66 results match your criteria: "Prehospital Research Unit[Affiliation]"

Ethical challenges are integral to health care and are associated with moral distress among health professionals. Moral distress can turn into burnout with a range of negative effects for professionals, patients, relatives, collaborators, and the organisation. Based on action research a focus group study was conducted inclucing prehospital personnel from the emergency services in the Region of Southern Denmark.

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Background: The prehospital use of blood lactate measurements is increasing. However, the test's benefits have not been methodically evaluated in non-trauma patients. This study had three aims: (1) To assess the evidence of prehospital blood lactate measurements' prognostic value in non-trauma patients, (2) to investigate to what extent the test changed early patient treatment, and (3) to evaluate the healthcare personnel's attitude towards the test.

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Background: Workplace violence against healthcare workers has been a well-known problem for more than 40 years. This problem is also relevant for prehospital personnel who are at risk of physical and/or psychological violence during work. Violence and threats of violence can have physical and psychological consequences, including personal challenges in their everyday life, use of sick days, reports, and the need for professional help.

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Importance: Early administration of supplemental oxygen for all severely injured trauma patients is recommended, but liberal oxygen treatment has been associated with increased risk of death and respiratory complications.

Objective: To determine whether an early 8-hour restrictive oxygen strategy compared with a liberal oxygen strategy in adult trauma patients would reduce death and/or major respiratory complications.

Design, Setting, And Participants: This randomized controlled trial enrolled adult trauma patients transferred directly to hospitals, triggering a full trauma team activation with an anticipated hospital stay of a minimum of 24 hours from December 7, 2021, to September 12, 2023.

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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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Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest.

N Engl J Med

October 2024

From Prehospital Emergency Medical Services, Central Denmark Region (M.F.V., A.L.P., A.H.P., S.W., L.W.F., C.M., K.B.W., A.B., T.H.D., L.K.R., L.R.M., M.L.L., T.E., A.G.N., C.R., L.W.A.), the Department of Clinical Medicine, Aarhus University (M.F.V., A.G., C.J.T., S.C., L.W.A.), and the Departments of Anesthesiology and Intensive Care (A.G., M.J.H., T.H.D., S.C., C.G.N., B.S., L.W.A.), Cardiology (C.J.T.), and Radiology (E.K.), Aarhus University Hospital, Aarhus, the Department of Anesthesiology and Intensive Care, Aalborg University Hospital (T.L.K., F.M.N.), the Center for Prehospital and Emergency Research, Department of Clinical Medicine, Aalborg University and Aalborg University Hospital (E.F.C.), and Emergency Medical Services, North Denmark Region (P.B.), Aalborg, the Prehospital Research Unit (S.M., P.M.H.) and Emergency Medical Services (J.H.H., M.B., L.-G.R.N., M.P., G.K.-A., P.M.H.), Region of Southern Denmark, the Department of Anesthesiology and Intensive Care, Odense University Hospital (J.H.H., M.B.), and the Department of Regional Health Research, University of Southern Denmark (A.C.B.), Odense, the Departments of Cardiology (F.F.) and of Anesthesiology and Intensive Care (L.R.), Copenhagen University Hospital, Gentofte Copenhagen University Hospital-Emergency Medical Services, Ballerup (F.F., J.W.B., H.A., S.H., T.H.F.), the Department of Clinical Medicine, University of Copenhagen (F.F., H.C.C., L.R., M.K.), and the Department of Cardiology, the Heart Center, Copenhagen University Hospital, Rigshospitalet (L.E.R.O., S.L.D.H.), Copenhagen, the Prehospital Center, Region Zealand, Næstved (H.C.C.), the Department of Anesthesiology and Intensive Care, Gødstrup Regional Hospital, Gødstrup (L.K.R.), the Department of Anesthesiology and Intensive Care, Randers Regional Hospital, Randers (L.R.M., T.E.), the Department of Anesthesiology and Intensive Care, Viborg Regional Hospital, Viborg (A.G.N.), the Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg (C.R.), the Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Esbjerg and Grindsted, Esbjerg (L.-G.R.N.), the Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding (M.P., A.C.B.), the Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Aabenraa (G.K.-A.), the Department of Anesthesiology and Intensive Care, Svendborg Hospital, Svendborg (P.M.H.), the Department of Anesthesiology and Intensive Care, Copenhagen University Hospital, Herlev (H.A.), the Department of Anesthesiology and Intensive Care, Copenhagen University Hospital-North Zealand, Hillerød (S.H.), the Department of Anesthesiology and Intensive Care, Zealand University Hospital, Køge (J.U.H.B.), the Department of Anesthesiology and Intensive Care, Nykøbing Falster Hospital, Nykøbing Falster (K.J.), the Department of Anesthesiology and Intensive Care, Holbæk Hospital, Holbæk (M.K.), and the Department of Anesthesiology and Intensive Care, Slagelse Hospital, Slagelse (M.S.) - all in Denmark.

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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Clinicians' attitudes towards supplemental oxygen for trauma patients - A survey.

Injury

January 2025

Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 6, 2100 Copenhagen, Denmark; Danish Air Ambulance, Brendstrupgårdsvej 7, 8200 Aarhus N, Denmark; Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Faculty of Health, Aarhus University, Vennelyst Blvd. 4, 8000 Aarhus, Denmark. Electronic address:

Article Synopsis
  • - The ATLS (2018) guidelines recommend providing supplemental oxygen to all severely injured trauma patients to prevent low blood oxygen levels, but this practice may risk causing excessive oxygen levels, which could lead to increased mortality and complications.
  • - A survey of 707 clinicians, predominantly from Denmark and mostly physicians, revealed that 73% do not believe supplemental oxygen should be given universally to severely injured trauma patients without considering their oxygen saturation levels.
  • - Respondents indicated that the average initial oxygen dosage for trauma patients with normal oxygen saturation was 0 liters per minute, with 58% choosing not to give supplemental oxygen at all, and the lowest acceptable oxygen saturation target was 94%.
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Patients' use of Danish emergency medical services before and during the COVID-19 pandemic: a register-based study.

Scand J Trauma Resusc Emerg Med

September 2024

Department of Anaesthesiol. Intens. Care Med., The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark.

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: Inter-hospital transfer is necessary for the transport of patients to specialized treatment. Rotor-wing aircraft may be used in lieu of ambulances in time-critical conditions over long distances and when specialist team skills are called for. The purpose of the review is to assess the current scientific literature that describes the scenario to develop a national guideline for inter-hospital transfers using rotor-wing aircraft.

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Background: Life-threatening conditions are infrequent in children. Current literature in paediatric prehospital research is centred around trauma and paediatric out-of-hospital cardiac arrests (POHCA). The aims of this study were to (1) outline the distribution of trauma, POHCA or other medical symptoms among survivors and non-survivors after paediatric emergency calls, and (2) to investigate these clinical presentations' association with mortality in children with and without pre-existing comorbidity, respectively.

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Background: Ethical challenges constitute an inseparable part of daily decision-making processes in all areas of healthcare. Ethical challenges are associated with moral distress that can lead to burnout. Clinical ethics support has proven useful to address and manage such challenges.

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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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Anaphylaxis is an allergic manifestation characterised by rapid onset and progression. Rapid treatment may be challenging in patients with atypical symptoms or no previous history of anaphylaxis. This study aimed to describe the clinical prehospital presentation of first-time anaphylactic patients.

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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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Prehospital and In-Hospital Treatment with Adrenaline and Related Prognosis in Anaphylaxis Patients.

Int Arch Allergy Immunol

July 2024

Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense, Denmark.

Introduction: Although intramuscular adrenaline is the recommended first-line treatment for anaphylaxis, not all patients receive this treatment. The consequences in daily clinical practice are sparsely described. This study aimed to investigate the treatment administered to anaphylactic patients and the related prognosis.

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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: The prehospital patients treated by ambulances and mobile emergency care units (MECU) are potentially critically ill or injured. Knowing the risks of serious outcomes in these patients is important for guiding their treatment. Some settings allow for prehospital arterial blood gas analyses.

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Background And Importance: Traumatic cardiac arrest is associated with poor prognosis, and timely evidence-based treatment is paramount for increasing survival rates. Physician-staffed helicopter emergency medical service use in major trauma has demonstrated improved outcomes. However, the sparsity of data highlights the necessity for a comprehensive understanding of the epidemiology of traumatic cardiac arrest.

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Here we report the results of a study on the association between drug delivery via intravenous route or intraosseous route in out-of-hospital cardiac arrest. Intraosseous drug delivery is considered an alternative option in resuscitation if intravenous access is difficult or impossible. Intraosseous uptake of drugs may, however, be compromised.

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Background: Volunteer First Responders are used worldwide. In the Region of Southern Denmark, two types of programs have been established. One of these programs consists of voluntary responders without any requirements of education or training who are summoned to prehospital cardiac arrests.

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The Field's mass shooting: emergency medical services response.

Scand J Trauma Resusc Emerg Med

November 2023

Copenhagen Emergency Medical Services, Ballerup, Denmark.

Background: Major incidents (MI) happen infrequently in Scandinavia and mass shootings are even less frequently occurring. Case reports and research are called for, as literature is scarce. On 3rd July 2022, a mass shooting took place at the shopping mall Field's in Copenhagen, Denmark.

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Background: Without accurate documentation, it can be difficult to assess the quality of care and the impact of quality improvement initiatives. Prehospital lack of documentation of the basic measurements is associated with a twofold risk of mortality. The aim of this study was to investigate data quality in the electronic prehospital patient record (ePPR) system in the Region of Southern Denmark.

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Article Synopsis
  • * The study will follow established protocols for systematic reviews, considering various study designs and languages, to ensure a comprehensive analysis of the existing literature.
  • * Findings will be published in a peer-reviewed journal and presented at conferences, providing valuable insights for optimizing emergency response strategies and resource allocation in healthcare.
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Importance: Despite some promising preclinical and clinical data, it remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective treatment for acute stroke.

Objective: To evaluate the effect of RIC when initiated in the prehospital setting and continued in the hospital on functional outcome in patients with acute stroke.

Design, Setting, And Participants: This was a randomized clinical trial conducted at 4 stroke centers in Denmark that included 1500 patients with prehospital stroke symptoms for less than 4 hours (enrolled March 16, 2018, to November 11, 2022; final follow-up, February 3, 2023).

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Communication in Sudden-Onset Major Incidents: Patterns and Challenges-Scoping Review.

Disaster Med Public Health Prep

September 2023

Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.

Objective: To identify and describe patterns and challenges in communication in sudden-onset major incidents.

Methods: Systematic scoping review according to Joanna Briggs Institute and PRISMA-ScR guidelines. Data sources included Cochrane Library, EMBASE, PubMed/MEDLINE, Scopus, SweMed+, Web of Science, and Google Scholar.

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