Hot Topics Notfallmedizin Update 2021

Liebe Kollegin, lieber Kollege!

Wir hoffen, dass unser wilder Ritt durch aktuelle Themen der Notfallmedizin gefallen hat. Hier einige Quellen und Links zum Thema:

Reanimation:

Intraossär schlechter als Intravenös?

REANIMATION

Intraossär schlechter als Intravenös? 

• Intraosseous compared to intravenous drug resuscitation in out-of-hospital cardiac arrest
• Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest
• Intravenous vs. intraosseous access and return of spontaneous circulation during out of hospital cardiac arrest
• Effect of Intravenous Versus Intraosseous Access in Prehospital Cardiac Arrest
• Intravenous vs. intraosseous access and return of spontaneous circulation during out of hospital cardiac arrest

Nurse led CPR

Cardiac Arrest Nurse Leadership (CANLEAD) trial: a simulation-based randomised controlled trial implementation of a new cardiac arrest role to facilitate cognitive offload for medical team leaders

Cardiac Arrest Center besser als „kleine Klinik“?

Association between admission to a cardiac arrest centre and survival to hospital discharge for adults following out-of-hospital cardiac arrest: A multi-centre observational study

Abbruch der Reanimation!

• ERC Guidelines 2021: 12 Ethics

• Kardiopulmonale Reanimation: Aussichtslose Situationen erkennen

• Frailty status predicts futility of cardiopulmonary resuscitation in older adults
• Frailty is associated with adverse outcome from in-hospital cardiopulmonary resuscitation
  • Frailty Score bestimmen

Mechanische Thoraxkompression vs. „handgemachte“ CPR?

LUCAS II Device for Cardiopulmonary Resuscitation in a Nonselective Out-of-Hospital Cardiac Arrest Population Leads to Worse 30-Day Survival Rate Than Manual Chest Compressions

KRAMPFANFALL – GEBEN WIR ZU WENIG BENZODIAZEPINE?

• DGN Leitlinie Status Epilepticus (2020)
• DGN “Clinical Pathway”

CO-INTOXIKATION – OHNE NIV GEHT NIX!

Leitlinie „in Press“

AKUTES KORONARSYNDROM UND DOAK

DGK Konsensuspapier ACS + NOAK prähospital

TRANEXAMSÄURE – IMMER??

… bei Schädelhirntrauma nur wenig Nutzen!

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3)

Übersicht zu weiteren Studien

… bei SAB ohne Nutzen!

Ultra-early tranexamic acid after subarachnoid haemorrhage (ULTRA)

… bei Nasenblutung ohne Benefit!

The Use of Tranexamic Acid to Reduce the Need for Nasal Packing in Epistaxis (NoPAC)

… bei GI-Blutung ohne Benefit!

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT)

… inhalativ bei Hämoptysen effektiv!

Inhaled Tranexamic Acid for Hemoptysis Treatment

… wenn, dann nur nach schwerem Polytrauma (massiver Verletzung)

Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury

ALLES NEU, ALLES SCHLECHT?

• Tod der HWS-Orthese (Pin-Up Docs)
• 9 Gründe gegen NaCl als Volumentherapie (dasFOAM)
• 2020 NSTE-ACS Guidelines (ESC)