Der Anaesthesist
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Although the prognosis of many diseases relies on timely diagnosis and treatment, the admission process of patients taken into hospitals by emergency medical services (EMS) is often affected by delays or rejection of patients. A smooth interaction between these two phases is critical for the prognosis in time-critical situations. The implementation of an in-hospital coordinating emergency physician (ZINK) responsible for the admission of EMS patients, a concept which was developed and introduced in our hospital, is suggested. ⋯ Implementation of a ZINK can optimize the process of hospital admission in emergency patients. This can decrease the legal risk of hospitals and improve the external representation. Hospitals should consider designating a ZINK.
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The equipment carried in rescue helicopters concerning airway management is not standardized in Germany. The current DIN/EN equipment regulations are not detailed for every single item resulting in differences between the various rescue bases. The aim of this survey was to show existing differences in airway management equipment. ⋯ The rescue helicopters were found to have differences with respect to the equipment carried for airway management. Medical treatment according to current guidelines is possible on almost all bases.
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This case report reviews the anesthesiological complications of intrathecal baclofen (ITB) therapy. An 11-year-old boy with spasticity and apallic syndrome needed general anesthesia for exchange of a baclofen pump but 2 h later he became increasingly hypothermic, hypotonic with bradycardy and dyspnea. ⋯ The ITB is an increasingly used therapeutic option for multiple sclerosis and cerebral palsy. Therefore, emergency personal and anesthesiologists must be aware of the possible side effects of this medication.
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Out-of-hospital (OOH) pediatric emergencies have a relatively low prevalence. In Germany the vast majority of cases are attended by non-specialized emergency physicians (EPs) for whom these are not routine procedures. This may lead to insecurity and fear. However, it is unknown how EPs perceive and assess pediatric emergencies and how they could be better prepared for them. ⋯ Despite their own limited experience EPs can realistically assess the incidence and severity of pediatric emergencies. They felt the greatest deficits were in the care of infrequent but life-threatening emergencies. Three educational groups can be differentiated: knowledge and skills to be gained with children in hospital, clinical experience from adult care also applicable in children and rare diagnoses and interventions to be trained with manikins or simulators.