Ugeskrift for laeger
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On the basis of the literature, the development of war anaesthesiology is reviewed from the first war anaesthesia in 1847 until the present day. For nearly 100 years, ether was the main anaesthetic but, after the second world war, this was replaced by ketamine (Ketalar) which may be administrated by a simple injection or infusion. ⋯ Following a review of the advantages and disadvantages of ketamine as compared with inhalation anaesthesia under field conditions, it is concluded that ketamine is preferable in mobile units while larger and stationary units should have the possibility for employing current methods of anaesthesia also. A proposal is presented for standard anaesthesia in small units in situations in war and catastrophes.
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During a period of 16 years, prehospital advanced life support was provided for a total of 123 trauma patients. The average age was 32 years. Fifty-five patients were dead on the arrival of the mobile intensive care unit. ⋯ Out of the 63 treated patients, 27 suffered from respiratory failure, 23 were in shock and 35 were unconscious. Potential life-saving treatment in the form of intubation and/or massive intravenous infusion was provided for 24 patients, six of whom survived. On the basis of these results it is recommended that advanced prehospital life support should be extended also to include trauma patients.
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Ugeskrift for laeger · Jul 1989
[Mastectomy incisions and biopsy technics in view of subsequent reconstructive surgery in breast cancer].
Patients are referred to departments for plastic surgery increasingly frequently for breast reconstruction following mastectomy for cancer of the breast. Successful results depend greatly on the primary mastectomy carried out by surgeons without experience in reconstruction. It is particularly important that the incisions are suitably placed so that the final result can be satisfactory. ⋯ In four patients, the prosthesis had to be renewed on account of rupture during the subsequent years. Guidelines for placing the incisions at the primary mastectomy are suggested to facilitate successful reconstruction. Finally, a suitable biopsy technique is described.
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Ugeskrift for laeger · Jul 1989
[An mobile intensive care unit manned with medical personnel. Experience from a 16-year period].
An attempt is made to assess the value of a medically-staffed mobile intensive care unit which has functioned for 16 years at Holstebro Central Hospital. The medically-staffed ambulance responded to emergency calls concerning 2,048 patients. The average age was 56 years, 1,225 patients were men, 461 were women and in 362 cases the sex was not recorded. ⋯ Improvements in the existing prehospital emergency treatment are proposed. In particular, the alarm system should be changed. A medically-staffed mobile intensive care arrangement will render commencement of thrombolytic treatment possible in cases of acute myocardial infarction as early as possible.