Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Helicopter emergency medical services demonstrate reduced time to emergency anaesthesia in an undifferentiated trauma population: a retrospective observational analysis across three major trauma networks.","authors":"Daniel Heritage, Joanne Griggs, Jack Barrett, Scott Clarke, Rory Carroll, Richard Lyon, Duncan Bootland","doi":"10.1186/s13049-024-01313-y","DOIUrl":"10.1186/s13049-024-01313-y","url":null,"abstract":"<p><strong>Background: </strong>Early rapid sequence induction of anaesthesia (RSI) and tracheal intubation for patients with airway or ventilatory compromise following major trauma is recommended, with guidance suggesting a 45-min timeframe. Whilst on-scene RSI is recommended, the potential time benefit offered by Helicopter Emergency Medical Services (HEMS) has not been studied. We compared the time from 999/112 emergency call to delivery of RSI between patients intubated either in the Emergency Department or pre-hospital by HEMS.</p><p><strong>Methods: </strong>A retrospective observational cohort study of major trauma patients in South-East England who received a pre-hospital RSI (PHRSI) or Emergency Department RSI (EDRSI) between 2 January 2018 and 24 September 2019. Data were extracted from the UK Trauma Audit and Research Network database. The primary outcome was the time from emergency call to delivery of RSI. Secondary outcomes included mortality at 30-days or hospital discharge, time from arrival of service at hospital or scene to RSI, time from emergency call to Computerised Tomography scan, and conveyance interval. Linear regression was used to model time to RSI in both groups.</p><p><strong>Results: </strong>Of 378 eligible patients, 209 patients met inclusion criteria. 103 received a PHRSI and 106 received an EDRSI. Most patients were male (n = 171, 82%) and the median age was 48 years (IQR 28-65). 94% sustained a blunt injury mechanism and head was the most injured body region for both cohorts (n = 134, 64%). 63% (n = 67) of patients receiving a PHRSI were conveyed by helicopter. PHRSI was delivered significantly earlier with a median of 64 [IQR 51-75] minutes (95% CI, 60-68) compared with EDRSI with a median of 84 [IQR 68-113] minutes (95% CI, 76-94), p < 0.001).</p><p><strong>Conclusion: </strong>Major trauma patients who had a pre-hospital RSI received this time-critical intervention sooner after their injury than those who received an emergency anaesthetic after conveyance to a specialist hospital. Patient outcome benefit of HEMS delivered early RSI should be explored.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"138"},"PeriodicalIF":3.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899774","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 use and impact of prehospital blood lactate measurements in acute non-traumatic patients: a systematic review.","authors":"Louise Houlberg Walther, Hanne Beck Mieritz, Annmarie Touborg Lassen, Erika Frischknecht Christensen, Christian Backer Mogensen, Søren Mikkelsen, Anne Craveiro Brøchner","doi":"10.1186/s13049-024-01310-1","DOIUrl":"10.1186/s13049-024-01310-1","url":null,"abstract":"<p><strong>Background: </strong>The prehospital use of blood lactate measurements is increasing. However, the test's benefits have not been methodically evaluated in non-trauma patients. This study had three aims: (1) To assess the evidence of prehospital blood lactate measurements' prognostic value in non-trauma patients, (2) to investigate to what extent the test changed early patient treatment, and (3) to evaluate the healthcare personnel's attitude towards the test.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched until Aug 26, 2023. Cohort and randomized controlled trials assessing ≥ 20 acute non-trauma patients with prehospital lactate measurements were included if they reported (1) prognostic outcomes such as short-term mortality or (2) changes in early patient treatments. All study designs were included to assess (3) the healthcare personnel's opinion on prehospital lactate measurements. The risks of bias were assessed using the QUIPS tool, the Newcastle-Ottawa Scale, and the RoB-2. Study registration number CRD42020167169 (PROSPERO).</p><p><strong>Results: </strong>We screened 6028 study reports. We included 15 studies on (1) the prognostic value of prehospital lactate measurements. Elevated blood lactate levels were correlated to a higher short-term mortality risk in most of the studies but not in studies with out-of-hospital cardiac arrest (OHCA) patients. The 15 prognostic studies were all cohort studies with moderate or high risks of bias. Four studies investigated (2) early treatment changes. They found that the prehospital lactate measurement may have changed early treatment in sepsis patients. However, all four studies on treatment changes were at high risk of bias. Four studies were included on (3) the healthcare personnel's attitude towards the lactate measurement. Evidence of the healthcare personnel's opinion on prehospital lactate measurements was scarce.</p><p><strong>Conclusion: </strong>Most acute non-trauma patients with elevated prehospital lactate levels had increased risks of short-term mortality, except OHCA patients. Few studies suggested that measuring prehospital lactate levels could change early patient care, particularly in patients with suspected sepsis. The certainty of the evidence is low in this systematic review. The included studies were heterogeneous, and many had high risks of bias. Further studies are needed to investigate the impact of prehospital lactate measurements on patient care.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"137"},"PeriodicalIF":3.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899777","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 extent of physical and psychological workplace violence experienced by prehospital personnel in Denmark: a survey.","authors":"Brit Schøsler, Frederik Stuhr Bang, Søren Mikkelsen","doi":"10.1186/s13049-024-01311-0","DOIUrl":"10.1186/s13049-024-01311-0","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence against healthcare workers has been a well-known problem for more than 40 years. This problem is also relevant for prehospital personnel who are at risk of physical and/or psychological violence during work. Violence and threats of violence can have physical and psychological consequences, including personal challenges in their everyday life, use of sick days, reports, and the need for professional help. Therefore, this study aimed to describe the extent of and subsequent reporting of physical and psychological workplace violence toward the prehospital healthcare workers in Denmark in a two-year period. Moreover, we wanted to elucidate any possible effect of workplace violence on the private and professional lives of the prehospital healthcare personnel.</p><p><strong>Methods: </strong>A nation-wide survey where a validated anonymised questionnaire was directed to all of the approximately 4500 Danish prehospital healthcare workers.</p><p><strong>Results: </strong>Out of 584 complete responses we found that 47.4% had experienced psychological violence on the job whereas 25.7% had experienced physical violence on the job within the past two years. The perpetrators were mainly patients or relatives of the patients. Physical violence was mostly reported as punching, pushing, and kicking, while psychological violence included threats of violence and other intimidation. After experiencing violence the respondents reported both physical and psychological harm, which for some prehospital healthcare workers had consequences for their professional and/or personal life. Furthermore, some prehospital healthcare workers reported that the violence had resulted in some patients receiving worse treatment afterwards. We found that violence was rarely reported to either employers or the police, because respondents believed the events were not important enough to merit reporting, or because a report was not considered to make any difference to the healthcare worker. The survey demonstrates that, as a minimum, at least one healthcare worker in 30 and one healthcare worker in 16 has been exposed to episodes of violence and threats of violence within the last two years.</p><p><strong>Conclusion: </strong>We suggest that the prehospital organisations emphasise reporting future episodes of physical and/or psychological violence. Knowing the extent of the problem is a prerequisite for addressing, debriefing, and/or other psychological follow-up.</p><p><strong>Trial registration: </strong>N/A.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"136"},"PeriodicalIF":3.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883522","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":"Conventional versus task-based package organization for out-of-hospital emergency kits: an emergency medical services simulation study.","authors":"Daniel Laxar, Daniel Grassmann, Lena Reischmann, Alexandra Kaider, Bertram Schadler, Carmen Huber, Mario Krammel, Christina Hafner","doi":"10.1186/s13049-024-01309-8","DOIUrl":"10.1186/s13049-024-01309-8","url":null,"abstract":"<p><strong>Background: </strong>Emergency Medical Service crews are equipped with comprehensive emergency kits for routine care and to provide life-saving interventions in severely ill patients. While guidelines on contents and packing strategies of emergency kits for specific tasks and specialized situations exist, data for the design of out-of-hospital emergency kits in a general urban population is lacking. It may be possible to transfer the promising results of modern in-hospital packing strategies such as task-based package organization (TPO) to an Emergency Medical Service setting.</p><p><strong>Methods: </strong>Four types of emergency kit were used in this study: two novel backpack emergency kits were acquired for this study (one packed using a TPO approach (PAX bags) and the other a traditional non-TPO approach (inter-rescue)); the existing emergency kit; and a TPO-repack of the existing kit. We recruited 80 paramedics who each performed four different tasks in a simulated setting: preparation for endotracheal intubation; preparing an intravenous access and a crystalloid infusion; preparing intraosseous access with medication; and preparing for a forearm splint. Questionnaires were completed before starting, after each task, and at the end of each study session.</p><p><strong>Results: </strong>There was no overall difference for the primary outcome of task completion between the novel TPO and novel non-TPO kit (p = 0.11). However, for selected tasks (forearm splint) completion time was significantly different between these kits. Overall, participants performed fastest when using the existing emergency kit. Participants frequently omitted items required for critical procedures, regardless of kit type.</p><p><strong>Conclusion: </strong>TPO has been previously investigated in an in-hospital setting using participants with low exposure to medical emergencies, and with promising results. In our prehospital simulation setting with paramedics, equipment retrieval was neither faster nor more complete compared to non-TPO kits.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"135"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873304","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-alerts from critical care ambulances to trauma centers: a quantitative survey of trauma team leaders in Ontario, Canada.","authors":"Tara Williams, Brodie Nolan, Melissa McGowan, Tania Johnston, Sonja Maria, Johannes von Vopelius-Feldt","doi":"10.1186/s13049-024-01296-w","DOIUrl":"10.1186/s13049-024-01296-w","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-alerts from paramedics to trauma centers are important for ensuring the highest quality of trauma care. Despite this, there is a paucity of data to support best practices in trauma pre-alert notifications. Within the trauma system of Ontario, Canada, the provincial critical care transport organization, Ornge, provides pre-alerts to major trauma centers, but standardization is currently lacking. This study examined the satisfaction of trauma team leaders' (TTLs) satisfaction with current trauma pre-alerts and their preferences for logistics, content, and structure.</p><p><strong>Methods: </strong>This was a quantitative survey of TTLs at adult and pediatric trauma centers across Ontario, Canada. Recruitment was through email to trauma directors, with follow-up efforts to target low-response sites to achieve good geographical representation. The survey was completed online and contained a combination of single or multiple-choice questions, Likert scales and free text options.</p><p><strong>Results: </strong>In total, 79 TTLs from adult and pediatric lead trauma centers across Ontario responded to the survey, which took place over a 120-day period. The survey achieved good geographical representation. Given the current processes, TTLs describe moderate satisfaction with room for improvement (median score 3, IQR 3-4 on a 5-point Likert scale). Their overall preference was for timely and direct communication, with some concerns about multiple channels of communication around logistics. Most TTLs agreed on the important and less important content details found in common standardized framework tools. For structure, 28/79 TTLs strongly preferred the cognitive aid ATMIST, 13/79 preferred IMIST-AMBO, and 8/79 preferred MIST or SBAR as the most useful.</p><p><strong>Conclusions: </strong>There is room for improvement through standardizing communication and streamlined pre-alert channels. Some disagreements exist between TTLs, particularly regarding logistics. Further research should examine TTL satisfaction after implementing the change in the pre-alert notification framework, which can address localized issues through stakeholder meetings with individual TTLs.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"134"},"PeriodicalIF":3.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865905","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":"Adherence to national trauma triage criteria in Norway: a cross-sectional study.","authors":"Einar Frigstad Hoås, Waleed Mohammed Majeed, Olav Røise, Oddvar Uleberg","doi":"10.1186/s13049-024-01306-x","DOIUrl":"10.1186/s13049-024-01306-x","url":null,"abstract":"<p><strong>Background: </strong>Norwegian hospitals employed individual trauma triage criteria until 2015 when nationwide criteria were implemented. There is a lack of empirical evidence regarding adherence to Norwegian national criteria for activation of the trauma team (NTrC) and the decision-making processes regarding trauma team activation (TTA) within Norwegian trauma hospitals. The objectives of this study were to investigate institutional adherence to the NTrC and to investigate similarities and differences in the decision-making process leading to TTA in Norwegian trauma hospitals.</p><p><strong>Methods: </strong>A digital semi-structured questionnaire regarding adherence to criteria, TTA decision-making and criteria documentation was distributed to all Norwegian trauma hospitals (n = 38) in the spring of 2022. Contact details of trauma coordinators and registrars were provided by the Norwegian Trauma Registry secretariat. Follow-up telephone interviews were conducted at the investigator's discretion in cases of non-respondents or need to clarify answers.</p><p><strong>Results: </strong>Thirty-eight trauma hospitals were invited to answer the survey, where 35 hospitals responded (92%), making 35 the denominator of the results. Thirty-four (97.1%) hospitals stated that they followed NTrC. Thirty-three (94.3%) of the responding hospitals provided documentation of their criteria in use, of which twenty-eight (80%) of responding hospitals adhered to the NTrC. Three (8.6%) hospitals employed a tiered TTA approach with different sized teams. In addition four hospitals (11.4%) used specialized teams to meet the needs of defined patient groups (e.g. geriatric patients, traumatic brain injury). Twenty-one (60%) of the responding hospitals had written guidelines on who could perform TTA and in 18 hospitals (51.4%) TTA could be performed by pre-hospital personnel. Twenty-three (65.7%) of the hospitals documented which criteria that were used for TTA.</p><p><strong>Conclusion: </strong>There is good adherence to the national criteria for activation of the trauma team among Norwegian trauma hospitals after implementation of national guidelines. Individual hospitals argue the use of certain local criteria and trauma team activation decision-making processes to increase their precision in specific patient populations and demographics. Further steps should be done to reduce the variation in TTA decision-making processes among hospitals and improve documentation quality.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"133"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856361","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":"Solid organ transplantation originating from uncontrolled donation after circulatory death in Europe: a narrative review.","authors":"Yann Pionnier, Tom Darius, Andrea Penaloza, Francoise Steenebruggen, Florence Dupriez, Arne Neyrinck, Cornelia Genbrugge","doi":"10.1186/s13049-024-01305-y","DOIUrl":"10.1186/s13049-024-01305-y","url":null,"abstract":"<p><p>Human organ transplantation has begun in the 1960s with donation after circulatory death. At that time this was named non heart beating donation, later donation after cardiac death and nowadays it is named donation after circulatory death. Currently, we are facing a significant shortage of transplant organs in Europe and worldwide. To increase the graft acceptance from donation after controlled or uncontrolled circulatory death, preceding regional normothermic perfusion by an extracorporeal circulation before organ procurement or ex-situ machine perfusion are frequently implemented in clinical practice as organ assessment and reconditioning techniques. Due to these advancements more organs can be potentially transplanted, even after out-of-hospital cardiac arrest (OHCA). First line actors like emergency physicians and pre-hospital paramedics must be aware of such programs to recognize and refer patients for donation in OHCA situations. This review provides an overview of organs transplanted from uncontrolled donation after circulatory death (uDCD) and emphasize the role of the emergency physician in the organ donation cascade. Outcome of uDCD has a lower effectiveness than donation after brain death (DBD) and controlled donation after circulatory death (cDCD) for short term graft survival. However, observational studies illustrate that long term outcome from uDCD is comparable to graft outcome from cDCD and DBD. We summarize the studies reporting the procured organ rate and functional outcome of organs originated from uDCD. European databases indicate a high incidence of OHCA, where resuscitation efforts are initiated but the rate of return of spontaneous circulation (ROSC) remains limited. These patients represent a substantial potential pool of organ donors for uDCD programs. However, these programs tend to overestimate the number of potential donors. While organ procurement from uDCD has yielded favorable outcomes, further research is required to accurately assess the associated costs and benefits and to establish clear donor selection guidelines. Furthermore, the use of new technologies like extracorporeal Cardiopulmonary Resuscitation (E-CPR) for organ donation should be investigated from both medical and economical perspectives. Emergency departments must also explore the feasibility of implementing these programs.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"130"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856383","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":"Methoxyflurane in early analgesic therapy by ski patrol members on Swiss ski slopes - an observational cohort study.","authors":"Lena Benz, Jürgen Knapp, Fredy-Michel Roten, Markus Huber, Richard Steffen","doi":"10.1186/s13049-024-01308-9","DOIUrl":"10.1186/s13049-024-01308-9","url":null,"abstract":"<p><strong>Background: </strong>Pain therapy is an important first-response measure in the pre-clinical care of trauma patients. Injured individuals on ski slopes are usually given first aid by members of the ski patrol. The early implementation of adequate pain therapy by these paramedical rescuers can increase patient satisfaction and have a positive effect on the entire treatment process. In this context, we analysed the administration of methoxyflurane by ski patrol members on Swiss ski slopes.</p><p><strong>Methods: </strong>In this retrospective observational study, we evaluated 172 datasets, of which 149 concerned patients who were administered methoxyflurane. These datasets were taken from a quality-control survey related to the administration of methoxyflurane by members of the ski patrol in seven ski resorts in the Swiss Alps. The data was collected in the winter months of 2022/23. The ski patrol members had been previously trained by medical professionals and employed methoxyflurane following a defined algorithm, according to which patients with an initial numeric pain score of ≥ 4 qualified for the use of methoxyflurane. After each treatment, data on effectiveness and feasibility were collected by means of a standardised questionnaire. The primary outcome was defined as achieving effective pain therapy, which was designated as a reduction on the numerical rating scale of two or more points and a pain score of seven or less after administration. We then performed a linear regression analysis with the relative pain reduction as the outcome and sex, age, ski resort and injury class as covariates.</p><p><strong>Results: </strong>Methoxyflurane led to effective pain reduction in around two-thirds of patients on the ski slopes and was easy to use for trained ski patrol members. Median pain reduction was 2 points (interquartile range: 1 to 3) on the NRS scale. The regression model showed lower reduction in pain in lower extremity injuries. Sex, age and initial pain score were not associated with the extent of pain reduction. No serious side effects were observed.</p><p><strong>Conclusion: </strong>The administration of methoxyflurane by trained ski patrol members is a safe and effective option for early pain management in ski slope injuries. Methoxyflurane could thus represent a useful bridging measure, enabling the ski patrol to relieve moderate to severe pain until professional rescue services arrive. However, it does not seem ideal for lower leg injuries.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"132"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856379","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":"Methods and equipment available for prehospital treatment of accidental hypothermia: a survey of Norwegian prehospital services.","authors":"Tea Wick Barsten, Emilie Sunde, Øyvind Thomassen, Sigurd Mydske","doi":"10.1186/s13049-024-01302-1","DOIUrl":"10.1186/s13049-024-01302-1","url":null,"abstract":"<p><strong>Background: </strong>Accidental hypothermia is associated with increased morbidity and mortality and poses a significant challenge for both professional and volunteer rescue services in prehospital settings. This study investigated the methods and equipment available to treat patients with cold stress or accidental hypothermia before reaching hospital in Norway.</p><p><strong>Methods: </strong>We surveyed 156 respondents representing 708 units from both the professional and volunteer Norwegian prehospital chain of care between 2023 and 2024. Professional services included national ground ambulances, boat ambulances, national fixed wing and helicopter air ambulance services, search and rescue helicopter services, and urban search and rescue services. Volunteer services included Norwegian People's Aid and the Norwegian Red Cross Search and Rescue Corps. The survey queried the availability of active warming equipment, passive insulation materials, thermometers for detecting hypothermia, and preferred sites for temperature measurements. The study also investigated whether there has been a development in available equipment compared to a similar study conducted in 2013.</p><p><strong>Results: </strong>The survey achieved a response rate of 70.5%. Chemical heat pads were the most frequently used type of equipment for active external warming and were the only equipment used by volunteer rescue services. All services possessed equipment for passive external warming, with duvets, space blankets and wool- or cotton blankets being the most commonly available. Thermometers for detecting hypothermia were found in 86.3% of professional rescue services and 15% of volunteer units. Almost all respondents reported consistent equipment setups year-round.</p><p><strong>Conclusion: </strong>All Norwegian prehospital services, both professional and volunteer, reported having equipment available for active and passive external warming. Thermometers for detecting hypothermia were reported by all professional services. The most notable change in the equipment available to treat patients with prehospital cold stress and accidental hypothermia in Norway was the increased availability of active external rewarming equipment in 2024 compared with that in 2013.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"131"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856367","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 call utilization over a 10-years period: an observational study in Region Zealand, Denmark, 2013-2022.","authors":"Thea Palsgaard Møller, Josefine Tangen Jensen, Annette Kjær Ersbøll, Stig Nikolaj Fasmer Blomberg, Helle Collatz Christensen","doi":"10.1186/s13049-024-01307-w","DOIUrl":"10.1186/s13049-024-01307-w","url":null,"abstract":"<p><strong>Background: </strong>Improving prehospital emergency care requires a comprehensive understanding of the efficiency of emergency medical services and demand fluctuations. The medical emergency call is the primary contact between citizens and the emergency medical dispatch center, serving as the gateway to accessing emergency assistance. This study aimed to characterize the emergency call population and analyze the development of emergency call utilization in Region Zealand in Denmark during a 10-years period.</p><p><strong>Methods: </strong>This was an observational register-based study of administrative data from the emergency medical dispatch center in Region Zealand. Data was collected from 1 January 2013 to 31 December 2022. All unique emergency calls from residents to the emergency number \"1-1-2\" were included. Descriptive analyses were used to characterize the study population. Poisson regression models were used to calculate ratio estimates for the association between years and hospital catchment areas, using the incidence rate of emergency calls as outcome measure.</p><p><strong>Results: </strong>A total of 641,457 emergency calls were included. A significant increase in the total number of emergency calls was found, with an increase from 58,454 annual calls to 80,819 calls over the study period. The incidence rate per 1000 residents per year increased from 71.1 to 95.2, a 35% increase. The southern part of the region had significantly more emergency calls per 1000 residents per year during the study period compared to the eastern part of the region (IRR 1.70). Demographically, males comprised 52.3% of cases, and patients aged 65 and older represented 48.2% of calls. Emergency calls were \"Emergency level A\" in 45.5% and \"Emergency level B\" in 39.1%. In 22.3% of cases, the emergency call was categorized as \"Unclear problem.\" The most frequent categories were \"chest pain\" (12.7%), \"impaired consciousness\" (9.6%), \"breathing difficulties\" (8.8%), \"accidents\" (7.9%), and \"minor injuries\" (7.6%).</p><p><strong>Conclusions: </strong>The study revealed a significant increase in emergency calls, both in absolute numbers and per 1000 residents per year, indicating growing demand for emergency care, along with a surge in activity at the region's dispatch center. Regional disparities underscores the potential necessity for tailored developmental approaches over time.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"32 1","pages":"129"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856364","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}