Der Anaesthesist
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Burns caused by hydrofluoric acid can be life-threatening. Of special significance is the often underestimated local and sometimes delayed deep action of the highly diffusible free fluoride ions and the accompanying systemic toxicity. The specific antidote calcium gluconate can be topically applied, injected into tissue or infused intra-arterially. Because of the extreme danger of systemic toxicity even after seemingly trivial injuries, monitoring in the intensive care station, especially by measuring the calcium concentration in blood and electrocardiography, and therapy is recommended.
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[Quality assurance of haemotherapy in anaesthesia. Auswertung eines 3-jahrigen Erfahrungszeitraums].
The measures for quality assurance in haemotherapy developed at the Charite Campus Mitte according to the transfusion law of 1998 are introduced and discussed. ⋯ The self-inspection procedure in transfusion clinics still revealed potential for improvement, although documentation of transfusions were improved and the expiration of blood products and the resulting costs were substantially reduced.
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Surgical blood loss and trauma are the major causes of allogeneic blood transfusions, which still bear considerable risks. After the correction of hypovolemia, the anesthesiologist often has to deal with normovolemic anemia. ⋯ This is an individual threshold for each patient and depends on his or her capacity to compensate the decrease in blood oxygen content. Therefore, physiologic transfusion triggers should primarily be applied and not rigid numeric transfusion triggers, such as hemoglobin concentration, which do not take into account each patient's individual reserve.