On-scene times for helicopter services. Influence of central dispatch center strategy [Präklinische versorgungszeiten bei einsätzen der luftrettung. Einfluss der dispositionsstrategie der rettungsleitstelle]
Gries A.,University of Leipzig |
Stahl P.,Rot Kreuz Krankenhaus Kassel |
Spiess R.,Regierungsprasidium Giessen |
Luiz T.,Fraunhofer Institute for Experimental Software Engineering
Anaesthesist | Year: 2014
Background. Previous studies have suggested that when using several emergency systems and air rescue prehospital and on-scene times are extended, depending on the dispatch strategy. Emergency medical services (EMS) in Germany are delivered by ambulances (AMB) staffed by paramedics alone or with physicians (EMD) and by helicopter emergency medical services (HEMS) always staffed by both. The advantages of HEMS in countries with short transport distances and high hospital density are controversial. The best dispatching strategy for HEMS has not been determined. Objective. The BoLuS study in the German state of Hessen was designed to evaluate the influence of dispatch strategy on prehospital times for responses involving both HEMS and EMS. Methods. Rescue responses involving HEMS were prospectively evaluated in 12 regions of Hessen from July 2010 to September 2011. Although all regions had access to HEMS, only one had its own service. Data from both central dispatch centers and helicopter services were collected and combined to calculate the on-scene time (OST) and correlate it with dispatch strategy. Results. A total of 2111 emergency interventions were evaluated. Internal medicine emergencies accounted for 42.9 % of cases and trauma for 36.7 %. Just one patient was involved in 87.9 % of rescues. Two services were involved in 65.3 % of rescues and three or more in 31.5 %. The most common dispatch categories were initial dispatch of EMS and HEMS (50.6 %), initial dispatch of EMS with later request for HEMS (19.7 %) and initial dispatch of both EMS and EMD with later request for HEMS (17.4 %). The OST for these categories were 31.0 ± 13.7 min, 43.7 ± 16.2 min and 54.6 ± 21.3 min (p < 0.01), respectively. Conclusion. OST varies significantly depending on the number of EMS involved and the dispatch strategy. Sequential dispatching of ground and later HEMS wastes time. Getting an emergency physician to the scene as quickly as possible, reducing transport time to an appropriate hospital and caring for more complex emergencies are the main indications for HEMS. If HEMS appears likely to be needed, it should be dispatched immediately. © 2014 Springer-Verlag.
Schwarz D.,University of Gottingen |
Diesterbeck U.S.,University of Gottingen |
Failing K.,Justus Liebig University |
Konig S.,University of Gottingen |
And 4 more authors.
Journal of Dairy Science | Year: 2010
Somatic cell counts (SCC) are generally used as an indicator of udder health. Currently in Germany, 100,000 cells/mL is the threshold differentiating infected and noninfected mammary glands. The aim of our study was the detailed analysis of udder health in a representative part of the dairy cow population in Hesse, Germany. Between 2000 and 2008, 615,187 quarter foremilk samples were analyzed. In addition to evaluation of distribution of SCC and prevalence of mastitis pathogens, pathogen prevalence was also calculated depending on SCC. The data indicated that 38% of all samples had SCC >100,000 cells/mL and 62% showed SCC ≤100,000 cells/mL; 31% of all samples revealed SCC ≤25,000 cells/mL. Coagulase-negative staphylococci were the dominant pathogens in the Hessian quarter foremilk samples (17.17% of all samples) followed by Corynebacterium spp. (13.56%), Streptococcus uberis (8.7%), and Staphylococcus aureus (5.01%). Mastitis pathogens were detected in 83% of all samples with SCC >100,000 cells/mL. However, the prevalence of mastitis pathogens in the SCC range from 1,000 to ≤100,000 cells/mL was 8.5% (5.51% minor pathogens, 2.01% major pathogens, and 0.98% other pathogens). For farms producing high quality milk, exceptional hygiene management is compulsory. One of the farms randomly selected showed clearly different results from the Hessian survey. Fifteen percent more samples lay in the SCC range ≤100,000 cells/mL with a lower prevalence of mastitis pathogens of 1.91% (1.03% minor pathogens, 0.83% major pathogens, and 0.05% other pathogens). Based on these results, inflammatory processes can obviously be detected in mammary glands of udder quarters healthy according to the current definitions. However, we argue that such inflammation can be detected by examination of the relationship of immune cells in milk. © 2010 American Dairy Science Association.
Strecker T.,University of Marburg |
Uhlendorff J.,University of Marburg |
Diederich S.,University of Marburg |
Lenz-Bauer C.,Novartis |
And 10 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2012
In spring 2009, a new swine-origin influenza A (H1N1) virus emerged in Mexico. During the following weeks the virus spread worldwide, prompting the World Health Organization to declare the first influenza pandemic of the 21st century. Sustained human-to-human transmission and severe disease progression observed in some patients urged public health authorities to respond rapidly to the disease outbreak and vaccine manufacturers to develop pandemic influenza vaccines for mass distribution. With the onset of the pandemic we began to explore the potential of academic/industrial collaboration to accelerate the production of vaccines during an outbreak of an emerging virus by combining the use of an academic BSL-4 laboratory with the expertise of a commercial vaccine manufacturer. Methods and results: To obtain virus seed stocks used for the production of a vaccine to combat the pandemic H1N1 2009 influenza virus (H1N1pdm), we followed various strategies: (i) optimization of cell culture conditions for growth of wild-type H1N1pdm isolates; (ii) classical reassortment of H1N1pdm and standard influenza vaccine donor strain PR8; and (iii) generation of corresponding reassortant viruses using reverse genetics. To ensure a rapid transition to production, the entire potential seed stock development process was carried out in a certified canine kidney suspension cell line (MDCK 33016-PF) under Good Manufacturing Practice (GMP) conditions. Conclusions: The outcome of this study indicates that a combination of different experimental strategies is the best way to cope with the need to develop vaccines rapidly in the midst of an emerging pandemic. © 2012 by Walter de Gruyter • Berlin • Boston.
Sagkob St.,TU Munich |
Pache St.,Sachsisches Landesamt fur Umwelt |
Herrmann H.-J.,Landesbetrieb Landwirtschaft Hessen |
Wolter W.,Regierungsprasidium Giessen |
Bernhardt H.,TU Munich
Precision Livestock Farming 2011 - Papers Presented at the 5th European Conference on Precision Livestock Farming, ECPLF 2011 | Year: 2011
In a joint project a standard cluster and a new innovative cluster were compared. The new cluster (AktivPuls, System Happel) is characterized by an innovative liner design. The vacuum shut off in the massage phase leads to a vacuum reduction at the teat under all milking conditions even with zero milk flow. In a 2 × 7 herringbone parlour the standard and the control group (137 animals in total) was investigated for 127 days. The parameters of the milk removal as well as the udder health were all over the time of the trial reviewed with the analysis technology in the milking parlour and the livestock management program. For further investigations two LactoCorder recordings were implemented.
Schwarz D.,University of Gottingen |
Rivas A.L.,North Carolina State University |
Rivas A.L.,University of New Mexico |
Konig S.,University of Kassel |
And 5 more authors.
Journal of Dairy Science | Year: 2013
Lymphocytes play a significant role in the immunological processes of the bovine mammary gland and were found to be the dominant cell population in the milk of healthy udder quarters. The objective of this study was to investigate the quantitative relationship between CD2+ T and CD21+ B lymphocytes using flow cytometry. In a first study, quarter foremilk samples from apparently healthy udder quarters [somatic cell counts (SCC) ≤100,000cells/mL; n=65] were analyzed and compared with diseased quarters (SCC >100,000cells/mL; n=15). Percentages of CD2+ T cells were significantly higher in milk samples with SCC ≤100,000cells/mL than in those with SCC >100,000cells/mL, whereas percentages of CD21+ B cells developed in the opposite direction. As a result of this opposing trend, a new variable, the CD2/CD21 index-representing the percentages of CD2+ cells per CD21+ cells-was defined. Although diseased quarters with SCC >100,000cells/mL and the detection of major pathogens revealed generally CD2/CD21 indices <10, values >10 were observed in apparently healthy quarters. Hence, a CD2/CD21 index cutoff value of 10 may be suitable to aid differentiation between unsuspicious and microbiologically suspicious or diseased udder quarters. To test whether CD2/CD21 indices <10 were primarily related to pathogens, quarters with SCC ≤100,000cells/mL and >100,000cells/mL with different bacteriological status (culture negative, or minor or major pathogens) were selectively examined in a second biphasic study. In the first trial, 63 udder quarters were analyzed and 55 of these quarters were able to be sampled again in the second trial carried out 14 d later. In both trials, results of the first study were confirmed. Indeed, CD2/CD21 indices <10 were also found in quarters showing SCC ≤100,000cells/mL and containing minor or major pathogens at the time of the current or previous bacteriological analysis. The results of our examinations indicated a clear relationship between the CD2/CD21 index and the bacteriological status of the mammary gland. In combination with SCC, it offers a new marker for quick differentiation of unsuspicious and microbiologically suspicious or diseased udder quarters. © 2013 American Dairy Science Association.