Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
[Web-based for preanesthesia evaluation record: a structured, evidence-based patient interview to assess the anesthesiological risk profile].
At present, providers at an Anesthesia Preoperative Evaluation Clinic (APEC) may have difficulties in gaining access to relevant clinical information, including external medical records, surgical dictations etc. This common occurence makes obtaining an informed consent by the patient after a complete pre-anesthetic assessment difficult. This form of patient information is subject to wide interindividual variations and, thus, represents a challenge for quality assurance. ⋯ The basic practice is not changed by WACH. By means of WACH, the time point of the first contact with anesthesia is moved forward and occurs within a different framework. WACH has potential advantages for both patient and anesthesiologist, not least due to a higher patient safety.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
Case Reports[Intraosseous access on a 1300 g septical premature infant].
This article reports about the perioperative disposition of an intraosseous (IO) needle on a 15 days old critically ill premature infant (weight 1300g) in line with an urgent surgery and sole possible vascular access on circulation insufficiency. Due to vital danger there was perioperatively no time to place a large-bore vascular access in addition to the 2 lying 28G-submerging venous catheters with a minimal flow rate. ⋯ It was obvious, that a puncture of very small and weak bones is difficult and that a secure bone marrow puncture on infants beyond the weight category of 3 kg declared by the producer can be hard. Anyhow in case of emergency, an attempt is reasonable and useful, the effect after the application on the whole circulation situation was considerably verifiable.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
[Strategies for prevention of healthcare associated infection].
In light of the hazard of healthcare associated infection (HAI) and pandemic increase of multiresistant pathogens the prevention and control of HAI by implementing infection control strategies in a structured and systemic manner are becoming increasingly important in order to assure patient safety. A well balanced implementation of primary, secondary, and tertiary prevention in the format of a multibarrier concept together with surveillance of outcome measures are critical elements for a good hygiene practice. Criteria for structure-quality are optimal planned facility interieur supporting the clinical work-flow, adequate staffing of infection control practitioners and nurses, management of processes supporting infection prevention measures together with facility specific SOPs, and Surveillance and monitoring of the outcome together with feed-back to staff. Finally, any healthcare facility must be prepared for acute crisis such as outbreak management or management of critical incidences related to HAIs.