Suchergebnisse

Background With the on-going debate about which specialty should be responsible for intubations in the emergency department in mind, the aim of this study was to describe the prevalence of endotracheal intubation and other airway management procedures in emergency department patients in Sweden. Methods All patients registered in the Swedish Intensive Care Registry with admission date from January 1 2013 until June 7 2018 and reported admission type "from the emergency department" or "emergency department" reported in the SAPS3 scoring were included. All patients missing codes for procedures were excluded. Results A total of 110,072 admissions from an emergency department to an ICU were registered during the study period. Of these, 41,619 admissions (37.8%) were excluded due to lack of codes for medical procedures. The remaining 68,453 admissions (62.2%) were included, and 31,888 emergency airway procedures (within 3 h from admission time to the intensive care unit) were registered. Invasive emergency airway procedures were the most common type of airway procedure (n = 23,446), followed by non-invasive airway procedures (n = 8377) and high-flow nasal cannula (n = 880). In 2017 a total of 4720 invasive emergency airway management procedures were registered. Conclusions The frequency of invasive airway management procedures in Swedish EDs is low. With approximately 1.9 million adult ED visits per year, this gives an estimated incidence of 2.4 invasive airway management procedures per thousand ED visits in 2017. ; Funding Agencies|Linkoping University; Region Ostergotland, a public healthcare organization

Background Emergency departments (EDs) see a rising number of patients, but only a small fraction of ED patients need immediate intensive care. The characteristics of these patients are mostly unknown and there is reason to believe that there are large inter-hospital differences in thresholds for intensive care admissions from the ED. The purpose of this study was to give a nationwide overview of ED admissions directly to intensive care units. Methods We used the Swedish Intensive care Registry to identify all patients admitted to intensive care from the ED (January 1, 2013 until June 7, 2018). The primary outcome was discharge diagnosis after intensive care (primary ICU diagnosis code). ICU mortality and" ICU admission due to only observation" were analyzed as secondary outcomes. Results 110,072 ICU admissions were included, representing 94,546 unique patients. Intoxication, trauma and neurological conditions were the most common causes for intensive care, but large variations according to age, sex and hospital type were seen. Intoxication was the most prevalent diagnosis in young adults (46.8% of admissions in 18-29 years old), whereas infectious diseases predominated in the elderly (17.0% in 65-79 years old). Overall, ICU mortality was 7.2%, but varied substantially with age, sex, type of hospital and medical condition. Cardiac conditions had the highest mortality rates, reaching 32.9%. The mortality was higher in academic centers compared to rural hospitals (9.3% vs 5.0%). It was more common to be admitted to ICU for only observation in rural hospitals than in academic centers (20.1% vs 7.8%). Being admitted to ICU only for observation was most common in patients with intoxication (30.6%). Conclusions Overall, intoxication was the most common cause for ICU admission from the ED. However, causes of ED ICU admissions differ substantially according to age, sex and hospital type. Being admitted to the ICU only for observation was most common in intoxicated patients. ; Funding Agencies|Region Ostergotland; public healthcare organization; Linkoping University

Wie kann christliche Sozialethik Orientierungshilfen für die rechte Gestaltung moderner Gesellschaften entwickeln? Ausgehend von dieser Fragestellung bietet der Band einen gut verständlichen Einstieg in die Themen und Begrifflichkeiten der Christlichen Sozialethik. Er versetzt Studierende in die Lage, angesichts vielfältiger sozialer Probleme die Herausforderungen zu reflektieren, die sich im Spannungsfeld von gesellschaftlichen Anforderungen und christlicher Glaubensverantwortung stellen.

Personen mit Borderline-Persönlichkeitsstörung kämpfen täglich mit verschiedensten Herausforderungen. Sie erleben Wechselbäder zwischen Selbstliebe und Selbsthass. Das Borderline-Syndrom hat aber auch seine positiven Seiten. Diese können jedoch Fluch und Segen zu gleich sein. Bestätigung von anderen und Beziehungsarbeit helfen Betroffenen, sich selbst zu finden. Im Umgang mit ihnen sollte mehr Zeit eingeplant werden, denn sie benötigen einen ruhigen Ablauf. Mit viel Empathie, Wertschätzung, einer transparenten Arbeitsweise und Sachlichkeit haben Borderliner*innen eine gute Chance, an einer Mediation erfolgreich mitzuarbeiten.