Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Oct 2012
Review[Echocardiography in emergency admissions. Recognition of cardiac low-output failure].
Detection of acute cardiac dysfunction and differential diagnosis of low cardiac output syndrome is challenging for emergency physicians. For the critical ill patient it is essential to rapidly identify the underlying disease to initiate the correct therapy and optimize patient outcome. ⋯ The differentiation in preserved versus reduced left ventricular ejection fraction as a first assessment is helpful, particularly for physicians not well trained in echocardiography. The structured and focused approach to evaluate or exclude differential diagnoses of cardiac dysfunction is the key for optimal management of acute and critically ill patients with low cardiac output.
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Med Klin Intensivmed Notfmed · Oct 2012
[Ethic rounds in intensive care. Possible instrument for a clinical-ethical assessment in intensive care units].
Ethical problems, such as medical end-of-life decisions or withdrawing life-sustaining treatment are viewed as an essential task in intensive care units. This article presents the ethics rounds as an instrument for evaluation of ethical problems in intensive care medicine units. The benchmarks of ethical reflection during the ethics rounds are considerations of ethical theory of principle-oriented medical ethics. ⋯ In contrast to the clinical ethics consultation, the ethicist in the ethics rounds model is integrated as a member of the ward round team. Therefore ethical problems may be identified and analyzed very early before the conflict escalates. This preventive strategy makes the ethics rounds a helpful instrument in intensive care units.
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Med Klin Intensivmed Notfmed · Oct 2012
Review[Indirect laryngoscopy/video laryngoscopy. A review of devices used in emergency and intensive care medicine in Germany].
Airway management in intensive care or emergency medicine is particularly challenging and is often associated with life-threatening complications. An innovation in the field of airway management is the use of indirect laryngoscopy by means of video laryngoscopes. ⋯ However, the successful use in challenging intubations requires experience and regular use in daily practice. This review gives an overview of indirect laryngoscopes commonly used in Germany and also presents new study results for these novel devices.
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Med Klin Intensivmed Notfmed · Oct 2012
Review[Preventable mistakes during endotracheal intubation. Overview and concepts].
Endotracheal intubation is a standard procedure in anesthesiology as well as in intensive care medicine in many forms of assisted spontaneous breathing or controlled ventilation. In addition it continues to be the gold standard for airway protection in prehospital and in-hospital emergency medicine settings. Approaches will have to be considered to help prevent errors before they occur not only in the non-elective use of endotracheal intubation. The most common preventable situations are summarized in this paper.
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Med Klin Intensivmed Notfmed · Oct 2012
Case Reports[Severe organic dysphagia after long-term ventilation in a patient with sepsis and multiorgan failure].
A case of severe chronic dysphagia lasting more than 1 year after long-term ventilation due to sepsis is presented. Fiber optic endoscopic examination of swallowing (FEES) revealed retention of food on both sides of the base of the tongue and in both valleculae combined with severe penetration and postglutitive aspiration into the larynx. ⋯ The adhesion was resected using a CO(2) laser. The final examination 3 months later showed complete recovery of normal swallowing function.