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170 records – page 1 of 17.

[58 people with bullet wounds in Gothenburg during 18 months. This demonstrates the need for preparedness and competence within trauma care].

https://arctichealth.org/en/permalink/ahliterature273221
Source
Lakartidningen. 2015;112
Publication Type
Article
Date
2015
Author
Björn Holmström
Sven Alhbin
David Pazooki
Hans Granhed
Source
Lakartidningen. 2015;112
Date
2015
Language
Swedish
Publication Type
Article
Keywords
Adolescent
Adult
After-Hours Care
Aged
Blood pressure
Clinical Competence
Emergency Medical Services - standards
Health Care Costs
Humans
Injury Severity Score
Length of Stay
Male
Middle Aged
Retrospective Studies
Sweden - epidemiology
Wounds, Gunshot - economics - epidemiology - mortality
Abstract
From 1 January 2013 to 30 June 2014, 58 patients sustained gunshot wounds in the city of Gothenburg. 57 were males and the median age was 26 years. The majority of injuries were musculoskeletal. Ten patients died, of these 4 patients suffered single gunshot wounds to the head, while 6 patients had wounds to mediastinal structures and large abdominal vessels. 90 % of patients presented out-of-hours. The total length of stay for the 47 patients admitted was 316 days. Direct health care costs were calculated to 6.2 MSEK.
PubMed ID
26173141 View in PubMed
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The 2004 ACC/AHA Guidelines: a perspective and adaptation for Canada by the Canadian Cardiovascular Society Working Group.

https://arctichealth.org/en/permalink/ahliterature178142
Source
Can J Cardiol. 2004 Sep;20(11):1075-9
Publication Type
Article
Date
Sep-2004
Author
Paul W Armstrong
Peter Bogaty
Christopher E Buller
Paul Dorian
Blair J O'Neill
Author Affiliation
VIGOUR Centre, University of Alberta, Edmonton. paul.armstrong@ualberta.ca
Source
Can J Cardiol. 2004 Sep;20(11):1075-9
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Canada
Defibrillators, Implantable - standards
Electrocardiography
Emergency Medical Services - standards
Emergency Service, Hospital - standards
Female
Guideline Adherence
Humans
Male
Myocardial Infarction - diagnosis - therapy
Myocardial Reperfusion - standards
Severity of Illness Index
Survival Analysis
Treatment Outcome
Abstract
Major changes in acute ST elevation myocardial infarction (STEMI) management prompted a comprehensive rewriting of the American College of Cardiology/American Heart Association Guidelines. The Canadian Cardiovascular Society (CCS) participated in both the writing process and the external review. Subsequently, a Canadian Working Group (CWG), formed under the auspices of the CCS, developed a perspective and adaptation for Canada. Herein, accounting for specific realities of the Canadian cardiovascular health system, is a discussion of the implications for prehospital care and transport, optimal reperfusion therapy and an approach to decision making regarding reperfusion options and invasive therapy following fibrinolytic therapy. Major recent developments regarding indications for implantable cardioverter defibrillator(s) (ICDs) also prompted a review of indications for ICDs and the optimal timing of implantation given the potential for recovery of left ventricular function. At least a 40-day, preferably a 12-week, waiting period was judged to be optimal to evaluate left ventricular function post-STEMI. A recommended algorithm for the insertion of an ICD is provided. Implementation of the new STEMI guidelines has substantial implications for resources, organization and priorities of the Canadian health care system. While on the one hand, the necessary incremental funding to provide tertiary and quaternary care and to support revascularization and device implantation capability is desirable, it is equally or more important to develop enhanced prehospital care, including the capacity for early recognition, risk assessment, fibrinolytic therapy and/or triage to a tertiary care centre as part of an enlightened approach to improving cardiac care.
PubMed ID
15457302 View in PubMed
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[Access to general practitioners in a county in Troms]

https://arctichealth.org/en/permalink/ahliterature70574
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Publication Type
Article
Date
Aug-25-2005
Author
Anne Helen Hansen
Ivar J Aaraas
Jorun Støvne Pettersen
Gerd Ersdal
Author Affiliation
Tromsø kommune, Rådhuset, 9299 Tromsø. anne.helen.hansen@tromso.kommune.no
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Date
Aug-25-2005
Language
Norwegian
Publication Type
Article
Keywords
Comparative Study
Emergency Medical Services - standards - statistics & numerical data
English Abstract
Family Practice - standards - statistics & numerical data
Female
Health Services Accessibility - standards - statistics & numerical data
Humans
Interviews
Male
Norway
Physicians, Family
Physicians, Women
Referral and Consultation - standards - statistics & numerical data
Rural Health Services - standards - statistics & numerical data
Telephone
Urban Health Services - standards - statistics & numerical data
Abstract
BACKGROUND: In 2002 the Norwegian Board of Health made a survey of the accessibility of general practitioners in Troms county in North Norway. MATERIAL AND METHODS: In a telephone interview one secretary in each surgery informed about telephone response time, planned time for telephone consultations, recorded numbers of urgent consultations, and waiting time to obtain a routine consultation. RESULTS: On average, the planned telephone time was two hours per week. Telephone time was in inverse proportion to the number of patients on the doctor's list. Rural doctors spent twice as much time as urban colleagues on the telephone with their patients. Doctors with lists between 500 and 1500 patients had a higher proportion of urgent consultations compared with doctors with shorter or longer lists. INTERPRETATION: Telephone response time below two minutes and waiting times for routine consultations below 20 days appear to be within acceptable norms. When patient lists are above 1500, doctors' capacity to offer telephone contact and emergency services to their patients seems reduced.
PubMed ID
16138139 View in PubMed
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Achieving optimal care for ST-segment elevation myocardial infarction in Canada.

https://arctichealth.org/en/permalink/ahliterature162934
Source
CMAJ. 2007 Jun 19;176(13):1843-4
Publication Type
Article
Date
Jun-19-2007
Author
Andrew Travers
Author Affiliation
Emergency Health Services Nova Scotia, Dartmouth, NS. traverah@gov.ns.ca
Source
CMAJ. 2007 Jun 19;176(13):1843-4
Date
Jun-19-2007
Language
English
Publication Type
Article
Keywords
Angioplasty, Balloon, Coronary
Canada
Critical Pathways
Electrocardiography
Emergency Medical Services - standards - utilization
Fibrinolytic Agents - therapeutic use
Humans
Myocardial Infarction - drug therapy - therapy
Notes
Cites: Acad Emerg Med. 2006 Jan;13(1):84-916365334
Cites: Eur Heart J. 2003 Jan;24(1):28-6612559937
Cites: Circulation. 2003 Dec 9;108(23):2851-614623806
Cites: Can J Cardiol. 2004 Sep;20(11):1075-915457302
Cites: CMAJ. 2007 Jun 19;176(13):1833-817576980
Cites: Eur Heart J. 2006 May;27(10):1146-5216624832
Cites: Eur Heart J. 2006 Jul;27(13):1530-816757491
Cites: N Engl J Med. 2006 Nov 30;355(22):2308-2017101617
Comment On: CMAJ. 2007 Jun 19;176(13):1833-817576980
PubMed ID
17576982 View in PubMed
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Adherence to resuscitation guidelines during prehospital care of cardiac arrest patients.

https://arctichealth.org/en/permalink/ahliterature163594
Source
Eur J Emerg Med. 2007 Apr;14(2):75-81
Publication Type
Article
Date
Apr-2007
Author
Hetti Kirves
Markus B Skrifvars
Marko Vähäkuopus
Kaj Ekström
Matti Martikainen
Maaret Castren
Author Affiliation
Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, 00029 HUS, Helsinki, Finland. Hetti.Kirves@hus.fi
Source
Eur J Emerg Med. 2007 Apr;14(2):75-81
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Aged
Emergency Medical Services - standards
Emergency Service, Hospital - standards
Female
Finland
Guideline Adherence - statistics & numerical data
Heart Arrest - therapy
Hospitalization
Humans
Logistic Models
Male
Middle Aged
Outcome Assessment (Health Care)
Practice Guidelines as Topic
Prognosis
Resuscitation
Abstract
The impact of prehospital care after the return of spontaneous circulation in out-of-hospital cardiac arrest patients is not known. This study describes adherence to the resuscitation guidelines, factors associated with poor adherence and possible impact of prehospital postresuscitation care on the outcome of out-of-hospital cardiac arrest.
One hundred and fifty-seven Finnish out-of-hospital cardiac arrest patients hospitalized during 1 year, were analyzed retrospectively. Patient and arrest characteristics, prehospital postresuscitation care and survival to hospital discharge were analyzed using multivariate logistic regression.
Forty percent of the patients received care accordant with the guidelines. Male sex (P=0.045), witnessed arrest (P=0.031), initial ventricular fibrillation/ventricular tachycardia rhythm (P=0.007) and the presence of an emergency physician (P=0.017) were associated with care in line with the current guidelines. In multivariate logistic regression analysis, age over median (odds ratio=3.6, 95% confidence interval 1.5-8.6), nonventricular fibrillation/ventricular tachycardia initial rhythm (odds ratio=4.0, 95% confidence interval 1.6-9.8), administration of adrenaline (odds ratio=7.0, 95% confidence interval 2.3-21.4) and unsatisfactory prehospital postresuscitation care (odds ratio=2.5, 95% confidence interval 1.1-6.3) were associated with a failure to survive up to hospital discharge.
Less than 50% of out-of-hospital cardiac arrest patients received prehospital postresuscitation care compatible with the current guidelines. Markers of poor prognosis were associated with unsatisfactory care, which in turn was more frequent among the patients who did not survive to hospital discharge. The importance of the guidelines should be highlighted in the future.
PubMed ID
17496680 View in PubMed
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Age disparities in stroke quality of care and delivery of health services.

https://arctichealth.org/en/permalink/ahliterature149008
Source
Stroke. 2009 Oct;40(10):3328-35
Publication Type
Article
Date
Oct-2009
Author
Gustavo Saposnik
Sandra E Black
Antoine Hakim
Jiming Fang
Jack V Tu
Moira K Kapral
Author Affiliation
Stroke Research Unit, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. saposnikg@smh.toronto.on.ca
Source
Stroke. 2009 Oct;40(10):3328-35
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Aging - physiology - psychology
Atrial Fibrillation - drug therapy - prevention & control
Cohort Studies
Cost of Illness
Deglutition Disorders - diagnosis - prevention & control - therapy
Emergency Medical Services - standards - statistics & numerical data - trends
Female
Health Policy
Health Services - economics
Hospital Units - standards - statistics & numerical data - trends
Hospitalization - economics
Humans
Longevity
Male
Middle Aged
Mortality - trends
Ontario
Outcome Assessment (Health Care) - economics
Patient Discharge - economics
Pneumonia - epidemiology
Prospective Studies
Quality of Health Care - statistics & numerical data - trends
Quality of Life
Severity of Illness Index
Stroke - complications - mortality - therapy
Thrombolytic Therapy - statistics & numerical data - trends
Warfarin - therapeutic use
Abstract
Limited information is available on the effect of age on stroke management and care delivery. Our aim was to determine whether access to stroke care, delivery of health services, and clinical outcomes after stroke are affected by age.
This was a prospective cohort study of patients with acute ischemic stroke in the province of Ontario, Canada, admitted to stroke centers participating in the Registry of the Canadian Stroke Network between July 1, 2003 and March 31, 2005. Primary outcomes were the following selected indicators of quality stroke care: (1) use of thrombolysis; (2) dysphagia screening; (3) admission to a stroke unit; (4) carotid imaging; (5) antithrombotic therapy; and (6) warfarin for atrial fibrillation at discharge. Secondary outcomes were risk-adjusted stroke fatality, discharge disposition, pneumonia, and length of hospital stay.
Among 3631 patients with ischemic stroke, 1219 (33.6%) were older than 80 years. There were no significant differences in stroke care delivery by age group. Stroke fatality increased with age, with a 30-day risk adjusted fatality of 7.1%, 6.5%, 8.8%, and 14.8% for those aged 59 or younger, 60 to 69, 70 to 79, and 80 years or older, respectively. Those aged older than 80 years had a longer length of hospitalization, increased risk of pneumonia, and higher disability at discharge compared to those younger than 80. This group was also less likely to be discharged home.
In the context of a province-wide coordinated stroke care system, stroke care delivery was similar across all age groups with the exception of slightly lower rates of investigations in the very elderly. Increasing age was associated with stroke severity and stroke case-fatality.
PubMed ID
19696418 View in PubMed
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[Ambulance response intervals in connection with cardiac arrest in Oslo]

https://arctichealth.org/en/permalink/ahliterature53934
Source
Tidsskr Nor Laegeforen. 2001 Mar 20;121(8):900-3
Publication Type
Article
Date
Mar-20-2001
Author
K. Sunde
K O Fremstad
J. Furuheim
P A Steen
Author Affiliation
Anestesiavdelingen, Kirurgisk divisjon Ullevål sykehus 0407 Oslo. kjetil.sunde@ioks.uio.no
Source
Tidsskr Nor Laegeforen. 2001 Mar 20;121(8):900-3
Date
Mar-20-2001
Language
Norwegian
Publication Type
Article
Keywords
Ambulances - standards - statistics & numerical data
Emergency Medical Services - standards - statistics & numerical data
English Abstract
Heart Arrest - epidemiology - mortality
Humans
Norway - epidemiology
Retrospective Studies
Time and Motion Studies
Urban Health Services - statistics & numerical data
Abstract
INTRODUCTION: An important factor determining survival after out-of-hospital cardiac arrest is how fast the ambulance personnel can reach the patient. MATERIALS AND METHODS: In a two-year period between 1996 and 1998, all ambulance calls to patients with out-of-hospital cardiac arrest in Oslo were evaluated. Of 1,026 cardiac arrests, 130 were excluded because of missing data. RESULTS: The median ambulance response interval was 7.2 min (5.7-9.0 as 25-75% percentiles). There was a tendency to shorter response intervals to the central parts of Oslo with medians between 3 and 4 min, while 14 more peripheral boroughs had median response intervals over 8 min. Of the 627 cases where the ambulance starting point was registered, 76% were from the only ambulance station in Oslo, located downtown. INTERPRETATION: In our opinion, the median ambulance response interval is unsatisfactory in large parts of Oslo, as a long response time gives a dramatically lower survival rate after cardiac arrest. A reorganisation and decentralization of the Oslo Emergency Medical Service System seems necessary.
PubMed ID
11332374 View in PubMed
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Source
Tidsskr Nor Laegeforen. 2001 Mar 20;121(8):899
Publication Type
Article
Date
Mar-20-2001
Author
D. Haga
Source
Tidsskr Nor Laegeforen. 2001 Mar 20;121(8):899
Date
Mar-20-2001
Language
Norwegian
Publication Type
Article
Keywords
Ambulances - standards
Emergency Medical Services - standards - statistics & numerical data
Humans
Norway
PubMed ID
11332373 View in PubMed
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[Ambulance transportation and prehospital treatment in connection with admission for suspected acute myocardial infarction]

https://arctichealth.org/en/permalink/ahliterature53765
Source
Ugeskr Laeger. 2002 Mar 11;164(11):1493-6
Publication Type
Article
Date
Mar-11-2002
Author
Claus-Henrik Rasmussen
Anders P Munck
Torben H Haghfelt
Jakob Kragstrup
Author Affiliation
Syddansk Universiteit, Forskningsenheden for Almen Medicin i Odense, Odense Universitetshospital, Kardiologisk Forskningsenhed.
Source
Ugeskr Laeger. 2002 Mar 11;164(11):1493-6
Date
Mar-11-2002
Language
Danish
Publication Type
Article
Keywords
Ambulances - standards - utilization
Denmark
Emergency Medical Services - standards - utilization
English Abstract
Hospitals, University
Humans
Myocardial Infarction - diagnosis - drug therapy - therapy
Patient Admission
Physician's Practice Patterns
Quality of Health Care
Research Support, Non-U.S. Gov't
Time and Motion Studies
Abstract
INTRODUCTION: The aim was to describe ambulance transportation and pre-hospital treatment in connection with admission for suspected acute myocardial infarction. MATERIAL AND METHODS: For all patients with suspected acute coronary syndrome who were urgently admitted to the Cardiological Department, Odense University Hospital between 3 August 1998 and 6 December 1998, information about ambulance transportation and pre-hospital treatment was collected through interviews with the patients and study of ambulance records, admission notes, and hospital medical records. In addition, details of the regarding response times were obtained from Falck's emergency service and from nurses' papers. RESULTS: Altogether 279 patients (83%) were transported by ambulance. Half the ambulances arrived at the hospital after 34 minutes (range 11-140 minutes), but every third ambulance took more than 40 minutes to reach the hospital. The pre-hospital treatment of all the patients was: oxygen 69%, nitroglycerin sublingually 46%, nitrous oxide 2%, defibrillation 1.4%, acetylsalicylic acid 9%, morphine injection 8%, and ECG monitoring 57%. CONCLUSION: The study showed that there were quality problems, as every third ambulance took more than 40 minutes to reach the hospital. It also showed that acetylsalicylic acid and morphine were used only to a limited extent in a pre-hospital situation.
PubMed ID
11924473 View in PubMed
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170 records – page 1 of 17.