Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2011
Implementation of a new emergency medical communication centre organization in Finland--an evaluation, with performance indicators.
There is a great variety in how emergency medical communication centers (EMCC) are organized in different countries and sometimes, even within countries. Organizational changes in the EMCC have often occurred because of outside world changes, limited resources and the need to control costs, but historically there is often a lack of structured evaluation of these organization changes. The aim of this study was to evaluate if the performance in emergency medical dispatching changed in a smaller community outside Helsinki after the emergency medical call centre organization reform in Finland. ⋯ After implementation of a new EMCC organization in Finland the percentage and number of high priority calls increased. There was a trend, but no statistically significant increase in the emergency medical dispatchers' ability to detect patients with life-threatening conditions despite structured education, regular evaluation and standardization of protocols in the new EMCC organization.
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Scand J Trauma Resus · Jan 2011
Comparative StudyOccupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals.
D-CPR (Defibrillator Cardiopulmonary Resuscitation) is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR). Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated External Defibrillators). The aim was to investigate potential differences in practical skills between different healthcare professions before and after training in D-CPR. ⋯ Nearly all healthcare professionals learned to use the AED. There were no differences in CPR skill performances among the different healthcare professionals.
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Scand J Trauma Resus · Jan 2011
Randomized Controlled Trial Multicenter Study Comparative StudyReliability of the Cerebral Performance Category to classify neurological status among survivors of ventricular fibrillation arrest: a cohort study.
The Cerebral Performance Category (CPC) score is widely used in research and quality assurance to assess neurologic outcome following cardiac arrest. However, little is known about the inter- and intra-reviewer reliability of the CPC. ⋯ In this cohort study of survivors of out-of-hospital ventricular fibrillation cardiac arrest, the use of the CPC to classify favorable versus unfavorable neurological status at hospital discharge produced variable inter- and intra-reviewer agreement. The findings provide useful context to interpret outcome evaluations that report CPC.
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Scand J Trauma Resus · Jan 2011
Multicenter Study Comparative Study Clinical TrialAssociation between a single-pass whole-body computed tomography policy and survival after blunt major trauma: a retrospective cohort study.
Single-pass, whole-body computed tomography (pan-scan) remains a controversial intervention in the early assessment of patients with major trauma. We hypothesized that a liberal pan-scan policy is mainly an indicator of enhanced process quality of emergency care that may lead to improved survival regardless of the actual use of the method. ⋯ In this study, a liberal pan-scan policy was associated with lower trauma mortality. The causal role of the pan-scan itself must be interpreted in the context of improved structural and process quality, is apparently moderate and needs further investigation with regard to the diagnostic yield and changes in management decisions. (The Pan-Scan for Trauma Resuscitation [PATRES] Study Group, ISRCTN35424832 and ISRCTN41462125).
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Scand J Trauma Resus · Jan 2011
Randomized Controlled TrialThe effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial.
Prevention and treatment of hypothermia by active warming in prehospital trauma care is recommended but scientific evidence of its effectiveness in a clinical setting is scarce. The objective of this study was to evaluate the effect of additional active warming during road or air ambulance transportation of trauma patients. ⋯ In mildly hypothermic trauma patients, with preserved shivering capacity, adequate passive warming is an effective treatment to establish a slow rewarming rate and to reduce cold discomfort during prehospital transportation. However, the addition of active warming using a chemical heat pad applied to the torso will significantly improve thermal comfort even further and might also reduce the cold induced stress response.