Publications by authors named "Helle C Christensen"

Background: Improving prehospital emergency care requires a comprehensive understanding of the efficiency of emergency medical services and demand fluctuations. The medical emergency call is the primary contact between citizens and the emergency medical dispatch center, serving as the gateway to accessing emergency assistance. This study aimed to characterize the emergency call population and analyze the development of emergency call utilization in Region Zealand in Denmark during a 10-years period.

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Background: Good outcomes in stroke care require swift diagnostics, for which magnetic resonance imaging (MRI) as first-line brain imaging is superior to computed tomography scans. Reduced length of stay (LOS) in hospital and emergency departments (ED) may optimize resource use. Fast-track stroke MRI was implemented as the primary imaging technique for suspected stroke, in the ED at Copenhagen University Hospital-Herlev and Gentofte in 2020.

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Background: The guidelines for Advanced Life Support issued by the European Resuscitation Council recommend considering drug delivery through intraosseous access if intravenous access to the vascular bed is not feasible or unsuccessful. Emergency prehospital intraosseous cannulation may theoretically lead to an increased risk of long-term complications such as osteomyelitis, osteonecrosis, or compartment syndrome. Such complications have previously been reported in case reports or small sample case series.

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Background: Telehealth has become increasingly essential in healthcare provision, also in the Prehospital Emergency Medical Services (EMS), where live video is implemented as a supplemental tool to assess and triage medical emergency calls. So far, using video for emergency calls seems beneficial for patient assessment and dispatcher-assisted first aid. However, the EMS dispatchers' experiences with and perceptions of using video during emergency calls are largely unexplored.

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Background: The global strain on Emergency Medical Services (EMS) is reflected in the increasing number of emergency ambulance dispatches. Shorter EMS response times have demonstrated some effect on very specific and rare conditions. It is unknown if the increased number of ambulance dispatches compromises response times.

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Article Synopsis
  • Out-of-hospital cardiac arrest is a major global health issue, necessitating effective vascular access for drug administration during resuscitation.
  • A clinical trial comparing intraosseous and intravenous methods found that both had similar effectiveness for restoring circulation, with around 30% of patients in each group succeeding.
  • At 30 days post-arrest, survival rates and favorable neurologic outcomes also showed no significant differences between the two methods, indicating both approaches are equally viable.
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Background: Chest pain is a frequent cause of health care contacts. We examined the prehospital management, in-hospital discharge diagnoses, and mortality of patients calling a non-emergency and emergency medical service with chest pain.

Methods: The Copenhagen Emergency Medical Services (EMS) consists of a non-emergency medical helpline (calls to 1813) and emergency medical service (1-1-2 calls).

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Background: Ongoing opioid treatment can potentially modify symptoms of myocardial infarction (MI) and cause a lack of recognition and treatment delay.

Objectives: The purpose of this study was to examine MI symptoms and the time to hospitalization for patients in ongoing opioid treatment compared to patients without ongoing opioid treatment.

Methods: We evaluated calls to the Copenhagen Emergency Medical Services in Denmark from 2014 to 2018.

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Background: During the COVID-19 pandemic, disturbing images of ambulances unable to respond to the demands for prehospital assistance appeared from several parts of the world. In Denmark, however, a notion occurred that the demands for emergency medical assistance declined. The purpose of this study was to compare the patients' use of the Danish Emergency Medical Services (EMS) before and during the COVID-19 pandemic.

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Background: Trauma systems are crucial for enhancing survival and quality of life for trauma patients. Understanding trauma triage and patient outcomes is essential for optimizing resource allocation and trauma care.

Aims: The aim was to explore prehospital trauma triage in Region Zealand, Denmark.

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Importance: In patients with ST-segment elevation myocardial infarction (STEMI), acute inflammation is related to the extent of myocardial damage and may increase infarct size. Thus, administration of pulse-dose glucocorticoid in the very early phase of infarction may reduce infarct size.

Objective: To determine the cardioprotective effect of prehospital pulse-dose glucocorticoid in patients with STEMI.

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Article Synopsis
  • This study examined cardiovascular screening in patients with ANCA-associated vasculitis (AAV) and found higher rates of ECG abnormalities compared to matched controls.
  • A total of 1431 AAV patients were analyzed, revealing a significant link between major ECG abnormalities and increased cardiovascular mortality risk.
  • The findings suggest incorporating ECG assessments into regular care for AAV patients to better manage their cardiovascular health.
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  • Early percutaneous coronary intervention (PCI) is crucial for treating STEMI, yet the impact of delays in PCI timing has not been thoroughly evaluated.
  • A study in Copenhagen analyzed the effects of delays caused by system factors or hospital distance on outcomes for STEMI patients, finding significant differences based on time from distress call to PCI.
  • Results showed that delays over one hour substantially increased the risk of death, recurrent heart attacks, or heart failure, highlighting the importance of reducing the time from the first contact to PCI for better patient outcomes.
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Objectives: Call-takers face a complex situation when assessing medical problems in emergency medical services calls. Patients with myocardial infarction experiencing atypical symptoms risk misinterpretation. We examined development in call-takers' decision-making process in telephone consultations with patients having imminent myocardial infarction.

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Objectives: In Denmark, the use of bicycles is widespread, and head injuries are often seen in cyclists involved in collisions. Despite the well-known effects of using a helmet to reduce head injuries, using helmets is not mandatory in Denmark. The primary objective of this study was to provide data regarding injury outcomes and helmet usage.

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Non-conveyance refers to the practice of treating a patient on-site without transporting them to a medical facility. It may decrease unnecessary hospital transfers and improve patient satisfaction. Nonetheless, ensuring patient safety remains paramount.

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This study used demographic data in a novel prediction model to identify areas with high risk of out-of-hospital cardiac arrest (OHCA) in order to target prehospital preparedness. We combined data from the nationwide Danish Cardiac Arrest Registry with geographical- and demographic data on a hectare level. Hectares were classified in a hierarchy according to characteristics and pooled to square kilometers (km2).

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Background: Defibrillation is essential for achieving return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (OHCA) with shockable rhythms. This study aimed to investigate if the type of defibrillator used was associated with ROSC in OHCA.

Methods And Results: This study included adult patients with OHCA from the Danish Cardiac Arrest Registry from 2016 to 2021 with at least 1 defibrillation by the emergency medical services.

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Background: Foreign body airway obstruction (FBAO) stands as an important contributor to accidental fatalities, yet prompt bystander interventions have been shown to improve survival. This study aimed to evaluate the incidence, interventions, and survival outcomes of patients with out-of-hospital cardiac arrest (OHCA) related to FBAO in comparison to patients with non-FBAO OHCA.

Methods: In this population-based cohort study, we included all OHCAs in Denmark from 2016 to 2022.

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Background: Improving oxygenation and ventilation in drowning patients early in the field is critical and may be lifesaving. The critical care interventions performed by physicians in drowning management are poorly described. The aim was to describe patient characteristics and critical care interventions with 30-day mortality as the primary outcome in drowning patients treated by the Danish Air Ambulance.

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Article Synopsis
  • Out-of-hospital cardiac arrest (OHCA) is a common and deadly event in Denmark, with around 5000 cases annually, and survival within 30 days is linked to symptoms experienced before the event.
  • The study focused on OHCAs witnessed by emergency medical services in Denmark from 2016-2018, analyzing data to assess the survival odds related to prodromal complaints while considering factors like age and sex.
  • Results indicated that symptoms like chest pain and heart palpitations significantly improved survival odds, whereas signs of unresponsiveness or bluish skin reduced the likelihood of surviving 30 days post-arrest.
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The electrocardiogram (ECG) is a non-invasive diagnostic tool holding significant clinical importance in the diagnosis and risk stratification of cardiac disease. However, access to large-scale, population-based digital ECG data for research purposes remains limited and challenging. Consequently, we established the Danish Nationwide ECG Cohort to provide data from standard 12-lead digital ECGs in both pre- and in-hospital settings, which can be linked to comprehensive Danish nationwide administrative registers on health and social data with long-term follow-up.

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Purpose: Stroke treatments are time-sensitive, and thus early and correct recognition of stroke by Emergency Medical Services is essential for outcomes. This is particularly important with the adaption of mobile stroke units. In this systematic review, we therefore aimed to provide a comprehensive overview of Emergency Medical Services dispatcher recognition of stroke.

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Advanced stroke treatment is time-dependent and, therefore, relies on recognition by call-takers at prehospital telehealth services to ensure fast hospitalisation. This study aims to develop and assess the potential of machine learning in improving prehospital stroke recognition during medical helpline calls. We used calls from 1 January 2015 to 31 December 2020 in Copenhagen to develop a machine learning-based classification pipeline.

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