-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Medical errors frequently contribute to morbidity and mortality. Prehospital emergency medicine is prone to incidents that can lead to immediate deadly consequences. Critical incident reporting can identify typical problems and be the basis for structured risk management in order to reduce and mitigate these incidents. METHODS: We set up a free access internet website for German-speaking countries, with an anonymous reporting system for emergency medical services personnel. After a 7-year study period, an expert team analysed and classified the incidents into staff related, equipment related, organisation and tactics, or other. RESULTS: 845 reports were entered in the study period. Physicians reported 44% of incidents, paramedics 42%. Most patients were in a life-threatening or potentially life-threatening situation (82%), and only 53% of all incidents had no influence on the outcome of the patient. Staff-related problems were responsible for 56% of the incidents, when it came to harm, 78% of these incidents were staff related. CONCLUSIONS: Incident reporting in prehospital emergency medicine can identify system weaknesses. Most of the incidents were reported during care of patients in life-threatening conditions with a high impact on patient outcome. Staff-related problems contributed to the most frequent and most severe incidents.
Emergency Medicine Journal 01/2013; · 1.44 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: [Me(4) N](+) [SO(2) F(3) ](-) , the first example of a [SO(2) F(3) ](-) salt, has been prepared from Me(4) NF and SO(2) F(2) . The colorless, microcrystalline solid was characterized by its infrared and Raman spectra. The trigonal bipyramidal structure of C(2v) symmetry of the [SO(2) F(3) ](-) anion is predicted by ab initio calculations. Two oxygen atoms with d(SO)=143.2 pm and one fluorine atom with d(SF)=157.9 pm occupy the equatorial plane. The two fluorine atoms in the axial position with d(SF)=168.5 pm are repulsed by the two oxygen atoms forming a bent axis with ∡(F(ax) SF(ax) )=165.2°.
Chemistry 01/2011; 17(3):925-9. · 5.93 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Dimethyltrifluorophosphorane reacts with strong fluoride donors, such as CsF, Me(4)NF, and Me(4)PF, under formation of dimethyltetrafluorophosphates. The salts were characterized by infrared and Raman spectroscopy and in acetonitrile solutions by NMR spectroscopy. The experimental results show that only the trans isomer is formed. Theoretical calculations (B3LYP/6-31+G* and RHF/6-31+G*) of the trans and cis isomer yielded a difference of the Gibbs free energy of 29.4 kJ/mol (B3LPY/6-31+G*). The Me(4)N(+)[Me(2)PF(4)](-) crystallizes in the orthorhombic space group Pnma with four formula units per unit cell and dimensions of a = 1303.5(3), b = 799.8(2), and c = 1023.8(4) pm. The phosphorus atom has an octahedral environment with P-C distances of 183.4(3) pm and P-F bond lengths in the range between 166.1(1) and 168.2(1) pm. In the crystal packing, anions and cations are linked via weak fluorine hydrogen contacts forming a three-dimensional network.
Inorganic Chemistry 07/2010; 49(14):6421-7. · 4.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We wanted to identify incidents that led or could have led to patient harm during prehospital cardiopulmonary resuscitation. A nationwide anonymous and Internet-based critical incident reporting system gave the data. During a 4-year period we received 548 reports of which 74 occurred during cardiopulmonary resuscitation. Human error was responsible for 85% of the incidents, whereas equipment failure contributed to 15% of the reports. Equipment failure was considered to be preventable in 61% of all the cases, whereas incidents because of human error could have been prevented in almost all the cases. In most cases, prevention can be accomplished by simple strategies with the Poka-Yoke technique. Insufficient training of emergency medical service physicians in Germany requires special attention. The critical incident reports raise concerns regarding the level of expertize provided by emergency medical service doctors.
European journal of emergency medicine: official journal of the European Society for Emergency Medicine 05/2010; · 0.73 Impact Factor
