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Alkoholpatienten als Risikopatienten

Was muss der Notfallmediziner beachten?

Alcoholic patients as risk patients

What needs to be considered by the emergency physician?

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Zusammenfassung

Hintergrund

Notfallmediziner sind häufig mit akuten oder langfristigen Folgen eines schädlichen Alkoholkonsums konfrontiert. Erkennen, Differenzialdiagnose und die Erstversorgung der Alkoholfolgeerkrankungen gehören zu den Kernkompetenzen aller Notfallmediziner.

Methode

Recherche und Auswertung aktueller Literatur.

Ergebnisse und Schlussfolgerung

Bei akuter Alkoholintoxikation tritt häufig als Komplikation eine Hypothermie auf, die nicht übersehen werden sollte. Auf eine mögliche Schädel- und Hirnverletzung ist besonders zu achten und bei Verdacht mittels CT auszuschließen. Bei Stoffwechselstörungen, die per se eine Bewusstlosigkeit bedingen können, muss an eine Hyponatriämie und eine Hypoglykämie gedacht werden. Bei chronischem Alkoholmissbrauch sollte die erhöhte Suizidalität beachtet werden. Da Aggressivität und Gewalt v. a. bei Alkoholpatienten vermehrt auftritt, sollten die Notaufnahmen und Rettungsdienste organisatorisch und personell auf diese oft aufwendig zu versorgenden und aggressiven Patienten vorbereitet und geschult werden.

Abstract

Background

Emergency physicians are often faced with acute or long-term consequences of alcoholic intoxication and harmful use of alcohol. Recognition, differential diagnosis, and initial treatment of alcohol-related disorders are among the core competencies of all emergency physicians. We discuss the emergency aspects of alcohol-related disorders.

Method

Research and analysis of current literature.

Results and conclusion

In acute alcohol intoxication, suspected intracranial injury or bleeding must be excluded by performing a CT scan. Hyponatremia and hypoglycemia as alcohol-independent causes for somnolence or unconsciousness should also be excluded. Hypothermia is often a side effect of alcoholic intoxication and should not be missed. In chronic alcohol abuse, there is increased suicidality. Because violence occurs more frequently in intoxicated patients, it is very important that emergency staff is well trained and emergency rooms are structurally equipped to be able to safely treat these complex and potentially aggressive patients.

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Authors and Affiliations

  1. Interdisziplinäre Notaufnahme (INA), Klinikum Stuttgart – Katharinenhospital, Kriegsbergstr. 60, 70174, Stuttgart, Deutschland

    S. Rauscher, L. Lomberg &  T. Schilling

Authors
  1. S. Rauscher
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  2. L. Lomberg
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  3. T. Schilling
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Corresponding author

Correspondence to T. Schilling.

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Interessenkonflikt

S. Rauscher, L. Lomberg und T. Schilling geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Redaktion

C. Jäkel, Lübben

S. Poloczek, Berlin

R. Somasundaram, Berlin

C. Wrede, Berlin

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Rauscher, S., Lomberg, L. & Schilling, T. Alkoholpatienten als Risikopatienten. Notfall Rettungsmed 19, 28–32 (2016). https://doi.org/10.1007/s10049-015-0120-y

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  • DOI: https://doi.org/10.1007/s10049-015-0120-y

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