The Prehospital assessment of severe trauma patients' performed by the specialist ambulance nurse in Sweden - a phenomenographic study

Background A common feature of prehospital emergency care is the short and fragmentary patient encounters with increased demands for efficient and rapid treatment. Crucial decisions are often made and the premise is the specialist ambulance nurse’s ability to capture the situation instantaneously. The assessment is therefore a pre-requisite for decisions about appropriate actions. However, the low exposure to severe trauma cases in Sweden leads to vulnerability for the specialist ambulance nurse, which makes the assessment more difficult. Our objective was to describe specialist ambulance nurses’ perceptions of assessing patients exposed to severe trauma. Methods This study had a phenomenographic approach and was performed in 2011 as an interview study. 15 specialist ambulance nurses with a minimum of 2.5 years of experience from praxis were included. The analysis of data was performed using phenomenography according to Marton. Results The perceptions of assessing patients exposed to severe trauma were divided into: To be prepared for emergency situations, Confidence in one’s own leadership and Developing professional knowledge. Conclusions This study reveals that the specialist ambulance nurse, on the scene of accident, finds the task of assessment of severe trauma patients difficult and complicated. In some cases, even exceeding what they feel competent to accomplish. The specialist ambulance nurses feel that no trauma scenarios are alike and that more practical skills, more training, exercise and feedback are needed

Trademark as a legitimate barrier in trade

The relationship between Intellectual Property (IP), free movement of goods and competition law has always been complex. While IP safeguards an exclusive right that is territorial, the free movement of goods and competition principles aim to have free competition on the market and at first sight, they seem to be in conflict. Trademark rights works as a legitimate barrier for market entry and has the possibility to shut out competitors however has the exhaustion principle limit these rights and the European Court of Justice has made a distinction between the existence and exercise of IPRs. Exhaustion makes sure that once a product is put on the Union market by the proprietor or with their consent, they cannot limit competition because their rights are consumed. It has been established that trademarks have different functions that it is worthy of protection, however the question has been raised whether parallel importers or grey marketers distorts fair trade and infringes the proprietors rights by affecting these types of functions. Parallel trade can cause tension between IPR’s and competition law and especially in connection with exclusive licensing. The free movement of goods provisions are also relevant in this context due to that they work as the fundamental framework to trade. They cover both imports and exports and apply to situation where trade barriers emerge, although there are some legitimate justifications for restricting trade. Under competition law a trademark can create market power that could be caught under the Article 101 of the Treaty Of the Function of the European Union that prohibits agreements that distorts competition. IPRs will not distort competition by just existing but the licensing of them may give rise to anti-competitive behaviour. The vertical relationships are usually exempted from the competition laws but there may be types of restrains that will fall under the provisions and especially when having a certain degree of market power. Modern technology has changed the market and created new obstacles that may be approached from both a free movement and competition law perspective. Because of Internets impact on trade it has raised a lot of question about how to apply the classic trademark provisions in a new forum

The case of the women with the broken heart

Takotsubo can be detected as a kindred disease, predominantly affecting post-menopausal women. By correctly identifying these patients as having an acute heart failure syndrome, the outcome can be favorable

Medical tattoos impact on CPR decisions

Non

BEING RESPONSIBLE FOR THE LIFE OF ANOTHER HUMAN BEING

   A common feature of prehospital emergency care are short and fragmentary patient encounters with in­creased demands for efficient and rapid treatment. Crucial decisions are often made, based on the premise of the ambulance staff`s ability to capture the situation instantaneously. The assessment is, therefore, a pre-requisite for decisions about appropriate actions. However, a low exposure to severe trauma cases leads to vulnerability for the ambulance staff, which makes the assessment more difficult. Assessment of severe trauma patients at the scene of accident is difficult and complicated. No trauma scenarios are alike and practical skills, training, and feedback are therefore necessary

Learning through simulation

With simulation, caregivers are given the opportunity to improve their knowledge and skills. With simulation, both theoretical and practical knowledge is taught. With the experiences that simulation creates, critical thinking and better care are developed. Learning through simulation complements the learning that takes place in everyday work and can have a positive effect of the advances of the care profession. The purpose of simulation may vary and different learning theories are used, both based on learning objectives and the purpose of the simulation. The experience gained from simulation prepares caregivers on how similar complex situations can be handled in the future

The Swedish industry's needs of competences in sustainable development - A comparative analysis to the engineering education at Chalmers University of Technology

The Swedish industry’s needs of competences in sustainable development - A comparative analysis to the engineering education at Chalmers University of Technology The engineers employed in the Swedish industry develop and work with a multitude of products and processes, which have varying influence on society and the environment. It is thus important for engineers to have a good understanding of how the products and processes they work with affect sustainable development. And, in order for the engineers to receive relevant education in the field of sustainable development, it is important for educational institutions to have an understanding of what competences are needed amongst future engineers. This report discusses the competences in sustainable development (SD) sought after by the Swedish industry. It also presents a comparison to the engineering education at Chalmers University of Technology (Chalmers) in order to analyze if the education at hand meets the competence needs within the industry. The report is based on interviews with sustainability managers and other relevant personnel at 16 major companies in Sweden. These companies cover areas such as manufacturing, energy, consultancy, construction, and retail and are based in Sweden but have both national and international presence. It is also based on an analysis of contents in 70 courses on environment and SD at Chalmers. The interviews and course content inventory were compared, an in order to provide further details, the views on SD competence needs amongst Chalmers alumni and students were gathered through two surveys. The results indicate that the Swedish industry demands a higher general competence level in SD amongst all engineers. The company interviewees mention that all engineers need a better understanding of basic issues regarding SD in order to make relevant choices in their daily work. This is confirmed by the alumni where 35 % claim that they encounter SD issues sometimes or daily in their work, but at the same time only 47 % of the above mentioned alumni claim they have enough competence to make decisions from a SD perspective. The company interviewees and alumni regard competences in environmental issues and sustainable business development as important. The company interviewees also mention communication as an integral part of SD competence. The course content inventory has shown that environmental issues are focused upon the most in the SD education at Chalmers, and business development and social issues are less focused upon

Prehospital CPR training performed with visual feedback

INTRODUCTION: Swedish firefighters are a part of the emergency medical services. Therefore, they perform prehospital cardiopulmonary resuscitation (CPR) on a regular basis. Training becomes crucial for maintaining the CPR skills and increasing the patients’ chances of survival. Training with visual feedback is for Swedish firefighters a new way of training CPR. The aim of this study was to evaluate firefighters’ perception of a CPR manikin with visual feedback. METHOD: This study had a qualitative approach. Data were collected by interviews with 16 firefighters after performing CPR on a manikin with visual feedback. The data were analyzed with a manifest content analysis. RESULTS: Visual feedback makes it easy to identify and maintain correct compression rate. There is a need for identifying too deep compressions. Uncertainty regarding the closeness to the stomach arises when using the whole hand during compressions instead of just the wrist. To accomplish an open airway requires a bit of adjustment of the manikins’ head. DISCUSSION: To train and learn CPR is feasible with visual feedback. The firefighters can maintaing a correct compression rate and correct compression depth during the sessions. Ventilating a patient with bag-valvemask or pocket mask may require training with visual feedback to guarantee the firefighters being able to secure an open airway of the patient. All these skills are essential and improve the chance of survival for the patients

Primärvården och evidensen Evidensbaserad praktik i svensk offentlig primärvård från olika perspektiv

The development of information technology and growing insight into the limitations of the old paradigm of practicing medicine resulted in historical events that led to the emergence of evidence-based practice (EBP). Which centers upon putting the evidence of science and clinical knowledge of the health professional in dialogue with the patient and his or her needs and preferences in receiving care. The thesis aim to investigate the prerequisites of evidence-based practice following the evidence-based medicine (EBM) model. Which was accomplished by conducting four studies spread across the domains of evidence-based practice. The studies combined qualitative and quantitative methodology and results in a contemporary description of the attitudes towards evidence-based practice and its possibility to be applied within the primary healthcare organization of today. The key findings of the thesis show that increasing demand for efficiency results in a chronic lack of time and resources to properly execute individual notions of what evidence-based practices ought to be. The deficiency of knowledge and resources is present on both co-worker and managerial levels. In addition, the results indicate that there exist attitudes towards research are somewhat reluctant, that is, that research and evidence-based practice are recognized as something positive and needed. Although research and tasks associated with evidence-based practice seemed somewhat extracurricular. At the same time, it´s mentioned that co-workers also stated that it was sometimes hard to get information relevant for use in primary care. The perceived barrier signals that the influence of economic value and efficiency takes precedence on a practice that ought to be aimed at helping the patient. Primary healthcare is very much heavily reliant on information, which in turn is dependent of internal and external factors to direct resources such as time. Today, there is a growing patient-centered care. Aimed at reducing the existent gap between evidence and clinical practice