Pedelec users get more severely injured compared to conventional cyclists

Background For years e-bike (Pedelec) sales have been steadily increasing. Therefore, the incidence of e-bike-related injuries and deaths has been growing. Due to clinical experience, emergency personnel are suspecting that e-bikers might be injured more severely compared to conventional bicyclists suffering from an accident. This topic has not yet been analyzed for Germany. Objective Analysis of injury severity and mortality following e-bike and conventional bicycle accidents in a level I trauma center in Germany. Material and methods Data of patients treated after a bicycle accident at the accident and emergency department as well as the clinic for traumatology and orthopedics of the Evangelical Hospital (Evangelisches Krankenhaus) Oldenburg were gathered from 1 March 2017 to 1 March 2019. Results In this study 59 electric bicycle users (e-bikers) and 164 conventional cyclists were included. The average age of e-bikers was 62 years compared to 48 years in the group of conventional cyclists. Comorbidities were significantly more frequent in the e-bike group compared to classical cyclists. The e-bikers were found to be significantly more severely injured than conventional bicyclists, the mean injury severity scores (ISS) were 5.2 and 3.4, respectively. E-bikers were admitted to the hospital more often and for longer periods than the control group. There was no significant difference in mortality. Conclusion E-bikers are more severely injured in accidents compared to conventional cyclists. Due to older age and comorbidity they form a sensitive trauma subgroup. Based on demographics, an increase of old age, more frail cyclists and a growing incidence of serious e-bike accidents is to be expected. Preventive measures, such as helmet usage and riding lessons should be introduced, especially in e-bikers. E-bikers in the emergency department should be examined and treated with special care and aggressive diagnostics. A low threshold for an initial interdisciplinary assessment (shock room management) is advised

Telecooperation in healthcare is possible

Infrastructure and solutions for information and communication technologies (ICT) are important market drivers also in healthcare market. In Germany the need for telecooperation and unified communications and collaboration (UCC) in the healthcare market is growing especially in the sectors hospitals, emergency, primary care and healthcare providers. ICT infrastructure will push new integrated solutions. Conditions are: standardized ICT infrastructure that provides secure networks, connectors to networks and security services, trusted platforms or secure clouds as well as interoperability services like IHE-profiles (integrating the healthcare enterprise) e.g. HL7, DICOM, XDS, PIX. This paper describes this ICT market situation and conditions and shows three healthcare areas for growing inter-/intrasectoral telecooperation: audio-/videocommunication, telecooperation with data and document exchange and full integrated telecooperation based on IHE-crosslinking and medical data exchange solutions (MDES). As a result the authors claim, that telecooperation in healthcare is possible and improves chances of emergency survival as well as recovery of patients

Bicycle helmets : do we need a European legislation?

An increased use of bicycles comes along with an increased number of bicycle accidents. Bicycle accidents are more frequent than recorded by the police. To evaluate the real number of bicycle accidents during 12 months in Münster, Germany, injuries were collected by the Police and in each emergency unit anonymously. 2,153 patients had to be treated in a hospital, nearly triple the number of accidents that were registered by the police. Beside fractures of the upper extremities with major surgery, traumatic brain injuries were the leading cause for hospital admission. Bicycle helmet use can reduce traumatic brain injuries and the related number of deaths and hospital admissions. Laws on bicycle helmet might decrease the use of bicycles and therefore the reduction of positive health benefits. Other methods of accident prevention may lead to positive effects as helmet legislation as well, while having no reduction in bicycle use

Informationen zur medizinischen Vorgeschichte in der Notaufnahme

Background!#!The introduction of an electronic health record (EHR) or an emergency care data set (ECDS), as well as reforms in emergency medical care, is currently part of political debate in Germany. Currently, no data are available of how emergency departments could benefit from an ePA or NFD in Germany. The aim of this study was to determine if a patient's medical history has an influence on diagnostic and therapeutic decisions in the emergency department.!##!Methodology!#!To answer this question, a descriptive observational study was conducted in an interdisciplinary emergency department with a study population of n = 96.!##!Results!#!For 55 patients (59%) neither a doctor's letter nor a drug list was found. However, in 48% of the patients who were admitted to the hospital via the emergency department, additions to the anamnesis record could be identified. Eight (9%) patients showed that therapy and/or diagnostic decisions should have been discussed or changed if the supplemented anamnestic information had been available in the emergency room. In addition, the study revealed that the duration of the anamnesis was prolonged in case of missing medical history (mean: 10-15 min, standard deviation: ±<5 min). In contrast to the patients with a medical history (mean: 5-10 min, standard deviation: ±<5 min).!##!Conclusion!#!Based on the data stored in EHR and ECDS, therapy and diagnostic decisions could be made more reliably. In the absence of a medical history, the time required for medical history taking in emergency departments is significantly longer, which could be reduced by introducing EHR or ECDS

Verfügbarkeit von Patienteninformationen in der Notaufnahme

Background!#!Fast access to information from other healthcare service providers is particularly important in emergency medicine, as the patients are often unknown and treatment decisions have to be made promptly.!##!Objectives!#!The study aims to identify the challenges that emergency departments face in obtaining information on patient history, the expected benefits of easier access to information and which information is most urgently needed.!##!Materials and methods!#!An online survey throughout Germany was carried out among medical staff working in emergency departments. In all, 181 questionnaires were fully completed and could be included in the data analysis.!##!Results!#!Of the respondents, 77.9% said it was difficult or very difficult to receive external data at the point of patient care. The survey participants estimate that they need an average of around 47 min to obtain information about one patient. 99.4% believe that patient care would benefit from an easier and faster information exchange. Medication lists, discharge letters, information on previous illnesses and allergies were classified as the most important data elements.!##!Conclusions!#!There is an urgent need for action with regard to the considerable effort involved in obtaining information on emergency patients. Digital solutions such as the recently introduced emergency data set can offer additional value for clinical emergency care if they are widely used

Telemedicine in Emergency Care - Results of GMDS Workshop

On April 23th 2012, the first workshop on Telemedicine in Emergency Care was organized in Berlin. The workshop addressed different issues ranging from communication between dispatcher and hospitals to telemedicine used in the German army. Different applications for acute trauma, stroke and heart problems were introduced and the chances and obstacles were discussed. User acceptance, adequate finance, interface issues, data privacy, mobile data networks and devices and evaluation were identified as the main challenges as well as the main factors for long term success