Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2014
Comparative StudyNoninvasive continuous versus intermittent arterial pressure monitoring: evaluation of the vascular unloading technique (CNAP device) in the emergency department.
Monitoring cardiovascular function in acutely ill patients in the emergency department (ED) is of paramount importance. Arterial pressure (AP) is usually monitored using intermittent oscillometric measurements with an upper arm cuff. The vascular unloading technique (VUT) allows continuous noninvasive AP monitoring. In this study, we compare continuous AP measurements obtained by VUT with intermittent oscillometric AP measurements in ED patients. In addition, we aimed to investigate whether continuous noninvasive AP monitoring allows detection of relevant hypotensive episodes that might be missed with intermittent AP monitoring. ⋯ VUT using the CNAP system for noninvasive continuous AP measurement shows reasonable agreement with intermittent oscillometric measurements in acutely ill ED patients. Continuous AP monitoring allows immediate recognition of clinically relevant hypotensive episodes, which are missed or only belatedly recognized with intermittent AP measurement.
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Scand J Trauma Resus · Jan 2014
The use of transcutaneous CO2 monitoring in cardiac arrest patients: a feasibility study.
Prediction of the return of spontaneous circulation (ROSC) in cardiac arrest patients is a parameter for deciding when to stop cardiopulmonary resuscitation (CPR) or to start extracorporeal CPR. We investigated the change in transcutaneous PCO2 (PtcCO2) in cardiac arrest patients. ⋯ PtcCO2 monitoring provides non-invasive, continuous, and useful monitoring in cardiac arrest patients.
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Scand J Trauma Resus · Jan 2014
Randomized Controlled TrialEvaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial.
The Amberg-Schwandorf Algorithm for Primary Triage (ASAV) is a novel primary triage concept specifically for physician manned emergency medical services (EMS) systems. In this study, we determined the diagnostic reliability and the time requirements of ASAV triage. ⋯ The ASAV is a specific concept for primary triage in physician governed EMS systems. It may detect red patients reliably. The test performance criteria are comparable to that of mSTaRT, whereas ASAV triage might be accomplished slightly faster. From the data, there was no evidence for a clinically significant reliability difference between typical staffing of mobile intensive care units, patient transport ambulances, or disaster response volunteers. Up to now, there is no clinical validation of either triage concept. Therefore, reality based evaluation studies are needed.
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Scand J Trauma Resus · Jan 2014
Barriers and opportunities in assessing calls to emergency medical communication centre - a qualitative study.
Previous studies have described the difficulties and the complexity of assessing an emergency call, and assessment protocols intended to support the emergency medical dispatcher's (EMD) assessment have been developed and evaluated in recent years. At present, the EMD identifies about 50-70 % of patients suffering from cardiac arrest, acute myocardial infarction or stroke. The previous research has primarily been focused on specific conditions, and it is still unclear whether there are any overall factors that may influence the assessment of the call to the emergency medical communication centre (EMCC). ⋯ Barriers in assessing the call to the EMCC were associated with contradictory information, the absence of a primary problem, or the structure of the call. Opportunities were associated with a clear symptom description that was also repeated, and the RN's use of different communication strategies such as closed loop communication.
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Scand J Trauma Resus · Jan 2014
Mobile videoconferencing for enhanced emergency medical communication - a shot in the dark or a walk in the park? -- A simulation study.
Videoconferencing on mobile phones may enhance communication, but knowledge on its quality in various situations is needed before it can be used in medical emergencies. Mobile phones automatically activate loudspeaker functionality during videoconferencing, making calls particularly vulnerable to background noise. The aim of this study was to investigate if videoconferencing can be used between lay bystanders and Emergency Medical Dispatch (EMD) operators for initial emergency calls during medical emergencies, under suboptimal sound and light conditions. ⋯ Videoconferencing on mobile phones can be used for the initial emergency call during medical emergencies also in suboptimal conditions.