Notfall Rettungsmed
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Notfall Rettungsmed · Apr 2022
[Management of critically ill nontrauma patients in a nonuniversity emergency department].
Today there exists only limited knowledge regarding the care of critically ill nontrauma (CINT) patients in the resuscitation room (RR) in Germany. The goal of this observational study was to describe the management of CINT patients in the RR of a nonuniversity emergency department. ⋯ Patients in a nonuniversity nontrauma RR are resource-intensive and have a high in-hospital lethality. RR care can be completed within 60 min. In order to achieve better comparability between patient populations of different locations, it is necessary to uniformly define admission criteria for the nontrauma resuscitation room.
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Notfall Rettungsmed · Mar 2022
Review[Best practice-example of a paramedic competence system in the context of user and patient safety: the Reutlinger Weg].
The discussion about the competencies and responsibilities of paramedics has been going on for decades and is the subject of controversial legal debates and currently the focus of political attention due to the heterogeneous country-specific design. However, there are only a few published examples of a so-called competency system for the safe and effective use of prehospital emergency medicine interventions. The practical experience of a competence system is presented. ⋯ Safety culture must be exemplified. Standard operating procedures (SOPs) are the guideline for implementation. In a competence system, certified paramedics can be granted authorization and thus contribute to rapid and efficient patient care, while keeping emergency physicians available for indications requiring their competencies.
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Notfall Rettungsmed · Jan 2022
[Prehospital stabilization of a critically ill patient with telemetric medical guidance].
We report about the prehospital treatment of an 82-year-old man with septic shock as a complication of acute pancreatitis. Initially only an advanced life support ambulance was on scene. After the primary assessment, the team decided to call for an emergency-physician-staffed helicopter. ⋯ Therefore, they requested telemetric support. Despite massive centralization and difficult circumstances, the team succeeded to stabilize the patient in ongoing consultation of the tele-emergency physician. This cooperation made immediate und uneventful transportation after arrival of the helicopter possible.
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Notfall Rettungsmed · Jan 2022
Differences in training among prehospital emergency physicians in Germany.
Germany has an interdisciplinary physician-based emergency medical service. Differences in training likely lead to different levels of expertise. ⋯ The number of performed procedures markedly differed for some skills between different primary specialties. Recommendations regarding a procedural volume were not always met, suggesting missing expertise for some skills. A defined number of procedures should therefore be a formal requirement to be eligible for board certification in prehospital emergency medicine.
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Notfall Rettungsmed · Jan 2022
Review[Decision support for patient admission in case of suspicion of COVID-19].
During a pandemic situation, patients with suspected coronavirus disease (COVID-19) are also treated by emergency medical services (EMS). In order to establish an adequate procedure, a decision aid for the allocation of patients in case of suspicion of COVID-19 has been prepared for the ambulance staff as well as for the emergency physician in the Bavarian EMS. ⋯ The flowchart allows patients to be categorized in three stages, based on (vital) parameters and criteria such as risk factors and specific framework conditions. The aim is to provide emergency physicians and ambulance staff with guidance for the assessment of patients and the resulting transport decision with a suitable target clinic if necessary.