Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Sep 2015
[Clinical practice of systemic lysis in prehospital resuscitation. Success and complication rates].
Systemic thrombolysis was introduced as the sole prehospital treatment option in patients with cardiac arrest in the setting of acute myocardial ischemia or pulmonary embolism; however, it remains the subject of discussion. ⋯ The indication for systemic thrombolysis in the context of prehospital resuscitation should remain restricted to patients with clear symptoms of acute pulmonary embolism or recurrent episodes of ventricular fibrillation in the setting of acute myocardial infarction. Due to a lack of evidence, systemic thrombolysis should not be used as a treatment of last resort in younger patients with persistent ventricular fibrillation.
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Med Klin Intensivmed Notfmed · Jun 2015
Comparative StudyContinuous glucose monitoring on the ICU using a subcutaneous sensor.
Hypoglycemia is a frequent and feared complication of insulin therapy on the intensive care unit (ICU). Sedated patients in particular are at risk for hypoglycemia due to the absence of clinical symptoms. Furthermore, recent studies point to a correlation between the variability of blood glucose and mortality. Therefore, continuous glucose monitoring has the potential to influence outcome due to a better control of blood glucose in critically ill patients. ⋯ sCGM monitoring via a subcutaneous sensor demonstrated high accuracy and considerable variability compared to blood gas samples, even in critically ill patients.
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Med Klin Intensivmed Notfmed · Jun 2015
Review[Respiratory emergencies and airway management in children].
Respiratory emergencies in children are frequent and are caused by the specific airway anatomy and the susceptibility for infections. This article reviews the specific approach to pediatric airway management. According to the ABC guidelines of the European Resuscitation Council, the described algorithm should help to identify, classify, and treat such emergencies, giving those with less pediatric experience a tool for the management of respiratory illness in children. Focus is on the emergency care of the most common diseases in this age group.
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Med Klin Intensivmed Notfmed · Jun 2015
[Mild head injury in children and adults: Diagnostic challenges in the emergency department].
Mild head injuries are one of the most frequent reasons for attending emergency departments and are particularly challenging in different ways. While clinically important injuries are infrequent, delayed or missed injuries may lead to fatal consequences. ⋯ Established check lists of clinical risk factors for children and adults regarding traumatic brain injuries allow specific and rational decision-making for cranial CT imaging. Clinically important intracranial injuries can be reliably detected and unnecessary radiation exposure avoided at the same time.
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Med Klin Intensivmed Notfmed · Jun 2015
[Position paper for a reform of medical emergency care in German emergency departments].
The hospital emergency departments play a central role for the in- and outpatient care of patients with medical emergencies in Germany. In this position paper we point out some general financial and organizational problems of German emergency departments and urge for a higher significance of emergency care in the German health system as an element of public services. The corresponding reform proposals include a change in hospital financing towards a more budget-based system for the emergency departments, an improved structural planning for regional and transregional emergency care, an intensified cooperation with the emergency services of the ambulatory care physicians, a better organizational representation of emergency care within the hospitals and an advancement of emergency medicine in postgraduate medical education.