Scand J Trauma Resus
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Scand J Trauma Resus · Apr 2024
ReviewNon-technical skills needed by medical disaster responders- a scoping review.
There is no universal agreement on what competence in disaster medicine is, nor what competences and personal attributes add value for disaster responders. Some studies suggest that disaster responders need not only technical skills but also non-technical skills. Consensus of which non-technical skills are needed and how training for these can be provided is lacking, and little is known about how to apply knowledge of non-technical skills in the recruitment of disaster responders. Therefore, this scoping review aimed to identify the non-technical skills required for the disaster medicine response. ⋯ Non-technical skills are skills that disaster responders need. Which non-technical skills are most needed, how to train and measure non-technical skills, and how to implement non-technical skills in disaster medicine need further studies.
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Scand J Trauma Resus · Mar 2024
Characteristics of traumatic major haemorrhage in a tertiary trauma center.
Major traumatic haemorrhage is potentially preventable with rapid haemorrhage control and improved resuscitation techniques. Although advances in prehospital trauma management, haemorrhage is still associated with high mortality. The aim of this study was to use a recent pragmatic transfusion-based definition of major bleeding to characterize patients at risk of major bleeding and associated outcomes in this cohort after trauma. ⋯ Early identification of patients at high risk of major bleeding is challenging but essential for rapid definitive haemorrhage control. The major bleeding trauma cohort is a small part of the entire trauma population, and is characterized of being younger, male gender, higher ISS, and exposed to more penetrating trauma. Early identification of patients at high risk of major bleeding is challenging but essential for rapid definitive haemorrhage control.
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Scand J Trauma Resus · Mar 2024
Prognostic value of arterial carbon dioxide tension during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients receiving extracorporeal resuscitation.
Current guidelines on extracorporeal cardiopulmonary resuscitation (ECPR) recommend careful patient selection, but precise criteria are lacking. Arterial carbon dioxide tension (PaCO2) has prognostic value in out-of-hospital cardiac arrest (OHCA) patients but has been less studied in patients receiving ECPR. We studied the relationship between PaCO2 during cardiopulmonary resuscitation (CPR) and neurological outcomes of OHCA patients receiving ECPR and tested whether PaCO2 could help ECPR selection. ⋯ PaCO2 before ECMO implementation had prognostic value for neurological outcomes in OHCA patients. Patients with PaCO2 < 70 mmHg had higher possibility of FO, even in those with non-shockable rhythm or longer low-flow duration. PaCO2 could serve as an ECPR selection criterion.
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Scand J Trauma Resus · Mar 2024
Firefighters and police search dog handlers' experiences working closely with paramedics in urban search and rescue incidents: a qualitative focus group study from Oslo.
Rescue operations are in Norway defined as situations where patients are difficult to access or that more resources are needed than the health services alone possess and can put in operation (Bull A, Redningshåndboken er endelig her! [Internet]. Hovedredningssentralen. 2018 [cited 2023 May 15]. Available from: https://www.hovedredningssentralen.no/redningshandboken-er-endelig-her/ ). Rescue operations after large incidents may include civil protection, military forces, non-governmental organizations and other resources, but the initial rescue effort must be performed by the emergency services as time often is of essence. The central area of an accident where special training and personal protection equipment is necessary or mandatory is called the Hot Zone. This study examines Urban Search And Rescue (USAR) firefighters and police officers reported experiences from ambulance personnel's contribution in the Hot Zone. ⋯ Firefighters and police officers regard USAR-trained EMS-personnel as a natural and integrated part in urban search and rescue teams. EMS-personnel in the dangerous area deliver safety and medical professional assistance to both rescue workers and patients. Informants in this study had clear opinions on how to establish and maintain such a service.