Abstract:
BACKGROUND:Despite numerous studies on prehospital airway management, results are difficult to compare due to inconsistent or heterogeneous data. The objective of this study was to assess advanced airway management from international physician-staffed helicopter emergency medical services. METHODS:We collected airway data from 21 helicopter emergency medical services in Australia, England, Finland, Hungary, Norway and Switzerland over a 12-month period. A uniform Utstein-style airway template was used for collecting data. RESULTS:The participating services attended 14,703 patients on primary missions during the study period, and 2,327 (16 %) required advanced prehospital airway interventions. Of these, tracheal intubation was attempted in 92 % of the cases. The rest were managed with supraglottic airway devices (5 %), bag-valve-mask ventilation (2 %) or continuous positive airway pressure (0.2 %). Intubation failure rates were 14.5 % (first-attempt) and 1.2 % (overall). Cardiac arrest patients showed significantly higher first-attempt intubation failure rates (odds ratio: 2.0; 95 % CI: 1.5-2.6; p < 0.001) compared to non-cardiac arrest patients. Complications were recorded in 13 %, with recognised oesophageal intubation being the most frequent (25 % of all patients with complications). For non-cardiac arrest patients, important risk predictors for first-attempt failure were patient age (a non-linear association) and administration of sedatives (reduced failure risk). The patient's sex, provider's intubation experience, trauma type (patient category), indication for airway intervention and use of neuromuscular blocking agents were not risk factors for first-attempt intubation failure. CONCLUSIONS:Advanced airway management in physician-staffed prehospital services was performed frequently, with high intubation success rates and low complication rates overall. However, cardiac arrest patients showed significantly higher first-attempt failure rates compared to non-cardiac arrest patients. All failed intubations were handled successfully with a rescue device or surgical airway. TRIAL REGISTRATION: STUDY REGISTRATION:www.clinicaltrials.gov NCT01502111 . Registered 22 December 2011.
journal_name
Scand J Trauma Resusc Emerg Medauthors
Sunde GA,Heltne JK,Lockey D,Burns B,Sandberg M,Fredriksen K,Hufthammer KO,Soti A,Lyon R,Jäntti H,Kämäräinen A,Reid BO,Silfvast T,Harm F,Sollid SJ,Airport Study Group.doi
10.1186/s13049-015-0136-9subject
Has Abstractpub_date
2015-08-07 00:00:00pages
57issn
1757-7241pii
10.1186/s13049-015-0136-9journal_volume
23pub_type
杂志文章,多中心研究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:Major trauma often comprises fractures of the thoracolumbar spine and these are often accompanied by relevant thoracic trauma. Major complications can be ascribed to substantial simultaneous trauma to the chest and concomitant immobilization due to spinal instability, pain or neurological dysfunction, impair...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-020-00737-6
更新日期:2020-05-24 00:00:00
abstract::Authors Wagner et al. in your journal demonstrated effectiveness of mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts. We dare to comment on this article and advocate to use mechanical chest co...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 信件
doi:10.1186/s13049-016-0293-5
更新日期:2016-08-17 00:00:00
abstract:BACKGROUND:This systematic review and meta-analysis aims to critically compare the outcomes of plate fixation (PF) versus intramedullary fixation (IF) for the treatment of mid-shaft clavicle fractures. METHODS:Relevant original studies were searched in electronic databases of Medline, Embase, Cochrane central database...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s13049-015-0108-0
更新日期:2015-03-20 00:00:00
abstract:BACKGROUND:Fluid therapy is a common and crucial treatment in the emergency department (ED). While fluid responsiveness seems to be a promising method to titrate fluid therapy, the evidence for its value in ED is unclear. We aim to synthesise the existing literature investigating fluid responsiveness in ED. METHODS:ME...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/s13049-017-0370-4
更新日期:2017-03-06 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: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:BACKGROUND:During early treatment of haemorrhagic shock maintenance of cerebral and end-organ oxygen supply by fluid resuscitation is mandatory. Gelatin-polysuccinat (GP) recently regained attention despite a still unclear risk profile and widely unknown effects on cerebral and peripheral microcirculation. This study i...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0477-2
更新日期:2018-02-09 00:00:00
abstract:BACKGROUND:Albumin may be beneficial in patients with septic shock but availability is limited and cost is high. The objective of the present study was to investigate if the use of dextran-70 in addition to albumin and crystalloids influences organ failure or mortality in patients with severe sepsis or septic shock. M...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-017-0413-x
更新日期:2017-07-06 00:00:00
abstract:BACKGROUND:The scientific evidence of a beneficial effect of physicians in prehospital treatment is scarce. The objective of this systematic review of controlled studies was to examine whether physicians, as opposed to paramedical personnel, increase patient survival in prehospital treatment and if so, to identify the ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/1757-7241-17-12
更新日期:2009-03-05 00:00:00
abstract:BACKGROUND:Prehospital advanced airway management, including prehospital endotracheal intubation is challenging and recent papers have addressed the need for proper training, skill maintenance and quality control for emergency medical service personnel. The aim of this study was to provide data regarding airway managem...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-19-10
更新日期:2011-02-08 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::The European HEMS and Air ambulance Committee's Medical working group recently published Best Practice advice on pre-hospital emergency anaesthesia and advanced airway management. We believe that this initiative is important. In our opinion however, the competence requirements recommended by the authors do not meet th...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 信件
doi:10.1186/s13049-019-0613-7
更新日期:2019-03-18 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::There is a general decline in penetrating abdominal trauma throughout the western world. As a result of that, there is a significant loss of expertise in dealing with this type of injury particularly when the patient presents to theatre with physiological instability. A significant percentage of these patients will no...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-18-40
更新日期:2010-07-14 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
abstract:BACKGROUND:Despite the efforts of the modern Emergency Medical Service Systems (EMS), survival rates for sudden out-of-hospital cardiac arrest (OHCA) have been poor as approximately 10% of OHCA patients survive hospital discharge. Many aspects of OHCA have been studied, but few previous reports on OHCA have documented ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-20-80
更新日期:2012-12-17 00:00:00
abstract:BACKGROUND:Motor vehicle collisions (MVCs) are a common cause of major trauma and death. Following an MVC, up to 40% of patients will be trapped in their vehicle. Extrication methods are focused on the prevention of secondary spinal injury through movement minimisation and mitigation. This approach is time consuming an...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-020-00818-6
更新日期:2021-01-14 00:00:00
abstract:BACKGROUND:Time is a crucial factor in an emergency department and the effectiveness of diagnosing depends on, among other things, the accessibility of rapid reported laboratory test results; i.e.: a short turnaround time (TAT). Former studies have shown a reduced time to action when point of care technologies (POCT) a...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/1757-7241-20-71
更新日期:2012-10-08 00:00:00
abstract:BACKGROUND:Bee and wasp stings are among the most common triggers of anaphylaxis in adults representing around 20% of fatal anaphylaxis from any cause. Data of pre-hospital treatment of bee and wasp induced anaphylactic reactions are sparse. This study aimed to estimate the incidence of bee and wasp induced anaphylacti...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-016-0344-y
更新日期:2017-01-14 00:00:00
abstract:BACKGROUND:Patients with isolated traumatic brain injury (TBI) are likely to benefit from effective prehospital care to prevent secondary brain injury. Only a few studies have focused on the impact of advanced interventions in TBI patients by prehospital physicians. The primary end-point of this study was to assess the...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-019-0590-x
更新日期:2019-01-28 00:00:00
abstract::This paper describes a simple approach to emergency burr hole evacuation of extra-axial intracranial haematoma that can be used in the uncommon situation when life saving specialist neurosurgical intervention is not available. ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 社论
doi:10.1186/1757-7241-20-24
更新日期:2012-04-02 00:00:00
abstract:BACKGROUND:Immediate recognition of stroke symptoms is crucial to ensure timely access to revascularisation therapy. Medical dispatchers ensure fast admission to stroke facilities by prioritising the appropriate medical response. Data on medical dispatchers' ability to recognise symptoms of acute stroke are therefore c...
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/s13049-016-0277-5
更新日期:2016-07-07 00:00:00
abstract:BACKGROUND:The primary aim of this study was to describe the frequency of pulmonary infiltrates on chest X-ray (CXR) during community acquired Gram-negative bacteremia at a single centre in Denmark. METHODS:The patients were retrospectively identified from the laboratory information system and clinical and radiologica...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-21-88
更新日期:2013-12-17 00:00:00
abstract::Major incidents are resource-demanding situations that require urgent and effective medical management. The possibility to extract learning from them is therefore important. Comparative analysis of information based on uniform data collection from previous incidents may facilitate learning. The Major Incident Reportin...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/s13049-015-0132-0
更新日期:2015-08-05 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
abstract::Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extra-corporeal cardiopulmonary resuscitation (ECPR) is a novel use of an established technology that provides greater blood flow and oxygen delivery during cardiac arrest than closed chest co...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/s13049-018-0489-y
更新日期:2018-03-27 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
pub_type: 杂志文章
doi:10.1186/s13049-019-0672-9
更新日期:2019-11-07 00:00:00
abstract::The role of Emergency Medicine Physicians (EMP) in the care of trauma patients in North America has evolved since the advent of the specialty in the late 1980's. The evolution of this role in the context of the overall demands of the specialty and accreditation requirements of North American trauma centers will be dis...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/1757-7241-17-37
更新日期:2009-08-23 00:00:00
abstract:BACKGROUND:Acute pain is a frequent symptom, but little is known about the frequency and causes of acute pain in the prehospital population. The objectives of this study were to investigate the frequency of moderate to severe pain among prehospital patients and the underlying causes according to primary hospital diagno...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0521-2
更新日期:2018-07-03 00:00:00