[Future-oriented further development and approaches to "individualised" cardiopulmonary resuscitation].

Resuscitation research plays a crucial role in improving survival rates and neurological outcomes following cardiac arrest. This review highlights essential aspects of current resuscitation research and examines the integration of various treatment approaches into existing resuscitation protocols, with a particular focus on individualized resuscitation. The current literature on several key topics in resuscitation is presented.

Cannabis-Associated Emergencies.

Background: Now that the Cannabis Act legalizing the use of cannabis has come into effect in Germany, the frequency of cannabis use in Germany may rise, and with it the number of cannabis-related visits to emergency departments.

Methods: In this narrative review, we identify and evaluate the observed trends in case numbers after cannabis legalization in other countries, the common reasons for emergency department visits, and the options for treatment. Data on trends in cannabis-related emergency contacts in Germany were provided by the Poison Control Center North and are evaluated descriptively.

Acidosis as a promising early indicator of mortality among point-of-care parameters and vital signs in non-traumatic critically ill patients.

Background: The management of critically ill patients, arriving at the emergency department (ED), requires structured care in critical care facilities, particularly in the resuscitation room. This study examines the significance of initial vital signs and blood gas analysis (BGA)-derived values as clinically useful early indicators of mortality risk in critically ill patients, both during in the resuscitation room care and within the following 30 days, with a focus on evaluating the individual predictive performance of accessible clinical parameters.

Methods: We pooled data from two consecutive retrospective observational studies in a German university ED to analyze an unselected patient population of non-traumatic critically ill patients.

CT imaging in post-resuscitation care of non-traumatic resuscitation room patients in German hospitals.

Background: The procedures and locations where patients are admitted to hospitals and subsequently diagnosed after out-of-hospital cardiac arrest (OHCA) in Germany exhibit considerable heterogeneity. Specifically, advanced imaging diagnostic methods via computed tomography (CT) show significant variation in both timing and execution. However, echocardiography (ECHO) is not an alternative to CT in this setting, as both modalities serve distinct diagnostic purposes.

Return to work after major trauma: a systematic review.

Introduction: Individuals suffering from major trauma and survive, often face diverse physical, psychological, and cognitive restrictions which can influence the (health-related) quality of life and the ability to work. Even though, return to work is not necessarily related to the health status of the individual, but it is viewed as a sign of successful reintegration and is a vital parameter of recovery.

Objective: The aim was to systematically review factors influencing return to work (RTW) after suffering from major trauma.

Evaluation of alcohol intoxication on primary and secondary haemostasis - results from comprehensive coagulation testing.

Background: Alcohol intoxication is known to affect blood coagulation. The specific effects remain poorly understood. Here, we investigate the impact of severe alcohol intoxication on blood clotting by comprehensive coagulation testing.

[Optimal management of patients with acute dyspnea and pulmonary diseases in a respiratory care unit].

Acute dyspnea, a main symptom of different diseases in pneumology, cardiology and internal medicine, is one reason why patients present themselves in the emergency department (ED). Acute dyspnea is a frequent and complex symptom. Patients presenting with acute dyspnea in the ED are characterized by a higher rate of transfer to intensive care unit and mortality as compared to patient with chest pain or with abdominal pain.

Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization.

Background: The reduction of processing times in the treatment of acute ischemic stroke is of outstanding importance. Our objective is to analyze the acute stroke care chain from onset to treatment in a city in Germany comprising three stroke units. Additionally, we discuss solutions for detected treatment delays.

[Typical causes and clinical presentations of traumatic and nontraumatic soft tissue and organ haemorrhage in emergency departments].

Acute bleeding often occurs in a wide variety of forms in clinical emergency medicine. In traumatic bleeding, soft tissue injuries to the head or extremities are common, while severe bleeding is less common in chest injuries or pelvic trauma. In nontraumatic emergencies, gastrointestinal bleeding is the leading cause, but many other bleeding entities are possible.

[Retrospective analysis of the resuscitation room management of nontraumatic critically ill children in a university emergency department (OBSERvE-DUS-PED study)].

Background: The establishment of a resuscitation room management for nontraumatic critically ill children appears to make sense. This study collected data of pediatric patients suffering from nontraumatic critically ill conditions treated in a resuscitation room.

Methods: The retrospective OBSERvE-DUS-PED study (November 2019-October 2022) recorded pediatric patients (age < 18 years) who were admitted to the emergency department (ED) for resuscitation room care.

[Monitoring of cardiovascular emergencies in the emergency department].

In the emergency department, patients with potential or confirmed cardiovascular diseases constitute a significant portion of the overall patient population. Monitoring for cardiovascular surveillance of these patients, until and during the diagnostics and acute therapy often presents an interdisciplinary and interprofessional challenge. This is partly due to the limited number of monitoring spaces in emergency departments.

Triage Performance Across Large Language Models, ChatGPT, and Untrained Doctors in Emergency Medicine: Comparative Study.

Background: Large language models (LLMs) have demonstrated impressive performances in various medical domains, prompting an exploration of their potential utility within the high-demand setting of emergency department (ED) triage. This study evaluated the triage proficiency of different LLMs and ChatGPT, an LLM-based chatbot, compared to professionally trained ED staff and untrained personnel. We further explored whether LLM responses could guide untrained staff in effective triage.

[Development of violence-associated penetrating trauma in the Düsseldorf metropolitan region over a 5-year period (GewPen study)].

Introduction: Penetrating injuries are a rare but recurring emergency situation in the out-of-hospital and in-hospital emergency settings. The purpose of this study was to determine the incidence and characteristics of injuries associated with penetrating violence across a German metropolitan region over a 5-year period.

Material And Methods: In the retrospective study, a database query of the control center of the Düsseldorf rescue service area was used to identify and descriptively analyze all rescue service operations with penetrating violence-associated injuries in the years 2015, 2017, and 2019.

Prehospital anesthesia in postcardiac arrest patients: a multicenter retrospective cohort study.

Background: Currently, the data regarding the impact of prehospital postcardiac arrest anesthesia on target hemodynamic and ventilatory parameters of early postresuscitation care and recommendations on its implementation are rare. The present study examines the incidence and impact of prehospital postcardiac arrest anesthesia on hemodynamic and ventilatory target parameters of postresuscitation care.

Methods: In this multicentre observational study between 2019 and 2021 unconscious adult patients after out-of-hospital-cardiac arrest with the presence of a return-of-spontaneous circulation until hospital admission were included.

Perceptions on Specialist Palliative Care Involvement During and After Cardiopulmonary Resuscitation: A Qualitative Study.

Importance: Cardiopulmonary resuscitation (CPR) is an exceptional physical situation and may lead to significant psychological, spiritual, and social distress in patients and their next of kin. Furthermore, clinicians might experience distress related to a CPR event. Specialist palliative care (sPC) integration could address these aspects but is not part of routine care.

[Presentations for HIV post-exposure prophylaxis in emergency departments: guideline and recommendations].

Patients often present to emergency departments after potential or confirmed exposure to human immunodeficiency virus (HIV) asking for recommendations concerning the initiation of post-exposure prophylaxis (PEP). These presentations may occur after occupational as well as non-occupational exposure. PEP entails taking a triple antiretroviral therapy for 28-30 days.