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Naforum Gratulerer Alle Vinnerne! orum NAF Tidsskrift for Norsk anestesiologisk forening, DNLF 25 4 CT ved legging av thorakale epiduraler? Devices for patients with severe heart failure after revascularization – ethical and economical implications Cushings 2012 syndrom og akutt, kortisolindusert psykose - En kasustikk med litt interesse for anestesileger……… Natt i Gaza Kreativt forskningsjuks Fosfat – viktigere enn du tror LEDER Anita With Vårøy Takk for sist! Og takk til Høstmøtekomiteen for et spennende og velorganisert møte! Det er utrolig godt med et slikt faglig avbrekk i hverdagen. Og kombinasjonen med nysnø i Tromsø; Perfekt timing. En hvit Tromsdalstind er virkelig et syn for øyet. Dette ga et anestesiologisk løft i høstmørket. Vel tilbake ble jeg møtt av et referat fra planlagte innsparingstiltak i avdelingen for neste budsjettperiode. Det ble en liten nedtur, men vi er vel der alle……. Det er dog vanskelig å se hva man kan kutte ned hvor. Det er ikke ordet sløsing jeg forbinder med vår daglige behandling av pasientene. Vel vel…. Vi får gjøre vårt beste… Jeg vil igjen benytte anledningen til å takke dere for alle innspill dette året. Det gjør styrearbeidet inspirerende også rent faglig. Anita W. Vårøy Kristiansand, 13.11.12 Prisene på Høstmøtet Forskningsprisen Eirik Skogvold hold Otto Moldestads minneforelesning - ”(Bedre) studiedesign i akutt- og intensivmedisin - hvorfor og hvordan?” Abstraktpriser Eksperimentelt arbeid: Ole Johannes Grymyr, OUS – RH. A three dimensional accelerometer can monitor left ventricular function independent of sensor alignment with the cardiac coordinate axes. Klinisk studie: Marlin Comelon, OUS – UUS . A comparison of oxycodone PR versus oxycodone + naloxone PR after laparoscopic hysterectomy. Kasuistikk: Espen Rørvik, OUS – RH. Gravid kvinne med dilatert kardiomyopati. NAForum gratulerer alle vinnerne! 2 NAForum, Tidsskrift for Norsk anestesiologisk forening NAForum Tidsskrift for Norsk anestesiologisk forening INNHOLD Vol 25; 2012, nr 4 NAForum er et uavhengig tidsskrift. Meninger og holdninger avspeiler ikke nødvendigvis den offisielle holdning til styret i NAF eller Dnlf. Signerte artikler står for forfatterenes egen regning. Kopiering av artikler kan tillates etter kontakt med ansvarlig redaktør og oppgivelse av kilde. Styret 2012-2013 Leder Anita With Vårøy Sørlandet sykehus, Kristiansand [email protected] Kontakt for Intensivutvalget Sekretær Marie Rønning St Olavs Hospital, Trondheim 2 Lederen har ordet 34 Kreativt forskningsjuks [email protected] Ib Jammer Kontakt for Smerteutvalget Anita With Vårøy Kasserer Eivinn Årdal Skjærseth Redaktøren har ordet 36 Statusraport fra Black Lion St Olavs Hospital, Trondheim 5 Anne Berit Guttormsen Hospital i Addis Abeba [email protected] Per Anders Hunderi Kontakt for Akuttutvalget 6 Uforklarlig perioperativ hjertesvikt? Høstmøtesekretær Søren E. Pischke Trond Elden, Erik Waage Nielsen 39 Verdenskongress i Buenos Aires Oslo Universitetssykehus, – vitenskap, tango og politikk Rikshospitalet, Oslo 10 CT ved legging av thorakale epiduraler? Jannicke Mellin-Olsen [email protected] Arne M. Skjold Kontakt for Forskningsutvalget 42 Verdens kongressen i Medlemssekretær Marit Bekkevold 13 Epidural analgesi (EDA) under anestesiologi i Buenos Aires Haukeland Universitetssjukehus, og etter operasjon og under fødsel: Ulrich Spreng Bergen Råd om effektiv og trygg praksis [email protected] Harald Breivik, Audun Stubhaug 46 Fosfat- viktigere enn du tror Kontakt for Anestesiutvalget og Leiv Arne Rosseland Andreas Skulberg sr Styremedlem Linda Over Jonkman (nestleder) Sykehuset Levanger, Levanger 19 Case # 1. A real airway problem 48 Sportsdrikk med fosfat Kontakt for Kvalitets- og John G. Brock-Utne Andreas Skulberg, Finn Reiestad og Per Hamre pasientsikkerhetsutvalget NAForum-redaktør Anne Berit Guttormsen 21 Case #2. Why so sleepy? 50 Grunnleggende ferdigheter ved Haukeland Universitetssjukehus, John G. Brock-Utne hjerte-lunge-redning er avgjørende Bergen Conrad A. Bjørshol [email protected] 23 Devices for patients with severe heart NAFweb-redaktør Håkon Trønnes failure after revascularization 51 Field triage of victims of trauma St Olavs Hospital HF, Trondheim – ethical and economical implications – Efficacy of trauma team [email protected] Michael Busch activation protocols Marius Rehn Design/layout 28 Cushings syndrom og akutt, Akuttjournalen Arena AS kortisolindusert psykose - En kasustikk 52 Terapeutisk hypotermi etter hjertestans Liv K. Norland Michael Busch [email protected] med litt interesse for anestesileger……… Bjørg Elvevoll Annonser 54 Årsmøte i Norsk Akuttjournalen Arena AS 30 BEST – 15 år med bedre og anestesiologisk forening 2012 Kjell O. Hauge [email protected] systematisk teamtrening Anne Berit Guttormsen 58 “The Quick and the Dead” Forside Reidar Kvåle Erik Johan Solheim 31 Natt i Gaza. Status 21.11.12 Styrets hjørne NAForum på internett Mads Gilbert 59 www.nafweb.no Materiellfrister nr 3-12 1. september Bli medlem i NAF NAF er en fagmedisinsk forening under Den Norske Legeforening (DNLF). Du må være medlem av DNLF for å kunne være medlem av NAF. Spesialister i anestesiolgi er automatisk medlemmer av NAF. LIS må melde seg inn. Meld deg inn via www.nafweb. no. NAF vil gjerne ha deg som medlem! Medlemsfordeler: NAForum 4 ganger i året. Autom- atisk medlemskap i SSAI, Acta Anaesthesiologica, 10 nummer i året, Høstmøtet til redusert pris. Som nafweb.no medlem kan du også delta på ”de nordiske utdan- nelsene” i Intensivmedisin, Smerte, Obstetrisk anestesi, Akuttmedisin og Barneanestesi og inten- sivmedisin (se www.ssai.info) Kontingent til DNLF: Spesialister: kr 7 315. Medlemmer uten spesialistgodkjenning: kr 6 480 < 3 år etter avlagt embetseksamen: kr 5 480 Bosatt i utlandet: kr 3 655 Studenter: kr 570 ISSN 0802-5088 NAForum, Vol 25; 2012, nr 4 3 NAForum 1/2012. 1/1 side. Format 210x280 + 4 mm UniPerc percutan tracheostomi sett med tracheostomikanyle UniPerc percutan tracheostomi sett som utføres med dilatasjons- teknikk. Prosedyren er mindre invasiv enn ved tradisjonell trache- ostomi. Prosedyren er basert på seldinger guidewire teknikk. Alle komponenter som trengs for å utføre prosedyren finnes i settet. Settet er spesielt beregnet til overvektige pasienter og pasienter med ødem i glottisområdet. Settet fåes med tracheostomikanyle i str 7, 8 eller 9 mm ID. Settet inneholder: • Skalpell • Pre-lubrikert singel • Gel • 14G nål dilator • 10 x 10 cm • Dilatasjonstang • UniPerc trachostomi- kompresser • 10 ml sprøyte kanyle m/Soft Seal • Wedge • Guidewire 14FR Cuff • Rengjørings- • Liten dilator med 10 • Introducer børste mm markering • 2 stk innerkanyler • Innførings kateter • Tracheostomibånd Kontakt oss for mer informasjon. Tlf. 24 05 66 20. E-post: [email protected]. www.medinor.no Verdiskapende produkter og tjenester til helsesektoren 4 NAForum, Tidsskrift for Norsk anestesiologisk forening Annonse Januar 1/1 side.indd 9 10.05.12 13:35 NAForum 1/2012. 1/1 side. Format 210x280 + 4 mm REDAKTØREN Anne Berit Guttormsen I am always ready to learn, although I do not always like being taught. Winston Churchill Nå er det jul igjen, å nå er det jul igjen og jula varer helt til påske…….. Tida flyg – jeg har ferie- må ta igjen den ferien jeg ikke fikk tatt ut i sommer- gjør ikke noe det. Akkurat nå er jeg i Tr.heim- iskaldt 14 kuldegrader og ikke et snøfnugg. Håper nå at jula blir hvit og ikke svart. Kommer rett fra København – Luftveiskurs med Michael Seltz Kristensen – hands-on – kanonbra – vi må trene mer, mer, mer….. Klinikkoverlegen, KSK, Haukeland Uiniversitetssykehus reserverer plass for sine ansatte på disse kursene – videreutdanning taes på alvor - et eksempel til etterfølgelse for andre ledere. Besøker en mor som har fått en interkurrent sykdom- klarer seg ikke helt selv – må innlegges på sykehus – lungebetennelse- antibiotika - sengeleie. Har bodd alene i sju år nå, ensomhet preger tilværelsen – venninnene er døde- korttidshukommelsen svikter – angsten over å glemme – har jeg husket alt - hvor er nøklene mine- reiser du i morgen du - er det min morgenkåpe – nei… det er ikke min –kryssord – no problem – like god som UniPerc percutan tracheostomi sett for 10 år siden- hva spiste du til middag – husker ikke. Takknemeligheten over at slektninger og venner stiller opp når en ikke er der. Fantastisk når en vet at hverdagen er travel for oss alle. Jeg er utålmodig – sett på som streng, slem, krevende- Lever med den filosofi at litt krav på sikt bedrer med tracheostomikanyle selvfølelsen uavhengig av alder og funksjonsnivå, gitt at kravet er tilpasset ytevnen. Hvorfor bor du ikke her? UniPerc percutan tracheostomi sett som utføres med dilatasjons- Vet ikke jeg hvordan livet kan gjøres innholdsrikt og leveverdig for de som er litt lei seg og som ikke helt kommer i hu - som føler at de er alene i teknikk. Prosedyren er mindre invasiv enn ved tradisjonell trache- verden og tror at ingen bryr seg? Ensomheten gnager…………….. ostomi. Prosedyren er basert på seldinger guidewire teknikk. Alle komponenter som trengs for å utføre prosedyren finnes i settet. Settet er spesielt beregnet til overvektige pasienter og pasienter Trondheim 2/12/12 med ødem i glottisområdet. Settet fåes med tracheostomikanyle i AB str 7, 8 eller 9 mm ID. Settet inneholder: • Skalpell • Pre-lubrikert singel • Gel • 14G nål dilator • 10 x 10 cm • Dilatasjonstang • UniPerc trachostomi- kompresser • 10 ml sprøyte kanyle m/Soft Seal • Wedge NAFweb.no • Guidewire 14FR Cuff • Rengjørings- • Liten dilator med 10 • Introducer børste mm markering • 2 stk innerkanyler • Innførings kateter • Tracheostomibånd
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