Notfall Rettungsmed
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Notfall Rettungsmed · Jan 2022
[Prehospital stabilization of a critically ill patient with telemetric medical guidance].
We report about the prehospital treatment of an 82-year-old man with septic shock as a complication of acute pancreatitis. Initially only an advanced life support ambulance was on scene. After the primary assessment, the team decided to call for an emergency-physician-staffed helicopter. ⋯ Therefore, they requested telemetric support. Despite massive centralization and difficult circumstances, the team succeeded to stabilize the patient in ongoing consultation of the tele-emergency physician. This cooperation made immediate und uneventful transportation after arrival of the helicopter possible.
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Notfall Rettungsmed · Jan 2022
Review[Learning with digital media in emergency medicine-a path through the jungle of possibilities].
Digital media, such as podcasts, wikis, ePortfolios, and extended reality applications, provide excellent learning opportunities with a high degree of connectivity and flexibility for learners, as well as for learning facilitators. This not only enables location-independent and pandemic-resilient learning, but also a high degree of autonomy for the learners. The megatrend of digitalization opens up many possibilities, but there are also stumbling blocks and limitations. ⋯ Learning is not only changing due to new learning technologies, but also due to the growing importance of informal learning, the increasing significance of the ability to quickly access high-quality knowledge, faster-changing professional biographies, and the use of digital universal tools. Thus, in the jungle of possibilities, an estimation of scientific quality criteria is often difficult and a differentiated consideration is necessary. Basically, the question of appropriate methods must be asked and it must be critically questioned whether the learning/competency objectives can be achieved with the planned digitalized media. Digital media cannot and should not replace practical training in the workplace.
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Sepsis is a challenge in emergency medicine, as this life-threatening organ dysfunction, caused by a dysregulated host response to an infection, presents manifold and therefore is often recognized too late. ⋯ Therapy of sepsis and septic shock is summarized in bundles, whereby the first bundle should ideally be completed within the first hour-in analogy to "golden hour" concepts in other emergency medical entities, such as trauma care. In the out-of-hospital setting, therapy focuses on securing vital parameters, according to the ABCDE scheme, with a particular focus on volume therapy. Further procedures within the 1 h bundle, such as lactate measurement, obtaining microbiological samples, and starting an anti-infective therapy, are broadly available in hospital only. The aim is to control the site of infection as soon as possible. Therefore, an appropriate designated hospital should be chosen carefully and informed in advance, in order to initiate and pave the way for further clinical diagnostic and treatment paths. Moreover, structured and target-oriented handovers, as well as regular training, are required.
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The number of patients with nonurgent health conditions using emergency departments (ED) is growing steadily. It is unclear however whether this is associated with limited health literacy of patients. ⋯ The results indicate a need for action to improve health literacy in Germany. In particular, current structural changes in emergency care in Germany have to be considered.
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Notfall Rettungsmed · Jan 2022
[Impact of the COVID-19 lockdown on emergency medical service operations].
As a response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, extensive contact restrictions were imposed by law in Germany as in other European countries. The present study intends to clarify the effect of these restrictions on emergency medical service (EMS) operations. ⋯ EMS experienced a reduction of operations as a result of contact restrictions, although not as pronounced as was recently described for emergency rooms. This supports the hypothesis that the reduction is particularly evident in less severe cases and in younger patients. The reduction in pneumonia and COPD cases is striking. On the one hand, this could indicate that contact restrictions reduce the incidence of other respiratory infections and their impact on chronic respiratory disorders, but it could also mean that patients try to avoid hospital treatment.