Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2004
Case Reports[Malposition of a central venous catheter in a patient with severe chest trauma].
The placement of a central venous catheter is associated with specific risks including malposition of the catheter. We report the case of a 32 year old man who suffered from a severe thoracic trauma including haematopneumothorax on his left side. In the emergency room a large-bore central venous catheter was placed in the left subclavian vein, after blood had been aspirated successfully. ⋯ Haematothorax was caused by a laceration of the upper lobe of the left lung with severe bleeding from great vessels. This case shows that successful aspiration of blood does not exclude malposition of a central venous catheter. Correct position of the catheter must be verified using appropriate methods including chest X-ray, intracardiac ECG tracing or display of the central venous pressure curve on a monitor.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2004
Randomized Controlled Trial Clinical Trial[Is ginger a relevant antiemetic for postoperative nausea and vomiting?].
Ginger (Zingiber officinale) has traditionally been used in China for gastrointestinal symptoms, including nausea and vomiting. A recent systematic review on the possible antiemetic effect of ginger for various indications, including PONV, morning sickness, and motion sickness, concluded that ginger was a promising antiemetic herbal remedy, but the clinical data were insufficient to draw firm conclusions. Since that publication, additional data has accumulated and thus an updated meta-analysis was performed. ⋯ Ginger is not a clinically relevant antiemetic in the PONV setting.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2004
Comparative Study[SNAP-index and bispectral index during induction of anaesthesia with propofol and remifentanil].
Measurement of "depth of anesthesia" is of enormous interest to the anesthesiologist. New monitor systems, based on the electroencephalogram (EEG) were developed. The aim of the present study was to compare the SNAP index and the Bispectral index during induction of anesthesia with propofol and remifentanil. ⋯ SNAP index and BIS were reliable parameters to distinguish different levels of sedation, but SNAP index was not able to reflect the analgesic potency of remifentanil during propofol infusion.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2004
[Intensive care within the context of military long-distance transport].
Due to the changed task spectrum of the German Federal Armed Forces with participation in international deployments for UN and NATO the concept of Aeromedical Evacuation (MedEvac) gained a new quality for the Air Force as well as for the Medical Corps. The transport of mostly severely injured or critically ill patients requires both, medical equipment which has to be permanently adapted to the national standard, and qualified intensive-care-personnel. At present, the aircrafts used for such deployments are four C-160 Transall, one CL-601 Challenger and two Airbus A310, which, if necessary, can be equipped with one or more intensive-care "patient transportation units" (PTU). ⋯ The PTU corresponds to the technical equipment of the intensive care unit of a level-1-trauma centre and ensures an intensive-care therapy on highest level also during longer transportation. The work with this equipment, the characteristics of the long-distance air transport and the special situation of the military deployment causes special demands on the qualifications of the assigned personnel. Primarily planned for the repatriation of injured or ill soldiers, in the mean time, this concept is also essential for the medevac of civilian victims after mass casualties worldwide.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2004
Biography Historical Article[Adam hammer (1818 - 1878) - remarks on a forgotten pioneer of ether anaesthesia in obstetrics].
Adam Hammer, born in 1818, and working as a doctor for the poor since 1847 in Mannheim, was the first person in the German speaking world to use ether for pain relief during labor on February 18th 1847. He took part in the abortive April 1848 Revolution in Mannheim - a pinnacle of German liberalism and later of political radicalism, which attented to abolish the Monarchy and introduce a democratic Republic. After the revolution was put down, Hammer emigrated to the United States and settled down in St. ⋯ In 1877 he returned to Germany and died one year later. The biography of Adam Hammer mirrows that of many other German-Americans whose emigration proved to be a gain for America but a loss for Germany. This story was destinated to be repeated in terrible circumstances some decades later.