Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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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.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2014
Review[OR-management and self-improvement - a discrepancy?].
Today, operating room management is essential for a modern hospital. The strategic controls of this cost-intensive area and the ongoing cost pressure have necessitated management attention to this area. ⋯ For these fields data is needed to identify and measure the performance of these departments in the dimensions of finances, development, processes and patient's needs. The key performance indicators are exemplified for an anaesthesia department and discussed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2014
[OR management - Checklists for OR-design for OR-managers - results of a workshop].
The construction of an operating room (OR) suite represents an important intermediate- and long term investment. The planning process starts with the quantitative estimation of the procedures to be carried out which defines the operative capacity for the life time of the facility. This permits the calculation of the number of ORs and the definition of the resources for the recovery room, the intermediate care and intensive care unit. ⋯ Dedicated locations for a simultaneous preparation of the instrumentation tables permit parallel processing. Thus an adequate capacity of preparation rooms and storage rooms is necessary. Dressing rooms, rest rooms, showers and lounges are important for the working conditions and should be planned in an adequate size and number.
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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.