Notfall Rettungsmed
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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.
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Sepsis is a challenge in emergency medicine, as this life-threatening organ dysfunction, caused by a dysregulated host response to an infection, presents manifold and therefore is often recognized too late. ⋯ Therapy of sepsis and septic shock is summarized in bundles, whereby the first bundle should ideally be completed within the first hour-in analogy to "golden hour" concepts in other emergency medical entities, such as trauma care. In the out-of-hospital setting, therapy focuses on securing vital parameters, according to the ABCDE scheme, with a particular focus on volume therapy. Further procedures within the 1 h bundle, such as lactate measurement, obtaining microbiological samples, and starting an anti-infective therapy, are broadly available in hospital only. The aim is to control the site of infection as soon as possible. Therefore, an appropriate designated hospital should be chosen carefully and informed in advance, in order to initiate and pave the way for further clinical diagnostic and treatment paths. Moreover, structured and target-oriented handovers, as well as regular training, are required.
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Recent advances in acute stroke therapy have been shown to improve clinical outcome and therefore reduce long-term disability. Acute therapy procedures in stroke have a limited time frame after onset of symptoms; thus, rapid emergency management is critical. The Tyrolean Stroke Pathway was developed to optimize the entire treatment pathway from stroke onset to outpatient rehabilitation. ⋯ The project showed that a holistic standardized stroke pathway from acute management up to outpatient rehabilitation can be successfully implemented in clinical routine. The project improved the entire health care pathway of stroke patients. The Stroke Action Plan for Europe 2018-2030 recommends to have national plans for stroke that encompass the entire chain of care.
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Notfall Rettungsmed · Jan 2022
Review[Learning with digital media in emergency medicine-a path through the jungle of possibilities].
Digital media, such as podcasts, wikis, ePortfolios, and extended reality applications, provide excellent learning opportunities with a high degree of connectivity and flexibility for learners, as well as for learning facilitators. This not only enables location-independent and pandemic-resilient learning, but also a high degree of autonomy for the learners. The megatrend of digitalization opens up many possibilities, but there are also stumbling blocks and limitations. ⋯ Learning is not only changing due to new learning technologies, but also due to the growing importance of informal learning, the increasing significance of the ability to quickly access high-quality knowledge, faster-changing professional biographies, and the use of digital universal tools. Thus, in the jungle of possibilities, an estimation of scientific quality criteria is often difficult and a differentiated consideration is necessary. Basically, the question of appropriate methods must be asked and it must be critically questioned whether the learning/competency objectives can be achieved with the planned digitalized media. Digital media cannot and should not replace practical training in the workplace.
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Notfall Rettungsmed · Jan 2022
[Usability of an app to overcome language barriers in paramedic care].
Communication with foreign-speaking patients in emergency medical situations can be challenging. In contrast to the inpatient setting, adequate interpreters are often not readily available in emergency services. At the same time, however, emergency situations require rapid assessment as the basis for any treatment. ⋯ Given that the app studied is a complex work tool, its usability and attractiveness were rated as overall good, and paramedics who had already used the app rated it even more positively. This could indicate a hesitancy by some paramedics to use a complex digital tool in complex situations that are already characterized by language and cultural barriers.