Der Anaesthesist
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We have used the Stewart approach to typical acute and compensated acid-base disorders here. Dedicated software developed by the author is available with this article and will be of help to anyone considering analyzing his or her own patients using the Stewart approach. The Stewart approach shares analytical steps with the more traditional Siggard-Andersen method, and in most cases the two methods arrive at the same therapeutic solutions. The Stewart approach is, however, more than merely a biophysical appendix to the traditional clinical model, since metabolic acid-base disorders in particular are understood within a completely different pathophysiological framework; this results in a fresh and sometimes unexpectedly helpful perspective that highlights the functional relevance of seemingly forgotten components such as the chloride ion or albumin.
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Case Reports
[Application of the current resuscitation guidelines 2005. Case report of successful cardiopulmonary resuscitation].
The international guidelines for cardiopulmonary resuscitation are subject to continuous modification and were revised in November 2005. This report describes a case of an out-of-hospital cardiopulmonary resuscitation where the patient survived a cardiac arrest without neurological sequelae after chest compression (30:2), bag-mask ventilation and multiple biphasic defibrillation (single shocks). This article gives a practical review of the most important new recommendations in the current resuscitation guidelines. The accomplished measures are discussed on the background of the new recommendations.
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Case Reports
[Accidental intoxication with unlabeled, generic transdermal fentanyl patches caused by insufficient instruction].
A somnolent 78-year-old male patient was brought to our emergency room by an ambulance with the presumptive diagnosis of stroke. Cranial computed tomography provided no evidence. On the intensive care unit of the neurosurgical department the patient was completely undressed. ⋯ Under the presumptive diagnosis of an opioid intoxication by a transdermal therapeutic system naloxone was infused over 3 days. The patient reported after rapidly awaking that fentanyl patches had been prescribed by his family practitioner the day before. The patient recovered without any sequelae.
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Comparative Study
[Preclinical transtracheal emergency ventilation. Animal experimental comparison of two techniques].
Prehospital transtracheal ventilation via a needle cricothyroidotomy may be lifesaving in cannot-intubate-cannot-ventilate situations. A self-made device consisting of a three-way stopcock placed between a transtracheal airway catheter and an oxygen supply was constructed and the effectiveness of the device was compared with a hand-triggered emergency jet generator in animal experiments. ⋯ The efficacy of the self-made device during the experiment was comparable with the efficacy of the hand-triggered emergency jet injector.