Scand J Trauma Resus
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Scand J Trauma Resus · Aug 2019
Multicenter Study Observational StudyEpinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study.
The beneficial effect of epinephrine during resuscitation from out-of-hospital cardiac arrest (OHCA) has been inconclusive, and potential harm has been suggested, particularly in trauma victims. Although no significant improvement in neurological outcomes has been found among resuscitated patients using epinephrine, including trauma patients, the use of epinephrine is recommended in the Advanced Trauma Life Support protocol. Given that the use of vasopressors was reported to be associated with increased mortality in patients with massive bleeding, the undesirable effects of epinephrine during the resuscitation of traumatic OHCA should be elucidated. We hypothesised that resuscitation with epinephrine would increase mortality in patients with OHCA following trauma. ⋯ The relationship between the use of epinephrine during resuscitation and decreased 7-day survival was found in patients with OHCA following trauma, and the propensity score-matched analyses validated the results. Resuscitation without epinephrine in traumatic OHCA should be further studied in a randomised controlled trial.
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Scand J Trauma Resus · May 2019
Multicenter StudySocioeconomic disparities in prehospital stroke care.
Recent studies have revealed socioeconomic disparities in stroke outcomes. Here, we investigated whether prehospital stroke care differs with respect to socioeconomic status (SES). ⋯ We found socioeconomic inequities in prehospital stroke care which could affect the efficacy of acute stroke treatment. The ambulance nurses' ability to recognise stroke/TIA may partly explain the observed inequities.
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Scand J Trauma Resus · Apr 2019
Multicenter StudyA prospective stepped wedge cohort evaluation of the new national trauma team activation criteria in Sweden - the TRAUMALERT study.
Trauma triage based on prehospital information facilitates correct allocation of in-hospital resources. The Swedish national two-tier trauma team activation (TTA) criteria were revised in 2016. The current study aimed to evaluate the safety and efficacy of the new criteria. ⋯ The newly implemented Swedish TTA criteria result in a reduction in limited TTA frequency, indicating an increased efficiency in use of resources. The over- and undertriage is unchanged compared to former criteria, thus upholding patient safety.
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Scand J Trauma Resus · Apr 2019
Multicenter StudyThe HEAVEN criteria predict laryngoscopic view and intubation success for both direct and video laryngoscopy: a cohort analysis.
Existing difficult airway prediction tools are not practical for emergency intubation and do not incorporate physiological data. The HEAVEN criteria (Hypoxaemia, Extremes of size, Anatomic challenges, Vomit/blood/fluid, Exsanguination, Neck mobility) may be more relevant for emergency rapid sequence intubation (RSI). ⋯ The HEAVEN criteria may be useful to predict laryngoscopic view and intubation performance for DL and VL during emergency RSI.
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Scand J Trauma Resus · Apr 2019
Multicenter StudyInjury registration for primary prevention in a provincial Russian region: setting up a new trauma registry.
The Shenkursk Injury Registry (SHIR) was established in the Shenkursk District, Northwestern Russia in 2015 for the purposes of primary prevention. The SHIR covers all injuries (ICD-10 diagnoses from S00 to T78) for which medical aid is given at the Shenkursk central district hospital and includes data about injury circumstances. We used the SHIR data to assess the quality of the SHIR as an evidence basis and for the local preventive applications. ⋯ With consideration of possible insubstantial overestimates of the average injury severity, the SHIR data can be considered sufficiently complete, reliable, and representative of the injury situation in the Shenkursk District. Therefore, SHIR is an adequate evidentiary basis for planning local injury prevention.