Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2016
Review[Patient blood management: Does the approach also make sense in children?].
Patient blood management describes an interdisciplinary concept which aims at rational and adequate use of blood products accompanied by strategies to prevent and treat anemia, to reduce blood loss and to use alternatives to blood transfusion. While patient blood management has been widely implemented in adult medicine, concepts for such measures in the care of children are rare. ⋯ There are differences in the physiology of hemoglobin and cardiovascular systems, particularly in the first year of life. It can be difficult to determine impending anemic hypoxia in children, so that indication for transfusion based on standardized hemoglobin threshold values should always be supported by an individual risk-benefit analysis based on clinical assessment.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2016
Case Reports[Case report: 40-year-old patient with massive bleeding undergoing cesarean section].
We report a case of a 40-year-old patient suffering major bleeding when undergoing cesarean section for delivery with placenta previa. After surgery the patient suffered from severe bleeding several times and again underwent surgery with abdominal packing. After an abdominal compartment syndrome and an ARDS a post transfusion purpura was found to be the cause of the repeated bleeding and could successfully be treated with a cycle of plasmapheresis.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2016
[Legal characteristics of expert opinions of anaesthetic cases of the North German Arbitration Board].
The Arbitration Board for Medical Liability Issues of the State Medical Councils of Northern Germany in Hannover (North German Arbitration Board, NGAB) settles about 100 cases in the area of anaesthesiology per year. In these proceedings the patient carries the burden of proof. ⋯ This article exemplifies cases, for which the NGAB recognized such facilitation of the burden of proof. In each of these cases, the NGAB asserted the damage claim.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2016
[Expert Opinion Cases - What documentation is necessary from a legal perspective?].
Doctors are obliged by professional code and civil law (630 f German Civil Code [BGB] §) to document their medical activities in relation to patients. The documentation serves as proof of executed measures and thus for backing up medical/therapeutic issues. Documentation shall be made immediately after or during the treatment and if the original content remains recognizable, can be supplemented/modified. ⋯ Some special laws (eg. laws governing X rays, Transfusion Act) require that documents be stored for longer periods. Documentation errors are - unlike patient information errors/medical malpractice - no basis for damages claims by the patient, but may result in medical malpractice process with the burden of proof in favor of the patient (§ 630 h BGB). The patient has, in principle, the right to inspect the medical documents relating to him.