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DOI: 10.1055/a-2267-1634
Hämatologische und onkologische Notfälle
Maligne Erkrankungen zählen zu den wesentlichen Treibern der globalen Krankheitslast und betreffen insbesondere ältere Patienten. Für die Akut- und Notfallversorgung ist es daher wichtig, ein Verständnis des Spektrums möglicher Komplikationen zu entwickeln und einen praktikablen Ansatz zur Versorgung dieser Patienten zu entwickeln. Dieser Beitrag gibt einen Überblick über die wichtigsten Komplikationen und Symptome.
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Auf die Besonderheiten von Patienten mit bestehenden und bislang nicht vorbekannten Erkrankungen aus dem hämatologisch-onkologischen Spektrum und die besondere Vulnerabilität dieser Patienten ist unbedingt zu achten.
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Der Rettungsdienst kann konfrontiert werden mit
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lokalen Komplikationen der malignen Erkrankung,
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systemischen Komplikationen wie thromboembolischen Ereignissen, Blutbildveränderungen und Elektrolytstörungen,
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therapieassoziierten Komplikationen.
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Eine leitsymptombasierte Vorgehensweise kann helfen, die Komplexität der Grunderkrankung sowie des jeweiligen therapeutischen Regimes zu beherrschen und ein zielorientiertes Vorgehen in der Akutversorgung zu etablieren.
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Entscheidend ist, hämatologisch-onkologische Krankheitsbilder und damit verbundene Komplikationen bei der differenzialdiagnostischen Abklärung zu bedenken und deren Dringlichkeit korrekt einzuschätzen. So stellt beispielsweise der Befund einer subsegmentalen Lungenarterienembolie in einer Staging-Bildgebung bei einem asymptomatischen Patienten eine grundlegend andere Situation dar als der akute und ohne adäquates Trauma einsetzende Rückenschmerz.
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Gleichzeitig sollte die frühzeitige, hämatologisch-onkologische Rücksprache gesucht werden, um die rasche und zielgerichtete Weiterbetreuung im Anschluss an die Akutsituation gewährleisten zu können.
Schlüsselwörter
Tumorlysesyndrom - Rückenmarkkompression - Thromboembolie - Einflussstauung - Thrombopenie - Notfallmedizin - KrebserkrankungPublication History
Article published online:
02 September 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
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