When it comes to prehospital resuscitation of very elderly patients, the emergency medical team is often faced with an ethical dilemma. On the one hand, there are the medical indications, and on the other, there are the patient's wishes. The medical indication is often questionable when the prognosis is poor, and patients often refuse life-saving measures in old age. The presented case outlines the options available when medical intervention has been successful, but the patient's advance directive contradicts the treatment. The legal and ethical considerations are presented here.
Objective For project planning in emergency medical services, it can be highly beneficial to prospectively identify key factors that may be responsible for project failure. This study examined various predictors of project failure in emergency medical services. Methods A questionnaire survey was conducted among preclinical emergency medicine professionals, most of whom were highly experienced in project management. Results and Conclusion The main causes of project failure identified were a lack of prioritization within the organization, inadequate framework conditions, and insufficient competence in project management. Other relevant factors included an excessive number of parallel projects, insufficient support from top management, and unrealistic time management. A close connection was observed between insufficient involvement of top management, lack of prioritization, and resource bottlenecks. The findings suggest that both structural conditions (framework conditions, resources) and leadership behavior, as well as project management competences in emergency medical services, can substantially contribute to project failure. In particular, the combination of missing prioritization, insufficient involvement of top management, and resource bottlenecks may be responsible when projects fail. Future studies should examine project success in emergency medical services using objective criteria. Project success requires clear priorities, management support, limited parallel projects, realistic time planning, competent project management, and good team communication. This reduces risks and saves resources for projects in emergency medical services.
Prehospital emergency care relies on devices for vital parameter assessment and clinical decision-making. This article briefly covers the physiological and physical principles behind modern pulse oximetry, CO-oximetry, and invasive and non-invasive blood pressure measurement. It highlights appropriate applications, patient-safety aspects, and common errors in device use and interpretation using short clinical examples. Sound clinical decisions require both understanding of measurement devices and consideration of the patient's clinical condition. Healthcare providers should be trained in proper application, they should be able to recognize device limitations, and critically question implausible readings.
Witnessed or unwitnessed foreign body ingestion and aspiration are common paediatric emergencies, particularly in infants (< 1 year) and toddlers (1-3 years). Foreign body aspiration can result in potentially life-threatening airway obstruction, whereas foreign body ingestion may also constitute a time-critical emergency with a high risk of complications depending on the nature and location of the foreign body. This article describes the recognition, assessment and management of these emergencies in paediatric patients during prehospital emergency care.
