Scand J Trauma Resus
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Scand J Trauma Resus · Nov 2024
The NACA score predicts mortality in polytrauma patients before hospital admission: a registry-based study.
The early assessment of the severity of polytrauma patients is key for their optimal management. The aim of this study was to investigate the discriminative performance of the NACA score in a large dataset by stratifying the severity of polytraumatized patients in correlation to injury severity score (ISS), Glasgow Coma Scale (GCS), and mortality. ⋯ This study provides valuable evidence supporting the effectiveness of the NACA score in assessing the severity of polytrauma patients in both the pre-ER and ER condition. Considering the statistical significant correlation with the GCS and with the ISS, NACA is a valid score for assessing polytrauma patients.
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Scand J Trauma Resus · Nov 2024
Observational StudyEmergency neurosurgery for traumatic brain injury by general surgeons at local hospitals in Sweden: a viable option when time is brain.
Timing of surgical evacuation of mass lesions in traumatic brain injury (TBI) is crucial. However, due to geographical variations, transportation time to the nearest neurosurgical department may be long. To save time, general surgeons at a local hospital may perform the operation, despite more limited experience in neurosurgical techniques. This study aimed to determine whether patient outcomes differed between those who had undergone emergency neurosurgery at local hospitals by general surgeons vs. at university hospitals by neurosurgeons. ⋯ Although a slightly greater proportion of patients who underwent emergency neurosurgery at local hospitals died, there was no difference in the rate of favourable outcome. Thus, in patients with impending brain herniation, when time is of the essence, evacuation of traumatic intracranial bleeding by general surgeons at local hospitals remains a highly viable option.
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Scand J Trauma Resus · Nov 2024
Multicenter StudyHypothermic cardiac arrest: prognostic factors for successful resuscitation before rewarming.
To indicate factors predicting return of spontaneous circulation in patients with hypothermic cardiac arrest in the pre-rewarming period. ⋯ Patients with core body temperature < 25 °C, hypoxemia, and those who sustained unwitnessed hypothermic cardiac arrest have weak chances for successful resuscitation before rewarming. They can benefit from immediate transportation to an extracorporeal life support facility under continuous cardiopulmonary resuscitation. Effective rewarming and oxygenation during the prehospital period can increase the chances for return of spontaneous circulation. Recurrence of cardiac arrest during rewarming is uncommon.
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Septic shock (SS) is a potential life-threatening condition in which an early identification and immediate therapy stand out as the main cornerstones to improve survival chance; in this context, emergency medical services (EMS) become key to reduce the time between diagnosis and management in the ICU or emergency department. However, guidelines for the prehospital management of SS patients remains unclear, and literature around this topic is scant. Our scoping review was conducted following the PICO framework and a search strategy related to septic shock management and diagnosis in prehospital settings was executed in PubMed, Scopus and Virtual Health Library; articles in English and Spanish from 2015, onwards, were screened by the authors and selected by mutual consensus. Our aim is to analyze the prehospital management strategies of SS reported in the literature, and to showcase and summarize the screening tools, demographic factors, clinical manifestations and prognostic factors of SS in the prehospital setting.
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Scand J Trauma Resus · Nov 2024
Electrical burns in train climbers treated in the Helsinki Burn Centre during the last 30 years.
Patients who climb onto the roof of a stationary train carriage and sustain a high voltage electrical injury from the overhead cables represent a rare type of electrical injury. The aim of this study was to review all the electrical burns and their outcomes in train climbers treated in the Helsinki Burn Centre during the last three decades. ⋯ In conclusion, train climbers represent a rare group of young patients with electrical burns. Precautionary strategies should be implemented to prevent these injuries that are associated with high morbidity and mortality.