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Article ; Online: International efforts for improved terror preparedness: a necessity and an obligation.

Achatz, Gerhard / Bieler, Dan / Franke, Axel / Friemert, Benedikt

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2023 Volume 49, Issue 2, Page(s) 587–588

MeSH term(s)	Humans ; Hospitalization ; Terrorism
Language	English
Publishing date	2023-05-09
Publishing country	Germany
Document type	Editorial ; Comment
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-023-02251-7
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Article ; Online: Application of the PANELVIEW instrument to evaluate the guideline development process of the German polytrauma guideline.

Goossen, Käthe / Bieler, Dan / Weise, Alina / Nothacker, Monika / Flohé, Sascha / Pieper, Dawid

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2024

Abstract: Background: PANELVIEW is an instrument for evaluating the appropriateness of the process, methods, and outcome of guideline development and the satisfaction of the guideline group with these steps.: Objective: To evaluate the guideline development ... ...

Abstract	Background: PANELVIEW is an instrument for evaluating the appropriateness of the process, methods, and outcome of guideline development and the satisfaction of the guideline group with these steps. Objective: To evaluate the guideline development process of the German guideline on the treatment of patients with severe/multiple injuries ('German polytrauma guideline') from the perspective of the guideline group, and to identify areas where this process may be improved in the future. Methods: We administered PANELVIEW to the participants of the 2022 update of the German polytrauma guideline. All guideline group members, including delegates of participating medical societies, steering group members, authors of guideline chapters, the chair, and methodological lead, were invited to participate. Responses were analysed using descriptive statistics. Comments received were categorised by domains/items of the tool. Results: After the first, second, and last consensus conference, the guideline group was invited via email to participate in a web-based survey. Response rates were 36% (n/N = 13/36), 40% (12/30), and 37% (20/54), respectively. The mean scores for items ranged between 5.1 and 6.9 on a scale from 1 (fully disagree) to 7 (fully agree). Items with mean scores below 6.0 were related to (1) administration, (2) consideration of patients' views, perspectives, values, and preferences, and (3) the discussion of research gaps and needs for future research. Conclusion: The PANELVIEW tool showed that the guideline group was satisfied with most aspects of the guideline development process. Areas for improvement of the process were identified. Strategies to improve response rates should be explored.
Language	English
Publishing date	2024-02-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-024-02470-6
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Zs.A 1221: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: The potential of point-of-care diagnostics to optimise prehospital trauma triage: a systematic review of literature.

Stojek, Leonard / Bieler, Dan / Neubert, Anne / Ahnert, Tobias / Imach, Sebastian

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2023 Volume 49, Issue 4, Page(s) 1727–1739

Abstract: Purpose: In the prehospital care of potentially seriously injured patients resource allocation adapted to injury severity (triage) is a challenging. Insufficiently specified triage algorithms lead to the unnecessary activation of a trauma team (over- ... ...

Abstract	Purpose: In the prehospital care of potentially seriously injured patients resource allocation adapted to injury severity (triage) is a challenging. Insufficiently specified triage algorithms lead to the unnecessary activation of a trauma team (over-triage), resulting in ineffective consumption of economic and human resources. A prehospital trauma triage algorithm must reliably identify a patient bleeding or suffering from significant brain injuries. By supplementing the prehospital triage algorithm with in-hospital established point-of-care (POC) tools the sensitivity of the prehospital triage is potentially increased. Possible POC tools are lactate measurement and sonography of the thorax, the abdomen and the vena cava, the sonographic intracranial pressure measurement and the capnometry in the spontaneously breathing patient. The aim of this review was to assess the potential and to determine diagnostic cut-off values of selected instrument-based POC tools and the integration of these findings into a modified ABCDE based triage algorithm. Methods: A systemic search on MEDLINE via PubMed, LIVIVO and Embase was performed for patients in an acute setting on the topic of preclinical use of the selected POC tools to identify critical cranial and peripheral bleeding and the recognition of cerebral trauma sequelae. For the determination of the final cut-off values the selected papers were assessed with the Newcastle-Ottawa scale for determining the risk of bias and according to various quality criteria to subsequently be classified as suitable or unsuitable. PROSPERO Registration: CRD 42022339193. Results: 267 papers were identified as potentially relevant and processed in full text form. 61 papers were selected for the final evaluation, of which 13 papers were decisive for determining the cut-off values. Findings illustrate that a preclinical use of point-of-care diagnostic is possible. These adjuncts can provide additional information about the expected long-term clinical course of patients. Clinical outcomes like mortality, need of emergency surgery, intensive care unit stay etc. were taken into account and a hypothetic cut-off value for trauma team activation could be determined for each adjunct. The cut-off values are as follows: end-expiratory CO Discussion: A preliminary version of a modified triage algorithm with hypothetic cut-off values for a trauma team activation was created. However, further studies should be conducted to optimize the final cut-off values in the future. Furthermore, studies need to evaluate the practical application of the modified algorithm in terms of feasibility (e.g. duration of application, technique, etc.) and the effects of the new algorithm on over-triage. Limiting factors are the restriction with the search and the heterogeneity between the studies (e.g. varying measurement devices, techniques etc.).
MeSH term(s)	Humans ; Triage/methods ; Lactic Acid ; Point-of-Care Testing ; Point-of-Care Systems ; Brain Injuries, Traumatic/diagnosis ; Brain Injuries, Traumatic/therapy ; Wounds and Injuries/diagnosis ; Wounds and Injuries/therapy ; Emergency Medical Services/methods
Chemical Substances	Lactic Acid (33X04XA5AT)
Language	English
Publishing date	2023-01-26
Publishing country	Germany
Document type	Systematic Review ; Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-023-02226-8
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Zs.A 1221: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Update zur überarbeiteten S3-Leitlinie Polytrauma

Schweigkofler, Uwe / Seekamp, Andreas / Bieler, Dan

Notfallmedizin up2date

2023 Volume 18, Issue 02, Page(s) 137–152

Keywords	Schwerverletztenversorgung ; Behandlungsstandard ; Polytrauma ; Schockraumzuweisung ; Leitlinie
Language	German
Publishing date	2023-06-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2255461-0
ISSN	1862-6955 ; 1611-6550
ISSN (online)	1862-6955
ISSN	1611-6550
DOI	10.1055/a-2053-9561
Database	Thieme publisher's database

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Article: Prähospitale Versorgung von Schuss- und Explosionsverletzungen

Pavlu, Stefanie / Bieler, Dan / Pavlu, Florian / Kollig, Erwin

retten!

2023 Volume 12, Issue 02, Page(s) 96–107

Keywords	Schussverletzung ; Explosionsverletzung ; PHTLS ; MANV
Language	German
Publishing date	2023-04-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ISSN	2193-2395 ; 2193-2387
ISSN (online)	2193-2395
ISSN	2193-2387
DOI	10.1055/a-1983-5482
Database	Thieme publisher's database

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Article ; Online: EuroTrauma, delays in access to bleeding control. A comparison between a conventional and a hybrid trauma center, both European military trauma centers.

de Malleray, Hilaire / Hackenberg, Lisa / Cardinale, Michael / Kollig, Erwin / Schwab, Robert / Bordes, Julien / Bieler, Dan

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2024

Abstract: Purpose: Comparison of access times to CT and surgical/radiological bleeding control between two European military trauma centers.: Methods: Retrospective and observational study conducted in two military level 1 trauma centers in Toulon (France) and ...

Abstract	Purpose: Comparison of access times to CT and surgical/radiological bleeding control between two European military trauma centers. Methods: Retrospective and observational study conducted in two military level 1 trauma centers in Toulon (France) and Koblenz (Germany) between 2013 and 2018. Inclusion of severe trauma patients with ISS > 15 with clinical and biological criteria of bleeding. Results: Inclusion of 607 patients (318 in Toulon and 289 in Koblenz). Mean ISS 30. Median access time to CT significantly lower for Koblenz, 14 vs. 30 min; p < 0.001. Median access time to the emergency bleeding control lower in Toulon 84 min vs. 92 (p = 0.114). No impact on mortality at 24 h 9% in Koblenz and 11% in Toulon. Mortality at 28 days identical 17%. Conclusion: The organizational innovation at the military hospital in Koblenz saves time in the injury assessment. However, it has no impact on the access time to the scanner and on the mortality at 24 and 28 days. This fight against hemorrhage is a management bundle including delays, transfusion, and team training. Clinical trial registration: 2,002,878 v 0.
Language	English
Publishing date	2024-01-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-024-02455-5
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Zs.A 1221: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Versorgung von Kriegsverletzten aus der Ukraine in den Traumanetzwerken der DGU – Anspruch, Wirklichkeit und Motivation im Verlauf von 18 Monaten ….

Franke, Axel / Bieler, Dan / Dühr, Sandra / Friemert, Benedikt / Lehmann, Wolfgang / Matthes, Gerrit

Unfallchirurgie (Heidelberg, Germany)

2023 Volume 127, Issue 2, Page(s) 160–168

Abstract: Background: The war in Ukraine and the medical treatment of the wounded in hospitals in Germany has now represented a challenge for more than 15 months. The majority of trauma patients were distributed via the general holding center (GMLZ) at the ... ...

Title translation	Treatment of the wounded from the war in Ukraine in the trauma networks of the DGU-Requirement, reality and motivation over the course of 18 months….
Abstract	Background: The war in Ukraine and the medical treatment of the wounded in hospitals in Germany has now represented a challenge for more than 15 months. The majority of trauma patients were distributed via the general holding center (GMLZ) at the Federal Office of Civil Protection and Disaster Assistance (BBK) by the cloverleaf concept and the trauma networks. Initially, numerous offers of assistance were promoted with great solidarity. For documentation of the current motivation situation and also for identification of the potential for improvement, a 2-stage survey of senior physicians in the organized and certified hospitals in the trauma networks was carried out. Material and methods: An online survey of senior physicians of the trauma network hospitals was carried out with a semistructured written questionnaire in December 2022 and a follow-up survey during the Trauma Network Meeting (TNT) Congress in September 2023 in Frankfurt. Results: Of the questionnaires 113 could be evaluated in December 2022 and 70 completed questionnaires in September 2023. The answers came from national trauma centers (ÜTZ), regional trauma centers (RTZ) and local trauma centers (LTZ) each with approximately one third. On average 2.7 patients were treated in all participating hospitals up to December and up to September no more than 5 in more than half of the hospitals overall. The main challenges for all participants at both points in time were the long hospital stay, the demanding pathogen status and sometimes unclarified or not completely covered reimbursement of costs. Nevertheless, more than 80% of the specialist departments received backing from their hospital sponsors as well as their personnel for the continuing treatment of the wounded from Ukraine. Conclusion: The medical and professional challenges in the treatment of the wounded from Ukraine are, as expected, characterized by the demanding injury patterns of the musculoskeletal system and the colonization with multidrug-resistant pathogens. This results in a long course of treatment, where the remuneration does not always cover the costs. Despite these challenges the solidarity in the hospitals of the trauma networks is unbroken. Simultaneously, there are numerous possibilities for improvement in order to enhance the prerequisites for future comparable humanitarian assistance jointly with politics.
MeSH term(s)	Humans ; Motivation ; Ukraine ; Trauma Centers ; Hospitals ; Surveys and Questionnaires
Language	German
Publishing date	2023-12-18
Publishing country	Germany
Document type	English Abstract ; Journal Article
ISSN	2731-703X
ISSN (online)	2731-703X
DOI	10.1007/s00113-023-01395-w
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Terror preparedness as a service of general interest: the Terror and Disaster Surgical Care (TDSC®)-course.

Achatz, Gerhard / Bieler, Dan / Franke, Axel / Friemert, Benedikt

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2020 Volume 46, Issue 4, Page(s) 671–672

MeSH term(s)	Curriculum ; Disaster Planning ; Disasters ; Education, Continuing ; Emergency Medicine/education ; Europe ; General Surgery/education ; Germany ; Hospital Planning ; Humans ; Mass Casualty Incidents ; Personnel, Hospital/education ; Terrorism
Language	English
Publishing date	2020-08-13
Publishing country	Germany
Document type	Editorial ; Introductory Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-020-01454-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: An adapted 'Ottawa' method allowed assessing the need to update topic areas within clinical practice guidelines.

Goossen, Käthe / Bieler, Dan / Hess, Simone / Becker, Monika / Kalsen, Michael / Flohé, Sascha / Pieper, Dawid

Journal of clinical epidemiology

2022 Volume 150, Page(s) 1–11

Abstract: Objectives: To adapt and evaluate a method for assessing the need to update guideline topic areas involving multiple recommendations.: Study design and setting: The 'Ottawa method' uses literature signals to determine changes in evidence that trigger ...

Abstract	Objectives: To adapt and evaluate a method for assessing the need to update guideline topic areas involving multiple recommendations. Study design and setting: The 'Ottawa method' uses literature signals to determine changes in evidence that trigger a need to update individual guideline questions. We adapted the Ottawa method to include a process for aggregating updating signals by topic area (e.g., resuscitation) and tested this method using the German guideline on the treatment of patients with severe/multiple injuries. This involved a focused systematic evaluation of current evidence to identify updating signals and classifying the need to update for each topic area. Then, we surveyed the guideline group online about the modified method. Results: We conducted focused literature searches for 37 topic areas and screened a mean of 97 abstracts per topic area in 2021. The need to update was high for eight (21.6%), intermediate for eight (21.6%), and low for 21 topic areas (56.8%) based on updating signals. The survey response rate was 56% (24/43). Most guideline group members (94%, 16/17 responders) would use the Ottawa method again but their comments identified some weaknesses. Conclusion: The modified Ottawa method is a suitable, efficient tool to generate evidence-based updating signals for guideline topic areas involving multiple recommendations. Further fine-tuning is recommended.
Language	English
Publishing date	2022-06-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	639306-8
ISSN	1878-5921 ; 0895-4356
ISSN (online)	1878-5921
ISSN	0895-4356
DOI	10.1016/j.jclinepi.2022.06.003
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Uh III Zs.206: Show issues

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Article ; Online: Die extrakorporale Stoßwellentherapie als Therapiealternative bei posttraumatischer verzögerter Knochenheilung.

Hempe, Sebastian / Bieler, Dan / Braunegger, Grit / Schilling, Thomas / Waldeck, Stephan / Kollig, Erwin

Unfallchirurgie (Heidelberg, Germany)

2022 Volume 126, Issue 10, Page(s) 779–787

Abstract: Background: Impaired posttraumatic bone healing is a relevant complication of fractures. Usually, the standard treatment is surgical revision. For about 30 years extracorporeal shockwave therapy (ESWT) has emerged as an alternative treatment option with ...

Title translation	Extracorporeal shockwave therapy as an alternative treatment in cases of posttraumatic delayed bone union.
Abstract	Background: Impaired posttraumatic bone healing is a relevant complication of fractures. Usually, the standard treatment is surgical revision. For about 30 years extracorporeal shockwave therapy (ESWT) has emerged as an alternative treatment option with similar consolidation rates but less complications. Objective: This article aims to present our data in context to the current literature MATERIAL AND METHODS: From 2007 to 2016 a total of 97 patients diagnosed with impaired posttraumatic bone healing were treated with ESWT. Clinical and demographic data of this population were retrieved and analyzed retrospectively. Results: The general consolidation rate was 60.8%. Multiple variables were analyzed. A preinterventional bone gap ≥ 5 mm, initial dislocation > ½ of the bone shaft, nicotine consumption and a long time span from fracture to ESWT (> 6 months) were found as factors which significantly impair bone healing after ESWT. Conclusion: ESWT is a safe and promising alternative treatment option for delayed unions. Regarding risk factors of a poor outcome may be identified before and increase the rate of success.
MeSH term(s)	Humans ; Fractures, Ununited/surgery ; Extracorporeal Shockwave Therapy ; Treatment Outcome ; Retrospective Studies ; Fracture Healing ; Fractures, Bone/therapy
Language	German
Publishing date	2022-08-26
Publishing country	Germany
Document type	English Abstract ; Journal Article
ISSN	2731-703X
ISSN (online)	2731-703X
DOI	10.1007/s00113-022-01225-5
Database	MEDical Literature Analysis and Retrieval System OnLINE

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