Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2013
Historical Article[Development of emergency medical services in Germany - Western part of Germany].
Initially the premise of the rescue services was to deliver patients to medical care as quickly as possible. Due to the demands of the Heidelberger surgeon Kirchner a rethinking was initiated prior to World War 2. It was not until the 1960s that this concept was taken up again and physicians were incorporated into the rescue services. ⋯ After the economic and medical benefits of the deployment of emergency physicians had been demonstrated, the mandatory participation of emergency physicians was laid down in the laws on rescue services by the West German federal states. With increasing acceptance, there was a shift of the patient collective from accident victims to acute internal medical and neurological emergency cases. In order to realize the necessary efficacy of the cost-intensive organization the German Medical Council formulated guidelines for the qualification of emergency physicians.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2013
[Law on patient rights ("patientenrechtegesetz") - implications in the anesthesiological practice].
Since the beginning of the year the Law on Patient Rights ("Patientenrechtegesetz")has been in force and has to be obeyed in anesthesiological practice. It has especially specific consequences for the patient information about all possible risks. The present article takes a look at specific problems, such as the content of the information about the risks, the delegation of the conversation with the patient, the information about the risks in the case of an inability to consent or in the case of foreign-speaking patients and -last but not least - the documentation.
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A lifelong learning process is necessarily the basis for the specialization and expertise in the field of anesthesiology. Thus competency as a physician is a complex, multidimensional construction of knowledge, skills and attitudes to be able to solve and persist the complex daily work challenges in a flexible and responsible way. Experts therefore showflexible and intuitive capabilities in pursuing their profession. ⋯ However, there is beside the responsibility of the learners for their learning processalso a high obligation of the clinical teachers to attend the learning process and to ensure a positive learning atmosphere with scope for feedback. Some competencies potentially could be better learned in a “sheltered” room based on simulation outside the OR, for example to train rare incidents or emergency procedures. In general there should be ongoing effort to enhance the process of expertise development, also in context of patient safety and quality management.