Ugeskrift for laeger
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Ugeskrift for laeger · Apr 2008
Letter Historical Article[Junior physicians in emergency service--then].
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Limited evidence on perioperative fluid management has resulted in large variability in administered fluid regimens with unknown implications for the outcome. Present data indicate fluid overload and hypovolemia to be equally deleterious, and individualized fluid therapy may be recommended in high-risk patients undergoing major elective surgery. Future studies should be procedure-specific and with standardized perioperative management with increased focus on the postoperative period.
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Esophageal perforation can within hours result in seriously-ill patients with a high risk of complications. The array of treatment options is many and minimal invasive methods are emerging. ⋯ The potential applications of thoracoscopic surgery as a minimal invasive treatment for esophageal perforations are discussed, as well as the advantages of a combination of videothorascopic drainage and placement of a covered expandable stent. This combination must be evaluated in future studies.
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Ugeskrift for laeger · Mar 2008
Comparative Study[How is out-of-hospital cardiac arrest dispatched?].
In Denmark any person needing urgent medical help can dial 112 and get in contact with an alarm centre where a non-health educated operator assesses what kind of help is needed. A specific dispatch report (DR) is used if an ambulance is dispatched. We assessed which DRs were used for the Copenhagen Mobile Emergency Care Unit (MECU) in the case of out-of-hospital cardiac arrest. ⋯ Only 32% of the cases with cardiac arrest had a correct DR. We suspect that some of the patients had an unrecognized cardiac arrest at the time of contact to the alarm centre. The current alarm system can presumably be improved. The alarm centre has a central role in such a quality improvement.