Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2015
[Patient autonomy and informed consent - ethical and legal issues].
Informing patients about the benefits and risks of and alternatives to proposed medical or surgical procedures is crucial to the patient-physician relationship. It is a legal and ethical precondition to a patient's informed consent to a course of action. ⋯ This process promotes patient autonomy. Studies have shown that this approach builds trust, increases patient satisfaction with health care and results in a higher degree of professional fulfilment for the physician.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2015
[Health care power of attorney project at the University Hospital Frankfurt].
Under German law it is the patient alone who has the right to decide whether or not to undergo a particular medical procedure. Treating a patient without his or her consent always constitutes a serious infringement of the patient's constitutional right of self-determination as well as the right to physical integrity. ⋯ The University Hospital has developed its own health care power of attorney form for patient use. In addition, patients have the option of receiving additional information about other types of health care advance directives, such as a living will.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2015
[Invasive emergency techniques - In-field-amputation].
On-scene invasive emergency procedures, such as Cricothyroidotomy, chest drain, intraosseous puncture or even in-field-amputation, are often unavoidable, when indicated, and present a major challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. ⋯ This article presents the use of in-field-amputation, with reference to indication, implementation, problems and risks. It is part of a series of four articles on the subject of invasive emergency techniques.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2015
[Perioperative Management of adult patients with obstructive sleep apnea].
Obstructive sleep apnea (OSA) is a common sleep related breathing disorder with an increasing prevalence. Most surgical patients with OSA have not been diagnosed prior to surgery and are at an increased risk of developing perioperative complications. Preoperative identification of these patients is important in order to take appropriate measures concerning a safe perioperative management. ⋯ The extent and duration of postoperative continuous monitoring has to be determined on an individual basis. A preoperatively existing therapy with continuous positive airway pressure should be continued postoperatively as soon as possible. Patients with OSA may be managed on an outpatient basis if certain requirements are met.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2015
[New short-acting local anaesthetics for spinal anaesthesia - Well-tried substances for ambulatory surgery].
More and more operative procedures are performed in an ambulatory setting. Many patients are denied spinal anaesthesia, although it provides several advantages. ⋯ Additional perioperative measures, such as the use of atraumatic, thin spinal needles (25 or 27G), restrictive volume management, and early patient mobilisation, lead to a further reduction of complications. The new S1 guideline of the German Society of Anaesthesiology and Intensive Care Medicine encourages us anaesthetists to use spinal anaesthesia more frequently in an ambulatory setting.