Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine最新文献

{"title":"A retrospective survey study of paramedic students' exposure to SARS-CoV-2, participation in the COVID-19 pandemic response, and health-related quality of life.","authors":"Kristin Häikiö,&nbsp;Jeanette V Andersen,&nbsp;Morten Bakkerud,&nbsp;Carl R Christiansen,&nbsp;Kim Rand,&nbsp;Trine Staff","doi":"10.1186/s13049-021-00967-2","DOIUrl":"https://doi.org/10.1186/s13049-021-00967-2","url":null,"abstract":"<p><strong>Background: </strong>Healthcare workers have reported increased anxiety while working in hospitals during the COVID-19 pandemic, and the role of healthcare students in a health crisis has been discussed among clinicians and researchers. The simultaneous international shortage of personal protection equipment (PPE) during the first wave of the pandemic potentially exposed healthcare workers and students to the virus during their work and clinical training. Our aim was therefore to evaluate the extent to which paramedic students in Oslo, Norway, were exposed to the SARS-CoV-2 virus and were involved in voluntary and/or paid healthcare-related work. An evaluation was also made of the students' COVID-19-related symptoms and of their health-related quality of life (HRQoL) during the first wave of the pandemic.</p><p><strong>Methods: </strong>Paramedic students (n = 155) at Oslo Metropolitan University, Norway, were invited to complete an online survey five months after the first cases of COVID-19 were detected. The university was situated in the epicenter of the pandemic in Norway. The responses were analyzed using descriptive statistics, independent sample t-tests, and linear regression analysis.</p><p><strong>Results: </strong>Of the 109 respondents (70.3%), 40 worked in patient-related healthcare work. Of those, seven (17.5%) students experienced insufficient supplies of PPE, six (15.0%) participated in aerosol-generating procedures without adequate PPE, and nine (22.5%) experienced insufficient time to don PPE. Seventy-five (70.1%) students experienced no COVID-19-related symptoms, and no students tested positive for COVID-19. HRQoL was scored 0.92 (sd 0.12), which was significantly higher than for the general population before the pandemic (p = 0.002). Students continued with their education and participated in a variety of pandemic-related emergency tasks during the first wave of the pandemic.</p><p><strong>Conclusions: </strong>Paramedic students were valuable contributors to the national pandemic response. Despite potential exposure to SARS-CoV-2 in unpredictable emergency settings with limited supplies of personal protection equipment, no students tested positive for COVID-19. Their health-related quality of life remained high. Students' participation and utilization in similar health crises should be considered in future health crises.</p>","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"153"},"PeriodicalIF":3.3,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39531769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicopter emergency medical services missions to islands and the mainland during a 3-year period in Denmark: a population-based study on patient and sociodemographic characteristics, comorbidity, and use of healthcare services.","authors":"Thea Palsgaard Møller,&nbsp;Annette Kjær Ersbøll,&nbsp;Thora Majlund Kjærulff,&nbsp;Kristine Bihrmann,&nbsp;Karen Alstrup,&nbsp;Lars Knudsen,&nbsp;Troels Martin Hansen,&nbsp;Peter Anthony Berlac,&nbsp;Freddy Lippert,&nbsp;Charlotte Barfod","doi":"10.1186/s13049-021-00963-6","DOIUrl":"https://doi.org/10.1186/s13049-021-00963-6","url":null,"abstract":"<p><strong>Background: </strong>The Danish Helicopter Emergency Medical Services (HEMS) is part of the Danish Emergency Medical Services System serving 5.7 million citizens with 1% living on islands not connected to the mainland by road. HEMS is dispatched based on pre-defined criteria including severity and urgency, and moreover to islands for less urgent cases, when rapid transport to further care is needed. The study aim was to characterize patient and sociodemographic factors, comorbidity and use of healthcare services for patients with HEMS missions to islands versus mainland.</p><p><strong>Methods: </strong>Descriptive study of data from the HEMS database in a three-year period from 1 October 2014 to 30 September 2017. All missions in which a patient was either treated on scene or transported by HEMS were included.</p><p><strong>Results: </strong>Of 5776 included HEMS missions, 1023 (17.7%) were island missions. In total, 90.2% of island missions resulted in patient transport by HEMS compared with 62.1% of missions to the mainland. Disease severity was serious or life-threatening in 34.7% of missions to islands compared with 65.1% of missions to mainland and less interventions were performed by HEMS on island missions. The disease pattern differed with more \"Other diseases\" registered on islands compared with the mainland where cardiovascular diseases and trauma were the leading causes of contact. Patients from islands were older than patients from the mainland. Sociodemographic characteristics varied between inhabiting island patients and mainland patients: more island patients lived alone, less were employed, more were retired, and more had low income. In addition, residing island patients had to a higher extend severe comorbidity and more contacts to general practitioners and hospitals compared with the mainland patients.</p><p><strong>Conclusions: </strong>HEMS missions to islands count for 17.7% of HEMS missions and 90.2% of island missions result in patient transport. The island patients encountered by HEMS are less severely diseased or injured and interventions are less frequently performed. Residing island patients are older than mainland patients and have lower socioeconomic position, more comorbidities and a higher use of health care services. Whether these socio-economic differences result in longer hospital stay or higher mortality is still to be investigated.</p>","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"152"},"PeriodicalIF":3.3,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39529114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of emergency medical services benefit score: a European Delphi study.","authors":"Anssi Heino,&nbsp;Lasse Raatiniemi,&nbsp;Timo Iirola,&nbsp;Merja Meriläinen,&nbsp;Janne Liisanantti,&nbsp;Miretta Tommila","doi":"10.1186/s13049-021-00966-3","DOIUrl":"https://doi.org/10.1186/s13049-021-00966-3","url":null,"abstract":"<p><strong>Background: </strong>The helicopter emergency services (HEMS) Benefit Score (HBS) is a nine-level scoring system developed to evaluate the benefits of HEMS missions. The HBS has been in clinical use for two decades in its original form. Advances in prehospital care, however, have produced demand for a revision of the HBS. Therefore, we developed the emergency medical services (EMS) Benefit Score (EBS) based on the former HBS. As reflected by its name, the aim of the EBS is to measure the benefits produced by the whole EMS systems to patients.</p><p><strong>Methods: </strong>This is a four-round, web-based, international Delphi consensus study with a consensus definition made by experts from seven countries. Participants reviewed items of the revised HBS on a 5-point Likert scale. A content validity index (CVI) was calculated, and agreement was defined as a 70% CVI. Study included experts from seven European countries. Of these, 18 were prehospital expert panellists and 11 were in-hospital commentary board members.</p><p><strong>Results: </strong>The first Delphi round resulted in 1248 intervention examples divided into ten diagnostic categories. After removing overlapping examples, 413 interventions were included in the second Delphi round, which resulted in 38 examples divided into HBS categories 3-8. In the third Delphi round, these resulted in 37 prehospital interventions, examples of which were given revised version of the score. In the fourth and final Delphi round, the expert panel was given an opportunity to accept or comment on the revised scoring system.</p><p><strong>Conclusions: </strong>The former HBS was revised by a Delphi methodology and EBS developed to represent its structural purpose better. The EBS includes 37 exemplar prehospital interventions to guide its clinical use. Trial registration The study permission was requested and granted by Turku University Hospital (decision number TP2/010/18).</p>","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"151"},"PeriodicalIF":3.3,"publicationDate":"2021-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39524878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-hospital suPAR, lactate and CRP measurements for decision-making: a prospective, observational study of patients presenting non-specific complaints.","authors":"Milla Jousi,&nbsp;Marja Mäkinen,&nbsp;Johanna Kaartinen,&nbsp;Leena Meriläinen,&nbsp;Maaret Castrén","doi":"10.1186/s13049-021-00964-5","DOIUrl":"https://doi.org/10.1186/s13049-021-00964-5","url":null,"abstract":"<p><strong>Background: </strong>In the pre-hospital setting, non-urgent patients with non-specific chief complaints pose assessment challenges for the emergency medical systems (EMS). Severely ill patients should be identified among these patients, and unnecessary transport to the emergency department (ED) should be avoided. Unnecessary admissions burden EDs, deplete EMS resources and can even be harmful to patients, especially elderly patients. Therefore, tools for facilitating pre-hospital decision-making are needed. They could be based on vital signs or point-of-care laboratory biomarkers. In this study, we examined whether the biomarker soluble urokinase plasminogen activator receptor (suPAR), either alone or combined with C-reactive protein (CRP) and/or lactate, could predict discharge from the ED and act as a pre-hospital support tool for non-conveyance decision-making.</p><p><strong>Methods: </strong>This was a prospective, observational study of adult patients with normal or near-normal vital signs transported by an EMS to an ED with a code referring to deteriorated general condition. The levels of suPAR, CRP and lactate in the patients' pre-hospital blood samples were analysed. The values of hospitalized patients were compared to those of discharged patients to determine whether these biomarkers could predict direct discharge from the ED.</p><p><strong>Results: </strong>A total of 109 patients (median age: 81 years) were included in the study. Of those, 52% were hospitalized and 48% were discharged from the ED. No statistically significant association was found between suPAR and the ED discharge vs hospitalization outcome (OR: 1.04, 95% CI 0.97-1.13, AUROC: 0.58, 95% CI 0.47-0.69). Adding CRP (AUROC: 0.64, 95% CI 0.54-0.75) or lactate (AUROC: 0.60, 95% CI 0.49-0.71) to the regression models did not improve their diagnostic accuracy. None of the patients with a suPAR value of less than 2 ng/ml were admitted to hospital, while 64% of the patients with a suPAR value of more than 6 ng/ml were hospitalized.</p><p><strong>Conclusion: </strong>Pre-hospital suPAR measurements alone or combined with CRP and/or lactate measurements could not predict the ED discharge or hospital admission of 109 non-urgent EMS patients with non-specific chief complaints and normal or near-normal vital signs.</p>","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"150"},"PeriodicalIF":3.3,"publicationDate":"2021-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39524879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Symptoms presented during emergency telephone calls for patients with spontaneous subarachnoid haemorrhage.","authors":"Asger Sonne,&nbsp;Sarita Egholm,&nbsp;Laurits Elgaard,&nbsp;Niklas Breindahl,&nbsp;Alice Herrlin Jensen,&nbsp;Vagn Eskesen,&nbsp;Freddy Lippert,&nbsp;Frans Boch Waldorf,&nbsp;Nicolai Lohse,&nbsp;Lars Simon Rasmussen","doi":"10.1186/s13049-021-00962-7","DOIUrl":"https://doi.org/10.1186/s13049-021-00962-7","url":null,"abstract":"","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"149"},"PeriodicalIF":3.3,"publicationDate":"2021-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39518187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring safety culture in the Finnish ambulance service with Emergency Medical Services Safety Attitudes Questionnaire.","authors":"Anu Venesoja,&nbsp;Veronica Lindström,&nbsp;Pasi Aronen,&nbsp;Maaret Castrén,&nbsp;Susanna Tella","doi":"10.1186/s13049-021-00960-9","DOIUrl":"https://doi.org/10.1186/s13049-021-00960-9","url":null,"abstract":"<p><strong>Background: </strong>Emergency Medical Services (EMS) is, by its nature, a challenging context that may create risks for both patients and employees. It is also known that an organisation's safety culture has an influence on both patient and employee safety. Finnish EMS organisations lack knowledge of how their safety culture is perceived by their employees.</p><p><strong>Aim: </strong>This study aims to test the psychometric properties of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) in a Finnish EMS setting. We also explore the connections between individual- and organisation-based characteristics and safety attitudes in the Finnish EMS.</p><p><strong>Methods: </strong>A cross-sectional survey study design was used. The EMS-SAQ was used to collect data via social media. The instrument measures six domains of workplace safety culture: safety climate, teamwork climate, perceptions of management, job satisfaction, working conditions and stress recognition. The 5-point Likert scale was converted to a 100-point scale and mean ≥ 75 was dichotomized as a positive. Confirmatory factor analysis (CFA) was carried out to validate the EMS-SAQ in a Finnish setting. Other results were analysed by using non-parametric tests.</p><p><strong>Results: </strong>327 responses were included in the analysis. CFA showed that the total EMS-SAQ model had acceptable goodness-of-fit values in the Finnish EMS setting. Total mean scores for each safety culture domain were identified non-positively (mean score < 75); safety climate 60.12, teamwork climate 60.92, perceptions of management 56.31, stress recognition 64.55, working conditions 53.43 and job satisfaction 70.36. Higher education was connected to lower job satisfaction and the teamwork climate within the individual characteristics. All organisation-based characteristics caused at least one significant variation in the safety culture domain scores. Working area significantly affected (p < 0.05) five out of the six safety culture domain scores.</p><p><strong>Conclusions: </strong>The EMS-SAQ is a valid tool to evaluate safety culture among the Finnish EMS organisations; it offers a novel method to evaluate safety and patient safety within the Finnish EMS organisations. According to the findings, the organisation-based characteristics more likely had an impact on safety attitudes than did the individual-based characteristics. Therefore, it is suggested that the Finnish EMS organisations undertake safety culture development at the organisational level.</p>","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"148"},"PeriodicalIF":3.3,"publicationDate":"2021-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39514806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep-learning model for screening sepsis using electrocardiography.","authors":"Joon-Myoung Kwon,&nbsp;Ye Rang Lee,&nbsp;Min-Seung Jung,&nbsp;Yoon-Ji Lee,&nbsp;Yong-Yeon Jo,&nbsp;Da-Young Kang,&nbsp;Soo Youn Lee,&nbsp;Yong-Hyeon Cho,&nbsp;Jae-Hyun Shin,&nbsp;Jang-Hyeon Ban,&nbsp;Kyung-Hee Kim","doi":"10.1186/s13049-021-00953-8","DOIUrl":"https://doi.org/10.1186/s13049-021-00953-8","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a life-threatening organ dysfunction and a major healthcare burden worldwide. Although sepsis is a medical emergency that requires immediate management, screening for the occurrence of sepsis is difficult. Herein, we propose a deep learning-based model (DLM) for screening sepsis using electrocardiography (ECG).</p><p><strong>Methods: </strong>This retrospective cohort study included 46,017 patients who were admitted to two hospitals. A total of 1,548 and 639 patients had sepsis and septic shock, respectively. The DLM was developed using 73,727 ECGs from 18,142 patients, and internal validation was conducted using 7774 ECGs from 7,774 patients. Furthermore, we conducted an external validation with 20,101 ECGs from 20,101 patients from another hospital to verify the applicability of the DLM across centers.</p><p><strong>Results: </strong>During the internal and external validations, the area under the receiver operating characteristic curve (AUC) of the DLM using 12-lead ECG was 0.901 (95% confidence interval, 0.882-0.920) and 0.863 (0.846-0.879), respectively, for screening sepsis and 0.906 (95% confidence interval (CI), 0.877-0.936) and 0.899 (95% CI, 0.872-0.925), respectively, for detecting septic shock. The AUC of the DLM for detecting sepsis using 6-lead and single-lead ECGs was 0.845-0.882. A sensitivity map revealed that the QRS complex and T waves were associated with sepsis. Subgroup analysis was conducted using ECGs from 4,609 patients who were admitted with an infectious disease, and the AUC of the DLM for predicting in-hospital mortality was 0.817 (0.793-0.840). There was a significant difference in the prediction score of DLM using ECG according to the presence of infection in the validation dataset (0.277 vs. 0.574, p < 0.001), including severe acute respiratory syndrome coronavirus 2 (0.260 vs. 0.725, p = 0.018).</p><p><strong>Conclusions: </strong>The DLM delivered reasonable performance for sepsis screening using 12-, 6-, and single-lead ECGs. The results suggest that sepsis can be screened using not only conventional ECG devices but also diverse life-type ECG machines employing the DLM, thereby preventing irreversible disease progression and mortality.</p>","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"145"},"PeriodicalIF":3.3,"publicationDate":"2021-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39480970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial.","authors":"Bernd Wallner,&nbsp;Luca Moroder,&nbsp;Hannah Salchner,&nbsp;Peter Mair,&nbsp;Stefanie Wallner,&nbsp;Gabriel Putzer,&nbsp;Giacomo Strapazzon,&nbsp;Markus Falk,&nbsp;Hermann Brugger","doi":"10.1186/s13049-021-00957-4","DOIUrl":"https://doi.org/10.1186/s13049-021-00957-4","url":null,"abstract":"","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"143"},"PeriodicalIF":3.3,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8479911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39470240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of selection criteria and study design on reported survival outcomes in extracorporeal oxygenation cardiopulmonary resuscitation (ECPR): a systematic review and meta-analysis.","authors":"Sameer Karve,&nbsp;Dominique Lahood,&nbsp;Arne Diehl,&nbsp;Aidan Burrell,&nbsp;David H Tian,&nbsp;Tim Southwood,&nbsp;Paul Forrest,&nbsp;Mark Dennis","doi":"10.1186/s13049-021-00956-5","DOIUrl":"https://doi.org/10.1186/s13049-021-00956-5","url":null,"abstract":"<p><strong>Background: </strong>The use of extracorporeal membrane oxygenation (ECMO) during cardiac arrest (ECPR) has increased exponentially. However, reported outcomes vary considerably due to differing study designs and selection criteria. This review assessed the impact of pre-defined selection criteria on ECPR survival.</p><p><strong>Methods: </strong>Systematic review applying PRISMA guidelines. We searched Medline, Embase, and Evidence-Based Medicine Reviews for RCTs and observational studies published from January 2000 to June 2021. Adult patients (> 12 years) receiving ECPR were included. Two investigators reviewed and extracted data on study design, number and type of inclusion criteria. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Outcomes included overall and neurologically favourable survival. Meta-analysis and meta-regression were performed.</p><p><strong>Results: </strong>67 studies were included: 14 prospective and 53 retrospective. No RCTs were identified at time of search. The number of inclusion criteria to select ECPR patients (p = 0.292) and study design (p = 0.962) was not associated with higher favourable neurological survival. However, amongst prospective studies, increased number of inclusion criteria was associated with improved outcomes in both OHCA and IHCA cohorts. (β = 0.12, p = 0.026) and arrest to ECMO flow time was predictive of survival. (β = -0.023, p < 0.001).</p><p><strong>Conclusions: </strong>Prospective studies showed number of selection criteria and, in particular, arrest to ECMO time were associated with significant improved survival. Well-designed prospective studies assessing the relative importance of criteria as well as larger efficacy studies are required to ensure appropriate application of what is a costly intervention.</p>","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"142"},"PeriodicalIF":3.3,"publicationDate":"2021-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8474891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39449634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of troponin assay after electrical injuries: a 15-year multicentre retrospective cohort in emergency departments.","authors":"Delphine Douillet,&nbsp;Stéphanie Kalwant,&nbsp;Yara Amro,&nbsp;Benjamin Gicquel,&nbsp;Idriss Arnaudet,&nbsp;Dominique Savary,&nbsp;Quentin Le Bastard,&nbsp;François Javaudin","doi":"10.1186/s13049-021-00955-6","DOIUrl":"https://doi.org/10.1186/s13049-021-00955-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with electrical injury are considered to be at risk of cardiac arrhythmia. Assessing the risk of developing a major adverse cardiac event (MACE) is the cornerstone of patient management. The aim of this study was to assess the performance of initial troponin and troponin rise to predict Major Adverse Cardiac Events (MACEs) in all patients with electrical injuries admitted to the Emergency Department.</p><p><strong>Methods: </strong>This is a multicentre retrospective study in which consecutive patients with electrical injuries admitted to the Emergency Departments (ED) (adult and paediatric) of five French Hospitals were included between 2005 and 2019. The threshold for troponin elevation is based on the European Society of Cardiology guidelines for patients presenting without persistent ST segment elevation. The primary endpoint was the rate of MACE.</p><p><strong>Results: </strong>A total of 785 included patients were admitted to ED with a first diagnosis of electrical injury during the study period. Troponin assays were performed in 533 patients (67.9%), including 465 of 663 adults (70.1%) and 68 of 122 children (55.7%) and 17/533 (3.2%) of patients had an initial elevated troponin. If none of the clinical criteria for MACE were present (i.e., previous known heart disease, exposure to a high voltage of ≥ 1000 Volts, initial loss of consciousness, or an abnormal initial ECG), this defined a low-risk subgroup (n = 573, 76.0%) that could be safely discharged. The initial positive troponin assay had a sensitivity of 83.3 (95% CI 35.9-99.6%), a specificity of 97.7 (95% CI 96.1-98.8%), a positive likelihood ratio 36.6 (95% CI 18.8-71.1%) and a negative predictive value of 99.9 (95% CI 99.2-99.9%) in predicting a MACE.</p><p><strong>Conclusions: </strong>Troponin assay appears to be a predictive marker of MACE risk and should be considered in high-risk patients.</p>","PeriodicalId":501057,"journal":{"name":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine","volume":" ","pages":"141"},"PeriodicalIF":3.3,"publicationDate":"2021-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8474711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39449631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}