Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Mar 2016
Review Case Reports[Rapid diagnostic in the emergency unit: bedside sonography].
Using bedside ultrasound in the emergency room includes point of care sonography (echoscopy) and several protocols (RUSH, FATE, etc.). The aim of these protocols is to evaluate the life threatening emergency care situation without interrupting the clinical work flow. ⋯ In addition this article gives an overview about compression sonography of veins. Examples are presented on how to use bedside ultrasound in clinical settings.
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Many drugs influence vital functions via the sympathetic and the parasympathetic system. Besides that hypersensitivity reactions and reactions by chemical radicals that arise in drug metabolism may directly harm the heart muscle cell. Cardiac adverse drug reactions (ADR) result in disturbances of the heart rhythm, negative inotropic effects, direct damage to the heart muscle cell, and reduced perfusion of heart tissue. ⋯ This is of particular interest if more drugs are prescribed in combination. Now these effects may add up to pharmacodynamic drug-drug-interactions. Data banks like PSIAConline (www.psiac.de), individualization of drug prescription by therapeutic drug monitoring (TDM) combined with a clinical pharmacological report (www.konbest.de), as well as drug information systems such as AGATE (www.amuep-agate.de) are today of help not just to recognize such drug risks, but also to find professional and evidence based solutions for it.
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Emergency Departments ED may be an exceptionally good example of an interface within a hospital. EDs have no patients of their own but pass them over to other institutions, either to specialist departments within the hospital or to primary care providers. ⋯ The best way to secure handoff of information may be the formalization and standardization of this process, assuring patient safety and quality of care. Further study is required.
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Dtsch. Med. Wochenschr. · Dec 2015
Review[Nasal Highflow - Treatment option in severe hypoxaemia?].
Nasal High Flow (NHF) provides a warmed and humidified air stream. In pediatrics, this method is already in widespread use and is increasingly replacing the CPAP. New studies show success in treating adults. ⋯ At this juncture effectiveness of this easy to use method is not clear. Preliminary reports describe an improvement in ventilation by the NHF. Here, a wash-out of the airways and improved alveolar ventilation seem to be the main operating principles.