Subject(s)
Deglutition Disorders , Humans , Deglutition Disorders/etiology , Aged , Diagnosis, Differential , Aged, 80 and over , EsophagoscopySubject(s)
Vaccination , Humans , Aged , Germany , Vaccination/standards , Diarrhea/prevention & control , Travel , Aged, 80 and overABSTRACT
In Germany, physicians qualify for emergency medicine by combining a specialty medical training-e.g. internal medicine-with advanced training in emergency medicine according to the statutes of the State Chambers of Physicians largely based upon the Guideline Regulations on Specialty Training of the German Medical Association. Internal medicine and their associated subspecialities represent an important column of emergency medicine. For the internal medicine aspects of emergency medicine, this curriculum presents an overview of knowledge, skills (competence levels I-III) as well as behaviours and attitudes allowing for the best treatment of patients. These include general aspects (structure and process quality, primary diagnostics and therapy as well as indication for subsequent treatment; resuscitation room management; diagnostics and monitoring; general therapeutic measures; hygiene measures; and pharmacotherapy) and also specific aspects concerning angiology, endocrinology, diabetology and metabolism, gastroenterology, geriatric medicine, hematology and oncology, infectiology, cardiology, nephrology, palliative care, pneumology, rheumatology and toxicology. Publications focussing on contents of advanced training are quoted in order to support this concept. The curriculum has primarily been written for internists for their advanced emergency training, but it may generally show practising emergency physicians the broad spectrum of internal medicine diseases or comorbidities presented by patients attending the emergency department.
Subject(s)
Curriculum , Emergency Medicine , Emergency Service, Hospital , Internal Medicine , Internal Medicine/education , Humans , Germany , Emergency Medicine/education , Clinical Competence , Education, Medical, GraduateSubject(s)
Community-Acquired Infections , Pneumococcal Infections , Pneumonia, Pneumococcal , Humans , Aged , Streptococcus pneumoniae , Community-Acquired Infections/prevention & control , Pneumococcal Vaccines , Pneumonia, Pneumococcal/prevention & control , Vaccines, Conjugate , Pneumococcal Infections/prevention & controlSubject(s)
Geriatrics , Preoperative Exercise , Humans , Aged , Frail Elderly , Postoperative Complications , Preoperative CareABSTRACT
Vaccinations against infectious diseases are a highly effective preventive measure, especially in old age due to the higher susceptibility to infections. As the effectiveness of vaccinations decreases in old age due to immune senescence but also due to comorbidities, specific, more immunogenic vaccines have been developed for this target group. In Germany, the Standing Commission on Vaccination (STIKO) publishes annually updated vaccination recommendations also specifically for the 60+ years age group. Since 2018, standard vaccinations for this group have included herpes zoster vaccination with adjuvanted inactivated vaccine. Since 2021, the use of the quadrivalent influenza high-dose vaccine is recommended for this age group. Currently, the annual COVID-19 vaccination and the single pneumococcal vaccination with the new 20-valent conjugate vaccine have been added as standard vaccinations. The free STIKO app provides an always up to date overview of standard and indicated vaccinations for all age groups.
Subject(s)
Influenza Vaccines , Influenza, Human , Humans , COVID-19 Vaccines , Vaccination , Influenza Vaccines/therapeutic use , Germany , Influenza, Human/prevention & controlSubject(s)
Cardiac Surgical Procedures , Frailty , Heart Failure , Humans , Aged , Frail Elderly , Geriatric AssessmentABSTRACT
Medical progress and the increasing desire for self-determination, even in the most difficult life situations, as well as the associated increasing possibilities of influencing life and dying lead to possibilities but also obligations for individual treatment design. Especially at the end of life, the desire for provision is great and many decisions need to be made in advance or by proxy. In daily dealings with sick or seriously ill people at the end of their lives, it is very helpful if appropriate advance directives have been made and the patient's wishes can be implemented simply and clearly. With the possibility of advance planning for the end of life (Advance Care Planning (ACP)), there is a precautionary and planning concept that will hopefully be used more and more in the future.
Subject(s)
Advance Care Planning , Terminal Care , Humans , Geriatricians , Advance Directives , DeathABSTRACT
The timely integration of palliative medicine is an important component in the treatment of various advanced diseases. While a German S3-guideline on palliative medicine exists for patients with incurable cancer, a recommendation for non-oncological patients and especially for palliative patients presenting in the emergency department or intensive care unit is missing to date. Based on the present consensus paper, the palliative care aspects of the respective medical disciplines are addressed. The timely integration of palliative care aims to improve quality of life and symptom control in clinical acute and emergency medicine as well as intensive care.