Advancing a machine learning-based decision support tool for pre-hospital assessment of dyspnoea by emergency medical service clinicians: a retrospective observational study.

Background: In Sweden with about 10 million inhabitants, there are about one million primary ambulance missions every year. Among them, around 10% are assessed by Emergency Medical Service (EMS) clinicians with the primary symptom of dyspnoea. The risk of death among these patients has been reported to be remarkably high, at 11,1% and 13,2%.

Adaption of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care of children.

Background: The emergency medical service (EMS) addresses all chief complaints across all ages in various contexts. Children in EMS present a particular challenge due to their unique anatomical and physical properties, which require specific training that EMS clinicians often report lacking. This combination exposes children to incidents threatening patient safety.

Efficient Absorbance-Based Assay for Rapid Antibiotic Susceptibility Testing of Enterobacterales.

It is increasingly important to rapidly receive information on the antimicrobial susceptibility of bacteria due to the rise in antimicrobial resistance worldwide. However, traditional phenotypic methods are time-consuming. Thus, the objective of this study was to develop a rapid assay that can detect antibiotic-resistant bacterial isolates phenotypically in less than 2 h.

Added predictive value of prehospital measurement of point-of-care lactate in an adult general EMS population in Sweden: a multi-centre observational study.

Background: Emergency medical services (EMS) personnel must rapidly assess and transport patients with time-sensitive conditions to optimise patient outcomes. Serum lactate, a valuable in-hospital biomarker, has become more accessible in EMS settings through point-of-care (POC) testing. Although POC lactate levels are valuable in specific patient groups, its broader application in EMS remains unclear.

Development of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care.

Background: Emergency Medical Services (EMS) are a unique setting because care for the chief complaint is given across all ages in a complex and high-risk environment that may pose a threat to patient safety. Traditionally, a reporting system is commonly used to raise awareness of adverse events (AEs); however, it could fail to detect an AE. Several methods are needed to evaluate patient safety in EMS.

Virtual training for small group facilitators.

Background: In addition to providing patient care, interprofessional health care teams work collaboratively on a variety of projects. These projects often benefit from using facilitated small group project discussion sessions, such as the Harvard Macy Institute's (HMI) Step Back Process (SBP). Although having a trained facilitator is an important component of the SBP, only a limited number of health care professionals can attend HMI courses in person or virtually, limiting its impact.

Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study.

Background: There is a lack of knowledge regarding the epidemiology of severe trauma assessed by Swedish emergency medical services (EMS).

Aim: To investigate the prevalence of trauma in Sweden assessed by EMS from a national perspective and describe patient demography, aetiology, trauma type, prehospital triage and clinical outcomes.

Methods: Data from two national quality registries, the Swedish Ambulance Registry and the Swedish Trauma Registry (SweTrau) were collected from January 1 to December 31, 2019.

[Documentation of prehospital emergency care].

The scientific documentation of prehospital emergency care in Sweden is slowly expanding. The first thesis on the value of a mobile coronary care unit was defended in 1982. Since then, at least 106 theses have been defended at 15 educational institutes in Sweden.

Characteristics of a trauma population in an ambulance organisation in Sweden: results from an observational study.

Background: Globally, injuries are a major health problem, and in Sweden, injuries are the second most common reason for ambulance dispatch. However, there is a knowledge gap regarding the epidemiology of injuries requiring assessment by emergency medical services (EMS) in Sweden. The aim of the present study was to describe the prehospital population with injuries that have been assessed and treated by EMS.

Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study.

Introduction: The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting.

Lived experiences of being cared for by ambulance clinicians when experiencing breathlessness-A phenomenological study.

Background: Breathlessness is a serious and distressing symptom and a common reason why patients require prehospital care by ambulance clinicians. However, little is known about how patients experience this care when they are in a state of breathlessness.

Aim: The aim of this study is to describe the lived experiences of being cared for by ambulance clinicians when experiencing breathlessness.

Patients' lived experiences of breathlessness prior to prehospital care - A phenomenological study.

Aims And Objectives: The study aimed to describe how breathlessness is experienced by patients prior to prehospital care.

Design: A qualitative phenomenological design.

Methods: Lifeworld interviews were conducted with 14 participants.

Suboptimal prehospital decision- making for referral to alternative levels of care - frequency, measurement, acceptance rate and room for improvement.

Background: The emergency medical services (EMS) have undergone dramatic changes during the past few decades. Increased utilisation, changes in care-seeking behaviour and competence among EMS clinicians have given rise to a shift in EMS strategies in many countries. From transport to the emergency department to at the scene deciding on the most appropriate level of care and mode of transport.

Limited need for hospital resources among patients brought to hospital by the emergency medical services.

Background: In Sweden, the majority of patients who are transported to hospital by the emergency medical services (EMS) are relatively old and the majority suffer from comorbidity. About half these patients are admitted to a hospital ward and will stay in hospital. However, the other half will only make a visit to the emergency department (ED).

[The role of prehospital emergency care in Sweden has changed - patient safety has become a key issue].

Prehospital emergency care in Sweden has undergone dramatic changes in recent decades from the role of being a primary transport organization to a more differentiated approach to health care. The Swedish prehospital emergency nurse must therefore today make prehospital assessments to be able to decide whether patients should be transported to hospital with »fast-track« or sent to primary care or stay at home with advice on self-care. Therefore, »patient safety« has become a key issue and primary data indicate that there is a risk of a potential adverse event in approximately four percent of the primary assignments.

Automated external defibrillators delivered by drones to patients with suspected out-of-hospital cardiac arrest.

Aims: Early defibrillation is critical for the chance of survival in out-of-hospital cardiac arrest (OHCA). Drones, used to deliver automated external defibrillators (AEDs), may shorten time to defibrillation, but this has never been evaluated in real-life emergencies. The aim of this study was to investigate the feasibility of AED delivery by drones in real-life cases of OHCA.

Clinical outcomes and safety of passive leg raising in out-of-hospital cardiac arrest: a randomized controlled trial.

Background: There are data suggesting that passive leg raising (PLR) improves hemodynamics during cardiopulmonary resuscitation (CPR). This trial aimed to determine the effectiveness and safety of PLR during CPR in out-of-hospital cardiac arrest (OHCA).

Methods: We conducted a randomized controlled trial with blinded assessment of the outcomes that assigned adults OHCA to be treated with PLR or in the flat position.

Development and Utilization of a Medical Student Surgery Podcast During COVID-19.

Background: The 2019 coronavirus disease (COVID-19) pandemic drastically reduced learning opportunities for medical students. We sought to determine the cost and success of implementation of a podcast for a surgical department in a large academic hospital.

Methods: We created a podcast series for Israeli medical students during the COVID-19 epidemic based on the Medical Student Core Curriculum of the American College of Surgeons / Association for Surgical Education.

Prediction of a time-sensitive condition among patients with dizziness assessed by the emergency medical services.

Background: Dizziness is a relatively common symptom among patients who call for the emergency medical services (EMS).

Aim: To identify factors of importance for the early identification of a time-sensitive condition behind the symptom of dizziness among patients assessed by the EMS.

Methods: All patients assessed by the EMS and triaged using Rapid Emergency Triage and Treatment (RETTS) for adults code 11 (=dizziness) in the 660,000 inhabitants in the Municipality of Gothenburg, Sweden, in 2016, were considered for inclusion.

Evaluation and treatment of pain in the pre-hospital setting. A comparison between patients with a hip injury, chest pain and abdominal pain.

Background: A large proportion of patients who call 112 in Sweden do so because of pain. The purpose of this study was to compare three of the most common types of pain presented by the patients: chest pain, abdominal pain and hip injury, in terms of initial assessment, intensity, treatment and effect of treatment. The overall rationale was to evaluate whether the early assessment and treatment of pain in the pre-hospital setting is optimal or whether there is room for improvement.

Defining whole-grain foods - does it change estimations of intakes and associations with CVD risk factors: an Australian and Swedish perspective.

Historically, there are inconsistencies in the calculation of whole-grain intake, particularly through use of highly variable whole-grain food definitions. The current study aimed to determine the impact of using a whole-grain food definition on whole-grain intake estimation in Australian and Swedish national cohorts and investigate impacts on apparent associations with CVD risk factors. This utilised the Australian National Nutrition and Physical Activity Survey 2011-2012, the Swedish Riksmaten adults 2010-2011 and relevant food composition databases.

Prehospital lactate levels in blood as a seizure biomarker: A multi-center observational study.

Objective: The objective of this study was to assess the value of prehospital measurement of lactate level in blood for diagnosis of seizures in cases of transient loss of consciousness.

Methods: Between March 2018 and September 2019, prehospital lactate was measured with a point-of-care device by the emergency medical services in an area serving a population of 900 000. A total of 383 cases of transient loss of consciousness were identified and categorized as tonic-clonic seizure (TCS), other seizure, syncope, or other cause, according to the final diagnosis in the electronic medical records system.

Pre-hospital predictors of an adverse outcome among patients with dyspnoea as the main symptom assessed by pre-hospital emergency nurses - a retrospective observational study.

Background: Dyspnoea is one of the most common reasons for patients contacting emergency medical services (EMS). Pre-hospital Emergency Nurses (PENs) are independently responsible for advanced care and to meet these patients individual needs. Patients with dyspnoea constitute a complex group, with multiple different final diagnoses and with a high risk of death.

Difficulties in the prehospital assessment of patients with TIA/stroke.

Background: In patients with TIA/stroke, early assessment is critical.

Aim: To describe patients who were not directly transported to hospital by ambulance after prehospital assessment.

Methods: Patients hospitalized with TIA/stroke in Gothenburg, Data were obtained from the EMS and hospital case record system.