Cardiopulmonary resuscitation (CPR) during spaceflight - a guideline for CPR in microgravity from the German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG).

Background: With the "Artemis"-mission mankind will return to the Moon by 2024. Prolonged periods in space will not only present physical and psychological challenges to the astronauts, but also pose risks concerning the medical treatment capabilities of the crew. So far, no guideline exists for the treatment of severe medical emergencies in microgravity.

Verbal Motivation vs. Digital Real-Time Feedback during Cardiopulmonary Resuscitation: Comparing Bystander CPR Quality in a Randomized and Controlled Manikin Study of Simulated Cardiac Arrest.

The use of smartphone applications increases bystander CPR quality as well as the use of telephone CPR protocols. The present prospective, randomized, controlled manikin trial analyses the effects of a smartphone application (PocketCPR©) on CPR quality in a bystander CPR scenario compared to a dispatcher-assisted telephone CPR with the additional use of a metronome and verbal motivation. 150 laypersons were included to perform 8-minute CPR on a manikin.

Using a smartphone application (PocketCPR) to determine CPR quality in a bystander CPR scenario - A manikin trial.

Purpose Of The Study: Feedback devices and dispatcher assistance increase CPR quality in bystander resuscitation. Yet, there is no data comparing both approaches with uninstructed CPR. The present prospective, randomized, controlled, manikin trial aims to determine the effects of the use of a smartphone application (PocketCPR) on CPR quality in a bystander CPR scenario compared to dispatcher-assisted telephone CPR and uninstructed CPR.

Dispatcher-assisted compression-only cardiopulmonary resuscitation provides best quality cardiopulmonary resuscitation by laypersons: A randomised controlled single-blinded manikin trial.

Background: High-quality cardiopulmonary resuscitation (CPR) by laypersons is a key determinant of both outcome and survival for out-of-hospital cardiac arrest. Dispatcher-assisted CPR (telephone-CPR, T-CPR) increases the frequency and correctness of bystander-CPR but results in prolonged time to first chest compressions. However, it remains unclear whether instructions for rescue ventilation and/or chest compressions should be recommended for dispatcher-assisted CPR.

Transcutaneous PTCCO measurement in combination with arterial blood gas analysis provides superior accuracy and reliability in ICU patients.

Hyper or hypoventilation may have serious clinical consequences in critically ill patients and should be generally avoided, especially in neurosurgical patients. Therefore, monitoring of carbon dioxide partial pressure by intermittent arterial blood gas analysis (PaCO) has become standard in intensive care units (ICUs). However, several additional methods are available to determine PCO including end-tidal (PETCO) and transcutaneous (PTCCO) measurements.

Novel Navigated Ultrasound Compared With Conventional Ultrasound for Vascular Access—a Prospective Study in a Gel Phantom Model.

Objectives: The authors hypothesized that, compared with conventional ultrasound (CUS), the use of a novel navigated ultrasound (NUS) technology would increase success rates and decrease performance times of vascular access procedures in a gel phantom model.

Design: A prospective, randomized, crossover study.

Setting: A university Hospital.

Hyperoxia-Induced Protein Alterations in Renal Rat Tissue: A Quantitative Proteomic Approach to Identify Hyperoxia-Induced Effects in Cellular Signaling Pathways.

Introduction: In renal tissue as well as in other organs, supranormal oxygen pressure may lead to deleterious consequences on a cellular level. Additionally, hyperoxia-induced effect in cells and related free radicals may potentially contribute to renal failure. The aim of this study was to analyze time-dependent alterations of rat kidney protein expression after short-term normobaric hyperoxia using proteomics and bioinformatic approaches.

In a difficult access scenario, supraglottic airway devices improve success and time to ventilation.

The success of tracheal intubation (TI) is unacceptably low in unconventional positions. Supraglottic airway devices (SAD) have become an important alternative. An airway manikin was placed in a car, simulating an entrapped motor vehicle accident victim.

Emergency medical equipment on board German airliners.

Background: Medical emergencies often occur on commercial airline flights, but valid data on their causes and consequences are rare. Therefore, it is unclear what emergency medical equipment is necessary. Although a minimum standard for medical equipment is defined in regulations, additional material is not standardized and may vary significantly between different airlines.

An assessment of resuscitation quality in the television drama Emergency Room: guideline non-compliance and low-quality cardiopulmonary resuscitation lead to a favorable outcome?

Objective: Two earlier studies found that outcome after cardiopulmonary resuscitation (CPR) in the television medical drama Emergency Room (ER) is not realistic. No study has yet evaluated CPR quality in ER.

Design: Retrospective analysis of CPR quality in episodes of ER.

Response of rat lung tissue to short-term hyperoxia: a proteomic approach.

An inspiratory oxygen fraction of 1.0 is often required to avoid hypoxia both in many pre- and in-hospital situations. On the other hand, hyperoxia may lead to deleterious consequences (cell growth inhibition, inflammation, and apoptosis) for numerous tissues including the lung.

Injury severity and seating position in accidents with German EMS helicopters.

Introduction: Accident rates and fatality rates for Helicopter Emergency Medical Service (HEMS) missions have been investigated recently, but none of these studies considered the influence of the seating position in the helicopter. The aim of the present descriptive and observational study was to analyze injury severity depending on the seating position during HEMS accidents in Germany.

Material And Methods: Data from the German Federal Agency for Flight Accident Investigation was gathered for a period of 40 years (from 1970 to 2009).

Tracheal intubation in the ice-pick position with video laryngoscopes: a randomised controlled trial in a manikin.

Context: Tracheal intubation in nonstandardised positions is associated with a higher risk of tube misplacement and may have deleterious consequences for patients. Video laryngoscopes for tracheal intubation facilitate both glottic view and success rates. However, their use in the ice-pick position has not been evaluated.

Application of the FIA score to German rescue helicopter accidents to predict fatalities in Helicopter Emergency Medical Systems (HEMS) crashes.

Background: In the past several decades, multiple studies have examined factors influencing occupant survival in aviation crashes, but only a few have addressed this question in Helicopter Emergency Medical Systems (HEMS) accidents. The four-point FIA Score is a valid tool to measure fatality risk in aviation crashes.

Objective: The aim of the present study was to analyze the performance of the FIA Score when applied to German HEMS accidents, and to determine the prognostic value for fatalities and for survival.

Helicopter type and accident severity in Helicopter Emergency Medical Services missions.

Objective: Whereas accident rates and fatal accident rates for Helicopter Emergency Medical Services (HEMS) were investigated sufficiently, resulting consequences for the occupants remain largely unknown. The present study aimed to classify HEMS accidents in Germany to prognosticate accident severity with regard to the helicopter model used.

Methods: German HEMS accidents (1 Sept.

Comparison of different video laryngoscopes for emergency intubation in a standardized airway manikin with immobilized cervical spine by experienced anaesthetists. A randomized, controlled crossover trial.

Background: The aim of the present study was to evaluate whether different video laryngoscopes (VLs) facilitate endotracheal intubation (ETI) faster or more secure than conventional laryngoscopy in a manikin with immobilized cervical spine.

Methods: After local ethics board approval, a standard airway manikin with cervical spine immobilization by means of a standard stiff collar was placed on a trauma stretcher. We compared times until glottic view, ETI, cuff block and first ventilation were achieved, and verified the endotracheal tube position, when using Macintosh laryngoscope, Glidescope Ranger, Storz C-MAC, Ambu Pentax AWS, Airtraq, and McGrath Series5 VLs in randomized order.

Success rates and endotracheal tube insertion times of experienced emergency physicians using five video laryngoscopes: a randomised trial in a simulated trapped car accident victim.

Context: No randomised controlled trial has yet compared different video laryngoscopes in respect of the success rates and the time taken to achieve endotracheal intubation in trapped car accident victims.

Objective: The aim of the present study was to evaluate whether five video laryngoscopes facilitate tracheal intubation more quickly or more securely than conventional laryngoscopy.

Design: Prospective, controlled, randomised crossover trial.

A novel type of macrothrombocytopenia associated with a defect in α2,3-sialylation.

We describe a novel type of human thrombocytopenia characterized by the appearance of giant platelets and variable neutropenia. Searching for the molecular defect, we found that neutrophils had strongly reduced sialyl-Lewis X and increased Lewis X surface expression, pointing to a deficiency in sialylation. We show that the glycosylation defect is restricted to α2,3-sialylation and can be detected in platelets, neutrophils, and monocytes.

Acute loss of renal function attenuates slow leukocyte rolling and transmigration by interfering with intracellular signaling.

Acute loss of renal function reduces leukocyte recruitment into inflamed tissues, and we studied the molecular basis of this using intravital microscopy of cremaster muscle and an autoperfused flow chamber system after bilateral nephrectomy or sham operation in mice. Acute loss of renal function resulted in cessation of selectin-induced slow leukocyte rolling on E-selectin/intercellular adhesion molecule 1 (ICAM-1) and P-selectin/ICAM-1. It also reduced in vivo neutrophil extravasation (assessed by reflected light oblique transillumination) without affecting chemokine-induced arrest.

Rolling on E- or P-selectin induces the extended but not high-affinity conformation of LFA-1 in neutrophils.

Human blood neutrophils rolling on E- or P-selectin reduced their rolling velocity when intercellular adhesion molecule (ICAM)-1 was available. Similar to mouse neutrophils, this was dependent on P-selectin glycoprotein ligand 1 (PSGL1), alpha(L)beta(2) integrin, the Src family tyrosine kinase FGR and spleen tyrosine kinase SYK. Blocking phospholipase C or p38 MAP kinase attenuated, but did not abolish the velocity reduction.

Characterization of cyclin L2, a novel cyclin with an arginine/serine-rich domain: phosphorylation by DYRK1A and colocalization with splicing factors.

A novel method employing filter arrays of a cDNA expression library for the identification of substrates for protein kinases was developed. With this technique, we identified a new member of the cyclin family, cyclin L2, as a substrate of the nuclear protein kinase DYRK1A. Cyclin L2 contains an N-terminal cyclin domain and a C-terminal arginine/serine-rich domain (RS domain), which is a hallmark of many proteins involved in pre-mRNA processing.