Der Anaesthesist
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Hypotensive states that require fast stabilisation of blood pressure can occur during anaesthesia. In 1963, the 20:1 mixture of cafedrine/theodrenaline (Akrinor) was introduced in Germany for use in anaesthesia and emergency medicine in the first-line management of hypotensive states. Though on the market for many years, few pharmacodynamic data are available on this combination net beta-mimetic agent. ⋯ Cafedrine/theodrenaline quickly restores MAP during anaesthesia. Female gender is associated with higher effectiveness, while heart failure and beta-blocker administration lower the anti-hypotonic effect. Prospective studies in defined patient populations are warranted to further characterise the effect of cafedrine/theodrenaline.
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Statistically, the chance of a patient to win a court case because of a legally insufficient informed consent is approximately 70%. In Austria the judgment whether the anesthesia-related risk of a patient was correctly addressed depends generally on the opinion of a certified expert court witness (CW). ⋯ In future new methods of knowledge transfer to the patients should be developed. In addition, a standardization of the evaluation criteria for CWs in terms of improvement of legal certainty would be desirable.
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After analyzing the existing documentation protocol for the emergency room (ER), the department of anesthesiology of the Medical University of Göttingen (UMG) developed a new department-specific ER protocol. ⋯ The structured and elaborated documentation was limited to the target of two sides and succeeds in incorporating trauma patients as well as non-trauma patients in the ER.