Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2003
Comparative Study[Comparison of the emergency medical services systems of Birmingham and Bonn: process efficacy and cost effectiveness].
Due to rising health care costs there is a need to verify that the treatment by Emergency Medical Services (EMS) systems is efficient and cost effective. The integration of emergency physicians is inherent part of out-of-hospital emergency care and regulated by law in Germany but not in England and the United States of America. Aim of this study therefore was to conduct a cost performance analysis by evaluating the underlying structure, the costs incurred and the achieved performance in two EMS systems with paramedics or emergency physicians on scene. ⋯ The provider of the EMS in West-Birmingham--WMAS--organised a reliable system with high efficiency concerning unit hour utilisation and response time reliability. In the EMS of Bonn, in contrast, the complex therapy by the emergency physicians improved MEES considerably and increased probability of survival after CPR at a higher level of efficiency. Further investigations however are necessary to evaluate the presented parameter of efficiency.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2003
Case Reports[Lung edema in scuba diving].
The management of a diving-related emergency is frequently a great challenge for an emergency physician without a special diving medicine training or experiences. Almost every physician knows something about the medical therapy of diving-related accidents which are combined with a barotrauma or a decompression sickness. But there are still some rare symptoms and organ affections of diving-related emergencies which are unknown in common. In consideration of the present case of an acute diving-related lung edema we discuss the different reasons and differential diagnosis of diving emergencies.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2003
Historical Article[History of the rescue service in Germany--especially in regard to emergency medicine].
Emergency medicine is part of the oldest fields in medicine, however, organized rescue services were at first recognizable in the end of the 19th century or rather in the beginning of the 20th century. In 1908, on the first international congress for rescue services in Frankfurt, the preclinical part was described as a special science, for which a medical instruction would be necessary. In spite of an initially general rejection of an involvement of physicians in the rescue services, it was ascribed to physicians very early to carry out first aid in accidents or sudden illness. ⋯ As the system became more and more established, the characteristics of the patients changed and medical emergency patients increasingly constituted the population of patients. That leaded to a shift in the specialties of the physicians taking part in the emergency physician service. Regarding the qualification specific guidelines were released in 1983 by the federal chamber of physicians in Germany.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2003
Retraction Of Publication[Injection pain secondary to propofol-MCT/LCT and propofol-LCT--comparison of prophylaxis with lidocaine].
Pain on injection is one of the most described side-effects of the intravenous application of propofol. This study was designed to assess the efficacy of lidocaine 40 mg in preventing incidence and severity of injection pain for two different propofol solvents. ⋯ Propofol-MCT/LCT showed a significant advantage compared to propofol-LCT considering the severity of injection pain, but not in reducing the incidence of pain. The use of lidocaine resulted in a significant reduction of incidence and severity of injection pain for both propofol solvents.