Scand J Trauma Resus
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Scand J Trauma Resus · Dec 2022
Moderate and severe traumatic brain injury in general hospitals: a ten-year population-based retrospective cohort study in central Norway.
Patients with moderate and severe traumatic brain injury (TBI) are admitted to general hospitals (GHs) without neurosurgical services, but few studies have addressed the management of these patients. This study aimed to describe these patients, the rate of and reasons for managing patients entirely at the GH, and differences between patients managed entirely at the GH (GH group) and patients transferred to the regional trauma centre (RTC group). We specifically examined the characteristics of elderly patients. ⋯ Half of the patients were managed entirely at a GH, and these were mainly patients considered to have a low risk of further deterioration, patients with moderate TBI, and elderly patients. Less than two of ten patients ≥ 80 years old were transferred, and survival was poor regardless of the transferral status.
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Scand J Trauma Resus · Dec 2022
Observational StudyImplementation of a low-titre whole blood transfusion program in a civilian helicopter emergency medical service.
Early balanced transfusion is associated with improved outcome in haemorrhagic shock patients. This study describes the implementation and evaluates the safety of a whole blood transfusion program in a civilian helicopter emergency medical service (HEMS). ⋯ Implementing a whole blood transfusion program in civilian HEMS is feasible and safe and the logistics around out of hospital whole blood transfusions are manageable. Trial registration The study is registered in the ClinicalTrials.gov registry (NCT02784951).
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Scand J Trauma Resus · Dec 2022
Observational StudyCharacteristics of low acuity prehospital emergency patients with 48-h mortality, an observational cohort study.
Every year an emergency medical technician or paramedic treats and transports up to several hundred patients. Only some patients are acutely seriously ill, and a few of these show only discrete signs and symptoms of their condition. This study aims to describe patients who died within 48 h of being admitted non-emergently to hospital by ambulance, examine the extent to which critically ill patients are recognized prehospitally, and identify clinical warning signs that might be frequently overlooked. ⋯ It was estimated that death within 48 h could generally not be avoided prehospitally. The patients' median age was 83 years, and they often had serious comorbidity. Patients whose vital parameters met red or orange triage criteria were to a lesser degree triaged prehospitally, compared to patients in the yellow or green categories. Patients with acute aortic syndrome were not recognized by EMS 33.3% of the time.
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Scand J Trauma Resus · Dec 2022
Prehospital monitoring of cerebral circulation during out of hospital cardiac arrest ? A feasibility study.
About two-thirds of the in-hospital deaths after out-of-hospital cardiac arrests (OHCA) are a consequence of anoxic brain injuries, which are due to hypoperfusion of the brain during the cardiac arrests. Being able to monitor cerebral perfusion during cardiopulmonary resuscitation (CPR) is desirable to evaluate the effectiveness of the CPR and to guide further decision making and prognostication. ⋯ Our results suggest that both INVOS™5100 and ROOT® O3 can distinguish between ROSC and no ROSC in OHCA, and both could be used in the pre-hospital setting and during transport with minimal interference with ALS.