Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2014
Review[Invasive emergency techniques - Cricothyroidotomy].
On-scene invasive emergency procedures, such as cricothyroidotomy, chest drain, intraosseous puncture or even on-field-amputation, are often unavoidable, when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. ⋯ This article presents the use of cricothyroidotomy on adults and children, with reference to indication, implementation, problems and risks. It is part of a series of four articles on the subject of invasive emergency techniques.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2014
Review[Patient Blood Management - How does it work in practice? - The interdisciplinary cooperation].
Patient blood management (PBM), as a multidisciplinary, evidence-based treatment concept for reducing anemia and blood losses, should be realized in individual hospitals after local adaptation according to the available facilities. The implementation of a PBM program in clinical institutions will be a challenging but in every case worthwhile task. The local facilities may be insufficient to fulfill the training requirements of a large group of different personnel. ⋯ The formation of the core PBM team, in our case consisting initially of anaesthesiologists, surgeons, internists and transfusion medicine specialists as well as - the particularly important - motivated nursing personnel, is one of the most pressing and primary tasks in the establishment of a PBM project. It is also extremely important to firmly anchor the PBM project permanently within the hospital. Possible steps and details for this purpose are presented and discussed in terms of value and weighting by the authors on the basis of their actual experience in Frankfurt University Hospital.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2014
Review[Patient Blood Management - The inpatient care].
The multimodal concept of Patient Blood Management touches many aspects of in-hospital treatment. The goals are to preserve and strengthen the patients' own resources in order to avoid transfusion-associated adverse events. ⋯ The transfusion of allogeneic blood products shall be guideline-based only. The proposed package of measures has immense potential to increase patient safety!
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2014
Review[Patient Blood Management - The preoperative patient].
Preoperative anaemia is an independent risk factor for an increase in perioperative morbidity and mortality. Patient Blood Management (PBM) aims for an early detection of anaemia in elective surgery patients. ⋯ Such an outpatient PBM programme is only feasible, if anaesthesiologists, surgeons, haematologists, gastroenterologists, gynecologists, laboratory and transfusion medicine specialists work together in a PBM team using a common PBM plan. Communication within this team as well as with the patients' physicians in their private offices is key for a long lasting success of such a PBM programme.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2014
Review[Anaesthesiological management of patients with dementia].
The aging society challenges anaesthesiologists with a growing number of patients with dementia. These and their relatives worry about an aggravation of an already existing dementia or even the postoperative evocation of one. Common volatile anaesthetics and propofol are suspected to increase dementia - associated protein tau and amyloid-betalevels in the brain. ⋯ In dementia, perioperative malfunction of cognition, memory, attention, information processing, communication and social interaction abilities is of profound influence on the perioperative management. This review mentions actual knowledge about dementia forms and symptoms in brief. Recommendations for the anaesthesia care are given in more detail.