Maxillofacial injuries in severely injured patients after road traffic accidents-a retrospective evaluation of the TraumaRegister DGU® 1993-2014.

Objectives: It was the aim of the study to analyse the prevalence of maxillofacial trauma (MFT) in severely injured patients after road traffic accidence (RTA) and to investigate associated factors.

Materials And Methods: In a retrospective study, data from patients after RTA by the TraumaRegister DGU® from 1993 to 2014 were evaluated for demographical and injury characteristics. The predictor variable was mechanism of injury and the outcome variables were type of injury, severity and hospital resources utilization.

Hyperoxia or Therapeutic Hypothermia During Resuscitation from Non-Lethal Hemorrhagic Shock in Swine.

We previously demonstrated beneficial effects of 22 h of hyperoxia following near-lethal porcine hemorrhagic shock, whereas therapeutic hypothermia was detrimental. Therefore, we investigated whether shorter exposure to hyperoxia (12 h) would still improve organ function, and whether 12 h of hypothermia with subsequent rewarming could avoid deleterious effects after less severe hemorrhagic shock.Twenty-seven anesthetized and surgically instrumented pigs underwent 3 h of hemorrhagic shock by removal of 30% of the blood volume and titration of the mean arterial blood pressure (MAP) to 40 mm Hg.

Mesenchymal Stem Cells after Polytrauma: Actor and Target.

Mesenchymal stem cells (MSCs) are multipotent cells that are considered indispensable in regeneration processes after tissue trauma. MSCs are recruited to damaged areas via several chemoattractant pathways where they function as "actors" in the healing process by the secretion of manifold pro- and anti-inflammatory, antimicrobial, pro- and anticoagulatory, and trophic/angiogenic factors, but also by proliferation and differentiation into the required cells. On the other hand, MSCs represent "targets" during the pathophysiological conditions after severe trauma, when excessively generated inflammatory mediators, complement activation factors, and damage- and pathogen-associated molecular patterns challenge MSCs and alter their functionality.

[Prehospitale analgesia in adults].

After securing vital function, treatment of pain is an important aspect in emergency medical care. Irrespective of the underlying disease or injury, pain is an important warning symptom of the body and the most common reason for an emergency alert notification. A patient assesses quality of care and success of prehospital care using the criteria of the extent of pain relief he experiences.

Effects of Hyperoxia and Mild Therapeutic Hypothermia During Resuscitation From Porcine Hemorrhagic Shock.

Objective: Hemorrhagic shock-induced tissue hypoxia induces hyperinflammation, ultimately causing multiple organ failure. Hyperoxia and hypothermia can attenuate tissue hypoxia due to increased oxygen supply and decreased demand, respectively. Therefore, we tested the hypothesis whether mild therapeutic hypothermia and hyperoxia would attenuate postshock hyperinflammation and thereby organ dysfunction.

Mechanical chest compression: an alternative in helicopter emergency medical services?

Mechanical chest compression devices are mentioned in the current guidelines of the European Resuscitation Council (ERC) as an alternative in long-lasting cardiopulmonary resuscitations (CPR) or during transport with ongoing CPR. We compared manual chest compression with mechanical devices in a rescue-helicopter-based scenario using a resuscitation manikin. Manual chest compression was compared with the mechanical devices LUCAS™ 2, AutoPulse™ and animax mono (10 series each) using the resuscitation manikin AmbuMan MegaCode Wireless, which was intubated endotracheally and controlled ventilated during the entire scenario.

Improvement in glottic visualisation by using the C-MAC PM video laryngoscope as a first-line device for out-of-hospital emergency tracheal intubation: An observational study.

Background: Out-of-hospital tracheal intubation is associated with life-threatening complications. To date, no study has compared direct and video laryngoscopic views simultaneously in the same patients in an out-of-hospital setting.

Objectives: The aim of this study was to determine the effect of C-MAC PM video laryngoscope on laryngeal view, compared with direct laryngoscopy, and to estimate possible consequences for patient safety.

EZ-IO(®) intraosseous device implementation in German Helicopter Emergency Medical Service.

Background: Intraosseous access (IO) is a rapid and safe alternative when peripheral venous access is difficult. Our aim was to summarize the first three years experience with the use of a semi-automatic IO device (EZ-IO(®)) in German Helicopter Emergency Medical Service (HEMS).

Methods: Included were all patients during study period (January 2009-December 2011) requiring an IO access performed by HEMS team.

Cardio pump reloaded: in-hospital resuscitation during transport.

High-quality chest compressions are crucial during resuscitation if a positive outcome is to be achieved. Sometimes a patient must be transported within the hospital while chest compressions are being performed. We compared different chest compression devices [animax mono (AM), AutoPulse(®) (AP) and LUCAS2™ (L2)] with manual chest compression using a manikin during transport from a fifth floor ward to the cardiac catheterization laboratory in the basement.

Effects of pretreatment hypothermia during resuscitated porcine hemorrhagic shock.

Objectives: Accidental hypothermia increases mortality and morbidity after hemorrhage, but controversial data are available on the effects of therapeutic hypothermia. Therefore, we tested the hypothesis whether moderate pretreatment hypothermia would beneficially influence organ dysfunction during long-term, porcine hemorrhage and resuscitation.

Design: Prospective, controlled, randomized study.

Emergency cricothyroidotomy performed by inexperienced clinicians--surgical technique versus indicator-guided puncture technique.

Background: To improve the ease and safety of cricothyroidotomy especially in the hand of the inexperienced, new instruments have been developed. In this study, we compared a new indicator-guided puncture technique (PCK) with standard surgical technique (ST) regarding success rate, performance time and complications.

Methods: Cricothyroidotomy in 30 human cadavers performed by 30 first year anaesthesia residents.

Transport with ongoing resuscitation: a comparison between manual and mechanical compression.

Aim: In special circumstances it may be necessary to transport out-of-hospital cardiac arrest patients with ongoing resuscitation to the hospital. External mechanical chest compression devices could be an alternative for these resuscitations. The study compares manual chest compression with external mechanical devices and a semiautomatic device in transport conditions using a resuscitation manikin.

Effects of intravenous sulfide during resuscitated porcine hemorrhagic shock*.

Objective: Controversial data are available on the effects of hydrogen sulfide during hemorrhage. Because the clinical significance of hydrogen sulfide administration in rodents may not be applicable to larger species, we tested the hypothesis whether intravenous Na2S (sulfide) would beneficially influence organ dysfunction during long-term, porcine hemorrhage and resuscitation.

Design: Prospective, controlled, randomized study.

Early complementopathy after multiple injuries in humans.

After severe tissue injury, innate immunity mounts a robust systemic inflammatory response. However, little is known about the immediate impact of multiple trauma on early complement function in humans. In the present study, we hypothesized that multiple trauma results in immediate activation, consumption, and dysfunction of the complement cascade and that the resulting severe "complementopathy" may be associated with morbidity and mortality.

[Hyperbaric oxygenation: utility in intensive therapy - part 2].

Gangrene, non-clostridial myonecroses and intracranial abscesses are clinical entities for which hyperbaric oxygenation can be used therapeutically. Mortality and invalidity can be reduced by this means. Except for gangrene, HBO is used merely as an adjuvant for these diseases when conventional surgical, antibiotic and intensive therapy measures are not sufficient.

[Hyperbaric Oxygenation - utility in intensive therapy - part 1].

Hyperbaric Oxygenation (HBO) is a medical treatment, in which a patient breathes 100 % oxygen inside a treatment chamber at a pressure higher than at sea level. The indication for HBO has to be considered whenever gas bubbles present in tissue or blood circulation (decompression sickness, gas embolism) or when a high oxygen delivery is of crucial importance (CO-intoxication, selected anaerobic soft tissue infections). HBO must never be considered as a substitute for conventional surgical or intensive care therapy, but as an adjuvant of (potentially) crucial importance.

Two rescuer resuscitation--mission impossible? A pilot study using a manikin setting.

Objective: Advanced life support (ALS) in a cardiac arrest is usually performed by a team consisting of three people. The medical team of a Helicopter Emergency Medical Service (HEMS) often consists of two rescuers only. Due to that reason an algorithm was developed to provide ALS with two people.

Improved Data Quality by Pen Computer-Assisted Emergency Room Data Recording Following Major Trauma in the Military Setting.

Introduction: The characteristics of combat injuries differ from those of injuries encountered in civilian practice. Capturing detailed combat casualty data is therefore of importance. Experts classify the data sources for combat injuries as "inadequate" and request a better and more accurate record keeping.