Category Archives: Internal Medicine @en

Therapeutic hands in the rescue center

Why? = With minimal resources (medically and financially) the greatest possible therapeutic success in the initial treatment (minimax principle). = Fast-Track & Fast-Case = FAST – Rehabilitation!

Why should physiotherapists be integrated? = Protection of surgical supplies therapeutic, preventative actions / interventions for the changes of progress in pathophysiological (disease-related) reactions.
In addition, patients with fewer acute complaints, which are part of the everyday illness of physiotherapy, also frequent. Also, the risk of subacute discomfort, such as the fatal pause in an acute abdomen, may be present

Pubmed-Quelle: Describing physiotherapy interventions in an

+emergency department setting: an observational pilot study.
An integration of physiotherapy into the emergency room – instead of inactivity vs. → Mobility & Nature is movement only the emergency room its not – Enlightenment:

In various diseases, such as the cranial brain trauma, care should be taken instead of movement.

• Stress, anxiety, shock reduction through mobility &  enlightenment

• Authorized preservations for pathophysiological reasons – e.g. In acute prolapse / appendicitis – functional relationships between motion apparatus & (M. Iliopsoas), the patient should also be given a transfer and not even tapped from the bare to the examination table, whereby the inflamed appendix (appendix) can then be completely broken Then the exudate (excitatory pus) enters the abdominal cavity, which intensifies a surgical supply. Also, the provocation rapid test with a right-sided hip flexion against resistance can already make a perforation of the appendix (appendix) possible.

• If necessary, functional exercises adapted to the current time of the dream patient
– Securing the joint partners also isometrically depending on partial fracture
– Prevention / minimization of edema / exudation in the movement apparatus – edema = also anasarca (cardial)
– support of the cardiovascular system with simultaneous recognition of cardiac symptoms, such as the anasarca (right heart failure, renal insufficiency)
– prevention of shock stages, ⇓ stress parameters
– Prevention of compartment syndromes (development of physical therapies?)
– Support the lymphatic system (only if cardiac complaints) by MLD
– ↑ Preservation / production of a blood circulation control• can implement various therapies immediately and minimize later follow-up treatments (ambulatory / surgical), taking into account laboratory values, such as the cTNT – which can be minimized by a gentle movement activity

• ⇑ Outpatient patients as later clinical (⇑ Frequentization of outpatient patients (private patients / managers (who hardly find access to physio centers in regular working hours)) = Refinance (profitability) of the emergency room (more self-payers?)

• ⇑ immediate pain management during prolapse / outpatient care rather than surgical prolapse (⇓ profitability for surgical inventory)

• ⇑ faster release / problem (pain relief) at the patient = ⇑ (higher) evaluation relations in the DRG + previous release Patient = ⇑ bed turnover frequency

• ⇑ faster processing of patients = fewer waiting times for patients (time for further projects?)

• Further strengthen interdisciplinary team – synergistic therapy development?

• ⇓ Negative Casemanagements & ⇑ Consciousness of the body on the patient = a positive image of the company &  ⇑ Motivate patient for possible self-exercises = Minimize compliance / patient anxiety = ⇑ Strengthen collaboration

• short therapy chain = cost reduction since therapies can be implemented at the same time and
Subsequent surgical procedures are less intensive

• Relief of a medical & nursing teams

• faster outpatient dismissal of patients by physiotherapists with possible home exercises / self-treatments

• Cost-effective use of therapies and accurate consideration of therapies for patients

• Recognize long-term therapy goals faster (not only current!)

• Development of a remuneration / bonusesystem of the health insurances for emergency room

• functional adaptation of orthotics to the patient (for example, carpal tunnel syndrome track)

• Better risk management in the patient through stress reduction / prevention / first therapeutic treatment

• Integrate old / new tools of PT / Hydrotherapy. In the case of AVRT instead of ice water, to give the patient drink / respiratory therapy for panic attacks

• particular importance postcardial infarction patients, not only dependent on drugs such as amiodarone? But also from irritations of nerve bottlenecks (trauma, WAD,
Osteochondrosis Ganglion cervicothoracicum / over-irritation / dysreflexia peripheral M. Supinator (N.radialis) Loge de Gyon (ulnar nerve) associated with the plexus
Brachialis or the Ncl. Cardiaci directly by centrifugal traumatas. To what extent shock levels contribute to nervousness is questionable. But also visceral-visceral dysreflexia,
Such as by gastric ulcer, which might cause cardiac arrhythmias, would also be interesting.• (gentle movements in small cardiac tamponades (with subacute inflammation) only if the patient was active in the sport before)

• pure apical breathing (bonded intercostal spaces / ↑ dead space volume etc.), reduced speech sound image …

• Reduction of cTNT levels by exercise exercises?
A) Supporting muscle pump HKL
B) Respiratory therapy = ↓ Volumetric volume = ↓ pathophys dysregulation
Indication for advanced respiratory therapies (which also act as preventive) – stressful condition of the patient AVPU, SBD (age & HF, AF WAD (centrifugal trauma) patients
1. Irritation / elongation of the cervical ganglion / inferior arrhythmias
2. Indicated Horner symptom complex?
Trauma / chronic diseases – osteochondroses of the lower cervical spine while minimizing the neuroforamina / intervertebral foramen – which cause irritation of the plexus brachialis / truncus
Sympathicus – occasional orthopedic symptoms (in chronic course) Athoscopy of the interosseous spatum, paresthesia Acute hands / fingertips, ↑ Venenal signs – Vena cephalica – hand back !; Thoracic Outlet Syndrome as a Compensation Mechanism? Inspirationsthorax …

• Integration of back BGW zones, which are usually clearer than the extremities

• N. Splanchnici pelvici Irritation e.g. By hypomobility SIG

• Frank Sterling mechanism – stimulate preload by passive movement, high-bearing and thus faster to get a ROSC by a 1. defibrillation with adrenaline at the heart, due to increased preload of the atria (reduction of the risk of a subsequent infarction?)

• Improved compression therapy (functional & long-lasting) in a variety of traumas / wound management

• Development of new therapeutic approaches & faster diagnostics

• Preoperative care patient / preparation

• Combination of several therapy techniques (for example MT from Kaltenborn & Cyriax …) = risk minimization / ↓ treatment time

Gastric Perforation after Secret Maneuver Fatal splenic rupture scores Secret maneuver: case report and literature review.

  • Advanced compression therapy for eczema / various phlebotic syndromes
  • Extended risk management = contraindications in, for example, hypertension A. carotid sign / blue abdominal navel in portal hypertension – Malori white syndrome – esophageal varices
  • Unfortunately there is no funding of physiotherapy in the emergency room. Currently an emergency room should be recognized as a physiotherapy practice – according to the statement – Knappschaft . All other health insurance funds could not make an effort. This means that the emergency physician has to print prescriptions for the physical therapy that is currently on the side with him. Furthermore, thegerman Cure catalog has to stop Since he is an advancement / exercise of physiotherapy. (Germany is the only country in Europe with a catalog of medicines!) (Criminal prosecution of the theologians in Germany !!!)


New Guidelines 2015 for the Lifetime Immediate Measures: Here to download


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