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Jonsson, Anders
Publications (10 of 66) Show all publications
Hindorf, M., Lundberg, L. & Jonsson, A. (2018). Swedish Specialized Boarding Element Members' Experiences of Naval Hostile Duty. Journal of Special Operations Medicine, 01(18(3)), 45-49
Open this publication in new window or tab >>Swedish Specialized Boarding Element Members' Experiences of Naval Hostile Duty
2018 (English)In: Journal of Special Operations Medicine, ISSN 1553-9768, Vol. 01, no 18(3), p. 45-49Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The Swedish naval specialized boarding element participated in Operation Atalanta in 2013 to mitigate piracy by escorting and protecting ships included in the United Nations World Food Program in the Indian Ocean. We describe the experiences of the Swedish naval specialized boarding-element members during 4 months of international naval hostile duty. Some studies have reported experiences of naval duty for the Coast Guard or the merchant fleet; however, we did not find any studies that identified or described experiences of long-time duty onboard ship for the naval armed forces.

MATERIALS AND METHODS: The respondents wrote individual notes of daily events while onboard. Conventional content analysis was used on the collected data, using an inductive approach.

RESULTS: The findings revealed three broad themes: military preparedness, coping with the naval context, and handling physical and mental strain. Different categories emerged indicating that the participants need the ability to adapt to the naval environment and to real situations.

CONCLUSION: The Swedish navalforces should train their specialized element members in coping strategies. 

Place, publisher, year, edition, pages
St Petersburg, Florida: , 2018
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-15694 (URN)30222836 (PubMedID)2-s2.0-85056653254 (Scopus ID)
Available from: 2019-01-18 Created: 2019-01-18 Last updated: 2019-01-18Bibliographically approved
Andersson, S.-O., Lundberg, L., Jonsson, A., Tingström, P. & Abrandt Dahlgren, M. (2017). Doctors' and nurses' perceptions of military pre-hospital emergency care - When training becomes reality.. International Emergency Nursing, 32, 70-77, Article ID S1755-599X(17)30010-1.
Open this publication in new window or tab >>Doctors' and nurses' perceptions of military pre-hospital emergency care - When training becomes reality.
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2017 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 32, p. 70-77, article id S1755-599X(17)30010-1Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to identify physicians' and nurses' perceptions of military pre-hospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The results after pre-deployment training can be categorised as (1) learning about military medicine and (2) taking care of the casualty. The results after an international mission can be categorised as (1) collaborating with others, (2) providing general health care and (3) improving competence in military medicine. These results indicate that the training should be developed in order to optimise pre-deployment training for physicians and nurses. This may result in increased safety for the provider of care, while at the same time minimising suffering and enhancing the possibility of survival of the injured.

Keywords
International mission, Learning, Military pre-hospital emergency care, Qualitative method, Training
National Category
Other Medical Sciences not elsewhere specified
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-12889 (URN)10.1016/j.ienj.2017.01.001 (DOI)000402650700013 ()28228341 (PubMedID)2-s2.0-85013115681 (Scopus ID)
Available from: 2017-10-21 Created: 2017-10-21 Last updated: 2017-12-13Bibliographically approved
Silverplats, K., Jonsson, A. & Lundberg, L. (2016). A hybrid simulator model for the control of catastrophic external junctional haemorrhage in the military environment. Advances in Simulation, 1(5), Article ID 2016 1:5 DOI: 10.1186/s41077-016-0008-z.
Open this publication in new window or tab >>A hybrid simulator model for the control of catastrophic external junctional haemorrhage in the military environment
2016 (English)In: Advances in Simulation, ISSN 2059-0628, Vol. 1, no 5, article id 2016 1:5 DOI: 10.1186/s41077-016-0008-zArticle in journal (Refereed) Published
Abstract [en]

Catastrophic haemorrhage from extremity injuries has for a long time been the single most common cause of preventable death in the military environment. The effective use of extremity tourniquets has increased the survival of combat casualties, and exsanguination from isolated limb injuries is no longer the most common cause of death. Today, the most common cause of potentially preventable death is haemorrhage from the junctional zones, i.e. the most proximal part of the extremities, not amenable to standard tourniquets.

Different training techniques to control catastrophic haemorrhage have been used by the Swedish Armed Forces in the pre-deployment training of physicians, nurses and medics for many years. The training techniques include different types of human patient simulators such as moulage patients and manikins. Preferred training conditions for the control of catastrophic haemorrhage include a high degree of realism, in combination with multiple training attempts.

This report presents a new hybrid training model for catastrophic external junctional haemorrhage control. It offers a readily reproducible, simple and inexpensive opportunity to train personnel to deal with life threatening catastrophic junctional haemorrhage. In particular, this model offers an opportunity for non-medical military personnel in Sweden to practice control of realistic catastrophic haemorrhage, with multiple training attempts.

Keywords
Extremity injuries, Haemorrhage control, Haemostatic agents, Junctional haemorrhage, Military Prehospital training
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-8918 (URN)10.1186/s41077-016-0008-z (DOI)29449974 (PubMedID)
Available from: 2016-02-19 Created: 2016-02-19 Last updated: 2018-12-07Bibliographically approved
Ambjörnsson, J., Jonsson, A., Strömsöe, A., Andersson, H., Bång, A. & Bremer, A. (2016). Prehospital suspicion and identification of adult septic patients:Experiences of a screening tool. In: : . Paper presented at 2nd Global Conference on Emergency Nursing & Trauma Care, Sitges (Spain) September 22 - 24, 2016.
Open this publication in new window or tab >>Prehospital suspicion and identification of adult septic patients:Experiences of a screening tool
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2016 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Introduction:  Sepsis  is life threatening  and  requires  urgent healthcare  to reduce  suffering  and death. Therefore it is important that septic patients are identified early to enable treatment.

 

Aim: To investigate to what extent EMS personnel identified patients with sepsis using the "BAS

90-30-90"  model, and to describe assessments and medical procedures that were  undertaken by the personnel.

 

Methods: This was a retrospective study where  185 EMS medical records were  reviewed. The inclusion was based on patients who were later diagnosed with sepsis in the hospital.

 

Results: A physician assessed the patients  in 74 of the EMS cases, which lead to exclusion  of these  records  in  regard  to  the  EMS  personnel's  ability  to  identify  sepsis.  The  personnel documented  suspicion  of severe sepsis in eight (n=8) of the remaining 111 records (7.2%). The proportion  of patients  065 years  of age was 73% (n=135)  of which  37% (n=50) were over 80 years  old. Thirty-nine percent  (39%,  n=72)  were  females. The  personnel  documented blood pressure   in  91%  (n=168),  respiratory   rate  in  76%  (n=140),   saturation   in  100%  (n=185), temperature  in 76%  (n=141),  and  heart  rate  in  94%  (n=174)  of  the  records.  Systolic  blood pressure  <90 mmHg  was  documented  in 14,2%  (n=24),  respiratory  rate  030 in 36%  (n=50), saturation <90 in 49%   (n=91). temperature >38°C in 37.6% (n=53), and heart rate 090 in 70% (n=121) of the records. Documented medical procedures and treatments were intravenous  lines (70%, n=130), intravenous  fluids (10%, n=19) and administration  of oxygen (72%, n=133).

 

Conclusion:  The EMS personnel identified  only a few septic patients  with the help of the BAS

90-30-90  model when  all three criteria  would  be met for severe  sepsis. Either  advanced age (>65  years),   fever   (>38°C)   or  tachypnea (020  breaths/min)   appeared   to   increase  the personnel's suspicion  of sepsis. Oxygen, but not intravenous  fluids, was given in an adequate way.

Keywords
Sepsis, Assessment, Screening tool, Medical record review
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-10675 (URN)
Conference
2nd Global Conference on Emergency Nursing & Trauma Care, Sitges (Spain) September 22 - 24, 2016
Available from: 2016-09-09 Created: 2016-09-09 Last updated: 2017-05-04Bibliographically approved
Axelsson, C., Herlitz, J., Karlsson, A., Sjöberg, H., Jiménez-Herrera, M., Bång, A., . . . Ljungström, L. (2016). The Early Chain of Care in Patients with Bacteraemia with the Emphasis on the Prehospital Setting. Prehospital and Disaster Medicine, 31(3), 1-6
Open this publication in new window or tab >>The Early Chain of Care in Patients with Bacteraemia with the Emphasis on the Prehospital Setting
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2016 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 31, no 3, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Purpose:  There is a lack of knowledge  about the early phase of severe infection. This reportdescribes the early chain of care in bacteraemia as follows:  (a) compare patients who were and were not transported by the Emergency Medical Services (EMS); (b) describe various aspects of the EMS chain; and (c) describe factors of importance for the delay to the start ofintravenous antibiotics. It was hypothesized that, for patients with suspected sepsis judged by the EMS clinician, the delay until the onset of antibiotic treatment would be shorter.

Basic Procedures: All  patients  in the Municipality of Gothenburg  (Sweden) with apositive blood culture, when assessed at the Laboratory of Bacteriology in the Municipality of Gothenburg, from February 1 through April 30, 2012 took part in the survey.

Main Findings/Results:  In all, 696 patients fulfilled the inclusion criteria. Their mean agewas 76 years and 52% were men. Of all patients, 308 (44%) had been in contact with the EMS and/or the emergency department (ED). Of these 308 patients, 232 (75%) were transported by the EMS and 188 (61%) had “true pathogens” in blood cultures. Patients who were transported by the EMS were older, included more men, and suffered from more severe symptoms  and signs.The EMS nurse  suspected sepsis in only six percent of the cases. These patients had a delay from arrival at hospital until the start of antibiotics of one hour and 19 minutes  versus three hours and 21 minutes among the remaining patients (P = .0006). The corresponding figures for cases with “true pathogens” were one hour and19 minutes  versus three hours and 15 minutes  (P = .009).

Conclusion:  Among patients with bacteraemia, 75% used the EMS, and these patients were older, included more men, and suffered from more severe symptoms  and signs. The EMS nurse  suspected sepsis in six percent of cases. Regardless  of whether or not patients with true pathogens  were isolated,  a suspicion of sepsis by the EMS clinician at thescene was associated with a shorter delay to the start of antibiotic treatment.

Keywords
bacteremia; Emergency Medical Services; prehospital phase; sepsis
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-9562 (URN)10.1017/S1049023X16000339 (DOI)000376655700008 ()27026077 (PubMedID)2-s2.0-84961879870 (Scopus ID)
Available from: 2016-04-08 Created: 2016-04-08 Last updated: 2018-12-07Bibliographically approved
Karlsson, K., Niemelä, P., Jonsson, A. & Törnhage, C.-J. (2016). Using Shoulder Straps Decreases Heart Rate Variability and Salivary Cortisol Concentration in Swedish Ambulance Personnel. SH@W Safety and Health at Work, 7(1), 32-37
Open this publication in new window or tab >>Using Shoulder Straps Decreases Heart Rate Variability and Salivary Cortisol Concentration in Swedish Ambulance Personnel
2016 (English)In: SH@W Safety and Health at Work, ISSN 2093-7911, E-ISSN 2093-7997, Vol. 7, no 1, p. 32-37Article, review/survey (Refereed) Published
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hb:diva-8916 (URN)10.1016/j.shaw.2015.09.005 (DOI)000399096000005 ()27014488 (PubMedID)2-s2.0-84960895582 (Scopus ID)
Available from: 2016-02-19 Created: 2016-02-19 Last updated: 2018-12-07Bibliographically approved
Andersson, S.-O., Lundberg, L., Jonsson, A., Tingström, P. & Dahlgren, M. A. (2015). Fixing the wounded or keeping lead in the air-tactical officers' views of emergency care on the battlefield.. Military medicine, 180(2), 224-229
Open this publication in new window or tab >>Fixing the wounded or keeping lead in the air-tactical officers' views of emergency care on the battlefield.
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2015 (English)In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 180, no 2, p. 224-229Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to identify tactical officers' views of prehospital emergency care in the field before an international mission. A qualitative study with a phenomenographic approach based on interviews was used. The result of this study is a set of descriptive categories on a collective level, showing the variation in how the tactical officers perceived the phenomenon of emergency care in the battlefield. The result can be viewed as (1) noncombat-oriented including being able to do one's specialist task, being able to talk with local people, and being able to give first aid, and (2) combat-oriented including soldiers' skills and roles in the unit, being able to act in the unit, and being able to lead the care of injured. These findings are important for officers' preparation for international missions. The interaction between military and medical knowledge on-site care should be developed between the tactical officer and the medical personnel in order to minimize suffering and to enhance the possibility for survival of the casualty.

National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-8557 (URN)10.7205/MILMED-D-13-00558 (DOI)000349101900016 ()25643391 (PubMedID)2-s2.0-84928490657 (Scopus ID)
Available from: 2016-01-15 Created: 2016-01-14 Last updated: 2018-12-07Bibliographically approved
Andersson, S.-O., Lundberg, L., Jonsson, A., Tingström, P. & Abrandt Dahlgren, M. (2015). Fixing the wounded or keeping lead in the air-tactical officers' views of emergency care on the battlefield. Military medicine, 180(2), 224-229
Open this publication in new window or tab >>Fixing the wounded or keeping lead in the air-tactical officers' views of emergency care on the battlefield
Show others...
2015 (English)In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 180, no 2, p. 224-229Article, review/survey (Refereed) Published
Abstract [en]

The aim of this study was to identify tactical officers' views of prehospital emergency care in the field before an international mission. A qualitative study with a phenomenographic approach based on interviews was used. The result of this study is a set of descriptive categories on a collective level, showing the variation in how the tactical officers perceived the phenomenon of emergency care in the battlefield. The result can be viewed as (1) noncombat-oriented including being able to do one's specialist task, being able to talk with local people, and being able to give first aid, and (2) combat-oriented including soldiers' skills and roles in the unit, being able to act in the unit, and being able to lead the care of injured. These findings are important for officers' preparation for international missions. The interaction between military and medical knowledge on-site care should be developed between the tactical officer and the medical personnel in order to minimize suffering and to enhance the possibility for survival of the casualty.

National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:hb:diva-8915 (URN)10.7205/MILMED-D-13-00558 (DOI)000349101900016 ()25643391 (PubMedID)2-s2.0-84928490657 (Scopus ID)
Available from: 2016-02-19 Created: 2016-02-19 Last updated: 2018-12-07Bibliographically approved
Andersson Hagiwara, M., Kängström, A., Jonsson, A. & Lundberg, L. (2014). Effect of Simulation on the Clinical Competence of Swedish Ambulance Nurses. Australasian Journal of Paramedicine, 11(2), 1-7
Open this publication in new window or tab >>Effect of Simulation on the Clinical Competence of Swedish Ambulance Nurses
2014 (English)In: Australasian Journal of Paramedicine, ISSN 2202-7270, Vol. 11, no 2, p. 1-7Article in journal (Refereed) Published
Abstract [en]

ntroduction Simulation has become an established method for education and training of Emergency Medical Services personnel in different skills such as advanced airway techniques, also in evaluation and initial care of stroke patients and in pre - hospital trauma. Simula tion can be a useful method to improve learning. To our knowledge, there are only a few studies that relate simulation to the effect on clinical skills. The aim of the present study was to investigate the effect of simulation on the clinical competence in a pre - hospital trauma care course for ambulance nurses. Methods The study was performed using a before - after design. Seventeen ambulance nurse students who participated in a trauma care course were evaluated in two simulated trauma cases. All subjects had passed the initial theoretical part of the course. The pre - test was performed in the beginning of the following part of the course involving simulation and the post - test at the end of the course. The analysis was performed by assessment of performance, as seen on video - tapes from the pre - tests and the post - tests. A validated instrument was used to determine the level of student’ s clinical competence. Paired t - test was used to confirm differences between the pre - test and post - test results . Results There was a significant increase in the over - all results for the post - test, with a difference of 1.12 points (t=4.642, df=16, p= 0.001) Situation Awareness, Patient Assessment and Decision Making showed the most pronounced improvements. Conclusion The results imply t hat simulation in addition to traditional theoretical education improves the clinical competence of the students, in comparison to traditional education and training without any significant amount of simulation.

Place, publisher, year, edition, pages
Paramedics Australasia, 2014
Keywords
Prehospital akutsjukvård
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-1862 (URN)2320/13702 (Local ID)2320/13702 (Archive number)2320/13702 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2016-03-15
Jonsson, A., Lundberg, K., Sandman, L. & Kjellström, S. (2014). Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties. Military medicine, 8(179), 821-826
Open this publication in new window or tab >>Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties
2014 (English)In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 8, no 179, p. 821-826Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this qualitative study is to explore the Swedish military personnel's experience of what it means to perform a caring role in a combat zone. This study assesses the challenges faced by military medical personnel in the context of a combat zone. METHODS: The design was descriptive with a qualitative inductive approach. Twenty military medical personnel (physicians, nurses, and combat lifesavers) were interviewed individually. They had been involved in international military operations between 2009 and 2012. This study was analyzed using qualitative content analysis. RESULTS: The analysis produced four categories: being in a primarily noncaring organization, caring in emotionally charged relationships, lacking an open dialog about expectations of killing and having to prioritize scarce resources. CONCLUSIONS: This study shows that medical personnel easily adapt to a military setting. They care but also perform other tasks when they are in a combat zone. The medical personnel want to give care to host nation but use drugs they can spare.

Place, publisher, year, edition, pages
Association of Military Surgeons of the U S, 2014
Keywords
health science, Etics, Vårdvetenskap
National Category
Medical and Health Sciences Other Humanities
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-2044 (URN)10.7205/MILMED-D-14-00038 (DOI)25102524 (PubMedID)2320/14667 (Local ID)2320/14667 (Archive number)2320/14667 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-12-01Bibliographically approved
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