Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2019
[Child Abuse - Interdisciplinary Collaboration and Child Protection].
In Germany, the increasing focus on child abuse led to remarkable changes in recent years. The latest child protection laws (Kinderschutzgesetz, 2012) and the new medical guideline (AWMF S3+ Kinderschutzleitlinie, 2019) provide effective means for child protection services. ⋯ This article presents an update of the epidemiology, the legal situation, and the clinical manifestations concerning child abuse. With this information it foremost adresses medical professionals seeing children regularly without having a child protection team at disposal.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2019
[Anaesthesiologic Techniques for Patients at Risk of Aspiration].
Rapid sequence induction and intubation (RSII) is the appropriate method of inducing general anaesthesia in patients who are at a risk of aspiration. The classical RSII is limited to a few treatment recommendations which are rarely based on evidence-based findings. New techniques (e.g., video laryngoscopy) as well as new means of diagnostics (e.g., sonography) require reevaluation of traditional techniques. ⋯ This includes gastric tube and gastric sonography as well as modalities for anaesthesia induction, e.g. patient positioning, face mask ventilation, relaxometry, cricoid and left-paratracheal pressure. In-hospital, RSII treatment standards must be familiar to all team members and treatment processes have to be well established and practiced regularly. The aim of this article is to present systematics that can be used as a decision-making basis for local operating procedures.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2019
Case Reports[Severe Shock Symptoms Due to Ticagrelor Related Anaphylactoid Reaction Following ST Elevation Myocardial Infarction].
Ticagrelor as a P2Y12 receptor antagonist is recommended in patients with acute coronary syndrome without a primary cardiosurgical therapy. Severe relevant side effects, especially anaphylactic reactions, have not yet been described in the current literature. ⋯ This case should raise the awareness that a supposedly safe drug can still cause an anaphylactic shock.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2019
[Rapid Sequence Induction - Which Medication Should Be Used?]
The rapid sequence induction (RSI) is a not evidence-based technique designed to minimize the chance of pulmonary aspiration in high-risk patients requiring general anesthesia. Primary aim of this anesthetic technique is, therefore, a fast airway protection with an endotracheal tube to reduce the chance of passive or active regurgitation. This article discusses the anesthetic management of patients with an increased risk of aspiration, and, particularly, refers to the medications required for RSI.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2019
[Anaesthesia Induction in Non-fasting Patients - the Example of Pregnant Women and Children].
Aspiration during anesthesia induction is no triviality, but can lead to serious complications and mortality. The classic technique of rapid sequence induction (RSI) is a fundamental form of anesthesia induction in non-fasting patients to prevent pulmonary aspiration of gastric contents. ⋯ The preparation of an RSI involves the careful selection of medicines, equipment and monitoring. An important quality criterion of RSI is the atraumatic airway management in deep anesthesia with profound muscle relaxation without resistance (coughing, choking, pressing) of the patient.