This research project aims to develop needs-based care services for low-priority requests for assistance in rescue control centres via the 112 number.
To this end, the data collected using structured and (internationally) standardised query and decision support software and the secondary data recorded in the dispatch system for low-priority requests for assistance received via the emergency number 112 in the Oldenburger Land (GOL) large-scale control centre will be analysed. Based on these results, case studies will be defined and discussed in focus group interviews with the aim of evaluating the actual need for care options for low-priority requests for assistance and identifying use cases with possible care paths.

The project is funded by the Central Institute of Statutory Health Insurance Physicians.

High-quality healthcare, close to the person seeking help, even if a doctor is not on site, that is the goal of the project "Smart Emergency - rescue services newly networked! 5G telemedicine networking". To this end, the potential of 5G for innovative medical care for patients in rural areas is to be tapped and the players in the healthcare system are to be more closely networked. In this way, challenges such as a high workload for nursing staff, a low density of doctors, a shortage of specialists and an increasing volume of emergency care can be addressed.

A 5G telemedicine case, which combines medical devices as basic elements and innovative applications such as augmented reality glasses, will be tested under ideal 5G conditions as part of this project where scarce resources are particularly valuable - in a retirement and nursing home and a hospital in the district of Cloppenburg, in order to test both non-acute teleconsultation hours and emergency care as areas of application.

To create the necessary 5G infrastructure, campus networks are being installed to ensure real-time vital data transmission, stable high-quality telemedical video connections and the functionality of medical devices. The long-term goal is to be able to transfer the tested applications to mobile use cases, such as the emergency services, on a large scale as the 5G mobile communications infrastructure expands.

The project, which is being funded by the Federal Ministry of Digital and Transport for three years, will be scientifically monitored and evaluated by the Oldenburg Research Network for Emergency and Intensive Care Medicine at the University of Oldenburg from December 2021. The applicant is the district of Cloppenburg, other partners are Ernst & Young GmbH Wirtschaftsprüfungsgesellschaft, St. Pius-Stift Cloppenburg, St. Josefs-Hospital Cloppenburg, Cloppenburg gGmbH, Klinikum Oldenburg AöR and ZTM Bad Kissingen GmbH

For a number of years now, the number of call-outs to the emergency services has been rising steadily. This is not due to an increase in life-threatening emergencies. Rather, the number of call-outs has increased where on-site care would be sufficient. Due to a lack of alternatives, the rescue coordination centres have not been able to adequately support patients in their unclear but non-life-threatening situation. Against this background, the health insurance-funded project "Community emergency paramedic" project was jointly developed by several partners - the Oldenburg professional fire brigade, the German Red Cross Cloppenburg, Malteser Hilfsdienst Oldenburg and Vechta and the Ammerland rescue service - and went live on 2 January 2019.

A total of 25 "community emergency paramedics" with additional training are on duty. In the event of an unclear request for assistance below the emergency threshold, the rescue coordination centre deploys the community emergency paramedic as a medical specialist on site and thus obtains a clear picture.
The aim is to avoid having to send an ambulance originally intended for emergency rescue directly to low-threshold operations. On site, the community paramedic provides direct assistance and, if necessary, draws on the network of outpatient care by seeking contact with the relevant authorities or the family doctor.
The community paramedic can also access telemedical support from the Oldenburg Clinical Centre if required to provide support in the emergency situation.

The project is being scientifically monitored and evaluated by the Oldenburg Research Network for Emergency and Intensive Care Medicine, Maastricht University and Oldenburg Hospital.

The care of patients in emergency situations is one of the most important tasks in the healthcare sector. In recent years, the number of patients in emergency departments and ambulance services has risen steadily, while the number of emergencies handled by on-call doctors has continued to fall. Expenditure on rescue services has risen enormously during this period: In 2005, a total of 2.6 million euros was spent on rescue services while in 2015 it was already 4.6 million euros. However, this is not due to an increase in life-threatening emergencies. Rather, more patients are using the ambulance service or emergency departments even though they could actually be treated locally. In four municipalities in the Oldenburg region, "community emergency paramedics" are helping to relieve the pressure on ambulance services and emergency centres. They assess the patient's emergency situation and treat them on site if necessary. If possible, the community paramedics also decide on further treatment. Community paramedics are deployed when a life-threatening injury or illness has already been ruled out by the control centre, but without personal contact with the patient it is not possible to decide whether they should be referred to another care facility.

The aim of the research project is to show the changes in the utilisation of ambulance services and emergency departments as a result of the deployment of community paramedics. In addition, the further care of patients will be mapped and, at the same time, data on safety and quality of care will be collected and evaluated. It is planned to evaluate control centre, ambulance service and emergency admission register data. In addition, patient and general practitioner surveys will be conducted. In this way, the researchers involved want to obtain a data basis to steer the project and, if necessary, expand it to other districts. The project will be funded for two and a half years with a total of around 1.1 million euros, with the project starting on 1 July 2020.

Consortium partners

Maastricht University; Otto von Guericke University Magdeburg; Rheinisch-Westfälische Technische Hochschule Aachen

Further information

• Information sheet for patients
• Information sheet GP
• Data protection concept
• Draft vote

In the "NurBeat"neurologicalrespiratory medicinestudy, detailed key figures were collected in June 2022 with regard to the structures of neurological respiratory medicine in terms of bed capacity, equipment, staff and qualifications as well as treatment methods and concepts and the characteristics of the patients treated there. The data collected should contribute to an understanding of the structures in place, the creation of necessary structural features and the improvement of patient care.

Background

In the field of neurological respiratory medicine, there has been a considerable expansion and differentiation of the care landscape in Germany over the last decade. Three specialist areas can be distinguished within neurological respiratory medicine:

• Ventilation in acute neurointensive care
• Weaning and neurological-neurosurgical early rehabilitation with ventilation, which can include the treatment of paraplegic patients
• Ventilation of neuromuscular patients with progressive ventilatory insufficiency

The exact bed capacities of neurological respiratory medicine are just as little known as the structural features provided in the areas of bed capacity, equipment, personnel, qualifications, treatment methods and concepts.

As a pilot study, the "NurBeat" project team and the other authors developed an online survey with 48 questions on the type and size of facilities, structural criteria, equipment and staffing, which was supported by the German Society of Neurology (DGN), the German Interdisciplinary Society for Out-of-Hospital Ventilation (DIGAB) and the German Society for Neurorehabilitation (DGNR) (Groß et al. 2019). A total of 63 facilities with a total of 687 neurological ventilation beds took part in the online survey. Most organisational units had extensive structures in terms of equipment, staff and qualifications, treatment methods and concepts, but no equipment was consistently available with the exception of neurophysiological electrophysiology. The care of non-clinically ventilated neurological patients showed potential for improvement in the areas of apparatus-based diagnostics. In addition, most organisational units did not have the option of providing long-term outpatient or inpatient care for patients with outpatient ventilation. Thus, two fundamental requirements could already be demonstrated: finding a consensus on the structural features required for the treatment of neurological ventilated patients, who are often complex and seriously ill, and improving the care of outpatient ventilated patients within the speciality of neurology.

However, the following problems were present in the pilot study: 1. no linkability of the data collected and 2. insufficient selectivity with regard to the exact type of facility. In particular, this meant that a more precise characterisation of the individual care models (acute care hospital, specialist hospital/rehabilitation clinic) was not possible.

In NurBeat, these problems are solved by creating a time-based sample with the collection of patient data and by specifying questions according to the type of facility - analogous to the ICU-CardioMan study (Funcke et al. 2016). The study is under the auspices of the German Society for Neurorehabilitation (DGNR) and is supported by the German Interdisciplinary Society for Out-of-Hospital Ventilation (DIGAB). We expect an exact characterisation of the structures of neurological respiratory medicine in Germany. This in turn can be a significant support for the development of structural features and future certifications in the future. In two areas in particular, specific structural characteristics would be helpful in ensuring the quality of care:

• Centres that carry out ventilation weaning and neurological-neurosurgical early rehabilitation
• Centres that carry out the adjustment and long-term care of out-of-hospital ventilated patients

We kindly ask you to support our study with your co-operation. We will keep you up to date on the status of the implementation on this page.

Dr Martin Groß Prof Dr Marcus Pohl Dr Oliver Summ Annette Weigel Prof Dr Rainer Röhrig

The study is supported by the Oldenburg Research Network for Emergency and Intensive Care Medicine. Further information can be found at: uol.de/nurbeat

Use of mechanical insufflation-exsufflation [MI-E] for ineffective cough in diseases of the
peripheral or central nervous system

Patients in neurological intensive care units, specialised weaning wards and rehabilitation units often suffer from a cough disorder. This can be caused by a reflex disorder or muscle weakness. Coughing disorders can lead to life-threatening secretions, atelectasis and pneumonia. A mechanical cough assistant (mechanical insufflation-exsufflation; MI-E) can be used to improve coughing ability, prevent atelectasis and mobilise secretions from the bronchi. MI-E is already established as a standard treatment for patients with neuromuscular diseases.

The aim of the study is to demonstrate the effectiveness of MI-E interventions in ventilated neurological patients by means of a monocentric, randomised, controlled intervention study. The study was conducted at the Evangelical Hospital Oldenburg.

As part of the study events organised by the Oldenburg Research Network for Emergency and Intensive Care Medicine (OFNI), your personal data will be processed. Below you will be informed about the data processing in accordance with Art. 13 GDPR.

1. Name and contact details of the controller

   University of Oldenburg, public corporation, legally represented by the President, Ammerländer Heerstraße 114 - 118, 26129 Oldenburg.

2. Contact details of the data protection officer

   The Data Protection Officer, Ammerländer Heerstraße 114 - 118, 26129 Oldenburg, phone: 0441 798 4196, email: .

3. Purposes and legal bases of processing

   1. Purposes of the processing
   2. Legal basis of the processing

   Your data will be processed for the implementation and organisation of study events (workshops, interviews).

   Your data will be processed on the basis of your consent in accordance with Art. 6 para. 1 lit. a GDPR. You can revoke your consent at any time by sending an email to the OFNI. You are not obliged to provide your personal data.

4. Recipients of the personal data

   The recipients of your personal data are the employees of the OFNI at the University of Oldenburg. Your personal data will be treated confidentially in accordance with the GDPR. We do not intend to pass on your personal data to third parties or to third countries without your consent.

5. Duration of the storage of personal data

   Your personal data will be deleted at the end of the respective study event as soon as it is no longer required, unless you separately consent to the longer storage of your personal data.

6. Rights of data subjects

   You have the following rights:

   Right of access (Art. 15 GDPR), right to rectification (Art. 16 GDPR),

   right to erasure (Art. 17 GDPR), right to restriction of processing (Art. 18 GDPR), right to data portability (Art. 20 GDPR), right to object (Art. 21 GDPR)

   You also have the right to lodge a complaint with the State Commissioner for Data Protection of Lower Saxony.

7. Right of cancellation

   You can revoke your consent at any time for the future. This does not affect the legality of the data processing carried out on the basis of the consent until the revocation.