Performance of prehospital emergency anesthesia and airway management. An online survey

Background. The goal of rapid sequence induction (RSI) in cases of emergency situations is to secure the airway as quickly as possible to prevent pulmonary aspiration of gastric contents; however, the technique itself is not standardized. For example, the choice of drugs, application of cricoid pressure and the patient position remain controversial. A survey of emergency medical services (EMS) physicians throughout Germany was carried out to assess the different RSI techniques used and with respect to complying with the national guidelines for emergency airway management anesthesia and local standard operating procedures (SOP). Material and methods. Between 1 April 2017 and 31 May 2017, EMS medical directors in Germany were contacted and asked to distribute a 28-question online questionnaire to local EMS physicians. Of the questions 26 were multiple choice and 2 with plain text. After 6 weeks an e-mail reminder was sent. In addition, the survey was distributed via social media to EMS physicians. Results. In total the survey was opened 2314 times and 1074 completed responses were received (completion rate 46%). Most of the participants were male (78%) and anesthesiologists (70%) and only one quarter had a local SOP for RSI. The most frequently used muscle relaxant was succinylcholine (62%) and over half of the participants reported using cricoid pressure (57%). There was a distinction between the specialist disciplines in the selection of drugs. Propofol was used most by anesthesiologists, while the others still used etomidate on a larger scale. Nearly 100% could fall back on supraglottic devices (one third laryngeal mask, two thirds laryngeal tube) but only 32.8% with the recommended esophageal drainage. A video laryngoscope was available to 51% of all EMS physicians surveyed. Conclusion. The results of the survey demonstrate heterogeneity in RSI techniques used by EMS physicians in Germany. Medical equipment and safe care practices, such as labeling of syringes varied considerably between different service areas. The recommendations of the S1 national guidelines on emergency airway management and anesthesia should be adhered to together with the implementation of local SOPs

Diverse or uniform? Intercomparison of two major German project databases for interdisciplinary collaborative functional biodiversity research

Research on biodiversity, its relation to ecosystem functioning and services, and the assessment of the impacts of environmental change on biodiversity needs an interdisciplinary perspective. This implies a great diversity of data and data formats gathered mostly in short- to mid-term collaborative research projects. It has been common practice that projects develop specific data management and communication solutions. We compare solutions of two major German collaborative research programs in functional biodiversity research to derive functional commonalities. This in-depth analysis follows five categories of the data life cycle: (i) data acquisition, (ii) metadata management, (iii) database, (iv) exploration, analysis and visualization, and (v) data curation and preservation. The results show that even though both systems were developed completely independently, they reveal comparable overall features and a similar state of implementation. Major focus areas lie in the implementation of comparable metadata schemas and their importance for storage and access strategies for tabular data on the value level. Basic analysis tools and similar management functions are considered. Intensive communication with the users and the orientation of ongoing developments based on user requirements is also important. Both systems are different mostly in specific details which, however, do not influence the overall comparable performance. It should be also emphasized that the same functionality is achieved with completely different software. The choice of software is based on the evaluation of available technologies. Thereby it might be influenced by individual experiences of the developers, but is mainly determined by the data diversity, which forces the usage of flexible technologies to develop adaptable systems. It is concluded that overall features for project databases of collaborative research projects must be supplemented by sophisticated data description, storage, and analysis structures to serve the requirements of integrative functional biodiversity research. (C) 2011 Elsevier B.V. All rights reserved