Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2014
Review[Patient safety - mission for the future - Healthcare-associated infections and antibiotic resistances].
Healthcare-associated infections (HAI) are considered as one of the major challenges for modern health care. In the context of demographic change and the expected increase of invasive and complex patient treatment and concommittantrise in numbers of patients with underlying diseases with susceptibility to infections, quality of care and patient safety will in the near future depend strongly on the prevention of HAI. To avoid preventable HAI in terms of improved quality of care is beyond question, therefore mainly the prevalence of highly resistant microorganisms (HRMO) will becrucial for the success of treatment of unpreventable HAI. ⋯ Especially in the Netherlands and Denmark HRMO such as MRSA, VRE and CRE/4MRGN are still significantly less common than in Germany or France. The reason lies in the fact that in nearly all Dutch hospitals anintegrative infectious disease service (clinical microbiology and/or infectious diseaseas wellinfection prevention) was established already years ago, while in Germany - with few exceptions - in most hospitals only a basic infectious disease services (consulting hygienist, microbiological diagnosis is held by laboratories often far away from the patient). As hospitals are connected with each other with respect to theircommon care of patients, one of the most important challenges in future infection prevention will be the implementation of regional and intersectoral infection prevention and control.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2014
Review[Resuscitation between the Guidelines].
The standards of treatment of patients suffering cardiac arrest is defined by international guidelines for cardiopulmonary resuscitation, that are updated every five years. Scientific knowledge is continuously increasing and recent studies should be considered and discussed to improve the results of daily emergency care. ⋯ The strategies of postresuscitation care are also in the focus of interest. This review presents and discusses the value of recent investigations on resuscitation science.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2014
Review[Patient safety- missionforthefuture - Recommendations for the management of severe treatment complications and burdensome courses (preventing the "second victim")].
Avoiding complications is a major goal of all patient safety efforts. We are used to working with all kinds of algorithms for avoiding adverse events or for the diagnosis and treatment of possible unforeseen or inadvertent complications in our patients. ⋯ Therefore, the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) has elaborated guidelines for the individual professional concerned, for the colleagues of doctors involved, as well as for the supervisors and hospital institutions. The aim of these recommendations is to encourage our professional society to set a focus on this problem and to offer a structured course of action for the case that a major complication occurs in spite of all our efforts to maintain our patient's safety.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2014
Case Reports[Case report: Aneurysmatic subarachnoid hemorrhage - Complicated course due to coincidental manifestation of an inverted Tako-Tsubo-cardiomyopathy].
We report the case of a patient who suffered a serious subarachnoid hemorrhage with a cardialaffection and development of an inverted Tako-Tsubo-cardiomyopathy. To avoid apparent cerebral ischemia due to severe cerebral vasospasm after exhaustion of conservative therapeutic options a temporarily endovascular therapy with continuous intra-arterial application of Nimodipine was necessary. In the overall protracted and complicated course the special challenge were the therapeutic efforts to avoid apparent cerebral ischemia in context to the significant cardial affection.