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Jonson, Carl-Oscar, DocentORCID iD iconorcid.org/0000-0003-1383-375x
Publications (10 of 27) Show all publications
Toll John, R., Henricson, J., Junker, J., Jonson, C.-O., Nilsson, G., Björk Wilhelms, D. & Anderson, C. D. (2018). A cool response: the influence of ambient temperature on capillary refill time. Journal of Biophotonics, 11(6)
Open this publication in new window or tab >>A cool response: the influence of ambient temperature on capillary refill time
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2018 (English)In: Journal of Biophotonics, ISSN 1864-063X, E-ISSN 1864-0648, Vol. 11, no 6Article in journal (Refereed) Published
Abstract [en]

Objective

To describe the effect of low ambient temperature on skin temperature and capillary refill (CR) time in forehead, sternum and finger pulp.

Methods

An observational, nonrandomized experimental study on 15 healthy subjects (6 females) in a cold room (8°C). Outcome measures were skin temperature and quantified CR test after application of a standardized blanching pressure (9 N/cm2) using digital photographic polarization spectroscopy to generate CR times.

Results

The finger pulp showed marked temperature fall and prolonged CR times (>10 seconds). The CR registrations of the forehead and sternum were more comparable to curves observed in a control material at room temperature, and skin temperature falls were less marked. CR times were not prolonged in forehead measurements. At the sternum, some individuals showed CR times beyond guideline recommendations despite only a marginal reduction in skin temperature.

Conclusions

Low ambient temperature is a strong independent factor for CR time at peripheral sites. Reservation about sternum as a site of measurement is warranted since cold provocation produced prolonged CR times in some individuals. We found that the forehead is the most thermostable of the 3 sites and thus the preferred site to avoid ambient temperature artifact in measuring CR time.

Place, publisher, year, edition, pages
Wiley-VCH Verlagsgesellschaft, 2018
National Category
Atom and Molecular Physics and Optics
Identifiers
urn:nbn:se:liu:diva-145527 (URN)10.1002/jbio.201700371 (DOI)000434641700017 ()29384267 (PubMedID)
Note

Funding agencies: Socialstyrelsen; Region Ostergotland

Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2019-04-30Bibliographically approved
Prytz, E., Norén, C. & Jonson, C.-O. (2018). Fixation Differences in Visual Search of Accident Scenes by Novices and Expert Emergency Responders. Human Factors, 60(8), 1219-1227
Open this publication in new window or tab >>Fixation Differences in Visual Search of Accident Scenes by Novices and Expert Emergency Responders
2018 (English)In: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 60, no 8, p. 1219-1227Article in journal (Refereed) Published
Abstract [en]

Objective:

We sought to investigate whether expert–novice differences in visual search behavior found in other domains also apply to accident scenes and the emergency response domain.

Background:

Emergency service professionals typically arrive at accidents only after being dispatched when a civilian witness has called an emergency dispatch number. Differences in visual search behavior between the civilian witness (usually a novice in terms of emergency response) and the professional first responders (experts at emergency response) could thus result in the experts being given insufficient or erroneous information, which would lead them to arrive unprepared for the actual situation.

Method:

A between-subjects, controlled eye-tracking experiment with 20 novices and 17 experts (rescue and ambulance service personnel) was conducted to explore expert–novice differences in visual search of accident and control images.

Results:

The results showed that the experts spent more time looking at task-relevant areas of the accident images than novices did, as predicted by the information reduction hypothesis. The longer time was due to longer fixation durations rather than a larger fixation count.

Conclusion:

Expert–novice differences in visual search are present in the emergency domain. Given that this domain is essential to saving lives and also relies heavily on novices as the first link in the chain of response, such differences deserve further exploration.

Application:

Visual search behavior from experts can be used for training purposes. Eye-tracking studies of novices can be used to inform the design of emergency dispatch interviews.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
visual search, disaster response, emergency medicine, eye tracking, expert–novice differences
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-150343 (URN)10.1177/0018720818788142 (DOI)000449837300010 ()30102566 (PubMedID)
Note

Funding agencies: Swedish Civil Contingencies Agency (MSB) [2011-4957]

Available from: 2018-08-17 Created: 2018-08-17 Last updated: 2018-12-03Bibliographically approved
Lampi, M., Junker, J., Tabu, J. S., Berggren, P., Jonson, C.-O. & Wladis, A. (2018). Potential benefits of triage for the trauma patient in a Kenyan emergency department. BMC Emergency Medicine, 18(49), 1-7
Open this publication in new window or tab >>Potential benefits of triage for the trauma patient in a Kenyan emergency department
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2018 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 18, no 49, p. 1-7Article in journal (Refereed) Published
Abstract [en]

Background

Improved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Further, the study attempts to assess potential benefits of triage towards efficient management of trauma patients in one middle income country.

Methods

A prospective descriptive study was conducted. Adult trauma patients admitted to the emergency department during an 8-month period at Moi Teaching and Referral Hospital in Eldoret, Kenya, were included. Mode of arrival and vital parameters were registered. Variables included in the analysis were Injury Severity Score, time before physician’s assessment, length of hospital stay, and mortality. The patients were retrospectively categorized according to the Rapid Emergency Triage and Treatment System (RETTS) from patient records.

Results

A total of 571 patients were analyzed, with a mean Injury Severity Score of 12.2 (SD 7.7) with a mean length of stay of 11.6 (SD 18.3) days. The mortality rate was 1.8%. The results obtained in this study illustrate that trauma patients admitted to the emergency department at Eldoret are not assessed in a timely fashion, and the time frame recommendations postulated by RETTS are not adhered to. Assessment of patients according to the triage algorithm used revealed a significantly higher average Injury Severity Score in the red category than in the other color categories.

Conclusion

The results from this study clearly illustrate a lack of correct prioritization of patients in relation to the need for timely assessment. This is further demonstrated by the retrospective triage classification of patients, which identified patients with high ISS as in urgent need of care. Since no significant difference in to time to assessment regardless of injury severity was observed, the need for a well-functioning triage system is apparent.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Triage, Trauma, Emergency department
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-153305 (URN)10.1186/s12873-018-0200-7 (DOI)30497397 (PubMedID)2-s2.0-85057551142 (Scopus ID)
Note

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2019-05-07Bibliographically approved
Lowndes, B., Forsyth, K., Prytz, E., Jonson, C.-O., Abdelrahman, A., Matthew, S., . . . Hallbeck, S. (2017). A Preliminary Comparison of Three Tourniquet Instructions for Just-in-Time Guidance of a Simulated Tourniquet Application. In: Proceedings of the Human Factors and Ergonomics Society 2017 Annual Meeting: . Paper presented at The Human Factors and Ergonomics Society 61st Annual Meeting, October 9-13 October, Austin, Texas, USA (pp. 1076-1080). Santa Monica: Human Factors and Ergonomics Society, HFES
Open this publication in new window or tab >>A Preliminary Comparison of Three Tourniquet Instructions for Just-in-Time Guidance of a Simulated Tourniquet Application
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2017 (English)In: Proceedings of the Human Factors and Ergonomics Society 2017 Annual Meeting, Santa Monica: Human Factors and Ergonomics Society, HFES , 2017, p. 1076-1080Conference paper, Published paper (Refereed)
Abstract [en]

The American College of Surgeons (ACS) and the Department of Homeland Security (DHS) encourage the use of tourniquets as part of the “Stop the Bleed” campaign. Both have provided instructions for layperson tourniquet application in order to save the life of a hemorrhaging trauma victim. This study sought to compare the impact of using ACS and DHS instructions with manufacturer-provided instructions for the completion of simulated tourniquet application steps. Thirty surgical trainees completed a simulated tourniquet application with one of the three instruction sets. Their completion time and success for each step were measured. Participants that received ACS instructions failed the fewest number of steps (p < 0.01) and completed the task faster (Mean (SD) = 70 (33) seconds) compared to those with the manufacturer-provided instructions (p < 0.01). Tourniquet instruction sets need to be refined in order to optimize the success rate of just-in-time guidance for tourniquet application.

Place, publisher, year, edition, pages
Santa Monica: Human Factors and Ergonomics Society, HFES, 2017
Series
Human Factors and Ergonomics Society Annual Meeting. Proceedings, ISSN 1541-9312 ; 2017
Keywords
stop the bleed, tourniquet, just-in-time, training
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-141997 (URN)10.1177/1541931213601873 (DOI)
Conference
The Human Factors and Ergonomics Society 61st Annual Meeting, October 9-13 October, Austin, Texas, USA
Available from: 2017-10-17 Created: 2017-10-17 Last updated: 2017-10-17Bibliographically approved
Jonson, C.-O., Prytz, E. & Janson, O. (2017). A social network analysis of the emergency medical command during a live CBRNE exercise. In: Abstracts of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017: . Paper presented at WADEM Congress on Disaster and Emergency Medicine, Toronto, Canada, 25-28 April, 2017 (pp. S223-S224). Cambridge University Press
Open this publication in new window or tab >>A social network analysis of the emergency medical command during a live CBRNE exercise
2017 (English)In: Abstracts of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017, Cambridge University Press, 2017, p. S223-S224Conference paper, Oral presentation with published abstract (Other academic)
Place, publisher, year, edition, pages
Cambridge University Press, 2017
Series
Prehospital and Disaster Medicine, ISSN 1049-023X ; Volume 32, Issue S1
Keywords
social network analysis, sna, cbrne, first responder, emergency, disaster management, command and control
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-141755 (URN)10.1017/S1049023X17005787 (DOI)
Conference
WADEM Congress on Disaster and Emergency Medicine, Toronto, Canada, 25-28 April, 2017
Available from: 2017-10-17 Created: 2017-10-17 Last updated: 2017-11-22Bibliographically approved
Rybing, J., Prytz, E., Hornwall, J., Nilsson, H., Jonson, C.-O. & Bång, M. (2017). Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory. Journal Simulation & Gaming, 48(1), 131-152
Open this publication in new window or tab >>Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory
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2017 (English)In: Journal Simulation & Gaming, ISSN 1046-8781, E-ISSN 1552-826X, Vol. 48, no 1, p. 131-152Article in journal (Refereed) Published
Abstract [en]

Background Training of medical professionals is important to improve care during mass-causality events. Therefore, it is essential to extend knowledge on how to design valid and usable simulation-based training environments.

Purpose This article investigates how distributed cognition and simulation theory concepts can guide design of simulation-based training environments. We present the design and user evaluation of DigEmergo, a simulator for training and assessing emergency medicine management.

Design approach A prior Distributed Cognition in Teamwork (DiCoT) analysis of the Emergo Train System (ETS) guided the design process. The design objective of DigEmergo was to be useful, usable, retain distributed cognition features of ETS, and strengthen validity and output reliability.

Evaluation Eight expert ETS instructors participated in a formative system evaluation. The Technology Assessment Model (TAM) questionnaire was used to measure usefulness and ease of use. Observations and post-test interviews were conducted to contextualize the measures.

Results The results showed that DigEmergo was perceived as somewhat to quite useful and somewhat easy to use. Overall, expert users considered DigEmergo promising and successful in retaining core ETS features.

Conclusions The study indicates that a design methodology based on distributed cognition and simulation theory can be successfully combined to guide simulator (re)design and strengthen simulator validity.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
distributed cognition, emergency medicine management training, simulation, simulator design, simulator user evaluation
National Category
Computer Systems
Identifiers
urn:nbn:se:liu:diva-132723 (URN)10.1177/1046878116676511 (DOI)2-s2.0-85011578887 (Scopus ID)
Available from: 2016-11-21 Created: 2016-11-21 Last updated: 2018-05-02Bibliographically approved
Forsyth, K., Lowndes, B., Prytz, E., Jonson, C.-O., Matthew, S., Heller, S., . . . Blocker, R. (2017). Improving Instructions to Stop the Bleed. In: Proceedings of the Human Factors and Ergonomics Society 2017 Annual Meting: . Paper presented at The Human Factors and Ergonomics Society 61st Annual Meeting, 9-13 October, Austin, Texas, USA (pp. 588-592). Santa Monica: Human Factors and Ergonomics Society, HFES
Open this publication in new window or tab >>Improving Instructions to Stop the Bleed
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2017 (English)In: Proceedings of the Human Factors and Ergonomics Society 2017 Annual Meting, Santa Monica: Human Factors and Ergonomics Society, HFES , 2017, p. 588-592Conference paper, Published paper (Refereed)
Abstract [en]

The Stop The Bleed initiative was developed by the Department of Homeland Security to educate lay providers in bleeding reduction strategies. The current study evaluated: (1)three tourniquet instructions using a simulated tourniquet task and (2)participant confidence levels in tourniquet use and lay provider training. Thirty participants with limited clinical experience applied a tourniquet to a simulated limb using one of three instruction sets. Twelve of these participants (40%) participated in a tourniquet training session and focus group to discuss each instruction set. Participants preferred the most simple and pictoral instruction set, and identified opportunities for improvement in each set. Participant confidence in tourniquet use increased significantly following the task and the focus group. After the focus group, participant confidence in instructing lay providers on proper tourniquet use significantly increased. Adding key steps, contextual pictures, and indicators of success to instructions could support lay providers stop the bleed in life-threatening situations

Place, publisher, year, edition, pages
Santa Monica: Human Factors and Ergonomics Society, HFES, 2017
Series
Human Factors and Ergonomics Society Annual Meeting. Proceedings, ISSN 1541-9312 ; 2017
Keywords
tourniquet, instructions, human factors, stop the bleed
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-141983 (URN)10.1177/1541931213601631 (DOI)
Conference
The Human Factors and Ergonomics Society 61st Annual Meeting, 9-13 October, Austin, Texas, USA
Available from: 2017-10-16 Created: 2017-10-16 Last updated: 2017-10-17Bibliographically approved
Lampi, M., Junker, J., Berggren, P., Jonson, C.-O. & Vikström, T. (2017). Pre-hospital triage performance after standardized trauma courses. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 25, Article ID 53.
Open this publication in new window or tab >>Pre-hospital triage performance after standardized trauma courses
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2017 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 25, article id 53Article in journal (Refereed) Published
Abstract [en]

Background: The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass Casualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-Hospital Trauma Life Support courses. Methods: A questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident: decision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation. Swedish Advanced Trauma Life Support and Pre-Hospital Trauma Life Support course participants filled in the same triage skills questionnaire just before and after their respective course. Results: One hundred fifty-three advanced Trauma Life Support course participants were compared to 175 Pre-Hospital Trauma Life Support course participants. The response rates were 90% and 95%, respectively. A significant improvement was found between pre-test and post-test for the Pre-Hospital Trauma Life Support group in regards to decision-making. This difference was only noticeable among the participants who had previously participated in Mass Casualty Incident drills or had experience of a real event (pre-test mean +/- standard deviation 2.4 +/- 0.68, post-test mean +/- standard deviation 2.60 +/- 0.59, P = 0.04). No improvement was found between pre-test and post-test for either group regarding prioritization of the bus crash casualties or the correct identification of the most injured patients for immediate evacuation. Conclusions: Neither Advanced Trauma Life Support nor Pre-Hospital Trauma Life Support participants showed general improvement in their tested triage skills. However, participation in Mass Casualty Incident drills or experience of real events prior to the test performed here, were shown to be advantageous for Pre-Hospital Trauma Life Support participants. These courses should be modified in order to assure proper training in triage skills.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2017
Keywords
Mass Casualty Incident; Advanced Trauma Life Support; Pre-Hospital Trauma Life Support
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-138244 (URN)10.1186/s13049-017-0395-8 (DOI)000401773100001 ()28526053 (PubMedID)
Available from: 2017-06-14 Created: 2017-06-14 Last updated: 2018-05-02
Rosander, M. & Jonson, C.-O. (2017). Professional confidence in the roles as ambulance and medical incident commander. Journal of Contingencies and Crisis Management, 25(4), 289-300
Open this publication in new window or tab >>Professional confidence in the roles as ambulance and medical incident commander
2017 (English)In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 25, no 4, p. 289-300Article in journal (Refereed) Published
Abstract [en]

The aim was to investigate professional confidence in the roles of ambulance and medi- cal incident commander (AIC and MIC), and how it influences achievement of perfor- mance indicators at an incident site. A web survey based on theoretical constructs (e.g., social identity, efficacy, accountability) and questions about prehospital emergency care connected to the roles were used (n = 426 Swedish ambulance nurses and emer- gency medical technicians). The results showed that social identity, independence and occupation were moderators for professional confidence. Organizational support, rela- tional trust and independence were moderators for achieving performance indicators. Strengthening group identification and independence as MIC and independence and support for women as AIC together with a stronger organizational support can increase professional confidence and improve performance.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017
National Category
Psychology
Identifiers
urn:nbn:se:liu:diva-134156 (URN)10.1111/1468-5973.12156 (DOI)000416148300009 ()
Available from: 2017-01-26 Created: 2017-01-26 Last updated: 2018-05-02
Jonson, C.-O., Pettersson, J., Rybing, J., Nilsson, H. & Prytz, E. (2017). Short simulation exercises to improve emergency department nurses self-efficacy for initial disaster management: Controlled before and after study. Nurse Education Today, 55, 20-25
Open this publication in new window or tab >>Short simulation exercises to improve emergency department nurses self-efficacy for initial disaster management: Controlled before and after study
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2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 55, p. 20-25Article in journal (Refereed) Published
Abstract [en]

Introduction: Head nurses at emergency departments often assume responsibility for managing the initial response to a major incident, and to create surge capacity. Training is essential to enable these nurses to perform an effective disaster response. Evaluating the effects of such training is however complicated as real skill only can be demonstrated during a real major incident. Self-efficacy has been proposed as an alternative measure of training effectiveness. Purpose: The aim of this study was to examine if short, small-scale computer-based simulation exercises could improve head emergency nurses general and specific self-efficacy and initial incident management skills. Method: A within-group pretest-posttest design was used to examine 13 head nurses general and specific self efficacy before and after an intervention consisting of three short computer based simulation exercises during a 1-h session. Management skills were assessed using the computer simulation tool DigEmergo. Results: The exercises increased the head nurses general self-efficacy but not their specific self-efficacy. After completing the first two exercises they also exhibited improved management skills as indicated by shorter time to treatment for both trauma and in-hospital patients. Conclusion: This study indicates that short computer based simulation exercises provide opportunities for head nurses to improve management skills and increase their general self-efficacy.

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE, 2017
Keywords
Management; Mass casualty incident; Nurses; Simulation training; Surge capacity
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-139548 (URN)10.1016/j.nedt.2017.04.020 (DOI)000404700900005 ()28505521 (PubMedID)
Note

Funding Agencies|Swedish Civil Contingencies Agency (MSB) [2011-4957]

Available from: 2017-08-08 Created: 2017-08-08 Last updated: 2018-05-02
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1383-375x

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