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Article ; Online: Pro-Con Debate: Prehospital Blood Transfusion-Should It Be Adopted for Civilian Trauma?

Dudaryk, Roman / Heim, Catherine / Ruetzler, Kurt / Pivalizza, Evan G

2022 Volume 134, Issue 4, Page(s) 678–682

Abstract: Exsanguination is the leading cause of death in severely injured patients; nevertheless, prehospital blood transfusion (PHT) remains a controversial topic. Here, we review the pros and cons of PHT, which is now routine in treatment of military trauma ... ...

Abstract	Exsanguination is the leading cause of death in severely injured patients; nevertheless, prehospital blood transfusion (PHT) remains a controversial topic. Here, we review the pros and cons of PHT, which is now routine in treatment of military trauma patients in the civilian setting. While PHT may improve survival in those who suffer blunt injury or require prolonged transport from the site of injury, PHT for civilian trauma generally is not supported by high-quality evidence. This article was originally presented as a pro-con debate at the 2020 meeting of the European Society of Anesthesiology and Intensive Care.
MeSH term(s)	Blood Transfusion ; Emergency Medical Services ; Exsanguination ; Humans ; Wounds and Injuries/diagnosis ; Wounds and Injuries/therapy ; Wounds, Nonpenetrating
Language	English
Publishing date	2022-03-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000005747
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Article: Douleurs et arthrose.

Heim, Catherine / Hügle, Thomas

Revue medicale suisse

2018 Volume 14, Issue 612, Page(s) 1287–1290

Abstract: Osteoarthritis is one of the principal reasons for chronic pain worldwide. With the increase of life span, sedentary lifestyle and obesity, its socioeconomic impact is on the rise. The origin of osteoarthritis pain is heterogeneous and related to ... ...

Title translation	Pain and osteoarthritis.
Abstract	Osteoarthritis is one of the principal reasons for chronic pain worldwide. With the increase of life span, sedentary lifestyle and obesity, its socioeconomic impact is on the rise. The origin of osteoarthritis pain is heterogeneous and related to structural changes of all intra-and para-articular components. Optimization of biomechanics constitutes a principal pillar of therapeutic strategies. Although disease-modifying concepts are the main goal, symptomatic therapies may bring temporary relief. Identification of a neuropathic component of pain is important to implement the optimal pharmacotherapy. Based on today's knowledge, therapy evolves towards a multimodal approach, which should be implemented early on.
Language	French
Publishing date	2018-06-20
Publishing country	Switzerland
Document type	English Abstract ; Journal Article
ZDB-ID	2177010-4
ISSN	1660-9379
ISSN	1660-9379
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Article: Recognizing Preventable Death: Is There a Role of Survival Prediction Algorithms?

Radke, Oliver C / Heim, Catherine

Anesthesiology clinics

2018 Volume 37, Issue 1, Page(s) 1–11

Abstract: Monitoring the quality of trauma care is important but particularly challenging. Preventable death assessment aims to identify those cases where the patient's death would have not occurred if the patient had been treated differently. Determination of ... ...

Abstract	Monitoring the quality of trauma care is important but particularly challenging. Preventable death assessment aims to identify those cases where the patient's death would have not occurred if the patient had been treated differently. Determination of preventable death in trauma care is often based on calculated probability of survival, commonly by using the Trauma and Injury Severity Score (TRISS). TRISS is not suited for identifying all cases with opportunities for improvement. Combined with other methods such as morbidity and mortality conferences, however, it might be a valid approach if a complete review of all trauma deaths is not feasible at an institution.
MeSH term(s)	Algorithms ; Humans ; Injury Severity Score ; Probability ; Survival Analysis ; Trauma Severity Indices ; Wounds and Injuries/mortality
Language	English
Publishing date	2018-12-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2228899-5
ISSN	2210-3538 ; 1932-2275 ; 0889-8537
ISSN (online)	2210-3538
ISSN	1932-2275 ; 0889-8537
DOI	10.1016/j.anclin.2018.09.001
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Article ; Online: Pediatric Trauma: Six Years of Experience in a Swiss Trauma Center.

Svantner, Julianna / Dolci, Mirko / Heim, Catherine / Schoettker, Patrick

Pediatric emergency care

2019 Volume 37, Issue 12, Page(s) e1133–e1138

Abstract: Objectives: The purpose of this study was to provide an internationally comparable overview of pediatric trauma of the University Hospital of Lausanne to improve the care of children.: Methods: We analyzed the data from all injured children (<16 ... ...

Abstract	Objectives: The purpose of this study was to provide an internationally comparable overview of pediatric trauma of the University Hospital of Lausanne to improve the care of children. Methods: We analyzed the data from all injured children (<16 years of age) listed in our trauma registry from 2011 to 2016. These children were admitted to the resuscitation room after prehospital triage. Our data were analyzed using descriptive statistics. Results: We included 327 children. Sixty-three percent were male, and the median age was 8 years. Severe trauma (Injury Severity Score (ISS), >15) occurred in 97 children. The principal mechanisms of injury were falls (45%), traffic accidents (29%), and burns (14%). The most frequently affected areas were the head and external body regions. Intensive care admissions amounted to 27%. Twenty percent of patients underwent immediate surgery (wound care, neurosurgery, and orthopedic surgery). The overall mortality rate was 5.5%, with a median ISS of 9. The mortality of severe trauma was 17.5%, with a median ISS of 22. Half of the children died within 6 hours. The main causes of death were falls from greater than 5 m and traffic accidents as pedestrians. Conclusions: The demographics and patterns of injury in the pediatric trauma population are similar to other European pediatric trauma centers, but the mortality and the severity of injuries can vary (United Kingdom, 3.7%, median ISS of 9; Denmark, 7.3%, median ISS of 9; and Germany, 13.4%, median ISS of 25). The elevated early mortality rate suggests that improvements in prehospital care and early resuscitation could decrease mortality.
MeSH term(s)	Accidents, Traffic ; Child ; Humans ; Injury Severity Score ; Male ; Pedestrians ; Retrospective Studies ; Switzerland/epidemiology ; Trauma Centers ; Wounds and Injuries/epidemiology ; Wounds and Injuries/therapy
Language	English
Publishing date	2019-11-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	632588-9
ISSN	1535-1815 ; 0749-5161
ISSN (online)	1535-1815
ISSN	0749-5161
DOI	10.1097/PEC.0000000000001925
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Article: Medizinische Qualitätsarbeit - eine Bestandesaufnahme in Kleinporträts (26) TRAC - interdisziplinäres Traumaregister

Heim, Catherine

Schweizerische Ärztezeitung

2010 Volume 91, Issue 51/52, Page(s) 2031

Language	German
Document type	Article
ZDB-ID	507697-3
ISSN	0036-7486
Database	Current Contents Medicine

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Article ; Online: Survival prediction algorithms miss significant opportunities for improvement if used for case selection in trauma quality improvement programs.

Heim, Catherine / Cole, Elaine / West, Anita / Tai, Nigel / Brohi, Karim

Injury

2016 Volume 47, Issue 9, Page(s) 1960–1965

Abstract: Background: Quality improvement (QI) programs have shown to reduce preventable mortality in trauma care. Detailed review of all trauma deaths is a time and resource consuming process and calculated probability of survival (Ps) has been proposed as audit ...

Abstract	Background: Quality improvement (QI) programs have shown to reduce preventable mortality in trauma care. Detailed review of all trauma deaths is a time and resource consuming process and calculated probability of survival (Ps) has been proposed as audit filter. Review is limited on deaths that were 'expected to survive'. However no Ps-based algorithm has been validated and no study has examined elements of preventability associated with deaths classified as 'expected'. The objective of this study was to examine whether trauma performance review can be streamlined using existing mortality prediction tools without missing important areas for improvement. Methods: We conducted a retrospective study of all trauma deaths reviewed by our trauma QI program. Deaths were classified into non-preventable, possibly preventable, probably preventable or preventable. Opportunities for improvement (OPIs) involve failure in the process of care and were classified into clinical and system deviations from standards of care. TRISS and PS were used for calculation of probability of survival. Peer-review charts were reviewed by a single investigator. Results: Over 8 years, 626 patients were included. One third showed elements of preventability and 4% were preventable. Preventability occurred across the entire range of the calculated Ps band. Limiting review to unexpected deaths would have missed over 50% of all preventability issues and a third of preventable deaths. 37% of patients showed opportunities for improvement (OPIs). Neither TRISS nor PS allowed for reliable identification of OPIs and limiting peer-review to patients with unexpected deaths would have missed close to 60% of all issues in care. Conclusions: TRISS and PS fail to identify a significant proportion of avoidable deaths and miss important opportunities for process and system improvement. Based on this, all trauma deaths should be subjected to expert panel review in order to aim at a maximal output of performance improvement programs.
MeSH term(s)	Aged ; Algorithms ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Probability ; Quality Improvement/organization & administration ; Retrospective Studies ; Survival Analysis ; Trauma Centers/standards ; Trauma Severity Indices ; United Kingdom ; Wounds and Injuries/mortality
Language	English
Publishing date	2016-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2016.05.042
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Article ; Online: Revisiting transfusion safety and alternatives to transfusion.

Schoettker, Patrick / Marcucci, Carlos E / Casso, Gabriele / Heim, Catherine

Presse medicale (Paris, France : 1983)

2016 Volume 45, Issue 7-8 Pt 2, Page(s) e331–40

Abstract: Transfusion of blood products can be life saving when used appropriately. It carries however at the same time a potential for morbidity and mortality, depending on the patient, the product or the setting. Numerous strategies have been elaborated to ... ...

Abstract	Transfusion of blood products can be life saving when used appropriately. It carries however at the same time a potential for morbidity and mortality, depending on the patient, the product or the setting. Numerous strategies have been elaborated to minimize these risks, and in recent years, transfusion has no longer been regarded as essential for the management of a wide range of diseases. Uncomplicated surgeries in well-prepared patients can now be conducted without the use of transfusions. Questions about transfusion safety and shortage have led to extensive research on alternatives to blood transfusion, ranging from non-pharmacological to pharmacological solutions. Restrictive transfusion therapies, preoperative autologous blood donations, perioperative red cell salvage, acute normovolaemic haemodilution techniques or patient blood management are potential solutions where prothrombin complex or fibrinogen concentrates, synthetic anti-fibrinolytic agents, desmopressin, rFVIIa, or erythropoiesis stimulating agents may play a complementary pharmacologic role.
MeSH term(s)	Humans ; Patient Safety ; Transfusion Reaction
Language	English
Publishing date	2016-07
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	120943-7
ISSN	2213-0276 ; 0032-7867 ; 0755-4982 ; 0301-1518
ISSN (online)	2213-0276
ISSN	0032-7867 ; 0755-4982 ; 0301-1518
DOI	10.1016/j.lpm.2016.06.023
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Zs.A 794: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Reply to the letter to the editor of R. M. Hasler et al.

Heim, Catherine / Schoettker, Patrick / Wasserfallen, Jean-Blaise

Swiss medical weekly

2014 Volume 144, Page(s) w14003

MeSH term(s)	Female ; Humans ; Male ; Trauma Centers/statistics & numerical data ; Wounds and Injuries/epidemiology
Language	English
Publishing date	2014
Publishing country	Switzerland
Document type	Comment ; Letter
ZDB-ID	2036179-8
ISSN	1424-3997 ; 1424-7860
ISSN (online)	1424-3997
ISSN	1424-7860
DOI	10.4414/smw.2014.14003
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Article ; Online: Knowledge of Glasgow coma scale by air-rescue physicians

Heim Catherine / Schoettker Patrick / Gilliard Nicolas / Spahn Donat R

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 17, Iss 1, p

2009 Volume 39

Abstract: Abstract Objective To assess the theoretical and practical knowledge of the Glasgow Coma Scale (GCS) by trained Air-rescue physicians in Switzerland. Methods Prospective anonymous observational study with a specially designed questionnaire. General ... ...

Abstract	Abstract Objective To assess the theoretical and practical knowledge of the Glasgow Coma Scale (GCS) by trained Air-rescue physicians in Switzerland. Methods Prospective anonymous observational study with a specially designed questionnaire. General knowledge of the GCS and its use in a clinical case were assessed. Results From 130 questionnaires send out, 103 were returned (response rate of 79.2%) and analyzed. Theoretical knowledge of the GCS was consistent for registrars, fellows, consultants and private practitioners active in physician-staffed helicopters. The clinical case was wrongly scored by 38 participants (36.9%). Wrong evaluation of the motor component occurred in 28 questionnaires (27.2%), and 19 errors were made for the verbal score (18.5%). Errors were made most frequently by registrars (47.5%, p = 0.09), followed by fellows (31.6%, p = 0.67) and private practitioners (18.4%, p = 1.00). Consultants made significantly less errors than the rest of the participating physicians (0%, p < 0.05). No statistically significant differences were shown between anesthetists, general practitioners, internal medicine trainees or others. Conclusion Although the theoretical knowledge of the GCS by out-of-hospital physicians is correct, significant errors were made in scoring a clinical case. Less experienced physicians had a higher rate of errors. Further emphasis on teaching the GCS is mandatory.
Keywords	Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2009-09-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Knowledge of Glasgow coma scale by air-rescue physicians.

Heim, Catherine / Schoettker, Patrick / Gilliard, Nicolas / Spahn, Donat R

Scandinavian journal of trauma, resuscitation and emergency medicine

2009 Volume 17, Page(s) 39

Abstract: Objective: To assess the theoretical and practical knowledge of the Glasgow Coma Scale (GCS) by trained Air-rescue physicians in Switzerland.: Methods: Prospective anonymous observational study with a specially designed questionnaire. General ... ...

Abstract	Objective: To assess the theoretical and practical knowledge of the Glasgow Coma Scale (GCS) by trained Air-rescue physicians in Switzerland. Methods: Prospective anonymous observational study with a specially designed questionnaire. General knowledge of the GCS and its use in a clinical case were assessed. Results: From 130 questionnaires send out, 103 were returned (response rate of 79.2%) and analyzed. Theoretical knowledge of the GCS was consistent for registrars, fellows, consultants and private practitioners active in physician-staffed helicopters. The clinical case was wrongly scored by 38 participants (36.9%). Wrong evaluation of the motor component occurred in 28 questionnaires (27.2%), and 19 errors were made for the verbal score (18.5%). Errors were made most frequently by registrars (47.5%, p = 0.09), followed by fellows (31.6%, p = 0.67) and private practitioners (18.4%, p = 1.00). Consultants made significantly less errors than the rest of the participating physicians (0%, p < 0.05). No statistically significant differences were shown between anesthetists, general practitioners, internal medicine trainees or others. Conclusion: Although the theoretical knowledge of the GCS by out-of-hospital physicians is correct, significant errors were made in scoring a clinical case. Less experienced physicians had a higher rate of errors. Further emphasis on teaching the GCS is mandatory.
MeSH term(s)	Air Ambulances ; Glasgow Coma Scale ; Health Knowledge, Attitudes, Practice ; Humans ; Physicians ; Prospective Studies ; Rescue Work ; Surveys and Questionnaires ; Switzerland
Language	English
Publishing date	2009-09-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2455990-8
ISSN	1757-7241
ISSN	1757-7241
DOI	10.1186/1757-7241-17-39
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