Emergency Medicine in Finland: First Year Experiences of Specialist Training

Naskali, Jarno; Palomäki, Ari; Harjola, Veli Pekka; Hällberg, Ville; Rautava, Veli-Pekka; Innamaa, Tapio

doi:10.5152/jaem.2014.92679

Cited by 10 publications

(8 citation statements)

References 11 publications

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“…Emergency Medicine (EM) officially became a specialty in Finland at the beginning of 2013. However, practical education of Emergency Physicians (EPs) started earlier in our hospital, in October 2012 [ 7 ]. It was preceded by systematic education and practical training of nurses working in the ED [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Stroke thrombolysis given by emergency physicians cuts in-hospital delays significantly immediately after implementing a new treatment protocol

Heikkilä

Kuusisto

Stolberg

et al. 2016

Scand J Trauma Resusc Emerg Med

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BackgroundTissue plasminogen activator (tPA) treatment for acute ischaemic stroke (AIS) should be given as soon as possible, preferably within 60 min after arrival at hospital. There is great variation in door-to-needle times (DNTs) internationally, nationally and even within the same hospital. Various strategies for improving treatment delays have been presented. The role of emergency physicians (EPs) in treating AIS has been under discussion in recent years. Emergency Medicine (EM) officially became a specialty in Finland in 2013. Practical education of EPs in Kanta-Häme Central Hospital began in October 2012, together with reorganization of the in-hospital treatment path for AIS patients. The main change was shifting the on-call duty regarding stroke patients from internists or neurologists to EPs after the third quarter of 2013.MethodsThis was a retrospective study. The data, concerning the characteristics of tPA-treated patients, DNTs and onset-to-treatment times (OTTs) was collected from electronic and paper records. The period studied was 1 year before and 1 year during reorganization, i.e. 2012 and 2013.ResultsDuring the study period a total of 64 tPA treatments were given, 31 before and 33 during reorganization. The median DNT was 54 min in 2012, while it was 28 min in 2013 (p < 0.001). The median OTTs were 139 and 101 min before and during the start of reorganization, respectively (p < 0.001).ConclusionsBoth total and in-hospital delays in the treatment of ischaemic stroke were shortened significantly during reorganization. Emergency physicians are able to treat AIS patients within international time guidelines. Success was based on scrutinized reorganization and good cooperation between neurologists, EPs and radiologists.

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Section: Introductionmentioning

confidence: 99%

Stroke thrombolysis given by emergency physicians cuts in-hospital delays significantly immediately after implementing a new treatment protocol

Heikkilä

Kuusisto

Stolberg

et al. 2016

Scand J Trauma Resusc Emerg Med

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“…After the implementation of the independent medical speciality of Emergency Medicine in Finland [11] 19,20]. Rush hours and longer waiting times coincided with larger numbers of LWBS, even though the total rate was low.…”

Section: Discussionmentioning

confidence: 99%

Patients Left Without Being Seen in the Emergency Department – A Retrospective Observational Patient Record Study

Holmberg

Innamaa

Hällberg

et al. 2021

Preprint

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BackgroundThe share of patients leaving the emergency department without being seen by a physician (LWBS) is an important efficacy marker of emergency departments around the world. It has not however, been of special research interest in the Nordic countries. In this study, we assessed the LWBS rate in Kanta-Häme Central Hospital, in Hämeenlinna, Finland. Secondarily, we gathered information of LWBS patients along with all ED patients.MethodsIn this retrospective observational patient record study, our primary aim was to assess the LWBS rate of all patient visits (n = 41,631) over a 12-month period in a mid-sized Finnish secondary hospital ED. Alongside, we gathered specific information, such as age, gender, time of day and year for attendance, reason for attendance, return to healthcare and mortality after 7 and 30 days and after one year to show characteristics of LWBS patients. We present data and hourly distribution of the LWBS patients against all patient visits to the ED.ResultsA total of 305 LWBS cases were identified, leading to an LWBS rate of 0.73 %. Most LWBS took place during afternoon hours, when the ED was most crowded and waiting times were longest. Among LWBS patients, minor traumas and non-specific pain were the most common reasons for attending. Mortality among LWBS patients was naught (0.0 %) over a one-year follow-up.ConclusionsThe LWBS rate in the Kanta-Häme Central Hospital ED was low. Higher LWBS rate coincided with rush hours and longer waiting times. The proportion of minor traumas was greater than in some earlier studies. These results support the implementation of a fast track line for minor traumas in the ED.

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“…Emergency medicine was recognized as an independent speciality in Finland in 2013 [6]. When initiating practical training in this speciality in our emergency department (ED), we implemented a new treatment protocol for acute ischaemic stroke [7].…”

Section: Introductionmentioning

confidence: 99%

Short door-in-door-out time of stroke patients in need of thrombectomy in a primary stroke centre

2021

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COVID-19 epidemic has had a negative effect on the resources of emergency departments. While the number of acute ischaemic stroke (AIS) patients eligible for reperfusion therapies has decreased in the emergency departments (EDs), times to thrombolytic and endovascular treatments of AIS patients have become longer. In this paper, we report an ultra-fast diagnostic protocol in the settings of AIS in the ED of a primary stroke centre. Experiences using case studies of three patients have also been provided. Patients treated in accordance with the protocol received primary diagnoses and endovascular treatment with door-in-door-out times of 15 to 21 minutes.

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Emergency Medicine in Finland: First Year Experiences of Specialist Training

Cited by 10 publications

References 11 publications

Stroke thrombolysis given by emergency physicians cuts in-hospital delays significantly immediately after implementing a new treatment protocol

Stroke thrombolysis given by emergency physicians cuts in-hospital delays significantly immediately after implementing a new treatment protocol

Patients Left Without Being Seen in the Emergency Department – A Retrospective Observational Patient Record Study

Short door-in-door-out time of stroke patients in need of thrombectomy in a primary stroke centre

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