[Case Report - Bilateral humeral intraosseous access for CPR in a 3-years-old child]. / Kasuistik - Bilateraler intraossärer Zugang am Humerus bei Reanimation eines 3-Jährigen.

On-scene invasive emergency procedures, such as intraosseous puncture, are often unavoidable, when indicated, and present a challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular intervention by the emergency medical service, "last resort" measures occur very infrequently, particularly in pediatric emergencies. For the first time, this case report presents the use of intraosseous access at the humeral head with children, with reference to indication, implementation, problems and risks.

[Pre-hospital care management of acute spinal cord injury]. / Die akute traumatische Querschnittslähmung - Wie ist präklinisch vorzugehen?

Acute injury to the spine and spinal cord can occur both in isolation as also in the context of multiple injuries. Whereas a few decades ago, the cause of paraplegia was almost exclusively traumatic, the ratio of traumatic to non-traumatic causes in Germany is currently almost equivalent. In acute treatment of spinal cord injury, restoration and maintenance of vital functions, selective control of circulation parameters, and avoidance of positioning or transport-related additional damage are in the foreground. This article provides information on the guideline for emergency treatment of patients with acute injury of the spine and spinal cord in the preclinical phase.

[Cooperation between emergency and forensic medicine - retrospective evaluation of pre-hospital emergency measures]. / Netzwerk Rechts- und Notfallmedizin - Retrospektive Evaluation präklinischer Notfallmaßnahmen.

Emergency medical research is subject to special conditions. Emergency patients e.g. are generally considered to be non-capable of giving consent. This results in sparse emergency medical data when compared to clinical observation studies under controlled conditions. After emergency medical treatment, deceased patients are not rarely subject to forensic investigation. The cooperation between emergency and forensic medicine has not only emergency medical training potential in individual cases, but also scientific innovation potential especially with respect to the retrospective evaluation of pre-hospital emergency measures. Such partnerships (like in Berlin at the Charité - Universitätsmedizin Berlin between the Institute of Legal Medicine and the Center for Musculoskeletal Surgery or in Hamburg between the Institute for Legal Medicine at the University Hospital and the Municipal Fire Brigade with the Emergency Medical Service) are yet exceptional in Germany.

[Invasive emergency techniques - In-field-amputation]. / Invasive Notfalltechniken - Notamputation.

On-scene invasive emergency procedures, such as Cricothyroidotomy, chest drain, intraosseous puncture or even in-field-amputation, are often unavoidable, when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular intervention by the Emergency Medical Service, "last resort" measures occur very infrequently, particularly in relation to paediatric emergencies. As well as theoretical training, practice-oriented course concepts are essential in order to achieve high quality in these procedures. This article presents the use of in-field-amputation, with reference to indication, implementation, problems and risks. It is part of a series of four articles on the subject of invasive emergency techniques.

[Invasive emergency techniques - intraosseous devices]. / Invasive Notfalltechniken - Der intraossäre Zugang.

On-site invasive emergency procedures, such as cricothyroidotomy, chest drainages, intraosseous puncture or the even rarer on-site amputations, are often unavoidable when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular participation in the emergency medical services, "last resort" measures occur very infrequently, particularly in paediatric emergencies. As well as theoretical training, practice-oriented course concepts are essential in order to achieve high quality in these procedures. In this article we describe the use of intraosseous devices on adults and children, with reference to the indication, implementation, problems and risks. It is the third part of a series of four articles on the subject of invasive emergency techniques.

[Invasive emergency techniques--decompression of the pleura]. / Invasive Notfalltechniken--Entlastung des Pleuraraumes.

On-scene invasive emergency procedures, such as cricothyroidotomy, chest drain, intraosseous puncture or even on-field-amputation, are often unavoidable, when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular intervention by the emergency medical service, "last resort" measures occur very infrequently, particularly in relation to paediatric emergencies. Beside a theoretical education, practice-oriented course concepts are necessary to achieve a high quality of these measures. This article presents the use of decompression of the pleura on adults and children, with reference to indication, implementation, problems and risks. It is the second part of a series of four articles on the subject of invasive emergency techniques.

[Invasive emergency techniques--cricothyroidotomy]. / Invasive Notfalltechniken--Die Koniotomie.

On-scene invasive emergency procedures, such as cricothyroidotomy, chest drain, intraosseous puncture or even on-field-amputation, are often unavoidable, when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular intervention by the emergency medical service, "last resort" measures occur very infrequently, particularly in relation to paediatric emergencies. As well as theoretical training, practice-oriented course concepts are essential in order to achieve high quality in these procedures. This article presents the use of cricothyroidotomy on adults and children, with reference to indication, implementation, problems and risks. It is part of a series of four articles on the subject of invasive emergency techniques.

The feasibility of prostate cancer detection by triple spectroscopy.

OBJECTIVES: To determine the feasibility of ex situ prostate cancer detection by triple spectroscopy. A positive surgical margin following radical prostatectomy is an adverse factor for recurrence-free survival. Detection of residual cancer cells in vivo would be the most useful, allowing the resection of such tissue during the procedure. Aside from the use of frozen sections, the ability to detect positive surgical margins is limited. Laser-induced autofluorescence, white-light remission, and high-frequency impedance spectroscopy are methods that allow discrimination of tissues of different dignities based on their specific signature. We tested whether the combination of these techniques can differentiate malignant and benign prostate tissue ex vivo. MATERIALS AND METHODS: In preparation for future in vivo measurements, an ex vivo study was performed to detect characteristics of prostate tissue. Ninety-five tissue samples from 32 patients undergoing radical prostatectomy for clinically localized prostate cancer were taken immediately after removal of the prostate and stored in liquid nitrogen. Tissue samples were thawed for laser-induced autofluorescence, white-light remission, and high-frequency impedance spectroscopy. Based on these results, a computerized algorithm was developed for tissue differentiation. RESULTS: The statistical analysis of laser-induced autofluorescence and white-light remission data demonstrated a differentiation of benign and malignant prostate tissue with a sensitivity of 87.5% and a specificity of 87.3%. By adding the acquired high-frequency impedance data to the statistical analysis, sensitivity and specificity were increased to 93.8% and 92.4%. CONCLUSION: A highly accurate differentiation of prostate tissue was achieved in an ex vivo model. In vivo studies need to be performed to evaluate whether this technique can be successful in an intraoperative setting to detect positive surgical margins.