Der Anaesthesist
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The aim of this study was to examine whether it is possible to perform resuscitation according to the present European Resuscitation Council (ERC) guidelines with a modified algorithm in the case of special, e.g. military, circumstances. On international missions of the German Armed Forces a rescue team only consists of an emergency physician and a paramedic. As the German Armed Forces require the same means of medical aid for all soldiers on every type of mission worldwide the algorithm must meet the ERC requirements. ⋯ During military missions of the German Armed Forces there are no other options to perform resuscitation than by performing this procedure with only two rescuers. Using the algorithm in a modified way securing of the airway with an LT, the performance of over-the-head chest compressions and an effective resuscitation with advanced cardiac life support according to the ERC guidelines of 2005 are feasible even with 2 rescuers. Using the LT instead of endotracheal intubation to secure the airway particularly contributed to shortening the hands-off time.
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Physicians and nurses in anesthesia and critical care medicine are thought to be particularly prone to developing burnout. Epidemiologic data, however, are inconclusive especially because not all of the studies presented here are methodologically sound. Nevertheless, the following conclusions appear reasonable: in several European countries burnout is seen as a relevant problem in anesthesia and critical care medicine with a point-prevalence for moderate or severe burnout, as determined with the Maslach Burnout Inventory, at approximately 30% among nurses and approximately 40-50% among physicians. ⋯ Stress management programs appear to be somewhat efficacious although there are no studies to date for the clientele featured in this publication. Multimodal therapy can be recommended for pronounced burnout, including occupation-related treatment modalities. However, a general open mind towards warning signs of chronic stress disorder on the individual level as well as an adequate gratification for the work performance and sufficient control over the work routine on an organizational level appear to be among the important preventive measures.
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In recent years the number of interdisciplinary emergency departments (ED) at hospitals in Germany has increased. The model of decentralized first contact units for each medical discipline has been abandoned, last but not least due to economic considerations. While decentralized units could be staffed with personnel from each discipline there is much controversy surrounding the question of which kind of doctor is best suited for a centralized ED. ⋯ The smooth operation of centralized EDs is therefore important. Therefore, taking into account economical aspects, qualification and number of available personnel, this article introduces a staffing concept as a rational basis for an optimized patient management in centralized EDs in Germany. Taking the patient characteristics, the specific treatment modalities and the number of admissions to the ED into account, this paper will determine treatment time per patient and the necessary number of physicians, as well as an optimized staffing model for EDs.