Scand J Trauma Resus
-
Scand J Trauma Resus · Sep 2018
ReviewFirst establishment of a new table-rotated-type hybrid emergency room system.
The hybrid emergency room (hybrid ER) system was first established in 2011 in Japan. It is defined as an integrated system including an ER, emergency computed tomography (CT) and interventional radiology (IVR) rooms, and operating rooms. Severe trauma patients can undergo emergency CT examinations and therapies (surgeries) without being transferred. ⋯ Moreover, the patient table was also a surgical operating table, and the hybrid ER system had an air-conditioned operating room (class 10,000). In the anticipation of many trauma patients being transported to the ER, a new trauma bay with three additional beds next to the hybrid ER was established, which also had an air-conditioned operating room. This new rotated-type hybrid ER system facilitates efficient surgical functions during trauma resuscitation and can secure a wide working space for the medical team to immediately perform resuscitative procedures and IVRs without delay.
-
Scand J Trauma Resus · Sep 2018
Observational StudySafety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study.
After on-scene examination and /or treatment, emergency medical services (EMS) nurses must decide whether the patient requires further assessment or treatment, most frequently in a hospital. The primary objective of this study was to assess the reliability of the current EMS protocol by determining whether the decision not to transport the patient to a care provider was correct or not. ⋯ The data show that EMS nurses can effectively examine patients, but a low threshold of referral for consultation should be considered because one in four patients requested secondary medical attention for the same complaint(s) again. However, due to a low response rate (11.3%) more research is needed to further determine the safety of the current EMS protocol.
-
Scand J Trauma Resus · Sep 2018
ReviewHow does the length of cardiopulmonary resuscitation affect brain damage in patients surviving cardiac arrest? A systematic review.
Brain injury can occur after cardiac arrest due to the effects of ischaemia and reperfusion. In serious cases this can lead to permanent disability. This risk must be considered when making decisions about terminating resuscitation. There are very specific rules for termination of resuscitation in the prehospital setting however a similar rule for resuscitation in hospital does not exist. The aim of this review was to explore the effects of duration of cardiopulmonary resuscitation on neurological outcome in survivors of both in-hospital and out-of-hospital cardiac arrest achieving return of spontaneous circulation in hospital. ⋯ There is generally a better neurological outcome with a shorter duration of CPR in survivors of cardiac arrest however a cut-off beyond which resuscitation is likely to lead to unfavourable outcome could not be determined and is unlikely to exist. The findings of this review could be considered by clinicians making decisions about terminating resuscitation. This review has highlighted many gaps in the knowledge where future research is needed; a validated and reliable measure of neurological outcome following cardiac arrest, more focused research on the effects of duration on neurological outcome and further research into the factors leading to brain damage in cardiac arrest.
-
Scand J Trauma Resus · Sep 2018
Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015.
Peripheral nerve injury (PNI) as an adjunct lesion in patients with upper extremity trauma has not been investigated in a Central European setting so far, despite of its devastating long-term consequences. This study evaluates a large multinational trauma registry for prevalence, mechanisms, injury severity and outcome characteristics of upper limb nerve lesions. ⋯ PNI complicating upper extremity trauma might be more commonly encountered in Central Europe than suggested by previous foreign studies. PNI typically affect males of young age who show significantly increased length of hospitalization and subsequent need for inpatient rehabilitation. Hence these lesions induce extraordinary high financial expenses besides their impact on health related quality of life for the individual patient. Further research is necessary to develop specific prevention strategies for this kind of trauma.
-
Scand J Trauma Resus · Sep 2018
Observational StudyPeripheral measurements of venous oxygen saturation and lactate as a less invasive alternative for hemodynamic monitoring.
Peripheral measurement of venous oxygen saturation and lactate is a less invasive alternative to monitor tissue oxygenation as compared to measurements from a central venous catheter. However, there is a lack of evidence to support the use of peripheral measurements. In this study, we investigated the agreement between central and peripheral venous oxygen saturation and lactate. ⋯ We found a high bias but an acceptable trending ability between central and peripheral venous oxygenation. Central and peripheral lactate had excellent agreement. Further studies are necessary to validate the use of peripheral venous samples to identify patients at risk of impaired tissue oxygenation.