Scand J Trauma Resus
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Scand J Trauma Resus · Dec 2017
Comment LetterProper training and use of ultrasonography facilitates lumbar puncture.
With great interest, we read the study of Line Dussourd et al. concluding that ultrasonography allows better identification of anatomical structures before performing a lumbar puncture. We cannot concur with the conclusions of the study because the authors did not visualize the conus medullaris directly, nor did they assess the individual intervertebral levels. ⋯ We do agree that neuraxial ultrasound is of great benefit for the performance of lumbar punctures. Proper training and applying the correct technique, however, is necessary for obtaining all benefits ultrasonography offers.
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Scand J Trauma Resus · Dec 2017
Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services.
Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS). A second objective was to identify any occupational hearing loss amongst prehospital personnel. ⋯ We found that the exposure levels exceeded the recommendations described in the European Regulative for Noise, which requires further protective initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.
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Scand J Trauma Resus · Dec 2017
Comment LetterPre-hospital advanced airway management in children: a challenge that training can handle.
We respond to the Tarpgaard et al. article reporting on pre-hospital endotracheal intubation (PHETI) success and complications by Danish critical care teams including critical care anaesthetists. We compare the authors' results with previously published results from our service's experience with PHETI in a similar patient population, also with physician and paramedic medical teams. ⋯ A recently published study of 82 patients that we completed revealed the following results: 100, 91 and 14%, respectively. We propose training and operating protocols we believe contribute to this relative success in paediatric PHETI.
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Scand J Trauma Resus · Dec 2017
Impact of systolic blood pressure limits on the diagnostic value of triage algorithms.
Major incidents are characterized by a lack of resources compared to an overwhelming number of casualties, requiring a prioritization of medical treatment. Triage algorithms are an essential tool for prioritizing the urgency of treatment for patients, but the evidence to support one over another is very limited. We determined the influence of blood pressure limits on the diagnostic value of triage algorithms, considering if pulse should be palpated centrally or peripherally. ⋯ As a consequence, it might be important in which location pulses are palpated according to the algorithm at hand during triage of patients.
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Scand J Trauma Resus · Nov 2017
Observational StudyRoutine blood tests are associated with short term mortality and can improve emergency department triage: a cohort study of >12,000 patients.
Prioritization of acutely ill patients in the Emergency Department remains a challenge. We aimed to evaluate whether routine blood tests can predict mortality in unselected patients in an emergency department and to compare risk prediction with a formalized triage algorithm. ⋯ Routine blood tests were strongly associated with 30-day mortality in acutely ill patients and discriminatory ability was significantly higher than with a formalized triage algorithm. Thus routine blood tests allowed an improved risk stratification of patients presenting in an emergency department.