Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2008
Review[Medical doctor in mountain rescue service - a profession's perspective].
Helicopter emergency services (HEMS) carrying doctors trained in emergency medicine represent a well established system for primary care with increasing professionalism since their implementation in the seventies until now. However, considerable differences persist in Europe concerning the structure as well as integration of the system in the entire organisation of area-wide demands. Based on the particular geographic conditions in the alps which are highly associated with challenges for man and material a dense network of helicopter airbases has been established. ⋯ Advanced all-season training is compulsory due to seasonal differences in casualties. Well harmonized training with cross-border validity is not available to-date. Hence, the development of obligatory standard operating procedures should be the major goal of medical associations and societies.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2008
Practice Guideline[Optimisation of sedation practice in ICU by implementing of S2e Guidelines].
The S2e Guidelines for sedation practice of the German Society for Anaesthesiology and Intensive Care recommend a clear prior definition of depth of sedation to be achieved in a given case, monitoring of depth of sedation by means of scoring systems, appropriate selection of analgesics and sedatives and the use of patient-oriented treatment regimens. These measures not only reduce significantly length of artificial respiration, length of time spent on the intensive care unit and overall length of stay in the hospital but also the frequency of complications. Therefore, implementation of the Guidelines will result in significant reductions in costs in a given case. This is a decisive economic benefit for any hospital working under the restraints of the DRG system.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Review[Anesthesia in children with congenital heart disease].
Anesthesiologists involved in the care of children with congenital heart disease (CHD) have to understand the pathophysiology of each cardiac lesion and anticipate the impact of the planned procedure. Often the dimished margin of hemodynamic stability determines the guidelines of care. ⋯ Left-to-right shunting means a volume load to the left ventricle frequently combined with pulmonary hypertension. Right-to-left shunting leads to a central cyanosis.