Der Unfallchirurg
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The complete blackout of information technology (IT) in a hospital represents a major incident with acute loss of functionality. The immediate consequence is a rapidly progressive loss of treatment capacity. The major priority for the acute management of such an event is to keep patients safe and prevent life-threatening situations. ⋯ These must all be conceived, established, practiced and evaluated in advance with the clinics and departments. Ultimately, all isolated IT blackout concepts must be amalgamated into a compatible and functioning total framework. This structure must be maintained for as long as a partially or totally functioning IT has been reinstated.
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Emergency exit and escape routes in public buildings, such as schools, hospitals and administrative offices are controlled by legal rules and regulations. Thereby escape from the building is very well organized in cases of internal threats (e.g. fire, active shooter and hostage situations). Complex buildings with numerous rooms are a special challenge to emergency and law enforcement personnel. Without additional means of orientation a targeted localization of the incident is not possible in many cases. ⋯ For targeted localization of an internal incident there only seem to be three German systems worldwide that enable an intuitive and immediate orientation and guidance within buildings. An increasing threat of worldwide terrorism and the fact that hospitals are seen as crucial infrastructures for attacks by terrorists make the implementation of guidance and orientation systems in hospitals urgently necessary. This is the first review dealing with this topic.
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In view of the increasing violence and aggression against medical personnel in healthcare facilities, there are considerations by the legislature to punish violent offenders in hospitals more severely. Hospital and emergency room staff are increasingly confronted by physically and psychologically violent patients or their relatives. Sometimes medical treatment in a hospital or emergency room is an exceptional physical or mental situation for many patients and their relatives. ⋯ Structural, organizational and personal measures as well as concepts for dealing with aggressive patients are the cornerstones of employee protection. Professional training courses on de-escalation, self-protection and self-defense can also contribute to the protection of employees and are gladly accepted by the staff. Even in the extreme case of a rampage situation, hospital deployment and alarm plans have to be developed and established.
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This article reports the case of a 42-year-old male patient, who sustained a gluteal compartment syndrome after drug-induced immobilization with subsequent rhabdomyolysis and sciatic nerve palsy. Unlike compartment syndrome of the forearm or lower leg, this is a rare condition. ⋯ The sensorimotor function of the lower extremity improved already after the first treatment and secondary wound closure was possible after 1 week. The patient was discharged 11 days after admission with complete recovery of sensorimotor and renal functions.