| 1. |
- Israelsson, Johan, et al.
(författare)
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Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender
- 2017
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Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 114, s. 27-33
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.
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| 2. |
- Langhelle, A., et al.
(författare)
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Recommended guidelines for reviewing, reporting, and conducting research on post-resuscitation care: the Utstein style
- 2005
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 66:3, s. 271-83
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this report is to establish recommendations for reviewing, reporting, and conducting research during the post-resuscitation period in hospital. It defines data that are needed for research and more specialised registries and therefore supplements the recently updated Utstein template for resuscitation registries. The updated Utstein template and the out-of-hospital "Chain of Survival" describe factors of importance for successful resuscitation up until return of spontaneous circulation (ROSC). Several factors in the in-hospital phase after ROSC are also likely to affect the ultimate outcome of the patient. Large differences in survival to hospital discharge for patients admitted alive are reported between hospitals. Therapeutic hypothermia has been demonstrated to improve the outcome, and other factors such as blood glucose, haemodynamics, ventilatory support, etc., might also influence the result. No generally accepted, scientifically based protocol exists for the post-resuscitation period in hospital, other than general brain-oriented intensive care. There is little published information on this in-hospital phase. This statement is the result of a scientific consensus development process started as a symposium by a task force at the Utstein Abbey, Norway, in September 2003. Suggested data are defined as core and supplementary and include the following categories: pre-arrest co-morbidity and functional status, cause of death, patients' quality of life, in-hospital system factors, investigations and treatment, and physiological data at various time points during the first three days after admission. It is hoped that the publication of these recommendations will encourage research into the in-hospital post-resuscitation phase, which we propose should be included in the chain-of-survival as a fifth ring. Following these recommendations should enable better understanding of the impact of different in-hospital treatment strategies on outcome.
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| 3. |
- Axelsson, Åsa B., 1955, et al.
(författare)
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How bystanders perceive their cardiopulmonary resuscitation intervention : a qualitative study
- 2000
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Ingår i: Resuscitation. - Amsterdam : Elsevier. - 0300-9572 .- 1873-1570. ; 47:1, s. 71-81
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Tidskriftsartikel (refereegranskat)abstract
- The importance of bystander cardiopulmonary resuscitation (CPR) prior to arrival of the emergency medical service is well documented. In Sweden, CPR is initiated prior to emergency medical services (EMS) arrival in about 30% of cardiac arrests out-of-hospital, a figure which should be improved urgently. To do so, it is of interest to know more about the bystanders' perceptions of their intervention. A qualitative method inspired by the phenomenographic approach was applied to 19 bystanders who had performed CPR. In the analysis, five main categories and 14 subcategories emerged. The main categories were: to have a sense of humanity, to have competence, to feel an obligation, to have courage and to feel exposed. Interviews described how humanity and concern for another human being were the foundation of their intervention. CPR training offers the possibility to give appropriate help in this emergency. If the aim of CPR training was extended beyond teaching the skill of CPR to include preparation of the rescuer for the intervention and his/her reactions, this might increase the number of people able to take action in the cardiac arrest situation.
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| 4. |
- Bylow, Helene, et al.
(författare)
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Self-learning training versus instructor-led training for basic life support : A cluster randomised trial.
- 2019
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 139, s. 122-132
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare the effectiveness of two basic life support (BLS) training interventions.METHODS: This experimental trial enrolled 1301 lay people in BLS training. The participants were cluster randomised to either self-learning training or to traditional instructor-led training. Both groups used the Mini-Anne Kit (Laerdal Medical, Stavanger, Norway) and standardised film instructions. After training, the participants practical skills were measured on a Resusci Anne manikin and an AED trainer with the PC SkillReporting system (Laerdal Medical, Stavanger, Norway). The primary outcome was the total score from the modified Cardiff Test of basic life support with automated external defibrillation (19-70 points), six months after training. The secondary outcomes were total score directly after training and quality of individual variables, self-assessed knowledge, confidence and willingness to act, directly and six months after training.RESULTS: For primary outcome six months after training there was no statistically significant difference (p = 0.44) between the total score for the self-learning group (n = 670; median 59, IQR 55-62) compared with the instructor-led group (n = 561; median 59, IQR 55-63). The instructor-led training resulted in a statistically significant higher total score (median 61 versus 59, p < 0.0001), self-assessed knowledge and willingness to act, directly after training (secondary outcomes) compared with the self-learning training.CONCLUSIONS: There was no statistically significant difference in practical skills or willingness to act when comparing self-learning training with instructor-led training six months after training in BLS. However, directly after the intervention, practical skills were better when the training was led by an instructor.
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| 5. |
- Gellerstedt, Martin, 1966-, et al.
(författare)
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Could a computer-based system including a prevalence function support emergency medical systems and improve the allocation of life support level?
- 2006
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Ingår i: Eur J Emerg Med. - London, UK : Lippincott Williams & Wilkins, Ltd.. - 0969-9546 .- 1473-5695. ; 13:5, s. 290-4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate whether a computer-based decision support system could be useful for the emergency medical system when identifying patients with acute myocardial infarction (AMI) or life-threatening conditions and thereby improve the allocation of life support level. METHODS: Patients in the Municipality of Goteborg who dialled the dispatch centre due to chest pain during a period of 3 months. To analyse the relationship between patient characteristics (according to a case record form used during an interview) and the response variables (AMI or life-threatening condition), multivariate logistic regression was used. For each patient, the probability of AMI/life-threatening condition was estimated by the model. We used these probabilities retrospectively to allocate advanced life support or basic life support. This model allocation was then compared with the true allocation made by the dispatchers. RESULTS: The sensitivity, that is, the percentage of AMI patients allocated to advanced life support, was 85.7% in relation to the true allocation made by the dispatchers. The corresponding sensitivity regarding allocation made by the model was 92.4% (P=0.17). The specificity was also slightly higher for the model allocation than the dispatcher allocation. Among the 15 patients with AMI who were allocated to basic life support by the dispatchers, nine died (eight during and one after hospitalization). Among the eight patients with AMI allocated to basic life support by the model, only one patient died (in hospital) (P=0.02). CONCLUSION: A computer-based decision support system including a prevalence function could be a valuable tool for allocating the level of life support. The case record form, however, used for the interview can be refined and a model based on a larger sample and confirmed in a prospective study is recommended.
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| 6. |
- Magnusson, Carl, 1976, et al.
(författare)
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The final assessment and its association with field assessment in patients who were transported by the emergency medical service
- 2018
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Ingår i: Scandinavian Journal of Trauma Resuscitation & Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn patients who call for the emergency medical service (EMS), there is a knowledge gap with regard to the final assessment after arriving at hospital and its association with field assessment.AimIn a representative population of patients who call for the EMS, to describe a) the final assessment at hospital discharge and b) the association between the assessment in the field and the assessment at hospital discharge.MethodsThirty randomly selected patients reached by a dispatched ambulance each month between 1 Jan and 31 Dec 2016 in one urban, one rural and one mixed ambulance organisation in Sweden took part in the study. The exclusion criteria were age<18years, dead on arrival, transport between health-care facilities and secondary missions. Each patient received a unique code based on the ICD code at hospital discharge and field assessment.ResultsIn all, 1080 patients took part in the study, of which 1076 (99.6%) had a field assessment code. A total of 894 patients (83%) were brought to a hospital and an ICD code (ICD-10-SE) was available in 814 patients (91% of these cases and 76% of all cases included in the study). According to these ICD codes, the most frequent conditions were infection (15%), trauma (15%) and vascular disease (9%). The most frequent body localisation of the condition was the thorax (24%), head (16%) and abdomen (13%). In 118 patients (14% of all ICD codes), the condition according to the ICD code was judged as time critical. Among these cases, field assessment was assessed as potentially appropriate in 75% and potentially inappropriate in 12%.ConclusionAmong patients reached by ambulance in Sweden, 83% were transported to hospital and, among them, 14% had a time-critical condition. In these cases, the majority were assessed in the field as potentially appropriate, but 12% had a potentially inappropriate field assessment. The consequences of these findings need to be further explored.
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| 7. |
- Axelsson, C, et al.
(författare)
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Dispatch codes of out-of-hospital cardiac arrest should be diagnosis related rather than symptom related.
- 2010
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Ingår i: European journal of emergency medicine : official journal of the European Society for Emergency Medicine. - : Lippincott Williams & Wilkins, Ltd.. - 1473-5695 .- 0969-9546. ; 17:5, s. 265-9
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Tidskriftsartikel (refereegranskat)abstract
- To describe the characteristics and outcome in out-of-hospital cardiac arrest (OHCA) in relation to (i) whether OHCA was coded by the dispatcher as a diagnosis or as a symptom and (ii) the delay until the first unit was alerted at the dispatch centre.
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| 8. |
- Thorén, Ann-Britt, 1952, et al.
(författare)
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Measurement of skills in cardiopulmonary resuscitation-do professionals follow given guidelines?
- 2001
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Ingår i: European journal of emergency medicine. - London : Lippincott Williams & Wilkins. - 0969-9546 .- 1473-5695. ; 8:3, s. 169-176
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Tidskriftsartikel (refereegranskat)abstract
- Since it is suggested that only effective cardiopulmonary resuscitation (CPR) improves survival rates, quality control of training outcomes is important and comparisons between different training methods are desirable. The aim of this study was to test a model of quality assurance, consisting of a computer program combined with the Brennan et al. checklist, for evaluation of CPR performance. A small group of trained medical professionals (cardiac care unit nurses) (n = 10) was used in this pilot study. The result points out several points of concern: half of the participants did not open the airway prior to breathing control. Over 90% of all inflations were ‘too fast’ and 71% were ‘too much’. Only 6.5% of the inflations were correct. On average, the participants made 5.4 inflations per minute. Concerning chest compressions, 40% were ‘too deep’ while only 4% were ‘too shallow’. In spite of the fact that the participants had an average rate at 95 compressions per minute the number of compressions varied between 32 and 51 during 1 minute. When new guidelines are discussed, it would be beneficial if they were tested by a number of people to investigate if following the guidelines is at all possible. © 2001 Lippincott Williams & Wilkins, Inc.
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| 9. |
- Axelsson, Christer, et al.
(författare)
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Nationella regler krävs för ambulanssjukvård
- 2011
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Ingår i: Svenska Dagbladet. - 1101-2412. ; :2011-11-15
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- I Sverige är det upp till varje landsting att bestämma hur snabbt en ambulans ska vara på plats. I stället borde det finnas nationella riktlinjer kring hur tillgängligheten ska se ut, skriver flera ambulanssjuksköterskor.
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| 10. |
- Herlitz, Johan, et al.
(författare)
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Så skapas världens bästa ambulanssjukvård
- 2011
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Ingår i: Göteborgsposten. - 1103-9345. ; :2011-05-14
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Tiden från larm till dess att ambulans kommer har ökat dramatiskt de senaste tio åren i Västra Götaland. Samtidigt bedöms allt fler i behov av snabb utryckning. Kompetens finns att råda bot på detta – om den tillåts styra utvecklingen, skriver bland andra professor Johan Herlitz.
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