Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
Review[Anesthesiological management of the drug-abusing parturient: relevance of maternal substance abuse for obstetric anesthesia].
Most of the female consumers of legal and illegal substances are of childbearing age. Occasional use, use disorder and addiction commonly devolve into each other. A lot of young women quit consuming when planning a family or at the latest with the knowledge of pregnancy. The ongoing substance abuse during pregnancy requires a coordinated interdisciplinary collaboration for a sufficient care of these highly complex and individual cases.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
Review[Perioperative antimicrobial prophylaxis].
Perioperative antimicrobial prophylaxis (AMP) is an important but not the only procedure to prevent surgical site infections. The effectiveness of AMP to prevent surgical site infections has been proven in numerous studies during the last decades and is part of national and international guidelines. ⋯ This article provides an overview on recommended antibiotics for AMP and their activity against the expected bacterial pathogens in elective surgery. Furthermore, the current spectrum of microorganisms most frequently isolated from surgical site infections and alternative antibiotic strategies are discussed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
Review[Transfusion medicine: does treatment of anemia reduce costs to the national health system?].
Preoprative Anaemia is an independent risk factor in perioperative medicine. Furthermore, preoperative anaemia is associated with higher treatment costs and remains the main risk factor for the transfusion of packed red blood cells. ⋯ Treatment of anemia as one pillar of patient blood management bears the potential to reduce costs to the national health system by prevention of complications and transfusion-associated morbidity. The economic impact of the treatment of preoperative anaemia versus the treatment with blood products requires prospective evaluation.
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Surgical site infections are the second or third most common type of nosocomial infections in Germany. For hospitals an annual incidence of 130000-160000 cases is estimated. Microbiological findings basically depend on type of surgery and wound location. ⋯ Subsequently the wound can be closed by secondary intention or lead to open wound healing. An accompanying therapy with antibiotics is recommendable in case of advanced local or systemic infection. To document wounds is an essential part of treating wounds.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
[Web-based for preanesthesia evaluation record: a structured, evidence-based patient interview to assess the anesthesiological risk profile].
At present, providers at an Anesthesia Preoperative Evaluation Clinic (APEC) may have difficulties in gaining access to relevant clinical information, including external medical records, surgical dictations etc. This common occurence makes obtaining an informed consent by the patient after a complete pre-anesthetic assessment difficult. This form of patient information is subject to wide interindividual variations and, thus, represents a challenge for quality assurance. ⋯ The basic practice is not changed by WACH. By means of WACH, the time point of the first contact with anesthesia is moved forward and occurs within a different framework. WACH has potential advantages for both patient and anesthesiologist, not least due to a higher patient safety.