Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2020
[Anaesthesia-related Infection Prevention during Operations].
The processes of anaesthesia during operations enable surgical disciplines to perform a wide range of procedures. However, anaesthesia procedure may also represent a potential risk of infection for the surgical patient. Important hygiene measures concern the following topics: hand hygiene, surface disinfection, administration of parenteral drugs, dealing with catheters, intubation, perioperative antibiotic prophylaxis, temperature management, change intervals, OR workflow organization. The selection of hygiene measures for anaesthesia staff in the operating theatre listed in this article is presented in the sequence of the work flow, whereby certain topics such as hand hygiene naturally play an important role in all work phases.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2020
[Cancer Patients: Relevant Aspects for Anesthesiology].
Surgical oncology makes up an essential part of all surgical procedures performed. Anesthetists can contribute significantly to the treatment success by a thorough pre-operative assessment of patients. ⋯ Hence, it is the responsibility of anesthetists to gather knowledge about the changes in organ systems due to the rapidly increasing list of anti-cancer agents. This article serves as a review from anesthetists to anesthetists conveying the important aspects for taking a comprehensive patient history as well as summarizing the adverse events of major drug classes currently in use in oncology.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2020
[Do we Isolate Patients or Bugs? Challenging Isolation Precautions].
Isolation of patients with multidrug-resistant organisms (MRGN) has been recommended since years. Recent evidence suggests no benefit by this isolation procedure. Furthermore, isolation precautions may have potential negative effects on patient well-being and may increase therapeutic error. ⋯ Prevention of spreading bacteria is not done by isolation in room. In fact, it is a multifactorial continuous cycle of planning, teaching, surveillance and transfer of knowledge. Combination of education, compliance to standard precautions and continuous education may be a big step forward in fighting MRGN transmission and progression.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2020
[Disinfection, Bathing, Dressing: Avoiding Infections in the Intensive Care Unit].
In German intensive care units, 10 000 to 15 000 patients die annually due to nosocomial infections. Estimated 20 to 30% of these infections are preventable. Disinfecting is one of the most effective measures to avoid these infections. ⋯ Antiseptics-impregnated dressings represent a further possibility for reducing device-associated infections. However, recently there has been an increase in reports of resistance not only to antibiotics but also to antiseptics. Proper hygienic work and the rational use of antiseptics is a requirement for avoiding nosocomial infections and can reduce the development of resistance.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · May 2020
[Perioperative Drug Interactions - What Should Be Considered by Anesthetists].
Drug interactions cause numerous hospital admissions and even death. Administration of multiple therapeutic drugs increases the risk of relevant interactions. Pharmacologist consultation and also IT-based drug-interaction examination focus on this risk and may improve the safety and quality of the medical therapy. ⋯ Thus on the one hand modern narcosis uses drug interactions in performing "balanced anesthesia" and on the other hand it is essential to know about unwanted interactions that might arise of several mechanisms like chemical interactions as well as pharmacokinetic and pharmacodynamic ways. In this context, phenomena as the pharmaceutic influence on the QT-time have to be known as well as the so called serotonine syndrome for example. A detailed insight into the metabolism of administered drugs including elimination pathways like p-glycoprotein or enzymes of the cytochrome-p-450 family is helpful to maintain a basic survey.