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  1. Article: Patients' pathways to the emergency department: a scoping review.

    Nummedal, Målfrid Asheim / King, Sarah Elizabeth / Uleberg, Oddvar / Pedersen, Sindre Andre / Bjørnsen, Lars Petter

    International journal of emergency medicine

    2024  Volume 17, Issue 1, Page(s) 61

    Abstract: Background: Emergency department (ED) crowding is a common healthcare issue with multiple causes. One important knowledge area is understanding where patients arrived from and what care they received prior to ED admission. This information could be used ...

    Abstract Background: Emergency department (ED) crowding is a common healthcare issue with multiple causes. One important knowledge area is understanding where patients arrived from and what care they received prior to ED admission. This information could be used to inform strategies to provide care for low acuity patients outside of the hospital and reduce unnecessary ED admissions. The aim of this scoping review was to provide a comprehensive overview of global published research examining the acute care trajectory of all ED patients.
    Methods: The scoping review was performed according to the JBI Manual for Evidence Synthesis and the PRISMA-SCR checklist. A comprehensive literature search was performed to identify studies describing where patients arrived from and/or whose pathway of care was before an ED visit. The search was conducted in MEDLINE, Embase, and the Cochrane Library from inception through December 5th, 2022. Two reviewers independently screened the records.
    Results: Out of the 6,465 records screened, 14 studies from Australia, Canada, Haiti, Norway, Sweden, Switzerland, Belgium, Indonesia, and the UK met the inclusion criteria. Four studies reported on where patients physically arrived from, ten reported how patients were transported, six reported who referred them, and six reported whether medical care or advice was sought prior to visiting an ED.
    Conclusion: This scoping review revealed a lack of studies describing patients' pathways to the ED. However, studies from some countries indicate that a relatively large proportion of patients first seek care or guidance from a primary care physician (PCP) before visiting an ED. However, further research and published data are needed. To improve the situation, we recommend the development and implementation of a template for the uniform reporting of factors outside the ED, including where the patient journey began, which healthcare facilities they visited, who referred them to the ED, and how they arrived.
    Language English
    Publishing date 2024-05-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2411462-5
    ISSN 1865-1380 ; 1865-1372
    ISSN (online) 1865-1380
    ISSN 1865-1372
    DOI 10.1186/s12245-024-00638-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Current postgraduate training in emergency medicine in the Nordic countries.

    Björnsson, Hjalti Már / Bjørnsen, Lars Petter / Skjærbæk, Christian Baaner / Hruska, Katrin / Palomäki, Ari

    BMC medical education

    2023  Volume 23, Issue 1, Page(s) 469

    Abstract: Background: Emergency Medicine (EM) is an independent specialty in all five Nordic countries. This study aims to evaluate the structure of post-graduate EM training in the area.: Methods: A leading hospital or hospitals in EM training in each country ...

    Abstract Background: Emergency Medicine (EM) is an independent specialty in all five Nordic countries. This study aims to evaluate the structure of post-graduate EM training in the area.
    Methods: A leading hospital or hospitals in EM training in each country were identified. An e-survey was sent to each hospital to gather data on patient volume and physician staffing, curriculum, trainee supervision, and monitoring of progression in training.
    Results: Data were collected from one center in Iceland and Norway, two in Finland and Sweden, and four centers in Denmark. The data from each country in Denmark, Finland, and Sweden, were pooled to represent that country. The percentage of consultants with EM specialist recognition ranged from 49-100% of all consultants working in the participating departments. The number of patients seen annually per each full time EM consultant was almost three times higher in Finland than in Sweden. In Iceland, Denmark, and Sweden a consultant was present 24/7 in the ED but not in all centers in the other countries. The level of trainee autonomy in clinical practice varied between countries. Requirements for completing standardized courses, completing final exams, scientific and quality improvement projects, and evaluation of trainee progression, varied between the countries.
    Conclusions: All Nordic countries have established EM training programs. Despite cultural similarities, there are significant differences in how the EM training is structured between the countries. Writing and implementing a standardized training curriculum and assessment system for EM training in the Nordic countries should be considered.
    MeSH term(s) Humans ; Scandinavian and Nordic Countries ; Iceland ; Finland ; Sweden ; Norway ; Emergency Medicine
    Language English
    Publishing date 2023-06-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2044473-4
    ISSN 1472-6920 ; 1472-6920
    ISSN (online) 1472-6920
    ISSN 1472-6920
    DOI 10.1186/s12909-023-04430-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Medication error with methotrexate.

    Husby, Maren Wennberg / Bjørnsen, Lars Petter Bache-Wiig / Jørgensen, Arve / Lassen, Tone Merete / Jacobsen, Dag / Laugsand, Lars Erik

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2024  Volume 144, Issue 6

    Abstract: Background: A woman in her seventies presented to the accident and emergency department (A&E) with shortness of breath that had increased over a period of three weeks. She had a history of COPD, hypertension and polymyalgia rheumatica. A medication ... ...

    Title translation Feildosering av metotreksat.
    Abstract Background: A woman in her seventies presented to the accident and emergency department (A&E) with shortness of breath that had increased over a period of three weeks. She had a history of COPD, hypertension and polymyalgia rheumatica. A medication error involving methotrexate, used for autoimmune diseases, was discovered during her medical history review.
    Case presentation: The patient arrived with stable vital signs, including 94 % oxygen saturation and a respiratory rate of 20 breaths/min. She had been taking 2.5 mg of methotrexate daily for the past three weeks instead of the prescribed weekly dose of 15 mg. Other examinations revealed no alarming findings, except for a slightly elevated D-dimer level.
    Interpretation: Considering her medical history and exclusion of other differential diagnoses, methotrexate toxicity was suspected. The patient was admitted to the hospital and intravenous folinic acid was initiated as an antidote treatment. Five days later, the patient was discharged with an improvement in the shortness of breath. This case underscores the importance of effective communication in health care, particularly in complex cases like this, where understanding dosages and administration is crucial. Medical history, clinical examinations and medication reviews, often involving clinical pharmacists, are vital in the A&E to reveal medication errors.
    MeSH term(s) Humans ; Medication Errors ; Female ; Methotrexate/adverse effects ; Methotrexate/administration & dosage ; Aged ; Dyspnea/chemically induced ; Leucovorin/adverse effects ; Leucovorin/administration & dosage ; Antidotes/administration & dosage ; Antidotes/therapeutic use ; Antirheumatic Agents/adverse effects ; Antirheumatic Agents/administration & dosage
    Language Norwegian
    Publishing date 2024-03-21
    Publishing country Norway
    Document type Case Reports ; Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.23.0657
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Observational study on chest pain during the Covid-19 pandemic: changes and characteristics of visits to a Norwegian emergency department during the lockdown.

    Grande, Mikkel / Bjørnsen, Lars Petter / Næss-Pleym, Lars Eide / Laugsand, Lars Erik / Grenne, Bjørnar

    BMC emergency medicine

    2022  Volume 22, Issue 1, Page(s) 57

    Abstract: Background: Following the spread of the Covid-19 pandemic in 2020, reports emerged on decreasing emergency department (ED) visits in many countries. Patients experiencing chest pain was no exception. The aim of the current study was to describe how the ... ...

    Abstract Background: Following the spread of the Covid-19 pandemic in 2020, reports emerged on decreasing emergency department (ED) visits in many countries. Patients experiencing chest pain was no exception. The aim of the current study was to describe how the Covid-19 pandemic and the subsequential lockdown impacted the chest pain population in a Norwegian ED.
    Methods: All patients presenting to the ED with chest pain during the study period were included. Data were collected retrospectively from the time period January 6
    Results: Fewer patients with chest pain were seen in the ED following the national lockdown in Norway, compared to the corresponding 2019 period (week 13: 38% fewer; weeks 11-27: 16% fewer). By week 28, the rate normalized compared to 2019 levels. There was a relative increase in lower acuity patients among these patients, while fewer moderate acuity patients were seen. During the initial period following lockdown, the median age was lower compared to the corresponding 2019 period (58 years (IQR 25) vs 62 years (IQR 24), respectively). Admissions due to acute coronary syndromes (ACS) remained proportionally stable.
    Conclusions: Succeeding the Covid-19 outbreak and the subsequent national lockdown in Norway, fewer chest pain patients presented to the ED. Paradoxically, the patients seemed to be less severely ill and were on average younger compared to 2019 data. However, the proportion of patients admitted with ACS was stable during this period. This could imply that some patients may have failed to seek medical advice despite experiencing a myocardial infarction.
    MeSH term(s) Adult ; COVID-19/epidemiology ; Chest Pain/epidemiology ; Communicable Disease Control ; Emergency Service, Hospital ; Humans ; Pandemics ; Retrospective Studies
    Language English
    Publishing date 2022-04-02
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2050431-7
    ISSN 1471-227X ; 1471-227X
    ISSN (online) 1471-227X
    ISSN 1471-227X
    DOI 10.1186/s12873-022-00612-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Low-voltage electrical accidents, immediate reactions and acute health care associated with self-reported general health 4 years later.

    Goffeng, Lars Ole / Skare, Øivind / Brinchmann, Bendik C / Bjørnsen, Lars Petter / Veiersted, Kaj Bo

    Burns : journal of the International Society for Burn Injuries

    2022  Volume 49, Issue 2, Page(s) 329–343

    Abstract: Background and aims: Electricians frequently experience low-voltage electrical accidents. Some such accidents involve long-term negative health consequences. Early identification of victims at risk for long-term injury may improve acute medical ... ...

    Abstract Background and aims: Electricians frequently experience low-voltage electrical accidents. Some such accidents involve long-term negative health consequences. Early identification of victims at risk for long-term injury may improve acute medical treatment and long-term follow-up. This study aimed to determine acute exposure, health effects and treatment associated with general health ≥ 2 years after low-voltage electrical accidents.
    Methods: In a cross-sectional study, 89 male electricians who had experienced an electrical accident between 1994 and 2001 participated in a 2003 follow-up health examination. They were identified from a registry of low-voltage electrical accidents and included in the study. Based on exposure descriptions in the original accident reports, they were stratified into the following three groups: a current arc accident group (N = 34, mean age 38.8 years [standard deviation, SD = 12.2, range = 21-59]) and two groups with the passage of current through the body, either fixed to the current source ("no-let-go" group; N = 35, mean age 34.0 years [SD = 10.5, range = 21-57]) or not ("let-go" group; N = 20, mean age = 38.7 years [SD = 10.3, range = 21-63]). They retrospectively described acute reactions and assessed their current general health at the health examination. Multivariate linear regression, ordinal logistic regression and Fisher's exact test were used to compare acute reactions with health at follow-up in each exposure group.
    Results: The multivariate analysis indicated that after accidents with the passage of current through the body, severe acute headache (β = - 0.56, p = 0.013), years since the accident (β = - 0.16, p = 0.017) and the accident being perceived as frightening (β = - 0.48, p = 0.040) were negatively associated with general health ≥ 2 years later (R
    Discussion and conclusions: The acute reactions negatively associated with general health ≥ 2 years after low-voltage electrical accidents should alert the clinician in the acute phase after an electrical accident to the risk of developing negative long-term health effects. Future studies should specify long-term health beyond the concept of general health.
    MeSH term(s) Humans ; Male ; Adult ; Self Report ; Retrospective Studies ; Hypesthesia ; Cross-Sectional Studies ; Burns ; Accidents ; Health Status
    Language English
    Publishing date 2022-04-26
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 197308-3
    ISSN 1879-1409 ; 0305-4179
    ISSN (online) 1879-1409
    ISSN 0305-4179
    DOI 10.1016/j.burns.2022.04.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Correction: Patient characteristics in sepsis-related deaths: prevalence of advanced frailty, comorbidity, and age in a Norwegian hospital trust.

    Torvik, Marianne Ask / Nymo, Stig Haugset / Nymo, Ståle Haugset / Bjørnsen, Lars Petter / Kvarenes, Hanne Winge / Ofstad, Eirik Hugaas

    Infection

    2023  Volume 51, Issue 4, Page(s) 1117

    Language English
    Publishing date 2023-05-12
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 185104-4
    ISSN 1439-0973 ; 0300-8126 ; 0173-2129
    ISSN (online) 1439-0973
    ISSN 0300-8126 ; 0173-2129
    DOI 10.1007/s15010-023-02046-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Patient characteristics in sepsis-related deaths: prevalence of advanced frailty, comorbidity, and age in a Norwegian hospital trust.

    Torvik, Marianne Ask / Nymo, Stig Haugset / Nymo, Ståle Haugset / Bjørnsen, Lars Petter / Kvarenes, Hanne Winge / Ofstad, Eirik Hugaas

    Infection

    2023  Volume 51, Issue 4, Page(s) 1103–1115

    Abstract: Objective: To examine the prevalence of advanced frailty, comorbidity, and age among sepsis-related deaths in an adult hospital population.: Methods: Retrospective chart reviews of deceased adults within a Norwegian hospital trust, with a diagnosis ... ...

    Abstract Objective: To examine the prevalence of advanced frailty, comorbidity, and age among sepsis-related deaths in an adult hospital population.
    Methods: Retrospective chart reviews of deceased adults within a Norwegian hospital trust, with a diagnosis of infection, over 2 years (2018-2019). The likelihood of sepsis-related death was evaluated by clinicians as sepsis-related, possibly sepsis-related, or not sepsis-related.
    Results: Of 633 hospital deaths, 179 (28%) were sepsis-related, and 136 (21%) were possibly sepsis-related. Among these 315 patients whose deaths were sepsis-related or possibly sepsis-related, close to three in four patients (73%) were either 85 years or older, living with severe frailty (Clinical Frailty Scale, CFS, score of 7 or more), or an end-stage condition prior to the admission. Among the remaining 27%, 15% were either 80-84 years old, living with frailty corresponding to a CFS score of 6, or severe comorbidity, defined as 5 points or more on the Charlson Comorbidity Index (CCI). The last 12% constituted the presumably healthiest cluster, but in this group as well, the majority died with limitations of care due to their premorbid functional status and/ or comorbidity. Findings remained stable if the population was limited to sepsis-related deaths on clinicians' reviews or those fulfilling the Sepsis-3 criteria.
    Conclusions: Advanced frailty, comorbidity, and age were predominant in hospital fatalities where infection contributed to death, with or without sepsis. This is of importance when considering sepsis-related mortality in similar populations, the applicability of study results to everyday clinical work, and future study designs.
    MeSH term(s) Adult ; Humans ; Aged, 80 and over ; Frailty/epidemiology ; Frailty/diagnosis ; Retrospective Studies ; Prevalence ; Trust ; Sepsis/epidemiology ; Hospitals ; Comorbidity ; Hospital Mortality
    Language English
    Publishing date 2023-03-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 185104-4
    ISSN 1439-0973 ; 0300-8126 ; 0173-2129
    ISSN (online) 1439-0973
    ISSN 0300-8126 ; 0173-2129
    DOI 10.1007/s15010-023-02013-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Akuttmedisinsk utdanning i USA.

    Bjørnsen, Lars Petter

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2010  Volume 130, Issue 16, Page(s) 1638–1639

    Title translation Emergency medicine education in USA.
    MeSH term(s) Clinical Competence ; Emergency Medicine/education ; Emergency Medicine/standards ; Emergency Service, Hospital/manpower ; Emergency Service, Hospital/standards ; Foreign Medical Graduates ; Humans ; Internship and Residency ; United States
    Language Norwegian
    Publishing date 2010-08-26
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.10.0202
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Low-voltage electric shock - proposed new recommendations.

    Bjørnsen, Lars Petter / Svendsen, Trude Beathe / Bærheim, Dina / Dale, Jostein / Vesterfjell, Svend Peder / Ofstad, Eirik Hugaas / Næss-Pleym, Lars Eide / Goffeng, Lars Ole

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2022  Volume 142, Issue 4

    Title translation Strømgjennomgang fra lavspenning – forslag til nye anbefalinger.
    MeSH term(s) Electric Injuries/complications ; Electric Injuries/prevention & control ; Humans
    Language Norwegian
    Publishing date 2022-02-24
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.21.0880
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Akuttmottaket trenger egne spesialister.

    Bjørnsen, Lars Petter / Uleberg, Oddvar

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2015  Volume 135, Issue 14, Page(s) 1230–1232

    Title translation The emergency department needs their own specialists.
    MeSH term(s) Curriculum ; Education, Medical, Graduate ; Emergency Medicine/education ; Emergency Service, Hospital ; Humans ; Specialization
    Language Norwegian
    Publishing date 2015-08-11
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.15.0610
    Database MEDical Literature Analysis and Retrieval System OnLINE

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