Ladda ner den kompletta programboken här! - SFAI-veckan 2013

ONSDAG 19/9
60 ÅR INOM INTENSIVVÅRD I SVERIGE
SAL 1 11.10-11.40
Lars-Åke Augustsson, Anestesi och Intensivvårdskliniken, SÄS, Borås
TORSTEN GORDHS HÖGTIDSFÖRELÄSNING
SAL 1 11.40-12.30
INTENSIVE CARE TODAY AND TOMORROW
Andrew Rhodes, FRCP FRCA, Clinical Director of Critical Care. St George’s Healthcare NHS Trust, London, SW17
0QT, UK
Intensive care medicine is a relatively young specialty that is evolving quickly into an established and vital
hospital discipline. For a variety of reasons the discipline faces a number of challenges that need to be addressed
in the near future:
1. There are marked differences in how countries resource this service in terms of bed numbers and staff.
This can be seen in the variations in intensive care bed numbers per country even when corrected for
population size and economic wealth of the country.
2. Although CoBaTrICE has defined the core competencies for medical training in Intensive Care Medicine
there are still big differences in how these are achieved and assessed.
3. There are big differences within Europe in how Intensive Care is delivered, from both the medical and the
nursing perspective. For instance several Northern European countries (e.g. the United Kingdom) aim to
have one nurse per bed whereas this is very different in many Southern countries.
4. Many countries having growing and ageing populations. This combined with the changing perceptions as
to what Intensive Care can deliver is likely to lead to a mismatch between what we can supply and what is
needed.
5. Unless we start planning to meet this mismatch then we may end up with major problems.
6. There needs to be a greater understanding of what can be done and the best way of achieving this.
Understanding what quality is and how it can be influenced is likely to be key if we are to be able to
provide adequate numbers of beds for the future demand.
This lecture will cover many of these issues and points and summarize recent work that has looked into the
variations of provision and resource in Europe and how quality can be viewed and assessed and improved.
ORGANDONATION OCH TRANSPLANTATION
SAL 1 13.30-15.00
IDENTIFIERING AV ORGANDONATOR
Stefan Ström, Regional Donationsansvarig läkare, Uppsala Örebro regionen, Västmanlands sjukhus Västerås
PROGRAM
Sedan 1988 gäller enligt svensk lag hjärnrelaterade dödskriterier i form av total hjärninfarkt. Då total
hjärninfarkt utvecklats och döden konstaterats med direkta kriterier (klinisk neurologisk undersökning eller
aortocervical angiografi) får medicinsk behandling fortgå under högst 24 timmar. Under dessa 24 timmar är
det intensivvårdens ansvar att utreda frågan om donation av organ. Transplantation av organ är i Sverige sedan
1960 talet en väl etablerad medicinsk behandlingsform vid terminal svikt i flera organ. Transplantation av hjärta,
lunga och lever är livräddande och transplantation av njure, pankreas och ö-celler förbättrar livskvalitet och
förlänger livet. Organtransplantation är också samhällsekonomiskt lönsamt. En förutsättning för transplantation
är dock att det finns människor som vill donera sina organ och vävnader efter sin död och att möjligheten till
donation uppmärksammas inom intensivvården. ”Utan donation ingen transplantation”. I Sverige som i många
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