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Biomedical subjects

P Sefrin

Publications and source records attributed to P Sefrin.

At least 19 recordsLinked to original sources
PubMed1992

[Anesthesiologic problems in the elderly].

Nowadays approximately 20% of all patients operated are older than 60 years of age. So it seems to be interesting to investigate the effect on the increase of systemic disease of these patients, to estimate a proper anaesthesiological management. Anaesthesiological problems occur pre- and postoperatively because of restrictions of the cardiovascular and respiratory system, compromised renal function and defeds of the CNS. Therefore preoperatively registration and therapy of these risks are necessary, however diagnostic evaluation cannot be standardized. There is no typical anaesthesia for the elderly.

Aged↗
PubMed1992

[Current status of preclinical resuscitation. An overview based on recent literature and personal results].

Cardiopulmonary resuscitation is one of the most important topics in modern emergency care medicine. Especially the management of the prehospital cardiac arrest is a region of interest. This article is an attempt to show the current situation of the out-of-hospital resuscitation in the german-speaking area. In an own analysis of 166 resuscitations by emergency physicians and by consideration of results from other groups we found an outcome between four and seventeen percent finally successful resuscitations. The main prognostically favourable factors seem to be the following: non-traumatic cause for the cardiac arrest, ventricular fibrillation as the primarily ECG-statement and begin with CPR within ten minutes.

Adult↗
PubMed1991

[Emergency drugs in respiratory disorders. A choice of commonly used substances].

For the emergency care of respiratory disorders, in addition to clearing of the airways and keeping them open, drug treatment has an important role to play. The bronchodilatory effect of beta-sympathicomimetics brings about a marked decrease in the resistance to flow, but potential cardiovascular side effects must be considered. In the case of theophylline, the solvent, ethylene diamine has its own pharmacodynamic effects that can make it necessary to select different theophylline preparations. The drugs with a primarily cardiac effect, nitroglycerin, dobutamine and dopamine can produce pulmonary relief. Furosemide is specifically indicated for pulmonary edema. In addition to experience in the use of emergency drugs, an appropriate basic knowledge of the pharmacodynamics and pharmacokinetics is indispensable.

Adrenergic beta-Agonists↗
PubMed1979

[Metabolic changes in the multiply injured. Biochemical studies in multiply injured patients with reference to the severity of the injury].

Leading physical sign of "trauma-disease" in polytraumatized patients is hypovolemic shock. Changes in metabolism have been described previously. At present there are no reports concerning the time at which these changes occur. The early posttraumatic phase is characterized by normosodiemia and initial transient hypopotassemia, which is based on the renin-angiotensin-mechanism. The metabolic acidosis depending on trauma causes decreased oxygen perfusion of tissue, which possibly is found even before alterations of circulation are detected. Already at the site of the accident hyperglycemia and hyperglucagonemia with normal values of insulin were found. The increase of blood glucose was correlated to the values of adrenalin and to the insulin antagonist glucagon. The catabolism of proteins closely related to the degree of trauma continued as long as 5 days after injury. Analysis of the blood clotting system showed that in the early phase after trauma there are changes in hemostatic potential consisting in hemostatic defect. In several essential points the early posttraumatic phase of metabolism is different from that in a later phase. These facts should be kept in mind if planning therapy.

Acidosis↗
PubMed1979

[External heart compression with the heel (author's transl)].

External heart compression during cardiopulmonary resuscitation is an usual method. As an alternative to the arm-hand method the leg-heel method is proposed. Both methods were tested with a group of laymen and paramedical personnel at the Recording Resusci-Anne manequin. Criteria of evaluation were frequency, point, intensity and direction of heart pressure. 64 per cent of all test persons found the method of heel-compression to be of no value of the basis of personal experience. They showed early fatigue and complained of leg pain. The incidence of failure for both methods was comparable. Frequency and intensity of pressure showed no differences. The most important disadvantage appeared to be the lack of discharge of the sternum at the end of the phase of compression. Experience has shown that difficulties may arise from teaching several methods. Therefore the teaching of laymen should be restricted to one method only, usable universally. The restrictions of the leg-heel method are listed.

Evaluation Studies as Topic↗
PubMed1978

[Blood coagulation disorders in polytraumatized patients].

The lapse of coagulation disorders in polytraumatized patients is regarded as a substantial part of complications in the course of traumatic-hemorrhagic shock. In 71 polytraumatized patients blood-clotting tests were performed and showed that changes may already occur at a very early stage of the shock. The extent of these changes is closely related to the degree of the injury. It could be demonstrated that prompt shock-treatment and maintenance of adequate circulation as well as administration of low doses of heparin are important for spontaneous recompensation of the hemostatic defect.

Blood Coagulation Disorders↗