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A consensus-based template for uniform reporting of data from pre-hospital advanced airway managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: We successfully developed an Utstein-style template for documenting and reporting pre-hospital airway management. The core dataset for this template should be included in future studies on pre-hospital airway management to produce comparable data across systems and patient populations and will be implemented in systems that are influenced by the expert panel. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - November 20, 2009 Category: Emergency Medicine Authors: Stephen J M SollidDavid LockeyHans Morten LossiusPre-hospital advanced airway management expert group Paam Source Type: journals

Injury severity and serum amyloid A correlate with plasma oxidation-reduction potential in multi-trauma patients: a retrospective analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: In critical injury, the occurrence of increased oxidative stress or a reduced antioxidant status has been observed. The purpose of this study was to correlate the degree of oxidative stress, by measuring the oxidation-reduction potential (ORP) of plasma in the critically injured, with injury severity and serum amyloid A (SAA) levels. Methods: A total of 140 subjects were included in this retrospective study comprising 3 groups: healthy volunteers (N=21), mild to moderate trauma (ISS (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - November 19, 2009 Category: Emergency Medicine Authors: Leonard RaelRaphael Bar-OrKristin SalottoloCharles MainsDenetta SlonePatrick OffnerDavid Bar-Or Source Type: journals

Re: Infection control in burn patients: are fungal infections underestimated?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A response to Struck MF. Infection control in burn patients: are fungal infections underestimated? Scand J Trauma Resusc Emerg Med. 2009 Oct 9;17(1):51. [Epub ahead of print] PubMed PMID: 19818134. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - October 31, 2009 Category: Emergency Medicine Authors: David Dries Source Type: journals

Risk of symptomatic heterotopic ossification following plate osteosynthesis in multiple trauma patients: an analysis in a level-1 trauma centreEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Fracture care with plate osteosynthesis in polytrauma patients is associated with larger formations of symptomatic heterotopic ossifications (HO) while intramedullary nailing was associated with a higher rate of remote HO. For future fracture care of multiply injured patients these facts may be considered by the responsible surgeon. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - October 12, 2009 Category: Emergency Medicine Authors: Christian ZeckeyPhilipp MommsenFrank HildebrandJulia SchumannMichael FrinkHans-Christoph PapeChristian KrettekChristian Probst Source Type: journals

Out-of-hospital therapeutic hypothermia in cardiac arrest victimsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite many years of research, outcome after cardiac arrest is dismal. Since 2005, the European Resuscitation Council recommends in its guidelines the use of mild therapeutic hypothermia (32-34 degrees C) for 12 to 24 hours in patients successfully resuscitated from cardiac arrest. The benefit of resuscitative mild hypothermia (induced after resuscitation) is well established, while the benefit of preservative mild to moderate hypothermia (induced during cardiac arrest) needs further investigation before recommending it for clinical routine. Animal data and limited human data suggest that early and fast cooling might be e...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - October 11, 2009 Category: Emergency Medicine Authors: Wilhelm BehringerJasmin ArrichMichael HolzerFritz Sterz Source Type: journals

Prehospital therapeutic hypothermia after cardiac arrest - from current concepts to a future standardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Therapeutic hypothermia has been shown to improve survival and neurological outcome after prehospital cardiac arrest. Existing experimental and clinical evidence supports the notion that delayed cooling results in lesser benefit compared to early induction of mild hypothermia soon after return of spontaneous circulation. Therefore a practical approach would be to initiate cooling already in the prehospital setting.The purpose of this review was to evaluate current clinical studies on prehospital induction of mild hypothermia after cardiac arrest. Most reported studies present data on cooling rates, safety and feasibility o...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - October 11, 2009 Category: Emergency Medicine Authors: Antti KamarainenSanna HoppuTom SilfvastIlkka Virkkunen Source Type: journals

Prehospital cooling in cardiac arrest - the next frontier?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Therapeutic hypothermia (TH) in unconscious survivors of out-of-hospital cardiac arrest (OHCA) is now a well-documented part of post-resuscitation care. Implementation of TH into daily clinical practice has been far more successful in the Scandinavian countries than in the rest of the world. Still, many questions remain. One of them is whether prehospital cooling will result in better outcomes. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - October 11, 2009 Category: Emergency Medicine Authors: Eldar Soreide Source Type: journals

Infection control in burn patients: are fungal infections underestimated?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
With great interest, I read the paper of David J. Dries about recent developments, infection control and outcomes research in the management of burn injuries. I have some comments about an important, however missing, topic in the paragraphs concerning infection control. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - October 8, 2009 Category: Emergency Medicine Authors: Manuel Struck Source Type: journals

Management of a massive thoracoabdominal impalement: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 26 year old male was impaled through his chest and upper abdomen with an iron angle, one and half meter long and five centimeters thick. The iron angle entered the chest, through the epigastrium and exited posteriorly just inferior to the angle of left scapula. The patient was transported to hospital with the iron angle in situ. Positioning the patient for intubation proved a major challenge. An unconventional position for intubation allowed a successful airway management. Paucity of time prevented us from gauging the nature and extent of injury. The challenges posed by massive impalement could be successfully managed du...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - October 6, 2009 Category: Emergency Medicine Authors: Chhavi SawhneyNita D'souzaBiplab MishraBabita GuptaSubir Das Source Type: journals

The Prognostic Value of IL-6 for Organ Dysfunction and Mortality in Patients With Multiple InjuriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: We conclude that plasma IL-6 levels predict mortality and that they are a useful tool to identify patients who are at risk for development of MODS. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 26, 2009 Category: Emergency Medicine Authors: Michael FrinkMartijn van GriensvenPhilipp KobbeThomas BrinChristian ZeckeyBernhard VaskeChristian KrettekFrank Hildebrand Source Type: journals

Leadership is the essential non-technical skill in the trauma team - results of a qualitative studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Trauma is the leading cause of death for young people in Norway. Studies indicate that several of these deaths are avoidable if the patient receives correct initial treatment. The trauma team is responsible for initial hospital treatment of traumatized patients, and team members have previously reported that non-technical skills as communication, leadership and cooperation are the major challenges. Better team function could improve patient outcome. The aim of this study was to obtain a deeper understanding of which non-technical skills are important to members of the trauma team during initial examination and ...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 25, 2009 Category: Emergency Medicine Authors: Magnus HjortdahlAmund RingenAnne-Cathrine NaessTorben Wisborg Source Type: journals

Right-sided "trapdoor" incision provides excellent exposure of complex cervicothoracic vascular injury: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Combined cervicothoracical vascular traumas are very uncommon, mostly resulting from penetrating injuries. These injuries are accompanied with very high morbidity and mortality rates. In this manuscript we present a case of hemodinamycally unstable trauma patient whose major injury was penetrating trauma of both cervical and mediastinal major vessels. The standard surgical approach of median sternotomy and neck incision was insufficient, and the patient's instability forced the authors to improvise previously not described right-sided trap-door thoracomy. Incorporation of such incision in the surgical arsenal may be very e...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 23, 2009 Category: Emergency Medicine Authors: Boris KesselItamar AshkenaziIsaak PortnoyDan HebronDani EilamRicardo Alfici Source Type: journals

Critical Care in the Emergency Department: An assessment of the length of stay and invasive procedures performed on critically ill ED patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Critically ill patients are managed in the emergency department for a significant length of time. Although the majority of airway intervention occurs in the pre-hospital setting and ED, relatively few patients undergo other invasive procedures while in the emergency department. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 23, 2009 Category: Emergency Medicine Authors: Robert GreenJanet MacIntyre Source Type: journals

Thrombelastography and tromboelastometry in assessing coagulopathy in traumaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the basic principles of VHA, the correlation between the VHA whole blood clot formation in accordance with the cell-based model of haemostasis, the current use of VHA-guided therapy in trauma and massive transfusion (haemostatic control resuscitation), limitations of VHA and future perspectives of this assay in trauma. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 22, 2009 Category: Emergency Medicine Authors: Par JohanssonTrine StissingLouise BochsenSisse Ostrowski Source Type: journals

Why Do We Put Cervical Collars On Conscious Trauma Patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this commentary we argue that fully alert, stable and co-operative trauma patients do not require the application of a semi-rigid cervical collar, even if they are suspected of underlying cervical spine fracture, unless their conscious level deteriorates or they find the short-term support of a cervical collar helpful. Despite the historical and cultural barriers that exist, the potential benefits are such that this hypothesis merits rigorous testing in well-designed research trials. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 17, 2009 Category: Emergency Medicine Authors: Jonathan BengerJulian Blackham Source Type: journals

Pathophysiology of the systemic inflammatory response after major accidental traumaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Postponement of final reconstructive surgery until the inflammatory is normalized should be based on prospective randomized trials. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 14, 2009 Category: Emergency Medicine Authors: Anne Craveiro BrochnerPalle Toft Source Type: journals

Vascular injuries after blunt chest trauma: diagnosis and managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionBlunt thoracic vascular injury remains highly lethal, with most victims dying prior to reaching a hospital. Those arriving in extremis require immediate intervention, which may include treatment of other associated life threatening injuries. More stable injuries can often be medically temporized in order to optimize definitive management. Endovascular techniques are being employed with increasing frequency and can often significantly simplify management in otherwise very complex patient scenarios. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 13, 2009 Category: Emergency Medicine Authors: James O'ConnorChristopher ByrneThomas ScaleaBartley GriffithDavid Neschis Source Type: journals

Personal experience with whole-body, low-dosage, digital X-ray scanning (LODOX-Statscan)in trauma.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Lodox-Statscan is a whole-body, skeletal and soft-tissue, low-dose X-ray scanner Anterior-posterior and lateral thoraco-abdominal studies are obtained in 3-5 minutes with only about one-third of the radiation required for conventional radiography. Since its approval by the Food and Drug Administration (FDA) in the USA, several trauma centers have incorporated this technology into their Advanced Trauma Life Support protocols. This review provides a brief overview of the system, and describes the authors' own experience with the system. Methods: We performed a PubMed search to retrieve all references with 'Lodox'...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 11, 2009 Category: Emergency Medicine Authors: Dimitrios EvangelopoulosSimone DeyleHeinz ZimmermannAristomenis Exadaktylos Source Type: journals

Emergency presentation and management of acute severe asthma in childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Acute severe asthma is one of the most common medical emergency situations in childhood, and physicians caring for acutely ill children are regularly faced with this condition. In this article we present a summary of the pathophysiology as well as guidelines for the treatment of acute severe asthma in children. The cornerstones of the management of acute asthma in children are rapid administration of oxygen, inhalations with bronchodilators and systemic corticosteroids. Inhaled bronchodilators may include selective b2-agonists, adrenaline and anticholinergics. Additional treatment in selected cases may involve intravenous ...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - September 3, 2009 Category: Emergency Medicine Authors: Knut OymarThomas Halvorsen Source Type: journals

Knowledge of Glasgow coma scale by air-rescue physiciansEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ObjectiveTo assess the theoretical and practical knowledge of the Glasgow coma scale (GCS) by trained air-rescue physicians in Switzerland. Methods: Prospective anonymous observational study with a specially designed questionnaire. General knowledge of the GCS and its use in a clinical case were assessed. Results: From 130 questionnaires send out, 103 were returned (response rate of 79.2%) and analyzed. Theoretical knowledge of the GCS was consistent for registrars, fellows, consultants and private practitioners active in physician-staffed helicopters. The clinical case was wrongly scored by 38 participants (36.9%). Wrong ...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - August 31, 2009 Category: Emergency Medicine Authors: Catherine HeimPatrick SchoettkerNicolas GilliardDonat Spahn Source Type: journals

Reliability and validity of triage systems in paediatric emergency careEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The MTS and paedCTAS both seem valid to triage children in paediatric emergency care. Reliability of the MTS is good, moderate to good for the ESI and moderate for the paedCTAS. More studies are necessary to evaluate if one triage system is superior over other systems when applied in emergency care. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - August 26, 2009 Category: Emergency Medicine Authors: Mirjam van VeenHenriette Moll Source Type: journals

Emergency management and resuscitation of poisoned patients: perspectives from "down under"Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - August 22, 2009 Category: Emergency Medicine Authors: Mark Little Source Type: journals

The role of emergency medicine physicians in trauma care in North America: evolution of a specialtyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 discussed. Limited available data published in the literature examining the role of EMP's in trauma care will be reviewed with respect to its implications for an expanded role for EMPs in trauma care. Two training models currently in the early stages of development have been proposed to address needs for increase...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - August 22, 2009 Category: Emergency Medicine Authors: Michael Grossman Source Type: journals

Blood transfusion in the critically ill: does storage age matter?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this report, the current understanding of the biochemical and structural changes that occur during storage, known collectively as the storage lesion, is described, and the clinical evidence concerning the detrimental consequences associated with the transfusion of relatively older red cells is critically reviewed. Although the growing body of literature demonstrating the deleterious effects of relatively old blood is compelling, it is notable that all of these reports have been retrospective, and most of these studies have evaluated patients who received a mixture of red cell units of varying storage age. Until prospect...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - August 12, 2009 Category: Emergency Medicine Authors: Marianne VandrommeGerald McGwinJordan Weinberg Source Type: journals

Clinician performed resuscitative ultrasonography for the initial evaluation and resuscitation of traumaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionIn this review we explore the benefits and pitfalls of applying resuscitative ultrasound to every aspect of the initial assessment of the critically injured trauma patient. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - August 5, 2009 Category: Emergency Medicine Authors: Lawrence GillmanChad BallNova PanebiancoAzzam Al-KadiAndrew Kirkpatrick Source Type: journals

Rigid fibrescope Bonfils: use in simulated difficult airway by novicesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We examined the success rate of intubation and the ease of use in standardized simulated difficult airway scenarios by physicians. We compared the Bonfils to a classical laryngoscope with Macintosh blade. Methods: 30 physicians untrained in the use of rigid fibrescopes but experienced in airway management performed endotracheal intubation in an airway manikin (SimMan, Laerdal, Kent, UK) with three different airway conditions. We evaluated the success rate using the Bonfils (Karl Storz, Tuttlingen, Germany) or the Macintosh laryngoscope, the time needed for securing the airway, and subjective rating of both techniques. Resu...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - July 21, 2009 Category: Emergency Medicine Authors: Tim PiephoRudiger NoppensFlorian HeidChristian WernerAndreas Thierbach Source Type: journals

Regional coordination in medical emergencies and major incidents; plan, execute and teachEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The data presented in this study indicates that the center had achieved its primary tasks. Such regional organization with executive, planning, teaching and training responsibilities offers possibilities for planning, teaching and training disaster medicine by giving immediate feed-back based on real incidents. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - July 19, 2009 Category: Emergency Medicine Authors: Amir Khorram-ManeshAnnika HedelinPer Ortenwall Source Type: journals

A year of contemplation: looking back and moving forwardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As we enter July 2009, we are pleased to have passed the first 365 days of being an open access, freely available online journal on the World Wide Web and indexed in Pubmed. Currently 49 papers have been published and several more are awaiting publication in the near future. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - July 12, 2009 Category: Emergency Medicine Authors: Kjetil SoreideHans Morten Lossius Source Type: journals

Incidence of emergency contacts (red responses) to Norwegian emergency primary healthcare services in 2007 - a prospective observational studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics with medical problems that initially are classified as a potentially life-threatening situation, a red response. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - July 7, 2009 Category: Emergency Medicine Authors: Erik ZakariassenElisabeth Holm HansenSteinar Hunskaar Source Type: journals

Management of the critically poisoned patientEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion: If a poisoning is recognized early and appropriate testing and supportive care is initiated rapidly, the majority of patient outcomes will be good. Judicious use of antidotes should be practiced and clinicians should clearly understand the indications and contraindications of antidotes prior to administration. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - June 28, 2009 Category: Emergency Medicine Authors: Jennifer BoyleLaura BechtelChristopher Holstege Source Type: journals

Necrotizing Fasciitis of the lower extremity: a case report and current concept of diagnosis and management.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe a case of 21-year old man presenting with the history of trivial injury to the knee. Initially he was admitted and treated for septic arthritis but later was diagnosed as necrotizing fasciitis which was successfully treated with no ill effects what so ever from this devastating condition.This rare condition has been well reported in literature but still early diagnosis, which is a key for successful treatment, remains a challenge. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - June 15, 2009 Category: Emergency Medicine Authors: G NaqviS MalikW Jan Source Type: journals

Arterial embolization of an extrapleural hematoma from a dislocated fracture of the lumbar spine: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The extrapleural hematoma reduced in size after AE, and almost disappeared on the 14th day of hospitalization. The lumbar spinal fracture was successfully repaired on day 16, and the patient was kept in the hospital to recuperate. We believe that AE is effective for the management of intractable bleeding following fractures of the spine. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - June 9, 2009 Category: Emergency Medicine Authors: Seiji MoritaTomoatsu TsujiTomokazu FukushimaTakeshi YamagiwaHiroyuki OtsukaSadaki Inokuchi Source Type: journals

Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Besides emergency department overcrowdings, ambulance diversions, endangering patient's safety and increasing risk for in-hospital mortality, hospital-related incidents reduces and limits the regional preparedness by minimizing the surge capacity. In order to prevent a future irreversible disaster, this problem should be avoided and addressed properly by further regional studies. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - June 3, 2009 Category: Emergency Medicine Authors: Amir Khorram-ManeshAnnika HedelinPer Ortenwall Source Type: journals

Field triage in trauma - do the data really justify the conclusions?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Letter to the editor (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - May 29, 2009 Category: Emergency Medicine Authors: Marten Sandberg Source Type: journals

RE: Field triage in trauma - do the data really justify the conclusions?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Letter to the editor (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - May 29, 2009 Category: Emergency Medicine Authors: Marius RehnTorsten EkenAndreas Jorstad KrugerPetter Andreas SteenNils Oddvar SkagaHans Morten Lossius Source Type: journals

Low central venous saturation predicts poor outcome in patients with brain injury after major trauma: a prospective observational studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Continuous monitoring of central venous oxygen saturation (ScvO2) has been proposed as a prognostic indicator in several pathological conditions, including cardiac diseases, sepsis, trauma. To our knowledge, no studies have evaluated ScvO2 in polytraumatized patients with brain injury so far. Thus, the aim of the present study was to assess the prognostic role of ScvO2 monitoring during first 24 hours after trauma in this patients' population. Methods: This prospective, non-controlled study, carried out between April 2006 and March 2008, was performed in a higher level Trauma Center in Florence (Italy). In the ...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - May 21, 2009 Category: Emergency Medicine Authors: Alessandro Di FilippoChiara GonnelliLucia PerrettaGiovanni ZagliRosario SpinaMarco ChiostriGian Franco GensiniAdriano Peris Source Type: journals

Nonoperative management of blunt abdominal trauma - is it safe and feasible in a district general hospital?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: According to our experience, the hemodynamically stable or easily stabilized trauma patient can be admitted in a non-ICU ward with the provision of close monitoring. Splenic injury, especially with multiple-site free intra-abdominal fluid in abdominal computed tomography, carries a high risk for NOM failure. In this series, the main criterion for a laparotomy in a NOM patient was hemodynamic deterioration after a second rapid fluid load. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - May 13, 2009 Category: Emergency Medicine Authors: George A Giannopoulos, Iraklis E Katsoulis, Nikolaos E Tzanakis, Panayotis A Patsaouras and Michalis K Digalakis Source Type: journals

End-of-life issues in the acute and critically ill patientEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The challenges of end of life care require emergency physicians to utilize a multifaceted and dynamic skill set. Such skills include medical therapies to relieve pain and other symptoms near the end of life. Physicians must also demonstrate aptitude in comfort care, communication, cultural competency, and ethical principles. It is imperative that emergency physicians demonstrate a fundamental understanding of end of life issues in order to employ the versatile, multidisciplinary approach required to provide the highest quality end of life care for patients and their families. (Source: Scandinavian Journal of Trauma, Resusc...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 22, 2009 Category: Emergency Medicine Authors: Eric A Savory and Catherine A Marco Source Type: journals

Management of necrotizing myositis in a field hospital: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Necrotizing myositis is a rare and fatal disease of skeletal muscles caused by group A beta hemolytic streptococci (GABHS). Its early detection by advanced imaging forms the basis of current management strategy. Paucity of advanced imaging in field/ rural hospitals necessitates adoption of management strategy excluding imaging as its basis. Such a protocol, based on our experience and literature, constitutes: i. Prompt recognition of the clinical triad: disproportionate pain; precipitous course; and early loss of power- in a swollen limb with/ without preceding trauma. ii. Support of clinical suspicion by 2 ubiquitous labo...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 18, 2009 Category: Emergency Medicine Authors: Ramanathan Saranga Bharathi, Vinay Sharma, Rohit Sood, Arunava Chakladar, Pragnya Singh and Deep K Raman Source Type: journals

Out of hospital cardiac arrest outside home in Sweden, change in characteristics, outcome and availability for public access defibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the change in characteristics and outcome among these candidates in a 14 years perspective in Sweden. Methods: All patients who suffered an OHCA in whom cardiopulmonary resuscitation (CPR) was attempted between 1992 and 2005 and who were included in the Swedish Cardiac Arrest Register (SCAR). We included patients in the survey if OHCA took place outside home excluding crew witnessed cases and those taken place in a nursing home. Results: 26% of all OHCAs (10133 patients out of 38710 patients) fulfilled the inclusion criteria. Within this group, the number of patients each year varied between 530 and 896 and the...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 17, 2009 Category: Emergency Medicine Authors: Mattias Ringh, Johan Herlitz, Jacob Hollenberg, Marten Rosenqvist and Leif Svensson Source Type: journals

Penetrating abdominal injuries: management controversiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of ...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 17, 2009 Category: Emergency Medicine Authors: Muhammad U Butt, Nikolaos Zacharias and George C Velmahos Source Type: journals

Surgical management of abdominal compartment syndrome; indications and techniquesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The indications for surgical decompression of abdominal compartment syndrome (ACS) are not clearly defined, but undoubtedly some patients benefit from it. In patients without recent abdominal incisions, it can be achieved with full-thickness laparostomy (either midline, or transverse subcostal) or through a subcutaneous linea alba fasciotomy. In spite of the improvement in physiological variables and significant decrease in IAP, however, the effects of surgical decompression on organ function and outcome are less clear. Because of the significant morbidity associated with surgical decompression and the management of the en...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 14, 2009 Category: Emergency Medicine Authors: Ari Leppaniemi Source Type: journals

Fire fighters as basic life support responders: A study of successful implementationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: In this study, the implementation of BLS responders may have resulted in successful resuscitations. On basis of the close corporation between all participants in the chain of survival this project contributed to the first link: short response time and trained personnel to ensure early defibrillation. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 2, 2009 Category: Emergency Medicine Authors: Christian Bjerre Hoyer and Erika Frischknecht Christensen Source Type: journals

Management of burn injuries - recent developments in resuscitation, infection control and outcomes researchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury exists but new standards for description of burn-related infections have been presented. The value of the burn center in care of soft tissue problems including Toxic Epidermal Necrolysis and soft tissue infections is supported in recent papers. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - March 11, 2009 Category: Emergency Medicine Authors: David J Dries Source Type: journals

Diagnostic peritoneal lavage: a review of indications, technique, and interpretationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Diagnostic peritoneal lavage (DPL) is a highly accurate test for evaluating intraperitoneal hemorrhage or a ruptured hollow viscus, but is performed less frequently today due to the increased use of focused abdominal sonography for trauma (FAST and helical computed tomography (CT). All three of these exams have advantages and disadvantages and thus each still play unique roles in the evaluation of abdominal trauma. Since DPL is performed less frequently today, a review of its indications, technique, and interpretation is pertinent. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - March 8, 2009 Category: Emergency Medicine Authors: Jill S Whitehouse and John A Weigelt Source Type: journals

A systematic review of controlled studies: do physicians increase survival with prehospital treatment?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Our systematic review revealed only few controlled studies of variable quality and strength examining survival with prehospital physician treatment. Increased survival with physician treatment was found in trauma and, based on more limited evidence, cardiac arrest. Indications of increased survival were found in respiratory diseases and acute myocardial infarction. Many conditions seen in the prehospital setting remain unexamined. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - March 5, 2009 Category: Emergency Medicine Authors: Morten T Botker, Skule A Bakke and Erika F Christensen Source Type: journals

Undisclosed cocaine use and chest pain in Emergency Departments of SpainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
AimsIllicit cocaine consumption in Spain is one of the highest in Europe. Our objective was to study the incidence of undisclosed cocaine consumption in patients attending in two Spanish Emergency Departments for chest pain.MethodWe analysed urine samples from consenting consecutive patients attending ED for chest pain to determine the presence of cocaine, and other drugs, by semiquantative tests with fluorescence polarization immunoassay (FPIA). Results: Of 140 cases, 15.7 presented positive test for drugs, and cocaine was present in 6.4%. All cocaine-positive patients were younger (p (Source: Scandinavian Journal of Trau...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - March 2, 2009 Category: Emergency Medicine Authors: Guillermo Burillo-Putze, Beatriz Lopez, Juan Maria Borreguero Leon, Miquel Sanchez Sanchez, Martin Garcia Gonzalez, Alberto Dominguez Rodriguez, Eva Vallbona Afonso, Alejandro Jimenez Sosa and Oscar Miro Source Type: journals

Surgical management of penetrating pulmonary injuriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Chest injuries were reported as early as 3000 BC in the Edwin Smith Surgical Papyrus. Ancient Greek chronicles reveal that they had anatomic knowledge of the thoracic structures. Even in the ancient world, most of the therapeutic modalities for chest wounds and traumatic pulmonary injuries were developed during wartime. The majority of lung injuries can be managed non-operatively, but pulmonary injuries that require operative surgical intervention can be quite challenging. Recent progress in treating severe pulmonary injuries has relied on finding shorter and simpler lung-sparing techniques. The applicability of stapled p...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - February 23, 2009 Category: Emergency Medicine Authors: Patrizio Petrone and Juan A Asensio Source Type: journals

Successful use of inhaled nitric oxide to decrease intracranial pressure in a patient with severe traumatic brain injury complicated by acute respiratory distress syndrome: a role for an anti-inflammatory mechanism?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Use of inhaled nitric oxide in humans with traumatic brain injury and acute respiratory distress syndrome has twice previously been reported to be beneficial. Here we report a third case. We propose that inhaled nitric oxide may decrease the inflammatory response in patients with increased intracranial pressure caused by traumatic brain injury accompanied by acute respiratory distress syndrome thereby contributing to improved outcomes. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - February 17, 2009 Category: Emergency Medicine Authors: Thomas J Papadimos, Azedine Medhkour and Sooraj Yermal Source Type: journals

Precision of field triage in patients brought to a trauma centre after introducing trauma team activation guidelinesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Field triage is important for regional trauma systems providing high sensitivity to avoid that severely injured are deprived access to trauma team resuscitation (undertriage), yet high specificity to avoid resource over-utilization (overtriage). Previous informal trauma team activation (TTA) at Ulleval University Hospital (UUH) caused imprecise triage. We have analyzed triage precision after introduction of TTA guidelines. Methods: Retrospective analysis of 7 years (2001-07) of prospectively collected trauma registry data for all patients with TTA or severe injury, defined as at least one of the following: Inju...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - January 9, 2009 Category: Emergency Medicine Authors: Marius Rehn, Torsten Eken, Andreas Jorstad Kruger, Petter Andreas Steen, Nils Oddvar Skaga and Hans Morten Lossius Source Type: journals