Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Anaphylaxis is a serious life-threatening generalized or systemic hypersensitivity reaction. The aim of this paper is to provide knowledge on how to diagnose, treat and follow up patients with suspected anaphylaxis during general and local anaesthesia. ⋯ Allergic reactions during anaesthesia are rare and potentially life-threatening; patients should be followed up and treated in a standardized way.
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To secure the airway has the highest priority when handling critically ill and injured patients. The aim of this article is to present simple and new devices and techniques to secure the airway. ⋯ In the unconscious patient, it is of vital importance to maintain a secure airway with simple devices. Hypoxia subsequent to obstructed airways in unconscious patients will become life-threatening, and may cause cerebral ischemia and cardiac arrest within 5-6 minutes. All doctors should be able to ventilate patients with face-mask and bag-valve device. Intubation and tracheotomy should only be performed by trained personnel.
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Modern anaesthesia is still associated with a risk of serious complications. This article focuses on frequency, causes, and prevention of the most important anaesthetic complications. ⋯ Optimization of the patient's preoperative health is important to improve safety. The focus of the anaesthesiology department should be education and guidelines. Systems and routines for improved safety must also take into account that human and organizational factors may cause anaesthetic accidents.
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Relapses in multiple sclerosis, associated with significant functional impairment, should be treated with methylprednisolone. In case of repeated relapses or onset cases of multiple sclerosis there is an indication for preventive treatment with interferon-beta/glatiramer acetate (first-line treatment), natalizumab (second-line treatment) or mitoxantrone (third-line treatment).