Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2014
Review[Diclofenac up2date - Part 1: Pharmacology and comparison with other drugs].
The non-opioid analgesic diclofenac is used worldwide for musculoskeletal and perioperative pain therapy. Despite its frequent use and easy access as an "over the counter" drug, gastrointestinal, cardiovascular, and renal adverse drug effects have to be considered. Availability of diverse formulations (e.g. tablets, suppository, gel-formulations) with different indications, dosage recommendations and contraindications may easily lead to confusion, thus accounting for inadequate use on the one hand or withholding of an effective analgesic. This review may provide physicians in perioperative medicine, intensive care and pain therapy with important and suitable information about the pharmacology and appropriate use of this drug.
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Operating theaters are strongly linked to other units in a hospital such as the ICU, the wards and the emergency room for example. Good management skills are necessary to improve the productivity by 2-3 percent per year. To reach these goals resources' such as personnel, IT-systems, specific equipment and the adherence to professional standards are required. ⋯ OR managers should focus on logistics, IT-systems, capacity planning, quality standards and communications. The coordination of the daily workflow should be delegated using proper rules and standards and being supported by IT. Efficiency of the unit is important, but should never over rule patient outcome and safety.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2014
Review[Invasive emergency techniques - intraosseous devices].
On-site invasive emergency procedures, such as cricothyroidotomy, chest drainages, intraosseous puncture or the even rarer on-site amputations, are often unavoidable when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. ⋯ In this article we describe the use of intraosseous devices on adults and children, with reference to the indication, implementation, problems and risks. It is the third part of a series of four articles on the subject of invasive emergency techniques.