Der Anaesthesist
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After surgical operations delirium can occur as a serious and possible lethal complication in about 5-15% of patients. Additionally, risk factors such as old age, polymedication, organic and psychiatric diseases raise the incidence. After open-heart and orthopedic surgery more than half of the patients are affected. ⋯ In acute treatment, the butyrophenon-neuroleptic haloperidol is the drug of choice. In delirium caused by intoxication with anticholinergic agents, physostigmin is indicated. Benzodiazepines, clonidine and clomethiazole are used in particular for the treatment of withdrawal delirium.
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In 1994 the Department of Anaesthesiology and Intensive Care Medicine of the Justus Liebig University of Giessen decided to implement an Anaesthesia Information Management System (AIMS) to replace the previous hand-written documentation on paper. From 1997 until the end of 1998 the data sets of 41,393 anaesthesia procedures were recorded with the help of computers and imported into a data bank. Individual aspects and results of this data pool are presented under the aspect of how the system in its present form is able to guarantee documentation of quality according to the requirements of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). ⋯ The current documentation of AVBs in almost any hospital is incomplete. In contrast to the hand-written procedure, the AIMS provides recorded data for evaluation and guarantees more detailed and complete quality documentation. In addition, the effort needed for documentation is reduced. Whether these data sets really describe and measure quality or not has to be evaluated. In addition it has to be considered whether different requirements (such as automatic AVB recognition for an AIMS) are advantageous for quality documentation regarding the data raster and the AVB recognition, with respect to different documentation procedures.
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Historical Article
[News of ether anesthesia in the local press in the 1847 in Bamburg] 449 -1 [How much blood flow is required by the myocardium?].
The news of success in ether anesthesia on 16 October 1846 in Boston spread like wildfire through Europe. In the German-speaking countries, the national newspapers as conveyers of the development played a prominent role; this was especially the case for the Augsburger Allgemeine Zeitung whose correspondent, Aloys Martin [1], was a medical professional. The function of local newspapers has not yet been investigated. ⋯ These were then catalogued according to date, extent and contents. Starting on 22.01.1847, the events outside of and in Bamberg were reported on in 26 notices and articles of just a few lines to half a page and in advertisements; Aloys Martin also appears on the scene. Thus, the local press in Bamberg also informed its readers early and regularly on the discovery of ether and the succeeding events.
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Simulation has gained an important role in medical education and continuing education in the field of anaesthesia and emergency medicine. This article gives background information on how full-scale simulators are applied in medical education as well as in continuing education for advanced anesthesia and scientific applications. Acceptance of training seems enhanced by inclusion of the human factor aspect, since this has proven to be a major source for the development of critical situations in our specialty. Furthermore, drawbacks of the simulators available and the current training availability in Germany is described.