Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
-
About 80 % of all extremity amputations suffer from phantom limb pain following the operation. In this context, it is important to differentiate between painful phantom limb sensations, non-painful phantom limb sensations and residual limb pain. The pathophysiology of phantom limb pain is not fully understood. ⋯ Another significant aspect of therapy is senso-motory training, important to mention here would be mirror therapy, lateralisation and motor imaging. In case of an elective amputation, an epidural or axiliar plexus catheter should be considered prior to the amputation. The perioperative treatment with ketamine is debated.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2009
[Hemostasis management in multiple trauma patients--value of near-patient diagnostic methods].
Massively transfused multiple trauma patients commonly develop a complex coagulopathy which needs immediate treatment. Near-patient diagnostic methods are available for the management of this coagulopathy and for the guidance of the therapeutic options with blood products and haemostatic drugs: conventional laboratory analysis methods adapted to the point-of-care (POC) situation (blood gas analysis, point of care PT, APTT and platelet count), and the complex whole blood methods used for near-patient coagulation monitoring (thromboelastometry and platelet function analysis). Based on the new Guidelines of the German Medical Association for the use of blood and plasma derivates, interventions with blood products and haemostatic drugs in multiple trauma patients are suggested. The diagnostic value of near-patient methods for coagulation monitoring is discussed.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2009
[Risk communication in anaesthesia consultations].
It is the responsibility of all anaesthesiologists to inform their patients about the risk and benefits of available treatment options. It is also our duty to obtain the patient's informed consent. But how much information do patients want about risks, and how should this topic be approached during the preoperative consultation? In this article we will discuss risk perception in general and options to describe potential medical risks.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2009
[The German Protection against Infection Act (Infektionsschutzgesetz (IfSG))].
As a Federal law, the German Protection against Infection Act (Infektionsschutzgesetz (IfSG)) regulates the prevention and management of infectious diseases in humans. For the physician actively engaged in the management of patients, the requirement to report infectious diseases and the surveillance responsibility for specific nosocomial infections are of particular importance.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2009
Practice Guideline[Guidelines of the German Medical Association for Therapy with Blood Components and Plasma Derivatives--an introduction. Evidence-based recommendations for the risk-benefit analysis in hemotherapy].
The German transfusion laws authorize and instruct the German Medical Association to institute a working group to provide "Guidelines for Therapy with Blood Components and Plasma Derivatives" for the critical use of blood products to promote a standardized hemotherapy and to help to protect patients from avoidable risks. In particular, because the collection of such products requires the willingness of numerous volunteers to donate blood, the responsible and carefully considered application of blood products is mandatory. For the first time, the recommendations have been evaluated on evidence-based criteria and listed for many specific medical interventions so that comprehensive procedures can now be created for the transfusion personnel in hospitals and clinics.