Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Case Reports[Bicycle accident on the way to school--an interactive case report].
We report on the case of a multiply injured 14-year-old girl with severe open brain trauma, prehospital cardiopulmonary rescuscitation and immediate decompressive craniectomy. Despite the extremely poor prognosis, a very good outcome has been achieved. We discuss the influence of the time management on the outcome.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Review[Outpatient anesthesia--the office-based anesthetist].
The aim of the present article is to describe the field of activity and prevailing conditions for office-based anesthetists in Germany. From the introduction of outpatient operations on the basis of actual numbers, data and facts, we present the project profile and the structures of the different fields of activity and practice constellations for office-based anesthesiology. ⋯ With the aid of current numerical data the anesthetic procedures performed in the outpatient field through to the possibilities for development of continuous regional anesthetic procedures in catheter technique are illustrated. In conclusion, we discuss the economic conditions and the health-care economic significance together with a description of the current health-care quality of ambulant anesthesiology and the possibilities for participation in an error-reporting system.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Review[The implementation of an independent and differentiated pain management SOP (Standard Operating Procedure) for the interdisciplinary intensive care unit].
Up to the present day, pain management in the ICU (Intensive Care Units) is a unresolved clinical problem due to patient heterogeneity with complex variation in etiopathology and treatment of the underlying diseases. Therefore, therapeutic strategies in terms of standard operating procedure (SOP) are a necessary to improve the pain management for intensive care patients. Common guidelines for analgosedation are often inadequate to reflect the clinical situation. ⋯ In addition to our pre-existing SOP for analgosedation we implemented a pain management SOP for our interdisciplinary, anaesthesiologic ICU. A exploratory survey among the nurse staff was conducted to assess the efficacy of the SOP. The results of the evaluation after a 6 month follow-up indicated a faster onset of pain management and good acceptance by the nursing staff.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Review[Acute kidney injury--prevention, risk stratification and biomarkers].
Acute kidney injury influences negatively morbidity and mortality of the critically ill patient and causes increased costs by prolonged length of stay in the intensive care unit. At present the diagnosis and classification of acute kidney injury is derived from the RIFLE and AKIN criteria based on serum creatinine and urine output. ⋯ But none of the promising candidates is used in clinical routine up to now. For evaluation of clinical benefit the results of large prospective multicenter studies have to be awaited.