[Prehospital analgesia by emergency physicians and paramedics : Comparison of effectiveness].
e D Abstract BACKGROUND: In some German emergency medical service districts, analgesia is performed by paramedics without support of emergency physicians on scene. With regard to safety and effectiveness, paramedics should not be overshadowed by emergency physicians. OBJECTIVES: Is prehospital analgesia performed by paramedics under medical supervision or emergency physicians comparable regarding processes and effectiveness in the case of isolated limb injury? MATERIAL AND METHODS: As a retrospective analysis of patients with isolated limb injury, analgesia performed by paramedics and by emergency p...
Source: Der Anaesthesist - March 2, 2017 Category: Anesthesiology Authors: Schempf B, Casu S, Häske D Tags: Anaesthesist Source Type: research

[Does migraine lead perioperatively to stroke?]
PMID: 28246752 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 27, 2017 Category: Anesthesiology Authors: Van Waesberghe J, Coburn M Tags: Anaesthesist Source Type: research

The WHO recommendation for 80% perioperative oxygen is poorly justified.
PMID: 28246753 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 27, 2017 Category: Anesthesiology Authors: Volk T, Peters J, Sessler DI Tags: Anaesthesist Source Type: research

[Which fluids does my patient need and when yes, how much?]
PMID: 28243701 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 26, 2017 Category: Anesthesiology Authors: Sander M Tags: Anaesthesist Source Type: research

[Intramedullary placement of intraosseous cannulas inserted in the preclinical treatment of polytrauma patients : A retrospective, computed tomography-assisted evaluation].
t F Abstract BACKGROUND: Use of intraosseous access to the vascular system is rare in the pre-hospital setting (
Source: Der Anaesthesist - February 22, 2017 Category: Anesthesiology Authors: Jansen G, Leimkühler K, Mertzlufft F Tags: Anaesthesist Source Type: research

[Emergency medical training through simulation : Always the same for everyone?]
r M Abstract Simulation assumes a growing importance in the field of emergency medical education. Many rescue service schools work with simulators or even have their own simulation center. Classic resuscitation training in the classroom is increasingly being replaced by realistic case scenarios. But simulators themselves do not train! Using a simulator in emergency medical training does not necessarily mean achieving sustained learning success among the participants. Depending on the skills, abilities or competences being taught, there seems to be different requirements for simulation. However, there is ...
Source: Der Anaesthesist - February 19, 2017 Category: Anesthesiology Authors: Schaumberg A, Schröder T, Sander M Tags: Anaesthesist Source Type: research

[State of the art in fluid and volume therapy : A  user-friendly staged concept].
[State of the art in fluid and volume therapy : A user-friendly staged concept]. Anaesthesist. 2017 Feb 17;: Authors: Rehm M, Hulde N, Kammerer T, Meidert AS, Hofmann-Kiefer K Abstract Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperativ...
Source: Der Anaesthesist - February 16, 2017 Category: Anesthesiology Authors: Rehm M, Hulde N, Kammerer T, Meidert AS, Hofmann-Kiefer K Tags: Anaesthesist Source Type: research

[Impact assessment of inadequate hospital disaster management : Reflection based on a  risk model].
CONCLUSIONS: Risk management means recognizing risks, assessing risks and managing risks. In hospitals, this mostly means using a critical incident reporting system (CIRS), however risk management in the sense of disaster planning is largely unknown. With a three-dimensional risk matrix, we showed a clear correlation between the quality of disaster planning and relative risk or financial damage. To substantiate the presented theoretical considerations, however, further research must be designed and implemented. PMID: 28210762 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 15, 2017 Category: Anesthesiology Authors: Pfenninger E, Güzelel H Tags: Anaesthesist Source Type: research

[Pulmonary embolism].
Abstract Pulmonary embolism is a potentially fatal disorder and frequently seen in critical care and emergency medicine. Due to a high mortality rate within the first few hours, the accurate initiation of rational diagnostic pathways in patients with suspected pulmonary embolism and timely consecutive treatment is essential. In this review, the current European guidelines on the diagnosis and therapy of acute pulmonary embolism are presented. Special focus is put on a structured patient management based on the individual risk of early mortality. In particular risk assessment and new risk-adjusted treatment recomme...
Source: Der Anaesthesist - February 14, 2017 Category: Anesthesiology Authors: Hecker M, Sommer N, Hecker A, Bandorski D, Weigand MA, Krombach GA, Mayer E, Walmrath D Tags: Anaesthesist Source Type: research

[Diagnostic investigation in emergency medicine: Why case history is crucial].
We present the preclinical case of a patient reporting chest pain. Pain impeded physical examination. Reviewing the patient's detailed medical history after analgesia revealed a connection between the reported pain and vomiting. This led to a suspicion of organ perforation. Thus, the patient was admitted to a surgical emergency room (ER) and Boerhaave's Syndrome was diagnosed. After deterioration in the ER, cardiopulmonal reanimation (CPR), and successful surgical treatment, the patient was transferred to the intensive care unit (ICU) seven hours after first contact. PMID: 28194478 [PubMed - as sup...
Source: Der Anaesthesist - February 12, 2017 Category: Anesthesiology Authors: Mirus M, Heller AR Tags: Anaesthesist Source Type: research

[Airway management in intensive care units in Rhineland-Palatinate : Evolution over five years].
RR Abstract BACKGROUND: Securing the airway in severely ill patients is associated with a high rate of complications. So far, no information exists about the equipment readily available for airway management in German intensive care units (ICUs). It is also unknown if the range of material has improved over time. OBJECTIVES: In the present trial the availability of equipment for airway management in ICUs in Rhineland-Palatinate was evaluated at two different times. MATERIALS AND METHODS: Using a structured questionnaire, all ICUs in the state were contacted in the years 2010 and 2015. The avai...
Source: Der Anaesthesist - February 12, 2017 Category: Anesthesiology Authors: Piepho T, Härer T, Ellermann L, Noppens RR Tags: Anaesthesist Source Type: research

[Regional anesthesia for carotid surgery : An overview of anatomy, techniques and their clinical relevance].
CONCLUSIONS: With regional anesthetic techniques evolving to be more and more complex, the use of ultrasound is becoming increasingly indispensable in the operating theatre. For anesthesiologists with sufficient training and a profound knowledge of the respective anatomy, regional anesthesia seems to be a veritable alternative to general anesthesia for CEA. PMID: 28188324 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 9, 2017 Category: Anesthesiology Authors: Koköfer A, Nawratil J, Opperer M Tags: Anaesthesist Source Type: research

[Tranexamic acid in the German emergency medical service : A  national survey].
CONCLUSION: The survey shows a widespread distribution of TXA in the German EMS, which has significantly increased between 2010 and 2015. However, nationwide distribution has not yet been established. This rise in distribution is interpreted as a reaction to national and European guidelines for the management of severe bleeding and trauma care. A remaining question is to determine which patients should be treated with TXA, as hyperfibrinolysis is not detectable at the site of injury. PMID: 28184955 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 8, 2017 Category: Anesthesiology Authors: Zickenrott V, Greb I, Henkelmann A, Balzer F, Casu S, Kaufner L, von Heymann C, Zacharowski K, Weber CF Tags: Anaesthesist Source Type: research

Good neurological outcome after accidental hyopthermia presenting with asytole.
Abstract A 43-year-old woman became exhausted and fainted on descent at 1127 MAMSL altitude and snowfall. A rescue team diagnosed asystole. With manual cardiopulmonary resuscitation (CPR) she was transported to the next extracorporeal life support (ECLS) center. Admission temperature was 20.7 °C. CPR continued until ECLS was initiated. Two days later she was awake, orientated, and with no neurological deficits. With hypothermic cardiac arrest, a favorable outcome depends on early continuous CPR, triage, and ECLS rewarming. It holds true that "nobody is dead until they are warmed and de...
Source: Der Anaesthesist - February 6, 2017 Category: Anesthesiology Authors: Eckert I, Imboden P, Paal P, Koppenberg J Tags: Anaesthesist Source Type: research

[Avoidance of complications when dealing with central venous catheters in the treatment of children].
Abstract Central venous catheters (CVCs) are an important tool in the treatment of children. The insertion of a catheter may result in different complications depending of the type of catheter, the technique used for the insertion and the location. There are various techniques to reduce the risk of complications. In order to reduce the rate of complications of CVCs it is indispensable to perform a risk-benefit analysis for the individual patient before every insertion. The type of catheter used (for example tunneled catheters versus not-tunneled catheters) influences the rate of catheter-associated infec...
Source: Der Anaesthesist - February 6, 2017 Category: Anesthesiology Authors: Aprili D, Erb TO Tags: Anaesthesist Source Type: research

[Health-related quality of life after mechanical ventilation in the intensive care unit].
CONCLUSIONS: The EORTC QLQ-C30 questionnaire is suitable for the acquisition of the health-related quality of life in formerly critically ill patients. Health-related quality of life is severely impaired after mechanical ventilation in the intensive care unit. Future studies should consider health related quality of life as a possible study endpoint. PMID: 28175941 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 6, 2017 Category: Anesthesiology Authors: Schädler D, Kaiser L, Malchow B, Becher T, Elke G, Frerichs I, Küchler T, Weiler N Tags: Anaesthesist Source Type: research

[Monitoring during ventilation with Ventrain > ( ®)].
[Monitoring during ventilation with Ventrain>(®)]. Anaesthesist. 2017 Feb 03;: Authors: de Wolf M, Gottschall R, Enk D PMID: 28160042 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 2, 2017 Category: Anesthesiology Authors: de Wolf M, Gottschall R, Enk D Tags: Anaesthesist Source Type: research

[Estimation of artificial ventilation is impractible].
PMID: 28160043 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 2, 2017 Category: Anesthesiology Authors: Schmidt AR, Ruetzler K, Haas T, Schmitz A, Weiss M Tags: Anaesthesist Source Type: research

[New technical developments for inhaled sedation].
Abstract The circle system has been in use for more than 100 years, whereas the first clinical application of an anaesthetic reflector was reported just 15 years ago. In the circle system, all breathing gas is rebreathed after carbon dioxide absorption. A reflector, on the other hand, with the breathing gas flowing to and fro, specifically retains the anaesthetic during expiration and resupplies it during the next inspiration. A high reflection efficiency (number of molecules resupplied/number of molecules exhaled, RE 80-90%) decreases consumption. In analogy to the fresh gas flow of a circle s...
Source: Der Anaesthesist - January 30, 2017 Category: Anesthesiology Authors: Meiser A, Bomberg H, Volk T, Groesdonk HV Tags: Anaesthesist Source Type: research

[Trial sequential analysis : Sample size calculation for reliable meta-analyses].
CONCLUSION: The TSA is a suitable tool to minimize the risk of random errors and for a more reliable assessment of the evidence for the results of a meta-analysis. PMID: 28144687 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 30, 2017 Category: Anesthesiology Authors: Weibel S, Kranke P Tags: Anaesthesist Source Type: research

[Care for severely injured persons : Update of the 2016 S3 guideline for the treatment of polytrauma and the severely injured].
d M Abstract In 2011 the first interdisciplinary S3 guideline for the management of patients with serious injuries/trauma was published. After intensive revision and in consensus with 20 different medical societies, the updated version of the guideline was published online in September 2016. It is divided into three sections: prehospital care, emergency room management and the first operative phase. Many recommendations and explanations were updated, mostly in the prehospital care and emergency room management sections. These two sections are of special interest for anesthesiologists in field emergency p...
Source: Der Anaesthesist - January 29, 2017 Category: Anesthesiology Authors: Hilbert-Carius P, Wurmb T, Lier H, Fischer M, Helm M, Lott C, Böttiger BW, Bernhard M Tags: Anaesthesist Source Type: research

[Acute kidney injury - often overlooked and still fatal].
PMID: 28120015 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 23, 2017 Category: Anesthesiology Authors: Zarbock A Tags: Anaesthesist Source Type: research

[In situ broken 27-gauge spinal needle in a repeated caesarean delivery : Case report and literature review].
We report the rare case of an in situ fracture of a spinal needle within the setting of repeated caesarean delivery in a 28-year-old pregnant woman and discuss the responsible underlying factors. In particular, a wrong technique, limited experience, difficulties to identify the anatomical landmarks, as well as the use of spinal needles smaller than 25 G might promote such a complication. In order to ensure the stability of the spinal needle and to avoid an in situ fracture, the spinal needle should be never moved without the stylet. In case of repeated bone contact, a well-experienced anaest...
Source: Der Anaesthesist - January 23, 2017 Category: Anesthesiology Authors: Rieg AD, Dortgolz A, Macko S, Rossaint R, Schälte G Tags: Anaesthesist Source Type: research

[Sciatic nerve block "out-of-plane" distal to the bifurcation: effective and safe].
[Sciatic nerve block "out-of-plane" distal to the bifurcation: effective and safe]. Anaesthesist. 2017 Jan 24;: Authors: Geiser T, Apel J, Vicent O, Büttner J Abstract BACKGROUND: Ultrasound guided distal sciatic nerve block (DSB) at bifurcation level shows fast onset and provides excellent success rates. However, its safe performance might be difficult for the unexperienced physician. Just slightly distal to the bifurcation, the tibial nerve (TN) and common fibular nerve (CFN) can be shown clearly separated from each other. Therefore, we investigated if a block done here would pro...
Source: Der Anaesthesist - January 23, 2017 Category: Anesthesiology Authors: Geiser T, Apel J, Vicent O, Büttner J Tags: Anaesthesist Source Type: research

[Recommendation on temperature management after cardiopulmonary arrest and severe traumatic brain injury in childhood beyond the neonatal period : Statement of the German Society for Neonatology and Pediatric Intensive Care Medicine  (GNPI) and the scientific Working Group for Paediatric Anaesthesia (WAKKA) of the German Society of Anaesthesiology and Intensive Care (DGAI)].
This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36.5 °C) for 72 hours after cardiopulmonary arrest or severe traumatic brain injury for children beyond the neonatal period. PMID: 28091756 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 12, 2017 Category: Anesthesiology Authors: Brenner S, Eich C, Rellensmann G, Schuhmann MU, Nicolai T, Hoffmann F Tags: Anaesthesist Source Type: research

[Renal protection in intensive care : Myths and facts].
Abstract BACKGROUND: Acute kidney injury (AKI) is a common and severe complication in patients on the intensive care unit with a significant impact on patient mortality, morbidity and costs of care; therefore, renal protective therapy is most important in these severely ill patients. AIM OF THE REVIEW: Many renal protective strategies have been postulated during the last decades, which are sometimes still in place as a kind of "myth" but which are not always proven by evidence-based "facts". The aim of this review is therefore to question and compare some of these "myth...
Source: Der Anaesthesist - January 12, 2017 Category: Anesthesiology Authors: John S Tags: Anaesthesist Source Type: research

[Deaths from propofol abuse : Survey of institutes of forensic medicine in Germany, Austria and Switzerland].
ff F Abstract Previous references suggesting a high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in Germany, Austria and Switzerland concerning the number of autopsies carried out between 2002-2112 on medical personnel with the suspicion of abuse of propofol or other analgesics. The response rate was 67%. In 16 out of the 32 responding departments 39 deaths (27 males) were observed with previous connections to anesthesiology, inte...
Source: Der Anaesthesist - January 12, 2017 Category: Anesthesiology Authors: Maier C, Iwunna J, Tsokos M, Mußhoff F Tags: Anaesthesist Source Type: research

[Aus "Fehler und Gefahren" wird "Patientensicherheit" und aus "Trends und Medizin ökonomie" wird "Qualitätsmanagement und Medizinökonomie"].
[Aus "Fehler und Gefahren" wird "Patientensicherheit" und aus "Trends und Medizinökonomie" wird "Qualitätsmanagement und Medizinökonomie"]. Anaesthesist. 2017 Jan 11;: Authors: Schuster M, Markstaller K, Bauer M PMID: 28078373 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 10, 2017 Category: Anesthesiology Authors: Schuster M, Markstaller K, Bauer M Tags: Anaesthesist Source Type: research

[Anaesthesia procedures and invasive vascular access in severely injured patients at trauma room admission in Germany : An online survey].
CONCLUSION: In Germany, medical indication and schedule of invasive vascular catheterisation of severely injured patients in the trauma room is rarely regulated by SOPs and often performed at the discretion of the attending trauma team. Sonographic assistance during vascular puncture and electrocardiography for CVC tip detection is not as common as in non-emergency anaesthesia. Further studies are required to explore the real necessity and safety of invasive vascular catheterisation in multiple trauma patients in order to improve trauma care. PMID: 28078374 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 10, 2017 Category: Anesthesiology Authors: Struck MF, Hilbert-Carius P, Hossfeld B, Hinkelbein J, Bernhard M, Wurmb T Tags: Anaesthesist Source Type: research

[Human factors in medicine].
This article presents the full range of the term human factors from the (emergency) medical perspective. Based on the so-called Swiss cheese model by Reason, we explain the different types of error, what promotes their emergence and on which level of the model error prevention can be initiated. PMID: 28070607 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 8, 2017 Category: Anesthesiology Authors: Lazarovici M, Trentzsch H, Prückner S Tags: Anaesthesist Source Type: research

[Commentary to: Levosimendan for the Prevention of Acute Organ Dysfunction in Sepsis].
PMID: 28050620 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 2, 2017 Category: Anesthesiology Authors: Bruells CS, Kopp R Tags: Anaesthesist Source Type: research

[Legal pitfalls in emergency medicine - how is the situation in Austria?]
l W PMID: 28044186 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 1, 2017 Category: Anesthesiology Authors: Andel H, Kröll W Tags: Anaesthesist Source Type: research

[The ASA Classification - solid like a rock in anesthesiology].
PMID: 27999869 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 19, 2016 Category: Anesthesiology Authors: Gervais HW Tags: Anaesthesist Source Type: research

[ASA classification : Transition in the course of time and depiction in the literature].
This article describes the transition of the ASA classification over the past 75 years und summarizes the currently valid definitions. PMID: 27995282 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 18, 2016 Category: Anesthesiology Authors: Irlbeck T, Zwißler B, Bauer A Tags: Anaesthesist Source Type: research

[Practical training for paramedics : Transformation at the Leipzig University teaching hospital].
CONCLUSION: The development of a unique curriculum for the practical training of paramedics may contribute to standardized, high-quality, and cost-efficient training. PMID: 27942783 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 8, 2016 Category: Anesthesiology Authors: Girrbach FF, Bernhard M, Wessel M, Gries A, Bercker S Tags: Anaesthesist Source Type: research

[Introduction of Prehospital Emergency Ultrasound into an Emergency Medical Service Area].
CONCLUSION: Prehospital emergency ultrasound can be introduced into an emergency medical service area as a diagnostic modality that provides benefits to patients. Emergency physicians have to be specifically trained and to participate in continuous education activities. Especially in rural areas with longer transport routes and journey times, the early diagnosis of for example massive intra-abdominal bleeding is critical for the patient's prognosis. PMID: 27942784 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 8, 2016 Category: Anesthesiology Authors: Weilbach C, Kobiella A, Rahe-Meyer N, Johanning K Tags: Anaesthesist Source Type: research

[Factor  XIII : Pharmacodynamic and pharmacokinetic characteristics].
[Factor XIII : Pharmacodynamic and pharmacokinetic characteristics]. Anaesthesist. 2016 Dec 09; Authors: Adam EH, Kreuer S, Zacharowski K, Weber CF, Wildenauer R Abstract Factor XIII (FXIII) plays an important role in the field of blood coagulation. In the last decade, both congenital and acquired deficiencies have been investigated in clinical studies. FXIII is a versatile enzyme that leads to a covalent cross-linking of fibrin fibrils at the end of the clotting cascade and supports platelet adhesion to the damaged sub-endothelium with the result of a mechanically stable clot.Symptoms of FX...
Source: Der Anaesthesist - December 8, 2016 Category: Anesthesiology Authors: Adam EH, Kreuer S, Zacharowski K, Weber CF, Wildenauer R Tags: Anaesthesist Source Type: research

[Ventilator-associated pneumonia (VAP) : A  risk already at the time of anesthetic induction].
This article considers measures to prevent VAP during general anesthesia in adult patients (>18 years). Procedures beyond standard hygienic precautions for VAP prevention are reviewed. METHODS: A literature search in different databases (PubMed, Cochrane, Ovid und CINAHL) over the last five years. RESULTS: Beyond standard hygienic precautions, microaspiration should be avoided to prevent VAP. During mechanical ventilation at least 5 cm H2O PEEP is advised. Continuous monitoring and adjustment of cuff pressure is necessary. All patients mechanically ventilated after general anesthesia for more than ...
Source: Der Anaesthesist - December 8, 2016 Category: Anesthesiology Authors: Vetter L, Konrad C, Schüpfer G, Rossi M Tags: Anaesthesist Source Type: research

[Full-scale simulation in German medical schools and anesthesia residency programs : Status quo].
CONCLUSIONS: Important first steps have been taken to implement full-scale simulation in Germany. In addition to programs for medical students courses for physicians and nurses are available today. To reach everyone clinically involved in German anesthesiology on a regular basis the current capacities need to be dramatically increased. The basis for that to happen will be new concepts for funding, possibly supported by external requirements such as the national model curriculum for residency in anesthesiology. PMID: 27942787 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 8, 2016 Category: Anesthesiology Authors: Baschnegger H, Meyer O, Zech A, Urban B, Rall M, Breuer G, Prückner S Tags: Anaesthesist Source Type: research

[The old man and the I sea U : Essay on faith, fate and evidence - after the manner of Hemingway].
Abstract Robert Bartlett, emeritus Professor of surgery at the University of Michigan in Ann Arbor, USA, transformed classical works of world literature (Charles Dickens: A Christmas Carol, Lewis Carroll: Alice in Wonderland) into teaching aids for advanced training in intensive care medicine. He recently turned his hand to the well-known work of Ernest Hemingway: the Nobel Prize winning novel The Old Man and the Sea. Subsequent to Robert Bartlett's essay this article provides background information and comments on the current problems in modern intensive care medicine addressed in his essay. PMID: 27924353 [...
Source: Der Anaesthesist - December 5, 2016 Category: Anesthesiology Authors: Lewandowski K, Bartlett RH Tags: Anaesthesist Source Type: research

Recommendations of the German Association of Anesthesiology and Intensive Care Medicine (DGAI) on structured patient handover in the perioperative setting : The SBAR concept.
Abstract Teamwork in the operating room and in the intensive care unit necessitates clear and precise communication; however, interruptions in communication frequently occur, especially in the perioperative phase. Patients are particularly susceptible to deficits in communication, e.g. due to higher stress peaks, simultaneous admission of several patients and concomitant treatment of emergency cases. The German Society of Anesthesiology and Intensive Care Medicine (DGAI) therefore recommends the implementation of the so-called SBAR concept (S situation, B background, A assessment, R recommendation) for standardiza...
Source: Der Anaesthesist - November 28, 2016 Category: Anesthesiology Authors: von Dossow V, Zwissler B Tags: Anaesthesist Source Type: research

[Comment on: Dexmedetomidine for delirium prophylaxis in elderly patients after non-cardiac surgery in the intensive care unit].
PMID: 27900414 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 28, 2016 Category: Anesthesiology Authors: Van Waesberghe J, Eisert A, Coburn M Tags: Anaesthesist Source Type: research

[Management of anesthesia in endovascular interventions].
h T Abstract Cardiovascular diseases are one of the leading causes of morbidity and mortality in Germany. In these patients, the high-risk profile necessitates an interdisciplinary and multimodal approach to treatment. Endovascular interventions and vascular surgery have become established as an important element of this strategy in the past; however, the different anatomical localizations of pathological vascular alterations make it necessary to use a wide spectrum of procedural options and methods; therefore, the requirements for management of anesthesia are variable and necessitate a differentiated ap...
Source: Der Anaesthesist - November 28, 2016 Category: Anesthesiology Authors: Rössel T, Paul R, Richter T, Ludwig S, Hofmockel T, Heller AR, Koch T Tags: Anaesthesist Source Type: research

[Intensive care treatment after aneurysmal subarachnoid hemorrhage].
Abstract Aneurysmal subarachnoid hemorrhage (SAH) is a devastating disease and nearly one third of patients die in the acute phase. Due to the bleeding event, a hyperactive sympathetic nervous system and an uncontrolled inflammatory response have a profound local and systemic impact on other organ functions. Neuroendocrinological disorders and cardiopulmonary morbidity are dominant. Despite a decrease in hospital mortality for high volume centers, a high proportion of survivors suffer from neurological deficits. Knowledge of the pathophysiology of vasospasms in the later stages of the disease has in...
Source: Der Anaesthesist - November 28, 2016 Category: Anesthesiology Authors: Jaschinski U Tags: Anaesthesist Source Type: research

[Extracorporeal CO2 removal as an alternative to tracheotomy in a  patient with extubation failure].
We report a patient with chest trauma who was admitted to the ICU after surgery. As he fulfilled protocol-based criteria, he was extubated 7 days after admission. However, despite intermittent non-invasive ventilation, the patient had to be re-intubated on day 10 owing to progressive hypercapnia. We decided to support the patient with a mid-flow veno-venous extracorporeal carbon dioxide removal (ECCO2‑R) system instead of a tracheotomy. Sufficient CO2 removal was established with a blood flow of 1.5 l/min and the patient was successfully extubated within a few hours. After 5 days of E...
Source: Der Anaesthesist - November 27, 2016 Category: Anesthesiology Authors: Redel A, Ritzka M, Kraus S, Philipp A, Schlitt HJ, Graf B, Bein T Tags: Anaesthesist Source Type: research

[Highest level of clinical competence for endovascular interventions].
PMID: 27882390 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 22, 2016 Category: Anesthesiology Authors: Pestel G Tags: Anaesthesist Source Type: research

[The basis for well-founded simulations].
Abstract In medical education, simulation is gaining increasing importance for teaching a variety of subjects. A well-founded educational approach is necessary for effective use. In addition to material aspects, simulation environment, curriculum, learning environment, and methods of debriefing have to be considered. The role of a competent instructor should be emphasized and the importance of an elaborate change management process to implement a good concept should not be underestimated. PMID: 27832294 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 9, 2016 Category: Anesthesiology Authors: Meyer O, Rall M, Baschnegger H, Lazarovici M, Urban B Tags: Anaesthesist Source Type: research

[Under scrutiny by the state prosecutor : Legal pitfalls in emergency medicine].
Abstract Physicians who allow a suicide attempt to happen, which from an ex ante viewpoint was completely voluntary, cannot be held punishable for homicide or failing to provide medical assistance when the suicide corresponds to the putative will of the patient according to plausible information supplied by an authorized person with healthcare proxy. Guidelines for resuscitation also play a central role in the forensic practice for assessment of whether and when resuscitation can be terminated; therefore, it is urgently advised to follow and implement these guidelines: deviations are possible if they can be factua...
Source: Der Anaesthesist - November 2, 2016 Category: Anesthesiology Authors: Schelling P Tags: Anaesthesist Source Type: research

[Anesthesia for medical students : A brief guide to practical anesthesia in adults with a web-based video illustration].
Abstract In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career.Traditional strategies to teach medical st...
Source: Der Anaesthesist - October 26, 2016 Category: Anesthesiology Authors: Mathis S, Schlafer O, Abram J, Kreutziger J, Paal P, Wenzel V Tags: Anaesthesist Source Type: research

[Comment on: Decompressive craniectomy after traumatic brain injury].
n M PMID: 27787572 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 26, 2016 Category: Anesthesiology Authors: Höllig A, Coburn M Tags: Anaesthesist Source Type: research