Scand J Trauma Resus
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Scand J Trauma Resus · Aug 2018
Randomized Controlled Trial Multicenter Study Comparative StudyMechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a randomised controlled feasibility trial (COMPRESS-RCT).
Mechanical chest compression devices consistently deliver high-quality chest compressions. Small very low-quality studies suggest mechanical devices may be effective as an alternative to manual chest compressions in the treatment of adult in-hospital cardiac arrest patients. The aim of this feasibility trial is to assess the feasibility of conducting an effectiveness trial in this patient population. ⋯ The findings of COMPRESS-RCT will provide important information about the deliverability of an effectiveness trial to evaluate the effect on 30-day mortality of routine use of mechanical chest compression devices in adult in-hospital cardiac arrest patients.
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Scand J Trauma Resus · Aug 2018
Randomized Controlled Trial Multicenter StudyUse of the prognostic biomarker suPAR in the emergency department improves risk stratification but has no effect on mortality: a cluster-randomized clinical trial (TRIAGE III).
Risk stratification of patients in the emergency department can be strengthened using prognostic biomarkers, but the impact on patient prognosis is unknown. The aim of the TRIAGE III trial was to investigate whether the introduction of the prognostic and nonspecific biomarker: soluble urokinase plasminogen activator receptor (suPAR) for risk stratification in the emergency department reduces mortality in acutely admitted patients. ⋯ The TRIAGE III trial found no effect of introducing the nonspecific and prognostic biomarker suPAR in emergency departments on short- or long-term all-cause mortality among acutely admitted patients. Further research is required to evaluate how prognostic biomarkers can be implemented in routine clinical practice.
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Scand J Trauma Resus · Aug 2018
Multicenter Study Observational StudyEvaluating the ability of a trauma team activation tool to identify severe injury: a multicentre cohort study.
Sensitive decision making tools should assist prehospital personnel in the triage of injured patients, identifying those who require immediate lifesaving interventions and safely reducing unnecessary under- and overtriage. In 2014 a new trauma team activation (TTA) tool was implemented in Central Norway. The overall objective of this study was to evaluate the ability of the new TTA tool to identify severe injury. ⋯ Severe injury was infrequent and there was a substantial rate of overtriage. The ability of the TTA tool was relatively insensitive in identifying severe injury, but showed increased performance when utilizing physiologic and anatomical injury criteria. Many of the TTA mechanism of injury criteria might be considered for removal from the triage tool due to substantial rates of overtriage. This has relevance for the proposed development of national Norwegian TTA criteria.
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Scand J Trauma Resus · Jul 2018
Multicenter StudyMortality, risk factors and causes of death in Swedish patients with open tibial fractures - a nationwide study of 3, 777 patients.
Open tibial fractures are serious, complicated injuries. Previous studies suggested an increased risk of death, however, this has not been studied in large population-based settings. We aimed to analyze mortality including causes of death in all patients with open tibial fractures in Sweden. Moreover, we wanted to compare mortality rates with the Swedish population and determine whether treatment-related or demographic variables were independently associated with death. ⋯ Patients with open tibial fractures have an increased risk of death compared with the general population in all age- and gender-groups. External causes of death are over-represented and indicate a subgroup with a risky behaviour among younger males. Elderly patients have an increased risk of dying comparable to hip fracture patients. They are at risk for cardiovascular and respiratory failure and should be treated with urgency, emphasizing the need for specialized geriatric trauma units.
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Scand J Trauma Resus · Jul 2018
Multicenter StudyAssociation between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients - a retrospective Analysis.
Deranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various cardiac rhythms and cardiac arrest following trauma. ⋯ In adult trauma patients, pre-hospital higher blood glucose levels were related to tachycardic and shockable rhythms. Cardiac arrest was more frequently observed in hypoglycaemic and hyperglycaemic pre-hospital trauma patients. The rate of ROSC rose significantly with rising blood glucose concentration. Blood glucose measurements in addition to common vital parameters (GCS, heart rate, blood pressure, breathing frequency) may help identify patients at risk for cardiopulmonary arrest and dysrhythmias.