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Search Results: 1 - 10 of 401411 matches for " M?rten Sandberg "
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Field triage in trauma – do the data really justify the conclusions?
Mrten Sandberg
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2009, DOI: 10.1186/1757-7241-17-24
Abstract: I read with interest the recently published paper by Rehn and coworkers about field triage in trauma [1]. The topic is interesting and improved quality of the work and information flow from the scene-of-the-accident to the emergency department can save lives. However, some of the conclusions drawn by the authors can be challenged.First, the authors compared undertriage and overtriage of the traumatized patients and found 2% and 17% undertriage and 35% and 66% overtriage for anaesthetists and paramedics, respectively. They conclude that "anaesthetists perform precise trauma triage, whereas paramedics have potential for improvement" although the authors themselves state that "skewed mission profiles make comparison of differences in triage precision difficult" [1]. The ground ambulances staffed with paramedics are used locally while the helicopters staffed with anaesthetists are a regional resource. The helicopters are dispatched when major trauma is suspected while ground ambulances are dispatched to any sort of incidence. In Oslo, an anaesthetist-staffed ground ambulance operates alongside ordinary ambulances and the patients transported with this service are a subgroup of the patients transported by anaesthetists. If the triage precision between paramedics and anaesthetists is to be compared, data from ground ambulances in Oslo (with or without anaesthetist) should be used and the data from patients brought to the hospital by helicopter or other services should be excluded. Such a comparison would give a good indication about the real difference in triage precision between the two groups of prehospital care providers. Unfortunately, that subgroup analysis has not been performed. That is sad, because the numbers that is provided in the article is of little interest since the services that are compared are too different.Second, in the system described, the paramedics or the anaesthetists examine the patient and investigate the mechanism of the accident before reporti
Airway management in simulated restricted access to a patient - can manikin-based studies provide relevant data?
Anders R Nakstad, Mrten Sandberg
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2011, DOI: 10.1186/1757-7241-19-36
Abstract: Twenty anaesthesiologists from the Air Ambulance Department used iGEL?, laryngeal tube LTSII? and Macintosh laryngoscopes in two scenarios with either unrestricted (scenario A) or restricted (scenario B) access to the cranial end of the manikin. Different manikins were used for ETI and placement of the supraglottic devices. The technique selected by the physicians, the success rates and the times to completion were the primary outcomes measured. A secondary outcome of the study was an evaluation of the learning effect of using the same manikin or device several times.In scenario A, all anaesthesiologists secured an airway using each device within the maximum time limit of 60 seconds. In scenario B, all physicians secured the airway on the first attempt with the supraglottic devices and 16 (80%) successfully performed an ETI with either the Macintosh laryngoscope (n = 13, 65%) or with digital technique (n = 3, 15%). It took significantly longer to perform ETI (mean time 28.0 sec +/- 13.0) than to secure an airway with the supraglottic devices (iGel?: mean 12.3 sec +/- 3.6, LTSII?: mean 10.6 sec +/- 3.2). When comparing the mean time required for the two scenarios for each supraglottic device, there was a reduction in time for scenario B (significant for LTSII?: 12.1 versus 10.6 seconds, p = 0.014). This may be due to a training effect using same manikin and device several times.The amount of time used to secure an airway with supraglottic devices was low for both scenarios, while classic ETI was time consuming and had a low success rate in the simulated restricted access condition. This study also demonstrates that there is a substantial training effect when simulating airway management with airway manikins. This effect must be considered when performing future studies.Fast and safe airway management in the field is critical but sometimes challenging due to patient and environmental factors. Airway management in entrapped patients or patients located in a confined sp
Medical emergency motorcycle – is it useful in a Scandinavian Emergency Medical Service?
Anders Nakstad, Bj?rn Bjelland, Mrten Sandberg
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2009, DOI: 10.1186/1757-7241-17-9
Abstract: A prospective study was performed when MEM was introduced as a trial in an urban ambulance service in Norway.A total of 703 MEM missions were registered in the period. The mean emergency driving time was significantly shorter for the MEM than for the ambulance car located at the same station (6 min 24 seconds vs. 6 min 54 seconds). In addition to time-critical conditions, the MEM was used to evaluate patients when the need for emergency medical assistance was uncertain, and this practice lead to a reduced number of unnecessary car ambulance missions. No accidents involving the MEM were registered in the study period. The hourly cost of running the MEM was € 29 vs. € 75 for a car ambulance. However, the actual cost benefit is smaller since the weather conditions make it impossible to run a MEM in wintertime.The small reduction in driving time when using a MEM instead of a car ambulance was statistically significant but probably of little clinical importance. The number of unnecessary car ambulance missions was reduced. It was cheaper to operate a MEM than a car ambulance, but the cost-effectiveness was reduced since the MEM could not operate 12 months a year. The lack of accidents may be contributed to the extensive training of the drivers and the fact that the vehicle was operated in daylight only.In time-critical disorders like cardiac arrest, myocardial infarction, severe respiratory disease and polytrauma immediate response from the Emergency Medical Service (EMS) is crucial and the fastest mean of transport to the patient must be chosen [1,2]. Recently, it has been focused on the relatively long response times for car ambulances in urban traffic, and the use of medical emergency motorcycles (MEM) has been advocated. In a study from Taiwan, Lin and co-workers demonstrated that a motorcycle had a significantly shorter response time than a regular ambulance [3]. Soares-Oliveira and co-workers recently described the use of MEM in Portugal with emphasis on its effici
Oslo government district bombing and Ut?ya island shooting July 22, 2011: The immediate prehospital emergency medical service response
Stephen JM Sollid, Rune Rimstad, Marius Rehn, Anders R Nakstad, Ann-Elin Tomlinson, Terje Strand, Hans Heimdal, Jan Nilsen, Mrten Sandberg, Collaborating group
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-3
Abstract: A retrospective and observational study was conducted based on data from the EMS systems involved and the public domain. The study was approved by the Data Protection Official and was defined as a quality improvement project.We describe the timeline and logistics of the EMS response, focusing on alarm, dispatch, initial response, triage and evacuation. The scenes in the Oslo government district and at Ut?ya island are described separately.Many EMS units were activated and effectively used despite the occurrence of two geographically separate incidents within a short time frame. Important lessons were learned regarding triage and evacuation, patient flow and communication, the use of and need for emergency equipment and the coordination of helicopter EMS.On July 22, 2011, Norway was struck by two terrorist attacks. In the first attack, a car bomb exploded in the Oslo government district. The bomb comprised an ammonium nitrate/fuel oil (ANFO) mixture or "fertiliser bomb". Eight people were killed in the explosion. Two hours later, a lone gunman attacked a political youth camp on Ut?ya island, approximately 40 kilometres from Oslo, and killed 69 civilians. A single perpetrator carried out both attacks.The scale of the July 22, 2011 attacks and the resulting emergency medical service (EMS) response was unprecedented in Norway. The massive EMS response crossed jurisdictional lines and involved responders from multiple agencies throughout the region. In this paper, we describe the immediate prehospital EMS response to the July 22, 2011 attacks.The backbone of the Norwegian EMS is provided by on-call general practitioners (GPs) and ground ambulances [1]. According to national regulations, all ambulance units must be staffed by at least one certified emergency medical technician (EMT) [2]. However, most units are staffed by two EMTs, and in most urban systems, at least one EMT is a trained paramedic. The ambulance service is government-funded and organised under local healt
A Result for Orthogonal Plus Rank-1 Matrices
Mrten Wadenb?ck
Mathematics , 2015,
Abstract: In this paper the sum of an orthogonal matrix and an outer product is studied, and a relation between the norms of the vectors forming the outer product and the singular values of the resulting matrix is presented. The main result may be found in Theorem 1.
Selectivity in the Reinnervation of the Lateral Gastrocnemius Muscle after Nerve Repair with Ethyl Cyanoacrylate in the Rat
Thomas Landegren,Mrten Risling
Frontiers in Neurology , 2011, DOI: 10.3389/fneur.2011.00025
Abstract: There is a need for complementary surgical techniques that enable rapid and reliable primary repair of transected nerves. Previous studies after peripheral nerve transection and repair with synthetic adhesives have demonstrated regeneration to an extent comparable to that of conventional techniques. The aim of this study was to compare two different repair techniques on the selectivity of muscle reinnervation after repair and completed regeneration. We used the cholera toxin B technique of retrograde axonal tracing to evaluate the morphology, the number, and the three-dimensional location of α-motoneurons innervating the lateral gastrocnemius muscle and compared the results after repair with either ethyl cyanoacrylate (ECA) or epineural sutures of the transected parent sciatic nerve. In addition, we recorded the wet weight of the muscle. Six months after transection and repair of the sciatic nerve, the redistribution of the motoneuron pool was markedly disorganized, the motoneurons had apparently increased in number, and they were scattered throughout a larger volume of the spinal cord gray matter with a decrease in the synaptic coverage compared to controls. A reduction in muscle weight was observed as well. No difference in morphometric variables or muscle weight between the two repair methods could be detected. We conclude that the selectivity of motor reinnervation following sciatic nerve transection and subsequent repair with ECA is comparable to that following conventional micro suturing.
Invariant star-products on S^2 and the canonical trace
Keizo Matsubara,Mrten Stenmark
Mathematics , 2004, DOI: 10.1007/s11005-004-4290-7
Abstract: In the literature there are two different ways of describing an invariant star product on $S^2$. We show that the products are actually the same. We also calculate the canonical trace and use the Fedosov-Nest-Tsygan index theorem to obtain the characteristic class of this product.
On the Wake Flow Interaction between Model Turbines with Varying Streamwise Distance  [PDF]
Mubashar Khan, Ylva Odemark, Mats Sandberg, Jens H. M. Fransson
Open Journal of Fluid Dynamics (OJFD) , 2017, DOI: 10.4236/ojfd.2017.74038
Abstract:
Wind tunnel measurements using particle image velocimetry have been performed around two perforated discs, with varying streamwise distance, in order to simulate the wake interaction between wind turbines. The static pressure footprint (p-f) on ground level associated with the wake behind the disc and wake velocity data for both the streamwise and wall-normal velocity components with the corresponding turbulence intensities are reported. The p-f method shows that the size of the wake regions, behind the wind turbine models, initially drop when a second disc is placed just downstream of the first one. From a mutual distance (Δ χ) of about five disc diameters (5D), both wake footprints increase as the mutual distance is increased, and for very large mutual distances, approximately Δ χ/ D > 15, the footprint of the downstream disc has recovered and is about the same as for a single disc. At last we conclude that despite very different inlet conditions to the discs, with about 50% of reduced velocity on the centre line upstream of the second disc and an increase of the maximum streamwise fluctuations by 90%, the mean velocities in the wake are proven to scale with the hub height velocity.
Superconducting quantum interference phenomenon in Bi$_2$Sr$_2$CaCu$_2$O$_{8+δ}$ single crystals
M. Sandberg,V. M. Krasnov
Physics , 2005, DOI: 10.1103/PhysRevB.72.212501
Abstract: The operational dc-SQUID based on intrinsic Josephson junctions in Bi$_2$Sr$_2$CaCu2O$_{8+\delta}$ high-$T_c$ superconductor is fabricated and studied. The novel in-plane loop layout and the developed in-situ endpoint detection method allowed an accurate control of the number of junctions in the SQUID. A clear periodic modulation of the superconducting current as a function of magnetic flux through the SQUID loop is observed. This is an unambiguous evidence for the quantum interference phenomenon in Bi$_2$Sr$_2$CaCu2O$_{8+\delta}$ single crystals.
The Dynamical Functional Particle Method
Mrten Gulliksson,Sverker Edvardsson,Andreas Lind
Mathematics , 2013,
Abstract: We present a new algorithm which is named the Dynamical Functional Particle Method, DFPM. It is based on the idea of formulating a finite dimensional damped dynamical system whose stationary points are the solution to the original equations. The resulting Hamiltonian dynamical system makes it possible to apply efficient symplectic integrators. Other attractive properties of DFPM are that it has an exponential convergence rate, automatically includes a sparse formulation and in many cases can solve nonlinear problems without any special treatment. We study the convergence and convergence rate of DFPM. It is shown that for the discretized symmetric eigenvalue problems the computational complexity is given by $\mathcal{O}(N^{(d+1)/{d}})$, where \emph{d} is the dimension of the problem and \emph{N} is the vector size. An illustrative example of this is made for the 2-dimensional Schr\"odinger equation. Comparisons are made with the standard numerical libraries ARPACK and LAPACK. The conjugated gradient method and shifted power method are tested as well. It is concluded that DFPM is both versatile and efficient.
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