Competitive advantage gained from the use of helicopter emergency medical services (HEMS) for trauma patients: Evaluation of 1724 patients.

Objectives: The aim of the study was to analyze helicopter emergency medical service (HEMS) in comparison to EMS, in respect to patient's mortality and morbidity.

Design: From a cohort of traumatized patients (n = 1724) prospectively enrolled in the German trauma registry (DGU-R) at Frankfurt University Hospital from 2009 to 2013, 1646 could be analyzed for in-hospital mortality and short-term outcome (GOS) at discharge and compared between HEMS and EMS.

Measurements And Main Results: 129 patients (7.

Pre-hospital rescue times and interventions in severe trauma in Germany and the Netherlands: a matched-pairs analysis.

Purpose: The aim of this study was to compare the pre-hospital treatment of major trauma patients with similar injury patterns in Germany and the Netherlands.

Patients And Methods: This matched-pairs analysis is based on the TraumaRegister DGU®. The authors compared major trauma patients (ISS ≥ 16) from 2009 to 2015 treated in Dutch and German Level 1 trauma centers (TC).

The Reliability of the Pre-hospital Physical Examination of the Pelvis: A Retrospective, Multicenter Study.

Introduction: This study assesses the incidence of missed pelvic injuries in the pre-hospital setting.

Methods: All blunt trauma patients (ISS ≥ 9) with pre-hospital suspicion of and/or radiologically proven pelvic fracture documented in the TraumaRegister DGU (TR-DGU) of the German Trauma Society DGU (2002-2011) were identified and retrospectively analyzed. Patients with a missed pelvic injury in the pre-hospital period were compared with those who were correctly identified.

Kinetic therapy in multiple trauma patients with severe thoracic trauma: a treatment option to reduce ventilator time and improve outcome.

Purpose: Continuous lateral rotational therapy (CLRT) has been described as a promising approach for prophylaxis and treatment of respiratory complications in critically ill patients over two decades ago. However, meta-analyses failed to demonstrate any significant benefit on outcome by CLRT, possibly due to the heterogeneity and low overall quality of available studies.

Methods: Observational trial over a 3-year period on outcome in trauma patients (Injury Severity Score, ISS ≥16) with severe thoracic injury (Abbreviated Injury Scale, AIS ≥3) initially treated with CLRT as standard of care.

Epidemiology and outcome of penetrating injuries in a Western European urban region.

Purpose: Severe life-threatening injuries in Western Europe are mostly caused by blunt trauma. However, penetrating trauma might be more common in urban regions, but their characteristics have not been fully elucidated.

Methods: Retrospective analysis of data from patients admitted to our urban university level I trauma center between 2008 and 2013 with suspicion of severe multiple injuries.

[Current standard of care for initial management of open fractures in emergency departments : A nationwide survey in German trauma centers].

Background: Limiting the morbidity of open fractures requires highly specific initial treatment. In addition to a stringent surgical strategy, correct antibiotic prophylaxis seems to be associated with an improved outcome. In the current literature, the duration and type of antibiotic prophylaxis are under discussion.

Multidetector computed tomography (MDCT): simple CT protocol for trauma patient.

The purpose of this retrospective monocenter study was to evaluate a monophasic multidetector computed tomography (MDCT) protocol with a fixed delay for patients with polytrauma. A total of 2086 patients were evaluated retrospectively. For the intravenous contrast media, we used a fixed protocol with an injection for an adult patient of 120 mL at a rate of 2 mL/s.

Pre-hospital rescue times and actions in severe trauma. A comparison between two trauma systems: Germany and the Netherlands.

Introduction: The aim of this study was to compare the effect of national pre-hospital rescue strategies on the status of severely injured patients at the time of admission to a Trauma Center (TC) in Germany or the Netherlands.

Patients And Methods: This retrospective database analysis based on the TraumaRegister DGU(®) (TR-DGU) of the German Trauma Society compares the pre-hospital trauma system of Germany with three Trauma Centers (TCs) from the Netherlands. It comprises trauma patients from 2009 to 2012 admitted to a Level I TC, all patients aged 16-80 years primarily admitted with an ISS ≥ 16 and data available for mode of transport, pre-hospital measures and total pre-hospital time.

Risk stratification in trauma and haemorrhagic shock: scoring systems derived from the TraumaRegister DGU(®).

Scoring systems commonly attempt to reduce complex clinical situations into one-dimensional values by objectively valuing and combining a variety of clinical aspects. The aim is to allow for a comparison of selected patients or cohorts. To appreciate the true value of scoring systems in patients with multiple injuries it is necessary to understand the different purposes of quantifying the severity of specific injuries and overall trauma load, being: (1) clinical decision making; (2) triage; (3) planning of trauma systems and resources; (4) epidemiological and clinical research; (5) evaluation of outcome and trauma systems, including quality assessment; and (6) estimation of costs and allocation of resources.

[Current practice in coagulation and transfusion therapy in multiple trauma patients: A German nation-wide online survey].

Background: In recent years, the treatment of trauma-associated coagulopathy and bleeding has advanced enormously. The aim of this study was to assess the current practice of coagulation and transfusion management in Germany.

Patients And Methods: From October 2011 until January 2012 we conducted a survey via online-questionnaire that was sent per E-Mail to all members of the German Society for Trauma Surgery.

Incidental findings in patients with multiple injuries: how to proceed?

Background: Multislice computed tomography (MSCT) is the diagnostic criterion standard for the initial evaluation of patients with suspected multiple injuries. Besides scanning for injuries directly related to the initial trauma, MSCT scans can reveal pathologies unrelated to the trauma of clinical relevance.The aim of the present study was to determine the frequency and follow-up course of incidental findings in patients with multiple injuries.

[Rotating physician in CHIR-Net. Evaluation of the curriculum].

Background: Conduction of and participation in clinical trials is a major challenge for surgical departments especially as job performance in hospitals has increased immensely during the last few years due to economic aspects. Only 11.7 % of published clinical studies are randomized controlled trials.

[Why nurses fly and surgeons rotate. The surgical study network CHIR-Net].

Background: The German National Surgical Trial Network (CHIR-Net) which has been funded since 2006 by the Federal Ministry of Education and Research (BMBF, funding code 01GH1001A-01GH1001F, 01GH0702) is made up of eight regional surgical centers. The aim of the CHIR-Net is the design, implementation and publication of prospective, randomized, multicenter trials to support evidence-based medicine in surgery. Two main pillars of the CHIR-Net are the surgeon on rotation program and the flying study nurse program.

Early analgesic treatment regimens for patients with acute abdominal pain: a nationwide survey among general surgeons.

Introduction: Early pain relief in patients with acute nontraumatic abdominal pain in emergency departments has been discussed for years. Some randomized trials have addressed this issue but conclusive data are lacking. In this study, we assessed the current treatment practice in German hospitals in order to evaluate the necessity of a further clinical trial.

Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland.

Purpose: Bursitis is a common entity. However, evidence for the best treatment procedures is lacking, with management concepts varying internationally. We evaluated current treatment regimens for septic (SB) and nonseptic (NSB) prepatellar (PB) and (OB) olecranon bursitis in Switzerland and compared them to the published literature.

The golden hour of shock - how time is running out: prehospital time intervals in Germany--a multivariate analysis of 15, 103 patients from the TraumaRegister DGU(R).

Objectives: Although prehospital treatment algorithms have changed over the past years, the prehospital time of multiple trauma patients of some 70 min and the on-scene-treatment time (OST) of some 30 min have not changed since 1993. The aim of this study was to critically assess specific interventions and conditions at the scene in relation to their impact on prehospital rescue intervals.

Methods: We performed a retrospective data analysis of all multiple injured patients from the TraumaRegister DGU (English: German Trauma Society) from January 1993 to December 2010.

[Epidemiology, risk stratification and outcome of severe pediatric trauma].

Accidents and trauma are the leading cause of hospital admissions and major contributors to mortality in children and adolescents. There are age-specific injury patterns and differences in the clinical presentation of pediatric trauma and treatment both at the scene and in the emergency department can be observed. In general, pediatric trauma-scores to appreciate injury severity are adapted from the adult population.

Evaluation of the current treatment concepts in Germany, Austria and Switzerland for acute traumatic lesions to the prepatellar and olecranon bursa.

Background: Although traumatic lacerations of the olecranon (OB) and praepatellar bursae (PB) are common entities often associated with complications, no study could be found on this injury. The aim of this study was to survey the current treatment concepts for acute traumatic laceration of the OB and PB in Germany, Austria and Switzerland.

Materials And Methods: An international online survey was conducted among orthopaedic and trauma surgeons in Germany (TraumaNetwork DGU), Austria (Austrian Society of Trauma (ÖGU) and Orthopaedic (ÖGO) Surgeons) and Switzerland (Swiss Orthopaedic Surgeons and Swiss Society of Infectious Disease (CH)) (n=1967).

A critical reappraisal of the ATLS classification of hypovolaemic shock: does it really reflect clinical reality?

Aim: The aim of this study was to validate the classification of hypovolaemic shock given by the Advanced Trauma Life Support (ATLS).

Methods: Patients derived from the TraumaRegister DGU(®) database between 2002 and 2010 were analyzed. First, patients were allocated into the four classes of hypovolaemic shock by matching the combination of heart rate (HR), systolic blood pressure (SBP) and Glasgow Coma Scale (GCS) according to ATLS.

Liver cirrhosis but not alcohol abuse is associated with impaired outcome in trauma patients - a retrospective, multicentre study.

Introduction: Liver cirrhosis has been shown to be associated with impaired outcome in patients who underwent elective surgery. We therefore investigated the impact of alcohol abuse and subsequent liver cirrhosis on outcome in multiple trauma patients.

Materials And Methods: Using the multi-centre population-based Trauma Registry of the German Society for Trauma Surgery, we retrospectively compared outcome in patients (ISS ≥ 9, ≥ 18) with pre-existing alcohol abuse and liver cirrhosis with healthy trauma victims in univariate and matched-pair analysis.

[Standardized documentation in emergency departments with the core dataset of the DIVI].

In Germany the documentation of every prehospital emergency medical treatment has been standardized since 1997 based on the core data-set MIND (minimal emergency physician data-set). Against this background it is very surprising that there is still no standardized data-set implemented for the documentation of early inhospital emergency care. In order to create such a data-set the current state of documentation in many different hospitals all over the country was scrutinized.

[TEAM®-G (Trauma Evaluation and Management Germany). Serves as a basis for an interdisciplinary training in the emergency room].

Background: The implementation of ATLS® in the daily routine of trauma management in the emergency department is a challenge. This goal cannot be reached by educating ATLS® to a few team members only. In order to enforce the implementation of ATLS® in a level I trauma centre, a generic in-house training was introduced in 2009 with inter-professional integration of all specialists of the trauma team.

Rotational bed therapy after blunt chest trauma: a nationwide online-survey on current concepts of care in Germany.

Introduction: Blunt chest injuries are amongst the most life threatening injuries in adult multiple trauma patients. Nevertheless, the treatment of these thoracic injuries has not been standardized yet. Previous publications have reported on the prevention and the treatment of respiratory complications by using continuous lateral rotational bed therapy (CLRT), but there is still a lack of information using this approach in the presence of pulmonary contusions.