Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2017
[Prevention of Perioperative Hypothermia - Guidelines for Daily Clinical Practice].
Inadvertent perioperative hypothermia (body core temperature < 36 °C) is a serious complication leading to increased rates of wound infection, higher blood loss associated with increased transfusion requirements as well as patient dissatisfaction among others. Body core temperature is a vital parameter and needs constant monitoring just like heart rate, blood pressure and arterial oxygen saturation. Patient-, anesthesia-, surgery- and environment-related risk factors were identified for occurring perioperative hypothermia. ⋯ A bundle of procedures has to be arranged in order to improve patient outcome. Steps include general (e.g. staff instruction), pre- (e.g. prewarming), intra- (e.g. active warming) and postoperative (e.g. drug therapy) actions. An effective concept for prevention of perioperative hypothermia has to be adjusted to departments' specific constructional, organizational, process-related and staff characteristics with clearly visible and assigned responsibilities.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2017
[How Much Alarm Can the Human Being Tolerate?]
Due to growing technisation of intensive care the number of devices with integrated alarm systems is steadily increasing. However, most of the sounding alarms are false alarms causing high levels of frustration, aggression and inappropriate behaviour amongst the medical personnel. ⋯ In the interest of the medical staff and our patients, we should reduce the high frequency of false alarms by using modern alarm algorithms techniques, lower both noise exposure and stress load with the help of modern individualized alarm systems and by increasing awareness on the dangers of alarm fatigue through training and by using individualized patient-related alarm limits. Despite economic challenges hospitals and intensive care units should optimize staffing, thereby lowering the risk to patients and improving employee satisfaction.