Der Anaesthesist
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Critical care medicine plays an important role for the medical and economic success of hospitals. Knowledge and implementation of recent relevant studies are prerequisites for high quality intensive care medicine. The aim of the present manuscript is to present an overview of the most important publications in intensive care medicine in 2009 and comment on their clinical relevance. ⋯ New trends are bedside echocardiography and telemedicine. Unfortunately, a magic bullet has not been identified last year. The focus is still on team education and guideline-assisted therapy.
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Randomized Controlled Trial Comparative Study
[Quality of premedication and patient satisfaction after premedication with midazolam, clonidine or placebo : Randomized double-blind study with age-adjusted dosage].
Premedication aims at alleviating preoperative anxiety and nervousness and also at minimizing adverse effects. To our knowledge there is no study comparing efficacy and patient satisfaction of different premedications in age-adjusted dosage. ⋯ Midazolam was the most anxiolytic, sedative and favored premedication with the least adverse effects. Most patients would choose midazolam next time.
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This article has its roots in the consternation of head anesthetists over the loss of colleagues. Anesthesia, intensive care medicine, emergency medicine and pain therapy has lost too many first class colleagues through suicide, addiction, severe depression and other causes. It is time to direct attention not exclusively to patients but also to apply an important occupational principle in the rescue service and intensive care medicine to the profession of anesthetists: Every life counts. The following article supplies information on the frequency, methods and possible reasons for suicide by physicians and suggestions for the prevention of suicide as well as treatment of physicians who are at risk of suicide will be presented.
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Randomized Controlled Trial
[Management of short-term absence in a hospital : empirical investigations for implementation of an intervention protocol].
Short-term absence is an important cost factor and its impact is a challenge for all management levels. In this study the effectiveness of a supportive intervention scheme for the reduction of hospital short-term absenteeism is demonstrated. Short-term absenteeism is defined here as being away from the working place for less than 5 days. ⋯ Furthermore the effects of the intervention concept were sustained even after the formal ending of the intervention period. This activity has a significant influence on both the absenteeism statistics and the hospital's performance. An implementation of the scheme mainly in the core departments of the hospital, such as the operating theatre, anesthesiology and intensive care has proven to be very helpful.
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Since November 2009, the first European guidelines on perioperative cardiac care for non-cardiac surgery have been published by the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). The following article will describe the most important recommendations of these guidelines and discuss the clinically relevant differences to the corresponding recommendations of the current guidelines of the American College of Cardiology (ACC) and the American Heart Association (AHA).