Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2006
Review Case Reports[Out-of-hospital and early clinical management of polytrauma in a patient after severe car accident].
We report the case of a 30 year old driver of a car who was jammed after a severe traffic accident. In a step-by-step description of the out-of-hospital and early clinical management of the patient, the case report focuses on diagnostic, therapeutic, and strategic issues. Current controversies in the management of patients with combined thoracic and abdominal trauma are discussed in the light of recent literature.
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Invasive airway management techniques are the bottom line of most difficult airway management algorithms when less invasive measures (e.g. endotracheal intubation, bag-valve-mask ventilation, or supraglottic airways) have failed. Various devices for transtracheal jet ventilation in children are available, while cricothyrotomy is the gold standard for establishing an invasive airway in adults. Percutaneous tracheostomy could become an alternative to cricothyrotomy if applied by experienced physicians, however, clear scientific evidence to advocate percutaneous tracheostomy in airway emergencies is still pending.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2006
Review[Clinical management of the difficult airway].
Difficult airway management is among the key requirements in routine anaesthesia. Failures to secure the airways resulting in a "Cannot intubate, Cannot ventilate" situation can drastically increase morbidity and mortality of patients within a very short time. Therefore, an algorithm for management of the expected and unexpected difficult airway describing the sequence of various procedures, adapted to internal standards and to techniques that are available, has to be provided by each anaesthesia department. This not only facilitates the preparation of equipment and the training of personnel, but also ensures efficient decision making under time pressure.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2006
Review[Spinal regional anesthetic approaches in children: caudal block and spinal anesthesia].
Caudal anesthesia is a safe, simple and very effective method to provide excellent perioperative analgesia. It is used routineously in pediatric anesthesia and can be applied to nearly all children with surgery below the umbilicus. In contrast, spinal anesthesia is a very special technique for former preterm infants below the 50th postconceptive week who are prone to develop postoperative apnea. It has been suggested that some of the problems associated with general anesthesia in these patients may be avoided by the use of spinal anesthesia.