Die Veranderungen im Gesundheitswesen bewirken einen enormen Druck auf die Krankenhauser, so effizient wie moglich zu arbeiten.

Das Praxishandbuch fur die Funktionsdienste OP und Anasthesie unterstutzt Pflegende, damit sie den neuen Anforderungen gerecht werden konnen.

Die Operationsabteilung ist mit Personaleinsatz und kostenintensivem Materialbedarf der betriebswirtschaftlich teuerste Bereich der Krankenhauser. Bei einem chirurgisch versorgten Patienten entstehen allein 30% der Gesamtkosten im OP. Damit entscheidet die Leistungsfahigkeit des OP-Bereiches wesentlich den finanziellen Erfolg eines Krankenhauses im DRG-System. Um Kosten zu senken, mussen Schnittstellen zu "Nahtstellen" werden. Dies ist besonders im Bereich der standardisierten Operationen moglich und OP- und Anasthesiepflegepersonal muss sich daher interdisziplinar weiterbilden. "

Fundamentals of Anaesthesia is the gold standard text for the Primary FRCA, encapsulating the basic principles of modern anaesthesia in one easily accessible volume. Written and edited by experts with extensive FRCA examination experience, this text deliberately blends the expertise of invited authors in an unrivalled consistency of style more akin to that of a single author text. All of the subject matter required to pass the exam is condensed into an easy-to-read format. This fully updated fourth edition includes new guidelines, an improved chapter structure, and a new section on clinical ultrasound. The generous use of summary boxes, bullet points, tables and diagrams creates a text that is clear, concise and easy to navigate. Each section covers one of the four components of the SOE. This is a unique revision aid for the Primary FRCA and an essential companion for all exam candidates.

The updated guide to the Australian and New Zealand College of Anaesthetists final fellowship examination

The format of the Australian and New Zealand College of Anaesthetists (ANZCA) final examination has evolved in recent years. This updated exam guide keeps pace with these developments and assists anaesthetic trainees in preparation for the exam.

"Examination Anaesthesia, 2nd Edition" is a comprehensive study guide that focuses solely on the anaesthetic exam, eliminating confusion between this and the intensive care exams.

This invaluable medical text itemises all requirements of the Fellow of the Australian and New Zealand College of Anaesthetists (FANZCA) training scheme.

Components of the final examination are also detailed, including a breakdown of the marking scheme and recent results.

Helpful resources outlined in "Examination Anaesthesia, 2nd Edition" include new developments on the ANZCA website, textbooks, journals and exam courses along with a broad list of anaesthesia reference and review articles.

Trainees will also benefit from separate chapters based on the major components of the written and clinical ANZCA examinations, plus practical strategies for restructuring life around exam preparation.

Some important constraints of anesthesia must be taken into consideration when the pharmacological properties of modern anesthetics are discussed. The most imp- tant of these could be that the target effect be achieved preferably within seconds, at most within a few minutes. Similarly, offset of drug action should be achieved within minutes rather hours. The target effects, such as unconsciousness, are pot- tially life-threatening, as are the side effects of modern anesthetics, such as respi- tory and cardiovascular depression. Finally, the patient's purposeful responses are not available to guide drug dosage, because, either the patient is unconscious, or more problematically, the patient is aware but unable to communicate pain because of neuromuscular blockade. These constraints were already recognised 35 years ago, when in 1972 Volume XXX entitled "Modern Inhalation Anesthetics" appeared in this Handbook Series. The present volume is meant as a follow up and extension of that volume. At the beginning of the 1970's anesthesia was commonly delivered by inhalation, with only very few exceptions. The clinical understanding of that time considered anesthesia as a unique state achieved by any of the inhalation anesthetics, in- pendent of their specific molecular structure. "The very mechanism of anesthetic action at the biophase" was discussed within the theoretical framework of the "u- tary theory of narcosis".

Le situazioni critiche in medicina d'urgenza e in terapia intensiva rappresentano una tra le sfide piu difficili nella pratica clinica. La natura stessa dell'ambiente di cura, l'incertezza, il rischio elevato, i tempi ristretti e lo stress, rendono queste discipline particolarmente vulnerabili agli errori nella gestione dei pazienti. Nell'ultimo decennio e diventato sempre piu evidente, che la capacita di erogare trattamenti sicuri in queste circostanze dipende da un'approfondita conoscenza dei meccanismi all'origine dell'errore umano. Questo volume, che e la traduzione italiana della seconda edizione di Crisis Management in Acute Care Settings, propone una rassegna originale e completa di tutti i problemi correlati ai fattori umani, rilevanti per la sicurezza dei pazienti durante l'erogazione di trattamenti urgenti. Le energie di medici e psicologi si sono mescolate in un testo facilmente accessibile, che aiutera i medici e altri professionisti della salute a comprendere meglio i principi del comportamento umano e del processo decisionale nelle situazioni critiche, per evitare errori e garantire un trattamento piu sicuro ai loro pazienti.

This comprehensive book is written to inform and improve outcomes of patients in need of blood management during surgical procedures. Information is presented in an accessible format, allowing for immediate use in clinical practice. Beginning with an overview of the history of blood transfusions, early chapters present the foundational information needed to comprehend information in later chapters. Nuanced procedures, drugs, and techniques are covered, including new biologicals to assist clotting and blood substitutes. Further discussions focus on potential complications seen in blood transfusions, such as diseases of the coagulation system, pathogen transmissions, and acute lung injuries. Chapters also examine the complexities of treating specific demographics, of which include the geriatric patient and patients suffering from substance abuse. Essentials of Blood Product Management in Anesthesia Practice is an invaluable guide for anesthesiologists, surgeons, trauma physicians, and solid organ transplant providers.

Bei der Bluttransfusion handelt es sich um die Transplantation eines fremden flussigen Organs. Blutkomponenten und Plasmaderivate sind dabei verschreibungspflichtige Arzneimittel und durfen nur auf arztliche Anordnung abgegeben werden. Von dem am Patienten tatigen Arzt werden damit grundlegende klinisch-transfusionsmedizinische Kenntnisse fur den differenzierten Umgang mit Blutkomponenten und Plasmaderivaten gefordert. Das vorliegende Werk gibt diese Hilfestellung und vermittelt Basiswissen zu Blutprodukten und Transfusionen fur Nicht-Transfusionsmediziner. Es beschreibt u.a. die Risiken von Bluttransfusionen, die Grundlagen der Blutgruppenserologie und die Zusammensetzung von Blut und Blutprodukten sowie das Management bei Transfusionszwischenfallen; es geht auf das aktuelle Transfusionsgesetz ein und die Richtlinien zur Bluttransfusion sowie auf die Verordnung und Gabe von Blut und Blutprodukten. Das Werk ist praxisnah und ubersichtlich gestaltet mit vielen konkreten Tipps, Flussdiagrammen und Tabellen. Die 2. Auflage erscheint komplett aktualisiert erweitert, u.a. zu juristischen und arzneimittelrechtlichen Aspekten autologer Transfusionsverfahren und zum Effektivitatsvergleich autologer Verfahren wie Eigenblutspende versus Hamodilution versus maschinelle Autotransfusion. Das Werk richtet sich an klinisch tatige AErzte aller Fachdisziplinen, die keine ausgewiesenen Transfusionsmediziner sind.

Following the introduction in 2013 of the FFICM exam for trainees in intensive care, this book provides candidates with practice materials for the MCQ section. Written by a team of specialists in intensive care medicine, including senior trainees who have recently passed the new exam and authors of the popular FRCAQ website, the book contains 270 multiple true-false questions that cover the breadth of the current Faculty of Intensive Care Medicine curriculum. These are presented as three 90-question practice papers, providing candidates with a faithful simulation of the style, standard and format of the questions they will encounter. With short and long explanations for each question, presented with up-to-date references for extended reading, this book is both an ideal tool for in-depth exam preparation, and an excellent resource for practising consultants in intensive care medicine. It is also suitable for candidates taking the EDIC and other intensive care exams worldwide.

The proportion of the population of octogenarians and elderly patients presenting for intensive care is rapidly increasing thus exacerbating the need to modify our critical care management to cater for this patient group. This book will provide practical guidance on all issues related to the critical care of elderly patients, incorporating physiological and epidemiological information, clinical guidance, ethical and end-of-life issues and advice about optimal use of drugs and new technologies. Complications of polypharmacy, high-risk surgery and increased recovery times are also discussed. Chapters are concise, each including a list of key points and summary of available data, making this a quick reference for experienced consultants, as well as a useful resource for trainees preparing for exams.

Der vorliegende Atlas enthalt eine Sammlung spektralanaly- tischer EEG-Bilder und entsprechende Ausschnitte des kon- ventionellen EEG unter anasthesiologischen Massnahmen. Es ist eine Auswahl aus einer Reihe von EEG-Ableitungen, die wahrend anasthesiologischer Routinemassnahmen an einem allgemeinchirurgisch-gynakologischen Krankengut innerhalb der letzten Jahre durchgefuhrt wurden. Pramedikationen, Narkoseeinleitungen, -verlaufe und -ausleitungen sowie die Aufwachphase und Intensivbehandlungsverlaufe sind erfasst. Technische Handhabung und artefaktbedingte Stoerfaktoren fur EEG-Ableitungen im Routinebetrieb werden kurz darge- stellt. In den Einzelabschnitten mit spezieller Thematik wer- den jeweils charakteristische EEG-Befunde mit einpragsa- men Darstellungen als Musterbeispiele vorangestellt. Be- schreibungen von Abweichungen der gefundenen Norm, die auf die grosse Variabilitat der hervorgerufenen cerebralen Funktionsveranderungen hinweisen, folgen. Die im EEG dargestellten Verlaufe werden beschrieben und im Zusammenhang mit klinischen Parametern beurteilt. Befriedigende Interpretationen sind gelegentlich nicht moeg- lich, da vielfach physiologische und pathophysiologische Ur- sachen entsprechender cerebraler Funktionsveranderungen noch ungeklart sind. So bleibt wiederholt die Frage offen, ob es sich bei Abweichungen von der Norm um cerebrale Ursa- chen, oder um Sekundarphanomene extracerebraler Stoerun- gen handelt. Der Atlas ist eine fur sich abgeschlossene UEbersicht, jedoch auch eine Erganzung des 1983 im Springer Verlag erschiene- nen Buches: I. Pichlmayr, U. Lips, H. Kunkel: Das Elektroen- zephalogramm in der Anasthesie, das auch entsprechende Li- teraturangaben, auf die hier bewusst verzichtet wird, enthalt.

This fully updated third edition of this popular handbook provides a concise summary of perioperative management of high-risk surgical patients. Written by an international group of senior clinicians, chapters retain the practical nature of previous editions, with concise text in a bulleted format offering rapid access to key facts and advice. Several new chapters cover topics including: anesthetic mortality; cardiopulmonary exercise testing; perioperative optimization; obstructive sleep apnea and obesity hypoventilation syndrome; smoking, alcohol and recreational drug abuse; intraoperative ventilatory management; the role of simulation in managing the high-risk patient; anesthesia, surgery and palliative care; anesthesia and cancer surgery; neurotrauma and other high-risk neuro cases; anesthesia for end-stage renal and liver disease; and transplant patients. Essential reading for trainee anesthesiologists managing seriously ill patients during surgery or studying for postgraduate examinations, this is also a valuable refresher for anesthesiologists and intensivists looking for an update on the latest evidence-based care.

Head injuries are commonplace. Though most patients survive, the consequences, both physical and social, can be devastating. The methods of initial assessment and management can have a crucial effect on determining the outcome of the injury, and long-term effects. However, only a minority of head-injured patients are cared for by Neurosurgeons. The majority are seen by non-specialists, often junior doctors and nurses, and treated in district hospitals where specialist neurosurgical assistance is unavailable. As a guide for doctors and nurses working in the A & E department, or the Orthopaedic or General Surgical Ward, the emphasis of this book is on the early management of the head- injured patient. New to the second edition are chapters on managing the 'disturbed' head injured patient, a chapter of special value to nurses (who often have to deal with this difficult task). A new chapter on anaesthesia and head injuries has also been added, with other chapters significantly revised to reflect the crucial role played by anaesthetists in head injury management. Providing practical advice on the early treatment of minor head injuries, and the management of major head injuries, the book provides advice that will be essential in ensuring effective treatment of these patients. From reviews of first edition: '... an excellent account of the management of head injuries... this one certainly fulfils its stated aim and is to be recommended.' JOURNAL OF NEUROLOGY, NEUROSCIENCE, AND PSYCHIATRY '... concise and well-referenced... a worthwhile addition to an A& E department's bookshelves.' NURSING TIMES 'The text is easy to read, and is of particular use to non-specialist staff... Useful as an introduction for junior neurosurgeons in training.' ANNALS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND

Anaesthetic trainees often have enormous trouble understanding the quantitative aspects of the basic sciences underlying clinical anaesthetic practice. The subjects of pharmokinetics and statistics are often unpopular with trainees, and studied with little enthusiasm. In spite of their reluctance, this is an area that they are required to study and understand as a core part of their training for postgraduate exams. Mathematics and statistics for anaesthetists presents simple mathematical ideas, and explains how these can be used to model and understand problems which arise in clinical anaesthesia. The common features of the underlying mathematics are emphasised through a pictorial/graphical approach, in preference to vast amounts of algebra. The book presents statistics in an informal and less intimidating style that most standard statistical texts, incorporating illustrations and cartoons throughout. The book will be valuable to anaesthetists, in guiding them through what can be an intimidating part of their training.

Each issue of Anesthesia & Analgesia includes thought-provoking case reports that provide real-world insight on a wide variety of clinical scenarios. Now for the first time, this volume brings together 100 recently published case reports, grouped by A&A sections for ease of reference. Framed by A&A editors' take home messages in each section, these original case reports are valuable reading for anesthesiologists, residents, and nurse anesthetists. Examine and learn from 100 clinically significant cases, including: Excessive Surgical Adhesive Mimicking Aortic Root Abscess Tomographic Angiography Elective Venovenous Extracorporeal Membrane Oxygenation for Resection of Endotracheal Tumor Anesthetic Challenges for Posterior Spine Surgery in a Patient With Left Ventricular Assist Device Peripheral Neuromodulation for the Treatment of Postamputation Neuroma Pain Short-term Vision Loss Following Whipple Surgery Delayed Anaphylaxis to Mammalian Meat Following Tick Exposure and Its Impact on Anesthetic Management for Cardiac Surgery And many more Enhance Your eBook Reading Experience: Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.

Lebensbedrohliche Situationen im OP und auf der Intensivstation koennen nur bei exakter Diagnostik entsprechend therapiert werden. Eine umfassende apparative UEberwachung hat sich neben der kontinuierlichen klinischen Beurteilung durch die funf Sinne des behandelnden Arztes als unbedingt notwendig erwiesen. Die Ausweitung des Monitorings unter Einschluss elektronischer Messgroessen und intelligenter Verarbeitung macht es moeglich, die Grenzen der operativen und Intensivmedizin zu erweitern. Zweck dieses Buches ist es, UEberwachungsparameter und -techniken aus beiden Bereichen und die Prinzipien, Moeglichkeiten und Grenzen der UEberwachung zu prasentieren.

Cardiac Anaesthesia: A Practical Approach is the first concise reference text to cover all aspects of cardiac anaesthesia. Aimed at trainee anaesthetists and cardiac anaesthetic nurses, the book presents clear and concise guidelines enabling the medical practitioner with little or no cardiac experience to develop and practise the required skills. For convenience the book has been divided into three main sections: Anatomy, physiology, and pharmacology Anaesthesia for adults Anaesthesia for children For both adults and children, the book explains how to prepare the patient for cardiac surgery, presents instructions on anaesthesia for different types of cardiac surgery, and provides information on postoperative care. Cardiac Anaesthesia: a practical handbook will be an essential guide for anaesthetists in training, and nurses involved in the care of cardiac patients.

Neurologische, neurovegetative und psychische Veranderungen nach gro- ssen Operationen oder Intensivbehandlungen weisen auf abgelaufene Stoe- rungen cerebraler Funktionen hin. Solche Veranderungen sind bei genauer Analyse keineswegs selten; sie haben ein weites Spektrum der klinischen Manifestation. Wahrend die bestmoegliche Kreislaufuberwachung unter Einbeziehung der fortlaufenden EKG-Registrierung bei Narkosen und In- tensivbehandlungen heute als selbstverstandliche Routine gilt, ist bisher die objektive und laufende Kontrolle cerebraler Funktionszustande unter den verschiedensten Einflussen von Anasthesie, Operation und Intensivmedizin nicht befriedigend geloest. Der klinischen Neurophysiologie gelingt zunehmend - vor allem durch das EEG bei visueller wie auch spektralanalytischer Auswertung - die Dar- stellung funktioneller Veranderungen als AEquivalent bzw. als Ursache klini- scher, neurologischer und psychischer Stoerungen. Von aktueller Bedeutung ist deshalb die Frage, ob anasthesiologische EEG-UEberwachung sowohl vom theoretischen Ansatz her als auch in der praktischen Durchfuhrbarkeit geeignet ist, cerebrale Stoerungen, die durch perioperative Massnahmen aus- geloest werden, fruhzeitig zu erkennen, zu deuten und hierdurch bestmoeglich zu vermeiden oder zu behandeln. Letzlieh steht dahinter die Grundfrage, inwieweit anasthesiologische Massnahmen sich am EEG-Bild orientieren und danach gesteuert werden koennen und ob eine EEG-Analy- se sowohl fur den einzelnen Patienten als auch generell fur die Wertung einer anasthesiologischen Massnahme bedeutsam ist. Diesen Fragen der Relevanz und der Praktikabilitat einer anasthesiolo- gisehen EEG-UEberwachung wird in diesem Buch nachgegangen. Grundla- ge hierfur ist die Analyse von uber 1500 durchgefuhrten EEG-Ableitungen im anasthesiologisch-chirurgischen bzw. -gynakologischen Krankengut.

This concise reference provides a core curriculum for those who have to look after critically ill children. Early recognition of those children who need intensive care, prompt resuscitation, and safe transportation to specialized units are the keys to success for the sickest children. Management of the common disorders is covered in a practical manner, as are the legal and ethical considerations.

Die Elektrokonvulsionstherapie (EKT), d.h. die Auslosung eines generalisierten Krampfanfalls unter kontrollierten Bedingungen aus therapeutischen Grunden, erlebt seit ihrer Einfuhrung 1938 derzeit beinahe eine Renaissance. Trotz aller Fortschritte der Entwicklung neuer psychopharmakologischer und nicht-pharmakologischer Therapieverfahren bleibt die EKT weiterhin die wirksamste Therapieform fur einige psychiatrische Krankheitsbilder. Moderne Weiterenwicklungen der Anasthesiologie und Intensivmedizin liessen es in den letzten Jahren zu, viele medizinischen Kontraindikationen der EKT zu relativieren und diese Behandlungsform einer grosseren Patientenzahl anzubieten. Erstmals wird fur den deutschen Sprachraum ein Lehrbuch angeboten, das den aktuellen Stand der wissenschaftlichen Erkenntnisse bezuglich der EKT und anderer biologischer nichtpharmaklologischer Therapieverfahren zusammenfasst. Sowohl auf die wissenschaftliche Aufarbeitung des Themas mit der Darstellung neuester Erkenntnisse bezuglich der Grundlagen- und Therapieforschung als auch auf einen umfassenden Leitfaden fur die klinische Praxis wurde besonderer Wert gelegt."

Regional anaesthesia is currently undergoing a renaissance in paediatric anaesthetic practice, particularly in day case surgery, for post-operative pain relief and in ex-premature babies. However, most practical textbooks of local anaesthetic technique are not written with small children, and particularly newborn infants, in mind.

This practical manual has been designed to aid both those aiming to refresh their knowledge of the techniques of regional anaesthesia in babies and children, and those learning these methods for the first time. Whilst it is not intended as a substitute for direct trainig by experts, its clear and concise text and simple diagrams make it an ideal companion to 'hands on' training in the operating theatre. Both authors have extensive experience of teaching anaestheitc trainees.

The two introductory chapters of this book describe the relevant pharmacological and biological differences between infants, children and adults, and the general practical aspects of regional anaesthesia. The book is then divided into sections describing the nerve blocks of the major anatomical regions of the body. The descriptions of the different blocks can be read independently and include the relevant anatomy, indications, specific contraindictions, equipment, drugs and dosages, Each description concludes with a step-by-step guide to the block illustrated with photographs and simple diagrams.

Sepsis und septischer Schock gehen auch heute noch trotz aller Fortschritte der Intensivmedizin mit einer ausserst hohen Mortalitat einher. Auf der Basis eines verbesserten Verstandnisses der Pathophysiologie dieses komplexen Krankheitsbildes haben sich in den letzten Jahren neue therapeutische Ansatze entwickelt. Dieses Buch enthalt die Beitrage namhafter Grundlagenforscher und Kliniker aus Hygiene, Mikrobiologie, Infektologie, Physiologie, Chirurgie, innerer Medizin, Anasthesiologie und Intensivmedizin und gibt einen umfassenden UEberblick uber den derzeitigen Wissensstand zur AEtiologie, Pathophysiologie, Pravention und Therapie der Sepsis und ihrer Komplikationen.

The new Oxford Textbook of Cardiothoracic Anaesthesia provides a comprehensive overview of and a thorough grounding in this challenging subspecialty. Both cardiac and thoracic anaesthesia demand high levels of knowledge and skill, as minimally invasive surgical techniques demand a sounder understanding of the specialties and as more patients with co-morbidities present for surgery. Part of the Oxford Textbooks in Anaesthesia series, this volume covers the anatomy and physiology, pharmacology, post-operative complications, critical care, and all clinical aspects of cardiac and thoracic anaesthesia. Practical aspects, such as team working, and designing and equipping cardiothoracic theatre and critical care, are also included. The expert and international author team use their experience to ensure this textbook reflects current world-wide practice across the globe. This volume is published with a concurrent online version, which features access to the full content of the textbook, contains links from the references to primary research journal articles, allows full text searches, and provides access to figures and tables that can be downloaded to PowerPoint (R). Designed for consultants and trainees in cardiac and thoracic anaesthesia, this is the definitive source of expert knowledge for anaesthetists in this subspecialty. This print edition of Oxford Textbook of Cardiothoracic Anaesthesia comes with a year's access to the online version on Oxford Medicine Online. By activating your unique access code, you can read and annotate the full text online, follow links from the references to primary research materials, and view, enlarge and download all the figures and tables. Oxford Medicine Online is mobile optimized for access when and where you need it.

Rontgenthoraxaufnahmen richtig interpretieren

Thoraxaufnahmen, die auf der Intensivstation aufgenommen werden, unterscheiden sich in der Aufnahmetechnik und in den veranderten physiologischen und anatomischen Verhaltnissen von Standard-Thoraxaufnahmen, die am Rasterwandstativ angefertigt werden. Die Interpretation dieser Bilder bereitet selbst erfahrenen Radiologen und Intensivmedizinern haufig Schwierigkeiten.

Der Weg zur korrekten Interpretation: - Rontgen- und Aufnahmetechnik - Strahlenschutz und -belastung - Klinische Problematik und Interpretation von Thoraxaufnahmen auf der Intensivstation.

Neu in der 2. Auflage:

Bildmaterial moderner Aufnahmeverfahren

Indikationsstellung fur CT-Aufnahmen

Vergleich von Projektionsradiographie und Schnittbildradiographie und mogliche Pitfalls

Ein Praxisbuch von Radiologen, Intensivmedizinern und Medizinphysikern zum Lernen und Nachschlagen. Ein Muss fur jeden auf der Intensivstation tatigen Arzt "

Die Tracheotomie gewinnt im intensivmedizinischen Atemwegsmanagement stetig an Bedeutung. Mit Hilfe neuer perkutaner Tracheotomieverfahren wird dieser Eingriff zunehmend auch von nicht chirurgisch spezialisierten Intensivmedizinern aller Fachrichtungen durchgefuhrt. Dieses Buch wendet sich an den modernen Intensivmediziner; es stellt alle gegenwartig verfugbaren Verfahren zur Tracheotomie mit ihren Indikationen, Kontraindikationen und typischen Risiken detailliert vor und eignet sich auch als Nachschlagewerk fur intensivmedizinisch tatige Arzte aller Fachrichtungen."