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Sökning: WFRF:(Jonsson Anders) > Konferensbidrag > Högskolan i Borås > Refereegranskat

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  • Ambjörnsson, Joakim, et al. (författare)
  • Prehospital suspicion and identification of adult septic patients:Experiences of a screening tool
  • 2016
  • Konferensbidrag (refereegranskat)abstract
    • Introduction:  Sepsis  is life threatening  and  requires  urgent healthcare  to reduce  suffering  and death. Therefore it is important that septic patients are identified early to enable treatment. Aim: To investigate to what extent EMS personnel identified patients with sepsis using the "BAS90-30-90"  model, and to describe assessments and medical procedures that were  undertaken by the personnel. Methods: This was a retrospective study where  185 EMS medical records were  reviewed. The inclusion was based on patients who were later diagnosed with sepsis in the hospital. Results: A physician assessed the patients  in 74 of the EMS cases, which lead to exclusion  of these  records  in  regard  to  the  EMS  personnel's  ability  to  identify  sepsis.  The  personnel documented  suspicion  of severe sepsis in eight (n=8) of the remaining 111 records (7.2%). The proportion  of patients  065 years  of age was 73% (n=135)  of which  37% (n=50) were over 80 years  old. Thirty-nine percent  (39%,  n=72)  were  females. The  personnel  documented blood pressure   in  91%  (n=168),  respiratory   rate  in  76%  (n=140),   saturation   in  100%  (n=185), temperature  in 76%  (n=141),  and  heart  rate  in  94%  (n=174)  of  the  records.  Systolic  blood pressure  <90 mmHg  was  documented  in 14,2%  (n=24),  respiratory  rate  030 in 36%  (n=50), saturation <90 in 49%   (n=91). temperature >38°C in 37.6% (n=53), and heart rate 090 in 70% (n=121) of the records. Documented medical procedures and treatments were intravenous  lines (70%, n=130), intravenous  fluids (10%, n=19) and administration  of oxygen (72%, n=133). Conclusion:  The EMS personnel identified  only a few septic patients  with the help of the BAS90-30-90  model when  all three criteria  would  be met for severe  sepsis. Either  advanced age (>65  years),   fever   (>38°C)   or  tachypnea (020  breaths/min)   appeared   to   increase  the personnel's suspicion  of sepsis. Oxygen, but not intravenous  fluids, was given in an adequate way.
  • Backlund, Per, et al. (författare)
  • Pre-hospital training and simulation initiative
  • 2014
  • Konferensbidrag (refereegranskat)abstract
    • BackgroundThe pre-hospital process is a complex one involvingaspects such as medical skills as well as care taking,team performance, inter-organizational cooperation andcommunication. This calls for novel training methods andtechnology support. Our review of literature (covering theareas of pre-hospital care, training simulator technologiesand methods and process modelling) indicates that thedifferent aspects are typically trained in isolation, e.g.medical skills using patient simulators.ObjectiveThe pre-hospital training center project addresses theoverall complexity of the pre-hospital process by takingall of the aspects into account when designing scenariosand technology support for training the complete prehospitalprocess (covering alarm, on-scene activities,transportation and hand-over). This is indeed a challengingtask as we need to develop both training methods andtechnology support for a very complex training situation.MethodsThe project will develop a prototype scenario along withtechnology support to enact it. The training scenariowill involve many of the aspects listed above and will betested in a field experiment with ambulance personnel.ResultsThe expected outcome of the project is a platform forestablishing a pre-hospital simulation and training center.The initial technologies, research results and experienceswill be used to form a consortium for further work anddevelopment.ConclusionsWe have identified a need for a pre-hospital trainingcenter with the unique and ambitious idea of covering theentire pre-hospital process as well as its many interactingaspects. To the best of our knowledge this approach isnot at all common and we expect the complexity to be sohigh that it is a challenging enough research area that canonly be addressed if we have a well-designed simulationand training center in place with all the different areas ofknowledge represented, i.e. pre-hospital medicine as wellas simulation and visualization technology.
  • Lundberg, Lars, et al. (författare)
  • Applying military medical training models on the training of civilian ambulance nurses
  • 2012
  • Konferensbidrag (refereegranskat)abstract
    • Background: The pre-mission training of military medical personnel is based on simulation, using either moulage patients or full-scale simulation manikins. Furthermore, the training is preferably conducted in a realistic environment, including the logistic procedures required.Summary of work: The military approach to medical training has been considered interesting to apply on the postgraduate and continuing education for civilian ambulance nurses. One MD (professor) and one RN (associate professor) are now working part-time for the Armed Forces Centre for Defence Medicine and part-time for the University of Borås. A general aim is to improve the trauma education for civilian ambulance nurses, including prehospital procedures for command & control, and by introducing selected military techniques such as tourniquets and haemostatic agents to stop life-threatening bleedings also in civilian practice.Conclusions: We have a reason to believe that this recently initiated collaboration between military medicine and civilian prehospital medicine is mutually beneficial. The civilian Emergency Medical Services will become better trained and prepared, while the Armed Forces are likely to get a larger recruitment base of skilled medical personnel for future service in international missions.Take-home messages: Collaboration between organisations with similar interests, in this case the prehospital management of trauma victims, is likely to be mutually beneficial.
  • Suserud, Björn-Ove, et al. (författare)
  • Unique characteristics of ambulance care
  • 2005
  • Ingår i: Prehospital and Disaster Medicine. - Cambridge University Press. ; s. 8-9
  • Konferensbidrag (refereegranskat)
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