German Red Cross

About: German Red Cross is a healthcare organization based out in Berlin, Germany. It is known for research contribution in the topics: Transplantation & Mesenchymal stem cell. The organization has 653 authors who have published 1146 publications receiving 40111 citations. The organization is also known as: Deutsches Rotes Kreuz & DRK.

Development of an Adapted Model for Decision-Making to Improve Reasoning and Risk Assessment in an Emergency Team: A Prospective Simulation Study

Abstract: Background and Objectives: Medical staff is rarely trained in structured decision-making, relying instead on intuition without due consideration for the associated pros and cons. Materials and Methods: We adopted a model for decision-making to improve reasoning and risk assessment and carried out a prospective simulation study using paramedic students in a three-year training program. We conducted a training session in which participants were lectured on decision-making using the FAR-BEK model (German abbreviation for facts, alternatives, risks, competence, decision, control), physiological processes in decision-making under stress, as well as medico-legal aspects for the comprehension and justification of medical decisions. We analyzed pre- and post-training scenarios to elucidate the influence of training on decision-making. Results: Twenty paramedic students, with a mean age of 22.0 ± 1.7 years, took part in the study. The question of whether decision aids can be applied, initially affirmed by 40% of participants, rose to 71.4% (p = 0.011) following our training. Confidence in decision-making increased on a 7-point Likert scale from 4.5 to 4.8 points (p < 0.394). The reasoning behind the decisions rose from 5.3 to 5.6 points (p < 0.081). Indication, options, and risks rose significantly, from 5.4 to 6.1 points (p = 0.045). Overall, our simulation training significantly increased the points of decision support taken into account (57.8% vs. 88.9%, p < 0.001). Viewed individually, the largest increase of 180% was seen in risk assessment (33.3% vs. 93.3%, p < 0.002). The second largest increase of 150% was seen in the question of one’s own permissions (26.7% vs. 66.7%, p < 0.066). Also, the control increased (40.0% vs. 86.7%, p < 0.021). Conclusions: With a brief training course, both the awareness and the implementation of a structured decision-making model in paramedic students can be significantly increased. Nevertheless, no definitive conclusions can be made with respect to the implementation of real patient care. The application of structured, standardized decision-making tools may need to be further consolidated in routine medical use.

Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series

Abstract: In orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg-1 d-1. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6-22.4] g kg-1 d-1 to 17.4 [8.4-29.0] g kg-1 d-1 (P = 0.001), as did weight gain per kcal, from 0.08 [0.02-0.13] g kcal-1 d-1 to 0.11 [0.05-0.18] g kcal-1 d-1.Conclusion: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth. What is Known: • Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function. • Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants. What is New: • Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain. • Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.