Der Anaesthesist
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Offshore windfarms are constructed in the German North and Baltic Seas. The off-coast remoteness of the windfarms, particular environmental conditions, limitations in offshore structure access, working in heights and depths, and the vast extent of the offshore windfarms cause significant challenges for offshore rescue. Emergency response systems comparable to onshore procedures are not fully established yet. ⋯ Operational air medical rescue services and specific offshore emergency reaction teams have established a powerful rescue chain. Besides the present development of medical standards, more studies are necessary in order to place the rescue chain on a long-term, evidence-based groundwork. A central medical offshore registry may help to make a significant contribution at this point.
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Aside from suicide attempts or autoerotic accidents, serious injuries from strangulation are rare. In 1929, the accidental death of the famous dancer Isadora Duncan gained high profile. ⋯ In the pre-hospital setting, airway management has been challenging, as even a correctly placed airway device may initiate a rapid and marked deterioration of the patient's condition. The case history at hand outlines the death of a 47-year-old female, following entanglement of her scarf in bottling equipment.
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Case Reports
[Brown urine : Myoglobin-induced renal failure after concomitant administration of simvastatin and amiodarone].
Rhabdomyolysis is a rare but well-known complication of statin therapy. The risk is considerably increased when concomitant drugs are administered that inhibit metabolism and breakdown via the cytochrome CYP3A4. We report a case of myoglobin-induced acute renal failure secondary to the concomitant use of simvastatin and amiodarone. The risk of rhabdomyolysis is mainly determined by the statin dose; in the case of the concomitant use of CYP3A4 inhibitors, a maximal daily dose of 20 mg is recommended to avoid harmful drug interactions.
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Inflation of laryngeal masks is often performed only with regard to the clinical impression and without any objective measurement of cuff pressure. As a result the use of laryngeal masks frequently leads to postoperative complications, such as sore throat, dysphonia, dysphagia and nerve palsy. In this study the influence of continuous measurement of cuff pressure on the incidence of postoperative sore throat was investigated in patients who underwent laryngeal mask anesthesia. ⋯ In terms of the results of this study and with respect to data from the literature, measurement of cuff pressure should be compulsory during laryngeal mask anesthesia.
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In the hospital, human resource planning has to consider the needs and preferences of personnel and planners as well as the financial interest of the hospital. Additionally, staff planning has become more complex due to a growing number of part-time doctors as well as a variety of working shifts. ⋯ This study analyzed structures established in human resource planning in the anesthesiology departments for the first time. Time for planning varies significantly in comparable departments indicating suboptimal processes. Throughout Germany, the requirements for human resources planning are similar; for example, the software should integrate all aspects of HR planning. Different approaches are under evaluation but so far no software solution has prevailed. The used solutions vary substantially and therefore a comparison is difficult. There is no software solution with wide adoption.