Der Anaesthesist
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All hospitals that are defined as organ donation hospitals according to the Social Act V (SGB V), are legally bound to employ a transplant coordinator (TxB). The field of activities of the TxB includes not only the identification of donors, the diagnosis of irreversible loss of brain function, donor evaluation and organ protection but also the support of the complete organ donation process. ⋯ The activities are subject to the Transplantation Act and its implementation statutes; however, the TxB also needs corresponding knowledge of the various guidelines on organ donation and transplantation. Finally, the TxB is also responsible for the quality assurance of the organ donation process.
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A sharp rise in COVID-19 infections threatened to lead to a local overload of intensive care units in autumn 2020. To prevent this scenario a nationwide relocation concept was developed. ⋯ If the number of infections with SARS-CoV‑2 increases, a nationwide relocation concept for COVID-19 intensive care patients and non-COVID-19 intensive care patients should be installed at an early stage in order not to overwhelm the capacities of hospitals. Supply regions around a leading clinic with maximum intensive care options are to be defined with a central management that organizes the necessary relocations in cooperation with regional and superregional rescue service control centers. With this concept and the intensive care transports carried out, it was possible to effectively prevent the overload of individual clinics with COVID-19 patients in Baden-Württemberg. Due to that an almost unchanged number of patients requiring regular intensive care could be treated.
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The Ether Day, a key moment in the history of mankind, commemorates its 175th anniversary on 16 October 2021. On that day the dentist William T. G. ⋯ On the other hand, over the decades it has become clear that anesthesia is obviously beneficial for mankind in that it offers relief from pain and psychological stress but that it can also often show its dark side: substance abuse, use of anesthetics in torture and in executions. In addition, the role of anesthetics in resuscitation, palliative care, and allaying executions is unclear or controversial. Finally, the necessary formal legal steps to acknowledge a "human right to unconsciousness" have not yet been implemented.
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Focused treatment of epileptic emergencies, and in particular status epilepticus (SE), require a reliable differentiation of epileptic syndromes. In these cases, and especially in cases with predominant non-motor symptoms, clinical and electroencephalographic expertise is necessary. In 2020 the German guidelines for the management of SE were updated, which adhere to a strict stage-based treatment algorithm. ⋯ Therapeutic interventions especially for refractory forms of SE have been shown to be complex with relevant implications concerning intensive care aspects. Consequently, the modern treatment strategy of SE is characterized by an interdisciplinary approach. Future research is needed to define the optimal treatment of non-convulsive SE, in particular regarding the time point and degree of treatment escalation with associated ethical considerations.
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Review Historical Article
[From ether anesthesia to "green" anesthesia : Challenges in anesthesiology over the last 175 years].
The first public demonstration of ether anesthesia took place 175 years ago. Since that time, insensitivity to pain during surgical operations has been possible. The "Ether Day" has been portrayed in many ways. ⋯ In the beginning of the twenty-first century, the focus was initially on procedures that saved allogeneic blood. New topics emerged, ranging from the effects of anesthesia on tumors up to climate change. Anesthesiology must continue to face new challenges in the future.