Electric scooters are a popular form of transportation, but accidents have increased with increased usage over the last years with rising health care costs as a consequence. This study aims to ...quantify accidents associated with the use of alcohol and to compare injuries at the emergency department (ED) among patients who have been involved in an accident involving an electric scooter. We used data from a multi-center retrospective registry-based cohort in the Swedish Traffic Accident Data Acquisition. We included all patients that had been involved in an electric scooter accident needing a visit to all EDs in Stockholm, Sweden during 2019-2020. Data on alcohol intake was manually drawn from medical files. Out of all of the 369 patients, the majority were men (n = 223, 60%) and aged below 30 years (n = 181, 49%). In all, 102 (28%) of the patients had a positive history of alcohol intake prior to the accident. Patients with alcohol intake more often arrived nighttime than those without alcohol, via ambulance (40% and 24%, respectively, p-value < 0.01). Those with alcohol intake needed to be admitted to hospital from the ED instead of being discharged more often than those withour alcohol (17% and 9%, respectively, p-value < 0.05) even if the majority still had minor injuries. Every 33,000 trips on electric scooters are statistically accompanied by an accident leading to an ED visit. We conclude that accidents with electric scooters are often associated with alcohol intake. They often demand more resources, such as an ambulance transfer and admission to hospital, and involve multiple injuries, compared to those without alcohol intake.
Staff in hospitals are encouraged to write up incident reports whenever they notice an incident. There are few published compilations of these reports from an in-hospital cardiac arrest (IHCA) ...perspective.
To describe content of incident reports over ten years in a two-sited university hospital in order to share knowledge and thereby being able to improve resuscitation systems in hospitals.
All incident reports between 2010–June 2023 written at Karolinska University Hospital contain the words “CPR”, “cardiac arrest”, “resuscitation”, Do-Not–attend-CPR” (DNACPR), “life-sustaining treatment” were included for analysis. Reports were grouped into larger themes.
In all 588 reports was identified automatically by the hospitals system based on the totally selected keywords. The largest category was “Life-sustaining treatment” with 178 (30%) reports and thereafter “Preventing care” (117, 20%) and “Material” (80, 14%).
Our hospital has clearly valued incident reports as a mean to track on-going issues and serious events over time as well as a source to trigger educational interventions. To improve patient safety, a standardized approach for compilation of reports and actions would be helpful when sharing knowledge between hospitals and with the resuscitation community.
Dispatch of lay volunteers trained in cardiopulmonary resuscitation (CPR) and equipped with automated external defibrillators (AEDs) may improve survival in cases of out-of-hospital cardiac arrest ...(OHCA). The aim of this study was to investigate the functionality and performance of a smartphone application for locating and alerting nearby trained laymen/women in cases of OHCA.
A system using a smartphone application activated by Emergency Dispatch Centres was used to locate and alert laymen/women to nearby suspected OHCAs. Lay responders were instructed either to perform CPR or collect a nearby AED. An online survey was carried out among the responders.
From February to August 2016, the system was activated in 685 cases of suspected OHCA. Among these, 224 cases were Emergency Medical Services (EMSs)-treated OHCAs (33%). EMS-witnessed cases (n = 11) and cases with missing survey data (n = 15) were excluded. In the remaining 198 OHCAs, lay responders arrived at the scene in 116 cases (58%), and prior to EMSs in 51 cases (26%). An AED was attached in 17 cases (9%) and 4 (2%) were defibrillated. Lay responders performed CPR in 54 cases (27%). Median distance to the OHCA was 560 m (IQR 332–860 m), and 1280 m (IQR 748–1776 m) via AED pick-up. The survey-answering rate was 82%.
A smartphone application can be used to alert CPR-trained lay volunteers to OHCAs for CPR. Further improvements are needed to shorten the time to defibrillation before EMS arrival.
Abstract Background Patients treated with curatively intended surgery for oesophageal cancer have an approximately 30% chance of 5-year survival. Little is known about associations between ...postoperative health-related quality of life (HRQL) and long-term survival. Hypothesis Poor postoperative HRQL after curatively intended oesophageal cancer surgery is associated with a reduced long-term survival. Methods A Swedish nationwide cohort of oesophageal cancer patients, treated surgically between 2001 and 2005, was followed up until death or end of August 2009. Nine HRQL aspects were selected for analyses from EORTC QLQ-C30 and QLQ-OES18 questionnaires answered 6 months postoperatively. The HRQL measures were categorised into two groups: ‘good function’ versus ‘poor function’ and ‘no or minor symptoms’ versus ‘symptomatic’. Associations between HRQL and survival were analysed using Cox proportional hazard ratios (HR) and 95% confidence intervals (CIs), adjusted for potential confounding factors. Findings All 401 oesophageal cancer patients who survived at least 6 months postoperatively and responded to the questionnaires were included. For each of the nine selected outcomes, poor scores were associated with an increased hazard ratio of mortality: global HRQL (HR = 1.55; 95% CI 1.19–2:02), physical function (HR = 1.56; 95% CI 1.23–1.99), social function (HR = 1.52; 95% CI 1.19–1.94), fatigue (HR = 1.65; 95% CI 1.30–2.11), pain (HR = 1.45; 95% CI 1.22–1.87), dyspnoea (HR = 1.54; 95% CI 1.19–2.01), appetite loss (HR = 1.69; 95% CI 1.32–2.14), dysphagia (HR = 1.69; 95% CI 1.13–2.51) and oesophageal pain (HR = 1.29; 95% CI 1.02–1.65). Interpretations HRQL assessed 6 months after oesophageal cancer surgery can be used as a clinically useful prognostic factor.
Recently, ILCOR unveiled the ground-breaking global initiative “Ten Steps Toward Improving In-Hospital Cardiac Arrest” (IHCA).
To generate a baseline of how well the ten steps currently function in ...Sweden, in order to better target educational interventions.
A survey was created using an online form application (Google Forms) and sent to CPR coordinators and physicians in charge of CPR at all 74 Swedish hospitals participating in the Swedish Registry for Cardiopulmonary Resuscitation (SRCR). Hospitals were asked to self-evaluate their functionality on each step on a ten-point scale ranging from 1 “Not present or not functioning at all” to 10 “Very well-functioning”. Data regarding number of IHCA and their survival during 2018–2022 was gathered from the SRCR.
A total of 34 out of 74 (46%) Swedish hospitals participated in the survey, collectively representing 59% (7,113 out of 12,070) of IHCA cases in SRCR. The responding hospitals were satisfied with the functionality of just over half of the steps currently (median 60%, range 30–90%). The steps with the highest proportion of satisfied hospitals were found for step 6-rapid response systems (85%) and 7-guideline-based resuscitation (94%), while the steps with lowest proportion of satisfied hospitals were found for step 4-goals of treatment (32%) and step 9-person centred culture (18%). About half of participating hospitals expressed intent to prioritise upcoming years’ work on step 1- infrastructure, step 3- effective education and step 5- stop preventable IHCA.
The conclusion is that most hospitals judge themselves to be well-functioning on many of the ten steps, but steps involving effective education might need attention, as well as the tolerance for presence of preventable IHCA being low.
There is evidence that emergency department (ED) crowding is associated with increased mortality, however large multicenter studies of high quality are scarce. In a prior study, we introduced a ...proxy-measure for crowding that was associated with increased mortality. The national registry SVAR enables us to study the association in a more heterogenous group of EDs with more recent data. The aim is to investigate the association between ED crowding and mortality.
This was an observational cohort study including visits from 14 EDs in Sweden 2015-2019. Crowding was defined as the mean ED-census divided with expected ED-census during the work-shift that the patient arrived. The crowding exposure was categorized in three groups: low, moderate and high. Hazard ratios (HR) for mortality within 7 and 30 days were estimated with a cox proportional hazards model. The model was adjusted for age, sex, triage priority, arrival hour, weekend, arrival mode and chief complaint. Subgroup analysis by county and for admitted patients by county were performed.
2,440,392 visits from 1,142,631 unique patients were analysed. A significant association was found between crowding and 7-day mortality but not with 30-day mortality. Subgroup analysis also yielded mixed results with a clear association in only one of the three counties. The estimated HR (95% CI) for 30-day mortality for admitted patients in this county was 1.06 (1.01-1.12) in the moderate crowding category, and 1.11 (1.01-1.22) in the high category.
The association between crowding and mortality may not be universal. Factors that influence the association between crowding and mortality at different EDs are still unknown but a high hospital bed occupancy, impacting admitted patients may play a role.
Telemedicine for otolaryngological assessments Smedbäck, Johan; Ilicki, Jonathan; Perdahl, Tobias ...
American journal of otolaryngology,
11/2021, Letnik:
42, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Interestingly, Sclafani et al. reported that physicians in all were less satisfied with their ability to make a correct diagnosis in a telemedicine consultation in comparison to an in-person ...assessment. ...for the telemedicine consultation the patient history was collected by an automated digital triage system, which collates a detailed patient history. Future research on these challenges would be valuable in order to understand how to improve diagnostic accuracy and physician trust in telemedicine assessments.Copyright transfer statement In consideration of the American Journal of Otolaryngology's reviewing and editing my submission, the authors undersigned transfers, assigns and otherwise conveys all copyright ownership to Elsevier Inc. in the event that such work is published in the American Journal of Otolaryngology.CRediT authorship contribution statement Johan Smedbäck: Methodology, Data curation, Formal Analysis, Investigation, Writing – original draft.
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