Biomedical subjects

C F Larsen

Publications and source records attributed to C F Larsen.

At least 55 records · Page 3Linked to original sources

PubMed1991

Evaluation of intensified prehospital treatment in out-of-hospital cardiac arrest: survival and cerebral prognosis. The Odense ambulance study.

During a period of 3 years three different types of emergency medical service (EMS) systems were evaluated in a city with about 238,000 inhabitants/population density of 570/km2. Included were 393 out-of-hospital cardiac arrest patients in whom prehospital cardiopulmonary resuscitation was provided by personnel on basic, intermediate, or advanced care training. When ordinary ambulances (basic EMS) were used, 8 (5%) patients were discharged alive. When ambulances with specially trained paramedics (intermediate EMS) were used, 2 (1%) patients were discharged. Finally medically staffed ambulances with doctors collaborating (advanced EMS) were used, and 11 (13%) patients were discharged. The intermediate EMS system was used in another area with 45,000 inhabitants/population density of 340/km2, and in this area 20 (18%) patients were discharged. Among the survivors a psychological assessment in form of a test for dementia was assessed in long-term survivors (n = 30) together with 28 patients surviving acute myocardial infarction and 11 control persons. The results of the investigation demonstrate that the more intensive the prehospital treatment of out-of-hospital cardiac arrest, the more patients survive and the more patients survive with good cerebral function. However, the ambulances with specially trained paramedics were only effective in the area with 340 inhabitants/km2.

Brain Ischemia↗

PubMed1991

Dislocation of the lunate, triquetral, and hamate bones. Case report.

A patient sustained multiple injuries during a road traffic accident, including closed palmar luxation of the lunate together with dislocation of the triquetrum and hamulus of the hamate bone. Initially the injury was treated closed, but redislocation necessitated closed reduction and stabilisation with K-wires. Three years later movement was painless and slightly restricted despite persisting palmar dislocation of the lunate and triquetral bones as well as ulnar translocation.

Carpal Bones↗

PubMed1990

[Preventive effects of bicycle helmets].

The total number of persons injured following bicycle accidents in Denmark is estimated to be more than 50,000 annually. In half of the injured cyclists, lesions localized to the region of the head occur. Bicycle helmets provide considerable protection against brain injuries which constitute 13%. Several investigations from abroad and from Denmark have demonstrated that protection of the head can reduce the number of deaths and of acute brain injuries due to bicycle accidents. On the basis of the literature, it is concluded that bicycle helmets provide good protection of the head in connection with bicycle accidents. When a bicycle helmet is purchased, it is important to ensure that the helmet fits the head, that vision is not impeded and that the chinstrap secures the helmet correctly. Legislation is necessary to ensure that bicycle helmets sold in Denmark fulfill the minimum safety requirements.

Bicycling↗

PubMed1990

[Prehospital treatment. The Odense ambulance project. A prospective study].

No legislation exists about ambulance services in Denmark. The present Danish prehospital treatment is undertaken by Falcks Redningskorps A/S and the municipal fire services. During a period of 12 months (1.2.1988-31.1.1989) a prospective investigation was carried out in Odense concerning the effect of medical support to the ambulance service, partly in the form of a medically staffed ambulance, partly in the form of an arrangement in which an independent doctor's car (rendez-vous arrangement) was sent together with the nearest ambulance. In addition, the heart ambulance model as recommended by the Danish National Board of Health was also tested. Experience from abroad and recent Danish trial arrangements demonstrate the positive effect of extended professional prehospital treatment. The authors consider, therefore, that an ambulance law is required as this would ensure better and more uniform prehospital treatment in Denmark. Planning of the future prehospital treatment of acute and injured patients including the extent of the training, equipment and treatment must be established on the basis of a healtheconomical assessment of the Danish arrangements.

Ambulances↗

PubMed1990

[Ambulance services for patients with acute cardiac conditions in Denmark--current state].

In 1985, the Danish Board of Health published a review of the therapeutic value of heart ambulances. A report is presented here concerning the extent to which prehospital treatment of cardiac arrest recommended by the Board of Health has been intensified after publication of the review. The prehospital treatment of cardiac arrest has been intensified in four counties and in the municipalities of Copenhagen and Frederiksberg whereas it has not been altered in the remaining ten counties. Recent Danish investigations have demonstrated better prognosis both as regards survival and as regards recovery when intensified prehospital treatment of cardiac arrest is employed. Hence legislation steps should be taken to improve pre-hospital treatment of cardiac arrest.

Ambulances↗

PubMed1990

[First aid in cases of out-of-hospital heart arrest].

In connection with participation of doctors in the emergency ambulance service in Odense, the number of cases of observed cardiac arrest outside hospital was registered during a period of six months. The object was to assess how often primary treatment for cardiac arrest was instituted by passers-by before arrival of the ambulance. Seventy-four cases of observed cardiac arrest occurred. In 11 of these (15%) primary resuscitation was attempted outside hospital. In only three (4%) cases the primary resuscitation was undertaken by lay persons. Treatment of cardiac arrest before arrival of the ambulance increases survival. It is therefore essential to increase the number of courses in the treatment of cardiac arrest for lay persons, if mortality is to be reduced.

Denmark↗

PubMed1990

[Out-of-hospital heart arrest. Prospective study of various types of expanded prehospital treatment in Odense].

During the period 1.2.1988-31.1.1989, a prospective investigation was undertaken of the intensive prehospital treatment in Odense. Comparison was undertaken between a medically staffed ambulance (2 months), a motorized doctor (rendez-vous, model 4 months) and the heart ambulance (recommended by the Danish National Board of Health (6 months]. Out of 28 patients brought in by the medically staffed ambulance, two (7%) were discharged alive. Out of 57 patients brought in the phase with the motorized doctor nine (16%) were discharged alive. Out of 78 patients brought in by heart ambulance one (1%) was discharged alive. The results of this investigation reveal that the prehospital treatment of cardiac arrest in Odense can be improved by participation of a doctor in the treatment, (particularly the rendezvous model). Suggested improvements consist of 1) improved alarm system, 2) intensification of training laymen in treatment of cardiac arrest and 3) increased information to the population.

Ambulances↗

PubMed1990

[Intensified prehospital treatment of heart arrest increases the number of survivors with good cerebral function].

Psychological assessment in the form of a test for dementia was carried out in 69 individuals. Thirty of these were survivors of cardiac arrest outside hospital. Seven of these were brought to hospital in ordinary emergency ambulances, 14 in heart ambulances and nine in medically staffed ambulances. In addition, 28 patients with acute myocardial infarction (AMI) and 11 control persons were examined. The result of the investigation demonstrates that the more intensive the prehospital treatment of cardiac arrest, the more patients survive with good cerebral function. In particular, the percentage of cerebral damage was least in cases where a medically staffed ambulance was employed.

Brain Damage, Chronic↗

PubMed1990

[Medical cooperation in cases of detention. 1 year's experience in the Odense police district].

On 22.5.1987, a law was introduced in Denmark according to which persons under the influence of alcohol detained by the police should, as a rule, be medically examined. In Denmark (not including the Faroe islands and Greenland), 40% out of 26,598 persons placed in detention were medically examined in 1988. Out of 918 persons placed in detention in the Odense police district, 66% were medically examined and of these 5% were referred to hospital for further examination and/or treatment. Four of these were admitted, three of whom had life-threatening poisonings and one on account of a potentially disabling condition. No deaths occurred in detention in Odense. It seems reasonable that all persons placed in detention should be seen by a doctor and, similarly, the protective function of detention should be emphasized.

Adult↗

PubMed1990

Fractures of the proximal humerus in children. Nine-year follow-up of 64 unoperated on cases.

Fracture of the proximal humerus in children is rare. The records from 1976 to 1977 of 77 patients aged 0-15 years with a fracture or epiphyseal separation of the proximal humerus were reviewed. Totally, 64 of 72 patients had a follow-up examination (median observation time 9 years). Twenty-one children had an epiphyseal separation and 51 a metaphyseal fracture. All but 1 were treated conservatively. Seven had slight sequelae at follow-up, i.e., transient pain or minor restriction of motion. The rest were asymptomatic. Full remodeling of fractures left displaced occurred in all the cases. No avascular necrosis or shortening of the humerus were found. Nonoperative treatment is appropriate for proximal humeral fractures in children, even for those with extensive displacement.

Adolescent↗

PubMed1990

Radiography of the wrist. A new device for standardized radiographs.

A number of methods exist for determination of carpal bone angles on lateral wrist radiographs. However, there is no general or precise definition of the angles measured. In this study the positioning of the wrist is emphasized and a device used to obtain standardized radiographs is presented. An analysis of variance of two series of patients revealed no radiological difference between the contralateral wrists in the same person. We conclude that the asymptomatic wrist can be used as normal reference in the assessment of carpal bone angles in the pathological wrist and a difference between the carpal bone angles in the two wrists in the same person exceeding 5 degrees can be considered significant.

Adult↗

PubMed1989

[Hidden statistics of traffic accidents].

Only 19% of the 3,071 injured persons who were treated in the casualty department of Odense Hospital following traffic accidents in 1987 could be found again in the police registers of traffic accidents from the same region. All of the registrations from the police registers from the central region could be found again in the casualty department. In 1971, the corresponding coverage was 36%. The degree of coverage is particularly low for single bicycle accidents, other bicycle accidents, other single accidents and the hours immediately after midnight. Considerable disagreement exists concerning registration of the use of safety belts and crash helmets. In Odense, the municipal road authorities utilize the localization of the accidents reported by the casualty department. The decrease in the degree of coverage is due mainly to an increasing proportion of bicycle accidents. Where casualties require admission to hospital, the coverage is approximately 75%. This has remained unchanged throughout the years and it is therefore suggested that this proportion should be employed as indicator of the effect of the majority of prophylactic measures. In addition, proposals are made for simplification of the police registration forms.

Accidents, Traffic↗

PubMed1989

[External causes of accidents. How do the new registration rules function?].

On January 1, 1987 a new codification system was introduced in Denmark to replace the former E-codification. The function of the codification system was investigated by comparing two parallel registers comprising the same group of patients. During a one-year period from January 1 1987 to December 31 1987, a total of 1,475 patients were admitted to an orthopaedic department. Complete agreement between the two registers was found in 53% of all patients. The result of the investigation stresses the need for careful instruction to those who carry out the registration. The purpose of the registration is that it should be usable in the health care system as an instrument for registration of external causes of injury. The registration should also be a tool for the planning and managing of the resources spent on health services. This purpose is only partly achieved in the present registration.

Accidents↗

PubMed1989

[Cardiac arrest outside of hospital. A retrospective study in Odense].

During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement of treatment include: 1. Information to the population. 2. Training of first-aid staff in treatment of cardiac arrest. 3. Quicker arrival of ambulances and 4. Better staffing and training of ambulance staff in the use of a defibrillator possibly with participation of a doctor.

Denmark↗

PubMed1987