Der Anaesthesist
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Perioperative management in patients suffering from systemic mastocytosis is challenging. Most recommendations regarding anesthetic management in these patients are based on clinical reports, and there are controversies about the use of rocuronium and sugammadex. We present a case report of a patient with systemic mastocytosis who was given sugammadex for rocuronium reversal. ⋯ All studies published up to and including January 2021 concerning anesthetic management in systemic mastocytosis were included. Of the 122 articles located, 9 articles were included: 2 reviews and 7 case reports. Data from reviewed studies confirm that sugammadex can safely be administered in patients suffering from systemic mastocytosis.
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Timely emergency surgery is vital as this often has a direct impact on morbidity and mortality. The joint recommendations of the German Associations of Anesthesiologists (BDA), Surgeons (BDC), and Operating Room Management (VOp.M) for coordinative implementation have been available since 2016: N0 (surgery immediately), N1 (surgery start in the next free operating room), N2 (surgery start ≤ 6 h), N3 (surgery at the end of the elective schedule), N4/Urgent (surgery within 12-24 h). The aim of this study was to describe the situation of care in German hospitals of different sizes for the first time using routine data. ⋯ Cases with high urgency were surgically treated within a short time period. Overall, differences in time management of emergencies were only small between hospital types. The gradations in the temporal implementation of the individual emergency categories were due particularly to distinctions in the resources available, such as the number of operating theaters, including the run times.
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Coronavirus disease 2019 (COVID-19) has brought about unprecedented challenges to medical schools. Physical distancing as the most effective means of infection prevention renders traditional classroom teaching nearly impossible and new teaching methods are required to contain the infection risk whilst ensuring high-level education. ⋯ Technology Enhanced Learning was highly valued by our students and helped to reduce the need for classroom teaching; however, for teaching practical skills classroom teaching remains indispensable.
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A sharp rise in COVID-19 infections threatened to lead to a local overload of intensive care units in autumn 2020. To prevent this scenario a nationwide relocation concept was developed. ⋯ If the number of infections with SARS-CoV‑2 increases, a nationwide relocation concept for COVID-19 intensive care patients and non-COVID-19 intensive care patients should be installed at an early stage in order not to overwhelm the capacities of hospitals. Supply regions around a leading clinic with maximum intensive care options are to be defined with a central management that organizes the necessary relocations in cooperation with regional and superregional rescue service control centers. With this concept and the intensive care transports carried out, it was possible to effectively prevent the overload of individual clinics with COVID-19 patients in Baden-Württemberg. Due to that an almost unchanged number of patients requiring regular intensive care could be treated.