Demographics and functional outcome of shallow water diving spinal injuries in northern Germany - A retrospective analysis of 160 consecutive cases.

Aim: To describe demographic findings, typical injuries and functional neurological outcomes in patients with cervical trauma and tetraplegia sustained after diving into shallow water.

Patients And Methods: A retrospective study was performed including all patients treated in BG Klinikum Hamburg suffering from tetraplegia after jumping into shallow water between 1st June 1980 and 31st July 2018.

Results: One hundred and sixty patients with cervical spinal injuries and tetraplegia following a dive into shallow water were evaluated.

Association between the experience of violence and burnout among paramedics.

Purpose: Similar to many occupational groups in the rescue service, paramedics show increased mental health problems. Both situational and work-organizational factors play a role in the development of mental illnesses. The aim of the study is to investigate the connection of experienced violence and the development of burnout in the paramedical profession.

Relationship between ambient temperature and severe acute poisoning by alcohol and drugs.

Aim: To test the hypothesis that severe acute poisoning by alcohol and drugs is more frequent at higher rather than at lower ambient temperatures.

Method: This was a prospective observational study performed in a prehospital setting under marine west coast climate conditions. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period.

Association between Weather-Related Factors and Cardiac Arrest of Presumed Cardiac Etiology: A Prospective Observational Study Based on Out-of-Hospital Care Data.

Objective: The objective of this study was to determine the association between weather-related factors and out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology.

Methods: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period.

Molecular autopsy of sudden unexplained deaths reveals genetic predispositions for cardiac diseases among young forensic cases.

Aims: Coronary artery disease accounts for the majority of sudden cardiac deaths (SCD) in the older population whereas cardiomyopathies and arrhythmogenic abnormalities predominate in younger SCD victims (<35 years) with a significant genetic component. The elucidation of the pathogenetic cause of death might be relevant for the prevention of further deaths within affected families. Aim of this study was to determine the portion of underlying genetic heart diseases among unexplained putative SCD cases from a large German forensic department.

Reduced frequency of severe hypoglycemia at mild ambient temperatures between 10 and 20 °C: A population-based study under marine west coast climate conditions.

Aims: To determine the association between ambient temperature and severe hypoglycemia.

Methods: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period.

Relationship between ambient temperature and frequency and severity of cardiovascular emergencies: A prospective observational study based on out-of-hospital care data.

Objective: To test the hypothesis that more cardiovascular emergencies occur at low rather than at high temperatures under moderate climatic conditions.

Methods: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and from the local weather station were evaluated over a 5-year period.

Air Medical Evacuations From the German North Sea Wind Farm Bard Offshore 1: Traumatic Injuries, Acute Diseases, and Rescue Process Times (2011-2013).

Objective: Our purpose was 2-fold: 1) to show emergency-related traumatic injury and acute disease patterns and 2) to evaluate air rescue process times in a remotely located German offshore wind farm. Optimally, this will support methodologies to reduce offshore help time (time from the incoming emergency call until offshore arrival of the helicopter).

Methods: The type and severity of traumatic injuries and acute diseases were retrospectively analyzed for 39 air medevacs from August 2011 to December 2013, and the process times of air rescue missions were evaluated in detail.

[Pre-hospital care management of acute spinal cord injury].

Acute injury to the spine and spinal cord can occur both in isolation as also in the context of multiple injuries. Whereas a few decades ago, the cause of paraplegia was almost exclusively traumatic, the ratio of traumatic to non-traumatic causes in Germany is currently almost equivalent. In acute treatment of spinal cord injury, restoration and maintenance of vital functions, selective control of circulation parameters, and avoidance of positioning or transport-related additional damage are in the foreground.

[Cooperation between emergency and forensic medicine - retrospective evaluation of pre-hospital emergency measures].

Emergency medical research is subject to special conditions. Emergency patients e.g.

[Mass casualty incidents - current concepts and developments].

Medical concepts and strategies are permanently changing. Due to the emergency response in a mass casualty incident everyone who is involved has to work together with different organisations and public authorities, which are not part of the regular emergency medical service. Within the last 25 years throughout the whole country of Germany the role of a "chief emergency physician" has been implemented and in preparation for the FIFA World Cup 2006 mobile treatment units were set up.

[Invasive emergency techniques - intraosseous devices].

On-site invasive emergency procedures, such as cricothyroidotomy, chest drainages, intraosseous puncture or the even rarer on-site amputations, are often unavoidable when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular participation in the emergency medical services, "last resort" measures occur very infrequently, particularly in paediatric emergencies.

[Spinal cord injury (SCI) - Aspects of intensive medical care].

With 2000 new cases/year in Germany spinal cord injury (SCI) is quantitatively less important for intensive care medicine than, e.g., sepsis.

[Injuries caused by acids and bases - emergency treatment].

Emergency medical care for injuries caused by acids and bases is challenging for rescue services. They have to deal with operational safety, detection of the toxic agent, emergency medical care of the patient and handling of the rescue mission. Because of the rareness of such situations experience and routine are largely missing.

[Invasive emergency techniques--decompression of the pleura].

On-scene invasive emergency procedures, such as cricothyroidotomy, chest drain, intraosseous puncture or even on-field-amputation, are often unavoidable, when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular intervention by the emergency medical service, "last resort" measures occur very infrequently, particularly in relation to paediatric emergencies.

[Invasive emergency techniques--cricothyroidotomy].

On-scene invasive emergency procedures, such as cricothyroidotomy, chest drain, intraosseous puncture or even on-field-amputation, are often unavoidable, when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular intervention by the emergency medical service, "last resort" measures occur very infrequently, particularly in relation to paediatric emergencies.

Anterior cruciate ligament reconstruction using bone plug-free quadriceps tendon autograft: intermediate-term clinical outcome after 24-36 months.

Introduction: Although known as a possible graft option for decades, quadriceps tendon grafts have often been termed a second-line graft option. We report a consecutive case series using this method as the primary treatment line. The rationale for this study was to evaluate the midterm results of this method in a prospective and consecutive case series.

[Sepsis in emergency medicine--pre-hospital and early in-hospital emergency treatment].

Sepsis is a complex life threatening disease whose outcome decisively depends on a fast diagnosis and treatment. Emergency Medicine is confronted with the task to identify theses septic patients reliably and initiate early goal directed therapy and treatment with antibiotics as soon as possible to avoid a dangerous delay and reduce sepsis-related mortality. This article presents a review focused on the early steps of sepsis therapy in pre-hospital and early in-hospital emergency medicine.

[Intoxications in the prehospital setting].

Poisoning is an uncommon indication for the activation of the emergency medical service. Personal safety of the rescue team especially in situations with unknown toxins has highest priority. The goal of prehospital treatment includes symptom driven standard procedures as well as a specific treatment by antidotes.

[Bicycle accident on the way to school--an interactive case report].

We report on the case of a multiply injured 14-year-old girl with severe open brain trauma, prehospital cardiopulmonary rescuscitation and immediate decompressive craniectomy. Despite the extremely poor prognosis, a very good outcome has been achieved. We discuss the influence of the time management on the outcome.

[Serious complications following a marathon run: interactive case report of a dramatic course].

A marathon runner collapses after crossing the finish line and shows neurological disorders. Aftertreatment at the scene hyponatremia and cerebral edema are found at hospital admission. Thepatient is treated for "exercise-associated hyponatremia" (EAH) on the ICU for six days.

[Medical coverage of a road bicycle race].

Major sport events require adequate expertise and experience concerning medical coverage and support. Medical and ambulance services need to cover both participants and spectators. Likewise, residents at the venue need to be provided for.