Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2021
[Quality Improvement in Intensive Care Through Telemedicine: the TELnet@NRW Example].
The German health care system faces the great challenge of ensuring high-quality and comprehensive health care in the future as the shortage of physicians continues to grow. Telemedicine-supported healthcare networks, which guarantee access to specialized medical expertise close to the patient's home and tailored to their needs, and thus to high-quality patient-centered treatment, could provide a solution. The TELnet@NRW best-practice project provides a blueprint for expert teleconsultations and put them into practice. ⋯ A total of > 150 000 patients were included. With TELnet@NRW, a major step towards future-proof healthcare was taken, and for us this means providing patients with high-quality care close to patients' homes. This is currently being used as the conceptual basis for the Virtuelles Krankenhaus NRW as a possible solution for the continuation of former project services.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2021
[Quality Assurance in Intensive Care Medicine: Peer Reviews and Quality Indicators].
Goal-oriented quality management in health care is an essential tool to provide good medical practice and treatment. It aims at a patient-centred case management with high transparency of structural and clinical process aspects, as well as patient outcome. An objective and comprehensive description of clinical care includes the use of quality indicators. ⋯ This article focuses on peer review systems currently applied in German hospitals, and particularly describes quality indicators that have been established by DIVI (German Interdisciplinary Society of Intensive Care and Emergency Medicine). It also addresses the need for a professional dialogue between equal partners. This has to accompany each peer review that aims at an improvement in quality of critical patient care.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2021
[Blended Learning in Critical Care to Improve Quality of Care the ERIC-Training].
Communication and teamwork skills are, besides clinical knowledge, key components of high quality care in modern intensive care units. In light of high staff fluctuations among intensive care unit teams and disparities in clinical experience, an ongoing training is essential to ensure optimal performance in stressfull situations. ⋯ Enhanced Recovery after Intensive Care (ERIC) is a newly developed telemedical intervention targeted at improving evidence-based practice in critical care, guided by quality indicators defined by the German Interdisciplinary Society of Emergency and Critical Care Medicine (DIVI). This telemedical intervention is supplemented with a blended-learning concept combining an e-learning website, simulator-based workshops and on-site training in order to expand the knowledge and practical skills regarding adherence to the quality indicators.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2021
[Central Venous Access in Children: Technique and Complications].
Children with complex diseases often need central venous catheter, not only for intraoperative use, but also for parenteral nutrition, multiple blood draw due to lab examination and to administer drugs that cannot be given via peripheral lines. Whereas the landmark driven vascular access was teached for years, nowadays the routine use of ultrasound based techniques can be called the gold standard. This article highlights standard locations for central venous access like cannulation of the internal jugular vein as well as novel alternatives such as the cannulation of the brachiocephalic vein. ⋯ Several different formulas are available and can be used. Independent of the used formula, you have to make sure that complications due to incorrect depth of central venous line are a topic of the past. Finally, important tips and tricks to avoid failure and serious complications are discussed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2020
Case Reports[Multiple Stroke Syndrome Caused by Air Embolism Following Removal of a Central Venous Catheter].
The removal of a central venous catheter on a ward leads to a paradox air embolism in a 53-year-old male patient with an unknown ventricular septal defect. The patient undergoes sufficient cardiopulmonary resuscitation but suffers from a multiple stroke syndrome with serious neurological deficits.