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Der Anaesthesist

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https://www.readbyqxmd.com/read/28303282/-advance-directives-in-clinical-practice-living-will-healthcare-power-of-attorney-and-care-directive
#1
J Hack, B Buecking, C L Lopez, S Ruchholtz, C A Kühne
In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e...
March 16, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28289767/-update-on-muscle-relaxation-what-comes-after-succinylcholine-rocuronium-and-sugammadex
#2
N Zoremba, G Schälte, C Bruells, F K Pühringer
Due to the great advantages, it is not possible to imagine current practice in anesthesia without the adminstration of muscle relaxants. For a long time the administration of succinylcholine for rapid sequence induction (RSI) was considered to be the state of the art for patients at risk for aspiration. The favorable characteristics are, however, accompanied by many, sometimes severe side effects. Due to the development of non-depolarizing muscle relaxants, in particular rocuronium in combination with sugammadex, there is the possibility to achieve a profile of action similar to succinylcholine with low side effects...
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28289766/-complications-and-monitoring-standards-after-elective-craniotomy-in-germany
#3
C Henker, C Schmelter, J Piek
BACKGROUND: The increasing endeavors to make inpatient treatment processes more effective leads to a reduction of the length of stay in hospital and minimization of postoperative monitoring. Therefore, the aim of our study was to determine potential postoperative complications for neurosurgical patients undergoing elective surgery with respect to assessment of the relevance for intensive medical care. Furthermore, our approach was compared with the standard of postoperative care of such patients in Germany...
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28289765/-palliative-medicine-at-the-borderlines-of-life-and-death
#4
EDITORIAL
C Bausewein
No abstract text is available yet for this article.
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28289764/erratum-to-good-neurological-outcome-after-primary-accidental-hypothermia-presenting-with-asystole
#5
I Eckert, P Imboden, P Paal, J Koppenberg
No abstract text is available yet for this article.
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28275849/-beginning-of-continuous-wound-infusion-with-local-anesthetics-with-special-emphasis-on-the-contributions-from-walter-capelle-and-ewald-fulde
#6
M Goerig, A Gottschalk
Wound infusion with local anesthetics is a proven and safe analgesic procedure for modern perioperative patient care. Even the pioneers of local anesthesia practiced wound analgesia and emphasized the shortcomings of "single-shot" wound infusions. At the same time, they drew attention to the importance of long-lasting pain relief to prevent sequelae, especially after upper abdominal surgery with pneumonia, embolic events or postoperative ileus. In the early 1930s there were first sustained efforts to improve the efficiency and quality of pain therapy, especially after upper abdominal surgery by continuous wound infiltration with local anesthetics via intraoperatively introduced special cannulas...
March 8, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28265685/laparoscopic-partial-nephrectomy-in-a-patient-on-simvastatin-delayed-recovery-from-neuromuscular-blockade
#7
E E Abd El-Hakeem, A M Kaki, S A Almazlom, A J Alsayyad
Delayed recovery from anesthesia remains a very challenging subject for anesthesiologists. This case report describes the clinical course of delayed recovery from neuromuscular blockade after laparoscopic partial nephrectomy in a patient on simvastatin. The patient was hypertensive on regular treatment with oral captopril 25 mg twice daily and amlodipine 5 mg once daily and hypercholesterolemic on regular simvastatin 40 mg once daily with a normal electrocardiogram (ECG). All preoperative laboratory findings were within normal ranges...
March 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28258297/-prehospital-analgesia-by-emergency-physicians-and-paramedics-comparison-of-effectiveness
#8
B Schempf, S Casu, D Häske
BACKGROUND: In some German emergency medical service districts, analgesia is performed by paramedics without support of emergency physicians on scene. With regard to safety and effectiveness, paramedics should not be overshadowed by emergency physicians. OBJECTIVES: Is prehospital analgesia performed by paramedics under medical supervision or emergency physicians comparable regarding processes and effectiveness in the case of isolated limb injury? MATERIAL AND METHODS: As a retrospective analysis of patients with isolated limb injury, analgesia performed by paramedics and by emergency physicians was analyzed...
March 3, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28246753/the-who-recommendation-for-80-perioperative-oxygen-is-poorly-justified
#9
EDITORIAL
T Volk, J Peters, D I Sessler
No abstract text is available yet for this article.
February 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28246752/-does-migraine-lead-perioperatively-to-stroke
#10
J Van Waesberghe, M Coburn
No abstract text is available yet for this article.
February 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28243701/-which-fluids-does-my-patient-need-and-when-yes-how-much
#11
EDITORIAL
M Sander
No abstract text is available yet for this article.
February 27, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28210762/-impact-assessment-of-inadequate-hospital-disaster-management-reflection-based-on-a%C3%A2-risk-model
#12
E Pfenninger, H Güzelel
BACKGROUND: According to legal regulations alarm and emergency plans have to be developed and kept current in hospitals. However, often neither the hospital administration, nor the medical employees and nursing staff pay the necessary attention to these alarm and evacuation plans. In particular, risks and consequences - including financial ones - due to insufficient planning, are not adequately considered. OBJECTIVES: Risks in hospitals are assessed based on a risk analysis...
February 16, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28194479/-airway-management-in-intensive-care-units-in-rhineland-palatinate-evolution-over-five-years
#13
T Piepho, T Härer, L Ellermann, R R Noppens
BACKGROUND: Securing the airway in severely ill patients is associated with a high rate of complications. So far, no information exists about the equipment readily available for airway management in German intensive care units (ICUs). It is also unknown if the range of material has improved over time. OBJECTIVES: In the present trial the availability of equipment for airway management in ICUs in Rhineland-Palatinate was evaluated at two different times. MATERIALS AND METHODS: Using a structured questionnaire, all ICUs in the state were contacted in the years 2010 and 2015...
February 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28194478/-diagnostic-investigation-in-emergency-medicine-why-case-history-is-crucial
#14
M Mirus, A R Heller
We present the preclinical case of a patient reporting chest pain. Pain impeded physical examination. Reviewing the patient's detailed medical history after analgesia revealed a connection between the reported pain and vomiting. This led to a suspicion of organ perforation. Thus, the patient was admitted to a surgical emergency room (ER) and Boerhaave's Syndrome was diagnosed. After deterioration in the ER, cardiopulmonal reanimation (CPR), and successful surgical treatment, the patient was transferred to the intensive care unit (ICU) seven hours after first contact...
February 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28188324/-regional-anesthesia-for-carotid-surgery-an-overview-of-anatomy-techniques-and-their-clinical-relevance
#15
A Koköfer, J Nawratil, M Opperer
BACKGROUND: Perioperative care for patients undergoing carotid endarterectomy (CEA) often presents a challenge to the anesthesia provider, as this patient group commonly suffers from a wide range of comorbidities. Although clinical trials could not demonstrate a significant benefit associated with regional anesthesia for outcomes such as insult, cardiac infarction or mortality, many authors concur that regional anesthetic techniques might be preferential in specific patient populations for this type of surgery...
February 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28184955/-tranexamic-acid-in-the-german-emergency-medical-service-a%C3%A2-national-survey
#16
V Zickenrott, I Greb, A Henkelmann, F Balzer, S Casu, L Kaufner, C von Heymann, K Zacharowski, C F Weber
BACKGROUND: Trauma-induced coagulopathy, one of the leading causes of trauma-related death, is detected in about one of four trauma patients upon hospital admission. The current European Management of Major Bleeding and Coagulopathy Following Trauma guidelines, published in 2013, recommend that tranexamic acid (TXA) be administered as early as possible to inhibit hyperfibrinolysis (grade of recommendation (GoR 1A)). Furthermore, it is suggested that protocols for the management of patients with bleeding or showing signs of bleeding include the administration of the first dose of TXA at the site of injury or during transportation to hospital (GoR 2C)...
February 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28175941/-health-related-quality-of-life-after-mechanical-ventilation-in-the-intensive-care-unit
#17
D Schädler, L Kaiser, B Malchow, T Becher, G Elke, I Frerichs, T Küchler, N Weiler
BACKGROUND: It is unknown whether health related quality of life measured in German patients one year after mechanical ventilation in the intensive care unit is impaired or not. OBJECTIVES: The aim of this study was to assess health related quality of life one year after inclusion into a randomized controlled trial for weaning from mechanical ventilation with the help of a questionnaire that has never been used in critically ill patients and to investigate whether health related quality of life scores differ between the study population and a general German population...
February 7, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28175940/-avoidance-of-complications-when-dealing-with-central-venous-catheters-in-the-treatment-of-children
#18
D Aprili, T O Erb
Central venous catheters (CVCs) are an important tool in the treatment of children. The insertion of a catheter may result in different complications depending of the type of catheter, the technique used for the insertion and the location. There are various techniques to reduce the risk of complications. In order to reduce the rate of complications of CVCs it is indispensable to perform a risk-benefit analysis for the individual patient before every insertion. The type of catheter used (for example tunneled catheters versus not-tunneled catheters) influences the rate of catheter-associated infections and the comfort of the patient significantly...
February 7, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28160043/-estimation-of-artificial-ventilation-is-impractible
#19
LETTER
A R Schmidt, K Ruetzler, T Haas, A Schmitz, M Weiss
No abstract text is available yet for this article.
February 3, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28160042/-monitoring-during-ventilation-with-ventrain-%C3%A2
#20
LETTER
M de Wolf, R Gottschall, D Enk
No abstract text is available yet for this article.
February 3, 2017: Der Anaesthesist
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