Scand J Trauma Resus
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Scand J Trauma Resus · Mar 2019
Multicenter StudyUnplanned out-of-hospital birth and risk factors of adverse perinatal outcome: findings from a prospective cohort.
In France, while most babies are delivered at hospital, emergency medical services (EMS) weekly manage calls for unplanned out-of-hospital births. The objective of our study was to describe neonatal morbidity and mortality, defined as death or neonatal intensive care unit hospitalization at Day 7, in a prospective multicentric cohort of unplanned out-of-hospital births. ⋯ Our study assessed for the first time risk factors for adverse perinatal outcome in a large and multicenter cohort of unplanned out-of-hospital births. We have to improve temperature management in the out-of-hospital field and future trials are required to investigate strategies to optimize newborns management in the prehospital area.
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Scand J Trauma Resus · Feb 2019
Multicenter Study Observational StudyImpact of initial coagulation and fibrinolytic markers on mortality in patients with severe blunt trauma: a multicentre retrospective observational study.
Acute coagulopathy is a well-known predictor of poor outcomes in patients with severe trauma. However, using coagulation and fibrinolytic markers, how one can best predict mortality to find out potential candidates for treatment of coagulopathy remains unclear. This study aimed to determine preferential markers and their optimal cut-off values for mortality prediction. ⋯ Fibrinogen and D-dimer were the principal markers for stratification of mortality in patients with severe blunt trauma. These markers could function as therapeutic targets because they were significant predictors of mortality, independent from severity of injury.
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Scand J Trauma Resus · Nov 2018
Multicenter StudyTreat me nice! -a cross-sectional study examining support during the first year in the emergency medical services.
Working in the emergency medical service (EMS) can be extremely varying and sometimes physically and psychologically demanding. Being new in this context can be a great challenge. This study aim to describe what ambulance nurses consider to be important support during the first year in the EMS. ⋯ It was concluded that an important way to support newcomers in the EMS is to treat them 'nice'. This can be achieved by creating an open climate and a welcoming culture where the new professionals feel trusted and treated with respect, created ways to work structurally, have applicable medical guidelines, and for newcomers to receive feedback on their actions.
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Scand J Trauma Resus · Oct 2018
Multicenter StudyA retrospective comparison between non-conveyed and conveyed patients in ambulance care.
Not all patients where an ambulance is dispatched are conveyed to an emergency department. Although non-conveyance is a substantial part of ambulance care, there is limited insight in the non-conveyance patient population. Therefore, the study aim was to compare demographics, initial on-scene reasons for care, and vital signs between conveyed and non-conveyed patients attended by an ambulance. ⋯ This study shows that non-conveyed patients are younger, are more likely to be in (highly) rural areas, and more often have initial reasons for care related to mental, behavioral and neurodevelopmental disorders (ICD-10 chapter 5). Although abnormal vital functions/observation scale were more prevalent in the conveyance group, 58.6% of the non-conveyed patients had at least one abnormal vital function/observation scale.
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Scand J Trauma Resus · Sep 2018
Multicenter StudyA socio-economic analysis of increased staffing in the Norwegian helicopter emergency medical service.
The European Aviation Safety Agency (EASA) is preparing a new set of regulations that will cover working and resting periods for crew members engaged in emergency medical services with helicopters (HEMS) and aeroplanes (AEMS). Such a shared European regulatory framework has already been introduced for the majority of commercial operations with aeroplanes, whereas national regulations are still in place for helicopter operations. A possible consequence of changing the regulations on working and resting periods for helicopter operations is that current abilities to provide 24-h, continuous emergency readiness with the same helicopter crew will be changed to a daily shift pattern with two, and even up to three, different crews to cover one 24-h period. ⋯ Alternations to the working and resting periods for Norwegian HEMS operations that will result in a change from the current 24-h, continuous emergency readiness with the same crew, to a set-up with two, and up to three, different crews are not found to be socio-economically beneficial.