0000000000427503
AUTHOR
F. Heid
Schlaganfallversorgung in der Prähospitalphase
In westlichen Industrienationen ist der Schlaganfall die dritthaufigste Todesursache und die haufigste Ursache fur erworbene Behinderungen uberhaupt. Optimale Behandlungsbedingungen bestehen nur dann, wenn die Fruhsymptome des Schlaganfalls rechtzeitig erkannt werden und die Behandlung innerhalb von 3 h nach Einsetzen der Erstsymptome eingeleitet wird. Eine „Rettungskette des Schlaganfalls” muss deshalb Konzepte zur Fruherkennung, eine rasche prahospitale Versorgung gefolgt von effizienter Diagnostik und eine unmittelbar einsetzende Akuttherapie sinnvoll integrieren. Der vorliegende Beitrag hat zum Ziel, diesen Ansatz unter besonderer Berurcksichtigung der prahospitalen Phase darzustellen. …
Der Schlaganfall als medizinischer Notfall
Studies into the pathophysiology of acute ischaemic stroke have indicated that treatment options are likely to be optimised when early signs of stroke are recognised and treatment is initiated within 3 hours from symptom onset. For most patients there is a long delay between the onset of symptoms and the start of therapy. Many factors are responsible for this time delay: signs and symptoms often go unrecognised by patients, relatives and bystanders and stroke is not given a high priority by medical staff. Although a small number of stroke patients is treated as emergency and attended to by the emergency medical services within this time window, this number could easily be increased by inten…
Evaluation of the McGrath® Series 5 videolaryngoscope after failed direct laryngoscopy*
Summary Unanticipated difficulties during tracheal intubation and failure to intubate are among the leading causes of anaesthesia-related morbidity and mortality. Using the technique of video laryngoscopy, the alignment of the oral and pharyngeal axes to facilitate tracheal intubation is unnecessary. In this study we evaluated the McGrath® Series 5 videolaryngoscope for tracheal intubation in 61 patients who exhibited Cormack and Lehane grade 3 or 4 laryngoscopies with a Macintosh laryngoscope. Using the McGrath resulted in an improved glottic view, compared to Macintosh laryngoscope. Laryngoscopy was improved by one grade in 10%, by two grades in 80% and by three grades in 10% of cases (p …
The treatment of pain in urology
Contemporary medicine is characterized by sophisticated specialization of the individual physician. The specialist in urological surgery may undertake one of the most important and primary medical tasks, the mitigation and therapy of pain. This review aims to provide an overview of the concepts of pain therapy in urology. Most patients benefit from basic concepts of analgesia, including measuring and documenting pain scores at the bedside by the nursing staff. Patients undergoing very painful operative procedures require more potent techniques of analgesia, e.g. intravenous patient-controlled analgesia and epidural analgesia. These techniques need adequate supervision by an acute pain servi…
Performance of the C-MAC video laryngoscope in patients after a limited glottic view using Macintosh laryngoscopy
We applied the C-MAC videolaryngoscope in 52 consecutive patients who were found to have an unexpected Cormack and Lehane grade-3 (n = 49) and grade-4 (n = 3) laryngeal view with the Macintosh laryngoscope. The glottic view improved in 49 (94%) patients using the C-MAC. Tracheal intubation was successful in 49 of 52 patients (94%). In one patient, tracheal intubation failed using the C-MAC despite the presence of a Cormack and Lehane grade-2. These results suggest that the C-MAC videolaryngoscope has a role as a rescue device in cases of an initially difficult laryngeal view.