Medizinische Klinik-Intensivmedizin Und Notfallmedizin最新文献_第4页

[Treatment algorithm: skin care in critically ill patients]. 【治疗算法：危重患者皮肤护理】。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-03-01 Epub Date: 2025-01-07 DOI: 10.1007/s00063-024-01226-9

Armin Hauss, Lars Krüger, Mandy Fröhlich, Franziska Dierkes, Vanessa Stork, Lara Konstanty, Tina Ellerhausen, Sebastian Rieks, Julia Ruhland, Marisa Wittor, Franziska Wefer

引用次数: 0

[Evaluation of the role of an advanced practice dietitian in the intensive care unit]. [评估高级营养师在重症监护室中的作用]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-03-01 Epub Date: 2024-03-28 DOI: 10.1007/s00063-024-01124-0

Gioia Vinci, Reto Stocker

{"title":"[Evaluation of the role of an advanced practice dietitian in the intensive care unit].","authors":"Gioia Vinci, Reto Stocker","doi":"10.1007/s00063-024-01124-0","DOIUrl":"10.1007/s00063-024-01124-0","url":null,"abstract":"Background: In Swiss intensive care units (ICUs), nutritional management is hardly or not at all supported or supervised by dietitians. Nutritional management in the ICU is mainly performed by ICU nursing staff and intensive care specialists. In 2022, the role of an advanced practice dietitian (APD) was newly defined, created, and implemented in a Swiss ICU as part of a pilot project. In contrast to other countries, APDs are still scarce in Switzerland. Evaluation of the APD role is essential to further define the position and adapt it to needs. The aim of this survey was to evaluate the impact of the APD role 8 months after implementation.Materials and methods: The survey was conducted via online survey in February and March 2023. A total of 34 members of the ICU team participated, including physicians (n = 11), nurses (n = 20), and speech therapists (n = 3). In addition to workload, years worked in the company, and shiftwork, questions were asked about the level of awareness of the new APD position, integration of the APD into the ICU team, and the impact of the APD on nutritional management and the situation of the participants, as well as regarding documentation and prescribing skills. A descriptive analysis of the data was carried out in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA).Results and conclusion: The majority are aware of the APD and consider her as part of the ICU team. From the treatment team's point of view, the quality of the nutritional care provided as by the APD has improved and there is added value for patients and the ICU team. The delegated prescribing competence seems to improve nutritional management noticeably and is perceived as helpful and relieving by a majority. How the position will develop in terms of the competence profile remains to be seen.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"145-152"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319572","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}

引用次数: 0

[Mechanical support with impella decreases mortality in cardiogenic shock (DanGer Shock trial)]. [使用冲击栓进行机械支持可降低心源性休克患者的死亡率（DanGer 休克试验）]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-03-01 Epub Date: 2024-11-26 DOI: 10.1007/s00063-024-01213-0

Michael Buerke, Alexander Geppert

引用次数: 0

[In-hospital management of intracerebral hemorrhage]. [颅内出血的院内处理]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-03-01 Epub Date: 2024-11-29 DOI: 10.1007/s00063-024-01216-x

Jochen Sembill, Stefan Schwab

{"title":"[In-hospital management of intracerebral hemorrhage].","authors":"Jochen Sembill, Stefan Schwab","doi":"10.1007/s00063-024-01216-x","DOIUrl":"10.1007/s00063-024-01216-x","url":null,"abstract":"Background: Intracerebral hemorrhage (ICH) is a medical emergency with high morbidity and mortality. General and specific therapeutic approaches aim to improve the patient's outcome.Objectives: The objective of this article is to present the current scientific state regarding the in-hospital care of patients with ICH.Materials and methods: This narrative review presents and analyzes the current evidence regarding treatment options for ICH.Results: The primary focus of acute therapy is to prevent the prognostically unfavorable enlargement of the hematoma. This is associated with specific computed tomographic markers, as well as the initial hematoma volume, the use of anticoagulants, and a shorter time from symptom onset. An elevated blood pressure should be promptly and precisely lowered to a systolic value below 140 mm Hg, and the inhibition of coagulation must be immediately antagonized. This should be constituted into a treatment bundle with optimal adjustment of vital parameters and implementation of basic intensive care measures. Intraventricular hemorrhage can be effectively treated by external ventricular drainage and intraventricular fibrinolysis, with or without additional lumbar drainage. Minimally invasive procedures for hematoma removal have the potential to improve outcomes in lobar ICH. A realistic prognostic assessment forms the basis for informed treatment decisions regarding ICH.Conclusions: In recent years, the evidence supporting aggressive therapeutic approaches in ICH has become increasingly robust, with reliable results now available regarding the efficacy of individual or combined measures.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"129-134"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751129","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}

引用次数: 0

[Mpox-diagnosis, treatment, immunization, and prognosis]. [麻疹-诊断、治疗、免疫和预后]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-03-01 Epub Date: 2024-11-06 DOI: 10.1007/s00063-024-01198-w

Michael Buerke, Priyanka Böttger, Henning Lemm

{"title":"[Mpox-diagnosis, treatment, immunization, and prognosis].","authors":"Michael Buerke, Priyanka Böttger, Henning Lemm","doi":"10.1007/s00063-024-01198-w","DOIUrl":"10.1007/s00063-024-01198-w","url":null,"abstract":"Mpox (previously known as monkeypox) is receiving attention worldwide due to outbreaks in various countries since May 2022. On August 14, 2024, based on the increase Mpox infections, the World Health Organization (WHO) declared a public health emergency. The zoonotic disease is caused by the Mpox virus, an Orthopoxvirus related to other Poxviridae. The virus is transmitted via direct contact with infected bodily fluids, respiratory droplets, or contaminated objects and has an incubation time of 5-21 days. Symptoms include fever, headache, muscle pain, and a characteristic skin rash which progresses from macules, to papules, to vesicles, and to pustules before scabbing over. There are two main genetic clades of Mpox: clade I (Central Africa) and clade II (West Africa), whereby clade IIb was responsible for the 2022 outbreak. Diagnosis is based on PCR testing of skin lesions. Although Mpox may mimic other diseases such as chickenpox or syphilis, lymphadenopathy is a distinguishing feature. Treatment is primarily supportive, although antiviral agents such as tecovirimat and cidofovir have shown a certain efficacy. Vaccination is an important protective measure; MVA-BN and ACAM2000 are among the available vaccines. Prognosis depends on the clade, the access to medical care, and the underlying health status. Immunocompromised persons and children are at a higher risk of a severe course.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"141-144"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584707","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}

引用次数: 0

Mitteilungen der ÖGIAIN.

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-03-01 DOI: 10.1007/s00063-025-01260-1

引用次数: 0

[Dermatological conditions requiring intensive care treatment].

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-03-01 Epub Date: 2025-02-13 DOI: 10.1007/s00063-024-01239-4

Christiane Marks, Eugen Widmeier, Reinhard Marks, Sylvia Kardaun

引用次数: 0

[Diagnostic tools for stroke detection-from prehospital to diagnosis]. 【脑卒中检测的诊断工具——从院前到诊断】。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-03-01 Epub Date: 2025-01-07 DOI: 10.1007/s00063-024-01220-1

Christian Claudi, André Worm, Patrick Schramm, Hagen B Huttner

{"title":"[Diagnostic tools for stroke detection-from prehospital to diagnosis].","authors":"Christian Claudi, André Worm, Patrick Schramm, Hagen B Huttner","doi":"10.1007/s00063-024-01220-1","DOIUrl":"10.1007/s00063-024-01220-1","url":null,"abstract":"Background: Strokes are common neurological emergencies that require rapid diagnosis to minimize long-term damage. Prehospital detection and triage play a critical role in patient outcomes.Objective: How effective are different prehospital diagnostic tools for stroke detection, and which triage strategies optimize patient care?Methods: The article compares prehospital diagnostic tools for stroke detection and evaluates different transport strategies. Case studies illustrate their practical application.Results: Traditional stroke diagnosis methods have limitations, particularly in identifying strokes in the posterior circulation. Newer diagnostic tools that incorporate additional symptoms, such as dizziness and vision problems, show higher sensitivity. The choice of triage strategy depends on the severity of symptoms and regional factors. Direct transport to specialized centers is beneficial for severe strokes, while initial stabilization at nearby units is more efficient in rural areas.Conclusion: Modern diagnostic tools offer better sensitivity for prehospital stroke detection. Regional cooperation and the selection of appropriate triage strategies are key to improving stroke care.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"110-119"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957406","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}

引用次数: 0

Time delay and risk of toxicity of intraosseous anaesthesia use for awake intraosseous access in children.

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-02-27 DOI: 10.1007/s00063-025-01253-0

Daniel Pfeiffer, Martin Olivieri, Victoria Lieftüchter, Florian Hey, Florian Hoffmann

{"title":"Time delay and risk of toxicity of intraosseous anaesthesia use for awake intraosseous access in children.","authors":"Daniel Pfeiffer, Martin Olivieri, Victoria Lieftüchter, Florian Hey, Florian Hoffmann","doi":"10.1007/s00063-025-01253-0","DOIUrl":"https://doi.org/10.1007/s00063-025-01253-0","url":null,"abstract":"Introduction: Intraosseous access (IO) is a crucial, life-saving alternative vascular access in paediatric emergency medicine. In awake paediatric patients, the pain of drilling and flushing the marrow cavity are barriers to the use of the IO method or prompt the use of an intraosseous anaesthetic agent, which introduces the risk of dosing errors and drug toxicity. This study aims to identify the frequency of use of anaesthetic agents and analyse the time delay caused by their use.Methods: Prospective surveillance study analysing all patients, aged > 28 days to 18 years, who received one or more IO attempt(s) in and out of the hospital setting in Germany from 1 July 2017 to 30 June 2019 via the reporting mechanism of the German Paediatric Surveillance Unit (GPSU).Results: Our analysis identified 74 patients who received an IO attempt while awake. All patients were younger than 6 years old. Almost every third child (31.6%) was awake during IO use. In 18.9% of all awake patients, an intraosseous anaesthetic was used before the IO was drilled or the marrow cavity was flushed, introducing a significant time delay of approximately 3 min (p = 0.001) compared to IO attempts without intraosseous anaesthesia.Conclusions: Intraosseous anaesthesia prolongs the establishment of working vascular access in an emergency and introduces the risk of drug toxicity. To prevent adverse events, particular emphasis must be placed on placement without intraosseous anaesthesia, and alternative pain management (intranasal) must be considered if necessary. Training courses and guidelines should reflect the advised current practice.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517165","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}

引用次数: 0

[ECG interpretation in rescue and emergency medical services in Germany: results of a cross-sectional study]. [德国救援和紧急医疗服务中的心电图解读：横断面研究结果]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-02-25 DOI: 10.1007/s00063-025-01252-1

Angela Gerhard, Yvonne Treusch, Luis Möckel, Karin Kohlstedt, Thomas Hofmann

{"title":"[ECG interpretation in rescue and emergency medical services in Germany: results of a cross-sectional study].","authors":"Angela Gerhard, Yvonne Treusch, Luis Möckel, Karin Kohlstedt, Thomas Hofmann","doi":"10.1007/s00063-025-01252-1","DOIUrl":"https://doi.org/10.1007/s00063-025-01252-1","url":null,"abstract":"Background: The recording of an electrocardiogram (ECG) is an essential part of basic diagnostics in the emergency medical services (EMS). To provide initial care and make a preliminary diagnosis, paramedics and emergency physicians (EP) need knowledge about the ECG interpretation. Nevertheless, a few studies show that knowledge of ECG interpretation of paramedics and emergency physicians must improve.Objectives: The aim of this study was to analyze the ECG interpretation skills among EMS staff and EP in Germany.Materials and methods: An online survey was conducted to assess these skills from 22 February to 22 March 2023. The survey collected details about gender, age, professional training, years of professional experience, time since the last ECG training, and self-rated ECG interpretation ability. Subsequently, 9 different ECG had to be interpreted in the form of single-choice questions.Results: In all, 908 participants (EMS: 803; EP: 105) were evaluated. The survey identified a knowledge deficit in the interpretation of ECG. On average, 63.3% (EMS: 61.4%; EP: 76.5%) of the ECG were interpreted correctly. The ECG with ST-elevation myocardial infarction (STEMI) of the posterior wall was identified correctly by 79.1% (EMS: 78.1%; EP: 86.7%) of the participants. Specific weak points in interpreting ECG were AV-blocks, tachycardias, atrial fibrillation, bundle branch blocks, pacemaker ECG and determining the ventricular axis. The participants' self-assessment of their ECG skills correlated significantly with the results actually achieved (p ≤ 0.001; pbonf = 0.016; ρ = 0.378).Conclusion: Based on the lack of diagnostic skills in the interpretation of a 12 lead ECG, continuous education programs should be revised to improve the quality of patient care in prehospital emergency medicine.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494414","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}

引用次数: 0