Medizinische Klinik-Intensivmedizin Und Notfallmedizin最新文献

Background: Movement training for stroke patients is a crucial component of their treatment. Lack of time and staff are often described as limiting factors for the development of kinaesthetic competence. In contrast, a positive team atmosphere and awareness of kinaesthetics are seen to be beneficial.

Aim: The goal of this quality improvement project was to promote the kinaesthetic competence of a stroke unit (SU) nursing team and to investigate its influence on team dynamics.

Methods: As a team intervention for the project, a basic course in kinaesthetics in nursing, augmented by practical instructions, was conducted exclusively for the SU nursing team. The Kinaesthetics Competence Observation (KCO) instrument was used to determine competence development. The participants rated team dynamics on a scale of 0-10 points.

Results: In all, 88% of the nursing team took part in the quality improvement project and successfully completed the basic course. The kinaesthetic competence improved by 4.2 KCO points and the team dynamics also increased by around 2 points.

Discussion: A basic kinaesthetics course with practical instructions improves kinaesthetic competence. Continuous instruction, long-term process implementation and support from nursing managers are required to establish kinaesthetic competence in the long term.

Conclusion: The results show that a kinaesthetic training project carried out in this way has a positive influence not only on kinaesthetic competence but also on the dynamics of a care team.

Tropical diseases are becoming increasingly important in medical care in Germany due to climate change and the spread of vectors and viruses. The widely distributed Culex mosquitoes in Germany can transmit the West Nile virus, which causes West Nile fever. Severe neuroinvasive disease courses with acute flaccid paralysis, meningitis, and encephalitis are possible. The invasive tiger mosquito (Aedes albopictus) is increasingly establishing itself in Germany and is a potent vector of viruses that have so far occurred mainly in tropical-subtropical areas, including dengue and chikungunya virus. Severe dengue cases can manifest with hemorrhagic dengue fever, shock, or organ involvement. Dengue fever is currently still a travel-related disease in Germany. However, this may change in the context of climate change and increasing vector populations. Enhanced training and continuing education programs, as well as an expansion of diagnostic infrastructure and networking of health authorities and mosquito control, are crucial for optimal patient care.

Background: Simultaneous symptoms of impaired consciousness and fever are suspicious for acute bacterial meningitis. This is a medical emergency and prompt action is essential.

Objectives: The clinical workup for suspected bacterial meningitis as well as treatment recommendations and differential diagnosis for the main symptoms of decreased vigilance and fever are described.

Methods: Evaluation of selective literature using PubMed (U.S. National Library of Medicine®, Bethesda, MD, USA), especially taking into account the AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften) guideline of community-acquired bacterial meningoencephalitis in adults.

Results: Bacterial meningoencephalitis presents with the main symptoms of impaired consciousness, nuchal rigidity, headache and fever, which may, however, be absent in some cases. The diagnosis is confirmed by investigation of the cerebrospinal fluid. Further diagnostics include emergency laboratory tests, blood cultures, microbiological examinations, and cranial computed tomography (CCT). Empirical treatment should be administered promptly.

Conclusion: Acute bacterial meningitis must be considered in cases of loss of vigilance and fever, requiring a rapid, structured approach in the emergency department.