Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2013
Exclusion of context knowledge in the development of prehospital guidelines: results produced by realistic evaluation.
Prehospital work is accomplished using guidelines and protocols, but there is evidence suggesting that compliance with guidelines is sometimes low in the prehospital setting. The reason for the poor compliance is not known. The objective of this study was to describe how guidelines and protocols are used in the prehospital context. ⋯ The personnel take a positive view of the use of guidelines and protocols in prehospital work. The main obstacle to the use of guidelines and protocols in this organization is the format, due to the exclusion of context knowledge in the development process.
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Scand J Trauma Resus · Jan 2013
Comparative StudyHospital out-lying through lack of beds and its impact on care and patient outcome.
When medical wards become saturated, the common practice is to resort to outlying patients in another ward until a bed becomes free. ⋯ O patients had a worse prognosis than NO patients.
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Scand J Trauma Resus · Jan 2013
Comparative StudyEffects of red blood cell transfusion on hemodynamic parameters: a prospective study in intensive care unit patients.
The aim of the study was to investigate the effect of red blood cell (RBC) transfusion on hemodynamic parameters including transpulmonary thermodilution (TPTD)-derived variables. ⋯ In ICU patients, the transfusion of 2 RBC units induces a significant decrease in CO and CI because of a significant decrease in heart rate (while SV remains unchanged). Despite the decrease in CO, DO₂ significantly increases because of a significant increase in CaO₂. In addition, RBC transfusion results in a significant increase in MAP and SVRI. No significant changes in TPTD-parameters reflecting cardiac preload (GEDVI), pulmonary edema (EVLWI), and pulmonary vascular permeability (PVPI) are observed following RBC transfusion.
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Scand J Trauma Resus · Jan 2013
Effects of moving emergency trauma laparotomies from the ED to a dedicated OR.
The trauma room at Oslo University Hospital- Ulleval is fully equipped for major damage control procedures, in order to minimize delay to surgery. Since 2006, patients in need of immediate laparotomy have increasingly been transferred to a dedicated trauma operating room (OR). We wanted to determine the decrease in number of procedures performed in the emergency department (ED), the effect on time from admission to laparotomy, the effect on non-therapeutic laparotomies, and finally to determine whether such a change could be undertaken without an increase in mortality. ⋯ Moving this cohort of haemodynamically compromised trauma patients in need of emergency laparotomy out of the ED to a dedicated OR resulted in longer median time to laparotomy, but did not increase mortality.