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Der Anaesthesist

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https://www.readbyqxmd.com/read/28091758/-deaths-from-propofol-abuse-survey-of-institutes-of-forensic-medicine-in-germany-austria-and-switzerland
#1
C Maier, J Iwunna, M Tsokos, F Mußhoff
Previous references suggesting a high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in Germany, Austria and Switzerland concerning the number of autopsies carried out between 2002-2112 on medical personnel with the suspicion of abuse of propofol or other analgesics. The response rate was 67%. In 16 out of the 32 responding departments 39 deaths (27 males) were observed with previous connections to anesthesiology, intensive care or emergency departments of which 22 were physicians, 13 nurses, 2 other personnel and 2 were unknown...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28091757/-renal-protection-in-intensive-care-myths-and-facts
#2
S John
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication in patients on the intensive care unit with a significant impact on patient mortality, morbidity and costs of care; therefore, renal protective therapy is most important in these severely ill patients. AIM OF THE REVIEW: Many renal protective strategies have been postulated during the last decades, which are sometimes still in place as a kind of "myth" but which are not always proven by evidence-based "facts"...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28091756/-recommendation-on-temperature-management-after-cardiopulmonary-arrest-and-severe-traumatic-brain-injury-in-childhood-beyond-the-neonatal-period-statement-of-the-german-society-for-neonatology-and-pediatric-intensive-care-medicine%C3%A2-gnpi-and-the-scientific-working
#3
S Brenner, C Eich, G Rellensmann, M U Schuhmann, T Nicolai, F Hoffmann
The available data on the effectiveness of therapeutic hypothermia in different patient groups are heterogeneous. Although the benefits have been proven for some collectives, recommendations for the use of hypothermia treatment in other groups are based on less robust data and conclusions by analogy. This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#4
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28078373/-aus-fehler-und-gefahren-wird-patientensicherheit-und-aus-trends-und-medizin%C3%A3-konomie-wird-qualit%C3%A3-tsmanagement-und-medizin%C3%A3-konomie
#5
EDITORIAL
M Schuster, K Markstaller, M Bauer
No abstract text is available yet for this article.
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28070607/-human-factors-in-medicine
#6
M Lazarovici, H Trentzsch, S Prückner
The concept of human factors is commonly used in the context of patient safety and medical errors, all too often ambiguously. In actual fact, the term comprises a wide range of meanings from human-machine interfaces through human performance and limitations up to the point of working process design; however, human factors prevail as a substantial cause of error in complex systems. This article presents the full range of the term human factors from the (emergency) medical perspective. Based on the so-called Swiss cheese model by Reason, we explain the different types of error, what promotes their emergence and on which level of the model error prevention can be initiated...
January 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28050620/-commentary-to-levosimendan-for-the-prevention-of-acute-organ-dysfunction-in-sepsis
#7
C S Bruells, R Kopp
No abstract text is available yet for this article.
January 3, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28044186/-legal-pitfalls-in-emergency-medicine-how-is-the-situation-in-austria
#8
LETTER
H Andel, W Kröll
No abstract text is available yet for this article.
January 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28005161/-epidural-anesthesia-for-fetoscopy-retrospective-analysis-of-a%C3%A2-one-year-cohort
#9
N Kiefer, S F Suter, C Berg, U Gembruch, S U Weber
BACKGROUND: The introduction of routine prenatal screening using ultrasound has led to a substantial increase in diagnoses of fetal disorders that are amenable to intrauterine treatment. While an ultrasound guided insertion of small bore cannulas can be performed under local anesthesia, insertion of a fetoscope usually requires anesthetic management for the mother and the fetus. Additionally, the fetus' intrauterine position may have to be manipulated in order to enable access. Such manoeuvres depend on relaxation of the mother's abdominal wall...
December 22, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27999869/-the-asa-classification-solid-like-a-rock-in-anesthesiology
#10
EDITORIAL
H W Gervais
No abstract text is available yet for this article.
December 20, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27995282/-asa-classification-transition-in-the-course-of-time-and-depiction-in-the-literature
#11
T Irlbeck, B Zwißler, A Bauer
The American Society of Anesthesiologists classification of physical status (ASA PS) is a widely used system for categorizing the preoperative status of patients. The ASA class is a good independent predictor of perioperative morbidity and mortality. The definitions of the ASA classes have been amended several times since 1941, resulting in inconsistent and confusing usage in the current literature. Conflicting definitions of ASA PS exist, particularly for classes III, IV and V. The high variability of individual classifications by different anesthesiologist, however, can be explained by the previous lack of examples for diagnoses...
December 19, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27942787/-full-scale-simulation-in-german-medical-schools-and-anesthesia-residency-programs-status-quo
#12
H Baschnegger, O Meyer, A Zech, B Urban, M Rall, G Breuer, S Prückner
BACKGROUND: Simulation has been increasingly used in medicine. In 2003 German university departments of anesthesiology were provided with a full-scale patient simulator, designated for use with medical students. Meanwhile simulation courses are also offered to physicians and nurses. Currently, the national model curriculum for residency programs in anesthesiology is being revised, possibly to include mandatory simulation training. OBJECTIVES: To assess the status quo of full-scale simulation training for medical school, residency and continuing medical education in German anesthesiology...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27942786/-ventilator-associated-pneumonia-vap-a%C3%A2-risk-already-at-the-time-of-anesthetic-induction
#13
L Vetter, C Konrad, G Schüpfer, M Rossi
BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the most common and preventable infections in mechanically ventilated patients. It is associated with a high mortality rate. To prevent VAP, various strategies address this issue using "VAP-bundles", which are implemented in many intensive care units. The risk of acquiring VAP starts with the induction of anesthesia, strictly speaking at the time of intubation. This article considers measures to prevent VAP during general anesthesia in adult patients (>18 years)...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27942785/-factor%C3%A2-xiii-pharmacodynamic-and-pharmacokinetic-characteristics
#14
E H Adam, S Kreuer, K Zacharowski, C F Weber, R Wildenauer
Factor XIII (FXIII) plays an important role in the field of blood coagulation. In the last decade, both congenital and acquired deficiencies have been investigated in clinical studies. FXIII is a versatile enzyme that leads to a covalent cross-linking of fibrin fibrils at the end of the clotting cascade and supports platelet adhesion to the damaged sub-endothelium with the result of a mechanically stable clot.Symptoms of FXIII deficiencies vary within a broad spectrum from superficial skin bleeding episodes to severe, sometimes life threatening hemorrhage, requiring prophylactic or therapeutic replacement therapy...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27942784/-introduction-of-prehospital-emergency-ultrasound-into-an-emergency-medical-service-area
#15
C Weilbach, A Kobiella, N Rahe-Meyer, K Johanning
BACKGROUND: Emergency ultrasound as part of the provision of emergency medical services using mobile devices offers great benefits regarding to some important questions related to the management of critically ill and injured patients in the prehospital situation where diagnostic resources are limited. The aim of this study is to determine whether the comprehensive introduction of prehospital emergency ultrasound examinations into a German Emergency Medical Services ("rescue services") area is both feasible and beneficial for patients...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27942783/-practical-training-for-paramedics-transformation-at-the-leipzig-university-teaching-hospital
#16
F F Girrbach, M Bernhard, M Wessel, A Gries, S Bercker
BACKGROUND: The "Notfallsanitätergesetz" (the law pertaining to paramedics), which came into effect in January 2014, has fundamentally changed the training of health personnel in German prehospital emergency medicine. The apprenticeship now takes 3 years including 720 h of practical training in eligible hospitals. To date, however, there has been little experience of how the contents of the guidelines for practical training ("Ausbildungs- und Prüfungsverordnung") can be reasonably applied in the teaching hospitals...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27924353/-the-old-man-and-the-i-sea-u-essay-on-faith-fate-and-evidence-after-the-manner-of-hemingway
#17
K Lewandowski, R H Bartlett
Robert Bartlett, emeritus Professor of surgery at the University of Michigan in Ann Arbor, USA, transformed classical works of world literature (Charles Dickens: A Christmas Carol, Lewis Carroll: Alice in Wonderland) into teaching aids for advanced training in intensive care medicine. He recently turned his hand to the well-known work of Ernest Hemingway: the Nobel Prize winning novel The Old Man and the Sea. Subsequent to Robert Bartlett's essay this article provides background information and comments on the current problems in modern intensive care medicine addressed in his essay...
December 6, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27900414/-comment-on-dexmedetomidine-for-delirium-prophylaxis-in-elderly-patients-after-non-cardiac-surgery-in-the-intensive-care-unit
#18
J Van Waesberghe, A Eisert, M Coburn
No abstract text is available yet for this article.
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27812729/-under-scrutiny-by-the-state-prosecutor-legal-pitfalls-in-emergency-medicine
#19
P Schelling
Physicians who allow a suicide attempt to happen, which from an ex ante viewpoint was completely voluntary, cannot be held punishable for homicide or failing to provide medical assistance when the suicide corresponds to the putative will of the patient according to plausible information supplied by an authorized person with healthcare proxy. Guidelines for resuscitation also play a central role in the forensic practice for assessment of whether and when resuscitation can be terminated; therefore, it is urgently advised to follow and implement these guidelines: deviations are possible if they can be factually justified...
November 3, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27787572/-comment-on-decompressive-craniectomy-after-traumatic-brain-injury
#20
A Höllig, M Coburn
No abstract text is available yet for this article.
October 27, 2016: Der Anaesthesist
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