Publications by authors named "S Betz"

95 Publications

Point-of-care testing in out-of-hospital cardiac arrest: a retrospective analysis of relevance and consequences.

Scand J Trauma Resusc Emerg Med 2021 Aug 30;29(1):128. Epub 2021 Aug 30.

Center of Emergency Medicine, University Hospital of Marburg, Baldingerstraße, 35043, Marburg, Germany.

Background: Metabolic and electrolyte imbalances are some of the reversible causes of cardiac arrest and can be diagnosed even in the pre-hospital setting with a mobile analyser for point-of-care testing (POCT).

Methods: We conducted a retrospective observational study, which included analysing all pre-hospital resuscitations in the study region between October 2015 and December 2016. A mobile POCT analyser (Alere epoc®) was available at the scene of each resuscitation. We analysed the frequency of use of POCT, the incidence of pathological findings, the specific interventions based on POCT as well as every patient's eventual outcome.

Results: N = 263 pre-hospital resuscitations were included and in n = 98 of them, the POCT analyser was used. Of these measurements, 64% were performed using venous blood and 36% using arterial blood. The results of POCT showed that 63% of tested patients had severe metabolic acidosis (pH < 7.2 + BE <  - 5 mmol/l). Of these patients, 82% received buffering treatment with sodium bicarbonate. Potassium levels were markedly divergent normal (> 6.0 mmol/l/ < 2.5 mmol/l) in 17% of tested patients and 14% of them received a potassium infusion. On average, the pre-hospital treatment time between arrival of the first emergency medical responders and the beginning of transport was 54 (± 20) min without POCT and 60 (± 17) min with POCT (p = 0.07). Overall, 21% of patients survived to hospital discharge (POCT 30% vs no POCT 16%, p = 0.01, Φ = 0.16).

Conclusions: Using a POCT analyser in pre-hospital resuscitation allows rapid detection of pathological acid-base imbalances and potassium concentrations and often leads to specific interventions on scene and could improve the probability of survival.
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August 2021

[Out-of-hospital cardiac arrest during lockdown].

Notf Rett Med 2021 Aug 24:1-6. Epub 2021 Aug 24.

Zentrum für Notfallmedizin, Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße, 35043 Marburg, Deutschland.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Consequences of infection prevention measures during such contagion events can cause disadvantages especially for patients in out-of-hospital cardiac arrest (OHCA).

Methods: Retrospective analysis of OHCAs in one county from January-May in 2018, 2019 and 2020, with the first appearance of the SARS-CoV‑2 pandemic in 2020 and a high incidence of the influenza virus in 2018.

Results: A total of 497 OHCAs were investigated (2018  = 173; 2019  = 149; 2020  = 175). In this study, a constant resuscitation incidence (85-99 resuscitations/100,000 population/year) and locally typical patients (mean 70 years, 66% male; median PES 3) were found. There were no statistically significant differences in the initial situation of the patients (number of observed OHCAs, frequency of lay resuscitations, suspected causes of OHCAs, initial ECG rhythm) and the treatment course (frequency of return of spontaneous circulation [ROSC]/hospital admission/survival to hospital discharge, neurological outcome). None of the OHCA patients in 2020 tested positive for SARS-CoV‑2 and 3 patients in 2018 tested positive for the influenza virus.

Discussion: The lockdown during the first wave of SARS-CoV‑2 pandemic does not seem to have affected the outcome of OHCA patients without coronavirus disease 2019 (COVID-19) in the end.
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August 2021

Preliminary examination of Coaching in Context with clients with spinal cord injury.

Spinal Cord Ser Cases 2021 Apr 13;7(1):27. Epub 2021 Apr 13.

Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA.

Study Design: Repeated measures pilot study.

Objectives: This study examined Coaching in Context when introduced to community-dwelling adults with spinal cord injury (SCI).

Setting: Urban community.

Methods: Three volunteers participated in up to ten, 45-60-min Coaching in Context sessions. Number of coaching sessions was recorded. Usefulness of Coaching in Context was examined by the Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling (GAS), and the Moorong Self-efficacy Scale (MSES). Data were examined descriptively.

Results: Preliminary examination of Coaching in Context revealed successful implementation with adults with SCI living in the community. Mean COPM performance and satisfaction scores increased by 2.55 (SD = 2.25) and 4.27 (SD = 2.41), respectively. With the exception of one, each goal achieved or exceeded GAS expected level. Changed MSES scores ranged from +7 to +16.

Conclusions: The ability to implement and evaluate Coaching in Context with three adults with SCI was demonstrated. Improvement in goals established for coaching was also documented.
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April 2021

Thriving after pediatric spinal cord injury: two life stories.

Spinal Cord Ser Cases 2021 Mar 26;7(1):25. Epub 2021 Mar 26.

Department of Occupational Therapy and the Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA.

Introduction: The primary objective of this qualitative study was to explore the lived experience of spinal cord injury (SCI) as described by life story interviews with two adults who sustained SCI as children.

Case Presentation: Data were collected by conducting 15 life story interviews with two individuals with SCI. Atkinson's Life Story Interview approach along with open-ended questions was utilized to capture the narrative data. Polkinghorne's narrative analysis of eventful data approach was used to configure the data elements into a story with the purpose of understanding the lived experience of SCI of these two individuals. Four themes relevant to the experience of living with a chronic condition emerged: adjustment to life with SCI, hardiness, interdependence, and post-traumatic growth.

Discussion: This study illustrated how the two participants' personal development and life trajectories were deeply shaped by pediatric-onset SCI. The life story interview process proved to be an effective approach to understanding the lived experience of SCI as told by two adults with pediatric-onset SCI. While the two participants represented unique contexts, their stories conveyed several cohesive, transcendent themes relevant to the experience of living with a chronic condition. Future narrative inquiry research in individuals with pediatric-onset SCI is necessary to build a representation of this population's lived experiences.
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March 2021

Carcinoma Ex-Pleomorphic Adenoma Diagnosis During Global Health Engagement Operations.

Mil Med 2021 01;186(Suppl 1):828-832

Department of Otolaryngology-Head and Neck Surgery.

Introduction: In global health engagement settings, performance of oncologic surgery is evaluated by understanding the host nation healthcare capacity to include inpatient care support and the available postoperative adjunctive therapy to include chemotherapy and radiation therapy.

Materials And Methods: We present a case during Pacific Partnership 2018 of a patientwith a malignant facial mass diagnosed postoperatively. A literature review was conducted, searching specifically for cases related to pleomorphic adenoma (PA), carcinoma ex-PA, cases of misdiagnosis, and global health engagement operations.

Results: The patient presented without constitutional symptoms, clinical lymphadenopathy, or cranial nerve VII weakness with a preoperative host nation diagnosis of a benign salivary neoplasm (PA). Postoperatively, a gross total resection of the mass was diagnosed as high-grade adenocarcinoma-a carcinoma ex-PA of the parotid gland. Oncologic staging was noted to be advanced at T3N0, and the patient was referred back to the host nation surgeons for radiation oncology consultation and clinical surveillance to follow.

Discussion: Diagnosis of carcinoma ex-PA-a rare form of salivary gland malignancy-is not always straightforward because of its high degree of cellular heterogeneity, leading to inconsistencies in preoperative sampling results. This case addresses the preoperative diagnostic challenges associated with this type of malignancy, different types of possible treatment modalities aimed at reducing postoperative morbidity, and the preoperative and postoperative challenges that are critical to address during health engagement operations.
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January 2021