Abstract:
BACKGROUND:Delayed admission to appropriate care has been shown increase mortality following traumatic brain injury (TBI). We investigated factors associated with delayed admission to a hospital with neurosurgical expertise in a cohort of TBI patients in the intensive care unit (ICU). METHODS:A retrospective analysis of all TBI patients treated in the ICUs of Helsinki University Central Hospital was carried out from 1.1.2009 to 31.12.2010. Patients were categorized into two groups: direct admission and delayed admission. Patients in the delayed admission group were initially transported to a local hospital without neurosurgical expertise before inter-transfer to the designated hospital. Multivariate logistic regression was utilized to identify pre-hospital factors associated with delayed admission. RESULTS:Of 431 included patients 65% of patients were in the direct admission groups and 35% in the delayed admission groups (median time to admission 1:07h, IQR 0:52-1:28 vs. 4:06h, IQR 2:53-5:43, p <0.001). In multivariate analysis factors increasing the likelihood of delayed admission were (OR, 95% CI): male gender (3.82, 1.60-9.13), incident at public place compared to home (0.26, 0.11-0.61), high energy trauma (0.05, 0.01-0.28), pre-hospital physician consultation (0.15, 0.06-0.39) or presence (0.08, 0.03-0.22), hypotension (0.09, 0.01-0.93), major extra cranial injury (0.17, 0.05-0.55), abnormal pupillary light reflex (0.26, 0.09-0.73) and severe alcohol intoxication (12.44, 2.14-72.38). A significant larger proportion of patients in the delayed admission group required acute craniotomy for mass lesion when admitted to the neurosurgical hospital (57%, 21%, p< 0.001). No significant difference in 6-month mortality was noted between the groups (p= 0.814). CONCLUSION:Delayed trauma center admission following TBI is common. Factors increasing likelihood of this were: male gender, incident at public place compared to home, low energy trauma, absence of pre-hospital physician involvement, stable blood pressure, no major extra cranial injuries, normal pupillary light reflex and severe alcohol intoxication. Focused educational efforts and access to physician consultation may help expedite access to appropriate care in TBI patients.
journal_name
Scand J Trauma Resusc Emerg Medauthors
Raj R,Siironen J,Kivisaari R,Kuisma M,Brinck T,Lappalainen J,Skrifvars MBdoi
10.1186/1757-7241-21-67subject
Has Abstractpub_date
2013-09-10 00:00:00pages
67issn
1757-7241pii
1757-7241-21-67journal_volume
21pub_type
杂志文章abstract:BACKGROUND:A common dilemma in the management of pelvic fractures is recognizing the presence of associated abdominal injury. The purpose of this study was to determine the association between initial therapeutic intervention (laparotomy or transcatheter arterial embolization (TAE)) and mortality. METHODS:This was a c...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-21-82
更新日期:2013-12-03 00:00:00
abstract:BACKGROUND:Patients with cardiac arrest have lower survival rates, when resuscitation performance is low. In In-hospital settings the first responders on scene are usually nursing staff without rhythm analysing skills. In such cases Automated External Defibrillators (AED) might help guiding resuscitation performance. A...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-015-0170-7
更新日期:2015-10-31 00:00:00
abstract:BACKGROUND:The 19 Norwegian Emergency medical communication centres (EMCCs) use Norwegian Index for medical emergency assistance (Index) as dispatch guidelines. Little is known about the use of Index, nor its validity. We aimed to document the epidemiology of contacts made to the public emergency medical phone number a...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/1757-7241-22-2
更新日期:2014-01-08 00:00:00
abstract:BACKGROUND:Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to describe characteristics and 30-day survival following a TCA as compared with a medical out-of-hospital ca...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0500-7
更新日期:2018-04-23 00:00:00
abstract:BACKGROUND:A national Helicopter Emergency Medical Service (HEMS) was introduced in Denmark in 2014 to ensure the availability of physician-led critical care for all patients regardless of location. Appropriate dispatch of HEMS is known to be complex, and resource utilisation is a highly relevant topic. Population-base...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
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doi:10.1186/s13049-019-0672-9
更新日期:2019-11-07 00:00:00
abstract:BACKGROUND:The use of lung ultrasound (LUS) in ICU is increasing but ultrasonographic patterns of lung are often difficult to quantify by different operators. The aim of this study was to evaluate the accuracy and quality of LUS reporting after the introduction of a standardized electronic recording sheet. METHODS:Int...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-18-44
更新日期:2010-08-12 00:00:00
abstract:BACKGROUND:In 2011, the role of Point of Care Ultrasound (POCUS) was defined as one of the top five research priorities in physician-provided prehospital critical care and future research topics were proposed; the feasibility of prehospital POCUS, changes in patient management induced by POCUS and education of provider...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/s13049-018-0518-x
更新日期:2018-06-26 00:00:00
abstract::Traumatic spinal cord injury is a relatively rare injury in Denmark but may result in serious neurological consequences. For decades, prehospital spinal stabilisation with a rigid cervical collar and a hard backboard has been considered to be the most appropriate procedure to prevent secondary spinal cord injuries dur...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1186/s13049-019-0655-x
更新日期:2019-08-19 00:00:00
abstract:BACKGROUND:As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-r...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-017-0353-5
更新日期:2017-02-28 00:00:00
abstract:INTRODUCTION:There is a lack of epidemiological knowledge on medical emergencies outside hospitals in Norway. The aim of the present study was to obtain representative data on the epidemiology of medical emergencies classified as "red responses" in Norway. METHOD:Three emergency medical dispatch centres (EMCCs) were c...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-18-9
更新日期:2010-02-18 00:00:00
abstract:BACKGROUND:The Scandinavian Rapid Emergency Triage and Treatment System-pediatric (RETTS-p) is a reliable triage system that includes both assessment of vital parameters and a systematic approach to history and symptoms. In Scandinavia, the system is used in most pediatric emergency departments (PED). We aimed to study...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-021-00832-2
更新日期:2021-01-23 00:00:00
abstract:INTRODUCTION:In former studies from North America early Do-Not-Resuscitate orders (DNR orders) in patients with intracerebral haemorrhage (ICH) had negative prognostic impact on mortality. The influence of DNR orders on functional outcome and whether DNR orders are grounded on relevant patient characteristics is unknow...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-20-36
更新日期:2012-05-25 00:00:00
abstract:BACKGROUND:Telephone triage entails assessment of urgency and direction of flow in out-of-hours (OOH) services, while visual cues are inherently lacking. Triage tools are recommended but current tools fail to provide systematic assessment of the caller's perspective. Research demonstrated that callers can scale their d...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13049-019-0618-2
更新日期:2019-04-11 00:00:00
abstract:BACKGROUND:Studies have shown disparate results on the consequences of morphine use in ST-segment elevation myocardial infarction (STEMI). No study has evaluated alternative treatments that could be at least non-inferior to morphine without its potentially damaging consequences for myocardial function and platelet reac...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13049-020-00731-y
更新日期:2020-05-12 00:00:00
abstract:BACKGROUND:Drowning patients may benefit from the advanced airway management capabilities that can be provided by physician staffed helicopter emergency medical services. The aim of this study is to describe paediatric drowning patients treated by such a service examining tasking systems, initial physiology at the inci...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-015-0177-0
更新日期:2015-11-06 00:00:00
abstract:BACKGROUND:Coagulopathy often develops in patients with serious trauma and is correlated with the clinical outcome. The contribution of platelet activity and endothelial dysfunction to trauma-induced coagulopathy remain to be defined. The purpose of this study was to investigate the time courses of soluble P-selectin (...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-21-70
更新日期:2013-09-14 00:00:00
abstract:INTRODUCTION:Exsanguination due to uncontrolled bleeding is the leading cause of potentially preventable deaths among trauma patients. About one third of trauma patients present with coagulopathy on admission, which is associated with increased mortality and will aggravate bleeding in a traumatized patient. Thrombelast...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-19-52
更新日期:2011-09-28 00:00:00
abstract:BACKGROUND:The Amberg-Schwandorf Algorithm for Primary Triage (ASAV) is a novel primary triage concept specifically for physician manned emergency medical services (EMS) systems. In this study, we determined the diagnostic reliability and the time requirements of ASAV triage. METHODS:Seven hundred eighty triage runs p...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13049-014-0050-6
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
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abstract:BACKGROUND:Advances in technology have made ultrasound (US) devices smaller and portable, hence accessible for prehospital care providers. This study aims to evaluate the effect of a four-hour, hands-on US training course for physicians working in the prehospital setting. The primary outcome measure was US performance ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
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更新日期:2016-08-04 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/1757-7241-21-43
更新日期:2013-05-31 00:00:00
abstract::Population estimates projects a significant increase in the geriatric population making elderly trauma patients more common. The geriatric trauma patients experience higher incidence of pre-existing medical conditions, impaired age-dependent physiologic reserve, use potent drugs and suffer from trauma system related s...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 社论
doi:10.1186/1757-7241-21-4
更新日期:2013-01-23 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-20-21
更新日期:2012-03-27 00:00:00
abstract:BACKGROUND:Uncontrolled haemorrhage is still the leading cause of preventable death after trauma and the primary focus of any treatment strategy should be related to early detection and control of blood loss including haemostasis. METHODS:For assessing management practices across six European level I trauma centres wi...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-015-0147-6
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Pre-hospital advanced airway management has been named one of the top-five research priorities in physician-provided pre-hospital critical care. Few studies have been made on paediatric pre-hospital advanced airway management. The aim of this study was to investigate pre-hospital endotracheal intubation succ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-015-0140-0
更新日期:2015-08-27 00:00:00
abstract:BACKGROUND:Together with the ambulances staffed with emergency medical technicians (EMTs), general practitioners (GPs) on call are the primary resources for handling emergencies outside hospitals in Norway. The benefit of the GP accompanying the ambulance to pre-hospital calls is a matter of controversy in Norway. The ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-014-0047-1
更新日期:2014-08-22 00:00:00
abstract:BACKGROUND:No consensus exists in the literature on the use of uniform emergency room trauma team activation criteria (ERTTAC). Today excessive over- or undertriage rates continue to be a challenge for most trauma centres. Application of ERTTAC, published for use in the German TraumaNetwork DGU®, at a Swiss trauma cent...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0498-x
更新日期:2018-04-24 00:00:00
abstract:BACKGROUND:Emergency medical communication centres (EMCCs) dispatch and allocate ambulance resources, and provide first-aid guidance to on-scene bystanders. We aimed to 1) evaluate whether dispatcher guidance improved bystander first aid in trauma, and 2) to evaluate whether dispatchers and on-scene emergency medical s...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-016-0343-z
更新日期:2017-03-07 00:00:00
abstract:BACKGROUND:Pain is a common condition among prehospital patients. The present study is designed to determine whether adding low-dose ketamine as additional analgesia improves the pain/nausea scores and hemodynamic parameters compared to morphine sulphate alone among patients with bone fractures. METHODS:Prospective, p...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-17-61
更新日期:2009-11-27 00:00:00
abstract:BACKGROUND:Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-017-0365-1
更新日期:2017-02-28 00:00:00