Scand J Trauma Resus
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Scand J Trauma Resus · Aug 2010
Hospital employees' theoretical knowledge on what to do in an in-hospital cardiac arrest.
Guidelines recommend that all health care professionals should be able to perform cardiopulmonary resuscitation (CPR), including the use of an automated external defibrillator. Theoretical knowledge of CPR is then necessary.The aim of this study was to investigate how much theoretical knowledge in CPR would increase among all categories of health care professionals lacking training in CPR, in an intervention hospital, after a systematic standardised training. Their results were compared with the staff at a control hospital with an ongoing annual CPR training programme. ⋯ Overall theoretical knowledge increased after systematic standardised training in CPR. The increase was more pronounced for those without previous training and for those staff categories with the least medical education.
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Scand J Trauma Resus · Jul 2010
Focused nurse-defibrillation training: a simple and cost-effective strategy to improve survival from in-hospital cardiac arrest.
Time to first defibrillation is widely accepted to correlate closely with survival and recovery of neurological function after cardiac arrest due to ventricular fibrillation or ventricular tachycardia. Focused training of a cadre of nurses to defibrillate on their own initiative may significantly decrease time to first defibrillation in cases of in-hospital cardiac arrest outside of critical care units. Such a program may be the best single strategy to improve in-hospital survival, simply and at reasonable cost.
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Scand J Trauma Resus · Jul 2010
Current use of intraosseous infusion in Danish emergency departments: a cross-sectional study.
Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in both pediatric and adult resuscitation. We evaluated the current use of IOI in Danish emergency departments (EDs). ⋯ The study shows considerable variations in IOI usage in Danish EDs despite the fact that IOI devices were available in the majority of EDs. In addition, in many EDs there were no local guidelines on IOI and no training in the procedure. We recommend more extensive training of medical staff in IOI techniques in Danish EDs.
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Scand J Trauma Resus · Jun 2010
Case ReportsGunshot bullet embolus with pellet migration from the left brachiocephalic vein to the right ventricle: a case report.
We report the case of a 16 year old male who was the victim of a drive by shooting sustaining the rare but recognised complication of cardiovascular bullet embolism. He was seen as a trauma call in the emergency department and CT scanning revealed 70 shotgun pellets scattered throughout left sided sub-cutaneous tissues of the head and neck, and more significantly a single pellet within the right atrium. ⋯ Serial scanning showed the pellet had subsequently migrated into the right ventricle where it has remained since, presumably having become epithelialised. This case report highlights the importance of repeated scanning for the possibility of projectile migration within the cardiovascular system in similar cases of penetrating injury.
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Scand J Trauma Resus · Jun 2010
Editorial"Metabolic staging" after major trauma - a guide for clinical decision making?
Metabolic changes after major trauma have a complex underlying pathophysiology. The early posttraumatic stress response is associated with a state of hyperinflammation, with increased oxygen consumption and energy expenditure. ⋯ Recently, the concept of "metabolic staging" has been advocated, which takes into account the distinct inflammatory phases and metabolic phenotypes after major trauma, including the "ischemia/reperfusion phenotype", the "leukocytic phenotype", and the "angiogenic phenotype". The potential clinical impact of metabolic staging, and of an appropriately adapted "metabolic control" and nutritional support, remains to be determined.