Alex Lechleuthner

• Professor MD PhD
• TH Köln - University of Applied Sciences

In 2018, the Graded EMS Care System (Gestuftes Versorgungssystem, GVS) was introduced into the Cologne emergency medical services (EMS). This is a classification tool (classes 0–7) for EMS personnel to classify patients at the scene in terms of their need for resources and the urgency of their treatment [4]. Since each GVS grade is assigned an EMS...

Zusammenfassung Terrorismus, Amok und in zunehmendem Maße auch die mögliche Notwendigkeit der Bündnis- und Landesverteidigung (BV/LV) stellen für Krankenhäuser in Deutschland eine ernst zu nehmende Herausforderung dar, auf die sie aktuell nicht ausreichend und aus baulichen Aspekten gar nicht vorbereitet sind. Für Krankenhausneubauten gibt es keine...

Point-of-care sonography is a precondition in acute and emergency medicine for the diagnosis and initiation of therapy for critically ill and injured patients. While emergency sonography is a mandatory part of the training for clinical acute and emergency medicine, it is not everywhere required for prehospital emergency medicine. Although some medi...

Point-of-care sonography is a precondition in acute and emergency medicine for the diagnosis and initiation of therapy for critically ill and injured patients. While emergency sonography is a mandatory part of the training for clinical acute and emergency medicine, it is not everywhere required for prehospital emergency medicine. Although some medi...

Zusammenfassung Die Point-of-Care-Sonografie ist in der Akut- und Notfallmedizin ein fester Bestandteil der Diagnostik und Therapieeinleitung von kritisch kranken und verletzten Patienten. Während die Notfallsonografie im Rahmen der Zusatzweiterbildung für klinische Akut- und Notfallmedizin vorausgesetzt wird, wird diese für die prähospitale Notfal...

Point-of-care sonography is a precondition in acute and emergency medicine for the diagnosis and initiation of therapy for critically ill and injured patients. While emergency sonography is a mandatory part of the training for clinical acute and emergency medicine, it is not everywhere required for prehospital emergency medicine. Although some medi...

Zusammenfassung Die Bekämpfung der Corona-Pandemie ist nicht nur kompliziert (das heißt in Teilen nur von Experten und Expertinnen verstehbar), sondern auch komplex (das heißt selbst von Experten und Expertinnen nur schwer prognostizierbar). In 2021 blieb die Corona-Pandemie mit den bis dahin bekannten Varianten in Deutschland unter anderem durch k...

März , 2020 [HINWEISE FÜR WISSENSCHAFTLICHE ARBEITEN ] Lechleuthner, Alex: Hinweise für wissenschaftliche Arbeiten-Rettungsingenieurwesen (Rescue Engineering) 1 Hinweise für wissenschaftliche Arbeiten (Hausarbeiten, Seminararbeiten, Projektarbeiten, Bachelor-Seminar, Bachelor-und Master-Arbeiten, etc.) von Prof. Dr.med. Dr.rer.nat. Alex Lechleuthne...

Objectives: The Pediatric Emergency Ruler (PaedER) is a height-based drug dose recommendation tool that was reported to reduce life-threatening medication errors by 90%. The PaedER was introduced into the Cologne Emergency Medical Service (EMS) in 2008 along with educational measures, publications, and lectures for pediatric drug safety. We review...

Zusammenfassung Der vorliegende Fallbericht einer erfolgreichen Reanimation beruht auf der Durchführung von suffizienten Maßnahmen der Wiederbelebung durch den Ehemann, als seine Frau beim gemeinsamen Joggen einen Herz-Kreislauf-Stillstand aufgrund von Kammerflimmern erleidet. Es erfolgt eine Nachbesprechung mit dem Ehepaar nach 7 Monaten.

Objectives Out-of-hospital cardiac arrest (OHCA) is associated with excessively high mortality rates. Recent studies suggest benefits from extracorporeal cardiopulmonary resuscitation (ECPR) performed in selected patients. We sought to present the first results from our interdisciplinary ECPR program with a particular focus on early outcomes and po...

Zusammenfassung Eine 62-jährige, normgewichtige Patientin wird an einem schwülwarmen Sommernachmittag (30° Celsius) nach initialer Synkope mit Bewusstlosigkeit im häuslichen Umfeld bei klinischem Verdacht auf ein akutes Koronarsyndrom (AKS) (retrosternale linksbetonte Schmerzsymptomatik, typische EKG-Veränderungen) präklinisch entsprechend der Leit...

PMID: 33750525 In some cases of COVID-19, profound life-threatening hypoxia has been observed without the patient perceiving symptoms. This phenomenon, referred to as silent hypoxemia, is not unknown in other settings, but was first described in the context of COVID-19 (1, 2) and occurred in our COVID-19 patient popu- lation with increased frequenc...

In the differential diagnostics for causality of a preclinical circulatory arrest (out-of-hospital cardiac arrest, OHCA), a pericardial tamponade must be considered as a possible cause. In emergency medical services a pericardial tamponade usually follows severe trauma or occurs as a life-threatening complication of acute thoracic aortic dissection...

Notrufnummern dienen als einfaches Kommunikationsmittel aller Hilfeersuchen der Bevölkerung in Notfällen. Es ist eine optimale Nutzung der Rettungsinstanzen sicherzustellen. Daher ist es notwendig herauszuarbeiten, inwieweit die Bevölkerung, zur Nutzung der Rufnummer des ärztlichen Bereitschaftsdienstes 116117, sensibilisiert ist. Sie stellt eine E...

Objectives The most commonly used medical classification instrument in emergency medical services (EMS) in Germany is the National Advisory Committee for Aeronautics (NACA) system. However, no connection between medical severity classification and emergency response (e.g., general practitioner; ambulance; ill-transportation car, emergency physician...

In part I, the emergency medical services (EMS) which is part of the public protection system in Germany that works together with police and fire departments is described. Both the development of the EMS and the public protection system are examined. The public protection system of fire departments and EMS is structured into a system for everyday u...

In diesem Teil I wird der Einbau des Rettungsdienstes in das System der Gefahrenabwehr in Deutschland im Rahmen der Beschreibung der „Architektur des Rettungsdienstes“ erläutert. Dabei wird sowohl die Entwicklung des Rettungsdienstes als auch die Weiterentwicklung der Gefahrenabwehr beleuchtet. Das Gefahrenabwehrsystem in Deutschland gliedert sich...

Mit der Adressierung von Anschlagsszenarien und ihrer Vorplanung im Hinblick auf die rettungsdienstliche Bewältigung reicht es nicht, die aus der taktischen Medizin stammenden Geräte (z. B. Tourniquets, Dekompressionsnadeln etc.) zu beschaffen und zu schulen, sondern es müssen auch die dazugehörigen Einsatzkonzepte lokal entwickelt und ausgebildet...

The Franco-German joint research project RE(H)STRAIN deals with the assessment of the vulnerability of the rail-bound high-speed system against the background of terrorist threats. The authors present a resilience approach which evaluates different security designs to protect high-speed train networks. As part of the critical infrastructure transpo...

Recent attacks on rail-bound public transportation systems such as in Brussels (2016/17), Mumbai (2006), London (2005), Madrid (2004) and Tokyo (1995) intensified the dilemma of securing critical infrastructure on the one side and constrict the degree of passenger freedom on the other side. The protection of “open systems” such as the high-speed tr...

Background. Mortality in patients with out-of-hospital cardiac arrest (OHCA) remains high despite advances in resuscitation algorithms. Most of these patients die on scene and do not reach the hospital. It is currently subject to discussion whether transport to hospital with ongoing cardiopulmonary resuscitation (CPR) improves survival and neurolog...

Eine junge Frau erleidet eine Woche nach stattgehabter Tonsillektomie eine Nachblutung in ihrem Elternhaus. Der alarmierte Rettungsdienst trifft die Patientin initial wach an. Aufgrund einer massiven Blutaspiration wird die Patientin jedoch rasch hypoxisch und wenig später reanimationspflichtig. Die endotracheale Intubation misslingt, sodass ein ch...

Comparison of the application safety of triage algorithms for mass casualty incidents (MCI) used by emergency medical services (EMS)

Background: Education of schoolchildren in cardiopulmonary resuscitation (CPR) is a strategic goal for improvement of bystander CPR in society. Objective(s): The primary objective was to analyse the impact of CPR training on the resuscitation knowledge and self-confidence of secondary schoolchildren. In addition, independent predictors of improv...

In the aftermath of the 2004 Indian Ocean Tsunami, about 70’000 people were relocated in Sri Lanka, most of them due to the implementation of a Buffer Zone by the government, which prohibited the reconstruction of permanent housing along the coastline. Relocation of such a huge number of people was made possible through the involvement and financia...

The threat by terrorist assaults in Europe has increased in the recent years. This requires rethinking emergency strategies by police, firefighters, EMS and hospitals. To develop a comprehensive concept for dealing with "threatening situations" the task force "Tactical Medicine" of the Scientific Working Group Emergency Medicine of the German Socie...

Die steigende Anzahl von Personen, die mit einem Beatmungsgerat zu Hause leben, bedeutet eine Herausforderung fur den Rettungsdienst, konnen diese Patienten doch wie jeder andere Mensch auch erkranken und arztlicher Hilfe durch den Rettungsdienst bedurfen. Die auserklinische Beatmung erfordert bei einem notwendigen Transport in ein Krankenhaus den...

Critical Infrastructure Protection (CIP) is a challenging operation for all involved organisations: Authorities, critical infrastructure providers and even policy makers. Integrated risk management is required to keep risks as low as possible and well-developed crisis management helps to mitigate the effects of events that have occurred. Achieving...

Der Rettungsdienst wird häufig aufgrund einer akuten Schmerzsymptomatik alarmiert (ca. 15 % aller Einsätze, ca. 25 % aller Notarzteinsätze). Eine wesentliche Erwartung an den Rettungsdienst ist, dass er möglichst schnell akute Schmerzen lindert. Diese Ausgangslage ist Hintergrund einer seit mehreren Jahren andauernden Diskussion über die Fragen, ob...

Objective: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positiv...

Seit 2014 gilt das Notfallsanitatergesetz. Doch auch fast 3 Jahre nach Inkrafttreten sind noch nicht alle Details geklart. Was ist gut gelaufen und wo gibt es Nachbesserungsbedarf? Diese Fragen beantwortet der Vorsitzende des Bundesverbands Arztlicher Leiter Rettungsdienst Deutschland, Prof. Alex Lechleuthner, im Interview.

Glücklicherweise fehlt den deutschen Krankenhäusern praktische Erfahrung im Umgang mit Terroranschlägen. Dennoch ist eine adäquate Vorbereitung auf ein solches Szenario wichtig. Bei terroristischen Anschlägen müssen Krankenhäuser nicht nur damit rechnen, eine Vielzahl von Verletzten gleichzeitig zu behandeln. Neben der rein medizinischen Patientenv...

Der Arzt im Notfall muss regelmäßig den Bewusstseinszustand feststellen und beschreiben. Eine Bewusstseinsstörung bis hin zur Bewusstlosigkeit ist zunächst eine unspezifische Störung, die von außen erkennbar wird, da die Person nicht mehr „reagiert“. Grundsätzlich gilt, je tiefer eine Bewusstlosigkeit ist, d. h. je weniger der oder die Betroffene s...

The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe. This was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligibl...

Collapsed buildings are one of the most complex challenges for rescue forces. The large amount of incoming information in particular is a major challenge to handle for the involved forces. The Assessment of this information is necessary in order to be able to give reliable statements about the number of buried and missing victims. To improve the ha...

Analyse und Hinweise zur Einsatzplanung von Krankenhäusern zur Bewältigung internen und äußerer Gefahrenlagen.

Dealing with terrorist attacks is a major challenge - especially for critical infrastructure protection when hazards cannot be described in normative risk management systems, e.g., anthropogenic threats with low probability but high consequences. Using the example of rail-bound public transportation, a multi-agent simulation of a terrorist attack o...

Critical Infrastructure Protection (CIP) is a challenging operation for all involved organisations such as authorities, critical infrastructure providers, and even policies. On one hand, an integrated risk management is required to keep risks as low as possible, on the other hand a well-developed crisis management helps to mitigate the effects of o...

Public transportation systems are vulnerable in many ways. They form an open and elaborate network used daily by many people, making them soft targets for man-made disasters such as terrorist attacks. Various past events (e.g. Madrid 2004, London 2005, and Mumbai 2006) underscored this phenomenon in a gruesome manner. Public transportation provider...

Critical infrastructure such as public transportation systems (PTS) play an important role in today’s society and economy. Any disturbance leads to manifold consequences in other systems. Man-made disasters such as terrorist attacks pose special challenges. Characteristically, PTS are elaborate networks with mostly open access at many different ent...

Background The Paramedics Act (“Notfallsanitätergesetz”, NotSanG) came into force on 1.1.2014. However, it remains unclear which specific (even invasive) procedures paramedics should be empowered to perform autonomously at their own discretion (§ 4 para. 2 no. 1c NotSanG) or within the scope of medical assistance procedures (§ 4 para. 2 no. 2c NotS...

Due to the increasing danger of terrorist attacks, it is necessary to determine the preventive effects of security measures installed in e.g. public transportation systems. Since, there is no common practice to determine the preventive effects; we developed two different methodologies to analyse those effects, both are suitable for the assessment o...

The resilience mechanisms of Critical Infrastructures (CIs) are often hard to understand due to system complexity. With rising research interest, models are developed to reduce this complexity. However, these models imply reductions and limitations. According to the level of observation, models either focus on effects in a CI system or on effects i...

Incidents such as flooding are often multinational and cross-border events. With climate change, such events have become all the more frequent, posing a challenge to disaster and emergency management institutions in coordinating action to cope with them jointly. This causes manifold problems in a common understanding of semantics, language, work pr...

The MCI-Benchmark is a method for scientific evaluation of MCI exercises, regardless of scenarios and concepts. Benchmarking has its seeds in controlling and market analysis approaches and has been transferred to the needs of MCI exercises by the authors. The MCI-Benchmark places the patients’ needs in focus of the evaluation process. Therefore the...

Mass casualty incidents are fortunately rare events. That is why it is difficult to collect reliable data from real incidents to verify concepts. But, as MCI deals with emergency situations, continuous improvement of concepts and training of staff are a must. Therefore, exercises or drills are carried out. But, there is a dearth of standardized cri...

Background: Different events affecting public transportation systems such as the Madrid bomb attacks in 2004 have exposed the vulnerability of open and complex infrastructure. Providers have to deal with these threats and prepare to prevent and respond. For a systematic identification and assessment of threats, a variety of appropriate risk managem...

In Germany a large variety of concepts exists to prepare and deal with mass casualty incidents (MCI). The rare occurrence of MCI scenarios and the lack of possibilities to reliably collect data in real incidents do not allow a retrospective analysis of these concepts. Therefore, MCI exercises are the only way to verify existing concepts and to comp...

In facing recent natural and man-made disasters Disaster Risk Reduction (DRR) and Climate Change Adaption (CCA) calls for integrative thinking and learning across cultures, disciplines and institutions. In times of increasing complexity, insecurity and uncertainty thinking outside the box becomes essential. This first volume of “Integrative Risk an...

Zusammenfassung Der Ärztliche Leiter Rettungsdienst (ÄLRD) ist in Deutschland eine Funktion, die beim öffentlichen Träger des Rettungsdienstes angesiedelt ist. Seit der ersten Beschreibung dieser Funktion durch die Bundesärztekammer im Jahr 1994 haben immer mehr öffentliche Träger des Rettungsdienstes diese Funktion eingeführt. Die Ansiedelung beim...

In times of increasingly interlinked critical infrastructures (e.g., electricity, transport, information/communication, health, media/culture, state/administration, finance, water and food supply chain) and the corresponding dependencies upon them, terrorist attacks are creating more and more dangers in new and manifold dimensions. A blackout of on...

Einsatz von Sensortechnik und Datenübertragung im Umfeld von Großschadenslagen und Massenanfällen von Verletzten : Abschlussbericht zum Forschungsprojekt: evalMANV ; Projektzeitraum: 01.09.2010 - 31.12.2012

Good management of acute stroke is dependent on time and expertise. In Germany emergency medical care by ambulance services sometimes occurs without an emergency physician being sent to the scene. By reviewing current literature the question of patient care in the ambulance with or without an emergency physician is discussed. Presence of an emergen...

This paper describes a methodology of exercise monitoring using qualitative and quantitative tools. These tools document the exercise time flow, gauge appropriate measures and decisions and collect feedback of exercise participants. These three elements provide a basis to assess the quality of the undertaken measures. The documentation of the opera...