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Der Anaesthesist

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https://www.readbyqxmd.com/read/28600587/-consideration-of-the-habitus-increases-the-accuracy-of-estimation-in-the-application-of-cognitive-aids-in-pediatric-emergences
#1
LETTER
C G Erker, J Rotermund
No abstract text is available yet for this article.
June 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28597082/-difficulties-with-children-of-abnormal-weight
#2
LETTER
F Hoffmann, J Kaufmann, B Landsleitner, H Marung, T Nicolai, F Reifferscheid, U Trappe, P Jung
No abstract text is available yet for this article.
June 8, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28589374/-integration-of-palliative-care-into-intensive-care-systematic-review
#3
K Adler, D Schlieper, D Kindgen-Milles, S Meier, J Schwartz, P van Caster, M S Schaefer, M Neukirchen
BACKGROUND: One of the prime aims of intensive care is to cure patients or at least to extend life duration, sometimes to the extent of losing quality of life. Palliative care aims to improve the quality of life of patients with life-limiting conditions; however, some patients need both intensive and palliative care. About 5-10% of all deaths in Germany and 20% of all deaths in the USA occur in an intensive care unit (ICU) and many of those as well as other patients may benefit from palliative care consultation...
June 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28577108/-intracranial-hemorrhage-secondary-to-vitamin%C3%A2-k-deficiency-in-an-infant-despite-oral-vitamin%C3%A2-k-prophylaxis-also-a-challenge-for-the-anesthesiologist
#4
S Ackermann, J Schimpf, M Richter
This article presents the case of a 6-week-old infant who, despite oral vitamin K prophylaxis and otherwise normal developmental progress, suffered a severe intracerebral and subdural hemorrhage, which required surgical evacuation. The interdisciplinary approach is described with emphasis on the management of hemostasis. Furthermore, the clinical picture of intracranial bleeding due to vitamin K deficiency, which is nowadays rare in the Western World, is described in the anesthesiology literature for the first time...
June 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#5
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28510036/-caring-for-patients-but-carefully-of-course-structured-handover
#6
EDITORIAL
L Vogt, S Sopka
No abstract text is available yet for this article.
May 16, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28500500/-epistemology-in-the-intensive-care-unit-what-is-the-purpose-of-a-definition-paradigm-shift-in-sepsis-research
#7
P Dickmann, A Scherag, S M Coldewey, C Sponholz, F M Brunkhorst, M Bauer
The adoption of the new sepsis definition in early 2016 introduced a new paradigm for the clinical picture of sepsis. Up until now, sepsis was defined as a systemic inflammatory reaction (systemic inflammatory response syndrome, SIRS) to an infection. Based on a better understanding of the molecular mechanisms, the focus of the new definition is no longer the inflammatory response, but rather the tissue damage and impairment of organ function which this induces. The paradigm thus moves away from the infection and the systemic inflammatory response, and toward that which makes sepsis so dangerous in terms of both disease dynamics and outcome: organ failure due to a dysregulated host response to an infection...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#8
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28497243/-kids-save-lives-resuscitation-training-for-schoolchildren-systematic-review
#9
D C Schroeder, H Ecker, S Wingen, F Semeraro, B W Böttiger
BACKGROUND: Even in western developed countries, the probability of survival after out-of-hospital cardiac arrest (OHCA) is only 6-10%. In order to improve survival after OHCA, early initiation of cardiopulmonary resuscitation (CPR) by laypersons is essential. Introduction of CPR training in schoolchildren seems to be effective to increase lay-CPR rates. OBJECTIVE: The objective of the present investigation was to elucidate educational aspects of teaching schoolchildren in CPR and to summarize campaigns related to a comprehensive establishment of lay-CPR worldwide...
May 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28497242/-new-sepsis-3-definition-do-we-have-to-treat-sepsis-before-we-can-diagnose-it-from-now-on
#10
T Schmoch, M Bernhard, F Uhle, M Gründling, T Brenner, M A Weigand
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) have been available since the beginning of 2016. SEPSIS-3 completely replaces the old SIRS criteria in the definition of sepsis and defines sepsis from now on as "life-threatening organ dysfunction caused by a dysregulated host response to infection". However, it seems questionable whether in clinical practice the new definition is really superior to the old one. The most important question is the following: Is it helpful to have a definition that first recognizes a patient once organ dysfunction has occurred and the patient already needs intensive care?...
May 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28492980/-haemostatic-management-in-postpartum-haemorrhage-nationwide-survey-in-germany
#11
L Kaufner, K Ghantus, A Henkelmann, U Friedrichs, K Weizsäcker, A Schiemann, C von Heymann
BACKGROUND: In order to ensure evidence-based haemostatic management of postpartum haemorrhage (PPH, blood loss >500 ml) consistent with guidelines appropriate structural conditions must be fulfilled regardless of different levels (1-3) in perinatal care. The aim of the survey was to identify differences in haemostatic management in PPH under consideration of the different levels of perinatal care in Germany. MATERIALS AND METHODS: An electronic questionnaire assessing the structural and therapeutic preconditions for haemostatic management was sent to 533 anaesthesiology departments serving obstetric units...
May 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28488020/-unusual-complication-following-placement-of-an-epidural-catheter
#12
M Schlipköter, T Grieser, H Forst
We report an unusual complication following placement of a thoracic epidural catheter in a patient that had undergone surgery for pulmonary metastases of a malignant melanoma. The intra- and postoperative course was initially without complications. At 2 days, there was a small, conspicuous swelling above the site of epidural puncture, which was neither reddened nor painful. No neurological deficits were observed, and the patient explained that he had been aware of the swelling for more than 6 months; thus, the epidural catheter was not deemed to be responsible...
May 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28474245/-emergency-medicine-an-integral-element-of-public-services-in-the-search-of-its-identity
#13
EDITORIAL
S Prückner, M Bayeff-Filloff
No abstract text is available yet for this article.
May 4, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28474244/-morel-lavall%C3%A3-e-lesion-severely-injured-13%C3%A2-year%C3%A2-old-after-being-run-over
#14
F C F Schmitt, T Brenner, S Hofer, M A Weigand, P A Grützner, U Kneser, T Kremer, J Franke, U Müller
Accidents in which a person is run over are often associated with multiple serious injuries. Immediate bleeding control is crucial. Pressure and shear stress at the borders of subcutaneous tissue to the muscle fascia can cause hypoperfusion and the emergence of blood-filled cavities that are associated with a high risk of infection and necrosis, a so-called Morel-Lavallée lesion. Insufficient therapy can lead to local complications and furthermore to live-threatening sepsis.
May 4, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28474243/-preoperative-fasting-period-of-fluids-in-bariatric-surgery
#15
P Simon, U-C Pietsch, R Oesemann, A Dietrich, H Wrigge
BACKROUND: Aspiration of stomach content is a severe complication during general anaesthesia. The DGAI (German Society for Anesthesiology and Intensive Care Medicine) guidelines recommend a fasting period for liquids of 2 h, with a maximum of 400 ml. Preoperative fasting can affect the patients' recovery after surgery due to insulin resistance and higher protein catabolism as a response to surgical stress. OBJECTIVES: The aim of the study was to compare a liberal fasting regimen consisting of up to 1000 ml of liquids until 2 h before surgery with the DGAI recommendation...
May 4, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28474242/-quality-indicators-and-structural-requirements-for-cardiac-arrest-centers-german-resuscitation-council-grc
#16
REVIEW
K H Scholz, D Andresen, B W Böttiger, H J Busch, M Fischer, N Frey, M Kelm, C Kill, B Schieffer, C Storm, H Thiele, J T Gräsner
No abstract text is available yet for this article.
May 4, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28455651/-management-of-hemorrhage-in-patients-treated-with-direct-oral-anticoagulants
#17
REVIEW
O Grottke, H Lier, S Hofer
The introduction of nonvitamin K antagonistic, direct oral anticoagulants (DOAC) made thromboembolic prophylaxis easier for patients. For many physicians, however, there is still uncertainty about monitoring, preoperative discontinuation, and restarting of DOAC therapy. Guidelines for the management of bleeding are provided, but require specific therapeutic skills in the management of diagnostics and therapy of acute hemorrhage. Small clinical studies and case reports indicate that unspecific therapy with prothrombin complex concentrates (PCC) and activated PCC (aPCC) concentrate may reverse DOAC-induced anticoagulation...
April 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28455650/-use-of-cognitive-aids-in-pediatric-emergency-care-interdisciplinary-consensus-statement
#18
REVIEW
S Wirtz, C Eich, K Becke, S Brenner, A Callies, U Harding, C Höhne, F Hoffmann, J Kaufmann, B Landsleitner, H Marung, T Nicolai, F Reifferscheid, U Trappe, P Jung
Preclinical pediatric emergencies are rare events and are therefore often associated with stress and uncertainty for emergency medical service personnel. To ensure adequate treatment of pediatric patients a variety of different cognitive aids exist (e.g. books, apps, rulers, weight-adapted bag systems). Especially the size specifications of the medical equipment and the dosage of emergency medication are individually very different in children and are dependent on parameters, such as body height and weight...
April 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28447107/-role-of-anesthesiology-in-pain-medicine-and-palliative-care-treatment-in-german-hospitals-survey-of-department-heads-of-anesthesiology-on-treatment-structures
#19
J Erlenwein, F Petzke, U Stamer, W Meißner, F Nauck, E Pogatzki-Zahn, W Koppert, C Maier
BACKGROUND: The aim of this analysis was to describe the role of anesthesiology departments in pain medicine and palliative care services in German hospitals. METHOD: In the year 2012, all heads of departments of anesthesiology registered with the German Society of Anesthesiology and Intensive Care Medicine were surveyed about structures of pain medicine and palliative care services in their hospitals using a standardized postal questionnaire. RESULTS: Out of 408 returned questionnaires (response rate 47%) 403 could be evaluated...
April 26, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28424835/-future-of-emergency-medicine-in-germany-2-0
#20
REVIEW
A Gries, M Bernhard, M Helm, J Brokmann, J-T Gräsner
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment...
April 19, 2017: Der Anaesthesist
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