Comparison of the results of in-person and mobile phone surveys for a health facility assessment in Tajikistan: A validation study protocol.

Health facility assessments provide important data to measure the quality of health services delivered to populations. These assessments are comprehensive, resource intensive, and periodic to inform medium- to-longer-term policies. However, in absence of other reliable data sources, country decision makers often rely on outdated data to address service delivery challenges that change more frequently.

Intraosseous vs. intravenous access during out-of-hospital cardiac arrest: a Bayesian secondary analysis of a randomised clinical trial.

Aim Of The Study: This study aimed to apply a Bayesian probabilistic framework to the Intravenous vs. Intraosseous Vascular Access for Out-of-Hospital Cardiac Arrest (IVIO) trial data to evaluate the likelihood of benefit for each vascular access method while incorporating various prior beliefs.

Methods: The IVIO trial was a randomised trial comparing intraosseous to intravenous access in 1,479 adults with non-traumatic out-of-hospital cardiac arrest.

Oxygen Saturation in Relation to Flying Altitude. A Scoping Review Protocol.

Background: During air travel, the decrease in air pressure leads to a decrease in oxygen partial pressure causing oxygen desaturation. Every year, several commercial aircraft need to divert and perform unscheduled landings due to hypoxic symptoms or medical emergencies. How individuals are affected depends on their physical and medical conditions, as well as the cabin pressure of the aircraft.

Concrete silo collapse: emergency medical services response to a mass casualty incident.

Background: Major incidents evolving from occupational accidents are very infrequent in Scandinavia and therefore, case reports are called for. On 26 November, 2024, a fatal occupational accident took place during the construction of a concrete silo in the small rural town of Flemløse (population 574), Denmark. Three people died and six were injured as the result of a collapsing concrete roof during construction.

Development and Validation of a Case-Based Survey Assessing Ethical Decision-Making in Prehospital Resuscitation.

Objectives: Ethical considerations are central to deciding on resuscitation in a prehospital setting. A systematic study of ethical views can enlighten the area and potentially reveal variations in decision-making. We aimed to explore the ethical views on resuscitation and their impact on the reasoning of prehospital healthcare professionals using a qualitative approach and a structured questionnaire.

The use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based study.

Background: Acute pain in the prehospital setting is frequent and prehospital pain management presents multiple challenges, especially in children. There is a lack of high-level evidence regarding prehospital pain management in the paediatric population worldwide. In Denmark, this lack of evidence particularly concerns the frequency of the prehospital use of strong analgesics.

Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Randomized Clinical Trial.

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.

An assessment of long-term complications following prehospital intraosseous access: A nationwide study.

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.

Inter hospital transfers in rotor wing aircraft. Patterns and challenges. Protocol for a scoping review.

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.

Association of intraosseous and intravenous access with patient outcome in out-of-hospital cardiac arrest.

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.

What made primary health care resilient against COVID-19? A mixed-methods positive deviance study in Nigeria.

Introduction: The SARS-CoV-2 (COVID-19) pandemic overwhelmed some primary health care (PHC) systems, while others adapted and recovered. In Nigeria, large, within-state variations existed in the ability to maintain PHC service volumes. Identifying characteristics of high-performing local government areas (LGAs) can improve understanding of subnational health systems resilience.

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

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.

Vaccination Utilization and Subnational Inequities during the COVID-19 Pandemic: An Interrupted Time-Series Analysis of Administrative Data across 12 Low- and Middle-Income Countries.

Background: During and after the SARS-CoV-2 (COVID-19) pandemic, many countries experienced declines in immunization that have not fully recovered to pre-pandemic levels. This study uses routine health facility immunization data to estimate variability between and within countries in post-pandemic immunization service recovery for BCG, DPT1, and DPT3.

Methods: After adjusting for data reporting completeness and outliers, interrupted time series regression was used to estimate the expected immunization service volume for each subnational unit, using an interruption point of March 2020.

Anesthesiologists' skills in emergency cricothyroidotomy mandate a brush-up training after 3 months-A randomized controlled trial.

Background: In the Difficult Airway Society's 2015 "cannot intubate, cannot oxygenate" guideline, the emergency cricothyroidotomy is the final option when managing an unanticipated difficult airway. How often training for maintenance of this skill is required for anesthesiologists remains unknown. We aimed to assess if specialist-trained anesthesiologists' skills improved from a brush-up intervention and if skills were retained after 3 months.

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

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.

Vaccine hesitancy among healthcare workers in low- and middle-income countries during the COVID-19 pandemic: Results from facility surveys across six countries.

Background: Vaccine hesitancy remains a critical barrier in mitigating the effects of the ongoing COVID-19 pandemic. The willingness of health care workers (HCWs) to be vaccinated, and, in turn, recommend the COVID-19 vaccine for their patient population is an important strategy. This study aims to understand the uptake of COVID-19 vaccines and the reasoning for vaccine hesitancy among facility-based health care workers (HCWs) in LMICs.

Resilience of front-line facilities during COVID-19: evidence from cross-sectional rapid surveys in eight low- and middle-income countries.

Responsive primary health-care facilities are the foundation of resilient health systems, yet little is known about facility-level processes that contribute to the continuity of essential services during a crisis. This paper describes the aspects of primary health-care facility resilience to coronavirus disease 2019 (COVID-19) in eight countries. Rapid-cycle phone surveys were conducted with health facility managers in Bangladesh, Burkina Faso, Chad, Guatemala, Guinea, Liberia, Malawi and Nigeria between August 2020 and December 2021.

Healthcare utilization and maternal and child mortality during the COVID-19 pandemic in 18 low- and middle-income countries: An interrupted time-series analysis with mathematical modeling of administrative data.

Background: The Coronavirus Disease 2019 (COVID-19) pandemic has had wide-reaching direct and indirect impacts on population health. In low- and middle-income countries, these impacts can halt progress toward reducing maternal and child mortality. This study estimates changes in health services utilization during the pandemic and the associated consequences for maternal, neonatal, and child mortality.

Risk of delirium and impaired neurological outcome associated with delay in neurorehabilitation after acquired brain injury.

INTRODUCTION Brain injury from haemorrhage, trauma, aneurysm and stroke is characterised by high mortality and impaired neurological outcome. In the OUTREACH study, the authors wanted to assess patient care from admission to intensive neuro rehabilitation to discharge. We hypothesised that early rehabilitation was beneficial to neurological outcome.

The Great Belt train accident: the emergency medical services response.

Background: Major incidents (MI) are rare occurrences in Scandinavia. Literature depicting Scandinavian MI management is scarce and case reports and research is called for. In 2019, a trailer falling off a freight train struck a passing high-speed train on the Great Belt Bridge in Denmark, killing eight people instantly and injuring fifteen people.

Institutionalizing quality within national health systems: key ingredients for success.

Quality improvement initiatives can be fragmented and short-term, leading to missed opportunities to improve quality in a systemic and sustainable manner. An overarching national policy or strategy on quality, informed by frontline implementation, can provide direction for quality initiatives across all levels of the health system. This can strengthen service delivery along with strong leadership, resources, and infrastructure as essential building blocks for the health system.

Are monitoring and evaluation systems adequate to report the programmatic coverage of HIV services among key populations in countries?

There was no global guidance or agreement regarding when a country has an adequate system to report on the service packages among human immunodeficiency virus (HIV) key populations. This article describes an approach to categorizing the system in a country for reporting the service package among HIV key populations. The approach consists of four dimensions, namely the epidemiological significance, comprehensiveness of the service packages, geographic coverage of services, and adequacy of the monitoring system.