Der Anaesthesist
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One-lung ventilation is a standard procedure for many types of lung surgery. The anesthesiologist can be challenged if unknown anomalies of the bronchial tree occur. We report a patient with a tracheal bronchus on the right side presenting for left pneumonectomy, and present one possible solution to airway management.
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The difficult financial situation in German hospitals requires measures for improvement in process quality. Associated increases in revenues in the high income field "operating room (OR) area" are increasingly the responsibility of OR management but it has not been shown that the introduction of an efficiency-oriented management leads to an increase in process quality and revenues in the operating theatre. Therefore the performance in the operating theatre of the University Medical Center Göttingen was analyzed for working days in the core operating time from 7.45 a.m. to 3.30 p.m. from 2009 to 2014. ⋯ This improvement in process quality and cumulative incision-suture times as well as the increase in revenues, reflect the positive impact of an efficiency-oriented central OR management. The OR management releases due to measures of process optimization the necessary personnel and time resources and therefore achieves the basic prerequisites for increased revenues of surgical disciplines. The method presented can be used by other hospitals as a guideline to analyze performance development.
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Editorial Comment
[Perioperative ventilation: naturally lung-protective!]
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There are considerable similarities and intersections between forensic medicine and emergency medicine. This applies especially to frustraneously resuscitated patients or other lethal clinical courses of traumatized patients who are subject to latter forensic autopsy. ⋯ The pre-hospital situation represents a hotspot, but also a blind spot in the overall trauma mortality. In recent clinical registers, preclinical deaths go mostly unrecorded, despite the undisputed benefits of clinical registers.