Der Anaesthesist
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In the German emergency medical system (EMS) psychiatric emergency situations (PES) are now responsible for up to 15% of all calls for the emergency physician (EP). A survey which was first conducted in 1996 to reveal knowledge about PES, reported a significant need for training. Seven years later it is interesting to investigate whether different conditions in the EMS may have changed assessments and attitudes. ⋯ The results indicate an increase of relevance of PES in the German EMS, however, assessments made by the EP only changed marginally over the time period. The subjective awareness of the frequency of PES underestimates the reality in emergency medicine. The importance of training programs remains high to improve knowledge and to reduce feelings of incapability.
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Case Reports
[Anaesthesia for radiation therapy of brain tumours in children. A multidisciplinary challenge].
Radiation therapy of childhood intracranial malignancies is always a challenge for radiation oncologists, anaesthetists and paediatric oncologists. Detailed knowledge of the course of the disease prior to radiation therapy and a critical evaluation of the child's actual physical status are mandatory in each case. Furthermore the anaesthetist should be informed about the child's individual preferences and aversions. ⋯ Interdisciplinary communication structures which must always involve the child's parents have to be established. Perfect adjustment of the mask that fixes the head during each radiation procedure is necessary to give the child the possibility to breathe spontaneously without an endotracheal tube or a laryngeal mask. Two case reports highlight these aspects of the complex procedure of paediatric radiation therapy which are relevant for the anaesthetist.
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This case report describes a cortical subarachnoid bleeding in a 29-year-old woman who presented with headache and left-sided hemiplegia 7 days after spinal anaesthesia for caesarean section. Magnetic resonance imaging revealed a parietal subarachnoid bleeding on the right side. The patient recovered completely. Recognized causes of subarachnoid haematoma following a caesarean section under spinal anaesthesia are discussed.
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Biography Historical Article
[Laudation for university professor Dr. med. Konrad Johannes Falke].