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  • 1.
    Aléx, Jonas
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Brister i systematiskt omhändertagande på olycksplatser: en studie av traumasimuleringar inom ambulanssjukvården2018Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, artikel-id EWFHArtikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Ett systematiskt traumaomhändertagande på olycksplats har stor betydelse för patienters överlevnad. Syftet med denna studie var att observera sjuksköters­kor i ambulanssjukvården och följsamhet till konceptet »prehospital trauma life support« vid traumaomhändertagande i en simuleringssituation. Ett observationsprotokoll utformades för att analysera videoinspelningar. Resultatet visar på brister i det systematiska omhändertagandet och ett ineffektivt omhändertagande på skadeplats. Användandet av observationsprotokoll i traumasimulering kan kvalitetssäkra sjuksköterskors följsamhet till vedertagna koncept.

  • 2.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Vestin, Christin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Validating a questionnaire - prehospital preparedness for pediatric trauma patients2017Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 34, s. 2-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In recent decades, prehospital emergency care has undergone extensive development. Today, prehospital emergency nurses (PENs) are well trained and provide advanced care to patients of all ages. Caring for pediatric trauma patients is considered to be particularly demanding. However, in Sweden and internationally, there is a lack of research regarding PENs' preparedness for caring for pediatric trauma patients.

    Objective: The development and testing of a questionnaire on self-reported preparedness among PENs caring for pediatric trauma patients in a prehospital emergency setting.

    Methods: Questionnaire development included face and content validity tests resulting in 38 questions. Eighteen of these questions were analyzed by test-retest. The content of the questionnaire was statistically analyzed.

    Results: Fifteen questions were considered valid after reliability and validity tests. Three questions did not fulfill the stability criteria. The content analyses show a low degree of experience with pediatric trauma patients and half of the participants reported stress symptoms when responding to such alarms.

    Conclusion: The questionnaire assessing PENs preparedness caring for pediatric trauma patients in Sweden is considered to be suitable for research and clinical practice to improve the care of pediatric trauma patients and the health of PENs, although further testing of the questionnaire is required.

  • 3.
    Doohan, Isabelle Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Affiliated to Arctic Research Centre, Umeå University, Umeå, Sweden.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Affiliated to Arctic Research Centre, Umeå University, Umeå, Sweden.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Affiliated to Arctic Research Centre, Umeå University, Umeå, Sweden.
    Survivors' experiences of consequences and recovery five years after a major bus crash2018Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, nr 3, s. 1179-1187Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: There is a lack of long-term follow-up studies focused on injured and uninjured survivors’ experiences of the recovery process after major traffic crashes.

    Aim/objective: To explore survivors’ experiences of long-term physical and psychological consequences and recovery five years after a major bus crash.

    Methodological design and justification: A qualitative design was used to explore experiences in a 5-year follow-up study.

    Research methods: Participants were 54 survivors of a bus crash with 56 survivors and six fatalities. Telephone interviews were analyzed with qualitative content analysis.

    Results: The theme overarching the categories is “visible and existential marks in everyday life” and it represents the range of the crash’s influence in the survivors’ lives. The first category, “health consequences in daily life,” has four subcategories covering quick recovery, suffering in daily life, distress in traffic situations, and long-term pain. Described reasons for quick recovery among survivors were previous crisis experiences, traveling alone, being uninjured, and not being exposed to traumatic impressions. For the other survivors, being reminded of the crash caused disturbing reactions, such as sweating, anxiety, and flashbacks. Survivors avoided going by bus if they could. A group of the injured survivors were still suffering from limiting and painful injuries. The second category, “oneself and social connection,” has three subcategories that include self-awareness, impact on relationships, and connectedness. Survivors developed a stronger bond to their significant other or separated from their partner within the first couple of years. Friendships and a sense of connectedness among survivors were sources of long-lasting comfort and support.

    Conclusion: There is a need for more information about disruptive long-lasting consequences, such as travel anxiety, and available treatments. Initially, health-promoting connectedness can be facilitated by treating survivors as a group of people who belong together, from the day of the crash and throughout the recovery process. 

  • 4.
    Doohan Stjerna, Isabelle
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för polisutbildning vid Umeå universitet. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Limited medical perspective at a strategic level in relation to mass casualty incidents in Swedish tunnels2019Ingår i: International Journal of Emergency Management, ISSN 1471-4825, E-ISSN 1741-5071, Vol. 15, nr 4, s. 360-374Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Mass casualty incidents (MCI) in tunnels can result in devastating consequences. Despite this, there is a knowledge gap in the perspectives and experiences of strategic stakeholders in relation to the emergency medical response to MCI in tunnels. This study aims to explore and describe this issue. The study includes 11 interview participants from the emergency services organisations and governmental and municipal organisations in Sweden. The results indicate that the medical perspective is inadequately represented at a strategic level due, among other, to limited input from emergency medical representatives during planning stages and a lack of social networks. The results implicate a need to create and improve networks among the stakeholders from the involved organisations. Emergency medical personnel should not only be acknowledged for their expertise but should also be included to a greater extent in the planning stages and exercises. Medical and rescue personnel need time to jointly discuss how they, in the best way, can save lives in tunnel MCIs.

  • 5.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    To prevent without over-protecting: children and senior citizens injured during outdoor activities2015Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Bakgrund: Skador är ett vanligt folkhälsoproblem. För de som överlever en skadehändelse kan icke-dödliga skador leda till smärta och funktionshinder. Fall är en vanlig orsak till icke-dödliga skador. Många av dessa skador uppkommer vid någon sorts fysiks aktivitet. Barn och äldre personer drabbas i stor utsträckning av skador på grund av deras fysiska, psykiska och sociala sårbarhet. Omgivningen utomhus påverkar risken att skada sig eftersom människor ofta är mer aktiva där. Fysisk aktivitet är en del i en hälsosam livsstil och en allt vanligare rekommendation som ges inom hälsooch sjukvården för att minska risken för fetma och kroniska sjukdomar. Det finns hälsovinster för barn och äldre personer av att vara aktiva men också en komplexitet i att skadas utomhus. För att barn och äldre personer på ett säkert sätt ska kunna ta del av de hälsosamma fördelar fysisk aktivitet innebär behövs mer forskning. Det övergripande syftet med denna avhandling var att undersöka skador bland barn och äldre som uppkommit under utomhusaktiviteter och utforska erfarenheter och uppfattningar om risker och möjligheten att öka säkerheten utomhus.

    Metoder: Studierna genomfördes i norra Sverige. Deltagarna var barn upp till 12 år (Studie I & II) och personer i åldern 65 år och äldre (Studie III & IV). Studierna I och III är retrospektiva tvärsnittsstudier. Uppgifterna har samlats in genom en skadedatabas (IDB) på ett sjukhus med en väldefinierad population och ett upptagningsområde av en radie på 60 kilometer. Data i studie III kompletterades med en studiespecifik enkät utformad utifrån Haddons matrix. Skadedata har främst analyserats deskriptivt. Studie II var en fältstudie bestående av 14 dagars observationer, sex fokus-gruppintervjuer med barn, och fyra fokus-gruppintervjuer med lärare. De tre datakällorna lades ihop i analysen och analyserades med kvalitativ innehållsanalys. Studie IV var en fokus-gruppstudie med intervjuer av 31 äldre personer indelade i sex grupper. Data i studie IV analyserades med kvalitativ innehållsanalys.

    Resultat: I studie I registrerades 795 skadehändelser av barn i utomhusmiljö med icke-lindriga skador, såsom frakturer, under 2007-2009.De vanligaste rapporterade aktiviteterna som bidrog till skador var relaterade till lek, sport och transport. Markunderlaget var en bidragande orsak till skadehändelsen, tillsammans med produkter som studsmattor, klätterställningar, cyklar och slalom/snowboard utrusning. I fältstudien (Studie II) har barn på skolgården setts klättra högt i klätterställningar, åka med hög fart nedför backar eller slåss med pinnar i skogen. Olika uppfattningar om risk och säkerhet på skolgården påverkar barnens möjlighet till utomhusaktiviteter under skoltid. I studie III, registrerades 300 skadehändelser av äldre personer efter att de fallit och skadats som fotgängare under januari 2009 till april 2011. Kvinnor var överrepresenterade i skadematerialet. Sextio procent drabbades av ickelindriga skador. Frakturer var den vanligaste skadetypen. Faktorer i omgivningen som is och snö var den vanligast beskrivna orsaken till skadehändelsen, samt att det var dåligt sandat på skadeplats. Då skadehändelserna inträffade i offentliga områden angav de skadade fotgängarna att kommunen var ansvarig för det dåliga underhållet av trottoarer och gator/vägar. Men de erkände också sitt eget ansvar för att förhindra att liknande skadehändelser skulle upprepas, det vill säga genom att ändra sitt beteende och använda säkerhetsprodukter. De pensionärer som deltog i fokus-grupp intervjuerna (Studie IV) beskrev hur de anpassade sig till åldersrelaterade förändringar för att kunna vara aktiva utomhus, bland annat genom att ta ansvar och använda sunt förnuft. Att känna sig trygg i närmiljön och att använda säkerhetsprodukter ökade möjligheten till utomhusaktiviteter. Däremot ansågs fallrädsla, brister i säkerhetsprodukter och farliga omgivningar som snö, is och samspelet med cyklister på gång och cykelbanor förhindra utomhusaktiviteter.

    Slutsats: Icke-lindriga skador som frakturer bland barn och äldre personer och som uppkommer under utomhusaktiviteter kan vara, och måste vara, i fokus för skadeförebyggande arbete. Olika perspektiv på risker och säkerhet kan påverka barns utelek på skolgården och äldre personers mobilitet. Det finns ett behov av en balans mellan lärarnas sunda förnuft och den kunskapsbas som finns inom skadeprevention. På samma sätt finns det ett behov av en balans mellan hälsosamma fysiska aktiviteter och en acceptabel skaderisk. Sjuksköterskor är en lämplig grupp professionella som kan arbeta med denna komplexitet och försöka optimera insatser för att barn och äldre personer på ett säkert sätt ska kunna delta i utomhusaktiviteter på skolor och i andra offentliga områden.

  • 6.
    Gyllencreutz, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Björnstig, Johanna
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Rolfsman, Ewa
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Outdoor pedestrian fall-related injuries among Swedish senior citizens: injuries and preventive strategies2015Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 2, s. 225-233Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Senior citizens get around, to a large extent, as pedestrians, and safe walking is desirable for senior citizens allowing them to stay mobile, independent and healthy in old age. Senior citizens are over-represented in injury statistics, and fall-related injuries are common. The aim of this study was to investigate fall-related injuries including healthcare costs among senior citizen pedestrians injured when walking in public outdoor environments and to describe their self-reported causes and suggested preventive strategies. The data were based on a combination of information from injury data and a questionnaire. Three hundred senior citizens attended one emergency department after sustaining injuries from pedestrian falls; 60% suffered nonminor injuries, mostly fractures. One-fifth of the pedestrians were hospitalised for an average of 8 days with an indirect hospital cost of 6.2 million EUR (55 million SEK). Environmental factors such as ice were the most commonly described cause of the injury incident. Forty per cent of the respondents indicated that the municipality was responsible for the cause of the injury incident. Fewer respondents mentioned their own responsibility as a preventive strategy. Thirty per cent described a combination of improvements such as better road maintenance, changes in human behaviour and use of safety products as preventive strategies. It is of great importance to highlight general safety, products and preventive strategies to minimise injury risks, so that pedestrians can safely realise the known health benefits of walking and thereby limit healthcare costs.

  • 7.
    Gyllencreutz, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Pedersen, Ida
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Enarsson, Elisabeth
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    The experience of healthcare staff of incident reporting with respect to venous blood specimen collection practices’2019Ingår i: Policy and Practice in Health and Safety, ISSN 1477-3996, E-ISSN 1477-4003, Vol. 17, nr 2, s. 146-155Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Venous blood specimen collection is an important practical task that results in an analysis response that often leads to a clinical decision. Errors due to inaccurate venous blood specimen collection are frequently reported and can jeopardize patient safety because inaccurate specimens may result in a delayed or incorrect diagnosis and treatment. However, few healthcare personnel have written an error report regarding venous blood specimen collection practices. The aim of this study is to describe the experiences of healthcare personnel with incident reporting of venous blood specimen collection practices in primary health care. Our study is based on 30 individual interviews with healthcare personnel from 10 primary health care centres. Data were analysed using qualitative content analyses. Personnel experiences of incident reporting were summarized in three categories; Uncertainties in the planning and organization, High workload and low priority and, A need for support and guidance. More specifically, barriers hinder personnel in reporting mistakes. An interpretation based on the results is that surrounding circumstances within the organization influence whether personnel report mistakes or not. The result indicates a need for parallel systems, to identify and report errors or near-misses to prevent mistakes. Processed incidents should be returned promptly to the personnel to use as a learning experience. Having a valid questionnaire and a key person to write an incident report, might reduce the burden on the health care staff and increase the numbers of incident reports and patient safety.

  • 8.
    Gyllencreutz, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Rolfsman, Ewa
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap.
    Frånberg, Gun-Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Approve or disapprove risky outdoor play among school children: a field studyManuskript (preprint) (Övrigt vetenskapligt)
  • 9.
    Gyllencreutz, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Rolfsman, Ewa
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap.
    Frånberg, Gun-Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Injury risks during outdoor play among Swedish schoolchildren: teachers' perceptions and injury preventive practices2020Ingår i: Education 3-13, ISSN 0300-4279, E-ISSN 1475-7575, Vol. 48, nr 1, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Approximately 36,000 Swedish children seek medical care annually because of injuries during school time. The purpose of this field study is to investigate risky outdoor play at the school yard and to describe teachers’ perceptions of risk and safety in relation to learning and development. The study includes observations of children (6–12 years old) during outdoor activities as part of the school’s activities and includes focus-group interviews with teachers and children. Children were seen climbing high in play facilities, speeding down slides, or competing with sticks in the woods. Different views of risk and safety among the participants influence outdoor play activities. Teachers’ knowledge of risk seems to be derived from common sense and personal experiences rather than from a professional perspective. A joint approach of educational and medicine disciplines is desirable when it comes to children’s health and development.

  • 10.
    Gyllencreutz, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Rolfsman, Ewa
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Non-minor injuries among children sustained in an outdoor environment: a retrospective register study2015Ingår i: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, E-ISSN 1745-7319, Vol. 22, nr 1, s. 3-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to investigate non-minor injuries sustained during outdoor activities among 0-12 year old children and to explore self-reported circumstances surrounding these incidents. During 2007-2009, the Umea University Hospital injury database (IDB) registered 795 children with moderate (n = 778) and serious (n = 17) injuries, such as fractures. The IDB includes data from a questionnaire completed in the emergency department by the injured child or a parent. The open-ended questions catch the injured child's description of what circumstances precede the injury incident. The most commonly reported activities contributing to injuries were play, sport, and transport. Surface impacts were also reported as contributing factors along with products such as trampolines, bicycles, and downhill skis. By achieving a deeper knowledge about the activities and circumstances that precede non-minor injury incidents, creating safer outdoor environments may be feasible.

  • 11.
    Gyllencreutz, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Everyday outdoor mobility in old age: focus group interviews with active senior citizens2015Ingår i: Healthy Aging Research, ISSN 2261-7434, Vol. 4, artikel-id 32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Senior citizens are over-represented in injury statistics, and fall-related injuries are globally recognized as a major threat to their health and wellbeing. Outdoor falls are likely to occur among those who are active and healthy when walking or cycling. The objective of this study was to explore active senior citizens’ experiences and perceptions of how their safety could be increased and their risk reduced in outdoor environments.

    Methods: Six focus-group interviews with 31 healthy and active senior citizens were conducted in northern Sweden. Data were analyzed via a qualitative content analysis method.

    Results: Participants adjusted to age-related changes in order to stay safe during outdoor mobility. Outdoor activities were facilitated by having confidence of safety within the environment, and by using safety devices. Fear of, for example, falling and dangerous environments, such as uneven surfaces, as well as the shortcomings of safety devices, were constraining elements for outdoor activity.

    Conclusions: It is of great importance to raise awareness of healthy aging and to illuminate directions for environmental changes. Asking old people about their experiences allows the researcher to identify with their perspective, and may give a more comprehensive understanding of the most appropriate recommendations for health and safety improvements.

  • 12.
    Hanberger, Anders
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap, Centrum för utvärderingsforskning (UCER).
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Studies of effects of local safety policy: an overview and narrative synthesis2013Rapport (Övrigt vetenskapligt)
    Abstract [en]

    The objective is to describe existing studies of effects of local safety policy (LSP), aimed at reducing risks, preventing injuries and improving the safety in a community, in an overview. LSP refers to all kinds of safety interventions including one- and multi-component interventions.

    Methods: We screened six databases for publications published 2000-2011 and selected publications through title/abstract and full-text exam. The search terms corresponded to the concept LSP. Studies of health care, crime, fire prevention, industry, terrorism, and traffic with motorized vehicles were excluded. The main findings were categorized as positive, mixed, and no intervention effects.

    Results: 22 reviews and 45 primary studies were selected. The safety domains/target groups evaluated in these studies include: home (n=272), child (n=253), whole population/community (n=142), elderly (n=130), bicyclist (n=67), pedestrian (n=40), and school safety (n=15). Education was the most frequently studied intervention followed by exercise/training and safety inspection/assessment. Bicycle helmet legislation, safety education, burn prevention, traffic calming, and fall prevention exercise programs were found to be effective for some age groups of the population.

    Conclusion: Positive intervention effects are contingent, dependent on many factors, and require a valid intervention theory and successful implementation. There is a need to support continuing collection of local intervention and outcome data, and to develop evaluation of local safety interventions.

    Implications: A policy implication of this overview is the need for supporting improved monitoring and evaluation of LSP. Support for continuing collection of high-quality data, preferably disaggregated, on safety interventions,   incidents, and injuries on the local level would allow for better conclusions on intervention effects.

  • 13.
    Hylander, Johan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Centre for Disaster Medicine, Umeå University.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Centre for Disaster Medicine, Umeå University.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Centre for Disaster Medicine, Umeå University.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Centre for Disaster Medicine, Umeå University.
    Prehospital management provided by medical on-scene commanders in tunnel incidents in Oslo, Norway: an interview study2019Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 27, nr 1, artikel-id 78Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: High demands are placed on the emergency medical services to handle rescue operations in challenging environments such as tunnels. In Oslo, Norway a specialised management function within the emergency medical services, the medical on-scene commander, in line with the command structure within the police and fire brigade, might support or take over command and control from the ambulance incident officer arriving as the first ambulance personnel on scene. The aim was to shed light on the emergency medical service experiences from real tunnel incidents described by the Oslo medical on-scene commanders.

    Methods: Interviews were conducted with six of the seven medical on-scene commander in Oslo, Norway. Data were analysed using a qualitative content analysis.

    Results: The overall theme was "A need for mutual understanding of a tunnel incident". The medical on-scene commander provided tactical support, using their special knowledge of risk objects and resources in the local area. They established operation plans with other emergency services (the police and fire brigade) in a structured and trustful way, thus creating a fluent and coordinated mission. Also, less time was spent arguing at the incident site. By socialising also outside ordinary working hours, a strong foundation of reliance was built between the different parties. A challenge in recent years has been the increasing ordinary workload, giving less opportunity for training and exchange of experiences between the three emergency services.

    Conclusions: The enthusiastic pioneers within the three emergency services have created a sense of familiarity and trust. A specially trained medical on-scene commander at a tunnel incident is regarded to improve the medical management. To improve efficiency, this might be worth studying for other emergency medical services with similar conditions, i.e. tunnels in densely populated areas.

  • 14.
    Karlsson, Sofia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Engström, Gunnar
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Preparedness for mining injury incidents: interviews with Swedish rescuers2017Ingår i: Safety Science Monitor, ISSN 1443-8844, Vol. 20, nr 1, artikel-id 5Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives. To explore the perceptions and experiences of mining-, rescue service- (RS), and emergency medical service (EMS) personnel regarding how to handle incidents in an underground mine.

    Methods. Six focus-group interviews and 10 individual interviews were carried out with groups of mining-, RS and EMS personnel, who served the underground mining industry located in small municipalities in a sparsely populated area of northern Sweden. The transcripts of the interviews were analysed using qualitative content analysis.

    Results. The three groups mostly described experiences of minor incidents and announced a limited preparedness for handling major mining incidents. Collaboration was described as being difficult because of limited knowledge about the others’ responsibilities and capacities. Few non-mining personnel were trained, or prepared to fulfil their tasks in an underground environment, and some expressed that they would even refuse to go underground because of concerns for their own safety.

    Conclusions. There is a need for more collaboration and joint practices between and among the groups involved in rescue operations. Collaboration between mine- and RS personnel exists, but the EMS personnel is largely excluded from this interaction. Therefore, the EMS personnel are insecure about how to handle underground mining incidents. A closer collaboration between all organizations in preparing for mining incidents is emphasized, and would have positive effects on the rescue operation. Some experiences may also be used under similar circumstances, such as incidents in railway and road tunnels.

  • 15.
    Karlsson, Sofia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    The medical perspective on mining incidents: Interviews with emergency medical service (EMS) personnel2019Ingår i: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 8, nr 3, s. 236-246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose of this paper is to examine emergency medical service (EMS) personnel’s perceptions and experiences of managing underground mining injury incidents.

    Design/methodology/approach: In total, 13 EMS personnel were interviewed according to a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using qualitative content analysis.

    Findings: An underground mining environment was described as unfamiliar and unsafe and, with no guidelines for operational actions in an extreme environment, such as underground mines, the EMS personnel were uncertain of their role. They therefore became passive and relied on the rescue service and mining company during a major incident. However, the medical care was not considered to be different from any other prehospital care, although a mining environment would make the situation more difficult and it would take longer for the mine workers to be placed under definitive care.

    Originality/value: This study complements earlier studies by examining the EMS personnel’s perceptions and experiences of major incidents.

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