| 1. |
- Blom, Mathias, et al.
(författare)
-
The probability of patients being admitted from the emergency department is negatively correlated to in-hospital bed occupancy - a registry study.
- 2014
-
Ingår i: International Journal of Emergency Medicine. - : Springer Science and Business Media LLC. - 1865-1380 .- 1865-1372. ; 7:8
-
Tidskriftsartikel (refereegranskat)abstract
- The association between emergency department (ED) overcrowding and poor patient outcomes is well described, with recent work suggesting that the phenomenon causes delays in time-sensitive interventions, such as resuscitation. Even though most researchers agree on the fact that admitted patients boarding in the ED is a major contributing factor to ED overcrowding, little work explicitly addresses whether in-hospital occupancy is associated to the probability of patients being admitted from the ED. The objective of the present study is to investigate whether such an association exists.
|
|
| 2. |
- Fares, S, et al.
(författare)
-
Emergency medicine in the United Arab Emirates
- 2014
-
Ingår i: International journal of emergency medicine. - : Springer Science and Business Media LLC. - 1865-1372 .- 1865-1380. ; 7:1, s. 4-
-
Tidskriftsartikel (refereegranskat)
|
|
| 3. |
- Abelsson, Anna, et al.
(författare)
-
To enhance the quality of CPR performed by youth layman
- 2019
-
Ingår i: International Journal of Emergency Medicine. - : BioMed Central. - 1865-1372 .- 1865-1380. ; 12:1
-
Tidskriftsartikel (refereegranskat)abstract
- By educating laymen, survival after cardiac arrest can increase in society. It is difficult to reach the entire population with cardiopulmonary resuscitation (CPR) training. However, if 15% of the population knows how to perform CPR, an increase in short- and long-term survival in patients suffering a cardiac arrest could be seen. To educate youth is a way to reach parts of the population. This study aimed to investigate the effect of a 2-h CPR intervention for youth.
|
|
| 4. |
|
|
| 5. |
- Blom, Mathias, et al.
(författare)
-
Associations between in-hospital bed occupancy and unplanned 72-h revisits to the emergency department: a register study.
- 2014
-
Ingår i: International Journal of Emergency Medicine. - : Springer Science and Business Media LLC. - 1865-1380 .- 1865-1372. ; 7:Jun 28
-
Tidskriftsartikel (refereegranskat)abstract
- A possible downstream effect of high in-hospital bed occupancy is that patients in the emergency department (ED) who would benefit from in-hospital care are denied admission. The present study aimed at evaluating this hypothesis through investigating associations between in-hospital bed occupancy at the time of presentation in the ED and the probability for unplanned 72-hour (72-h) revisits to the ED among patients discharged at index. A second outcome was unplanned 72-h revisits resulting in admission.
|
|
| 6. |
- Bäckström, Denise, et al.
(författare)
-
Physicians’ challenges when working in the prehospital environment : a qualitative study using grounded theory
- 2024
-
Ingår i: International Journal of Emergency Medicine. - : BMC. - 1865-1372 .- 1865-1380. ; 17:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn the rapid development in prehospital medicine the awareness of the many challenges in prehospital care is important as it highlights which areas need improvement and where special attention during education and training should be focused. The purpose of this study is to identify challenges that physicians face when working in the prehospital environment. The research question is thus; what challenges do physicians face when working in prehospital care?MethodThis is a qualitative study with an inductive approach and is based on individual interviews. The interviews were analyzed using the Classic Grounded Theory (GT) method as an approach. The interviews were conducted as semi-structured interviews via the digital platform Zoom during winter / early spring 2022.ResultsChallenges for prehospital physicians can be understood as a process that involves a balancing act between different factors linked to the extreme environment in which they operate. This environment creates unique challenges not usually encountered in routine hospital practice, which results in trade-offs that they would not otherwise be faced with. Their individual situation needs to be balanced against organizational conditions, which means, among other things, that their medical decisions must be made based on limited information as a result of the constraints that exist in the prehospital environment. They must, both as individuals and as part of a team, maneuver in time and space for decision-making and practical tasks. This theory of balancing different entities is based on four themes; thus the theory is the relation between the four themes: leadership, environment, emotion management and organization.ConclusionsWith the help of previous studies and what we have found, it is reasonable to review what training is needed before starting to work prehospital as a physician. This should include components of the themes we have described: organization, environment, leadership and emotional management.
|
|
| 7. |
- Habbouche, S., et al.
(författare)
-
Comparison of the novel WEst coast System for Triage (WEST) with Rapid Emergency Triage and Treatment System (RETTS (c)): an observational pilot study
- 2022
-
Ingår i: International Journal of Emergency Medicine. - : Springer Science and Business Media LLC. - 1865-1372 .- 1865-1380. ; 15:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Most Swedish emergency departments (ED) use the triage system Rapid Emergency Triage and Treatment System (RETTS (c)), which over time has proven to prioritize patients to higher triage levels. When many patients are prioritized to high triage levels, challenges with identifying true high-risk patients and increased waiting time for these patients has emerged. In order to achieve a more balanced triage in relation to actual medical risk, the triage system WEst coast System for Triage (WEST) was developed, based on the South African Triage Scale (SATS). The aim of this study was to perform an initial evaluation of the novel emergency triage system WEST compared to the existing RETTS (c). Methods Both RETTS (c) and WEST are five level triage systems illustrated by colors. Nurses from each of the three adult EDs of Sahlgrenska University Hospital in Gothenburg and the ambulance service assessed and triaged 1510 patients according to RETTS (c) and immediately thereafter filled out the WEST triage form. Data from each triage report were analyzed and grouped according to the triage color, chief complaint, and outcome of each patient. Data on discharge categories and events within 72 h were also collected. Data were analyzed with descriptive statistical methods. Results In general, WEST displayed lower levels of prioritization compared to RETTS (c), with no observed impact on patients' medical outcomes. In RETTS (c) orange triage level, approximately 50% of the patients were down prioritized in WEST to yellow or green triage levels. Also, in the RETTS (c) yellow triage level, more than 55% were down prioritized to green triage level in WEST. The number of patients who experienced a serious event during the first 72 h was few. Three patients died, these were all prioritized to red triage level in RETTS (c). In WEST two of these patients were prioritized to red triage level and one to orange triage level. All these patients were admitted to hospital before deterioration. Conclusions WEST may reduce over prioritization at the ED, especially in the orange and yellow triage levels of RETTS (c), with no observed increase in medical risk. WEST can be recommended for a clinical comparative study.
|
|
| 8. |
- Hugelius, Karin, 1977-, et al.
(författare)
-
Health among disaster survivors and health professionals after the Haiyan Typhoon: a self-selected Internet-based web survey
- 2017
-
Ingår i: International Journal of Emergency Medicine. - : Springer Science and Business Media LLC. - 1865-1372 .- 1865-1380. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Natural disasters affected millions of people worldwide every year. Evaluation of disaster health and health response interventions is faced with several methodological challenges. This study aimed (1) to describe survivors' and health professionals' health, 30 months after a natural disaster using a web-based self-selected Internet sample survey designed and (2) to evaluate the health effects of disaster response interventions, in the present study with a focus on disaster radio. Methods: A web-based survey was used to conduct a cross-sectional study approximately 30 months after typhoon Haiyan. The GHQ-12, EQ-5D-3L, and EQ-VAS instruments were used in addition to study-specific questions. A self-selected Internet sample was recruited via Facebook. Results: In total, 443 survivors, from what 73 were health professionals, participated in the study. The Haiyan typhoon caused both physical and mental health problems as well as social consequences for the survivors. Mental health problems were more frequently reported than physical injuries. Health professionals reported worse overall health and a higher frequency of mental health problems compared to other survivors. Conclusions: There were short-term and long-term physical, psychological, and social consequences for the survivors as a result of the Haiyan typhoon. Mental health problems were more frequently reported and lasted longer than physical problems. Health professionals deployed during the disaster reported worse health, especially concerning mental health problems. The survey used was found useful to describe health after disasters. Keywords: Disaster, Natural disaster, Disaster medicine, Disaster response, Mental health, Health professionals
|
|
| 9. |
|
|
| 10. |
- Strandqvist, Erik, et al.
(författare)
-
Physician-staffed prehospital units: a retrospective follow-up from an urban area in Scandinavia
- 2023
-
Ingår i: International Journal of Emergency Medicine. - : BMC. - 1865-1372 .- 1865-1380. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe aim of this study was to determine when and how rapid response vehicles (RRVs) make a difference in prehospital care by investigating the number and kinds of RRV assignment dispatches and the prehospital characteristics and interventions involved.MethodsThis retrospective cohort study was based on data from a quality assurance system where all assignments are registered. RRV staff register every assignment directly at the site, using a smartphone, tablet, or computer. There is no mandatory information requirement or time limit for registration. The study includes data for all RRVs operating in Region Stockholm, three during daytime hours and one at night - from January 1, 2021 to December 31, 2021.ResultsIn 2021, RRVs in Stockholm were dispatched on 11,283 occasions, of which 3,571 (31.6%) resulted in stand-downs. In general, stand-downs were less common for older patients. The most common dispatch category was blunt trauma (1,584 or 14.0%), which accounted for the highest frequency of stand-downs (676 or 6.0%). The second most common category was cardiac arrest (1,086 or 9.6%), followed by shortness of breath (691 or 6.1%), medical not specified (N/S) (596 or 5.3%), and seizures (572 or 5.1%).ConclusionThe study findings confirm that RRVs provide valuable assistance to the ambulance service in Stockholm, especially for cardiac arrest and trauma patients. In particular, RRV personnel have more advanced medical knowledge and can administer medications and perform interventions that the regular ambulance service cannot provide.
|
|
| 11. |
- Vedin, Tomas, et al.
(författare)
-
Prospective comparison of capillary and venous brain biomarker S100B : Capillary samples have large inter-sample variation and poor correlation with venous samples
- 2019
-
Ingår i: International Journal of Emergency Medicine. - : Springer Science and Business Media LLC. - 1865-1372 .- 1865-1380. ; 12:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Guidelines for the emergency management of mild traumatic brain injury have been used for over a decade and are considered safe. However, they recommend computerized tomography for at least half of these patients. The Scandinavian Neurotrauma Committee guideline uses serum S100B protein level to rule out intracranial hemorrhage. Analysis of capillary serum S100B protein level has not yet been employed for this purpose. The primary aim of this study was to investigate the correlation and agreement of capillary and venous serum S100B protein level over a spectrum of concentrations typical for mild traumatic brain injury. Methods: Eighteen patients with traumatic intracranial hemorrhage and 39 volunteers without trauma to the head within the past 7 days were recruited. Blood was sampled from patients with intracranial hemorrhage daily up to four consecutive days and healthy volunteers were sampled once during the study. One venous and two capillary samples were drawn at each sampling event. Samples were analyzed using the Cobas e411 S100 electrochemiluminescence assay. Results: Median serum S100B protein level of capillary sampling 1 was 0.12 (IQR 0.075-0.21) μg/l and median serum S100B protein level of capillary sampling 2 was 0.13 (IQR 0.08-0.22) μg/l. Median serum S100B protein level of all venous samples was 0.05 (IQR 0.03-0.07) μg/l. Correlation plots of capillary and venous samples showed poor correlation and Bland-Altman plots showed a large dispersion of samples and wide limits of agreement. Conclusion: The results of this study indicate that correlation and agreement between capillary and venous samples are low, and because of this, we cannot recommend studies on capillary serum S100B protein level to rule out intracranial hemorrhage in mild traumatic brain injury. Given the limitations of the current sampling and analysis methods of capillary protein S100B protein level, we conclude that evaluating its predictive ability to rule out intracranial hemorrhage should be withheld until more reliable methods can be incorporated into the study design.
|
|
| 12. |
- Wallgren, Ulrika M., 1971-, et al.
(författare)
-
Keywords reflecting sepsis presentation based on mode of emergency department arrival : a retrospective cross-sectional study
- 2021
-
Ingår i: International Journal of Emergency Medicine. - : Springer-Verlag New York. - 1865-1372 .- 1865-1380. ; 14:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Current sepsis screening tools are predominantly based on vital signs. However, patients with serious infections frequently present with normal vital signs and there has been an increased interest to include other variables such as symptoms in screening tools to detect sepsis. The majority of patients with sepsis arrive to the emergency department by emergency medical services. Our hypothesis was that the presentation of sepsis, including symptoms, may differ between patients arriving to the emergency department by emergency medical services and patients arriving by other means. This information is of interest to adapt future sepsis screening tools to the population in which they will be implemented. The aim of the current study was to compare the prevalence of keywords reflecting the clinical presentation of sepsis based on mode of arrival among septic patients presenting to the emergency department.METHODS: Retrospective cross-sectional study of 479 adult septic patients. Keywords reflecting sepsis presentation upon emergency department arrival were quantified and analyzed based on mode of arrival, i.e., by emergency medical services or by other means. We adjusted for multiple comparisons by applying Bonferroni-adjusted significance levels for all comparisons. Adjustments for age, gender, and sepsis severity were performed by stratification. All patients were admitted to the emergency department of Södersjukhuset, Stockholm, and discharged with an ICD-10 code compatible with sepsis between January 1, and December 31, 2013.RESULTS: "Abnormal breathing" (51.8% vs 20.5%, p value < 0.001), "abnormal circulation" (38.4% vs 21.3%, p value < 0.001), "acute altered mental status" (31.1% vs 13.1%, p value < 0.001), and "decreased mobility" (26.1% vs 10.7%, p value < 0.001) were more common among patients arriving by emergency medical services, while "pain" (71.3% vs 40.1%, p value < 0.001) and "risk factors for sepsis" (50.8% vs 30.8%, p value < 0.001) were more common among patients arriving by other means.CONCLUSIONS: The distribution of most keywords related to sepsis presentation was similar irrespective of mode of arrival; however, some differences were present. This information may be useful in clinical decision tools or sepsis screening tools.
|
|
| 13. |
- Bergenfeldt, Henrik, et al.
(författare)
-
Delayed intracranial hemorrhage after head trauma seems rare and rarely needs intervention—even in antiplatelet or anticoagulation therapy
- 2023
-
Ingår i: International Journal of Emergency Medicine. - 1865-1372. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Traumatic brain injury causes morbidity, mortality, and at least 2,500,000 yearly emergency department visits in the USA. Computerized tomography of the head is the gold standard to detect traumatic intracranial hemorrhage. Some are not diagnosed at the first scan, and they are denoted “delayed intracranial hemorrhages. ” To detect these delayed hemorrhages, current guidelines for head trauma recommend observation and/or rescanning for patients on anticoagulation therapy but not for patients on antiplatelet therapy. The aim of this study was to investigate the prevalence and need for interventions of delayed intracranial hemorrhage after head trauma. Methods: The study was a retrospective review of medical records of adult patients with isolated head trauma presenting at Helsingborg General Hospital between January 1, 2020, and December 31, 2020. Univariate statistical analyses were performed. Results: In total, 1627 patients were included and four (0.25%, 95% confidence interval 0.06–0.60%) patients had delayed intracranial hemorrhage. One of these patients was diagnosed within 24 h and three within 2–30 days. The patient was diagnosed within 24 h, and one of the patients diagnosed within 2–30 days was on antiplatelet therapy. None of these four patients was prescribed anticoagulation therapy, and no intensive care, no neurosurgical operations, or deaths were recorded. Conclusion: Traumatic delayed intracranial hemorrhage is rare and consequences mild and antiplatelet and anticoagulation therapy might confer similar risk. Because serious complications appear rare, observing, and/or rescanning all patients with either of these medications can be debated. Risk stratification of these patients might have the potential to identify the patients at risk while safely reducing observation times and rescanning.
|
|
