Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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The attitude of humility in the context of surgical intensive care medicine incorporates a serving attitude towards the patient and the recognition of limitations in intensive care medicine. Limitations are set in the indications for intensive care medicine, in that which is medically possible and reasonable as well as ethically by the will of the patient which is binding for physicians. ⋯ It is absolutely necessary to recognize and avoid futile care because this involves the use of resources which will be lost for the care of other patients who would profit from intensive care. The formal difficulties in the definition and determination of futile care are discussed.
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Multiple trauma is an independent injury pattern which, because of its complexity, is responsible for 25 % of the costs for the treatment of all injured patients. Because of the often long-lasting physical impairment and the high incidence of residual permanent handicaps, it is apparent that multiple trauma can lead to a reduction in patient quality of life. ⋯ The fact that mortality after multiple trauma has decreased but not impairment of the quality of life makes it clear that in addition to the acute medical treatment, a follow-up treatment including not only physiotherapy but also psychotherapy is crucial for multiple trauma patients.