Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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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.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2014
Review[Patient safety - mission for the future - The importance of CriticalIncidentReportingSystems (CIRS)in clinical practice].
Every day patients experience harm due to errors and complications. To improve this situation, patient safety is increasingly becoming important in the treatment process. ⋯ Observers and members of the care team are given the opportunity to anonymously report critical incidents and thus allow an analysis by an evaluation team. The goal is not to sanction the behavior of an individual, but to identify particular structural and organizational sources of error and to derive improvements.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2014
Review[Patient safety - mission for the future - Managing with Complications: What do I Tell the Patients and What the Relatives?].
In cases of unintended treatment courses an adequate communication is mandatory. Empathetic conversations expressing human warmth can pave the way to the avoidance of forensic consequences. ⋯ The patient has a right to view his or her complete patient records and to demand that copy be made at the patient's expense. In the case of information to relatives the physician must observe the content and scope of his/her obligation to medical confidentiality.
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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.