Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2013
[Flight and altitude medicine for anesthetists-part 3: emergencies on board commercial aircraft].
The demographic trend of industrialized societies is also reflected in commercial airlines' passengers: passengers are older nowadays and long-haul flights are routine mode of transport despite considerable chronic and acute medical conditions. Moreover, duration of non-stop flight routes and the number of passengers on board increase. Thus, the probability of a medical incident during a particular flight event increases, too. ⋯ Besides flight operations and technical aspects, the medical infrastructure on the ground has to be considered carefully. Regardless of the amount of experience of a physician medical emergencies on board an aircraft usually represent a particular challenge. This is mainly due to the unfamiliar surroundings, the characteristics of the cabin atmosphere, the often existing cultural and language barriers and legal liability concerns.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2013
[Perioperative fluid management in infants and toddlers].
The more than 50 years ago of Holiday and Segar created fundamentals of fluid therapy with sodium hypotonic solutions require revision. Hypotonic electrolyte solutions should not be longer used perioperatively. To maintain the water balance in the perioperative phase stable, children need balanced electrolyte solutions, corresponding to the composition of the extracellular space. ⋯ Fasting deficit and intraoperative maintenance requirement will be covered by an increased rate of infusion of a balanced electrolyte solution. Intraoperative losses and correction needs to be replaced according to clinical criteria. Balanced electrolyte solution with and without 1% glucose are very safe with respect to hyponatremia, hypo-and hyperglycemia, and accidental overinfusion.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Review[Outpatient anesthesia--the office-based anesthetist].
The aim of the present article is to describe the field of activity and prevailing conditions for office-based anesthetists in Germany. From the introduction of outpatient operations on the basis of actual numbers, data and facts, we present the project profile and the structures of the different fields of activity and practice constellations for office-based anesthesiology. ⋯ With the aid of current numerical data the anesthetic procedures performed in the outpatient field through to the possibilities for development of continuous regional anesthetic procedures in catheter technique are illustrated. In conclusion, we discuss the economic conditions and the health-care economic significance together with a description of the current health-care quality of ambulant anesthesiology and the possibilities for participation in an error-reporting system.