Mobile computed tomography at the Munich Oktoberfest : From idea to implementation.

Background: The Munich Oktoberfest, the largest folk festival in the world, attracts around 6.2 million visitors over 16-18 days. Some of the visitors exhibit certain risky behaviors, leading to a significantly increased number of medical emergencies during the festival.

Occupational stress profiles of prehospital and clinical staff in emergency medicine-a cross-sectional baseline study.

Background: Occupational stress among emergency medical staff remains a central problem. Prior to the COVID-19 pandemic, many studies were focused on the working conditions of clinical emergency staff, but few examined the occupational stress profiles of prehospital emergency dispatchers (ED). The aim of this study is therefore to provide baseline data on the differences in occupational stress profiles between prehospital and clinical emergency medical staff.

[Forced centralized allocation in the emergency department-what has the COVID-19 pandemic changed?].

Background: IVENA eHealth (IVENA, interdisziplinärer Versorgungsnachweis, mainis IT-Service GmbH, Offenbach am Main, Germany) supports the coordination of emergency admissions by providing real-time data on treatment options in hospitals. Overload or technical problems can lead to hospitals having to temporarily deregister parts or the entire emergency department, which can lead to acute admissions. The COVID-19 pandemic may have further exacerbated the situation, which was analyzed as part of this study.

[Head injuries and their wound treatment].

Head injuries are frequent occurrences in emergency departments worldwide and are notable for the fact that attention must be paid to the sequelae of intracranial and extracranial trauma. It is crucial to assess potential intracranial injuries and to strive for both medically sound and esthetically pleasing extracranial outcomes. The aim of this continuing education article is to provide a refresher on knowledge of head injuries and the associated nuances for wound care.

[Impact of the COVID-19 pandemic on the care of major trauma patients: analysis from the TraumaRegister DGU®].

Background: The treatment of major trauma patients requires intensive care capacity, which is a critical resource particularly during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, the aim of this study was to analyze the impact on major trauma care considering the intensive care treatment of COVID-19 positive patients.

Methods: Demographic, prehospital, and intensive care treatment data from the TraumaRegister DGU® of the German Trauma Society (DGU) in 2019 and 2020 were analyzed.

Medical and cardio-vascular emergency department visits during the COVID-19 pandemic in 2020: is there a collateral damage? A retrospective routine data analysis.

Background: In this retrospective routine data analysis, we investigate the number of emergency department (ED) consultations during the COVID-19 pandemic of 2020 in Germany compared to the previous year with a special focus on numbers of myocardial infarction and acute heart failure.

Methods: Aggregated case numbers for the two consecutive years 2019 and 2020 were obtained from 24 university hospitals and 9 non-university hospitals in Germany and assessed by age, gender, triage scores, disposition, care level and by ICD-10 codes including the tracer diagnoses myocardial infarction (I21) and heart failure (I50).

Results: A total of 2,216,627 ED consultations were analyzed, of which 1,178,470 occurred in 2019 and 1,038,157 in 2020.

Preparation of hospitals for mass casualty incidents in Bavaria, Germany: care capacities for penetrating injuries and explosions in TerrorMASCALs.

Background: In a terror attack mass casualty incident (TerrorMASCAL), compared to a "normal" MASCAL, there is a dynamic course that can extend over several hours. The injury patterns are penetrating and perforating injuries. This article addresses the provision of material and personnel for the care of special injuries of severely injured persons that may occur in the context of a TerrorMASCAL.

Comparison of volume-controlled, pressure-controlled, and chest compression-induced ventilation during cardiopulmonary resuscitation with an automated mechanical chest compression device: A randomized clinical pilot study.

Aim Of The Study: Automated mechanical chest compression devices (AMCCDs) can help performing high-quality cardiopulmonary resuscitation (CPR). Guidelines for CPR are lacking information about the optimal ventilation mode during CPR using AMCCDs. Aim of this pilot study was to compare three common ventilation modes during CPR using AMCCD.

[Operation preparation in trauma surgery].

The success of a surgical procedure is significantly influenced by several critical factors. The safety of the patient is the primary goal. To this end, the term surgical preparation covers a number of procedures aiming to ensure the safety for the patient and a successful surgical intervention: verifying the indications, planning the intervention, identification of potential harmful factors, risks and countermeasures, patient education and documentation.

[Childhood emergencies-worsening healthcare bottlenecks for children in a systematic long-term analysis of the EMS system in a German metropolis].

Background: Children have the right to the best possible medical care. The lack of treatment capacity is rising steadily and increasingly leads to forced centralized allocation of patients by the emergency medical services (EMS) to pediatric emergency departments that are, officially, temporarily "closed".

Aim: The aim of this study is to present trends in allocation of pediatric emergency patients in greater Munich.

[Role of university hospitals in Bavaria during the COVID-19 pandemic].

Background: In early 2020 the German healthcare system was put into a state of emergency due to the coronavirus disease 2019 (COVID-19) pandemic. Bavaria had to deal with more severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections than any other German state during the first wave and currently has over 270,000 cases, accounting for about one fifth of all COVID-19 cases in Germany. The Bavarian Ministry of Interior together with the Bavarian Sate Ministry of Health and Care issued a general ruling at the beginning of the first wave that ordered the centralised organisation of hospital capacity, a redesign of the information technology (IT) management system and introduced reporting obligations for SARS-CoV-2/COVID-19.

Testing mechanical chest compression devices of different design for their suitability for prehospital patient transport - a simulator-based study.

Background: Mechanical chest compression (mCPR) offers advantages during transport under cardiopulmonary resuscitation. Little is known how devices of different design perform en-route. Aim of the study was to measure performance of mCPR devices of different construction-design during ground-based pre-hospital transport.

Effects of weather, air pollution and Oktoberfest on ambulance-transported emergency department admissions in Munich, Germany.

Background: Climate change and increasing risks of extreme weather events affect human health and lead to changes in the emergency department (ED) admissions and the emergency medical services (EMS) operations. For a better allocation of resources in the healthcare system, it is essential to predict ED numbers based on environmental variables. This publication aims to quantify weather, air pollution and calendar-related effects on daily ED admissions.

[Unguis incarnatus-conservative or operative treatment? A practical treatment algorithm].

Unguis incarnatus, an ingrown toenail, is a common condition in primary care, which is encountered by various medical professions. Inconsistent conservative treatment and nonindicated surgical treatment often result in complications and recurrence of the disease. Patients must be thoroughly informed about the complexity of the nail organ.

Code Stroke Patient Referral by Emergency Medical Services During the Public COVID-19 Pandemic Lockdown.

Background: The COVID-19 pandemic caused public lockdowns around the world. We analyzed if the public lockdown altered the referral pattern of Code Stroke patients by Emergency Medical Services (EMS) to our Comprehensive Stroke Center.

Methods: Retrospective single-center study at a Bavarian Comprehensive Stroke Center.

Forced Centralized Allocation of Patients to Temporarily 'Closed' Emergency Departments.

Background: Because insufficient data are available, the overall number of patients treated in German emergency departments can only be estimated. It is evident, however, that case numbers have been rising steadily in recent years, and that a lack of capacity is now leading with increasing freuqency to forced centralized allocation of patients by the emergency medical services (EMS) to emergency departments that are, officially, temporarily "closed".

Methods: Trends in patient allocation of this type in greater Munich, Germany, over the years 2013-2019 were analyzed for the first time on the basis of data from 904 997 cases treated by the emergency rescue services.