[Changes and developments in emergency medical services: key challenges for rescue management]. / Veränderungen und Entwicklungen in der präklinischen Notfallversorgung: Zentrale Herausforderungen für das Rettungsdienstmanagement.

Emergency medical services (EMS) and pre-hospital rescue management in Germany as a whole are currently confronted with numerous challenges. In the last decade, the number of calls has risen in almost every EMS area, resulting in a significant increase of ambulance provision. However, human resources management is becoming increasingly difficult and technical and medical requirements are rising steadily. Increasingly, voices are calling for a fundamental reform of emergency care.The aim of this article is to give an overview of the current developments, trends and future challenges in order to illustrate the requirements for present and prospective rescue management. Different topics and areas of action were identified using a non-systematic literature search. The requirements for rescue management are brought together iteratively.The challenges facing EMS are versatile and complex, as are the demands on its management. The heterogeneous and small-scale organisational structure of emergency medical services in Germany poses a major challenge for reform processes. The lack of scientific competencies in EMS also complicates process optimisation. The increasing academisation and research in this field are to be welcomed.

[Watching behavior at accident sites-it is not always "curiosity," it is not always "rubberneckers"]. / Zuschauendes Verhalten an Unglücksorten ­ nicht immer ist es "Schaulust", nicht immer sind es "Gaffer".

Almost every day, the media report that emergency services at accident sites are hindered by rubberneckers. Such behaviors are criticized by firefighters, rescue service employees, and the general public and regarded as "unethical," "irresponsible," or even as an expression of social brutalization. Emotionally, the topic is highly charged.This article gives an overview of the hypotheses and theories that can be used to explain watching behavior. A literature search was conducted to identify biological, ethological, individual, and social psychological explanatory approaches for watching behavior at accident sites. These individual approaches are brought together in an integrative framework model.It turns out that watching behavior at accident sites is by no means solely due to "curiosity" and "desire to look." Rather, a complex combination of biological, individual, and social psychological motives with social, event, and personal moderator variables must be assumed. The blanket designation of spectators at accident sites as rubbernecks thus does not do justice to the complexity of the phenomenon. Watching behavior at accident sites is individual and multifactorially justified. Only a correspondingly comprehensive understanding of the problem provides a solid basis for the derivation of suitable prevention and intervention strategies.

[Psychosocial Emergency Care After the Death of a Parent: Guidelines for Dealing with Affected Children]. / Psychosoziale Notfallversorgung nach dem Tod eines Elternteils: Leitlinien für den Umgang mit betroffenen Kindern.

Psychosocial Emergency Care After the Death of a Parent: Guidelines for Dealing with Affected Children Does psychosocial emergency care after parental death affect children's mental health? Or do affected children consider psychosocial emergency care useful at all? And what do children really want in this situation? Against the background of these questions, data were collected both qualitatively and quantitatively from a sample of 35 affected children and adolescents. The results show no mental health differences between groups (children with PSNV, n = 11 and children without PSNV, n = 24). Nevertheless, affected children appear to evaluate psychosocial emergency care after parental death positively. The derived guidelines therefore represent a further step towards psychosocial emergency care adapted to the needs of children and can therefore serve as orientation for practice.

[Outpatient care for mentally traumatized children and adolescents in Germany]. / Ambulante psychotherapeutische Versorgungssituation von traumatisierten Kindern und Jugendlichen in Deutschland.

Outpatient care for mentally traumatized children and adolescents in Germany Abstract. Objective: In Germany, information on outpatient care for mentally traumatized children and adolescents are not available. Therefore, the study tried to investigate outpatient care in this patient-group by licensed medical and psychological psychotherapists. Method: Altogether, 206 outpatient psychotherapists with qualification for trauma therapy and license to treat children and adolescents were asked to participate by completing an anonymous standardized questionnaire. Results: The response rate was 44 %. Only 20 out of 92 participants stated that they gained sufficient knowledge regarding mental trauma treatment during their training. Besides, the study revealed that not all traumatized children and adolescents have prompt access to treatment, due to the lack of therapeutic capacities by the psychotherapists. Conclusion: The results point to the problem of not sufficient education on mental trauma in children and adolescents during the training of psychotherapists. Moreover, an increase of the capacities for treatment became obvious. Psychotherapeutic care of traumatized children and adolescents can be difficult in some regions in Germany. Consequently, training and post-graduate education of psychotherapists as well as the planning of outpatient infrastructure should be changed.

[The Need for Psychosocial Support of Parents of Children in Neonatal Care]. / Die Notwendigkeit der psychosozialen Begleitung von Eltern in der Neonatologie.

Background Advances in neonatal care have reduced mortality but increased morbidity in babies born pre-maturely or after high-risk pregnancies. However, this often increases the burden on the family and the parents in particular. A systematic review of the literature was conducted that demonstrated the importance of psychosocial support for parents of children in neonatal care. Methods A systematic search of Pubmed, Psyndex, CINAHI and medpilot was conducted. Reference lists of the included articles were also searched for relevant publications. A free-text search found further publications. Together, 78 publications (from 1975-2015) were included in our review. Results A shift from a biomedical model and child-centred treatment to family-centred care has already taken place in neonatal care. However, there is still a considerable gap between theory and practice. Although there is awareness of the need for psychosocial support of parents, the focus of day-to-day care is still on medical interventions and life-supporting treatment for the child. In particular, while the importance of an assessment of needs as a basis for family-centred psychosocial support appears to be well-known, validated screening instruments are rarely used. In addition, the demand for psychosocial support of parents is not just solely determined by the child's medical risk. Conclusions The results highlight the challenges of delivering individualised psychosocial support to families within a healthcare system of limited resources, with practitioners having to take into account the developing parent-child relationship as well as health economics. In future, psychosocial support should be based on evidence rather than intuition. Attachment theory and research, and health psychology can contribute to this development.

[The psychology of children resuscitation]. / Die Psychologie der präklinischen Kinderreanimation--Wie verhalten Sie sich angemessen?

The management of pre-hospital cardiac arrest in children requires psychosocial as well as medical skills. This paper provides a review of the current literature regarding the psychological aspects of pre-hospital cardiac arrest in children.