Der Anaesthesist
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Telemedicine has already entered the rescue service in some regions of Germany. This case description is about a telemedical emergency physician case where an emergency doctor was also at the scene of the emergency. ⋯ She decided to contact the tele-emergency medical services (tele-ems) and could then be instructed to perform intraosseous access, drug treatment and electrical cardioversion in the unstable patient. The cooperation with the tele-ems physician enabled the still inexperienced emergency physician to perform a guideline-compliant treatment and to transport the stabilized patient to the hospital in a timely manner.
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The immune system is an effective defense against invading pathogens and is accompanied by recruitment of immune cells and initiation of an inflammatory reaction. This can also be triggered by noninfectious stimuli, e.g. a large surgical intervention and cause severe tissue destruction and organ dysfunction. ⋯ This excessive immune response leads to release of proinflammatory cytokines, endothelial dysfunction, damage to the glycocalyx, activation of leukocytes as well as tissue and organ destruction. This article summarizes the molecular principles of the surgery-associated inflammatory reaction, the differentiation from other inflammatory complications and treatment options.