Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2019
[Perioperative Neurocognitive Disorders - Postoperative Prevention Strategies].
Postoperative delirium (POD) is a common and serious complication after surgery. It is associated with increased morbidity and mortality as well as neurocognitive disorder and associated loss of autonomy and increased need for care. As professionals, it is our duty to treat our patients in a holistic individual concept with the aim to reintegrate our patients into their home and social environment afterwards. ⋯ Interprofessional cooperation plays just as important a role as the implementation of the listed preventive measures. Finally, the modified Hospital Elder Life Program is presented, which presents and applies preventive measures as a system-oriented and interdisciplinary concept, which "prevents functional decline and allows older adults to return home at the maximal level of independence". From our point of view, the training of a professional delirium team is a future-oriented complementary measure in the treatment concept of Perioperative Neurocognitive Disorders (PND), which finds its justification as an interface in the treatment of high-risk patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2019
[Recommendations for the Detection and Specification of Perioperative Neurocognitive Disorders].
Perioperative neurocognitive disorders (pNCD) are relevant to long term treatment outcome after elective surgery. The detection of pNCD is challenging and based on extended neuropsychological testing that often is not feasible due to economy driven time constraints during preoperative risk assessment. ⋯ In our article we provide an overview of the new recommended diagnostic criteria for pNCD based on the publication by the Nomenclature Consensus Working Group in November 2018. We discuss ideas for the implementation of clinical routine pNCD screening in patients aged 70 years or older with elective surgery and possible options for further support of patients screened positively and their families and care givers.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2019
[Child Abuse - Interdisciplinary Collaboration and Child Protection].
In Germany, the increasing focus on child abuse led to remarkable changes in recent years. The latest child protection laws (Kinderschutzgesetz, 2012) and the new medical guideline (AWMF S3+ Kinderschutzleitlinie, 2019) provide effective means for child protection services. ⋯ This article presents an update of the epidemiology, the legal situation, and the clinical manifestations concerning child abuse. With this information it foremost adresses medical professionals seeing children regularly without having a child protection team at disposal.