norway stavanger

Document Sample
norway stavanger Powered By Docstoc
					                              candinavian




                                                                                     2005
                                  update
                                                                                                        on trauma,
                                                                                                        resuscitation and
                                                                                                        emergency medicine
meet, have fun, share ideas and look into the future of trauma, resuscitation and emergency medicine.




                                                  stavanger norway
                                                                      september 8-10 2005




        conference programme




                                    www.scandinavian-update.org                                           www.akuttjournalen.com
                                                                                  signatur.no
        Fresenius Kabi.
        Your world-wide specialist in
        clinical nutrition, infusion therapy
        and services.


        Welcome to our booth
        at the main sponsors exhibition area.




        Fresenius Kabi Norge AS
        Gjerdrumsvei 12, NO-0484 Oslo, Norway
        Telephone + 47 22 58 80 00
        Telefax    + 47 22 58 80 01


.. 2   Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                   contents

                                                         3       welcome to scandinavian update
                                                         5       practical information
                                                         5       city map
                                                         6       welcome to stavanger
                                                         7       staff / organising committee
                                                         7       hosts
                                                         7       faculty
                                                         8       pre conference symposiums
                                                         8       conference programme
                                                        13       other scientific activities
                                                        13       round-table discussion
                                                        13       workshops
                                                        13       learning centre
                                                        13       rapid extrication demonstration
                                                        13       scandinavian update awards
                                                        13       stand-up science
                                                        14       guided tours in stavanger
                                                        14       see stavanger by air
                                                        16       exhibition area map
                                                        17       learning centre map
                                                        17       exhibitors
                                                        19       abstracts




                   welcome to scandinavian update
It is an honour and pleasure to welcome you to the first Scandinavian Update on trauma,
resuscitation and emergency medicine in Stavanger. On behalf of the Scientific- and Organising
Committees we welcome you to join us and meet your colleagues as well as the experts in your field of
interest.

The Formula of Survivial* illustrates how the interaction between medical science, educational efficiency
and local organisation does affect outcome. Scandinavian Update on trauma, resuscitation and
emergency medicine will focus on the Formula of Survivial. We do hope Scandinavian Update will become
the meeting point for all Scandinavian doctors, nurses and paramedics involved with saving lives inside
and outside the hospital.

In the good spirit of TraumaCare 2002 Scandinavia, the SCANTEM (Scandinavian Networking Group on
Trauma and Emergency Management) was established and held its first meeting in Gothenburg in 2004.
Scandinavian Update 2005 will be the second SCANTEM-meeting.

We have made the program highly interactive. There will be pro-con debates, round-table discussions,
hands-on workshops, learning centre, and Stand-up science. There will also be special sessions on
important topics like prehospital airway management, critical bleeding and therapeutic hypothermia.
Along with you, there is a good mixture of international and Scandinavian guests in the multi-speciality
faculty. And do not miss the Scandinavian Update Prize of Honour lecture on Thursday at 18.30.

According to the theme of the conference, Formula of Survivial, four prizes will be awarded during the Karibu - Welcome reception. We hope that
the awards for Best Scientific Paper, sponsored by Akuttjournalen, Best Educational Program, sponsored by Laerdal Medical, Best System Implementation
sponsored by Novo Nordisk, and last but not least Scandinavian Update Prize of Honour, sponsored by Fresenius Kabi, will stimulate to further development
of trauma, resuscitation and emergency medicine in Scandinavia.

The conference venue is the Clarion Hotel Stavanger, close to the inner harbour in the charming city centre of Stavanger, not far from the famous
Lysefjorden and Preikestolen/The Pulpit Rock.

Meet, have fun, share ideas, and look into the future of trauma, resuscitation and emergency medicine.


Welcome to Scandinavian Update 2005!

Eldar Søreide                                                           Hans Morten Lossius
Chairman Scientific Committee                                            Chairman Organising Committee

* The ILCOR Advisory Statement on Education in Resuscitation (table 1: Theoretical model of factors in patient outcome). Resuscitation 2003; 59: 11-43.




                                                                                                                                        Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                                                                                                                                                                                                                   3 ..
             practical information
Organised by             Akuttjournalen - The Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
                         SCANTEM - Scandinavian Networking Group for Trauma and Emergency Management

Conference venue         Clarion Hotel Stavanger, Ny Olavskleiv 8

Plenary Hall             Hall A and Hall B, Clarion Hotel 1st floor. See map on page 16

Exhibition               Exhibition area will be located next to the conference hall (1st floor) and in the bar area (2nd floor). See map on page 16

Learning centre          Clarion Hotel, 3rd floor. See map on page 17

Work-shops               Stavanger Hall (Clarion Hotel, 1st floor, next to conference hall). For more information, see page 13

Round-table              Perspektiv (Clarion Hotel, 14th floor). For more information, see page 13

Smoking                  The conference venue is a non-smoking area

Conference language English

Faculty secretariat      Located next to the conference hall (1st floor)

Conference secretariat Located next to the conference hall (1st floor)

                         Opening hours:
                         Thursday        September 8       08-17.30
                         Friday          September 9       08-17.30
                         Saturday        September 10      08-17.00

Registration             In the Conference secretariat during the opening hours


                         Registration fee includes:
                         - Admission to all scientific sessions and exhibition areas, learning centre, round-table discussions and work-shops.
                            Please notice that name bagde must be carried throughout the conference.
                         - Certificate of Attendance
                         - Final programme
                         - Lunch at Clarion Hotel or “Hall Toll”
                         - Karibu/welcome-reception and the Scandinavian Update prize-award

Lunch                    12.00-13.30 at Clarion Hotel      or at “Hall Toll”     (Skansegaten 2, see map for location), according to your reservation.
                         Remember to bring your lunch-ticket!
                         Check lunch-ticket for venue.

Transportation           The airport is located about 14 km from the Congress Area
                         Bus - Airport shuttle every 20 minutes from Radisson Hotel Atlantic or Radisson SAS Royal Hotel
                         Taxi - Transfer from the airport to the hotels takes 10-15 minutes. Telephone: 51 90 90 90




                                                                       Hall Toll              Norwegian Petrol Museum
                                                                       Lunch venue
                                                                       Stand-up Science
                                                                       Conference Pub
                                                                                                        Departure Preikestolen
                                                                   Departure Fjord-safari                      The Pulpit-rock


                                           Old Stavanger




                                                                                                Comfort Hotel Grand




                                      Rapid Extrication Demonstration

                                                                         Radisson SAS Atlantic Hotel

                                    Radisson SAS Royal Hotel
                                                                    Clarion Hotel Stavanger
                                                                    Conference hotel




                                                                               Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                                                                                                                                                          5 ..
                welcome to stavanger
       It is a great pleasure for me to welcome you to Stavanger.


       We have a proud tradition for hosting important trauma, resuscitation and emergency medicine meetings. To mention a few:
       1964: 1st International Symposium on CPR
       1994: the Scandinavian Conference on Disaster and Emergency Medicine
       2000: AirMed 2000
       2002: TraumaCare2002 Scandinavia
       2003: 6th Scandinavian CPR conference


       This year’s high light is the Scandinavian Update on Trauma, Resuscitation and Emergency Medicine that will gather 500
       delegates and faculty from around the world. But, we will not stop here. Next year in May Stavanger will host
       Resuscitation 2006, the 8th scientific congress of the European Resuscitation Council.


       Stavanger has a long history of international outlook and progress made possible through worldwide contact and trade.
       Today Stavanger is best known as one of the most important energy cities in the world, being the capital of the Norwegian
       energy industry supplying about 1/3 of Europe’s gas needs. The city has a friendly and charming downtown full of shops, bars and cafes, being the
       surroundings for many concerts, events, exhibitions and festivals. The cultural beat of our city has made it possible for the Stavanger-region to become
       the European Capital of Culture in 2008. We will build on our determination and flexibility to see new possibilities and act accordingly. A further aim is to
       explore beyond the horizon, towards the unknown, towards new partnerships, new skills and experience.


       The city is surrounded by some of Norway’s most varied and spectacular natural cathedrals. Open sea and sweeping vistas, narrow fjords and steep
       mountains, the Pulpit rock and the magnificent Kjerag, some of the finest beaches in Europe, deep clear fjords scattered with picturesque isles. All giving a
       feel of nature’s strength and beauty.


       I hope you will be able to experience some of this as you take part in the conference, and that you will have at good a time here in Stavanger. I am sure
       that the organisers, the people of the city, the hotels and everyone else will do their best to make sure that you do just so.


       Leif Johan Sevland
       Mayor




                staff/organising committee

       Eldar Søreide                        Hans Morten Lossius                      Anna Fosså                Tine Askvik Lossius
       Chairman Scientific Committee         Chairman Organising Committee            Conference organiser      Faculty Organiser


       Inger Brit Bakkalia,                 Atle Hagen                               Liv K. Norland
       “Fjord-safari” Organiser             Exhibition Organiser                     Graphic Designer




                hosts
       Marianne Amdal                  Solveig Gjertsen                 Reidun Kartevold                 Sigstein Rasmussen              Mona Ulstein
       Eli Hagen Bang                  Anne Brit Gudmundsen             Bjørg Kindervaag                 Einar Svendsen                  Anne Mette J. Warland
       Anita Cambell                   Anette Gundersen                 Hilde Konradsen                  Elsa Søyland                    Anne Siri Vik
       Anne Sissel Dyrstad             Synnøve Halvorsen                Reidun Lie                       Liv Kari Thorsen                Siv Waage
       Atle Døskeland                  Morten Hinna                     Siv Karin Malmin                 Kjell Tjosevik                  Rune Ådnøy
       Eva Egeland                     Karin Jensvold                   Kristin Borgenvik Matre          Inger Marie Toftevåg            Mette Pettersen
       Helga Freyer                    Egil Johannesen                  Kjersti Nyborg                   Oddveig Tolo
       Åshild Førland                  Anna C Karlsen                   Tone Osmundsen                   Tone Tolo




.. 6     Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
     faculty
Mehdi Behzadi               Norway                       Freddy Lippert                   Denmark

Mari Bergan                 Norway                       Hans Morten Lossius              Norway

Peter Berlac                Denmark                      Pia Malmquist                    Sweden

Annette Bore                Norway                       Jan Martinsen                    Norway

Guttorm Brattebø            Norway                       Sindre Mellesmo                  Norway

Geir Sverre Braut           Norway                       Jannicke Mellin-Olsen            Norway

Michael Busch               Norway                       Alma D. Möller                   Iceland

Maaret Castrén              Finland                      Niklas Nielsen                   Sweden

Erika F. Christensen        Denmark                      Jan Erik Nilsen                  Norway

Gareth Davies               United Kingdom               Jan Erik Nordrehaug              Norway

Charles Deakin              United Kingdom               Thomas Olsson                    Sweden

Elizabeth Dorph             Norway                       Kees H. Polderman                The Netherlands

Richard Dutton              USA                          Stein Atle Puntervoll            Norway

Kristinn Eiriksson          Norway                       Marit Qvam                       Norway

Bosse Ek                    Sweden                       Thomas Rajka                     Norway

Bente Lüdemann Elstad       Norway                       Ronald Rolfsen                   Norway

Wenche Mathiesen Fjælberg   Norway                       Malcolm Russel                   United Kingdom

Tina Gaarder                Norway                       Olav Røise                       Norway

Harald V. Genzwuerker       Germany                      Mårten Sandberg                  Norway

Harald Haga                 Norway                       Birgit Schober                   Norway

Lauri Handolin              Finland                      Tom Silfvast                     Finland

Sven Arne Hapnes            Norway                       Nils Oddvar Skaga                Norway

Jon-Kenneth Heltne          Norway                       Kerstin Sluys                    Sweden

Morten Hestnes              Norway                       Stephen J. M. Sollid             Norway

Poul Kongstad               Sweden                       Kjetil Sunde                     Norway

Markku Kuisma               Finland                      Jon Arne Søreide                 Norway

Asgeir Kvam                 Norway                       Karl-Christian Thies             The Netherlands

Hedda Kolle                 Norway                       Øyvind Thomassen                 Norway

Audun Langhelle             Norway                       Ingrid Tjoflåt                    Norway

Ole Christian Langlo        Norway                       Else Tønnesen                    Denmark

Alf Inge Larsen             Norway                       Anna Tötterman                   Norway

Petter Larsen               Norway                       Thore Wickström                  Sweden

Jens Flensted Lassen        Denmark                      Torben Wisborg                   Norway

Ari Leppäniemi              Finland                      Per Örtenwall                    Sweden

Kristian Lexow              Norway                       Olav Østebø                      Norway

Thomas Lindner              Norway                       Anders Östlund                   Sweden

Anne Lippert                Denmark




                                             Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                                                                                                                        7 ..
                   pre conference symposiums
        September 7 2005
        1100 - 1300 Perspektiv, Clarion Hotel 14th floor      SCANTEM working-group:
                                                             Clinical practice guidelines on massive bleeding

        September 7 2005
        1400 - 1600 Perspektiv, Clarion Hotel 14th floor      SCANTEM working-group:
                                                             Scandinavian major trauma outcome study

        September 7 2005
        1600 - 1800 Perspektiv, Clarion Hotel 14th floor      Scandinavian AIS® Instructor meeting


        September 7 2005
        1100 - 1800 Atlantic Hotel                           Faculty meeting ATLS®-Norway and APLS®-Norway
                                                             Arranged by: The Norwegian Air Ambulance Foundation.
                                                             For more information, see: www.ATLS.no



       _____ conference programme

                            thursday                                                                                                           september 8


                        PLENARY HALL (HALL A+HALL B)
       1000 - 1200      Conference opening

                        SESSION 1 Keynote-lectures
                        Moderators:   Ari Leppäniemi, Finland
                                      Eldar Søreide, Norway



                                 Maaret Castrén, Finland
                                 Recent developments in Scandinavian trauma care, resuscitation and emergency medicine – what has changed?


                                 Harald V. Genzwuerker, Germany
                                 The new role of supraglottic airway devices in trauma, resuscitation and emergency medicine – will it affect my clinical
                                 practice?



                                 Kees H. Polderman, The Netherlands
                                 Therapeutic hypothermia in trauma and resuscitation – a therapy that works!



                                 Anna Tötterman, Norway
                                 Are trauma patients still bleeding to death? If so, how come?


       1200 - 1330      Lunch

                        HALL A                                                               HALL B
       1330 - 1500      SESSION 2A                                                           SESSION 2B
                        Emergency cardiac care – an update.                                  The bleeding trauma patient – new Scandinavian
                                                                                             guidelines?
                        Moderators:       Alf Inge Larsen, Norway                            Moderators:    Per Örtenwall, Sweden
                                          Jens Flensted Lassen, Denmark                                     Tina Gaarder, Norway
                        Is Percutanous Coronary Intervention (PCI) the only                  Critical bleeding in trauma – an international overview with
                        alternative in ST-elevation myocardial infarction (STEMI)?           focus on personal experiences from a US Level 1 center.
                        What about thrombolytics? An update with a Scandinavian              Richard Dutton, USA
                        perspective.
                        Jens Flensted Lassen, Denmark                                        Prehospital care means securing the airway, ventilate, not
                                                                                             hyper-infuse the patient and to stop bleedings – as simple as
                        Cardiac arrest and STEMI offshore. Do the patients get the           that?
                        care they need when they need it?                                    Charles Deakin, United Kingdom
                        Kristian Lexow, Norway
                                                                                             How to diagnose and stop critical bleedings - the surgeon’s
                        The chain of survival in patients with cardiac arrest and            perspective.
                        STEMI. Do we save hearts but not brains? Norwegian                   Ari Leppäniemi, Finland
                        experiences.
                        Jan Erik Nordrehaug, Norway                                          Anaesthesia, airways and fluid management in the
                                                                                             Emergency department and the OR – what have we learnt?
                        Acute PCI without cardiac surgery backup? Extreme sport or           Nils Oddvar Skaga, Norway
                        best practice?
                        Alf Inge Larsen, Norway                                              The ICU phase in the patient with massive bleeding - not as
                                                                                             simple as you may think.
                        Emergency cardiac care in the future - where cardiology,             Else Tønnesen, Denmark
                        emergency and intensive care medicine should meet.
                        Jan Erik Nordrehaug, Norway



.. 8   Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
1500 - 1530   Coffee-break

              HALL A                                                                HALL B
1530 - 1730   SESSION 3A                                                             SESSION 3B
              Trauma care and resuscitation under extreme                            Emergency medicine and resuscitation – pitfalls and
              conditions. When the going gets tough, the tough                       pearls.
              gets going?
              Moderators:   Tom Silfvast, Finland                                    Moderators:      Freddy Lippert, Denmark
                            Torben Wisborg, Norway                                                    Anders Östlund, Sweden
              Resuscitation and emergency medicine in remote and Artic               An international perspective on trauma, resuscitation and
              areas.                                                                 education from a Globetrotter
              Øyvind Thomassen, Norway                                               Jannicke Mellin-Olsen, Norway

              Accidental hypothermia and trauma at sea. Experiences                  Sudden airway and ventilation problems in the intensive
              from the North Sea                                                     care ambulance – now what?
              Kristian Lexow, Norway                                                 Mårten Sandberg, Norway

              Prehospital team work – is it possible under extreme stress?           The patient is in the Emergency Depatyement and you
              Experiences from the London HEMS.                                      suspect a ruptured spleen - what’s next?
              Gareth Davies, United Kingdom                                          Kristinn Eiriksson, Norway

              Prehospital team work – is it possible under extreme stress?           Major trauma and critical bleedings – experiences from
              Experiences from the Norwegian HEMS.                                   Sweden.
              Jan Martinsen, Norway                                                  Anders Östlund, Sweden

              Taking care of the care provider – does debriefing do us any            Post-resuscitation therapeutic hypothermia has changed
              good?                                                                  everything, including prognostication. Be aware!
              Yes: Birgit Schober, Norway                                            Kjetil Sunde, Norway
              No: Ingrid Tjoflåt, Norway



1830          “Karibu - Come and meet all your friends”
              Welcome-reception in Stavanger Hall, at the Conference Hotell, Clarion. Scandinavian Update Awards. Prize of Honour lecture.


              Scandinavian Update Prize of Honour lecture.

2000          Hall Toll - The conference pub
              Official meeting place for Scandinavian Update 2005. The lounge is reserved for you only – every night.
              Enjoy Stavanger’s newest and most exiting meeting place. Remember to bring your badge!

              Hall Toll is also the meeting point for Stand-up Science, which will take place on Friday. (see map on page 5)




                                               Karibu - Welcome
                                                       Stavanger Hall
                                                   September 8 2005 18.30

                               Welcome-reception in Stavanger Hall, at the Conference Hotell, Clarion.

                                                 Get together with colleagues and friends.

                                        Combine entertainment, fingerfood and a glass of wine

                                              with the award of Scandinavian Update prizes.



                                               Scandinavian Update Prize of Honour lecture.




                                                                             Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                                                                                                                                                        9 ..
                            friday                                                                                                             september 9

                                                                                           HALL B
        0800 - 0820                                                                        The London Bombings 7 July
                                                                                           Gareth Davies, United Kingdom


                        HALL A                                                             HALL B
        0830 - 1000      SESSION 4A                                                        SESSION 4B
                         Prehospital emergency care – paramedics only, or?                 Education in trauma and emergency medicine – why
                                                                                           simulation save lives.
                         Moderators:      Jan Erik Nilsen, Norway                          Moderators:     Anne Lippert, Denmark
                                          Maaret Castrén, Finland                                          Jannicke Mellin-Olsen, Norway
                         The Norwegian paramedic works in an integrated system. Is         How to turn your surgical nightmare into success in just a few
                         the result duet or duel around the patient?                       hours. An update on how to learn life-saving haemostatic
                         Olav Østebø, Norway                                               interventions.
                                                                                           Tina Gaarder, Norway
                         Training and education in trauma, resuscitation and
                         emergency medicine. The perspective of a nurse                    See one, do one, kill one? Why we need to change the way
                         anaesthetist working off-shore in the North Sea.                  we learn advanced airway management.
                         Petter Larsen, Norway                                             Jon-Kenneth Heltne, Norway

                         Prehospital emergency care. Is the use of doctors a waste of      The importance of simulation training in trauma resuscitation.
                         money and resources because nurses and paramedics can             Lauri Handolin, Finland
                         do it better?
                         Yes: Bosse Ek, Sweden                                             It’s time for a new European team based trauma course!
                         No: Poul Kongstad, Sweden                                         Karl-Christian Thies, The Netherlands

                         The nurse anaesthetist trained paramedic-rescuer – a hybrid       Trauma team training – from better to BEST! What should the
                         worth looking into, or just too much of everything?               next step be?
                         Stein Atle Puntervoll, Norway                                     Torben Wisborg, Norway


        1000 - 1030     Coffee-break

                        HALL A                                      HALL B                                      EXHIBITION AREA 2ND FLOOR
        1030 - 1200      SESSION 5A                                 SESSION 5B                                  SESSION 5C
                         Recent controversies in trauma             Resuscitation guidelines in 2010            Free Papers Oral Presentation
                         and emergency medicine.                    – will everything be different then?
                         Moderators:   Asgeir Kvam,                 Moderators:      Niklas Nielsen,            Moderators:       Else Tønnesen,
                                       Norway                                        Sweden                                       Denmark
                                       Eldar Søreide,                                Kjetil Sunde,                                Olav Røise,
                                       Norway                                        Norway                                       Norway
                         Ambulance helicopters in trauma – a        The 2005 Consensus on Science and           1030-1105
                         lifesaving service or just expensive       Treatment Recommendation (CoSTR)            Functional outcomme of surgically
                         transportation?                            Conference in Dallas. What do we            treated unstable pelvic ring fractures
                         Gareth Davies, United Kingdom              know about the present situation?           Michael Maru, United Kingdom
                                                                    Kjetil Sunde, Norway                        Evaluation of the airway of the
                         Hypotensive fluid resuscitation – more                                                  SimManTM full- scale patientsimulator
                         than just a nice theory?                   Ventilation and chest compression – is      Rasmus Hesselfeldt, Denmark
                         Richard Dutton, USA                        it that important? An update for the
                                                                    advanced life support provider.             A patient’s story from a hospital in South
                         Alarm and dispatch and EMS services        Elizabeth Dorph, Norway                     Sudan
                         in Europe - why such big differences?                                                  Ingrid Tjoflaat, Norway
                         Freddy Lippert, Denmark                    Do guidelines save lives by                 How quick is the EMS Belgrade in getting
                                                                    themselves? Or is there more to             to the scene of a public accident
                         Therapeutic hypothermia – still some       it? Like efficient education and             Zivanovic Slavoljub, Serbia and
                         controversial issues?                      implementation?                             Montenegro
                         Tom Silfvast, Finland                      Anne Lippert, Denmark
                                                                                                                Resuscitation of avalanche victims. How
                                                                                                                have the rescue procedures changed
                         Early weaning from the ventilator is       Advanced cardiac life support not so
                                                                                                                after the implementation of the ICAR-
                         important for the ultimate outcome.        important after all?
                                                                                                                MEDCOM recommendation?
                         But how do we do it?                       Markku Kuisma, Finland
                                                                                                                Sylweriusz Kosinski, Poland
                         Wenche Mathiesen Fjælberg, Norway
                                                                    Therapeutic hypothermia in post-            Helicopter Evacuation of the Severely
                                                                    cardiac arrest patient will become          Injured in Mountain Accidents
                                                                    standard of care – experiences from         Przemyslaw Gula, Poland
                                                                    The Northern Hypothermia Network.           Deaths in the operating room following
                                                                    Niklas Nielsen, Sweden                      severe trauma
                                                                                                                Jerzy Lasek, Poland
                                                                                                                Multicentre study of optimalo
                                                                                                                management strategy in severe multiple
                                                                                                                trauma
                                                                                                                Leszek Brongel, Poland
                                                                                                                ABC step by step approach to
                                                                                                                unconscious patient -Alghorytm of
                                                                                                                decision making
                                                                                                                Marko Zelinka, Slovenia

                                                                                                                1105-1200
                                                                                                                Poster walk
                                                                                                                Guided by:        Alma D. Möller,
                                                                                                                                  Iceland
                                                                                                                                  Jon-Kenneth Heltne,
                                                                                                                                  Norway



.. 10   Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
1200 - 1220     Rapid extrication of entrapped patients in motor-vehicle accident
                The local rescue service of Stavanger will demonstrate this recently developed and internationally recognized technique in
                “Olavskleiva” - 50 meters further down from the Conference venue, Clarion.
                Co-ordinators: Sven Arne Hapnes and Olav Østebø

1200 - 1330   Lunch
                HALL A                                                                 HALL B
1330 - 1500     SESSION 6A                                                             SESSION 6B
                The future of emergency departments in Scandinavia                     The trauma team and survival – what are the crucial
                – better TRIAGE and a new speciality?                                  factors?
                Moderators:     Pia Malmquist, Sweden                                  Moderators:   Anna Tötterman, Norway
                                Thomas Olsson, Sweden                                                Lauri Handolin, Finland

                Emergency medicine in Scandinavia - a separate speciality              Do trauma patients die because of lack of surgical trauma
                or a sub-speciality?                                                   competence in our hospitals?
                Separate speciality: Pia Malmquist, Sweden                             Tina Gaarder, Norway
                Sub-speciality: Tom Silfvast, Finland
                                                                                       The trauma team members themselves – a crucial factor for
                Emergency nurse practioner: a new speciality for emergency             survival?
                nursing in Scandinavia?                                                Mari Bergan, Norway and Hedda Kolle, Norway
                Kerstin Sluys, Sweden
                                                                                       The multitrauma patient soon arrives in the Emergency
                Criteria based TRIAGE - one step forward in patient safety?            Department - what’s next?
                Ole Christian Langlo, Norway                                           Lauri Handolin, Finland

                Rapid Emergency Score - what is it and how do I use it?                Liver trauma – surgical success without surgery. Also a good
                Thomas Olsson, Sweden                                                  example of teamwork?
                                                                                       Jon Arne Søreide, Norway
                A new Scandinavian emergency medicine education for
                anaesthesiologists                                                     The trauma patient arrives in the ICU - end of history? Or just
                Peter Berlac, Denmark                                                  the beginning?
                                                                                       Else Tønnesen, Denmark

1500 - 1530   Coffee-break
                HALL A                                                                 HALL B
1530 - 1730     SESSION 7A                                                            SESSION 7B
                Emergency airway management – pitfalls and pearls                     The East-Asian tsunami disaster and the aftermath. A
                                                                                      well organised medevac or random action?
                Moderators:       Harald V. Genzwuerker, Germany                      Moderators:    Ari Leppäniemi, Finland
                                  Eldar Søreide, Norway                                              Jan Erik Nilsen, Norway
                                                                                                     Thore Wickström, Sweden
                CO poisoning – a threat to the Nordic lifestyle?                      The Finnish experience.
                Øyvind Thomassen, Norway                                              Ari Leppäniemi, Finland

                Prehospital use of anaesthetic drugs – anaesthesiologists             The Norwegian experience.
                only!                                                                 Sindre Mellesmo, Norway
                Peter Berlac, Denmark
                                                                                      The Icelandic experience.
                Prehospital use of anaesthetic drugs – anaesthesiologist              Alma D Möller, Iceland
                only? Of course not!
                Gareth Davies, United Kingdom                                         The Swedish experience.
                                                                                      Thore Wickström, Sweden
                New Scandinavian guidelines for prehospital airway
                management – time for consensus!                                      Evacuation of severly injured Scandinavian patients after the
                Mårten Sandberg, Norway                                               Tsunami-disaster in Thailand – some personal experiences.
                                                                                      Bente Lüdemann Elstad, Norway
                In failed endotracheal intubation (ETI) all alternatives are not
                equal. The German experience.                                         Panel discussion with questions from the audience
                Harald Genzwuerker Germany

                Panel discussion with questions from the audience


 1745           Fjord Safari
                Departure: Skagen kaien (see map on page 5)
                A cruise in magnificent scenery, with a nice meal and entertainment included.

                NOTE: Only pre-registered participants.




                                                                  KED
 1900           Stand-up Science
                                                                 ,
                Hall Toll, The conference pub (see map on page 5), is the meeting point for a new concept for free paper presentations.




                                   LY B                        OO
                                                   orted                     convince
                Presenters will stand up, only supported by a flip-over, and convinc you that their work will affect the future of
                                     n                medicine.
                trauma, resuscitation or emergency medicine



                               FUL
                          mme,
                For programme, see page 13.

                NOTE: Only pre-registered participants

 2000           Hall Toll - The conference pub
                Official meeting place for Scandinavian Update 2005. The lounge is reserved for you only – every night.
                Enjoy Stavanger’s newest and most exiting meeting place. Remember to bring your badge!

                Hall Toll is also the meeting point for Stand-up Science, which will take place on Friday. (see map on page 5)



                                                                             Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                                                                                                                                                         11 ..
                            saturday                                                                                                             september 10
                        HALL A                                                                HALL B
        0830 - 1000     SESSION 8A                                                            SESSION 8B
                        The link between in-hospital factors and survival in                  The hostile environment - how to protect yourself
                        resuscitation and trauma – do we have the answers?                    while taking care of the patient?
                        Moderators:     Kees H. Polderman, The Netherlands                    Moderators:     Malcolm Russel, United Kingdom
                                        Kjetil Sunde, Norway                                                  Hans Morten Lossius, Norway

                        Post-resuscitation care. Are all hospitals equal, or are some         Survival in the combat zone
                        better than others?                                                   Malcolm Russel, United Kingdom
                        Audun Langhelle, Norway
                                                                                              How to prepare yourself and your EMS for mass-casualties
                        Traumatic brain injury. Big differences in survival and               due to violent actions? The Swedish experience
                        outcome in different trauma systems. How come?                        Per Örtenwall, Sweden
                        Kees H Polderman, The Netherlands
                                                                                              How to prepare yourself and your EMS for mass-casualties
                        If major differences in outcome exist, should the public              due to violent actions? The Danish experience
                        know?                                                                 Freddy Lippert, Denmark
                        Yes: Eldar Søreide, Norway
                        No: Geir Sverre Braut, Norway                                         How to prepare yourself and your EMS for mass-casualties
                                                                                              due to violent actions? The Norwegian experience
                        Quality of care and patient safety are important factors long         Ronald Rolfsen, Norway
                        neglected!
                        Guttorm Brattebø, Norway                                              The violent patient and his “friends” in the ED – a real
                                                                                              challenge. US experience.
                        Early implementation of a simple, but effective approach to           Richard Dutton, USA
                        therapeutic hypothermia – a single centre experience
                        Annette Bore, Norway


        1000 - 1030     Coffee-break
                        HALL A                                                                HALL B
        1030 - 1200     SESSION 9A                                                            SESSION 9B
                        A Scandinavian major trauma outcome study – time                      The implementation of new Life Support courses in
                        for setting new standards for the organising of the                   Scandinavia – so what?
                        trauma chain of survival?
                        Moderators:     Anders Östlund, Sweden                                Moderators:       Anne Lippert, Denmark
                                        Ari Leppäniemi, Finland                                                 Mårten Sandberg, Norway
                        A Scandinavian major trauma outcome study – more than                 Are the Prehospital Trauma Life Support (PHTLS) and
                        just a vision!                                                        Advanced Trauma Life Support (ATLS) courses still the right
                        Ari Leppäniemi, Finland                                               concept for Scandinavia?
                                                                                              Yes: Sindre Mellesmo, Norway
                        AIS courses in Scandinavia? Why and where?                            No: Karl-Christian Thies, The Netherlands
                        Per Örtenwall, Sweden
                                                                                              American trauma courses for nurses: where do Scandinavian
                        Use of the TRISS methodology – garbage in, garbage out?               nurses go from here?
                        Nils Oddvar Skaga, Norway                                             Kerstin Sluys, Sweden

                        The key role of the trauma registrar to get things rolling!           Why Advanced Paediatric Life Support should be a
                        Morten Hestnes, Norway                                                mandatory course for you all!
                                                                                              Thomas Rajka, Norway
                        Trauma registries – what have we learnt? And is it worth the
                        money?                                                                More LS courses to come? But do they solve the problems?
                        Olav Røise, Norway                                                    Freddy Lippert, Denmark

        1200 - 1330     Lunch
                                                                                              HALL B
        1330 - 1500     DISPATCH SEMINAR - PART 1
                        What is going on in dispatching? Recent and future developments in the field of emergency medical dispatching.
                        1330-1340 Introduction

                        1340-1400 The dispatching process - indicators of quality
                                  Kristian Lexow, Norway

                        1400-1420 Organisation of emergency services and health care services. What impact do differences between
                                  countries have on emergency medical dispatching services?
                                  Egil Bovim, Norway

                        1420-1450 Dispatching in the Nordic countries - differences an similarities
                                  Asgeir Kvam, Norway

                        1450-1500 Discussion

        1500 - 1530     Coffee-break
        1530 - 1700
                        DISPATCH SEMINAR - PART 2
                        1530-1550 Protocols in dispatching; The key question - what is evidence based?
                                  Maaret Castrén, Finland

                        1550-1610 Telephone-CPR
                                  Maaret Castrén, Finland

                        1610-1630 Utstein in dispatching -why and how?
                                  Freddy Lippert, Denmark

                        1630-1650 Discussion

                        1650-1700 End notes


.. 12   Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
_____ other scientific activities
Round-table discussion
Venue: Perspektiv (Clarion Hotel, 14th floor) Timetable will be announced at the conference secretariat

                                                                                         Facilitators
Critical bleedings                                                                       Tina Gaarder, Norway
Therapeutic hypothermia                                                                  Niklas Nielsen, Sweden and Kjetil Sunde, Norway
Trauma registries                                                                        Olav Røise, Norway
Prehospital airway management                                                            Mårten Sandberg, Norway
SCANTEM                                                                                  Hans Morten Lossius, Norway
Education of prehospital physicians                                                      Jan Erik Nilsen, Norway
Scandinavian collaborative research projects                                             Else Tønnesen, Denmark
Scandinavian guidelines in trauma, resuscitation and emergency medicine.                 Eldar Søreide, Norway


Workshops
Venue: Stavanger Hall (Clarion Hotel, 1st floor, next to Plenary Hall A) Timetable and registration at the conference secretariat

Emergency airway management                                                              Stephen Sollid
Micro - and macro simulation in trauma, resuscitation and emergency medicine             Stephen Sollid
Ultrasound in trauma, resuscitation and emergency medicine                               Michael Busch, Mehdi Behzadi,
                                                                                         Harald Haga and Thomas Lindner

Learning centre
Venue: Clarion Hotel, 3rd floor

Fresenius Kabi Norge as                                                            EuroTARN (European Trauma Audit and Research Network)
Laerdal Medical as                                                                 Air Doc (Western Norway Regional Health Authority)
Novo Nordisk Scandinavia ab                                                        KVITTRA (Swedish National Trauma Registry)
Norwegian Air Ambulance Foundation                                                 SINTEF (The Foundation for Scientific and Industrial Research
                                                                                          at the Norwegian Institute of Technology)
Scandinavian Update awards
Venue: Stavanger Hall (Clarion Hotel, 1st floor)

Thursday 1830
According to the theme of the conference, the Formula of Survivial,
the following prizes will be awarded during the “Karibu” - the welcome-reception:
-Best scientific paper
-Best educational programme
-Best system implementation
-Scandinavian Update’s Prize of honour


Rapid extrication of entrapped patients in motor-vehicle accident
Venue: Olavskleiva (see map on page 5)

Friday 1200-1220
The local rescue service of Stavanger will demonstrate this recently developed
and internationally recognized technique in “Olavskleiva” - 50 meters further
down from the Conference venue, Clarion.
The extrication technique was awarded “Best Free Paper”
during Trauma Care 2004.
Co-ordinators: Sven Arne Hapnes and Olav Østebø


Stand-up Science
Venue: Hall Toll - The conference pub (Skansegaten 2, see map on page 5)

Friday 1900
- Prehospital TRIAGE decisions in Sweden estimated by a casualty scenario enquiry                                 Birger Pålsson, Sweden
- The predictive value of the criteria for trauma team activation at the University Hospital of Northern Norway   Andreas Krüger, Norway
- Prehospital documentation of physiological data: Are we good enough?                                            Per Bredmose, Denmark
- Comparison of European Registries of Trauma – first report of the EuroTARN Group                                 Antoinette Edwards, United Kingdom
- First step in the chain of survival – accuracy in 112-calls                                                     Allan Bach, Denmark
- Patients’ experience of their emergency calls                                                                   Kerstin Forslund, Sweden
- Intuitive and repetitive use of the Laryngeal Tube (LT) by first responders – a manikin study                    Thorstein Finteis, Germany
- Passive ventilation secondary to chest compressions in cardiac arrest patients                                  John O’Neill, United Kingdom
- Outcome of cardiopulmonary resuscitation in intensive care units in a university hospital                       Kingsley Enohumah, Germany
- Angiographic Embolization as Part of a Standardized Protocol in the Treatment of Traumatic Pelvic Bleeding      Anna Tötterman, Norway




                                                                                   Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                                                                                                                                                              13 ..
                 guided tours in stavanger
        City sightseeing 3 hours by bus
        On this tour we pass the Ledaal manor, which is now used as a residence for royalty when visiting Stavanger. On the way to Ullandhaug we pass Hafrsfjord
        where a historical sea battle was fought in the age of the Vikings, 1.100 years ago. We will make a photo stop by the national monument Sverd i fjell
        (Swords in Rock). Next stop is the Telecommunications tower where you get a beautiful view of Stavanger and Ryfylke area.
          A visit to the Stavanger Cathedral will also be made. This Cathedral, built of stone in the 12th and the 13th centuries, is one of the few churches in
        Scandinavia which has kept its original design.
          We will visit and get guided tour of the Norwegian Canning Museum located in the premises of the former canning factory in Old Stavanger.
        In this authentic factory environment, the production of canned brisling can still be seen. The tour terminates with a walk through Gamle Stavanger, the
        old part of Stavanger, and Europe’s best-preserved wooden house settlement.
        Min. 20 participants pr bus. English speaking guide.

        Price            Per person: NOK 295,- including all entrances                                 Tickets - Pre book or sold at stand 25 on 2nd floor
        Departure       Thursday 14.00                                                                 • Pre book by mail at booking@guidecompagniet.no
                        Friday      14.00                                                              • Tickets will be sold until 12.00 every day.
                        Saturday 14.00                                                                 • Payment by cash only.


        City walk 2 hours
        We start with a walk through Gamle Stavanger, the old part. This is Europe’s best-preserved wooden house settlement, consisting of more than 150 houses.
        The houses were built at the end of the 17th and early 18th century and are now protected by a special preservation law and form a charming area.
        Continuing by foot we pass the harbour and local market to Stavanger Cathedral. Built of stone in the 12th and 13th centuries, it’s one of the few churches
        in Scandinavia that has kept its original design. At the end of the tour, we pass shopping streets and finally Valbergtårnet, the old watch and fire tower built
        around 1850 - 1853. From here you can enjoy a view of the harbour.
        Min. 10 participants. English speaking guide

        Price           Per person: NOK 295,- including all entrances                                  Tickets - Pre book or sold at stand 25 on 2nd floor
        Departure       Thursday 14.00                                                                 • Pre book by mail at booking@guidecompagniet.no
                        Friday      14.00                                                              • Tickets will be sold until 12.00 every day.
                        Saturday 14.00                                                                 • Payment by cash only.


        Fjord sightseeing to the majestic Pulpit Rock 3,5 hours
        The fjord was carved by glaciers in the ice ages. End to end, it measures 42 km (23 miles) with rocky walls falling nearly vertically over 1000 m (3,000 ft)
        into the water. A tour on the beautiful Lysefjorden offers many impressive experiences. Experience idyllic islands, the majestic Pulpit Rock (Prekestolen),
        “Fantahålå” and fantastic nature.
        Min. 15 participants. There is a kiosk on board and guiding in several languages (cd).

        Price           Per person: NOK 280,- including all entrances                                  Tickets - Pre book or sold at stand 25 on 2nd floor
        Departure       Thursday 12.00                                                                 • Pre book by mail at booking@guidecompagniet.no
                        Friday      12.00                                                              • Tickets will be sold until 11.00 every day.
                        Saturday 12.00                                                                 • Payment by cash only.




                    guided hike to Preikestolen/The Pulpit Rock
                                    Join a guided hike to the Pulpit Rock on Saturday.


                                    12.40    Departure from Clarion hotel. The guide will meet at the hotel and walk you down to the ferry quay for departure at
                                             1300 from Stavanger to Tau. A hot meal and all trasportation costs included.
                                             Please visit stand 24 for further details.
                                                   Equipment: Good footwear, water bottle(s). Dress accordingly to the weather forecast for the day.
                                                   Duration:     The hike takes approximately 2 hours each way. The whole trip takes approx. 8 hours.
                                                   Price         Per person: NOK 370,- including all transportation costs.
                                                   Departure     Saturday 12.40
                                                   Tickets       Pre book or sold at stand 23 on 2nd floor
                                                                 Payment by cash only




                    see stavanger by air
        See the wonderful nature in Ryfylke from one of our helicopters!
        NorCopter offers you a 30 minutes spectacular view of the cities of Stavanger and Sandnes, the Lysefjord with
        Pulpit Rock and the beautiful islands outside Stavanger for NOK 1000.- each person (assuming all seats taken in
        the helicopter).

        Booking: Telephone 88 00 14 14 or visit our stand (24) on 2nd floor



.. 14     Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                          Welcome to Stavanger!



                                                                                 Clarion Hotel Stavanger
                                                                                 The conference hotel




                                                                      Radisson SAS              Radisson SAS
                                                                      Atlantic Hotel            Royal Hotel




                                                                                           Laerdal Medical




Hosting Scandinavian Update 2005, Stavanger extends a historical   May 10-13 next year the ERC congress "Resuscitation 2006" will be
chain of international events which dates back to the First        held in our city.
International Symposium of Resuscitation in 1961.
                                                                   Laerdal strives to assist our partners locally and worldwide in
Over the last ten years Stavanger has been venue for five inter-   helping save lives, and is proud to welcome conference participants
national conferences within resuscitation and emergency            to visit us while in Stavanger.
medicine, as well as several Utstein expert meetings.



www.laerdal.no
       exhibition area                                  exhibition hours Thursday: 9-17                                Friday: 9-17                        Saturday: 9-15.30

Stavanger Hall - Exhibition area 1st floor
                                                                                                                                                      Exhibitors 1st floor           Stand
   Emergency Exit                                                              WC             WC
                                   Scene                                                                                                              Inclino AS                       1
                                                                                                                                                      Display Products AS              2
                                                                                                                                                      Snøgg                            3
                                                                                                                                                      Eli Lilly AS                     4
                                                                                                                                                      Fresenius Kabi Norge AS          5
                                                                                                                                                      Glaxo Smith Kline                6
   Emergency Exit
                                                                                                                                                      Laerdal Medical                  7
                                                                                                                                                      Norwegian Air
                                Hall   B                                                                                                              Ambulance Foundation             8
                                                                                                                                                      Brain Med AS                     9
   Emergency Exit
                                                                                                                                                      Adecco Helse AS                 10




                                                                                                                Faculty Secretariat
                                                                                                                                                      VBM Medizintechnik              11
                                                                                                                                                      GE Heallthcare Technologies     12
                                                                                                                                                      Medtech                         13




                                                                                                                                            AV-room
                                                                                                                                                      Novo Nordisk Scandinavia AB     14
                                                                                                                                                      Infiniti Medical                 15

                                                                                                                                      V
                                                                                                                                                      Exhibitors 2nd floor           Stand
                                                                                                                                                      Akuttjournalen                  16
                                Hall   A
                                                                                                                                                      Nycomed Pharma                  17

                                                                                                                                      III             Fagerhult                       18
                                                                                                                                                      Less                            19
   Emergency Exit
                                                                                                                                                      JoyMed AS                       20
                                                                                                                                                      VidaCare                        21
                                Work Shop area                                                                                        II              Ferno Norden as                 22
                                                                 Lifts
                                                                                                                                                      Norsk Folkehjelp                23
                                                                                                                                                      Norcopter                       24
                                                                                                                Secretariat




                                                                                                       Stairs                                         Guidecompagniet                 25
                                                                                                  ks
                                                                                                 de




                                                                                                                                                      World Medical Center            26
                                                                                          at ion/
                                                                                             ion




          Wardrobe
                                                                                       or rat




                                                                                                                                                      Diacor AS                       27
                                                                                    Inf gist
                                                                                         m




                                                                                                                                                      OttoPreiss AS                   28
                                                                                      Re




 WC
                                                                                                                                                      Medtronic                       29
                     Emergency Exit          Entrance
                                                                         Emergency Exit
                                                                                                                                                      Work Shop area
                                                                                                                                                      Airway management
                                                                                                                                                      Ultrasound
                                                                                                                                                      Micro- and macrosimulation

Exhibition area 2nd floor

                                                                               Hotel reception




                                                             Corridor
                           21          20        19
Free paper
presentations
                22                                      18
                                                               Lift



                             28        29               17     Lift


                                                               Lift                         Stairs



  23
  24                            27
                     26                                 16
  25                                                                     Bar
              learning centre
         Learning centre 3rd floor
                                                           EuroTARN
                                          (European Trauma Audit and Research Network)

                                                             Air Doc
                                            (Western Norway Regional Health Authority)
              Norwegian Air
              Ambulance Foundation                          KVITTRA                                                   Fresenius Kabi Norge as
                                                 (Swedish National Trauma Registry)

                                                              SINTEF
                                        (The Foundation for Scientific and Industrial Research
                                              at the Norwegian Institute of Technology)




                 Emergency Exit                                                                                                                    Laerdal Medical as

                         Poster exhibition area          Poster exhibition area



                                  WC




                                                                                             Poster exhibition area
                                  WC


                                                                                                                                  Novo Nordisk Scandinavia ab




                                                                                                     Restaurant                   Novo Nordisk Scandinavia ab




         exhibitors

Main sponsors:




Exhibitors:




                                                                                                                              Scandinavian Update 2005 on trauma, resuscitation and emergency medicine
                                                                                                                                                                                                         17 ..
                                                                     NovoSeven «Novo Nordisk»
                                                                     Rekombinant koagulasjonsfaktor VIIa-konsentrat.
                                                                     PULVER OG VÆSKE TIL INJEKSJONSVÆSKE, oppløsning 60 kIE, 120 kIE og
                                                                     240 kIE: Hvert sett inneh.: I) Eptacog alfa (aktivert) 60 kIE, resp. 120 kIE og 240 kIE
                                                                     (1,2 mg, resp. 2,4 mg og 4,8 mg), natriumklorid, kalsiumkloriddihydrat, glysylglysin,
                                                                     polysorbat 80, mannitol. II) Vann til injeksjon 2,2 ml, resp. 4,3 ml og 8,5 ml.
                                                                     Indikasjoner: NovoSeven er indisert for behandling av blødningsepisoder og for
                                                                     å forhindre blødninger ved kirurgi eller invasiv undersøkelse hos følgende pasient-
                                                                     grupper: Pasienter med medfødt hemofili med inhibitorer mot koagulasjonsfaktor VIII
                                                                     eller IX > 5 BU, pasienter med medfødt hemofili som forventes å ha høy anamnestisk
                                                                     respons på administrering av faktor VIII eller faktor IX, pasienter med ervervet hemofili,
                                                                     pasienter med medfødt mangel på faktor VII, pasienter med Glanzmanns trombasteni
                                                                     med antistoffer mot GP IIb-IIIa og/eller HLA, og som har vært eller er refraktær mot
                                                                     blodplatetransfusjon.
                                                                     Dosering: Hemofili A eller B med inhibitorer eller ervervet hemofili: Bør gis så fort som
                                                                     mulig etter at blødningen har startet. Initialt anbefales 90 µg pr. kg kroppsvekt gitt i 1
                                                                     dose som intravenøs bolusinjeksjon. Det kan være påkrevd med ytterligere injeksjoner
                                                                     etter den initiale dosen. Behandlingens varighet og intervallene mellom injeksjonene vil
                                                                     variere avhengig av blødningens alvorlighetsgrad og hvilken type invasiv undersøkelse
                                                                     eller kirurgi som blir anvendt. Doseringsintervall: Initialt 2-3 timer for å oppnå hemostase.
                                                                     Såfremt fortsatt terapi er påkrevd, kan doseringsintervallet økes suksessivt til hver 4.,
                                                                     6., 8. eller 12. time i den aktuelle behandlingsperioden. Milde til moderate blødninger:
                                                                     Tidlig initiert hjemmebehandling med dosering på 4,5 kIE (90 µg) pr. kg kroppsvekt
                                                                     viser seg å være effektivt i behandlingen av milde til moderate ledd-, muskel- og
                                                                     slimhinneblødninger. 1-3 doser gis hver 3. time for å oppnå hemostase, og en ytterligere
                                                                     dose for å opprettholde hemostase. Hjemmebehandlingens varighet bør ikke overskride
                                                                     24 timer. Alvorlige blødninger: Det anbefales en initial dose på 4,5 kIE (90 µg) pr. kg
                                                                     kroppsvekt, og denne kan gis underveis til sykehuset hvor pasienten behandles. Dosen
                                                                     varierer avhengig av blødningstype og alvorlighetsgrad. Doseringsfrekvensen bør initialt
                                                                     være hver 2. time inntil klinisk effekt er observert. Såfremt fortsatt terapi er påkrevd, kan
                                                                     doseringsintervallet økes til 3 timer de første 1-2 dager. Deretter kan doseringsintervallet
                                                                     økes suksessivt til hver 4., 6., 8. eller 12. time i den aktuelle behandlingsperioden. En
                                                                     større blødning kan behandles i 2-3 uker, men behandlingstiden kan forlenges såfremt
                                                                     det er klinisk nødvendig. Invasiv undersøkelse/kirurgi: En initial dose på 4,5 kIE (90 µg) pr.
                                                                     kg kroppsvekt bør gis umiddelbart før operasjonen. Doseringen bør gjentas etter 2 timer
                                                                     og deretter med 2-3 timers intervaller de første 24-48 timer, avhengig av type kirurgisk
                                                                     inngrep og pasientens kliniske status. Ved større operasjoner bør doseringen fortsette
                                                                     med 2-4 timers intervaller i 6-7 dager. Doseringsintervallet kan deretter økes til 6-8 timer
                                                                     i ytterligere 2 uker. Ved større operasjoner kan det være nødvendig med behandling i
                                                                     opptil 2-3 uker inntil sårtilheling er oppnådd. Mangel på faktor VII: Anbefalt dosering for
                                                                     behandling av blødninger i forbindelse med kirurgi og invasiv undersøkelse er 15-30 µg
                                                                     pr. kg kroppsvekt hver 4.-6. time inntil hemostase er oppnådd. Dose og injeksjonsfrekvens
                                                                     må tilpasses individuelt. Glanzmanns trombasteni: Anbefalt dose for behandling av
                                                                     blødninger og for å forhindre blødninger ved kirurgi eller invasiv undersøkelse er 90 µg
                                                                     (dosering 80-120 µg) pr. kg kroppsvekt i intervaller på 2 timer (1,5-2,5 timer). Det bør gis
                                                                     minst 3 doser for å sikre effektiv hemostase. Anbefalt administreringsvei er bolusinjeksjon
                                                                     fordi det kan forekomme mangel på effekt i forbindelse med kontinuerlig infusjon. For de
                                                                     pasientene som ikke er refraktære mot blodplatetransfusjon, er blodplater første valg i
                                                                     behandling av Glanzmanns trombasteni.
                                                                     Forsiktighetsregler: Ved patologiske tilstander der vevsfaktor kan komme sterkere til
                                                                     uttrykk enn det som anses som normalt, er det en mulighet for utvikling av trombose eller
                                                                     induksjon av disseminert intravaskulær koagulasjon (DIC). Slike tilstander kan omfatte
                                                                     pasienter med fremskreden arterosklerose, knusningsskade, sepsis eller DIC. Da preparatet
                                                                     inneholder spormengder av muse-IgG, bovint IgG og andre restproteiner fra kulturen
                                                                     (hamsterproteiner og bovine serumproteiner), er det en liten risiko for at pasienter som
                                                                     behandles utvikler overfølsomhet for disse proteinene. Kjent overfølsomhet for muse-,
                                                                     hamster-, eller bovine proteiner kan være en kontraindikasjon. I tilfeller med alvorlige
                                                                     blødninger skal preparatet administreres ved sykehus, fortrinnsvis sykehus spesialisert
                                                                     i behandling av hemofilipasienter med koagulasjonsfaktor VIII- eller IX-inhibitorer
                                                                     eller, hvis dette ikke er mulig, i nært samarbeid med spesialist på hemofilibehandling.
                                                                     Hjemmebehandlingens varighet bør ikke overskride 24 timer. Dersom blødningen ikke
                                                                     er under kontroll, er sykehusbehandling nødvendig. Pasienter med faktor VII-mangel bør
                                                                     overvåkes med hensyn til protrombintid og faktor VII-koagulasjonsaktivitet før og etter
                                                                     administrering. Dersom faktor VII-aktiviteten ikke når forventet nivå, eller blødningen
                                                                     ikke er under kontroll etter behandling med anbefalt dose, kan det være mistanke om
                                                                     antistoffdannelse og antistoffanalyse bør utføres. Risiko for trombose hos pasienter med
                                                                     faktor VII-mangel som er behandlet med preparatet er ukjent.
                                                                     Interaksjoner: Samtidig bruk av protrombinkomplekskonsentrater (aktiverte eller
                                                                     inaktiverte) bør unngås. Det er rapportert at antifibrinolytika reduserer blodtap i for-
                                                                     bindelse med kirurgi hos hemofilipasienter, spesielt i områder med stor fibrinolytisk
                                                                     aktivitet, som i munnhulen. Foreløpig erfaring indikerer at samtidig bruk av antifi-
                                                                     brinolytika ved større og mindre kirurgiske inngrep er klinisk sikkert.
                                                                     Graviditet/Amming: Overgang i placenta: Det er ukjent om preparatet kan forårsake
                                                                     fosterskader hvis gitt til gravide eller om det påvirker forplantningsevnen. Bør bare brukes
                                                                     under graviditet dersom det er strengt nødvendig. Overgang i morsmelk: Risiko ved bruk
                                                                     under amming er ikke klarlagt. Forsiktighet tilrådes ved bruk under amming.
                                                                     Bivirkninger: Sjeldne (<1/1000): Manglende effekt. Svært sjeldne: Blod: Koagu-
                                                                     lasjonsforstyrrelser slik som økt D-dimer og konsumptiv koagulopati. Gastrointes-
                                                                     tinale: Kvalme. Hud: Hudutslett. Neurologiske: Cerebrovaskulære sykdommer der-
                                                                     iblant hjerneinfarkt og hjerneischemi. Sirkulatoriske: Episoder med arteriell trombose
                                                                     som hjerteinfarkt eller ischemi og tarminfarkt, episoder med venetrombose, som
                                                                     tromboflebitt, dyp venetrombose og dertil hørende lungeemboli, blødningsepisoder
                                                                     ved at allerede eksisterende blødninger kan vedvare ved utilstrekkelig effekt eller ikke-
                                                                     optimalt doseringsregime. Øvrige: Feber, smerter, spesielt på injeksjonsstedet, økning i
                                                                     alaninaminotransferase, alkalisk fosfatase, laktasedehydrogenase og protrombinnivåer.
                                                                     Egenskaper: Klassifisering: Aktivert rekombinant koagulasjonsfaktor VIIa fremstilt ved
                                                                     genteknologi vha. nyreceller fra babyhamster (BHK-celler). Virkningsmekanisme: Binding
                                                                     av faktor VIIa til eksponert vevsfaktor. Dette komplekset aktiverer direkte faktor X til
                                                                     faktor Xa, som initierer omdannelsen av protrombin til trombin og fører til dannelse
                                                                     av en hemostatisk propp ved konvertering av fibrinogen til fibrin. Faktor VIIa aktiverer
                                                                     i tillegg faktor IX til faktor IXa. Dermed vil en farmakodynamisk effekt av faktor VIIa
                                                                     kunne resultere i økt dannelse av faktor IXa, faktor Xa samt trombin. Imidlertid er faktor
                                                                     VIIa praktisk talt inaktiv med mindre det dannes et kompleks med vevsfaktor/fosfolipid,
                                                                     som er lokalt til stede etter en skade på karveggen. Rekombinant faktor VIIa vil derfor
                                                                     kun indusere lokal hemostase. En teoretisk risiko for utvikling av systemisk aktivering
                                                                     av koagulasjonssystemet hos pasienter som lider av underliggende sykdommer og som
                                                                     dermed er predisponert for DIC, kan ikke fullstendig utelukkes. Halveringstid: 2-3 timer.
Please visit booth No 14 for further information                     Oppbevaring og holdbarhet: Etter rekonstituering er NovoSeven kjemisk og fysisk
                                                                     stabilt i 24 timer ved 25°C. Sett fra et mikrobiologisk synspunkt bør preparatet brukes
                                                                     straks. Oppbevaringstid og oppbevaringsbetingelser vil normalt ikke være mer enn 24
on NovoSeven® and to hear more about our                             timer ved 2-8°C, med mindre rekonstituering har funnet sted under kontrollerte og
                                                                     validerte aseptiske forhold.

interesting ”Lunch & Learn” sessions                                 Andre opplysninger: Tilberedning og administrering: Hver pakning inneholder
                                                                     overføringskanyle, engangssprøyte, desinfeksjonsservietter, infusjonssett samt pak-
                                                                     ningsvedlegg med bruksanvisning. Den vedlagte engangssprøyten er forlikelig med det
                                                                     oppløste preparatet, men rekonstituert NovoSeven må ikke oppbevares i plastsprøyter.
                                                                     Veiledningen i pakningsvedlegget skal følges nøye. Preparatet må ikke blandes med
                                                                     infusjonsvæsker eller gis som drypp.
                                                                     Pakninger og priser: 60 kIE: 1 sett kr 8132,50, 120 kIE: 1 sett kr 16230,70 240
                                                                     kIE: 1 sett kr 32426,90.

                                                                     Fullstendig preparatomtale (SPC) kan fåes ved henvendelse til Novo Nordisk
                                                                     Scandinavia AS, Hauger skolevei 16, 1309 Rud, tlf +47 67 17 85 00



                                                                                                                Sist endret: 26.11.2004. Priser pr. februar 2005




                          Novo Nordisk Scandinavia AB
                          Box 50587 • SE-202 15 Malmö
                 Phone: +46 (0)40 388 900 • Fax: +46 (0)40 187 249
                               www.novoseven.com

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:52
posted:10/27/2011
language:English
pages:18