Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Gender (in)equality in nordic ambulance services: do ambulances have glass ceilings?","authors":"Christoffer Ericsson, Veronica Lindström, Jeanette Viggen Andersen, Trine Møgster Jørgensen, Jonas Alex, Anu Venesoja","doi":"10.1186/s13049-025-01358-7","DOIUrl":"10.1186/s13049-025-01358-7","url":null,"abstract":"<p><p>Political efforts in the Nordic countries aim to promote gender equality. However, an assumption is that patriarchal structures remain embedded in EMS organizations, often leading to a 'glass ceiling' effect for women. The Emergency Medical Services (EMS), generally positioned at the intersection of safety authorities and healthcare, operates within environments often shaped by masculine values and norms. Concurrently, the service also connects strongly to compassion, caring and nursing, which have been historically female-dominant professions and working environments. In recent decades, more females have entered the EMS. Despite the growing number of female paramedics, challenges persist, particularly in relation to gender inequality and workplace culture. Females in EMS field continue to face gender stereotypes, which may contribute to inequality. Gender stereotypes, combined with research describing sexual harassment and bias, underscore the need for further discussions and research on the impact of gender on paramedic work environments and career pathways for women working in the service.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"45"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651641","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":"Return to work after major trauma: a systematic review.","authors":"Anne Neubert, Sebastian Hempe, Dan Bieler, Denise Schulz, Carina Jaekel, Michael Bernhard, Joachim Windolf","doi":"10.1186/s13049-025-01351-0","DOIUrl":"10.1186/s13049-025-01351-0","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals suffering from major trauma and survive, often face diverse physical, psychological, and cognitive restrictions which can influence the (health-related) quality of life and the ability to work. Even though, return to work is not necessarily related to the health status of the individual, but it is viewed as a sign of successful reintegration and is a vital parameter of recovery.</p><p><strong>Objective: </strong>The aim was to systematically review factors influencing return to work (RTW) after suffering from major trauma.</p><p><strong>Material and methods: </strong>A search on seven databases was performed. The identified publications were selected according to the inclusion criteria: adults (≥ 16 years) who suffered a major trauma (Injury Severity Score ≥ 16) in studies that explored factors associated with RTW. Risk of bias was assessed with the 'Quality in Prognostic studies' tool. Due to reporting quality of the included studies no meta-analysis was performed. Data were clustered, qualitatively analyzed and factors are assessed based on the strength of evidence. (PROSPERO registration: CRD42022357649).</p><p><strong>Results: </strong>12 studies with 6907 participants (mean age 45 years, 75% males, mean ISS 28) were included. The included studies had low to moderate risk of bias for most domains, the domain 'study confounding' had most often a high risk of bias. Many factors were identified including physical (e.g., injury locations), personal (e.g., age) but also environmental factors (e.g., preinjury income). Only four factors (age, educational level, intensive care unit (ICU) stay and Length of stay (LOS) hospital) are based on moderate or strong evidence. The identified factors reflect the complex interactions within the process of regaining the ability to work after major trauma.</p><p><strong>Discussion: </strong>This systematic review was able to map the evidence surrounding factors affecting RTW after major trauma. Most of the identified factors are currently only based on limited evidence. According to these factors, younger patients with a higher educational level who have a shorter LOS in hospital and a shorter ICU stay might have better chances of RTW.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"44"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651787","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 emergency anaesthesia in 2025: ten years on from the modification of induction regimes.","authors":"Mark Hodkinson, David Zideman, Kurtis Poole","doi":"10.1186/s13049-025-01354-x","DOIUrl":"10.1186/s13049-025-01354-x","url":null,"abstract":"<p><p>Pre-hospital emergency anaesthesia has become a common intervention in pre-hospital emergency medicine. Induction regimes have been modified significantly in the last decade largely guided by medical literature. A Thames Valley Air Ambulance working group have reviewed contemporary literature, developing updated guidelines on the induction and maintenance of pre-hospital emergency anaesthesia. The choice of agents remains unchanged, but there is a growing emphasis on providing a more tailored anaesthetic considering the patient's frailty, background history and presenting physiology. Additional research into the optimal dose and combination of drugs is warranted, together with further exploration of patient's physiological responses to pre-hospital anaesthesia.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"42"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626601","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":"It is time for Last Aid training for emergency medical service personnel and the public!","authors":"Georg Bollig, Erika Zelko","doi":"10.1186/s13049-025-01359-6","DOIUrl":"10.1186/s13049-025-01359-6","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"41"},"PeriodicalIF":3.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617810","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":"Global, regional, and national assessment of foreign body aspiration (1990-2021): novel insights into incidence, mortality, and disability-adjusted life years.","authors":"Pingping Zheng, Ning Zhang, Zixi Chen, Zhelong Jiang","doi":"10.1186/s13049-025-01352-z","DOIUrl":"10.1186/s13049-025-01352-z","url":null,"abstract":"<p><strong>Background: </strong>Foreign body aspiration (FBA) is a preventable yet underrecognized global health challenge, contributing to substantial clinical and economic burdens. Comprehensive and comparable analyses of FBA trends across diverse populations and socioeconomic contexts remain limited. Leveraging data from the 2021 Global Burden of Disease (GBD) Study, we provide an in-depth global, regional, and national analysis of FBA trends over the past three decades, including the first evaluation of disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs).</p><p><strong>Methods: </strong>We examined FBA incidence, mortality, and disease burden across regions, nations, ages, sexes, and Socio Demographic Index (SDI) levels from 1990 to 2021, calculating age-standardized incidence (ASIR) and death (ASDR) rates, as well as estimated annual percentage changes (EAPCs).</p><p><strong>Results: </strong>Globally, FBA incidence declined by 35.3% between 1990 and 2021 (EAPC: -2.02; 95% CI: -2.13 to -1.91), with marked reductions among children under 5 years of age. Nonetheless, total FBA-related deaths rose slightly from 99,329 (95% UI: 80,764-112,381) in 1990 to 103,915 (95% UI: 82,081-113,555) in 2021. While many regions showed improvement, countries such as Italy, Georgia, and Zimbabwe recorded increases in ASIRs. In 2021, children under 5 remained at highest risk of morbidity, while older adults (≥ 70 years), especially in high-income Asia Pacific and Western Europe, showed elevated mortality. Notably, younger children achieved substantial decreases in incidence, death, and DALYs, yet older populations faced modest rises in mortality and DALYs. Higher-SDI regions reported the greatest morbidity and mortality, and high-middle SDI regions exhibited the highest DALYs, YLLs, and YLDs, reflecting the influence of socioeconomic development on FBA burden.</p><p><strong>Conclusions: </strong>Global FBA incidence declined from 1990 to 2021, yet the number of associated deaths continued to rise, indicating ongoing challenges in prevention and management. High- and middle-high SDI regions carried the greatest burden, with children under 5 and older adults (≥ 70 years) particularly affected. These patterns suggest that both advancing socioeconomic development and population aging influence FBA outcomes. Strengthening surveillance, improving emergency response, and implementing targeted, population-specific prevention strategies are essential for reducing the global FBA burden.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"40"},"PeriodicalIF":3.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606810","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":"Pediatric trauma over a decade: demographics, mechanisms of injury, and mortality at a major Danish trauma center-a retrospective cohort study.","authors":"Mette Schytt Price, Nikolaj Raaber, Per Hviid Gundtoft, Frederik Trier","doi":"10.1186/s13049-025-01348-9","DOIUrl":"10.1186/s13049-025-01348-9","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, the number of fatal accidents among children and adolescents has declined. Nevertheless, trauma remains a significant cause of death among children and adolescents in high-income countries, despite significant advancements in prevention and care. Pediatric trauma patients differ substantially from adults in terms of their physiology, anatomy, and daily activities; therefore, they show distinct injury patterns and require different care. The aim of this study was to investigate mortality from trauma in pediatric patients admitted by trauma team activation at the Aarhus University Hospital Trauma Center (AUH-TC) in a highly developed country with exceptionally low child mortality, where trauma is a leading cause of death in this age-group. By evaluating trends in demographics, mechanisms of injury, injury severity, and outcomes, this study aims to provide insights into trauma care and outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included 1,037 pediatric patients (< 18 years old) consecutively admitted by trauma team activation from 1 January 2011 to 31 December 2021. The pediatric patients accounted for 14% of the total trauma population, which consisted of 7307 patients in total. Data on demographics, Injury Severity Score (ISS), mechanism of injury, and 30-day mortality were analyzed. Descriptive statistics were reported.</p><p><strong>Results: </strong>Boys accounted for 58% of the patients (n = 595). Falls were the mechanism of injury in 47% (n = 308) of children under 13 years old, while traffic-related injuries accounted for 38% (n = 139) of adolescents aged 14-17 years. Severe injuries (ISS > 15) were associated with traffic accidents in 25% of cases. The number of traumas peaked on weekends (71%) and during the spring/summer (29%). The ISS was greater than 15 in 13% (n = 130) of the patients, and the overall 30-day mortality rate was 1.6% (n = 17).</p><p><strong>Conclusions: </strong>This study found no significant change in pediatric trauma incidence at AUH-TC over a decade. In Denmark, the few children with an ISS above 15 are predominantly injured in traffic accidents, with risk increasing with age. There was a low incidence of patients with an ISS above 15, and mortality rates were lower than in similar studies. These findings on injury patterns and severity may aid in risk assessment, accident prevention, and hospital resource planning. Further research with extended follow-up is recommended to assess potential trends in trauma mechanisms over time.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"39"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598317","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":"Awareness strategies and the physiological impact of pain in prehospital analgesia management.","authors":"Neslihan Ergun Suzer, Sarper Yilmaz","doi":"10.1186/s13049-025-01343-0","DOIUrl":"10.1186/s13049-025-01343-0","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"38"},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568664","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: 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/s13049-025-01356-9","DOIUrl":"10.1186/s13049-025-01356-9","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"37"},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558504","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":"Using the properties of the odds ratio to improve precision in meta-analysis: an update on the benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically ill and injured patients.","authors":"Ryan D McHenry","doi":"10.1186/s13049-025-01345-y","DOIUrl":"10.1186/s13049-025-01345-y","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"36"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544053","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":"Utilization of non-invasive ventilation before prehospital emergency anesthesia in trauma - a cohort analysis with machine learning.","authors":"André Luckscheiter, Manfred Thiel, Wolfgang Zink, Johanna Eisenberger, Tim Viergutz, Verena Schneider-Lindner","doi":"10.1186/s13049-025-01350-1","DOIUrl":"10.1186/s13049-025-01350-1","url":null,"abstract":"<p><strong>Background: </strong>For preoxygenation, German guidelines consider non-invasive ventilation (NIV) as a possible method in prehospital trauma care in the absence of aspiration, severe head or face injuries, unconsciousness, or patient non-compliance. As data on the utilization and characteristics of patients receiving NIV are lacking, this study aims to identify predictors of NIV usage in trauma patients using machine learning and compare these findings with the current national guideline.</p><p><strong>Methods: </strong>A cross-regional registry of prehospital emergency services in southwestern Germany was searched for cases of emergency anesthesia in multiply injured patients in the period from 2018 to 2020. Initial vital signs, oxygen saturation, respiratory rate, heart rate, systolic blood pressure, Glasgow Coma Scale (GCS), injury pattern, shock index and age were examined using logistic regression. A decision tree algorithm was then applied in parallel to reduce the number of attributes, which were subsequently tested in several machine learning algorithms to predict the usage of NIV before the induction of anesthesia.</p><p><strong>Results: </strong>Of 992 patients with emergency anesthesia, 333 received NIV (34%). Attributes with a statistically significant influence (p < 0.05) in favour of NIV were bronchial spasm (odds ratio (OR) 119.75), dyspnea/cyanosis (OR 2.28), moderate and severe head injury (both OR 3.37) and the respiratory rate (OR 1.07). Main splitting points in the initial decision tree included auscultation (rhonchus and bronchial spasm), respiratory rate, heart rate, age, oxygen saturation and head injury with moderate head injury being more frequent in the NIV group (23% vs. 12%, p < 0.01). The rates of aspiration and the level of consciousness were equal in both groups (0.01% and median GCS 15, both p > 0.05). The prediction accuracy for NIV usage was high for all algorithms, except for multilayer perceptron and logistic regression. For instance, a Bayes Network yielded an AUC-ROC of 0.96 (95% CI, 0.95-0.96) and PRC-areas of 0.96 [0.96-0.96] for predicting and 0.95 [0.95-0.96] for excluding NIV usage.</p><p><strong>Conclusions: </strong>Machine learning demonstrated an excellent categorizability of the cohort using only a few selected attributes. Injured patients without severe head injury who presented with dyspnea, cyanosis, or bronchial spasm were regularly preoxygenated with NIV, indicating a common prehospital practice. This usage appears to be in accordance with current German clinical guidelines. Further research should focus on other aspects of the decision making like airway anatomy and investigate the impact of preoxygenation with NIV in prehospital trauma care on relevant outcome parameters, as the current evidence level is limited.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"35"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544055","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}