Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2001
[Optimized logistics in the prehospital management of acute stroke].
Current management of acute stroke is characterised by an aggressive approach including specific therapy i. e. reperfusion therapy. However currently stroke patients often arrive too late in hospitals offering adequate treatment. Therefore optimized logistics play a predominant role in modern stroke management. ⋯ This study demonstrates the efficacy of educational efforts in reducing latencies and in screening patients potentially suitable for thrombolysis. Future efforts will comprise more intense education of a high risk subpopulation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2001
[The importance of access-to-patient-period in the emergency service].
The "period-to-help" (Hilfsfrist) is defined by the federal states as a measure for further planning and structure the emergency services. This period is composed of distinct time intervals and ends with the arrival of the rescue team at the emergency. From a physician's point of view it is merely the time to the first contact with the patient that is of vital interest. Data on the discrepancy between arrival at the emergency scene and the first contact with the patient are lacking. ⋯ If we consider that road accidents count for merely 10 % of all emergencies it seems appropriate to re-define the so-called "period-to-help" (Hilfsfrist) that takes into account the "access-to-patient" period (Zugangszeit) that is on average 50 seconds. The primary goal of any further planning must be to keep the interval without sufficient therapy as short as possible.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2001
ReviewThe anemic patient in the ICU: How much does the heart tolerate?
Anemia in the critical care setting is a common condition frequently resulting in the use of red cell transfusions. Of particular concern are those anemic, critically ill patients with ischemic heart disease. This critically ill population may be predisposed to the adverse consequences of anemia, by the very nature of their underlying cardiac disease. ⋯ Research to date has provided opposing views in terms of the optimal transfusion strategies for use in this "at risk" population. While observational studies have indicated that a liberal strategy is more beneficial, a recent RCT found that a strategy maintaining hemoglobin concentrations between 70 and 90 g/L may result in similar, if not better, outcomes. Further studies are needed, however, to clarify whether the results of this trial can be generalized to patients with cardiovascular disease.