Medizinische Klinik-Intensivmedizin Und Notfallmedizin最新文献

{"title":"[Visual diagnosis for experts].","authors":"Laura Arheilger, Nicolas Müller, Mattia M Müller, Christoph Camille Ganter, Rene Hage, Mace Schuurmans, Sascha David","doi":"10.1007/s00063-024-01166-4","DOIUrl":"10.1007/s00063-024-01166-4","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"690-693"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Spiritual care competences of healthcare workers in emergency and intensive care-a prospective questionnaire study].","authors":"J Schwartz, T Tenge, K Lanhenke, S Meier, M Schallenburger, Y-N Batzler, T Roser, D Wetzchewald, M Neukirchen","doi":"10.1007/s00063-024-01185-1","DOIUrl":"https://doi.org/10.1007/s00063-024-01185-1","url":null,"abstract":"<p><strong>Background: </strong>In intensive and emergency care, patients and their relatives are confronted with potentially existential crises. Spiritual care can be an additional resource to address related psychosocial and physical symptoms and to support patients and their relatives. Accordingly, healthcare workers need spiritual skills to recognize and respond to these needs.</p><p><strong>Objectives: </strong>What spiritual competencies do healthcare workers in intensive and emergency care have? Are there differences between professions and genders? What factors influence spiritual competencies?</p><p><strong>Materials and methods: </strong>The prospective questionnaire study included physicians participating in intensive care and emergency medicine courses and nurses who were training or working in intensive and emergency care. Self-reported spiritual competencies were assessed using the Spiritual Care Competence Questionnaire (SCCQ), which captures the following areas: perceptual competence, team-spirit, documentation competence, self-awareness and proactive opening, knowledge about other religions, competence in conversation techniques and proactive empowerment-competence.</p><p><strong>Results: </strong>We included 465 physicians (50% female, years in profession: mean = 4.0, standard deviation [SD] = 3.5) and 86 nurses (80% female, years in profession: mean = 12.7, SD = 10.7). The average SCC was 2.3 (SD 0.4) out of a maximum of 4 points, with higher spiritual competences among spiritual and religious respondents. There were differences in specific competencies between the professions and genders. Women indicated a higher level of competence in the area of perception and conversation skills, physicians in documentation skills.</p><p><strong>Conclusions: </strong>Overall, there is a clear need to train healthcare staff in the field of intensive care and emergency medicine.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Severe intoxication after yew (Taxus) ingestion-case report and literature review].","authors":"J L Lohmeyer, C Enneking, P Mammen, T Horlacher, M Roiss, G N Schmidt, M W Bergmann, T Spangenberg","doi":"10.1007/s00063-024-01187-z","DOIUrl":"https://doi.org/10.1007/s00063-024-01187-z","url":null,"abstract":"<p><strong>Background: </strong>Severe yew (Taxus) intoxication is a rare condition that can lead to life-threatening cardiac arrhythmia. The survival of patients requires highly specialized emergency and intensive care treatment.</p><p><strong>Objectives: </strong>Systematic overview of the clinical picture and important treatment options.</p><p><strong>Methods: </strong>Case report of severe yew intoxication with subsequent literature review of comparable case reports. Analysis of 33 case reports with a total of 37 critically intoxicated patients from the years 2000-2024 from Europe and North America.</p><p><strong>Results: </strong>Severe yew intoxications were almost exclusively the result of suicidal intent. Patients average age was 33 (± 14.5) years. The use of antiarrhythmic drugs and electrical stimulation of the heart often proved to be ineffective or deteriorating in its effect over time. The use of lipid emulsion and/or digoxin-specific Fab fragments has little evidence. The average duration of a clinically relevant arrhythmogenic effect was 22±11.7 h.</p><p><strong>Conclusions: </strong>The management of yew intoxication is primarily limited to symptomatic treatment. The availability of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in a \"bridge-to-recovery\" concept appears to be of utmost importance.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum zu: Stellenschlüssel für therapeutische Gesundheitsfachberufe auf Intensivstationen.","authors":"Silke Klarmann, Anke Hierundar, Teresa Deffner, Andreas Markewitz, Christian Waydhas","doi":"10.1007/s00063-024-01145-9","DOIUrl":"10.1007/s00063-024-01145-9","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"586"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of nursing visits on primary nursing : An evaluation study in an intensive care unit].","authors":"Dirk Johnen, Lars Krüger, Thomas Mannebach, Francesco Squiccimarro, Gero Langer, Elke Hotze","doi":"10.1007/s00063-024-01163-7","DOIUrl":"10.1007/s00063-024-01163-7","url":null,"abstract":"<p><strong>Background: </strong>After a pilot phase in 2017, nursing visits (PV) were implemented in an intensive care unit (ICU) at a university hospital. So far, published findings on the impact of PV on the primary nursing organisation system (process-responsible nursing [PP]) could not be identified.</p><p><strong>Aim: </strong>Primary aim was to investigate the effects of PV on PP from the nurses perspective. Secondary aims included comparison with the results of the pilot phase (t₀) to determine further effects, general conditions of the PP and the overall evaluation.</p><p><strong>Methods: </strong>A quantitative evaluation study using a standardised questionnaire was used.</p><p><strong>Results: </strong>The survey was conducted in September to October 2023 (t₁) with a response rate of 74.6% (n = 47). On a scale of 1-6 (strongly agree; strongly disagree), 100.0% of the process-responsible nurses (PP; n = 8) and 77.0% of the nurses without process responsibility (P; n = 30) rated the PV at levels 1-3 (p = 0.328) as contributing to the evaluation of care planning for patients with process responsibility. PV provided support for the implementation of PP (PP: 100.0%, n = 8; P: 79.5%, n = 31; p = 0.318) and had a statistically significant effect (r = 0.97, p = 0.035) on improving the quality of care and care planning for patients with procedural responsibility. The nurses indicated with levels 1-3 that the patients were more consciously brought into the focus of nursing care through the PV (t₁: 74.4%, n = 35; t0: 86.4%, n = 38; p = 0.953). The PV should take place weekly and was rated with a median of 2 (IQR t₁: 1-3; t₀:1-2).</p><p><strong>Conclusion: </strong>PV support the implementation of PP and patient-centred care in the ICU.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"564-573"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Therapeutic healthcare professional staffing requirements in intensive care units].","authors":"Silke Klarmann, Anke Hierundar, Teresa Deffner, Andreas Markewitz, Christian Waydhas","doi":"10.1007/s00063-024-01125-z","DOIUrl":"10.1007/s00063-024-01125-z","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic healthcare professionals in the multiprofessional intensive care unit (ICU) team are important for early mobilization, dysphagia therapy, and psychosocial care of critically ill patients.</p><p><strong>Objective: </strong>Despite the high relevance of therapeutic healthcare professions for care in ICUs, there are no recommendations on the specific staffing of therapists in ICUs.</p><p><strong>Results: </strong>Considering the main areas of activity of the individual professional groups and based on productivity time, a requirements analysis for staffing ICUs of different care levels with physiotherapists, occupational therapists, speech therapists, and psychologists was performed. For every 10 beds in the highest care level (LoC3), 1.28 full-time equivalent (FTE) physiotherapists, 0.91 FTE occupational therapists and speech therapists, and 0.80 FTE psychologists should be employed.</p><p><strong>Conclusion: </strong>In order to implement multiprofessional patient treatment and support for relatives in the ICU, it is essential to employ a proportionate number of therapeutic healthcare professionals.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"581-585"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment algorithm: prone position in critically ill patients].","authors":"Carsten Hermes, Lars Krüger, Tobias Ochmann, Vanessa Erbes, Detlef Eggers, Anke Kany, Ricardo Klimpel, Victoria König, Marcel Ansorge, Anett Henck, Tobias Wittler, Thomas Bein, Stefan J Schaller","doi":"10.1007/s00063-024-01146-8","DOIUrl":"10.1007/s00063-024-01146-8","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"574-577"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Stress ulcer prophylaxis with proton pump inhibitors in intensive care medicine].","authors":"Philipp Kasper, Frank Tacke, Guido Michels","doi":"10.1007/s00063-024-01172-6","DOIUrl":"10.1007/s00063-024-01172-6","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"598-599"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum zu: Lebertransplantation bei akutem und akut-auf-chronischem Leberversagen.","authors":"Jonathan F Brozat, Julian Pohl, Cornelius Engelmann, Frank Tacke","doi":"10.1007/s00063-024-01188-y","DOIUrl":"10.1007/s00063-024-01188-y","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"609-610"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Preclinical loading in patients with acute chest pain and acute coronary syndrome - PRELOAD survey].","authors":"Sascha Macherey-Meyer, Simon Braumann, Sebastian Heyne, Max Maria Meertens, Tobias Tichelbäcker, Stephan Baldus, Samuel Lee, Christoph Adler","doi":"10.1007/s00063-023-01087-8","DOIUrl":"10.1007/s00063-023-01087-8","url":null,"abstract":"<p><strong>Background: </strong>Guidelines on myocardial infarction (MI) recommend antithrombotic and anticoagulatory treatment at time of diagnosis. MI with ST segment elevation (STEMI) is mostly a certain diagnosis. Acute coronary syndrome without ST segment elevation (NSTE-ACS) has diagnostic uncertainty and remains a working diagnosis in the prehospital setting.</p><p><strong>Objective: </strong>Assessment of prehospital loading with aspirin and heparin depending on ACS subtype and pretreatment with oral anticoagulants.</p><p><strong>Methods: </strong>The PRELOAD survey was a nationwide German study. STEMI/NSTE-ACS scenarios were designed and varied in pretreatment: I) no pretreatment, II) new oral anticoagulants (NOAC), III) vitamin K antagonist (VKA). Loading strategy was assessed and included: a) aspirin (ASA), b) unfractionated heparin (UFH), c) ASA + UFH, d) no loading.</p><p><strong>Results: </strong>A total of 708 emergency physicians were included. In NSTE-ACS without pretreatment, 79% chose loading (p < 0.001). ASA + UFH (71.4%) was the preferred option. In corresponding STEMI scenario, 100% chose loading and 98.6% preferred ASA + UFH (p < 0.001). In NSTE-ACS with NOAC pretreatment, 69.8% favored loading (p < 0.001); in VKA pretreatment the corresponding rate was 72.3% (p < 0.001). In each scenario, ASA was the preferred option. In STEMI with NOAC pretreatment, 97.5% chose loading (p < 0.001); analogous rate was 96.8% in STEMI with VKA pretreatment (p < 0.001). ASA was the preferred option again.</p><p><strong>Conclusions: </strong>Prehospital loading was the preferred treatment strategy despite the diagnostic uncertainty in NSTE-ACS and guidelines recommending loading at time of diagnosis. Pretreatment with oral anticoagulants resulted in a strategy shift to loading with only aspirin. In STEMI patients, this indicates potential undertreatment.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"529-537"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}