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.

Analysis of severe hand trauma injury frequency during "Munich's Oktoberfest" within the last 9 years in comparison to years with absence due to the COVID-19 pandemic.

Introduction: Within its 2 week period, the Oktoberfest attracts around 6 million visitors yearly to Munich, Germany. Due to alcohol intake, congested halls, and disorderly activities, numerous accidents occur. Although many hand injuries are observed, the impact of Oktoberfest on severe hand trauma injury frequency is under investigated.

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.

Excessive hospitalization of patients with seizures in the Germany prehospital emergency system: a retrospective cohort study.

Seizures are a common reason for calling emergency medical services. A lack of guidelines on prehospital treatment in Germany leads to high transportation rates and reduced confidence in decision making by professionals. Our aim was to investigate the reasons for hospitalization and evaluate their necessity.

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.

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.

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.

The influence of foehn winds on the incidence of severe injuries in southern Bavaria - an analysis of the TraumaRegister DGU®.

Background: Foehn describes a wind which occurs in areas with close proximity to mountains. The presence of foehn wind is associated with worsening health conditions. This study analyzes the correlation between a foehn typical circulation and the incidence for suffering a severe trauma.

[Delayed occurrence of compartment syndrome of the upper arm after shovelling snow by a patient under oral anticoagulation].

This article reports the case of an 81-year-old male patient under treatment with oral anticoagulation who suffered delayed compartment syndrome of the upper arm from arterial capillary hemorrhage after shovelling snow. The diagnosis was made 48 h after the initial symptoms in the emergency surgical department of the Klinikum rechts der Isar (München) with the presence of clear neurological deficits. Following computed tomography angiography (CTA) imaging an emergency dermatofasciotomy was carried out as well as a vascular ligature via a medial approach.

Continuous chest compressions with a simultaneous triggered ventilator in the Munich Emergency Medical Services: a case series.

Mechanical chest compression devices are commonly used providing a constant force and frequency of chest compression during cardiopulmonary resuscitation. However, there are currently no recommendations on ventilation during cardiopulmonary resuscitation with a mechanical chest compression device using continuous mode. An effective method for ventilation in such scenarios might be a triggered oxygen-powered resuscitator.

Emergency room as primary point of access in the German healthcare system : Objective evaluation and interview of motivation for ER entrance of 235 ER patients in a German hospital.

Background: The importance of emergency rooms (ERs) as everyday healthcare suppliers is growing. Due to increasing patient flows, hospitals are forced to raise physicians' and caregivers' headcount continuously to meet the new demand of patients seeing the ER as primary point of contact in non-emergency situations. Patients from various cultural and educational backgrounds approach the ER for different reasons.

Differences in pain treatment between surgeons and anaesthesiologists in a physician staffed prehospital emergency medical service: a retrospective cohort analysis.

Background: Although pain treatment is an important objective in prehospital emergency medicine the incidence of oligoanalgesia is still high in prehospital patients. Given that prehospital emergency medicine in Germany is open for physicians of any speciality, the prehospital pain treatment may differ depending on the primary medical education. Aim of this study was to explore the difference in pain treatment between surgeons and anaesthesiologists in a physician staffed emergency medical service.

Influence of age and level of activity on the applicability of a walker orthosis - a prospective study in different cohorts of healthy volunteers.

Background: Walker orthosis are frequently prescribed as they are removable to allow wound control, body care and physiotherapy and are adaptable to the soft tissue conditions. The prerequisite for successful treatment with any walker orthosis is a correct use by the patient. Therefore, the aim of this study was to investigate patients' handling of a commonly used walker.