Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Mar 2014
Review[Noninvasive ventilation in out-of-hospital emergency medicine].
Noninvasive ventilation is mechanical respiratory support without the use of an artificial airway. There is no need for a tube or analgosedation. There are some advantages in comparison to invasive forms of ventilation. ⋯ In order to offer noninvasive ventilation to all patients, it also has to be available in the prehospital setting. Modern mechanical ventilators, which are used in emergency medical service, are eligible to provide noninvasive ventilation.
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Med Klin Intensivmed Notfmed · Mar 2014
Randomized Controlled Trial Multicenter Study[Temperature management after cardiac arrest].
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Med Klin Intensivmed Notfmed · Mar 2014
Comparative Study[Age-adjusted D-dimer cut-offs to diagnose thromboembolic events: validation in an emergency department].
In elderly patients, an unspecific increase of fibrin degradation products in blood is observed. Thus, the D-dimer test to rule out thromboembolic events has a high false-positive rate in elderly patients. Our aim was to validate an age-adjusted D-dimer cut-off and to assess its utility in elderly patients. ⋯ The age-adjusted D-dimer cut-off point increases the proportion of older patients, in whom an acute thromboembolic event can be excluded.
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Helicopter emergency medical service (HEMS) have become a main part of prehospital emergency medical services over the last 40 years. Recently, an ongoing discussion about financial shortage and personal shortcomings question the role of cost-intensive air rescue. Thus, the value of HEMS must be examined and discussed appropriately. ⋯ Medical competence is key in order to balance guideline compliant or maximal care versus optimal care characterized as a mission-specific, individualized emergency care concept. Although, medical decision making and treatment is typically based on the best scientific evidence, personal skills, competence, and the mission scenario will determine the scope of interventions suitable to improve outcome. Thus, the profile of requirements for the HEMS medical crew is high.
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Med Klin Intensivmed Notfmed · Feb 2014
[Attitude of intensive care specialists toward deceased organ donation in Germany. Results of a questionnaire at the 12th Congress of the German Interdisciplinary Association for Intensive and Emergency Medicine].
Organ transplantation is the only treatment option for many patients with end-organ failure. Due to lack of transplantable organs, patients already on the waiting list die every day. The number of organ donors in Germany fell in 2012 by 12.8 %, reaching its lowest level since 2002. The medical and nursing personnel in intensive care units have a key role in the recruitment of potential organ donors; therefore, a survey was conducted on this subject. ⋯ The vast majority of the intensive care personnel supports organ donation, but less than half of the respondents have an organ donor card. The reports of irregularities in the organ allocation were scrutinized, but had apparently no significant impact on the individual and collective fundamental donor decision.