Scand J Trauma Resus
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Scand J Trauma Resus · Nov 2019
Multicenter StudyPrognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study.
Severe accidental hypothermia (AH) is life threatening. Thus, prognostic prediction in AH is essential to rapidly initiate intensive care. Several studies on prognostic factors for AH are known, but none have been established. We clarified the prognostic ability of the Sequential Organ Failure Assessment (SOFA) score in comparison with previously reported prognostic factors among patients with AH. ⋯ The SOFA score demonstrated better discrimination ability as a mortality predictor among all known prognostic factors in patients with AH.
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Scand J Trauma Resus · Nov 2019
Multicenter StudyDispatcher-assisted cardiopulmonary resuscitation for traumatic patients with out-of-hospital cardiac arrest.
Resuscitation efforts for traumatic patients with out-of-hospital cardiac arrest (OHCA) are not always futile. Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) during emergency calls could increase the rate of bystander cardiopulmonary resuscitation (CPR) and thus may enhance survival and neurologic outcomes of non-traumatic OHCA. This study aimed to examine the effectiveness of DA-CPR for traumatic OHCA. ⋯ DA-CPR was not associated with better outcomes for traumatic OHCA in achieving a sustained ROSC. The DA-CPR program for traumatic OHCAs needs further studies to validate its effectiveness and practicability, especially in the communities where rules for the termination of resuscitation in prehospital settings do not exist.
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Scand J Trauma Resus · Oct 2019
Multicenter Study Observational StudyVariation in accessibility of the population to an Emergency Medical Communication Centre: a multicentre observational study.
Access to an Emergency Medical Communication Centre is essential for the population in emergency situations. Handling inbound calls without delay requires managing activity, process and outcome measures of the Emergency Medical Communication Centre to improve the workforce management and the level of service. France is facing political decisions on the evolution of the organisation of Emergency Medical Communication Centres to improve accessibility for the population. First, we aim to describe the variation in activity between Emergency Medical Communication Centres, and second, to explore the correlation between process measures and outcome measures. ⋯ The activity dynamics of the six Emergency Medical Communication Centres are not identical. This variability, illustrating the particularity of each centre, must be accurately assessed and should be taken into account in managerial considerations. The call taker occupation rate is the leverage in the workforce management to improve the population accessibility.
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Scand J Trauma Resus · Oct 2019
Multicenter StudyPredicting acute coronary syndrome in males and females with chest pain who call an emergency medical communication centre.
Chest pain is a frequent reason for calls in emergency medical communication centre (EMCC). Detecting a coronary origin by phone is a challenge. This is especially so as the presentations differ according to gender. We aimed to establish and validate a sex-based model to predict a coronary origin of chest pain in patients calling an EMCC. ⋯ Predictors of an ACS diagnosis in patients calling an EMCC for chest pain differ between men and women. We developed an accurate predictive model for men, but for women, the accuracy was poor.
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Scand J Trauma Resus · Oct 2019
Multicenter StudyLimitation of treatment in prehospital care - the experiences of helicopter emergency medical service physicians in a nationwide multicentre survey.
Making ethically sound treatment limitations in prehospital care is a complex topic. Helicopter Emergency Medical Service (HEMS) physicians were surveyed on their experiences with limitations of care orders in the prehospital setting, including situations where they are dispatched to healthcare facilities or nursing homes. ⋯ Making limitation of care orders is an important but often invisible part of a HEMS physician's work. HEMS physicians expressed that patients in long-term care were often without limitations of care orders in situations where an order would have been ethically in accordance with the patient's best interests.