Medizinische Klinik-Intensivmedizin Und Notfallmedizin最新文献_第5页

[Palliative extubation after ROSC in the emergency setting-a guideline for emergency physicians]. [急诊ROSC后姑息拔管——急诊医师指南]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-29 DOI: 10.1007/s00063-025-01271-y

Christian Volberg, Katharina Politt, Sebastian Passon, Nils Heuser, Elena Hofacker, Hinnerk Wulf

引用次数: 0

[Onboarding in emergency medicine : Methods, challenges and opportunities]. [急诊医学入职：方法、挑战和机遇]

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-28 DOI: 10.1007/s00063-025-01281-w

Robert Girshausen, Sebastian Graf, Theresa Holz, Julia Lorenz, Thorsten Masson, Justus Wolff, Navid Azad

{"title":"[Onboarding in emergency medicine : Methods, challenges and opportunities].","authors":"Robert Girshausen, Sebastian Graf, Theresa Holz, Julia Lorenz, Thorsten Masson, Justus Wolff, Navid Azad","doi":"10.1007/s00063-025-01281-w","DOIUrl":"https://doi.org/10.1007/s00063-025-01281-w","url":null,"abstract":"Emergency medicine places high demands on all specialized healthcare professionals. A structured onboarding process is essential for high-quality care and effective interprofessional collaboration. Current onboarding concepts in emergency departments are heterogeneous and often insufficient. Organizational measures, such as reliable rotation schedules, evaluation meetings and the integration of interprofessional perspectives create the foundation for effective onboarding. Investing in induction concepts promotes employee loyalty, team dynamics and efficiency of patient care in the long term.A wide range of methods can be utilized for knowledge transfer, including the use of digital media and low-threshold learning units in everyday working life. Simulation plays a particularly important role, enabling realistic, interprofessional and interdisciplinary training of emergency situations. Internal standards should be actively included and communicated during induction. Mentoring programs for new professionals provide orientation and enable regular, personalized feedback. An open error culture that views mistakes as an opportunity for improvement should be communicated from the outset and practiced within the team. In addition, biopsychosocial stresses such as shift work, moral distress and emotional exhaustion must be addressed. Digital learning platforms and artificial intelligence (AI)-supported tools will increasingly enable new, personalized learning pathways. The development of uniform (inter)national standards could improve onboarding on a broad scale and promote the exchange between emergency departments.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[The geriatric syndrome frailty in the context of readmission to the intensive care unit : Study protocol of a mixed-methods study]. [在重症监护室再入院的背景下的老年综合征虚弱：混合方法研究的研究方案]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-23 DOI: 10.1007/s00063-025-01280-x

Denise Schindele, Marc Moritz Berger, Irmela Gnass

{"title":"[The geriatric syndrome frailty in the context of readmission to the intensive care unit : Study protocol of a mixed-methods study].","authors":"Denise Schindele, Marc Moritz Berger, Irmela Gnass","doi":"10.1007/s00063-025-01280-x","DOIUrl":"https://doi.org/10.1007/s00063-025-01280-x","url":null,"abstract":"Background: Frailty syndrome is characterized by a decline in physiological reserves and a reduced resistance to internal and external stressors. In addition to a higher mortality rate, patients who are frail are more prone to complications during hospitalization, including admission to an intensive care unit (ICU). Studies indicated that frailty syndrome may serve as a predictor of readmission to the ICU. The impact of frailty syndrome on readmission to an ICU in Germany remains to be elucidated, as extant research primarily originates from non-German-speaking countries and is only partially transferable.Aim: The primary objective of this study is to characterize the syndrome of frailty (measured using the Clinical Frailty Scale [CFS] ≥ 5) as a potential risk factor for readmission to the ICU. Secondly, the study will examine which factors, specifically nursing and medical measures on intermediate care and normal wards, can influence readmissions to the ICU.Method: The study employs an explanatory sequential mixed-methods design, comprising a quantitative and a qualitative research phase. In the quantitative phase, a prospective cohort study will be conducted to investigate the association between frailty syndrome and ICU readmissions (≤ 30 days after discharge or during the same hospital stay) in patients ≥ 65 years of age. Concurrently, a document analysis will be conducted in the qualitative phase to identify care measures that could influence readmission.Expected results: The primary hypothesis of this study is that patients diagnosed with frailty syndrome (CFS ≥ 5) exhibit a higher risk of readmission to the ICU compared to non-frail patients. This inquiry will be conducted in the quantitative phase of the study. The qualitative research component is designed to elucidate non-intensive care measures that may influence readmission.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diaphragm ultrasound monitoring and sequential muscle training for weaning elderly COPD patients from mechanical ventilation. 隔膜超声监测和顺序肌肉训练在老年COPD患者脱离机械通气中的应用。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-23 DOI: 10.1007/s00063-025-01270-z

Huazuo Liu, Qin Su, Linyuan Zhu

{"title":"Diaphragm ultrasound monitoring and sequential muscle training for weaning elderly COPD patients from mechanical ventilation.","authors":"Huazuo Liu, Qin Su, Linyuan Zhu","doi":"10.1007/s00063-025-01270-z","DOIUrl":"https://doi.org/10.1007/s00063-025-01270-z","url":null,"abstract":"Background: Weaning elderly patients with chronic obstructive pulmonary disease (COPD) from mechanical ventilation is a complex and critical process. This study aims to assess the efficacy of ultrasound monitoring of diaphragm function combined with sequential muscle training in predicting and facilitating this weaning process.Methods: In this randomized controlled trial, 100 elderly COPD patients on mechanical ventilation were divided into two groups: an intervention group receiving sequential muscle training and a control group with standard care. The training regimen targeted the diaphragm and accessory respiratory muscles. Diaphragmatic ultrasonography was performed on participants to measure the right diaphragm excursion (DE), contraction velocity, diaphragm thickening fraction (DTF), and respiratory rate (RR)/DTF.Results: The intervention group demonstrated significant improvements in diaphragmatic function, with mean DE increasing to 2.40 ± 0.46 cm, CV to 1.99 ± 0.37 cm/s, DTF to 0.35 ± 0.05, and RR/DTF 61.0 ± 8.0, compared to the control group's DE of 2.06 ± 0.46 cm, CV of 1.54 ± 0.44 cm/s, DTF of 0.30 ± 0.06, and RR/DTF 55.7 ± 7.3. Notably, the weaning success rate was higher in the intervention group (58.33%) compared to the control group (43.75%).Conclusion: Sequential muscle training, alongside standard care, significantly improves diaphragmatic function and increases weaning success rates in elderly COPD patients. These findings suggest that incorporating targeted respiratory muscle training into the care regimen could facilitate the weaning process, highlighting the potential for improving patient outcomes in critical care settings.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Respiratory infection with mucocutaneous lesions : A rare manifestation of a known pathogen]. 呼吸道感染伴皮肤粘膜病变：一种已知病原体的罕见表现。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-22 DOI: 10.1007/s00063-025-01277-6

Paul Witte, Adriana Sirova, Michael Christ

引用次数: 0

[Do nurses perform sonography in Germany? A survey]. 在德国护士做超声检查吗？一项调查)。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-04 DOI: 10.1007/s00063-025-01269-6

Lars Krüger, Oliver Rothaug, Rolf Dubb, Peter Nydahl

{"title":"[Do nurses perform sonography in Germany? A survey].","authors":"Lars Krüger, Oliver Rothaug, Rolf Dubb, Peter Nydahl","doi":"10.1007/s00063-025-01269-6","DOIUrl":"https://doi.org/10.1007/s00063-025-01269-6","url":null,"abstract":"Background: Internationally, ultrasounds are carried out by various healthcare professionals and in particular by nurses. It is not yet known whether and in what context this takes place in Germany.Aim: Are ultrasounds performed by nurses in daily nursing care in Germany? Secondary objectives were the context, frequency, qualifications and impact on the nursing care process and teamwork.Methods: Quantitative survey using an online questionnaire with 28 closed and one open question, which was sent out in professional networks.Results: A total of 476 people took part, of whom 98.7% (n = 470) were evaluable. The primary respondents were nurses (80.9%, n = 359) who worked in hospitals (83.0%, n = 390) in the intensive care unit (37.2%, n = 175). A total of 13.2% (n = 62) stated that nurses use sonography in practice. It takes most frequently place for venipuncture or placement of an indwelling cannula (74.2%, n = 46), puncture of an arterial vessel (59.7%, n = 37) and determination of perfusion or peripheral blood sampling (45.2% each, n = 28). Ultrasounds are usually performed several times a week or month (36.4%, n = 12) and the qualification is primarily acquired in the patient's own institution (36.4%, n = 12). A total of 7.0% (n = 33) use ultrasound themselves, which improves work processes (63.6%, n = 21) and communication within the team (48.5%, n = 16) and also leads to greater recognition within the team (42.4%, n = 14).Conclusion: In Germany, only a small proportion of ultrasounds of inpatients are performed by nurses, but the activity improves corresponding workflows, communication within the team and leads to greater recognition.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mitteilungen der ÖGIAIN. OGIAN通讯。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-01 DOI: 10.1007/s00063-025-01274-9

引用次数: 0

Hospital admissions following emergency medical services in Germany: analysis of 2 million hospital cases in 2022. 德国紧急医疗服务后的住院情况：2022 年 200 万住院病例分析。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-01 Epub Date: 2024-04-23 DOI: 10.1007/s00063-024-01148-6

Martin Roessler, Claudia Schulte, Christoph Bobeth, Danny Wende, Christian Karagiannidis

{"title":"Hospital admissions following emergency medical services in Germany: analysis of 2 million hospital cases in 2022.","authors":"Martin Roessler, Claudia Schulte, Christoph Bobeth, Danny Wende, Christian Karagiannidis","doi":"10.1007/s00063-024-01148-6","DOIUrl":"10.1007/s00063-024-01148-6","url":null,"abstract":"Background: The use of emergency medical services (EMS) in Germany has increased substantially over the last few decades. While current reform efforts aim to increase effectiveness and efficiency of the German hospital and EMS systems, there is lack of data on characteristics of hospital cases using EMS.Objectives: To analyze and compare the characteristics of cases hospitalized with and without the use of EMS.Materials and methods: The BARMER health insurance data on more than 2 million hospital cases admitted in 2022 were analyzed. The distributions of age, clinical complexity (measured by patient clinical complexity levels, PCCL), main diagnoses, costs for EMS and hospital treatment, and multiple severity indicators were described. The overall severity of hospital cases was classified as \"low or moderate\" or \"high\" based on a combined severity indicator. All analyses were stratified by use of EMS and EMS type.Results: A total of 28% of all included hospital cases used EMS. Relative to hospital cases without use of EMS, hospital cases with use of EMS were older (physician-staffed ambulance: 75 years, interquartile range [IQR] 59-84, double-crewed ambulance: 78 years, IQR 64-85) and had a higher clinical complexity. The severity of more than 30% of the cases using EMS (except for patient transport service ambulance) was classified as \"low or moderate\". The distributions of main diagnoses differed by severity and use of EMS.Conclusions: The high proportion of cases with low or moderate severity using EMS may indicate a substantial potential to avoid the use of EMS in the context of hospital admissions in Germany. Further investigation is required to explore whether the proportion of cases using EMS could be reduced by optimizing preclinical service.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"230-237"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Diagnosis and treatment of acute pulmonary embolism]. 【急性肺栓塞的诊断与治疗】。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI: 10.1007/s00063-025-01249-w

M Hecker, M Bayer, G A Krombach, N Sommer

引用次数: 0

[Gustav Mahler: tragic life, mysterious illness, early death : Could intensive care medicine have saved him today?] [古斯塔夫-马勒：悲惨的一生、神秘的疾病、早逝：今天的重症监护医学能否挽救他？］

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-04-01 Epub Date: 2024-04-18 DOI: 10.1007/s00063-024-01137-9

Hans-Joachim Trappe

{"title":"[Gustav Mahler: tragic life, mysterious illness, early death : Could intensive care medicine have saved him today?]","authors":"Hans-Joachim Trappe","doi":"10.1007/s00063-024-01137-9","DOIUrl":"10.1007/s00063-024-01137-9","url":null,"abstract":"Background: Gustav Mahler was a composer of the late Romantic period, one of the most famous conductors of his time and, as opera director, one of the most important reformers of musical theatre. Mahler's life, illnesses, death and dying are little or not at all known to many.Objectives: Which illnesses determined Mahler's life? Could his early death have been avoided? From today's point of view, could modern intensive care medicine have helped him?Material and methods: A detailed analysis of Mahler's diseases was performed using scientific databases (medline, pubmed). All published articles were examined in detail.Results: Gustav Mahler was born in 1860 in Kalischt (Bohemia) and learned to play the accordion and piano at an early age. He studied music at the Vienna Conservatory from 1875 and completed his composition studies in 1878. Kapellmeister positions followed in several cities, from 1887 at the Vienna Court Opera and from 1908 at the Metropolitan Opera in New York. Mahler suffered from many illnesses, especially tonsillitis and haemorrhoids. In 1907 he was diagnosed with a mitral valve defect, in 1911 he developed bacterial endocarditis caused by streptococci, as a result of which Mahler died in Vienna in 1911. His life was marked by personal and health tragedies.Discussion: Mahler was an outstanding personality who left behind an extensive oeuvre. Among the compositional highlights are his 10 symphonies and the song compositions. Recurrent streptococcal infections led to mitral valve disease and endocarditis, the consequences of which caused Mahler's untimely death. Today's modern cardiology and intensive care medicine could have prolonged his life, but unfortunately this was not possible at the time when he was diagnosed with endocarditis.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"238-245"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0