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- Hasselqvist-Ax, I, et al.
(författare)
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Experiences among firefighters and police officers of responding to out-of-hospital cardiac arrest in a dual dispatch programme in Sweden: an interview study
- 2019
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 9:11, s. e030895-
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to explore firefighters’ and police officers’ experiences of responding to out-of-hospital cardiac arrest (OHCA) in a dual dispatch programme.DesignA qualitative interview study with semi-structured, open-ended questions where critical incident technique (CIT) was used to collect recalled cardiac arrest situations from the participants’ narratives. The interviews where transcribed verbatim and analysed with inductive content analysis.SettingThe County of Stockholm, Sweden.ParticipantsPolice officers (n=10) and firefighters (n=12) participating in a dual dispatch programme with emergency medical services in case of suspected OHCA of cardiac or non-cardiac origin.ResultsAnalysis of 60 critical incidents was performed resulting in three consecutive time sequences (preparedness, managing the scene and the aftermath) with related categories, where first responders described the complexity of the cardiac arrest situation. Detailed information about the case and the location was crucial for the preparedness, and information deficits created stress, frustration and incorrect perceptions about the victim. The technical challenges of performing cardiopulmonary resuscitation and managing the airway was prominent and the need of regular team training and education in first aid was highlighted.ConclusionsParticipating in dual dispatch in case of suspected OHCA was described as a complex technical and emotional process by first responders. Providing case discussions and opportunities to give, and receive feedback about the case is a main task for the leadership in the organisations to diminish stress among personnel and to improve future OHCA missions.
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| 2. |
- Hollenberg, J, et al.
(författare)
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Effects of native language on CPR skills and willingness to intervene in out-of-hospital cardiac arrest after film-based basic life support training: a subgroup analysis of a randomised trial
- 2019
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 9:5, s. e025531-
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate whether the students’ native language, Swedish as native language (SNL) versus other native language (ONL), affects cardiopulmonary resuscitation (CPR) skills or willingness to act after film-based training in Swedish.Setting13-year-old students in two municipalities.DesignA subgroup from a previous randomised study was analysed. During 2013 to 2014, a film-based CPR method was evaluated. Practical skills and willingness to act were assessed directly after training and after 6 months. CPR skills were evaluated using a modified Cardiff test.ParticipantsA total of 641 students were included in the analysis (SNL, n=499; ONL, n=142).Primary and secondary outcome measuresPrimary endpoint was the total score of the modified Cardiff test at 6 months. The secondary endpoints were total score directly after training, individual variables for the test and self-reported willingness to act.ResultsAt the practical test, SNL students scored better than ONL students; directly after training, 67% vs 61% of maximum score, respectively (p<0.001); at 6 months, 61% vs 56% of maximum score (p<0.001). Most students were willing to perform compressions and ventilation on a friend (SNL 85% vs ONL 84%). However, if the victim was a stranger, ONL students were more willing to perform both compressions and ventilation than SNL students (52% vs 38% after training, p<0.001; 42% vs 31% at 6 months, p=0.032). SNL students preferred to initiate chest compressions only.ConclusionsSNL students scored slightly higher in the practical CPR skill test than ONL students. Willingness to act was generally high, however ONL students reported higher willingness to perform both compressions and ventilation if the victim was a stranger. Further research is needed to investigate how CPR educational material should be designed and simplified for optimal learning by students. Different language versions or including feedback in CPR training can be a way to increase learning.Ethics approvalThe study was approved by the Regional Ethical Review Board of Linköping, Sweden (2013/358-31).Trial registration numberNCT03233490; Pre-results.
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| 3. |
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| 4. |
- Svensson, P, et al.
(författare)
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Association between cardiometabolic disease and severe COVID-19: a nationwide case-control study of patients requiring invasive mechanical ventilation
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:2, s. e044486-
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Tidskriftsartikel (refereegranskat)abstract
- The risks associated with diabetes, obesity and hypertension for severe COVID-19 may be confounded and differ by sociodemographic background. We assessed the risks associated with cardiometabolic factors for severe COVID-19 when accounting for socioeconomic factors and in subgroups by age, sex and region of birth.Methods and resultsIn this nationwide case–control study, 1.086 patients admitted to intensive care with COVID-19 requiring mechanical ventilation (cases), and 10.860 population-based controls matched for age, sex and district of residency were included from mandatory national registries. ORs with 95% CIs for associations between severe COVID-19 and exposures with adjustment for confounders were estimated using logistic regression. The median age was 62 years (IQR 52–70), and 3003 (24.9%) were women. Type 2 diabetes (OR, 2.3 (95% CI 1.9 to 2.7)), hypertension (OR, 1.7 (95% CI 1.5 to 2.0)), obesity (OR, 3.1 (95% CI 2.4 to 4.0)) and chronic kidney disease (OR, 2.5 (95% CI 1.7 to 3.7)) were all associated with severe COVID-19. In the younger subgroup (below 57 years), ORs were significantly higher for all cardiometabolic risk factors. The risk associated with type 2 diabetes was higher in women (p=0.001) and in patients with a region of birth outside European Union(EU) (p=0.004).ConclusionDiabetes, obesity and hypertension were all independently associated with severe COVID-19 with stronger associations in the younger population. Type 2 diabetes implied a greater risk among women and in non-EU immigrants. These findings, originating from high-quality Swedish registries, may be important to direct preventive measures such as vaccination to susceptible patient groups.Trial registration numberClinicaltrial.gov (NCT04426084).
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