{"id":4425,"date":"2023-08-12T18:29:05","date_gmt":"2023-08-12T18:29:05","guid":{"rendered":"https:\/\/paeder.com\/23-08-blog-amendment-btmg"},"modified":"2024-09-29T14:30:03","modified_gmt":"2024-09-29T14:30:03","slug":"23-08-blog-amendment-btmg","status":"publish","type":"post","link":"https:\/\/paeder.com\/en\/23-08-blog-amendment-btmg","title":{"rendered":"23-08 Blog Amendment BtMG"},"content":{"rendered":"<div class='flex_column av-rdjk7q-28ed9cfe8f5a636518b4e319faa5c4d2 av_one_fifth  avia-builder-el-0  el_before_av_three_fifth  avia-builder-el-first  first flex_column_div '     ><\/div>\n<div class='flex_column av-q3d6ja-c951afafdca671481ddbe8e190a7e891 av_three_fifth  avia-builder-el-1  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-nnvbh2-92da7fdce75907944b5d406458d9c906\">\n.avia-image-container.av-nnvbh2-92da7fdce75907944b5d406458d9c906 img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-nnvbh2-92da7fdce75907944b5d406458d9c906 .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-nnvbh2-92da7fdce75907944b5d406458d9c906 av-styling- avia-align-center  avia-builder-el-2  el_before_av_hr  avia-builder-el-first '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" class='wp-image-4440 avia-img-lazy-loading-not-4440 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-1030x408.jpg\" alt='' title='Header BtMG 1920 x 761'  height=\"408\" width=\"1030\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-1030x408.jpg 1030w, https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-300x119.jpg 300w, https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-768x304.jpg 768w, https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-1536x609.jpg 1536w, https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-1500x595.jpg 1500w, https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-705x279.jpg 705w, https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-450x178.jpg 450w, https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761-600x238.jpg 600w, https:\/\/paeder.com\/wp-content\/uploads\/2023\/08\/Header-BtMG-1920-x-761.jpg 1920w\" sizes=\"(max-width: 1030px) 100vw, 1030px\" \/><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-mgzohi-4b2b862294489b3e900d1ec7053712fa\">\n#top .hr.hr-invisible.av-mgzohi-4b2b862294489b3e900d1ec7053712fa{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-mgzohi-4b2b862294489b3e900d1ec7053712fa hr-invisible  avia-builder-el-3  el_after_av_image  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-24nv9i-9d027e871302e6b53b8e70da7e53e30e'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: right;\">August 12, 2023<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-1xg3eu-4796fdceba2d7e9adc447e1f723d5c44\">\n#top .av-special-heading.av-1xg3eu-4796fdceba2d7e9adc447e1f723d5c44{\npadding-bottom:10px;\ncolor:#fc0001;\n}\nbody .av-special-heading.av-1xg3eu-4796fdceba2d7e9adc447e1f723d5c44 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-1xg3eu-4796fdceba2d7e9adc447e1f723d5c44 .special-heading-inner-border{\nborder-color:#fc0001;\n}\n.av-special-heading.av-1xg3eu-4796fdceba2d7e9adc447e1f723d5c44 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-1xg3eu-4796fdceba2d7e9adc447e1f723d5c44 av-special-heading-h2 custom-color-heading  avia-builder-el-5  el_after_av_textblock  el_before_av_hr '><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >Emergency paramedics allowed to administer narcotics<\/h2><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-h7x9me-be656bcca893897fd8392dfa604b2c3d\">\n#top .hr.hr-invisible.av-h7x9me-be656bcca893897fd8392dfa604b2c3d{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-h7x9me-be656bcca893897fd8392dfa604b2c3d hr-invisible  avia-builder-el-6  el_after_av_heading  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-fcf51y-51fea796ac3edd5d5bd487a34519547f'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>On July 27, 2023, several amendments to the BtMG entered into force [1]. The following (abbreviated) statement is decisive: <em>&#8220;Narcotics may be administered by emergency paramedics without a prior doctor&#8217;s order if they act in accordance with standardized medical instructions, the arrival of a doctor cannot be awaited and the administration is necessary to avert danger to health or to eliminate or alleviate significant discomfort.&#8221;<\/em> It is now up to the medical directors of the emergency services to define standardized procedural instructions and to create organizational conditions that guarantee safety aspects and the documentation obligation.<\/strong>  In principle, this is an opportunity for faster, adequate pain therapy and thus a significant improvement in patient care. The legal text contains no statement on the age of patients or whether children &#8211; and if so, at what age &#8211; should also benefit from this change in the law. <strong>Caution in pediatric emergencies<\/strong> From the point of view of pediatric medicine, particular caution and the involvement of experts with pediatric pharmacological knowledge are imperative when planning concepts. Significant aspects in this regard are also addressed in the S2K guideline &#8220;Medication Safety in Pediatric Emergencies&#8221; [2]. For example, it also refers to children with a highly elevated risk profile, reviews the relevant literature, and provides specific recommendations. The table from the guideline:  <\/p>\n<p style=\"padding-left: 40px;\"><em><span style=\"color: #777777;\"><strong><span style=\"color: #999999;\">Children at greatly increased risk for respiratory depression from opioids and\/or sedatives.<\/span> <\/strong><\/span><\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><span style=\"color: #666666;\"><em>Muscle weakness, muscular or neurological in origin<\/em><\/span><\/li>\n<li><span style=\"color: #666666;\"><em>Upper airway obstruction, obstructive sleep apnea syndrome<\/em><\/span><\/li>\n<li><span style=\"color: #666666;\"><em>Neurodevelopmental delays or limitations.<\/em><\/span><\/li>\n<li><span style=\"color: #666666;\"><em>Neurodegenerative diseases<\/em><\/span><\/li>\n<li><span style=\"color: #666666;\"><em>Various syndromal diseases<\/em><\/span><\/li>\n<li><span style=\"color: #666666;\"><em>Difficult anatomical conditions of the airway<\/em><\/span><\/li>\n<li><span style=\"color: #666666;\"><em>Renal function impairment<\/em><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div><\/section><br \/>\n<section  class='av_textblock_section av-ll8gtlrt-84b77b2a8a76227bf070879fe6b9d109'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><span style=\"color: #333333;\"><strong>Avoid dangerous dosing errors with the PedNFL <\/strong><\/span> In addition, dosing errors with opioids are particularly dangerous and must be urgently avoided. Using fentanyl as an example, it was shown that threatening dosing errors previously occurred in 44% of children and that the use of the Pediatric Emergency Narcotics Lateral (P\u00e4dNFL; <a href=\"https:\/\/www.paeder.com\">www.paednfl.de)<\/a> completely prevented such errors [3].<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-djhe3q-5f4963bdaeeaa4b234d2117094a795c0\">\n#top .hr.hr-invisible.av-djhe3q-5f4963bdaeeaa4b234d2117094a795c0{\nheight:40px;\n}\n<\/style>\n<div  class='hr av-djhe3q-5f4963bdaeeaa4b234d2117094a795c0 hr-invisible  avia-builder-el-9  el_after_av_textblock  el_before_av_button '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<div  class='avia-button-wrap av-cwjzli-b0e8ffb640718daba4ad8b21472f598a-wrap avia-button-center  avia-builder-el-10  el_after_av_hr  el_before_av_hr ' >\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-cwjzli-b0e8ffb640718daba4ad8b21472f598a\">\n#top #wrap_all .avia-button.av-cwjzli-b0e8ffb640718daba4ad8b21472f598a{\nfont-size:20px;\nbackground-color:#ffcd00;\nborder-color:#ffcd00;\ncolor:#444444;\n-webkit-transition:all 0.4s ease-in-out;\n-moz-transition:all 0.4s ease-in-out;\n-ms-transition:all 0.4s ease-in-out;\n-o-transition:all 0.4s ease-in-out;\ntransition:all 0.4s ease-in-out;\n}\n<\/style>\n<a href='https:\/\/paeder.com\/shop'  class='avia-button av-cwjzli-b0e8ffb640718daba4ad8b21472f598a avia-icon_select-yes-left-icon avia-size-large avia-position-center' ><span class='avia_button_icon avia_button_icon_left' aria-hidden='true' data-av_icon='\ue859' data-av_iconfont='entypo-fontello'><\/span><span class='avia_iconbox_title' >Order the P\u00e4dNFL\/P\u00e4dOP here<\/span><\/a><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-bchdue-2fcee5420bb48f3ce8d0424413feafe5\">\n#top .hr.hr-invisible.av-bchdue-2fcee5420bb48f3ce8d0424413feafe5{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-bchdue-2fcee5420bb48f3ce8d0424413feafe5 hr-invisible  avia-builder-el-11  el_after_av_button  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-zidxi-45374f804d2be1e3589bbfd438f5555a'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p class=\"EndNoteBibliography\"><strong>Literature:<\/strong><\/p>\n<ol>\n<li>Act to Combat Supply Shortages of Off-Patent Drugs and to Improve the Supply of Pediatric Drugs (Arzneimittel-Lieferengpassbek\u00e4mpfungs- und Versorgungsverbesserungsgesetz &#8211; ALBVVG). BGBl. 2023 I No. 197 dated 26.07.2023<\/li>\n<li>Kaufmann J, Rascher W, Neubert A, Eich C, Krebs M, Schwab R, et al. S2k Guideline 027\/071: &#8220;Medication Safety in Pediatric Emergencies&#8221; AWMF 2021; <a href=\"https:\/\/www.awmf.org\/leitlinien\/detail\/ll\/027-071.html\">https:\/\/www.awmf.org\/leitlinien\/detail\/ll\/027-071.html<\/a><\/li>\n<li>Kaufmann J, Roth B, Engelhardt T, Lechleuthner A, Laschat M, Hadamitzky C, et al. Development and Prospective Federal State-Wide Evaluation of a Device for Height-Based Dose Recommendations in Prehospital Pediatric Emergencies: A Simple Tool to Prevent Most Severe Drug Errors. Prehosp Emerg Care 2018; 22: 252-259.<\/li>\n<\/ol>\n<\/div><\/section><br \/>\n<div  class='av-social-sharing-box av-83zhwm-8f74be0d22884a61ad56b7539e9cda22 av-social-sharing-box-default  avia-builder-el-13  el_after_av_textblock  el_before_av_hr  av-social-sharing-box-fullwidth'><div class=\"av-share-box\"><h5 class='av-share-link-description av-no-toc '>Share post<\/h5><ul class=\"av-share-box-list noLightbox\"><li class='av-share-link av-social-link-facebook' ><a target=\"_blank\" aria-label=\"Share on Facebook\" href='https:\/\/www.facebook.com\/sharer.php?u=https:\/\/paeder.com\/en\/23-08-blog-amendment-btmg&#038;t=23-08%20Blog%20Amendment%20BtMG' aria-hidden='false' data-av_icon='\ue8f3' data-av_iconfont='entypo-fontello' title='' data-avia-related-tooltip='Share on Facebook' rel=\"noopener\"><span class='avia_hidden_link_text'>Share on Facebook<\/span><\/a><\/li><li class='av-share-link av-social-link-twitter' ><a target=\"_blank\" aria-label=\"Share on Twitter\" 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