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 critical in organising emergency stroke care. We aimed to describe the sensitivity and positive predictive value of medical dispatchers' ability to recognise acute stroke during emergency calls, and to identify factors associated with recognition. METHODS:This was an observational study of 2653 consecutive unselected patients with a final diagnosis of stroke or transient ischemic attack (TIA). All admitted through the Emergency Medical Services Copenhagen, during a 2-year study period (2012-2014). Final diagnoses were matched with dispatch codes from the Emergency Medical Dispatch Centre. Sensitivity and positive predictive value were calculated. The effect of age, gender, and time-of-day was analysed using multivariable logistic regression. RESULTS:The sensitivity was 66.2 % (95 % CI: 64.4 %-68.0 %), and the positive predictive value was 30.2 % (95 % CI: 29.1 %-31.4 %). The multivariable logistic regression analyses showed that emergency calls during daytime and a final diagnosis of TIA vs. intracerebral haemorrhage (ICH), was positively associated with recognition of stroke (OR 2.70, 95 % CI: 2.04-3.57). DISCUSSION:This study reports a high rate of stroke recognition compared to other studies ranging from 31% to 74%. The high sensitivity is likely the result of a profound reorganisation of the Emergency Medical ServicesCopenhagen, including the introduction of EMDs with a medical profession, and a criteria-based dispatch tool. A recognition rate of 100 % is not obtainable without an inappropriate amount of false positive cases. CONCLUSIONS:We report an overall high recognition of stroke by medical dispatchers. A final diagnosis of TIA, compared to ICH, was positively associated with recognition of acute stroke. Emergency medical dispatchers serve as the essential first step in ensuring fast-track stroke treatment, which would promote timely acute therapy. TRIAL REGISTRATION:Unique identifier: NCT02191514.
journal_name
Scand J Trauma Resusc Emerg Medauthors
Viereck S,Møller TP,Iversen HK,Christensen H,Lippert Fdoi
10.1186/s13049-016-0277-5subject
Has Abstractpub_date
2016-07-07 00:00:00pages
89issn
1757-7241pii
10.1186/s13049-016-0277-5journal_volume
24pub_type
杂志文章,随机对照试验abstract:BACKGROUND:In head trauma cases involving antiplatelet agent treatment, the French Society of Emergency Medicine recommends performing computed tomography (CT) scans to detect brain lesions, 90% of which are normal. The value of CT is still debatable given the scarce number of studies and controversial results. METHOD...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0515-0
更新日期:2018-06-19 00:00:00
abstract:BACKGROUND:The objective of this investigation was to evaluate changes in intrathoracic pressure (Ppl), airway pressure (Paw) and vital organ perfusion pressures during standard and intrathoracic pressure regulation (IPR)-assisted cardiopulmonary resuscitation (CPR). METHODS:Multiple CPR interventions were assessed, i...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-015-0164-5
更新日期:2015-10-28 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::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: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:Trauma triage based on prehospital information facilitates correct allocation of in-hospital resources. The Swedish national two-tier trauma team activation (TTA) criteria were revised in 2016. The current study aimed to evaluate the safety and efficacy of the new criteria. METHODS:Five centres covering tra...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/s13049-019-0619-1
更新日期:2019-04-30 00:00:00
abstract:BACKGROUND:To identify the factors associated with the development of post-snakebite compartment syndrome (PSCS) in snakebite patients and to analyze the clinical prognosis of these patients. METHODS:We retrospectively reviewed the medical records of patients who presented to our institution with snakebites from March...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-015-0179-y
更新日期:2015-11-11 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:Cardiopulmonary resuscitation is the most urgent and critical step in the rescue of patients with cardiac arrest. However, only about 10% of patients with out-of-hospital cardiac arrest survive to discharge. Surprisingly, there is growing evidence that open-chest cardiopulmonary resuscitation is superior to ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,meta分析
doi:10.1186/s13049-019-0690-7
更新日期:2019-12-27 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:After severe polytrauma the dynamic process of coagulation may deteriorate towards a trauma-induced coagulopathy (TIC) promoting a dramatic increase in morbidity and mortality. Recent evidence suggests that microparticles (MPs) play a pivotal role at the interface between cellular and plasmatic coagulation s...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/s13049-018-0499-9
更新日期:2018-04-27 00:00:00
abstract:BACKGROUND:Experimental active compression-decompression (ACD) CPR is associated with increased haemodynamic outcomes compared to standard mechanical chest compressions. Since no clinically available mechanical chest compression device is capable of ACD-CPR, we modified the LUCAS 2 (Physio-Control, Lund, Sweden) to del...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0496-z
更新日期:2018-04-24 00:00:00
abstract::Bystander cardiopulmonary resuscitation (CPR) improves out-of-hospital cardiac arrest (OHCA) survival. In settings with prolonged ambulance response times, skilled bystanders may be even more crucial. In 2010, American Heart Association (AHA) and European Resuscitation Council (ERC) introduced compression-only CPR as ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-21-32
更新日期:2013-04-20 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:Formalized trauma systems have shown beneficial effects on patient survival and have harvested great recognition among health care professionals. In spite of this, the implementation of trauma systems is challenging and often met with resistance.Recommendations for a national trauma system in Norway were pub...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-20-5
更新日期:2012-01-26 00:00:00
abstract:BACKGROUND:Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complicat...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/s13049-017-0384-y
更新日期:2017-04-20 00:00:00
abstract:OBJECT:The aim of the study was to evaluate the early changes in pituitary hormone levels after severe traumatic brain injury (sTBI) and compare hormone levels to basic neuro-intensive care data, a systematic scoring of the CT-findings and to evaluate whether hormone changes are related to outcome. METHODS:Prospective...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-21-33
更新日期:2013-04-20 00:00:00
abstract:BACKGROUND:Hyperfibrinolysis (HF) is a major contributor to coagulopathy and mortality in trauma patients. This study investigated (i) the rate of HF during the pre-hospital management of patients with multiple injuries and (ii) the effects of pre-hospital tranexamic acid (TxA) administration on the coagulation system....
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-016-0314-4
更新日期:2016-10-10 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:In critically ill patients intravascular volume status and pulmonary edema need to be quantified as soon as possible. Many critically ill patients undergo a computed tomography (CT)-scan of the thorax after admission to the intensive care unit (ICU). This study investigates whether CT-based estimation of car...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-19-31
更新日期:2011-05-23 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:Accidental hypothermia increases mortality and morbidity in trauma patients. Various methods for insulating and wrapping hypothermic patients are used worldwide. The aim of this study was to compare the thermal insulating effects and comfort of bubble wrap, ambulance blankets / quilts, and Hibler's method, a...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/1757-7241-19-41
更新日期:2011-06-23 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:BACKGROUND:The novel coronavirus disease 2019 (Covid-19) pandemic has affected prehospital care systems across the world, but the prehospital presentation of affected patients and the extent to which prehospital care providers are able to identify them is not well characterized. In this study, we describe the presentat...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/s13049-020-00826-6
更新日期:2021-01-06 00:00:00
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 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:BACKGROUND:Major bile leak after blunt liver trauma is rare but challenging. It usually requires endoscopic retrograde cholangiography (ERC) for management. However, there is still lack of specific indications. The aim of this study is to elucidate risk factors for major bile leak and indications for early ERC after bl...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-22-26
更新日期:2014-04-15 00:00:00
abstract:BACKGROUND:Peripheral measurement of venous oxygen saturation and lactate is a less invasive alternative to monitor tissue oxygenation as compared to measurements from a central venous catheter. However, there is a lack of evidence to support the use of peripheral measurements. In this study, we investigated the agreem...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0537-7
更新日期:2018-09-10 00:00:00
abstract:BACKGROUND:This study compares the assessment, treatment, referral, and follow up contact with the dispatch centre of emergency patients treated by two types of solo emergency care providers in ambulance emergency medical services (EMS) in the Netherlands: the physician assistant (PA), educated in the medical domain, a...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-016-0279-3
更新日期:2016-06-29 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