Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2001
Review[Pain relief for vaginal delivery--an overview].
The multimodal aspects of labour pain, it's origin and effects, as well as the possibilities of it's treatment will be described from the obstetrician's point of view. This will include a comparison of methods in current common use during delivery including psychosomatic methods, physical methods, acupuncture, homeopathy, use of water, drug therapy as well as the use of local and regional anaesthesia. For particular discussion is the use of epidural catheter in delivery, with respect to availability, optimal timing and obtaining informed consent and it's documentation, as well as teamwork and clear interdisciplinary decisions concerning frequency and parameters of monitoring for epidural catheter anaesthesia following the motto: "how much is necessary, how little is possible?"
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2001
[10 years experience with extracorporeal membrane oxygenation].
Extracorporeal membrane oxygenation (ECMO) is a supportive therapy used for severe acute respiratory distress syndrome (ARDS). We present outcome, clinical parameters, and complications in a cohort of 245 ARDS patients of whom 62 were treated with ECMO. ⋯ ECMO is a therapeutic option for patients with severe ARDS, likely to increase survival. However, a randomized controlled study proving its benefit is still awaited. Until the development of a causal or otherwise superior therapy ECMO should be used in selected patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2001
[Hygiene status of ambulances and equipment in rescue services].
Focus on hygienic management in ambulances is presented based on findings from hygienic microbiological sampling. ⋯ Based on the results of hygienic microbiological analysis, the main focus of hygienic measures--besides hand disinfection--should be on spray disinfection of the sphygmomanometer cuffs and stethoscopes as well as disinfection of ambulance equipment and storage areas for sterile devices, supplemented by dust protection of ready-to-use materials and devices. Stationary dispensers for hand disinfection possessing at least midlength levers must become the standard in ambulances, and conventional handwashing basins with plastic drinking-water containers and pump must be eliminated entirely.