Der Anaesthesist
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The emergency call-taking process is crucial for the adequate disposition of emergency vehicles and the provision of first aid instructions. Moreover, it has a direct impact on the quality of out-of-hospital emergency care. Organizations such as the European Resuscitation Council, the German Federal Association of Emergency Medical Directors and the German Association of Emergency Dispatch Centers call for the nationwide implementation of a formal call-taking process in emergency dispatching. This is required for the provision of telephone-assisted cardiopulmonary resuscitation (T-CPR). ⋯ Structured emergency call-taking has not yet been comprehensively implemented in German emergency dispatch centers. Wherever it is used consistently, important quality parameters are improved. Further investigations should aim to identify crucial factors for its implementation and to analyze additional quality parameters.
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Randomized Controlled Trial Clinical Trial
Comparison of lateral and supine positions for tracheal extubation in children : A randomized clinical trial.
The lateral position is known to be advantageous for maintaining airway patency. This study compared the lateral and supine positions for tracheal extubation in pediatric patients when performing deep extubation. ⋯ In pediatric patients deep extubation in the lateral position improved SpO2 and reduced the incidence of stridor and laryngospasm in the early emergence period when compared to extubation in the supine position.
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Although pain services have been established in many hospitals, there is considerable heterogeneity among them with respect to organization of service, staff and qualifications of staff, and treatment approaches. With this recommendation, the German Society for Anesthesiology and Intensive Care Medicine defines requirements for pain services in hospitals with respect to organizational standards and staff qualifications. The therapy offered by pain services supplements the treatment provided by the other departments involved, ensuring the high quality of specialized pain management in all areas of the hospital. ⋯ In addition to definition of the space and equipment needed, each service should draft its own budget, and this should be adequate and plannable. Written agreements between the disciplines and transparent documentation, including patient-reported outcomes, are recommended to ensure quality. The provision of specialized pain therapy should have high priority over all disciplines or departments.