Air ambulance services in the Arctic 1999-2009: a Norwegian study

Norum, Jan; Elsbak, Trond M

doi:10.1186/1865-1380-4-1

Cited by 25 publications

(10 citation statements)

References 15 publications

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“…A review of the use of ultrasound in low-income countries concludes that obstetric ultrasound is a valuable tool in these settings [40]. Although Rwanda is a geographically small country there seem to be large differences in access to obstetric ultrasound between urban and rural areas.…”

Section: Discussionmentioning

confidence: 99%

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Holmlund

Ntaganira

Edvardsson

et al. 2017

Global Health Action

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Background: Obstetric ultrasound has become an indispensable part of antenatal care worldwide. Although the use of ultrasound has shown benefits in the reduction of maternal and foetal morbidity and mortality, it has also raised many ethical challenges. Because of insufficient numbers of midwives in Rwanda, uncomplicated pregnancy care is usually provided by nurses in local health centres. Obstetric ultrasound is generally performed by physicians at higher levels of healthcare, where midwives are also more likely to be employed. Objectives: To explore Rwandan midwives’ experiences and views of the role of obstetric ultrasound in relation to clinical management, including ethical aspects. Methods: A qualitative study design was employed. Six focus group discussions were held in 2015 with 23 midwives working in maternity care in rural and urban areas of Rwanda, as part of the CROss Country Ultrasound Study (CROCUS). Results: Obstetric ultrasound was experienced as playing a very important role in clinical management of pregnant women, but participants emphasised that it should not overshadow other clinical examinations. The unequal distribution of ultrasound services throughout Rwanda was considered a challenge, and access was described as low, especially in rural areas. To increase the quality of maternity care, some advocated strongly for midwives to be trained in ultrasound and for physicians to receive additional training. In general, pregnant women were perceived both as requesting more ultrasound examinations than they received, and as not being satisfied with an antenatal consultation if ultrasound was not performed. Conclusions: Obstetric ultrasound plays a significant role in maternity care in Rwanda. Increasing demand for ultrasound examinations from pregnant women needs to be balanced with medical indication and health benefits. Training of midwives to perform obstetric ultrasound and further training for physicians would help to address access to ultrasound for greater numbers of women across Rwanda. RESPONSIBLE EDITOR Virgilio Mariano Salazar Torres, Karolinska Institute, Sweden

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Section: Discussionmentioning

confidence: 99%

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Holmlund

Ntaganira

Edvardsson

et al. 2017

Global Health Action

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“…Norum and Elsbak describe the clinical and transfer characteristics of fixed and rotary wing aeromedical retrievals carried out in northern Norway for the 10 years 1999-2009 [1]. Acute cardiovascular diagnoses were encountered in 76/345 (22%) of the transported cohort [1,2], although it is not stated which, if any, of these patients suffered high-risk acute coronary syndromes (ACS) and/or ST elevation acute myocardial infarction (STEMI).…”

Section: Letter To the Editorsmentioning

confidence: 99%

“…Acute cardiovascular diagnoses were encountered in 76/345 (22%) of the transported cohort [1,2], although it is not stated which, if any, of these patients suffered high-risk acute coronary syndromes (ACS) and/or ST elevation acute myocardial infarction (STEMI). With one in five of the transported cohort potentially having a STEMI or high-risk ACS, a lengthy 3 h 33 min one-way transfer time [1] and attendant delays to accessing primary percutaneous reperfusion, Norum and Elsbak's study could have discussed the role of early recognition of ST elevation and prehospital thrombolysis.…”

Section: Letter To the Editorsmentioning

confidence: 99%

Letter to the editors: the potential role for prehospital thrombolysis and time-critical stroke transfers in the northern Norway aeromedical retrieval system; In response to: Norum J, Elsbak TM: Air ambulance services in the Arctic: a Norwegian study. Int J Emerg Med 2011, 4:1

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Int J Emerg Med

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The role for prehospital thrombolysis for ST-elevation acute myocardial infarction and time-critical stroke transfers in the northern Norway aeromedical retrieval system as well as the aero-evacuation impact of increased Arctic expedition tourism could benefit from further discussion by Norum and Elsbak. Close ECG surveillance for ST elevation and retrieval thrombolysis en route to the accepting hospital could be of benefit for acute coronary syndrome patients in northern Norway who require prolonged aeromedical transfer. For patients who remain within a reasonable time frame for stroke thrombolysis (up to 4.5 h after symptom onset), expedited transfer for neuroimaging to determine eligibility is recommended.

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“…Despite people being scattered within a substantial area (173,966 km 2 ), they have been promised, by the Northern Norwegian Regional Health Authority (NNRHA) trust, a healthcare of equal quality within the whole region. To meet such expectations, the NNRHA trust runs 11 medical hospitals and has 12 available air ambulance resources (six fixed wing aircrafts, four ambulance helicopters, two search and rescue helicopters) scattered on the mainland [16,17]. The regional PCI-centre is located at the University hospital of North-Norway (UNN) in Tromsø.…”

Section: Introductionmentioning

confidence: 99%

Treatment of acute myocardial infarction in the sub-arctic region of Norway. Do we offer an equal quality of care?

Norum

Hovland

Balteskard

et al. 2017

International Journal of Circumpolar Health

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Patients, relatives, healthcare workers and administrators are concerned about the quality of care offered. We aimed to explore the treatment of acute myocatrdial infarction (AMI) in Northern Norway, compare it with the national figures, and document whether there is an equal quality of care or not. The retrospective study included data on patients' treatment for AMI. The following sources were employed. The Norwegian Patient Registry, National Quality of Care Database, Norwegian Myocardial Infarction Registry and data from the National Air Ambulance Services of Norway. The period 2012-2014/15 was studied and the variables were: incidence of AMI, gender and age adjusted rates of AMI and revascularization (PCI, CABG) based on patient's place of living (according to hospital catchment area) and 30-day survival rate. The annual incidence of AMI was 9% higher in the northern region. Significant incidence variations (2.7–5.9 AMI/1000 inhabitants) between the hospitals' catchment areas were revealed. The 30-day survival rate varied between 85.1–92.1% between hospitals. The variation in revascularization/AMI rate was 0.72–1.54. Air amublance services' availability varied through the day. In conclusion, significant variations in the AMI rate and an unequal service within the region was revealed.

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Air ambulance services in the Arctic 1999-2009: a Norwegian study

Abstract: Norway has run a safe air ambulance service in the Arctic for the last 11 years. In the future more shipping and polar adventure operations may influence the need for air ambulances, especially during summer and autumn.

Cited by 25 publications

References 15 publications

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Letter to the editors: the potential role for prehospital thrombolysis and time-critical stroke transfers in the northern Norway aeromedical retrieval system; In response to: Norum J, Elsbak TM: Air ambulance services in the Arctic: a Norwegian study. Int J Emerg Med 2011, 4:1

Treatment of acute myocardial infarction in the sub-arctic region of Norway. Do we offer an equal quality of care?

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