Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Oct 2006
[Background and consequences of injuries missed when diagnosing severely injured accident victims in prehospital care in patients transported by ambulance to the University Medical Centre in Utrecht, 1999-2000].
To determine the background and consequences of failing to diagnose injuries in prehospital care. ⋯ Frequently missing an injury prior to hospitalization did not result in a poorer chance of survival or lesser quality of life. The risk of dying was mainly related to a higher age and a poorer general condition at the scene of the accident. According to these findings there is no reason to adapt the current policy with regard to initial care and transport of trauma patients.
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Ned Tijdschr Geneeskd · Oct 2006
Case Reports[The restless legs syndrome can be treated with dopamine agonists].
In three patients, a man aged 46 years and two women aged 74 and 38 years, respectively, restless legs syndrome (RLS) was diagnosed. The second patient had a low serum ferritin concentration. The patients were successfully treated with ropirinol, iron suppletion and gabapentine, and pramipexol, respectively. ⋯ Sleep is disturbed significantly, which interferes with normal functioning of the patients during the day. RLS may be caused by anaemia, uraemia or as a side effect of drugs such as selective serotonin uptake inhibitors (SSRIs), lithium and tricyclic antidepressants. RLS can be treated successfully by dopaminergic agents, especially dopamine agonists.
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Ned Tijdschr Geneeskd · Oct 2006
Comment[Protocols for trauma care and the missing of injuries in severely injured accident victims during the prehospital phase].
Standardizing trauma care according to internationally accepted life-support principles is being increasingly implemented in the prehospital as well as the intramural setting. In the primary survey it is important to distinguish between aspects of major and minor importance, without losing sight of details. ⋯ First attention should be paid to the mechanism of injury, related potential vital impairment and obvious visible injuries. The goal should be effective treatment, focused on the stabilization of vital functions and triage related to the choice of facility necessary for definitive care.
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Ned Tijdschr Geneeskd · Sep 2006
Review[End-of-life decisions in seriously ill patients: the position of intensive care nurses].
Intensive care units regularly have patients in whom a curative treatment plan is changed to palliative treatment. This does not only concern the medical and technical aspects, but also medical-ethical problems and questions relating to communication and organization. ⋯ The optimalization of collaboration between doctors and nurses by means of the mutual exchange of information unique to each different discipline as well as acknowledging one another's talents and skills, forms the basis of good communication and organization concerning end-of-life decisions. It is useful to formalize this collaboration by means of multidisciplinary discussions.
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Ned Tijdschr Geneeskd · Sep 2006
Comment Letter Case Reports[A patient who refused treatment after self-poisoning with paracetamol].