Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2010
Review[Training for real: simulation, team-training and communication to improve trauma management].
The focus on the role of non-technical skills such as communication, dynamic decision making, situational awareness and teamwork in emergency medicine has gained importance over the past few years. Especially during time-critical and complex treatment of severely injured patients in a multidisciplinary and interprofessional trauma-team these factors play an important role for patient-safety and process optimization and are a key factor influencing the perceived quality of a given scenario by the team members. ⋯ For the improvement of non-technical skills, particularly team communication and teamwork, a simulator-based training represents a valuable tool. The technical performance of portable manikin-based simulators has improved tremendously during the last decade, which facilitates realistic and true-to-life multidisciplinary team-training in trauma management.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2010
Review[Interaction of emergency medical services and the emergency department--challenges in the acute care of seriously ill or injured patients].
The needs of seriously ill or injured patients issue a challenge to the Emergency Department in terms of personnel, premises and organization. The acute and often interdisciplinary care necessitates optimal surrounding conditions and a stringent coordination of each single step in the in-hospital setting. ⋯ This review article describes the structural and organizational prerequisites of the appropriate management of seriously sick and injured patients in the Emergency Department. It also focuses on the interdisciplinary cooperation with other specialties during the initial resuscitation ("team approach") as well as during the ongoing clinical course.
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Obturator nerve block is commonly used for transurethral resections of the bladder in order to inhibit reflectory adductor muscle reaction during electrocoagulation and to reduce the risk of bladder wall perforation during transurethral surgery. Furthermore, obturator block is used to complete regional blocks for major knee surgery in addition to femoral and sciatic nerve blocks. Continuous techniques are sometimes used to treat chronic pain problems such as adductor spasm. ⋯ After laterocaudal redirection the canalis obturatorius is reached and the local anaesthetic is injected. The alternative approach is more often used: At the proximal tendon insertion of the adductor longus muscle the needle is introduced and advanced towards the anterior superior iliac spine. For both approaches a nerve stimulator is used and 15-20ml of local anaesthetic solution are injected.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2010
[Drug addiction and anaesthesia: most popular recreational drugs in Germany and anaesthesiological management of drug addicts].
Drug addicts need special anesthesiological care due to their co-morbidities, their modified need for analgesics and anesthetics and/or their specific substitution therapies. In spite of the high incidence of addiction worldwide controlled studies and evidence based recommendations for the anaesthesiological management of the patients are missing. ⋯ Inadequate analgesic treatment is known to be responsible for relapses into addiction and has strictly to be avoided. This holds true even for people with long term drug abstinence.