[Neurogenic oropharyngeal dysphagia is a frequent condition in patients admitted to the ICU]. / Neurogen dysfagi ses hyppigt hos patienter på intensivafdelinger.

Neurogenic oropharyngeal dysphagia (NOD) is a frequent condition in neurological patients admitted to the ICU, particularly in patients with brainstem lesions. The CNS damage itself can predispose to dysphagia, but also the treatment and preventive measures may predispose to and exacerbate the condition. Frequent pneumonia in a neurological patient is a warning signal that should cause screening for dysphagia. Complications are serious and can be fatal. Neurological patients should be examined for NOD before decannulation. Treatment is difficult, so prevention and multidisciplinary neurological rehabilitation is important.

[Frostbite injuries causing compromised airway after inhalation of propane]. / Forfrysninger som årsag til truet luftvej efter inhalation af flaskegas.

We describe a case report of a 23-year-old man with acute pharyngeal injuries due to frostbite subsequent to inhalation of propane. He was fiber-optically intubated on admission to hospital since his airways were considered acutely compromised. He was subsequently kept intubated for 11 days due to persistent pharyngeal oedema and frostbite injuries. The latter is caused by low temperature of propane upon release from a pressurized container. Injuries caused by frostbite often gradually progress and thus caution should be exerted in regards to airway management.

Visitation by physicians did not improve triage in trauma patients.

INTRODUCTION: A formalized trauma response team is designed to optimize the quality and progress of patient care for severely injured patients in order to reduce mortality and morbidity. The goal of this study was to determine over- and undertriage and to evaluate if a physician-manned pre-hospital response (MD-EMS) would reduce overtriage. Overtriage was defined as the process of over-estimating the level of injury sustained by an individual. MATERIAL AND METHODS: This was a retrospective study. All patients admitted with trauma team activation (TTA) (n = 1,468) during a four-year period (2007-2011) were included. Undertriage was estimated by assessing the fraction of major trauma patients (New Injury Severity Score (NISS) > 15) admitted to Viborg Regional Hospital in the project period without TTA. RESULTS: For each year, overtriage was 88.3% (2007), 89.9% (2008), 92.8% (2009) and 88.2% (2010); an NISS > 15 was seen in a total of 149 patients. Undertriage was 0.39% (2007), 0.46% (2008), 0.51% (2009) and 1.10% (2010); an NISS > 15 was seen in a total of 21 patients who were not received by a trauma team. We observed no significant difference in the NISS (p = 0.19) or in over-/undertriage (p = 0.76 and p = 0.058) when comparing the years before with the years after the introduction of the MD-EMS response. CONCLUSION: Our study shows a high degree of overtriage and a very low undertriage according to the currently accepted protocol guidelines. No effect was seen after the introduction of the MD-EMS. FUNDING: not relevant. TRIAL REGISTRATION: In compliance with the Scientific Committees for the Region of Central Jutland, approval for our project was obtained prior to collecting data.