Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2017
Review[Cerebral Emergency - Important Anesthesiological Aspects].
The anesthesiological management of cerebral emergency represents a great challenge for action under pressure and under time pressure and requires smooth interprofessional cooperation. The exact knowledge of the pathophysiological and pharmacological relationships is the basis for rapid identification of therapeutic influences and possible disturbing factors. In the acute situation, paCO2 and MAP are the central determinants for the anesthetist to ensure cerebral perfusion and the resulting cerebral oxygenation. ⋯ The door-to-needle time has to be kept as short as possible by defined treatment paths and rapid goal-oriented work. Every emergency also creates a stressful reaction in those treating the patient - in a sense, the cerebral emergency "in us". This has a decisive influence on the perception and action of the individual and the entire team.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2017
Review[Disaster Control and Civil Protection in Germany].
The train crash of Bad Aibling/Germany in February 2016 and the terrorist attacks of the recent years in Europe have demonstrated the urgent need to be prepared for such disastrous events. Disaster preparedness and disaster control are very important governmental duties, as are civil protection and civil defense. ⋯ While the Federation takes care of the civil protection and disaster assistance, the Länder are responsible for disaster control. The presented article focuses on these issues and gives valuable insights into the German system of disaster control and civil protection with a focus on health protection.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2017
Review[The Hospital Emergency Plan: Important Tool for Disaster Preparedness].
Hospitals need to be prepared for any kind of disaster. The terrorist attacks and mass shootings that took place in Europe in recent years impressively demonstrated the capability of hospitals to manage such challenging and disastrous events. ⋯ In this article we describe the entire process of drafting the emergency plan. We discuss the theoretical background as well as different models of disaster planning and we give important practical hints and tips for those in charge of the hospital disaster planning.
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Remifentanil is a short-acting opioid of high analgetic potency and superior controllability. It is widely used in day-case surgery, procedural sedation, for reduction of recovery-times and obstetrics and whenever excellent controllability of opioid effects is needed. Especially in combination with propofol it is used for target controlled infusion (TCI). The second part of the article shows the differences between groups of patients regarding the use of remifentanil.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2017
Review[Mass casualty incident - special features of "threatening situations"].
Terrorist attacks or amok runs may cause "threatening situations" for emergency medical services (EMS), fire fighters and physicians. Cooperation with the police is of paramount importance. In order to minimize the risk to rescue personnel and affected persons, emergency medical care has to follow tactical principles. ⋯ While only police should act in the unsafe area, the EMS can operate in the partly safe area after appropriate arrangements. Safety may only be achieved in emergency departments, which have to be made to secure areas by certain measures. The task force "Tactical Medicine" of the Scientific Working Group Emergency Medicine of the German Association for Anesthesiology and Intensive Care describes in this article essential criteria for a coordinated approach in "threatening situations".