Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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In order to prevent short-term complication, patients with frailty syndrome require special attention and care in the perioperative context. The implementation of a frailty screening and if possible, an advanced geriatric assessment in the clinical routine should take into account the clinical setting, the patient population as well as time and human resources. ⋯ Key aspects of such pathways include physiotherapeutic interventions, nutritional counselling, adequate pain medication, delirium prevention, patient blood management and extended perioperative monitoring. An interdisciplinary shared decision-making process together with patients can help develop realistic and individual treatment concepts to improve safety and outcome of frail patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2022
[The Frail Patient in a Fictitious Case Study].
Various limitations in everyday life can indicate a frailty syndrome. These limitations are not always directly visible and result from a wide variety of domains. Fried et al. described these limitations of different domains as frailty syndrome. ⋯ The aim is to specifically address the respective deficits and to develop an individual training concept together with the patient. Prehabilitation can significantly improve the risk of complications and the outcome of frail patients. In this context, it is important to establish routine screening in order to detect a frailty syndrome in everyday clinical practice and to create opportunities for prehabilitation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2022
[Clinical Treatment after Terrorist Attacks - Structures and Processes in Hospitals for terror-related Mass Casualty Incidents].
Due to several peculiarities the clinical treatment after terror-related mass casualty incidents (TerrorMASCAL) differs from handling a conventional MCI. For this reason, TerrorMASCAL situations should get attention as an own entity in hospitals emergency preparedness and response. Among other challenges hospitals surrounding the emergency area will have to deal with a large amount of non-triaged, non-treated and seriously harmed patients, some of them with unfamiliar and disfiguring injuries. ⋯ It is recommended that this algorithm should be defined in hospitals disaster and emergency planning. Surgical strategies concerning the treatment of terror victims might be oriented according to the principles of "tactical abbreviated surgical care" (TASC). This means that in extreme cases the initial measures have to be concerted to save as much lives as possible while accepting a reduced individual outcome.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2022
[Management of Clinical Capacity Overload Due to Mass Patient Influx].
Hospitals play a crucial role in the management of large-scale emergencies or disasters. This has been clearly demonstrated by the recent terrorist attacks in Europe, by the SARS-CoV-2 pandemic, and currently by the Ukraine war. In order to cope with extraordinary situations and large-scale emergencies, such as mass casualty incidents, hospitals need to be prepared in detail - by preparing and implementing a hospital contingency plan. The article presented here describes in hospital preparation for a mass casualty incident.