12.12.2022: The Air Force's rescue helicopter service has search and rescue missions as its main remit, but it is also included as a secondary resource in the air ambulance service (1). In 2007, the Ministry of Justice initiated a project to replace the old Sea King helicopters. The choice fell on the Leonardo AW101 (hereafter referred to as the SAR Queen). The new helicopter was phased in at Ørland Air Base in Trøndelag in mid-May 2021. The SAR Queen has been met with a variety of expectations. One the one hand, a new, modern helicopter might have fewer technical problems and operate better in poor...

06.01.2022: Low-voltage electric shock (< 1,000 V) (1, 2) is more common than high-voltage electric shock (3). Most cases involve young men at work, and many are referred to the Emergency Department (1). There are national and international guidelines for the management of electric shock, but clinical practice varies (2, 4, 5). This study is a survey of patients who were referred to the Emergency Department following low-voltage electric shock. Material and method Retrospective data were obtained from patients (N = 210) referred to the Emergency Department at St Olav's Hospital –Trondheim University...

03.05.2021: The majority of patients with a head injury are conscious during the initial assessment. The aim of the initial management is to identify those patients at risk of developing traumatic intracranial haematoma, while also avoiding unnecessary computed tomography (CT) scans and hospital admissions. In 2013, the Scandinavian Neurotrauma Committee (SNC) published guidelines for the initial management of adults with minimal, mild or moderate head injuries (1). A literature review that used the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria to assess the quality of ten...

25.03.2021: Studies show that some groups are more affected by the COVID-19 pandemic than others, both internationally and in Norway. A large study of socioeconomic factors in over one million cases in the United States found that a low level of education and an African-American background were strongly associated with infection, more severe symptoms and death as a result of COVID-19 (1). Immigrants are overrepresented in infection statistics throughout Scandinavia (2). In Norway, 36 % of those with confirmed COVID-19 are immigrants born abroad to foreign parents, even though they only represent 15 % of...

22.03.2021: Neurosarcoidosis is a rare, non-necrotising, granulomatous disease which affects both the central and the peripheral nervous system. The condition most frequently manifests as part of systemic sarcoidosis, and is seen in 5–15 % of sarcoidosis patients (1). Sarcoidosis is most frequently seen concurrently in the lungs, eyes and skin (2). The prevalence of neurosarcoidosis is about 1 in 100 000 (3), and the disease occurs most frequently in the age group 40–50 years (4). A positive neural tissue biopsy is a definitive diagnosis (5). CT thorax and PET coupled with bronchoalveolar lavage (BAL)...

12.02.2021: Compared to other countries, the consumption of antibiotics in Norway is low, and the proportion of narrow-spectrum antibiotics is high (1, 2). Dispensing on prescription outside institutions accounts for 80 % of total sales (1). Since 2012, the use declined year on year until 2018, followed by a small increase of 2 % in 2019. This decline is in line with the intentions in the National Plan Against Antibiotic Resistance of a 30 % reduction from 2012 to 2020 (3). In persons outside institutions, antibiotics are most frequently prescribed against respiratory infections. As a result, the use of...

25.01.2021: When severe injuries have been incurred, the initial focus is on surgical treatment and life-saving measures. In studies of this early phase, severe pain has been reported in more than 50 % of conscious patients (1, 2). A high incidence of chronic pain has also been reported in severely injured patients (3). In a study from Oslo University Hospital in 2007, 62 % of severely injured patients experienced severe or very severe pain during their hospital stay, and 24 % had severe chronic pain after six years (3). Early-stage pain management was mostly limited to opioids. In our study, we wanted to...

09.11.2020: Bariatric surgery is a common procedure at Norwegian hospitals nowadays, with just under 3000 such operations performed annually; almost 2000 in the public health service and 1000 in the private health service (1). Following surgery, most patients experience substantial weight reduction and an improvement in obesity-related comorbidities (2, 3), and the incidence of perioperative complications is low (4). However, the risk of negative long-term side effects and complications is relatively high (3). Patients who believe they have suffered an injury after treatment in the health service can...

12.10.2020: Fluoroquinolones have been available in Norway since the 1980s, with ciprofloxacin accounting for the greater part of usage. From 1999 to 2012, usage almost tripled. It then decreased thereafter and had almost halved by 2019 (1). Fluoroquinolones are highly potent antibiotics which exert their bactericidal effect through inhibition of DNA gyrase and DNA topoisomerase IV (2). A range of pathogenic microbes are in principle sensitive to fluoroquinolones. However, the emergence of resistance has increased sharply and is running largely parallel to usage (3). No other class of antibiotics has the...

28.09.2020: The summary care record electronic service stores a complete medication history for all patients. This history consists partly of copies of all electronic prescriptions, and partly of dispensing reports from pharmacies. Dispensing reports are received for both paper-based (including those received by telephone and telefax) and electronic prescriptions. When the summary care record receives a dispensing report for an electronic prescription, the dispensed medication is linked to the prescription and any remaining amounts are calculated. According to current regulations, with some exceptions...

13.08.2020: A pandemic can affect the population both somatically and psychologically. In England, 24 % of the population reported experiencing anxiety in connection with the swine flu in 2009 (1). We wished to investigate how the flow of patients to the Psychiatric Casualty Clinic in Oslo was affected during the acute phase of the COVID-19 pandemic. Material and method The Psychiatric Casualty Clinic is an emergency outpatient service under the direction of Oslo University Hospital. Located on the premises of the accident and emergency department in Oslo city centre, the clinic is open in the evenings...

03.08.2020: In 1992, the National Insurance Agency determined that primary care doctors should use ICPC (International Classification of Primary Care) for coding of diagnoses on reimbursement cards and sickness certifications. The purpose was to establish a consistent system for coding of diagnoses. Norway was thereby the first country to apply ICPC as an official national standard. Since 2004, the follow-up version ICPC-2 has been used (1). ICPC is based on a letter code for the organ system, including separate letter codes for general conditions, mental disorders and social problems, followed by a two...

29.06.2020: The use of benzodiazepines has increased sharply since they were first synthesised in the 1950s, and they have gradually replaced barbiturates and other hypnotic and anti-anxiety drugs (1). In 2008, 6 % of the Norwegian population was prescribed at least one benzodiazepine (2). Since the 1990s, z-hypnotics such as zopiclone (Imovane, Zopitin) and zolpidem (Stilnoct), have taken over for insomnia (3). Benzodiazepines and z-hypnotics are chemically dissimilar, but both act by increasing the effect of the neurotransmitter gamma-aminobutyric acid (GABA) on GABAA receptors in the brain. This...

29.06.2020: Gamma-hydroxybutyrate (GHB) and the closely related gamma-butyrolactone (GBL) and 1,4-butanediol (BD) are relatively new intoxicants in Norway. They first appeared in the 1980s (1). In 2014, 1.7 % in the age group 16–30 years reported that they had used GHB one or more times (2). At the main A&E clinic in Oslo, the number of GHB poisonings increased by 148 % from 2008 to 2012 (3). When taken as intoxicants, GHB, GBL and BD are mainly ingested orally in liquid form (1). GBL and BD are converted into GHB in the body. GHB has a dose-dependent central nervous system depressant effect and in low...

15.05.2020: On 30 January 2020 (week 5), the World Health Organization declared the novel coronavirus outbreak a public health emergency of international concern (PHEIC). On the next day, the Norwegian Ministry of Health and Care Services added COVID-19 to the list of notifiable diseases, irrespective of clinical symptoms. On 26 February (week 9), the first case of COVID-19 was detected in Norway. On 12 March (week 11), Norwegian authorities imposed strict control measures to limit contacts between persons, and on 14 March (week 11) travel restrictions were introduced with quarantine for people who...

04.05.2020: Postoperative pain after caesarean section may be underreported and poorly managed (1). In a cross-sectional study of postoperative pain in 215 Norwegian hospital patients in 2011, successful pain management was defined as average pain over the last 24 hours of ≤ 3 on the Numeric Rating Scale (NRS, 0–10). This was not achieved in 38 % of patients (2). The maternity ward at Oslo University Hospital, Ullevål has been using a multimodal regimen with 40 ml bupivacaine 2.5 mg/ml infiltration plus oral paracetamol 1 g × 4, ibuprofen 400 mg × 4 and oxycodone prolonged release 10 mg × 2 to prevent...

24.04.2020: The current pandemic caused by the SARS-CoV-2 virus was predicted to reach Norway shortly after the outbreak in China (1). Following the government decision to virtually shut Norway down on 12 March (week 11), acute admissions departments have prepared for a large influx of infected patients. The Emergency Department at St Olav's Hospital, Trondheim University Hospital is preparing for worst-case scenarios, but is now experiencing the calm before the storm. No Emergency Department health personnel are in quarantine, but as of 14 April 2020 a total of 15 members of the staff of St Olav's...

15.04.2020: Pocket-sized ultrasound devices have been on the market for about ten years. The price of a pocket ultrasound device is relatively low compared to that of a conventional ultrasound scanner, and pocket devices are highly portable and require little additional training to use. Their functionality is somewhat reduced compared to that of conventional scanners, with a limited range of probes, lower penetration, lower resolution, a smaller screen and an inability to measure velocity. Nevertheless, pocket ultrasound devices have proven to be a useful tool in several clinical settings. For...

24.03.2020: Rotavirus is the most frequent cause of severe diarrhoea in small children (1). In the period 2006–13, rotavirus was the cause of 63–65 % of all gastroenteritis-related hospital admissions in children under five years of age. Most cases were found at age 6–23 months, and the frequency was highest in the first and second quarters of the year (2, 3). We have no similar surveys of rotavirus infections in general practice, but several assessments of gastroenteritis, vomiting and diarrhoea, based on electronic reimbursement claims from GPs and doctors in the emergency primary health care units...

24.03.2020: Acute otitis media is a common reason for young children visiting a doctor or emergency primary health care unit (1). It is also a common reason for prescribing antibiotics for young children. If preventive measures were able to reduce the incidence of otitis, the use of antibiotics among children would also be reduced. Otitis is often caused by viruses, while pneumococci are the most common bacterial cause (2). Pneumococcal vaccines have been developed which have been shown to be effective against otitis caused by the serotypes found in the vaccine (3). Since the introduction of such...

09.12.2019: Emergency primary health care units are at their busiest during the Easter and Christmas holidays (1). It is more difficult to get an appointment with a GP during holiday periods. Also, many patients are away from home, staying in municipalities where they are not resident. Calling in at the local accident and emergency unit is therefore the only option available to them. However, although the Christmas break is generally a busy time in emergency units, some days are busier than others. As the spirit of Christmas is meant to bring peace to one and all, there would be reason to believe that our...

02.10.2019: In 2010, five users' and interest organisations took the initiative for the 'Joint Campaign for Drug-Free Treatment Programmes in the Mental Health Services' (1), and in 2015 the Ministry of Health and Care Services instructed the regional health trusts to establish treatment programmes that were drug-free. The objections raised by the psychiatric profession have been vehement and polarised (2, 3). At Jæren District Psychiatric Centre (Jæren DPS) we decided to identify the patients' wishes for a drug-free treatment option and whether the groups of patients who wanted this option shared any...

23.09.2019: Polydrug use is common, and increases the risk of negative health effects (1). A study that investigated all (N = 194) overdose deaths in Norway in 2012 found an average of 4.9 different drugs per autopsy (2). The study concluded that drugs taken in combination (especially opioids + benzodiazepines) are the main cause of fatal overdose. Mono-intoxication with heroin was not detected in any of the 194 fatal overdoses (2). Reporting of overdose is largely based on ICD-10, the international statistical classification of diseases and related health problems (3). A single substance, for example...

27.08.2019: Working conditions have a significant impact on public health. A Norwegian study has shown that up to 30–40 % of all sickness absence may be attributed to workplace conditions (1). To obtain a better overview of the patient examinations in hospital departments for occupational medicine and the National Institute of Occupational Health (STAMI), a shared, anonymous register of patient examinations was established in 2009 (2). This report describes the diagnoses, occupations and exposure factors that occur most frequently among young patients. This will elucidate the current situation and...

13.06.2019: The global climate changes we are witnessing entail consequences for our health. Heat-related morbidity and death are some of these consequences (1). The association between health condition and climate impact is complex and involves medical, social and environmental factors (2). Death can be directly caused by high temperatures (heat stroke) or indirectly by causes related to the effects of heat on chronic conditions such as diabetes, cardiovascular diseases, respiratory diseases and frailty in older persons (3). There is evidence of excess mortality among older people during heat waves in...