succumbed and 2/10 (20%) in the AE group. These discrepancies may be related to the high median ISS of 50 in the pelvic packing group, vs 40 in the angioembolization group vs 38 in the laparotomy group, reflected by a statistically significant difference in probability of survival (TRISS score) between emergency intervention groups (p < 0.001).</p><p><strong>Conclusion: </strong>Severe pelvic injuries are quite rare, with about 1 incident per month. About 2/3 are men and transport related injuries are the most common mechanism of injury. Patients in need of emergency intervention are characterized by a high median ISS and concomitant high mortality. A significant decline in emergency interventions were seen over time, which may be related to declining infusions of crystalloids and better transfusion protocols.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"102"},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235717","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":"Spinal cord injury in severely injured patients: results from the Swiss Trauma Registry.","authors":"Nader Hejrati, Felix C Stengel, Michael G Fehlings, Christian Maschmann, Martin N Stienen, Kai O Jensen","doi":"10.1186/s13049-025-01420-4","DOIUrl":"10.1186/s13049-025-01420-4","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"103"},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235718","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":"Cognitive biases in clinical decision-making in prehospital critical care; a scoping review.","authors":"Adam Awanzo, Julian Thompson","doi":"10.1186/s13049-025-01415-1","DOIUrl":"10.1186/s13049-025-01415-1","url":null,"abstract":"<p><strong>Purpose: </strong>Every day, critical care providers in the prehospital setting respond to time sensitive and outcome-critical emergencies, often in unfamiliar environments with little or no prior knowledge about the patient. In these demanding situations, they must make multifactorial clinical decisions that may be critical for the patient's life and future health. Errors in this complex decision-making have identified as a significant cause of patient harm and, consequently, there is increasing research focus upon clinical decision-making and risk mitigation in prehospital critical care. Cognitive biases have been identified as a common cause of these systematic errors in the hospital environment and these studies inspired the aim of this article to map current evidence and investigate, \"What cognitive biases affects clinical decision-making in prehospital critical care\".</p><p><strong>Materials and methods: </strong>A scoping review was conducted following Joanna Briggs Institute`s framework, by searching OVID MEDLINE and PubMed, EMBASE, and Cochrane for articles, no restrictions were set for type of article. Articles describing cognitive biases and clinical decision-making in pre-, and in-hospital critical care were included. Additionally, a search in Google scholar was conducted using keywords identified in included articles.</p><p><strong>Results: </strong>Five hundred unique articles were identified through the search, of which 16 articles examining cognitive biases and clinical decision making in critical care were included, with only two articles focussed exclusively on prehospital critical care. Twenty-eight unique cognitive biases were identified in these articles. The most identified cognitive biases were, anchoring bias, framing effect, availability bias, confirmation bias, overconfidence bias, premature closure, and omission bias. Twelve articles described contributing factors for cognitive biases and these were categorized into 3 main categories. The main categories identified were lack of unbiased feedback, social behaviour and beliefs, and time pressure. Eleven articles proposed mitigation factors, which were categorized into 3 categories, consisting of feedback and follow-up, organizational culture, and education and training.</p><p><strong>Conclusions: </strong>This scoping review has identified several cognitive biases that affect clinical decision-making, as well as research gaps in both pre- and in-hospital critical care. Identified evidence suggest that both clinicians and organisations are affected by cognitive biases in clinical decision-making in critical care. Future research should aim to establish how these cognitive biases affect clinical decisions in prehospital critical care, and what measures may mitigate the consequent errors, may reduce patient harm, and improve outcomes.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"101"},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217369","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":"Same standards - different outcomes? Why clinical governance is essential to safe and consistent high-quality patient care : A call for a european governance alliance in HEMS.","authors":"Johannes Strobel, Leif Rognås, Evi Steen, Dinis Reis Miranda, Jens Schwietring, Florian Reifferscheid, Simone Böbel, Marius Rehn","doi":"10.1186/s13049-025-01421-3","DOIUrl":"10.1186/s13049-025-01421-3","url":null,"abstract":"<p><p>Europe is facing major challenges in security, health, and climate, which place increasing demands on emergency medical systems. While European cooperation is advancing in sectors like defence and energy, emergency medicine remains largely nationally or regionally structured. Despite significant differences in funding, staffing and mission profiles, HEMS systems across Europe share many similarities, especially regarding patient population and professional standards. The newly founded European Governance Alliance in HEMS aims to use these commonalities to foster cross-border learning and collaboration, based on the principles of Clinical Governance. Through regular international \"Debrief & Discussion\" (D&D) meetings and peer learning visits, the Alliance promotes a culture of open reflection, shared learning, and continuous improvement. The long-term goal is to define and implement common governance standards and establish sustainable structures for peer-based quality development. This initiative offers a first concrete step towards structured, international cooperation in European air rescue- with the aim of improving systems, not individuals.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"99"},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210055","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":"Timings of pre-hospital life-saving interventions in mass casualty incidents: an observational simulation study.","authors":"Fayez Alruqi, Elaine Cole, Karim Brohi","doi":"10.1186/s13049-025-01417-z","DOIUrl":"10.1186/s13049-025-01417-z","url":null,"abstract":"<p><strong>Background: </strong>Mass casualty incidents (MCIs) pose significant challenges for pre-hospital care. In particular, there is a tension between the need for rapid triage and the need to deliver life-saving interventions (LSIs). Currently, only the simplest interventions are considered appropriate during triage. However, few data exist on how long it takes to perform LSIs, and there may be a difference between perception and reality. This study aims to determine the time intervals (TIs) to perform key LSIs in a simulated pre-hospital setting, and the differences between estimated and actual TIs.</p><p><strong>Methods: </strong>An observational simulation study was conducted over three sessions at two pre-hospital training centers. Pre-hospital care providers (PHCPs) performed 16 LSIs. A pre-intervention questionnaire was used to assess the participants' backgrounds and LSI experience. Non-parametric tests were used to compare TIs between professional groups and evaluate differences between estimated and actual TIs.</p><p><strong>Results: </strong>Twenty PHCPs participated: eight physicians and 12 paramedics, with a median pre-hospital experience of nine years. TIs for all LSIs were ≤ 130 s, except for rapid sequence induction and intubation (RSI), median 348 s (IQR: 329-366). Team-based LSIs where paramedics and physicians worked together, had prolonged durations for certain steps, with the RSI preparation stage being the longest (59% of total TI). Considerable delays were also observed in the post-placement securing phase (RSI: 43 s, chest tube: 58 s). All PHCPs tended to overestimate how long TIs take, with significant differences noted in supraglottic airway insertion, cricothyroidotomy, needle decompression and finger thoracostomy.</p><p><strong>Conclusion: </strong>We provide data on the time taken for LSIs in a simulated pre-hospital environment. Nearly all LSIs were completed within two minutes, yet PHCPs overestimated the time it takes to perform them. Approaches to the triage process may need to be reviewed in light of these data. There are further opportunities to streamline the delivery of some interventions.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"100"},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210056","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":"Association of mortality and physician experience in prehospital anaesthesia: a registry study on new physicians in Finnish helicopter emergency medical services.","authors":"Anssi Saviluoto, Piritta Setälä, Miretta Tommila, Jussi Pirneskoski, Lasse Raatiniemi, Jouni Nurmi","doi":"10.1186/s13049-025-01412-4","DOIUrl":"10.1186/s13049-025-01412-4","url":null,"abstract":"<p><strong>Background: </strong>Prehospital anaesthesia is a challenging procedure, and the outcome depends on the quality of the process. Hospital-acquired anaesthesia experience does not necessarily translate to high performance in the prehospital setting. We aimed to assess the quality and practice patterns in prehospital anaesthesia related to cumulative experience amongst new prehospital critical care physicians. In this study, we aimed to evaluate whether quality indicators for prehospital anaesthesia and related mortality improve as new prehospital critical care physicians become more experienced with this intervention.</p><p><strong>Methods: </strong>We conducted a registry-based observational study including all patients who underwent anaesthesia and airway management by physicians who started working in the national HEMS between January 2013 and August 2019. Patients were grouped and compared based on the provider's cumulative case volume at the time of the mission: 1-10, 11-20, 21-40, 41-80 and > 80 cases. The association between cumulative experience and 30-day mortality was assessed using multivariate logistic regression analysis. Secondary outcomes included first-pass intubation success, post-intubation hypoxia and hypotension, the combined use of a neuromuscular blocking agent and anaesthetic, on-scene time, mechanical ventilation usage, and rates of normocapnia, hypoxia, and hypotension at handover.</p><p><strong>Results: </strong>1,638 patients (median age 59, 64% male) were treated by 32 physicians. Median on-scene time decreased with increasing experience from 33 (interquartile range [IQR] 23-44) to 28 (IQR 19-38) minutes, P = 0.03. Higher experience was associated with increased use of mechanical ventilation (P < 0.001) and a combination of neuromuscular blocking agents and anaesthetics (P = 0.03). Other secondary outcomes did not show a statistically significant difference between the groups. Crude mortality decreased from 38 to 26% in the lowest to highest experience groups. In the multivariate logistic regression analysis, the same trend was still seen with the odds ratio of the highest experience group for 30-day mortality 0.59 (95% CI 0.38-0.94, lowest experience group as a reference).</p><p><strong>Conclusions: </strong>In a prehospital critical care service, outcomes improve after a high number of prehospital cases, even when physicians with a solid foundation in in-hospital anaesthesia are employed. Limiting physician turnover may improve the quality of care.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"98"},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188376","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":"High-altitude HEMS missions-a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021.","authors":"Eva Klocker, Lea Wienandts, Dario Josi, Simon Rauch, Roland Albrecht, Jürgen Knapp, Urs Pietsch","doi":"10.1186/s13049-025-01419-x","DOIUrl":"10.1186/s13049-025-01419-x","url":null,"abstract":"<p><strong>Background: </strong>Mountain sport activities are being practiced by an increasing number of people: The number of tourists visiting altitudes greater than 2,500 m above sea level in the Alps has been estimated at around 40 million people per year. For this reason, however, the number of emergencies in remote areas, which can be reached most rapidly by helicopter, has also increased.</p><p><strong>Methods: </strong>We retrospectively reviewed all rescue missions conducted by the Swiss Air Ambulance (Rega) in the period 2011-2021 that were carried out at an altitude of more than 2,500 m above sea level. Demographic and epidemiological data, medical measures implemented on scene, and the on-scene time were then analyzed for both trauma and non-trauma patients. Patients were categorized based on the National Advisory Committee for Aeronautics (NACA) score into non-injured (NACA 0), minor injured (NACA 0-3), seriously injured (NACA 4-6), deceased during mission (NACA 7), and already deceased on arrival of the HEMS team.</p><p><strong>Results: </strong>A total of 3,564 rescue missions were analyzed. Of the patients, 66.8% were male and the vast majority (88.4%) were adults. In terms of injury level, 88.1% of the patients were minor injured, with an NACA score of 0-3, while 9.4% were seriously injured, with a score of 4-6. Patients who died in scene (NACA 7) accounted for 2.5% of cases. We observed a significant increase in the number of minor injured patients with traumatic injuries over the period of observation. Factors that significantly influenced the on-scene time included the NACA score, hoist missions, and traumatic injuries in summer.</p><p><strong>Conclusion: </strong>Over the last ten years, the number of HEMS missions conducted at more than 2,500 m above sea level with non-injured and slightly injured patients has increased. The large number of HEMS missions with uninjured patients are of a preventive nature. Only around 9% of all rescue missions involved the medical treatment and rescue of seriously injured patients who required advanced medical interventions.</p><p><strong>Trial registration: </strong>Ethics approval and consent to participate BASEC Nr. Req202200189.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"97"},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188377","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}