Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2012
[Regional anaesthesia in obese patients: what's different?].
Basically regional anaesthesia offers a lot of advantages compared with general anaesthesia for obese patients, e.g. avoiding airway manipulation and systemic application of opioids. Although anesthesiologists are increasingly faced with obesity, regional anaesthesia poses a challenge because of missing landmarks, increased depth of nerval structures and difficulties in positioning these patients. ⋯ Ultrasound guidance may be an important aid but it is associated with specific phenomena caused by obesity. Further studies are needed to optimize regional anaesthesia techniques and dosing of local anaesthetics avoiding block failures as well to improve the patients' safety and outcome.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2012
[Prehospital treatment of polytrauma patients by emergency physicians].
Even in the 21st century major trauma still contributes to a svere loss of life in our society. Severly injured victims benefit from prehospital care that both considers tactical and medical aims. Knowledge of major trauma care has grown over the past years. ⋯ By putting up the new structure of german traumacenters involving certified trauma hospitals it is easier for ambulance doctors to find the best hospital for their patient. Thought has been given to nearly al organ systems and body-areas in the guidelines making them a very usefull orientation guide for prehospital care. Emergency anesthesie including intubation is a mayor issue of the new guidelines.