Der Anaesthesist
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Restoration of adequate tissue perfusion is the goal of resuscitation in septic shock. A growing understanding of microcirculatory dysfunction in sepsis led to a change in resuscitation practice away from targeting arterial and central venous pressures and towards tissue perfusion-guided protocols. ⋯ Based on the published study results vasopressin appears to be of potential benefit in adult patients with moderate septic shock (norepinephrine requirements < 15 μg/min) and lacking signs of systemic hypoperfusion (e.g. normal arterial lactate levels). A vasopressin infusion with the sole target to increase arterial blood pressure despite the presence of systemic hypoperfusion is dangerous and can result in a critical deterioration of tissue perfusion.
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Sudden death due to cardiac arrest represents one of the greatest challenges facing modern medicine, not only because of the massive number of cases involved but also because of its tremendous social and economic impact. For many years, the magic figure of 1 per 1000 inhabitants per year was generally accepted as an estimate of the annual incidence of sudden death in the industrialized world, with a survival rate of 6 %. This estimate was based on large numbers of published reports of local, regional, national and multinational experience in the management of cardiac arrest. ⋯ In addition, important scientific questions can be answered from the database. For example, a score for benchmarking the outcome quality after out-of-hospital resuscitation, known as the return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score, has been developed. The registry is available for all emergency medical services (EMS) and hospitals in Germany and other German-speaking countries.
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The word "secondary alarm" also sometimes known as "comfort alarm" means that a system indicates a critical situation (alarm condition) but this does not happen with the safety of an alarm system. A closer inspection of the small print reveals that the comfort alarm is in reality not an alarm but only additional information. This article summarizes in compact form what consequences this has for the user and what precautions should be taken when acquiring an alarm system.