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For Peer Review Only BMJ Open BMJ Open: first published as 10.1136/bmjopen-2013-002658 on 1 August 2013. Downloaded from Systematic literature review of templates for reporting pre- hospital major incident medical management ForJournal: peerBMJ Open review only Manuscript ID: bmjopen-2013-002658 Article Type: Research Date Submitted by the Author: 30-Jan-2013 Complete List of Authors: Fattah, Sabina; Norwegian Air Ambulance Foundation, Department of Research and Development,; University of Tromsø, Anaesthesia and Critical Care Research Group, Faculty of Health Sciences, Rehn, Marius; Norwegian Air Ambulance Foundation, Department of Research and Development,; Akershus University Hospital, Department of Anaesthesia and Intensive Care, Reierth, Eirik; University of Tromsø, University Library of Tromsø, Science and Health Library, Wisborg, Torben; University of Tromsø, Anaesthesia and Critical Care Research Group, Faculty of Health Sciences,; Finnmark Health Trust, Hammerfest Hospital, Department of Anaesthesiology and Intensive Care, <b>Primary Subject Emergency medicine Heading</b>: http://bmjopen.bmj.com/ Secondary Subject Heading: Medical management, Evidence based practice, Anaesthesia Disaster Medicine, Emergencies, Mass Casualty Incidents, Data Collection, Keywords: Health Care Management on September 30, 2021 by guest. Protected copyright. For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 1 of 21 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2013-002658 on 1 August 2013. Downloaded from 1 2 3 Systematic literature review of templates for reporting pre-hospital 4 5 major incident medical management 6 7 8 Sabina Fattah, MD1, 2. Marius Rehn, MD PhD1, 3. Eirik Reierth, Dr.scient4. 9 10 Torben Wisborg, Professor2, 5. 11 12 13 1. Department of Research and Development, Norwegian Air Ambulance Foundation, 14 15 Drøbak,For Norway peer review only 16 17 2. Anaesthesia and Critical Care Research Group, Faculty of Health Sciences, University 18 of Tromsø, Tromsø, Norway 19 20 3. Department of Anaesthesia and Intensive Care, Akershus University Hospital, 21 22 Lørenskog, Norway 23 4. Science and Health Library, University Library of Tromsø, University of Tromsø, 24 25 Tromsø, Norway 26 27 5. Department of Anaesthesiology and Intensive Care, Hammerfest Hospital, Finnmark 28 Health Trust, Hammerfest, Norway 29 30 31 32 33 Corresponding author: http://bmjopen.bmj.com/ 34 35 Sabina Fattah 36 37 Postal address: P.O box 94, 1448 Drøbak, Norway 38 E-mail: [email protected] 39 40 Telephone: +47 64 90 44 44 41 42 Fax: +47 64 90 44 45 on September 30, 2021 by guest. Protected copyright. 43 44 45 Keywords: Disaster Medicine, Emergencies, Mass Casualty Incidents, Data Collection, 46 47 Health Care Management. 48 49 50 51 Word count – 1933. 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml 1 BMJ Open Page 2 of 21 BMJ Open: first published as 10.1136/bmjopen-2013-002658 on 1 August 2013. Downloaded from 1 2 3 4 5 6 ABSTRACT 7 8 Objective: To identify, describe and quality appraise templates for reporting pre-hospital 9 major incident medical management. 10 11 Design: Systematic literature review according to PRISMA guidelines. 12 13 Data sources: PubMed/Medline, EMBASE, Cinahl, Scopus and Web of Knowledge. Grey 14 literature was also searched. 15 For peer review only 16 Eligibility criteria for selected studies: Templates published after 1 January 1990 and until 17 18 19 March 2012. All non-English literature except Scandinavian language literature, literature 19 without an available abstract and literature reporting only psychological aspects were 20 21 excluded. 22 23 Results: Main database searches identified 8497 articles. Of these 8389 were excluded based 24 on title and abstract. A further 96 were excluded with reason based on full-text. The 25 26 remaining 12 articles were included. In the grey literature all 107 retrieved articles were 27 28 excluded. Reference lists of the included literature identified five articles. A relevant article 29 published after completion of the search was also included. In the total of 18 included articles 30 31 10 different templates or sets of data are described; two methodologies for assessing major 32 33 incident response, three templates intended for reporting from exercises, two guidelines for http://bmjopen.bmj.com/ 34 reporting in medical journals, two analyses of previous disasters, and one Utstein-Style 35 36 template. 37 38 Conclusion: This study revealed a lack of a field-friendly, evidence based and validated 39 template for reporting from pre-hospital major incident medical management. In order to 40 41 allow rapid dissemination of areas for improvement, there is a need for a field-friendly 42 on September 30, 2021 by guest. Protected copyright. 43 template that is especially designed for the purpose. 44 Trial registration: The review is registered in PROSPERO (registration number: 45 46 CRD42012002051). 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml 2 Page 3 of 21 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2013-002658 on 1 August 2013. Downloaded from 1 2 3 ARTICLE SUMMARY 4 5 Article focus: identifying templates that enable systematic and uniform reporting of pre- 6 hospital major incident medical management. Further, to appraise the quality of and to extract 7 8 data fields from included templates. 9 10 Key messages: templates for reporting major incident medical management exist in different 11 formats, but none have been tested for feasibility. A uniform template with clearly defined 12 13 data variables focusing on reporting from the pre-hospital phase is necessary. 14 15 Strengths andFor limitations peer of the study: reviewThe strength of the study only is that it is a systematic 16 review following the PRISMA guidelines. The protocol was published and deviations from 17 18 protocol are revealed in the study report. A limitation is that only English and Scandinavian 19 20 language literature was included. 21 22 23 The original protocol of the study 24 25 The study protocol is available in BMJ Open (1). 26 27 28 INTRODUCTION 29 30 There has been an evolving trend in disaster medicine calling for elevated level of science 31 32 through improved reporting from major incidents (2-7). Previous expert group processes have 33 defined uniform data sets for reporting both in emergency medicine in general (8, 9) and in http://bmjopen.bmj.com/ 34 35 disaster medicine specifically (10, 11). These templates were designated as Utstein style 36 37 templates after the Norwegian monastery where their development took place. Qualitative 38 research methods have also been used to identify areas within pre-hospital critical care and 39 40 major incident management requiring further research (12, 13). A recent review identified that 41 42 data reporting from mass gatherings is non-uniform and called for consistent data to enable on September 30, 2021 by guest. Protected copyright. 43 future research (14). The importance of evaluating disaster exercises using pre-defined, high- 44 45 quality data has also been discussed as a potential for improving disaster health management 46 47 (15) and to compare outcome from different exercises (16). Analysis of standardized data 48 from previous incidents can allow decision-makers to make well-informed decisions (17). 49 50 51 52 This systematic review was designed to identify, describe and appraise the quality of 53 templates for reporting pre-hospital major incident medical management. Based on the 54 55 findings the need for a field-friendly, feasible template for uniform reporting from such 56 57 management was assessed. 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml 3 BMJ Open Page 4 of 21 BMJ Open: first published as 10.1136/bmjopen-2013-002658 on 1 August 2013. Downloaded from 1 2 3 METHODS 4 5 Search strategy 6 7 A systematic literature search was conducted to identify templates published between 1 8 9 January 1990 and until the date of the literature search (1). The controlled vocabulary of 10 Medical Subject Headings (MeSH) from PubMed, including subheadings, publication types 11 12 and supplementary concepts were used. The search was performed in the period from the 24 13 14 February to the 19 March 2012. A systematic search in grey literature was performed between 15 25 and 29 JuneFor 2012. peer review only 16 17 18 19 In the main database searches three sets of entry terms were applied and combined (cf figure 1 20 for search strategy). The first set of entry terms describes major incidents and the second set 21 22 of entry terms describes templates. In addition to the MeSH terms in the first two sets, a third 23 24 set of entry terms with free search phrases were included. For the grey literature search only 25 two sets of entry terms were combined (1). 26 27 28 29 30 Inclusion criteria 31 − Templates reporting medical management of the pre-hospital phase of major incidents. 32 33 − Templates published after 1 January 1990 (inclusive) and until the date of the http://bmjopen.bmj.com/ 34 35 literature search. 36 37 38 39 Exclusion criteria 40 − 41 All non-English literature except Scandinavian language. on September 30, 2021 by guest. Protected copyright. 42 − Literature without an available abstract. 43 44 − Literature reporting only psychological aspects. 45 46 47 48 Search findings 49 50 A total of 10,136 results from each individual database search were sent to Endnote X5 51 52 (Thomson Reuters, NY, USA). After removing duplicates the number of results was 8,497. 53 The grey literature search gave 107 results (cf figure 2 for search findings depicted in a flow 54 55 diagram). 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml 4 Page 5 of 21 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2013-002658 on 1 August 2013.
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