A randomized clinical trial of intranasal dexmedetomidine versus inhaled nitrous oxide for procedural sedation and analgesia in children.

Background: Procedural sedation and analgesia is an important part of pediatric emergency care, safe and clinically useful alternatives for adequate management are necessary. The objective of this clinical trial was to evaluate the non-inferiority of intranasal dexmedetomidine to nitrous oxide with respect to analgesia for a painful procedure in children 3-15 years of age.

Methods: This prospective, equally randomized, open-label, non-inferiority trial was conducted at a Pediatric Emergency Department.

Serious conditions among conveyed and non-conveyed patients presenting with nonspecific chief complaints to the ambulance service.

Background: It is a challenge for the ambulance service to identify which patients to convey to the emergency department (ED). Ideally this would be the patients with serious conditions requiring further care in the ED. However, patients presenting with non-specific chief complaints are difficult to prioritize and typically have normal or near normal vital signs despite up to one third having underlying serious conditions.

Exploring the circulating metabolome of sepsis: metabolomic and lipidomic profiles sampled in the ambulance.

Background: Sepsis is defined as a dysfunctional host response to infection. The diverse clinical presentations of sepsis pose diagnostic challenges and there is a demand for enhanced diagnostic markers for sepsis as well as an understanding of the underlying pathological mechanisms involved in sepsis. From this perspective, metabolomics has emerged as a potentially valuable tool for aiding in the early identification of sepsis that could highlight key metabolic pathways and underlying pathological mechanisms.

Valued technical and non-technical skills among disaster responders: a cross sectional study of disaster responders involved in the earthquake in Türkiye and Syria January 2023.

Introduction: Disaster responders are an important part of disaster response. However, despite large efforts to train disaster responders, there is a limited scientific knowledge regarding which competences and skills such responders value and lack during a real mission. The aim of this study was to investigate used and needed skills among disaster responders responding to the earthquake in Türkiye and Syria 2023 METHODS: A cross-sectional study using a non-randomized sample was conducted, collected between March and July, 2023.

One year cumulative incidence and risk factors associated with workplace violence within the ambulance service in a Swedish region: a prospective cohort study.

Objective: To measure the 1 year cumulative incidence of and analyse the risk factors associated with workplace violence directed towards the ambulance service in a Swedish region.

Design: Prospective cohort study.

Setting: The ambulance services in Örebro County Council (Sweden) contain approximately 300 000 inhabitants.

Patient-centered outcomes and outcome measurements for people aged 65 years and older-a scoping review.

Introduction: The aging population is a challenge for the healthcare system that must identify strategies that meet their needs. Practicing patient-centered care has been shown beneficial for this patient-group. The effect of patient-centered care is called patient-centered outcomes and can be appraised using outcomes measurements.

Recommendations for blood sampling in emergency departments from the European Society for Emergency Medicine (EUSEM), European Society for Emergency Nursing (EuSEN), and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase. Executive summary.

Aim: Blood Sampling Guidelines have been developed to target European emergency medicine-related professionals involved in the blood sampling process (e.g. physicians, nurses, phlebotomists working in the ED), as well as laboratory physicians and other related professionals.

Non-technical skills needed by medical disaster responders- a scoping review.

Background: There is no universal agreement on what competence in disaster medicine is, nor what competences and personal attributes add value for disaster responders. Some studies suggest that disaster responders need not only technical skills but also non-technical skills. Consensus of which non-technical skills are needed and how training for these can be provided is lacking, and little is known about how to apply knowledge of non-technical skills in the recruitment of disaster responders.

A randomized double-blind trial of intranasal dexmedetomidine versus intranasal esketamine for procedural sedation and analgesia in young children.

Background: Procedural sedation and analgesia are commonly used in the Emergency Departments. Despite this common need, there is still a lack of options for adequate and safe analgesia and sedation in children. The objective of this study was to evaluate whether intranasal dexmedetomidine could provide more effective analgesia and sedation during a procedure than intranasal esketamine.

Dynamic ambulance relocation: a scoping review.

Objectives: Dynamic ambulance relocation means that the operators at a dispatch centre place an ambulance in a temporary location, with the goal of optimising coverage and response times in future medical emergencies. This study aimed to scope the current research on dynamic ambulance relocation.

Design: A scoping review was conducted using a structured search in PubMed, Scopus and Web of Science.

A Retrospective Geospatial Simulation Study of Helicopter Emergency Medical Services' Potential Time Benefit Over Ground Ambulance Transport in Northern South Africa.

Objective: One of the most important benefits of helicopter emergency medical services (HEMS) is a time benefit, either through expedited access to the casualty or a reduction in the transport time to definitive care. However, HEMS utilization does not come without risk to the public and crew or at an insignificant cost. Cost is an essential consideration for health policy decisions, especially in low- to middle-income countries, such as South Africa.

Predicting sepsis using a combination of clinical information and molecular immune markers sampled in the ambulance.

Sepsis is a time dependent condition. Screening tools based on clinical parameters have been shown to increase the identification of sepsis. The aim of current study was to evaluate the additional predictive value of immunological molecular markers to our previously developed prehospital screening tools.

The burden of critical illness among adults in a Swedish region-a population-based point-prevalence study.

Background: Patients with critical illness have a high risk of mortality. Key decision-making in the health system affecting the outcomes of critically ill patients requires epidemiological evidence, but the burden of critical illness is largely unknown. This study aimed to estimate the prevalence of critical illness in a Swedish region.

The Association between Emergency Department Length of Stay and In-Hospital Mortality in Older Patients Using Machine Learning: An Observational Cohort Study.

The association between emergency department (ED) length of stay (EDLOS) with in-hospital mortality (IHM) in older patients remains unclear. This retrospective study aims to delineate the relationship between EDLOS and IHM in elderly patients. From the ED patients (n = 383,586) who visited an urban academic tertiary care medical center from January 2010 to December 2016, 78,478 older patients (age ≥60 years) were identified and stratified into three age subgroups: 60-74 (early elderly), 75-89 (late elderly), and ≥90 years (longevous elderly).

Design of a national patient-centred clinical pathway for sepsis in Sweden.

Background: The World Health Organization has adopted a resolution on sepsis and urged member states to develop national processes to improve sepsis care. In Sweden, sepsis was selected as one of the ten first diagnoses to be addressed, when the Swedish government in 2019 allocated funds for patient-centred clinical pathways in healthcare. A national multidisciplinary working group, including a patient representative, was appointed to develop the patient-centred clinical pathway for sepsis.

Length-of-Stay in the Emergency Department and In-Hospital Mortality: A Systematic Review and Meta-Analysis.

The effect of emergency department (ED) length of stay (EDLOS) on in-hospital mortality (IHM) remains unclear. The aim of this systematic review and meta-analysis was to determine the association between EDLOS and IHM. We searched the PubMed, Medline, Embase, Web of Science, Cochrane Controlled Register of Trials, CINAHL, PsycInfo, and Scopus databases from their inception until 14−15 January 2022.

Presentation of the septic patient to the emergency department with respect to age and sex - a retrospective cross-sectional study.

Objective: It is challenging to identify sepsis in the emergency department, in part due to the non-specific presentation of septic patients. Current clinical sepsis screening tools rely on vital signs but many patients present with near normal vital signs and are therefore not identified as septic. This suggests that variables, e.

Association between variables measured in the ambulance and in-hospital mortality among adult patients with and without infection: a prospective cohort study.

Background: Patients presenting with infection to the ambulance are common, but risk factors for poor outcome are not known. The primary aim of the current study was to study the association between variables measured in the ambulance and mortality among adult patients with and without infection. The secondary aim was to study the association between these variables and mortality in a subgroup of patients who developed sepsis within 36 h.

Experiences of exposure to workplace violence among ambulance personnel.

Background: Despite an increased occurrence of workplace violence within the ambulance services, little is known about being exposed for such incidents. The aim of this study was to explore ambulance personnel's experiences of workplace violence.

Method: Interviews with 15 Swedish ambulance personnel was conducted and analyzed using content analysis.

An observational pilot study: Prevalence and cost of high frequency emergency department users at Örebro University Hospital, Sweden.

Background: There is little research on high frequency emergency department users (HEDU) in Sweden. We aim to determine the prevalence and costs of HEDU compared to non-HEDU at Örebro University Hospital (ÖUH). Additionally, we will determine the factors and outcomes associated with being a HEDU.

Emergency medical dispatchers' experiences of managing emergency calls: a qualitative interview study.

Objectives: To explore the emergency medical dispatchers (EMDs) experiences of managing emergency medical calls.

Design: A qualitative interview study with an inductive approach. EMDs were interviewed individually using a semistructured interview guide.

Pathways to the emergency department - a national, cross-sectional study in Sweden.

Background: Swedish Emergency Departments (EDs) see 2.6 million visits annually. Sweden has a strong tradition of health care databases, but information on patients' pathways to the ED is not documented in any registry.

Facilitators and Barriers for Effective Staff Work in Swedish National Governmental Crisis Response to the COVID-19 Pandemic.

Objectives: The coronavirus disease (COVID-19) crisis response in Sweden was managed foremost by a collaboration of several national agencies. Normally, their strategical and operational collaboration is limited, but the pandemic required new and unfamiliar collaborations. This study aimed to clarify the facilitators and barriers of perceived effective staff work within and between 4 national agencies.