Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2015
Review[Robot-assisted surgery in visceral and thoracic surgery gynaecology, urology - importantanaesthetic considerations].
Robot-assisted surgery, as a development of laparoscopic surgery, has an increasing field of application. Beside urology, this technique has also been implemented in visceral and thoracic surgery and gynaecology. For the surgeon an enhanced view of the surgical field and a better mobility of the instruments are the most important advantages. ⋯ Therefore, a standardised order and protection of all i. v.-lines, cables and the ventilation-hose of the (double-lumen) tube is essential. After the roboter is connected to the patient, it is nearly impossible to change or extend patient monitoring. Especially in case of emergency, e. g. respiratory complications or heart failure, a close communication with the surgeon and a team approach are indispensable.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2015
Review[Community acquired pneumonia in the emergence department - do standardized care bundles improve quality of care?].
Community acquired pneumonia (CAP) is associated with high in-hospital mortality. The initial correct diagnosis, risk assessment and initiation of treatment are responsibilities of the emergency department (ED). In Germany, emergency medicine is not well established nationwide and organized in a very heterogeneous manner. ⋯ In own investigations we demonstrated that implementation of systematic guideline based care bundles for pneumonia significantly improves quality of care in the ED subsequently leading to decreased mortality during hospitalization. Early standardized care bundles in the ED reduce length-of-stay in the hospital and the intensive care unit. Furthermore, those strategies are accompanied with an improvement of economic characteristics.