Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2025
Randomized Controlled TrialExperimental hypothermia by cold air: a randomized, double-blind, placebo-controlled crossover trial.
Accidental hypothermia is associated with high morbidity and mortality. Research on treatment strategies for accidental hypothermia is complicated by the low incidence and heterogeneous patient population. We have developed a new method for clinical trials of experimental hypothermia, to enable further studies of active rewarming. If cold ambient air is effective as a cooling method, this would mimic the most frequent clinical setting of hypothermic patients and provide a feasible cooling method for field studies. We aimed to induce mild hypothermia in healthy volunteers by exposure to cold ambient air, and tested the hypothesis that drug-induced suppression of endogenous thermoregulation would be required. ⋯ The novel protocol utilizing cold air as a cooling method and drug-induced suppression of endogenous thermoregulation, is effective and enables future research projects. We have provided suggestions for minor alterations.
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Scand J Trauma Resus · Jan 2025
ReviewKey performance indicators in emergency department simulation: a scoping review.
One way to measure emergency department (ED) performance is using key performance indicators (KPIs). Thus, identifying reliable KPIs can be critical in appraising ED performance. This study aims to introduce and classify the KPIs related to ED in simulations through the Balanced Scorecard (BSC) framework. ⋯ The study findings have collected a comprehensive set of KPIs to measure ED performance in simulations. These results can assist policymakers, managers, and researchers in measuring ED performance and help improve ED performance through a holistic view.
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Scand J Trauma Resus · Jan 2025
Circumstantial risk factors for death after intensive care unit-to-unit inter-hospital transfer-a Swedish registry study.
Unit-to-unit transfer of critically ill patients infers hazards that may cause adverse events. Circumstantial factors associated with mortality after intensive care include days in the ICU, night-time or weekend discharge and capacity transfer as compared to other reasons for transfer. Distance travelled may also constitute an indirect risk. The aim of this study was to assess potential associations between these circumstantial factors and the risk of death 30 days after transfer. ⋯ Our results suggest that inter-hospital transfer is safe to carry out at any time of day and over shorter as well as longer distances.
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Scand J Trauma Resus · Jan 2025
Identification of major trauma using the simplified abbreviated injury scale to estimate the injury severity score: a diagnostic accuracy and validation study.
The Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) grade the severity of injuries and are useful for trauma audit and benchmarking. However, AIS coding is complex and requires specifically trained staff. A simple yet reliable scoring system is needed. The aim of this study was two-fold. First, to develop and validate a simplified AIS (sAIS) chart centred on the most frequent injuries for use by non-trained healthcare professionals. Second, to evaluate the diagnostic accuracy of the sAIS (index test) to calculate the simplified ISS (sISS) to identify major trauma, compared with the reference AIS (rAIS) to calculate the reference ISS (rISS). ⋯ The sAIS is accurate, but slightly imprecise in calculating the ISS. The development of this scale increases the possibilities to use a scoring system for severely injured patients in settings with a reduced availability of the AIS.
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Scand J Trauma Resus · Jan 2025
Observational StudySignificant room for improvement in the prehospital assessment and treatment of acute abdominal pain: a retrospective observational study.
Acute abdominal pain (AAP) is a common reason for calling emergency medical services (EMS). Despite the widely acknowledged importance of effective prehospital pain management, described by patients as crucial regardless of any other factor, studies on prehospital pain management in AAP patients are limited and suggest room for improvement. This is particularly relevant given the long-standing controversy surrounding the use of analgesia in AAP patients before a final diagnosis is made, which may still influence the prehospital pain management. ⋯ Significant room for improvement in the prehospital management of acute abdominal pain was found. The proportions of pain assessment, treatment and reassessment were low with nine out of ten patients leaving prehospital care with unknown, moderate or severe pain. Among the cases where pain assessment, treatment and reassessment were made and recorded, four out of five patients experienced significant pain relief, indicating the potential of better prehospital pain management.