Emergency 20 German Language Pack ((HOT)) Download

Background: In pediatric medical emergencies, paramedics and emergency physicians must often rely on the information of third parties, often caregivers, to gather information. Failing to obtain relevant information may lead to misinterpretation of symptoms and subsequent errors in decision making and clinical treatment. Thus, children and/or caregivers with limited proficiency of the locally spoken language may be at risk for medical errors. This study analyzes logs of rescue missions to determine whether paramedics could obtain essential information from German-speaking and foreign-language children and their caregivers.

Methods: We conducted a secondary data analysis based on retrospective data on pediatric patients of four emergency medical services (EMS) stations in Northern Germany. We defined language discordance with communication difficulties as main exposure. We used documentation quality as outcome defined as existing information on (a) pre-existing conditions, (b) current medication, and (c) events prior to the medical emergency. Statistical analyses include descriptive statistics, simple regression and multivariable regression. As multivariable regression model, a logistic regression was applied with documentation quality as dependent variable and language discordance with communication difficulties as independent variable adjusted for age, sex and Glasgow Coma Scale (GCS).

Emergency 20 German Language Pack Download

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Results: Data from 1,430 pediatric rescue missions were analyzed with 3.1% (n = 45) having a language discordance with communication difficulties. Patients in the pediatric foreign-language group were younger compared to German-speaking patients. Thorough documentation was more frequent in German-speaking patients than in patients in the foreign-language group. Pre-existing conditions and events prior to the medical emergency were considerably more often documented in German-speaking than for foreign-language patients. Documentation of medication did not differ between these groups. The adjustment of sex, age and GCS in the multivariable analysis did not change the results.

Conclusion: Language barriers are hindering paramedics to obtain relevant information in pediatric pre-hospital emergencies. This jeopardizes the safe provision of paramedic care to children who themselves or their caregivers are not fluent in German language. Further research should focus on feasible ways to overcome language barriers in pre-hospital emergencies.

During the COVID-19 pandemic and associated public health and social measures, decreasing patient numbers have been described in various healthcare settings in Germany, including emergency care. This could be explained by changes in disease burden, e.g. due to contact restrictions, but could also be a result of changes in utilisation behaviour of the population. To better understand those dynamics, we analysed routine data from emergency departments to quantify changes in consultation numbers, age distribution, disease acuity and day and hour of the day during different phases of the COVID-19 pandemic.

The number of emergency department consultations decreased rapidly during the COVID-19 pandemic, without extensive variation in the distribution of patient characteristics. Smallest changes were observed for the most severe consultations and older age groups, which is especially reassuring regarding concerns of possible long-term complications due to patients avoiding urgent emergency care during the pandemic.

As reference data we included data on 3 years prior to the pandemic starting with 06-03-2017. Data for the pandemic could be included until 13-06-2021 which marked the end of the ESEG project. We included data from emergency departments which provided at least one consultation recorded for each day of the study period. Every consultation recorded within this period fulfilling a minimal requirement for data transfer was included, i.e. information on age, day and hour of consultation provided.

Analysing data from a syndromic surveillance system using emergency department data can retrospectively contribute to the wider understanding of the impact of the COVID-19 pandemic and associated public health and social measures. However, given the implemented surveillance system at RKI where data is available on a daily basis, changes in health-care seeking behaviour could also be detected instantaneously and be routinely fed into public health decision-making. The basis of both of these aims is the analysis of changes in consultation numbers and the distribution of patient characteristics, as presented in this study.

The presented results show that while the overall number of consultations decreased during each phase of the COVID-19 pandemic compared to the time before the pandemic, the distribution of patient characteristics did not vary extensively. Especially older age groups and those presenting with more severe complaints showed the smallest relative decrease in each pandemic phase. This indicates that patients assumed to be more vulnerable did receive necessary emergency treatment and were not lacking access to emergency departments.

MS, LG and TSB conceptualised the study and research question. MS, AU and AA developed the study design and analysis plan. FG and JB ensured coordinated data sourcing from the AKTIN emergency department data registry. MS performed the analysis with support from AU. MS wrote the initial draft of the manuscript. All authors revised and approved the final manuscript.

Model fit for overall consultations showing number of cases per week (black) and fitted values (red) for A): a two-week delay, B): a one-week delay and C): no delay. Supplementary Fig. 2. Relative number of emergency department consultations stratified by weekday of consultation comparing the pandemic phases. Supplementary Fig. 3. Relative number of emergency department consultations stratified by hour of consultation comparing the pandemic phases. Supplementary Fig. 4. Relative change in % and 95 confidence interval for all emergency department consultations, comparing every pandemic phase with the pre-pandemic reference period. Supplementary Fig. 5. Relative change in % and 95 confidence interval for all emergency department consultations by weekday, comparing every pandemic phase with the pre-pandemic reference period. Supplementary Fig. 6. Relative change in % and 95 confidence interval for all emergency department consultations by hour of day, comparing every pandemic phase with the pre-pandemic reference period. Supplementary Table 1. Relative percentage change, 95% confidence interval and p-value for the pre-pandemic trend (i.e. linear time from start of study period until start of first interruption). Supplementary Table 2. Absolute and relative number of all emergency department consultations, consultations by age group, acuity level, weekday, and hour of day, stratified by pandemic phases.

COVID-19 pandemia is a major challenge to worldwide health care systems. Whereas the majority of disease presents with mild symptoms that can be treated as outpatients, severely ill COVID-19 patients and patients presenting with similar symptoms cross their ways in the emergency department. Especially, the variety of symptoms is challenging with primary triage. Are there parameters to distinguish between proven COVID-19 and without before? How can a safe and efficient management of these inpatients be achieved?

We conducted a retrospective analysis of 314 consecutive inpatient patients who presented with possible symptoms of COVID-19 in a German emergency department between March and April 2020 and were tested with a SARS-Cov-2 nasopharyngeal swab. Clinical parameters, Manchester Triage System categories, and lab results were compared between patients with positive and negative test results for SARS-Cov-2. Furthermore, we present the existing COVID-19 workflow model of the university hospital in Essen which proved to be efficient during pandemia.

Whereas the majority of patients presents with mild symptoms [2,3,4,5] and can be treated as outpatients, severely ill COVID-19 patients and patients with similar symptoms cross their way in the emergency department (ED). Due to the high infectiousness of SARS-Cov-2, it is crucial to separate patients with suspicion of COVID-19 and other patients as soon as possible to avoid further spread of the infection. Especially, the variety of symptoms in COVID-19 patients is challenging for the primary triage in the ED: fever, fatigue, dry cough, anorexia, myalgias, dyspnea, sputum production, and olfactory and taste disorders are the most frequent symptoms [2, 8].

We performed a retrospective, single-center case-control study that included all inpatient patients with possible symptoms of COVID-19 who were admitted to the emergency department between March and April 2020 and were tested by nasopharyngeal swab for SARS-Cov-2. At least one symptom upon arrival to the ED out of the following was required for inclusion: dyspnea, sore throat, cough, fever, headache, fatigue, myalgia, chest pain, nausea, diarrhea, and/ or dysgeusia. Patients without any of the mentioned symptoms were excluded as well as those without valid nasopharyngeal swab results. Our study was approved by the institutional ethics committee and informed consent was waived (file number: 20-9310-BO, date: 6 May 2020). The study was registered at the German Clinical Trials registry (trial number: DRKS00021675, date 8 May 2020).

To establish a central COVID-19 pandemia care center within the city of Essen (560,000 inhabitants), the university hospital was required to develop a safe and efficient workflow in the emergency department.

In the group of the COVID-19 patients, 18 patients (41.9%) were treated with oxygen upon admission in the emergency department. However, this was not significantly different to the 77 patients (28.5%) of the non-COVID-19 group who were supported with oxygen. e24fc04721