Der Anaesthesist
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Case Reports
[Accidental intoxication with unlabeled, generic transdermal fentanyl patches caused by insufficient instruction].
A somnolent 78-year-old male patient was brought to our emergency room by an ambulance with the presumptive diagnosis of stroke. Cranial computed tomography provided no evidence. On the intensive care unit of the neurosurgical department the patient was completely undressed. ⋯ Under the presumptive diagnosis of an opioid intoxication by a transdermal therapeutic system naloxone was infused over 3 days. The patient reported after rapidly awaking that fentanyl patches had been prescribed by his family practitioner the day before. The patient recovered without any sequelae.
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Clearly defined professional roles have the advantage that team members know what they are expected to do and what their expectations of other professional groups are. For the definition of roles a distinct number of interactions between persons are a prerequisite. In a typical operations room (OR) team members are not constantly involved and are often exchanged. Interactions between personnel are not strong enough to fulfil the designing process of role shaping. In this study the possible substitution of defined roles by a distinct professional culture in an OR was studied. ⋯ It is concluded that in this analysis the role definition was not clear. Optimization is therefore possible which could reduce conflict potential and contribute to a higher productivity.
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Comparative Study
[Preclinical transtracheal emergency ventilation. Animal experimental comparison of two techniques].
Prehospital transtracheal ventilation via a needle cricothyroidotomy may be lifesaving in cannot-intubate-cannot-ventilate situations. A self-made device consisting of a three-way stopcock placed between a transtracheal airway catheter and an oxygen supply was constructed and the effectiveness of the device was compared with a hand-triggered emergency jet generator in animal experiments. ⋯ The efficacy of the self-made device during the experiment was comparable with the efficacy of the hand-triggered emergency jet injector.
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In many hospitals operating room (OR) utilization rates and turnover times (the time from the end of the previous surgical procedure to the beginning of the next) are used as indicators of OR workflow inefficiency. However, there have been no detailed studies to determine whether these indicators really provide an adequate picture of avoidable wasting of time in the OR. ⋯ Utilization rate and perioperative turnover time cannot be used as indicators of OR workflow efficiency, since they cannot identify the days during which avoidable waiting times occur. If the aim is to identify underused OR time and factors that hamper workflow efficiency, waiting times and times without scheduled cases need to be recorded directly and separately.