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Sökning: WFRF:(Nilsson Christer) > Högskolan Dalarna

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1.
  • Andersson Hagiwara, Magnus, et al. (författare)
  • Adverse events in prehospital emergency care: A trigger tool study
  • 2019
  • Ingår i: BMC Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Prehospital emergency care has developed rapidly during the past decades. The care is given in a complex context which makes prehospital care a potential high-risk activity when it comes to patient safety. Patient safety in the prehospital setting has been only sparsely investigated. The aims of the present study were 1) To investigate the incidence of adverse events (AEs) in prehospital care and 2) To investigate the factors contributing to AEs in prehospital care. Methods: We used a retrospective study design where 30 randomly selected prehospital medical records were screened for AEs each month in three prehospital organizations in Sweden during a period of one year. A total of 1080 prehospital medical records were included. The record review was based on the use of 11 screening criteria. Results: The reviewers identified 46 AEs in 46 of 1080 (4.3%) prehospital medical records. Of the 46 AEs, 43 were classified as potential for harm (AE1) (4.0, 95% CI = 2.9-5.4) and three as harm identified (AE2) (0.3, 95% CI = 0.1-0.9). However, among patients with a life-threatening condition (priority 1), the risk of AE was higher (16.5%). The most common factors contributing to AEs were deviations from standard of care and missing, incomplete, or unclear documentation. The most common cause of AEs was the result of action(s) or inaction(s) by the emergency medical service (EMS) crew. Conclusions: There were 4.3 AEs per 100 ambulance missions in Swedish prehospital care. The majority of AEs originated from deviations from standard of care and incomplete documentation. There was an increase in the risk of AE among patients who the EMS team assessed as having a life-threatening condition. Most AEs were possible to avoid. © 2019 The Author(s).
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2.
  • Andersson Hagiwara, Magnus, et al. (författare)
  • Patient safety and patient assessment in pre-hospital care: a study protocol
  • 2016
  • Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 24:1, s. 1-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patient safety issues in pre-hospital care are poorly investigated. The aim of the planned study is tosurvey patient safety problems in pre-hospital care in Sweden.Methods/Design: The study is a retro-perspective structured medical record review based on the use of 11 screeningcriteria. Two instruments for structured medical record review are used: a trigger tool instrument designed forpre-hospital care and a newly development instrument designed to compare the pre-hospital assessment withthe final hospital assessment. Three different ambulance organisations are participating in the study. Every month,one rater in each organisation randomly collects 30 medical records for review. With guidance from the reviewinstrument, he/she independently reviews the record. Every month, the review team meet for a discussion ofproblematic reviews. The results will be analysed with descriptive statistics and logistic regression.Discussion: The findings will make an important contribution to knowledge about patient safety issues in prehospitalcare.
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3.
  • Carlsson, Magnus, et al. (författare)
  • Physiological demands of competitive sprint and distance performance in elite female cross-country skiing
  • 2016
  • Ingår i: Journal of Strength and Conditioning Research. - : Lippincott Williams & Wilkins. - 1064-8011 .- 1533-4287. ; 30:8, s. 2138-2144
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose was to investigate the relationship between elite females' competitive performance capability in sprint and distance cross-country skiing and the variables of gross efficiency (GE), work rate at the onset of blood-lactate accumulation (OBLA4mmol), maximal oxygen uptake (V[Combining Dot Above]O2max), maximal speed (Vmax), and peak upper-body oxygen uptake (V[Combining Dot Above]O2peak). Ten elite female cross-country skiers (age 24.5 ± 2.8 years) completed treadmill roller-skiing tests to determine GE, OBLA4mmol, and V[Combining Dot Above]O2max using the diagonal-stride technique as well as Vmax and V[Combining Dot Above]O2peak using the double-poling technique. International Ski Federations ranking points for sprint (FISsprint) and distance (FISdist) races were used as competitive performance data. There were correlations between the FISsprint and the V[Combining Dot Above]O2max expressed absolutely (p = 0.0040), Vmax (p = 0.012), and V[Combining Dot Above]O2peak expressed absolutely (p < 0.001) and as a simple ratio-standard (p = 0.049). The FISdist were correlated with OBLA4mmol (p = 0.048), V[Combining Dot Above]O2max expressed absolutely (L·min) (p = 0.015) and as a simple ratio-standard (p = 0.046), and V[Combining Dot Above]O2peak expressed absolutely (p = 0.036) and as a simple ratio-standard (ml·min·kg) (p = 0.040). The results demonstrate that the physiological abilities reflected by V[Combining Dot Above]O2max and V[Combining Dot Above]O2peak are indicators of competitive sprint and distance performance in elite female cross-country skiing. In addition, the ability to generate a high Vmax indicates the performance in sprint races, whereas the skier's OBLA4mmol reflects the performance capability in distance races. Based on the results, when evaluating the performance capacity of elite female cross-country skiers, it is recommended to use physiological variables that reflect competitive performance.
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4.
  • Magnusson, Carl, 1976, et al. (författare)
  • The final assessment and its association with field assessment in patients who were transported by the emergency medical service
  • 2018
  • Ingår i: Scandinavian Journal of Trauma Resuscitation & Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 26
  • 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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5.
  • Rydell, Andreas, et al. (författare)
  • Cardiovascular disease-linked plasma proteins are mainly associated with lung volume
  • 2023
  • Ingår i: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 9:2
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Epidemiological studies have shown that impaired lung function is common and associated with increased risk of cardiovascular disease. Increased levels of several inflammatory and cardiovascular disease-related plasma proteins have been associated with impaired lung function. The aim was to study the association between plasma proteomics and forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio.METHODS: We used a discovery and replication approach in two community-based cohorts, EpiHealth and the Malmö Offspring Study (total n=2874), to cross-sectionally study 242 cardiovascular disease- and metabolism-linked proteins in relation to FEV1, FVC (both % predicted) and FEV1/FVC ratio. A false discovery rate of 5% was used as the significance threshold in the discovery cohort.RESULTS: Plasma fatty acid-binding protein 4, interleukin-1 receptor antagonist, interleukin-6 and leptin were negatively associated with FEV1 and paraoxonase 3 was positively associated therewith. Fatty acid-binding protein 4, fibroblast growth factor 21, interleukin-1 receptor antagonist, interleukin-6 and leptin were negatively associated with FVC and agouti-related protein, insulin-like growth factor-binding protein 2, paraoxonase 3 and receptor for advanced glycation end products were positively associated therewith. No proteins were associated with FEV1/FVC ratio. A sensitivity analysis in EpiHealth revealed only minor changes after excluding individuals with known cardiovascular disease, diabetes or obesity.CONCLUSIONS: Five proteins were associated with both FEV1 and FVC. Four proteins associated with only FVC and none with FEV1/FVC ratio, suggesting associations mainly through lung volume, not airway obstruction. However, additional studies are needed to investigate underlying mechanisms for these findings.
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