Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2013
Review[Should opioids be routinely used for the induction of general anaesthesia for caesarean section?].
The spinal anaesthesia, epidural anaesthesia or combinations of these techniques (combined spinal epidural anaesthesia) so far remain the gold standard to facilitate caesarean section. For some reasons such as refusal by the patients, medical reasons or emergency caesarean section, a general anaesthesia can be necessary. In patients with preeclampsia hypertension during endotracheal intubation has to be avoided. ⋯ To lessen cardiovascular response, short acting Remifentanil has advantages, e.g. the fast clearance rate in newborns. However, the risk for the newborn from respiratory depression has to be considered and experienced staff to care for the newborn should be present after childbirth. Therefore, an interdisciplinary approach seems to be vital to cope with adverse effects that may arise due to the more frequent use of opioids in conjunction with general anaesthesia for caesarean section.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2013
Review[Training concepts for in-hospital emergencies].
In this manuscript training concepts, which help us to manage in-hospital emergency situations adequately, are described. International courses such as the Basic Life Support Course and the Advanced Life Support Course of the ERC are introduced. ⋯ The quality of the medical emergency team in the hospital should be monitored to find deficits and to improve teaching. The use of the new in-hospital emergency chart and participation in the new emergency register of the DGAI may be helpful.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2013
Review[Aviation and high-altitude medicine for anaesthetists. Part 4: human performance limitations and crew resource management].
For pilots and doctors, as well as a variety of other professions the knowledge of human performance limitations is essential, especially in critical situations. Crew resource management was developed in the 1980s in the aviation industry in order to ensure systematic training and support in such instances. Just recently, the value is recognized not only in other high reliability organizations but also in medicine.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2013
Review Historical Article[Propofol up2date. Part 1: history and pharmacological characteristics].
Propofol is a common hypnotic agent in anaesthesiology and intensive care medicine and for procedural sedation as well. Despite the intensive usage the full potential, pharmacokinetic and -dynamic abilities, interactions and side effects of the substance may not be realized by all providers. ⋯ Propofol is a highly potent hypnotic with a wide range of (un)desired effects. This article is reviewing the diversity of the substance in clinical practice.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2013
Case Reports[Case report. Leukocytosis in the course of Clostridium difficile infection].
Clostridium difficile infections (CDI) are increasing in incidence and severity, amongst other reasons because of the increasing spread of hypervirulent strains. Leukocytosis is a sign of severe CDI and is predictive for a complicated course. ⋯ Leukemia-related therapy patterns were not needed. Notably, in none of the patients a hypervirulent strain was isolated.