Current state of follow-up care for patients with Hymenoptera venom anaphylaxis in southwest Germany: Major impact of early information.

Background: Up to 3.5% of the population experience anaphylactic reactions in response to Hymenoptera stings. Current guidelines are in place for the diagnostic workup and follow-up care of patients with Hymenoptera venom anaphylaxis (HVA).

[German resuscitation registry : science and resuscitation research].

Sudden death due to cardiac arrest represents one of the greatest challenges facing modern medicine, not only because of the massive number of cases involved but also because of its tremendous social and economic impact. For many years, the magic figure of 1 per 1000 inhabitants per year was generally accepted as an estimate of the annual incidence of sudden death in the industrialized world, with a survival rate of 6 %. This estimate was based on large numbers of published reports of local, regional, national and multinational experience in the management of cardiac arrest.

[Mechanical resuscitation assist devices].

In Germany 100,000-160,000 people suffer from out-of-hospital cardiac arrest (OHCA) annually. The incidence of cardiopulmonary resuscitation (CPR) after OHCA varies between emergency ambulance services but is in the range of 30-90 CPR attempts per 100,000 inhabitants per year. Basic life support (BLS) involving chest compressions and ventilation is the key measure of resuscitation.

Hypertonic saline infusion during resuscitation from out-of-hospital cardiac arrest: a matched-pair study from the German Resuscitation Registry.

Aim: Survival rates after out-of-hospital-cardiac-arrest (OHCA) differ widely between EMS systems. Since hypertonic saline appears to improve long-term outcome after OHCA, some local EMS systems have included it in their treatment protocols for OHCA. Our first aim was to give a quality review of one of these protocols.

[Bystander resuscitation: the impact of first aid on survival].

About 75000 people suffer from sudden cardiac arrest in Germany every year. 47% of all out-of-hospital cardiac arrests (OHCA) in Germany are bystander witnessed, but in only 16.1% is bystander-initiated CPR undertaken.

[In-hospital emergency care of patients with in-hospital cardiac arrest].

In German hospitals there is a growing need to offer a high quality in-hospital emergency care, because of the increasing age of the patients and to the shortening of hospital stay, as well as the increasingly complex medical procedures increases the risk of emergencies. The in-hospital emergency care should not be different from the pre-hospital emergency care concerning both the training of personnel, as well as the equipment of the team. The incidence of in-hospital emergencies or sudden cardiac arrest is not known for Germany, but the frequency in the hospitals of different levels of care differs.

Choice of hospital after out-of-hospital cardiac arrest--a decision with far-reaching consequences: a study in a large German city.

Introduction: Between 1 and 31% of patients suffering out-of-hospital cardiac arrest (OHCA) survive to discharge from hospital. International studies have shown that the level of care provided by the admitting hospital determines survival for patients suffering from OHCA. These data may only be partially transferable to the German medical system where responders are in-field emergency medical physicians.

The impact of response time reliability on CPR incidence and resuscitation success: a benchmark study from the German Resuscitation Registry.

Introduction: Sudden cardiac arrest is one of the most frequent causes of death in the world. In highly qualified emergency medical service (EMS) systems, including well trained emergency physicians, spontaneous circulation may be restored in up to 53% of patients at least until admission to hospital. Compared with these highly qualified EMS systems, in other systems markedly lower success rates are observed.

ROSC after cardiac arrest--the RACA score to predict outcome after out-of-hospital cardiac arrest.

Aims: Return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation from cardiac arrest (CA) depends on numerous variables. The aim of this study was to develop a score to predict the initial resuscitation outcome-the RACA (ROSC after cardiac arrest) score.

Methods And Results: Based on 5471 prospectively registered out-of-hospital CAs patients between 1998 and 2008 within the German Resuscitation Registry, calculation of the RACA score was performed by multivariate logistic regression analysis with ROSC as the outcome variable.

Postresuscitation care with mild therapeutic hypothermia and coronary intervention after out-of-hospital cardiopulmonary resuscitation: a prospective registry analysis.

Introduction: Mild therapeutic hypothermia (MTH) has been shown to result in better neurological outcome after cardiopulmonary resuscitation. Percutaneous coronary intervention (PCI) may also be beneficial in patients after out-of-hospital cardiac arrest (OHCA).

Methods: A selected cohort study of 2,973 prospectively documented adult OHCA patients within the German Resuscitation Registry between 2004 and 2010.

The quality of emergency medical care in baden-württemberg (Germany): four years in focus.

Background: In 2004, the German federal state of Baden-Württemberg implemented a quality management system for pre-hospital emergency care. Since then, there has been a semi-annual assessment of the frequency of different types of emergency medical interventions and the quality of care.

Methods: The frequencies of different types of intervention were determined and reported both in absolute numbers and as incidence figures, i.

A national resuscitation registry of out-of-hospital cardiac arrest in Germany-a pilot study.

Background: Survival rate after out-of-hospital cardiac arrest (OHCA) has not significantly increased over the last decade. However, survival rate has been used as a quality benchmark for many emergency medical services. A uniform resuscitation registry may be advantageous for quality management of cardiopulmonary resuscitation (CPR).

[The DGAI CPR registry - the datasets "hospital care" and "long-term process"].

After several years of preparation the German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin--DGAI) has, during its annual conference 2007, officially launched the DGAI CPR registry. After implementation of the dataset "primary care" in 2004, the datasets "definite care" and "long-term process" have now been released. The completed, internet based database is open for any interested person or institution as a tool for quality management.

Realistic assessment of the physician-staffed emergency services in Germany.

In Germany the emergency medical services, which include dispatching emergency physicians to the scene, are considered to be among the best in the world. However, the hospitals admitting these patients still report shortcomings in prehospital care. The quality of an emergency medical service depends on both formal qualification and experience in managing such emergencies.

[Mobile blood gas and laboratory monitoring. A new technology in clinical routine].

Introduction: Decision-making on therapy in acute cases involves clinical examination and monitoring of vital parameters and fluid balance; especially, however, laboratory parameters. The present study compared the results of a new bedside laboratory analysis system (PortLab, i-STAT Corp., Princeton NJ) with the analytical results obtained in our central laboratory.

[Quality management in autologous blood donation].

In many anaesthesia departments, the autologous transfusions concept is an integral part of the perioperative measures catalogue. All patients benefit from this procedure, especially those who face an operation during which much blood will be lost. If a patient donates his/her own blood for their operation, there should not be any increase in risk to this patient.

[Preclinical resuscitation--which factors influence the long-term course? A 5-year follow-up].

Objective: The factors that influence long-term survival after out-of-hospital resuscitations were investigated.

Patients And Methods: Between 1985 and 1989, out of a total of 8403 responded emergency calls, 505 resuscitations were undertaken out of hospital by the emergency medical service in Göppingen. All emergency calls were recorded uniformly.