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  • 1. Abu-Zidan, FM
    et al.
    Siosteen, AK
    Wang, Jianpu
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery.
    Al-Ayoubi, Fawzi
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology.
    Establishment of a teaching animal model for sonographic diagnosis of trauma2004In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 56, no 1, p. 99-104Article in journal (Refereed)
    Abstract [en]

    Background: Ultrasound is widely accepted as a valuable diagnostic tool for detecting intra-abdominal and intrathoracic bleeding in trauma patients. Nevertheless, many doctors are reluctant to use it because they do not have sufficient training. This study aimed to define intraabdominal and intrathoracic fluid volumes that can be detected by sonography and their relation to fluid width in pigs to establish a clinically relevant animal model for teaching and training. Methods: Different volumes of normal saline were infused into the abdomen (50-2,000 mL) and chest (25-250 mL) in five anesthetized pigs. The maximum width of fluid as detected by ultrasound was recorded. The right upper quadrant, left upper quadrant, pelvis, and right paracolic section of the abdomen and right pleural cavity were studied. An experienced radiologist performed the studies. The effects on respiratory and cardiovascular functions were evaluated. Results: The sonographic findings in the pig were similar to those in humans. Up to 50 mL of intra-abdominal fluid and up to 25 mL of intrathoracic fluid could be detected by ultrasound. There was a significant correlation between the volume infused and the fluid width detected. The respiratory and cardiovascular monitoring of the animals showed that the infused intrathoracic volumes mimicked a survivable hemothorax. Conclusion: The pig may serve as an excellent clinically relevant model with which to teach surgeons detection of different volumes of intra-abdominal and intrathoracic fluids. The value of this model as an educational tool has yet to be tested.

  • 2. Gunnarsson, Mats
    et al.
    Walther, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Seidal, Tomas
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC-2, GE: Gastrokir.
    Effects of inhalation of corticosteroids immediately after experimental chlorine gas lung injury2000In: Journal of Trauma - Injury, Infection and Critical Care, ISSN 1079-6061, Vol. 48, no 1, p. 101-107Article in journal (Refereed)
    Abstract [en]

    Background: To assess the effects of treatment with nebulized corticosteroids immediately after chlorine gas injury. Methods: Eighteen anesthetized and mechanically ventilated pigs were exposed to chlorine gas (140 ppm for 10 minutes) and observed for 6 hours. Nine pigs were treated with nebulized beclomethasone-dipropionate 20 ╡g/kg (BDP group), and nine pigs were given no treatment (control group). Results: All animals developed severe pulmonary dysfunction. The initial decrease in PaO2 was similar in both groups, but BDP-treated animals improved whereas control animals deteriorated (p < 0.005, analysis of variance). Pulmonary vascular resistance increased in both groups but less in the BDP group (p < 0.01). Lung-thorax compliance was better preserved in the BDP group (p < 0.01), and oxygen delivery was significantly better in the BDP group (p < 0.01). One animal died in the BDP group, as did three animals in the control group. Conclusion: Immediate treatment with nebulized BDP improved pulmonary and cardiovascular function after experimental chlorine gas injury.

  • 3. Harness, Jay K
    et al.
    van Heerden, Jon
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC-2, GE: Gastrokir.
    Rothmund, Matthias
    Barraclough, Bruce
    Goode, A W
    Rosen, Irving B
    Fujimoto, Hoshihide
    Proye, Charles
    Future of thyroid surgery and training surgeons to meet the expectations of 2000 and beyond2000In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 24, no 8, p. 976-982Article in journal (Refereed)
    Abstract [en]

    What is the future of thyroid surgery in the new millennium? How can surgeons keep abreast of advances in thyroid endocrinology, genetics surgical therapy, and other aspects of thyroid disease management? How should surgeons be trained to become highly competent in thyroid disease and to perform safe, effective thyroid operative procedures? Nine internationally recognized endocrine surgeons were asked to express their views on these and related subjects. They noted that advances in molecular biology, pathology, and genetics of thyroid disease should allow more tailored surgical approaches during the twenty-first century. Current training of general surgical residents in thyroid and other types of endocrine surgery is highly variable, which may contribute to increased complication rates and number of second operations. The leadership for addressing these deficiencies and promoting a more organized approach to thyroid disease management should come from national endocrine surgery associations and their leaders. It is incumbent upon endocrine surgeons to maintain their central role in the management of many aspects of thyroid disease. Organizing teams of specialists into thyroid centers (centers of excellence) can (1) increase efficiency, (2) increase quality of care, (3) decrease costs, (4) encourage a more individualized approach to surgery, (5) lower complication rates, and (6) foster innovation in technology and disease management. Two years of additional fellowship training in thyroid and endocrine surgery is now being advocated by increasing numbers of national endocrine surgical associations as the best way to prepare surgeons for society's needs for highly skilled, competent thyroid surgeons of the future.

  • 4.
    Horiuchi, Yoshihito
    et al.
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Droog Tesselaar, Erik
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Henricson, Joakim
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Wikström, Thore
    Linköping University, Department of Clinical and Experimental Medicine, Disaster Medicine and Traumatology. Linköping University, Faculty of Health Sciences.
    Lennquist, Sten
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Unit . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Role of histamine release in nonspecific vasodilatation during anodal and cathodal iontophoresis2004In: Microvascular research, ISSN 0026-2862, Vol. 67, no 2, p. 192-196Article in journal (Refereed)
    Abstract [en]

    Nonspecific vasodilatation during iontophoresis is an important confounding factor in experimental pharmacology. In this investigation, we studied the involvement of sensory nerves and histamine-related reactions in causing nonspecific vasodilatation in a model of anodal and cathodal iontophoresis of sodium chloride. Firstly, we applied a mixture of local anesthetic (EMLA) cream to confirm its suppressive effect on nonspecific vasodilatation and to measure its efficacy in three different dosages (duration: 1, 2, and 3 h). We then investigated the role of histamine in nonspecific vasodilatation by giving an oral antihistamine drug (cetirizine) to subjects who had and had not been given EMLA. We found substantial suppression of the nonspecific vasodilatation in all EMLA-treated groups (all dosages) compared with untreated controls (with suppression rates of 60–65%). Dosage had no significant effect. A further suppression of nonspecific vasodilatation was seen after oral cetirizine during anodal and cathodal iontophoresis in both EMLA-treated and untreated groups. The antihistamine effect was most pronounced during anodal iontophoresis. These results suggest a histaminergic increase in perfusion that may be independent of neurogenic mechanisms and depend on polarity (anode or cathode). Local nerve blocks (EMLA) together with cetirizine may therefore be used to reduce nonspecific vasodilatation in both anodal and cathodal iontophoresis.

  • 5.
    Lennquist Montan, K.
    et al.
    University of Gothenburg, Sweden .
    Hreckovski, B.
    Gen Hospital Slavonski Brod, Croatia .
    Dobson, B.
    Hanover Associates, England .
    Ortenwall, P.
    University of Gothenburg, Sweden .
    Montan, C.
    Karolinska Institute, Sweden .
    Khorram-Manesh, A.
    University of Gothenburg, Sweden .
    Lennquist, Sten
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology.
    Development and evaluation of a new simulation model for interactive training of the medical response to major incidents and disasters2014In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 40, no 4, p. 429-443Article in journal (Refereed)
    Abstract [en]

    The need for and benefit of simulation models for interactive training of the response to major incidents and disasters has been increasingly recognized during recent years. One of the advantages with such models is that all components of the chain of response can be trained simultaneously. This includes the important communication/coordination between different units, which has been reported as the most common cause of failure. Very few of the presently available simulation models have been suitable for the simultaneous training of decision-making on all levels of the response. In this study, a new simulation model, originally developed for the scientific evaluation of methodology, was adapted to and developed for the postgraduate courses in Medical Response to Major Incidents (MRMI) organized under the auspices of the European Society for Trauma and Emergency Surgery (ESTES). The aim of the present study was to describe this development process, the model it resulted in, and the evaluation of this model. The simulation model was based on casualty cards giving all information normally available for the triage and primary management of traumatized patients. The condition of the patients could be changed by the instructor according to the time passed since the time of injury and treatments performed. Priority of the casualties as well as given treatments could be indicated on the cards by movable markers, which also gave the time required for every treatment. The exercises were run with real consumption of time and resources for all measures performed. The magnetized cards were moved by the trainees through the scene, through the transport lines, and through the hospitals where all functions were trained. For every patient was given the definitive diagnosis and the times within certain treatments had to be done to avoid preventable mortality and complications, which could be related to trauma-scores. The methodology was tested in nine MRMI courses with a total of 470 participants. Based on continuous evaluations and accumulated experience, the setup of the simulation was step-wise adjusted to the present model, including also collaborating agencies such as fire and rescue services as well as the police, both on-scene and on superior command levels. The accuracy of the simulation cards for this purpose was evaluated as "very good" by 63 % of the trainees and as "good" by 33 %, the highest two of the six given alternatives. The participants ranking of the extent that the course increased their competencies related to the given objectives on a 1-5 scale for prehospital staff had an average value of 4.25 +/- A 0.77 and that for hospital staff had an average value of 4.25 +/- A 0.72. The accuracy of the course for the training of major incident response on a 1-5 scale by prehospital staff was evaluated as 4.35 +/- A 0.73 and that by hospital staff as 4.30 +/- A 0.74. The simulation system tested in this study could, with adjustments based on accumulated experience and evaluations, be developed into a tool for the training of major incident response meeting the specific demands on such training based on recent experiences from major incidents and disasters. Experienced trainees in several courses evaluated the methodology to be accurate for this training, markedly increasing their perceived knowledge and skills in fields of importance for a successful outcome of the response to a major incident.

  • 6.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Education and training in disaster medicine2005In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 94, no 4, p. 300-310Article in journal (Refereed)
    Abstract [en]

    [No abstract available]

  • 7.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Disaster Medicine and Traumatology. Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Education and training in disaster medicine- time for a scientific approach2003In: International Journal of Disaster Medicine, ISSN 1503-1438, E-ISSN 1755-4713, Vol. 1Article in journal (Refereed)
  • 8.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: endokir.
    Effekten av varje åtgärd styr prioriteringen.1999In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 96, p. 3808-3810Article in journal (Other (popular science, discussion, etc.))
  • 9.
    Lennquist, Sten
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Introduction to the third "Focus-on" issue specially devoted to papers within the field of the ESTES section for Disaster and Military Surgery2011In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 37, no 1, p. 1-2Article in journal (Other academic)
    Abstract [en]

    Background: Ultrasound is widely accepted as a valuable diagnostic tool for detecting intra-abdominal and intrathoracic bleeding in trauma patients. Nevertheless, many doctors are reluctant to use it because they do not have sufficient training. This study aimed to define intraabdominal and intrathoracic fluid volumes that can be detected by sonography and their relation to fluid width in pigs to establish a clinically relevant animal model for teaching and training. Methods: Different volumes of normal saline were infused into the abdomen (50-2,000 mL) and chest (25-250 mL) in five anesthetized pigs. The maximum width of fluid as detected by ultrasound was recorded. The right upper quadrant, left upper quadrant, pelvis, and right paracolic section of the abdomen and right pleural cavity were studied. An experienced radiologist performed the studies. The effects on respiratory and cardiovascular functions were evaluated. Results: The sonographic findings in the pig were similar to those in humans. Up to 50 mL of intra-abdominal fluid and up to 25 mL of intrathoracic fluid could be detected by ultrasound. There was a significant correlation between the volume infused and the fluid width detected. The respiratory and cardiovascular monitoring of the animals showed that the infused intrathoracic volumes mimicked a survivable hemothorax. Conclusion: The pig may serve as an excellent clinically relevant model with which to teach surgeons detection of different volumes of intra-abdominal and intrathoracic fluids. The value of this model as an educational tool has yet to be tested.

  • 10.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Management of major accidents and disasters: An important responsibility for the trauma surgeons2007In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 62, no 6, p. 1321-1329Article in journal (Refereed)
  • 11.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Disaster Medicine and Traumatology. Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Protocol for reports from major accidents and disasters in the International Journal of Disaster Medicine2003In: International Journal of Disaster Medicine, ISSN 1503-1438, E-ISSN 1755-4713, Vol. 1, p. 79-86Article in journal (Refereed)
  • 12.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Disaster Medicine and Traumatology. Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    The Emergotrain system for training and testing disaster preparedness: 15 years of experience2003In: International Journal of Disaster Medicine, ISSN 1503-1438, E-ISSN 1755-4713, Vol. 1, p. 25-34Article in journal (Refereed)
  • 13.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: endokir.
    Which factors influence the time from submitting of a manuscript to publication?1999In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 165, p. 404-406Article in journal (Refereed)
  • 14.
    Lennquist, Sten
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Hodgetts, T.
    Academic Department of Military Emergency Medicine, Institute of Research and Development, Birmingham, United Kingdom.
    Evaluation of the response of the Swedish healthcare system to the tsunami disaster in South East Asia2008In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, Vol. 34, no 5, p. 465-485Article in journal (Refereed)
    Abstract [en]

    Objectives: When the tsunami in South East Asia hit the coast of Thailand on December 26, 2004, approximately 20,000 Swedish tourists were in the disaster zone. Of these, 548 died or were lost and more than 1500 were injured. The aim of this study was to evaluate the response of the Swedish health care system to the disaster in terms of assessment and support in the disaster zone, evacuation back to Sweden and continued treatment in Sweden. Methods: The evaluation was carried out based on (1) structured questionnaires to the staff of Thai hospitals, injured Swedish citizens and Swedish voluntary workers in the disaster zone, (2) semi-structured interviews with representatives of involved authorities, regional health care centres in Thailand and Sweden, hospital command centres, individuals treated for injuries and volunteer workers involved with supporting the injured, (3) on-site visits in the disaster zone, (4) analysis of reports following the tsunami. Results: A total of 11,000 injured were treated during the first 3 days following the tsunami at the six major hospitals in the Phang Nga, Phuket and Krabi provinces where the majority of the Swedish citizens were primarily taken care of. Of these 11,000, 3000 required hospital admission against a total bed capacity of 1400. Almost 1500 surgical operations were performed during the first 3 days across 33 operating theatres. Thai health care representatives and staff confirmed the requirement for teams from countries with many tourists in the area for practical and psychological support, interpretation, assessment for evacuation and undertaking early evacuation to home nations to release local health care resources. This need was also supported by the injured. Sweden, having the highest number of injured citizens next to the host country, was very late compared to other countries in sending assessment teams to the area and in supplying the needed support. Conclusions: With increased international travelling, many countries today have large numbers of their citizens in other parts of the world. For Sweden, this has been estimated to be 400,000 at any one time, often in areas known to be risk zones for natural disasters and terrorism. This fact of modern-day life demands welldesigned plans to support both citizens in the area and the local health care in several ways: non-medical support by mediating contact between injured and local medical staff, psychological and practical support, support in evacuating own citizens from the area to release local health care and (under specific conditions) medical support. This planning has to include prepared assessment teams that can be rapidly deployed to the scene and a command structure permitting rapid and accurate decisions on a governmental level. © 2008 Springer.

  • 15. Norberg, Karl-Axel
    et al.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: endokir.
    Framtiden ställer nya krav på katastrofmedicinsk kunskap.1999In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 96, p. 4638-4639Article in journal (Other (popular science, discussion, etc.))
  • 16.
    Olofsson, Pia
    et al.
    Linköping University, Department of Biomedicine and Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Abu-Zidan, Fikri M
    Trauma Group, Faculty of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
    Wang, Jianpu
    Linköping University, Department of Clinical and Experimental Medicine, Disaster Medicine and Traumatology. Linköping University, Faculty of Health Sciences.
    Nagelkerke, Nico
    Department of Community Medicine, Faculty of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
    Lennquist, Sten
    Linköping University, Department of Biomedicine and Surgery. Linköping University, Faculty of Health Sciences.
    Wikstrom, Thore
    Linköping University, Department of Clinical and Experimental Medicine, Disaster Medicine and Traumatology. Linköping University, Faculty of Health Sciences.
    The effects of early rapid control of multiple bowel perforations after high-energy trauma to the abdomen: implications for damage control surgery2006In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 61, no 1, p. 185-191Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This study evaluates the effects of early rapid control of multiple bowel perforations on cardiovascular and pulmonary function in high-energy traumatic shock compared with conventional small bowel resection anastomosis.

    METHODS: Fifteen anesthetized pigs, 10 to 12 weeks old, were exposed to a reproducible high-energy trauma and were divided into two groups. In the first group, the resection anastomosis group (RA, n = 8), small-bowel injuries were treated with resection and anastomosis; in the second group, the multiple bowel ligation group (BL, n = 7), small-bowel injuries were treated by resection and ligation. Repeated measurement analysis of variance was used to study the within group change overtime, the between group difference, and the interaction between them. Mean outcome measures were intravascular pressures, cardiac output, vascular resistance, lactic acid, and blood gases.

    RESULTS: The high-energy injuries caused traumatic shock in both groups with reduced cardiac output (p < 0.001) and lactic acidemia (p < 0.001). The BL group had a trend for higher cardiac output (p = 0.06). The rise in systemic and pulmonary vascular resistance was significantly reduced in the BL group compared with the RA group (p < 0.05). The BL group had a strong trend for higher oxygen extraction ratio (p = 0.06). There was a trend for less oxygen consumption in the BL group (p = 0.07). There was no difference in the lactic acidemia between the two groups.

    CONCLUSIONS: Early rapid control of multiple bowel perforations after high-energy trauma resulted in less impairment of cardiovascular function than conventional resection anastomosis of the bowel.

  • 17.
    Turegano, F
    et al.
    Hospital Gen Gregorio Maranon, Spain .
    Lennquist, Sten
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Editorial Material: Untitled2013In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 39, no 2, p. 105-106Article in journal (Other academic)
    Abstract [en]

    n/a

  • 18.
    Uranus, S.
    et al.
    Uranüs, S., Department of Surgery, Karl-Franzens Univ. Sch. of Medicine, Graz, Austria, Department of Surgery, Karl-Franzens Univ. Sch. of Medicine, Auenbruggerplatz 29, AT-8036 Graz, Austria.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Trauma management and education in Europe: A survey of twelve geographically and socioeconomically diverse European countries2002In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 168, no 12, p. 730-735Article in journal (Refereed)
    Abstract [en]

    Objective: To record the current standards of management and education in trauma surgery in 12 geographically and socioeconomically diverse countries in Europe. Design: Questionnaire study. Setting: Teaching hospital, Austria. Intervention: Questionnaire sent to experts on trauma in Austria, France, Germany, Italy, The Netherlands, Norway, Portugal, Romania, Spain, Sweden, Turkey, and the United Kingdom. Main outcome measure: Comparison of management of patients before, during, and after admission to hospital, and opportunities for initial and in-service training. Results: Management of patients and opportunities for training varied considerably from country to country, ranging from an organised trauma service throughout with specialised training to a haphazard and variable service that depended more on individual hospitals, doctors and patients. Conclusions: Standardisation of management and training would be desirable, and should be possible at least in countries that are members of the European Union.

  • 19.
    Wahlter, Sten
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Wenyao, S
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery.
    Lennquist, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: endokir.
    Pulmonary dynamics of radiolabelled erythrocytes and leucocytes in early gram-negative sepsis in pigs.1999In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 165, p. 979-985Article in journal (Refereed)
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