Trigger (medicine)

Under a trigger ( Engl. "Trigger") is understood in medicine and psychology the trigger for an operation (for example, pain.) A sensation, an emotion, a mechanical ventilation support, a symptom can cause or disease.

Triggers in anesthesiology

In anesthesiology , gaseous inhalation anesthetics ( halothane ) and depolarizing muscle relaxants ( succinylcholine ) - so-called trigger substances - can trigger malignant hyperthermia , a very rare, life-threatening complication of anesthesia . The administration of such substances causes a metabolic imbalance in the skeletal muscles if there is a corresponding genetic predisposition .

Triggers in surgery

Cardiac pacemakers are connected to electrodes that are used both to perceive the cardiac function and to stimulate it. An electrocardiogram (EKG) is recorded and evaluated using these electrodes . Depending on the purpose and structure, different signals from the EKG are used as triggers. The QRS complex from the ECG is often used as a trigger to detect the heartbeat. If no heartbeat is detected within an adjustable period of time, stimulation with an electrical impulse follows.

Triggers in dermatology

The skin of patients suffering from atopic eczema is very sensitive to internal and external irritations known as provocation factors or triggers. You can, in conjunction with strong itching a reddening of the skin trigger that is fast becoming one eczema develops.

Triggers in internal medicine

The most important cause of portal hypertension is cirrhosis of the liver . The triggers are categorized according to their location in the current path.

Triggers in intensive and emergency medicine

In intensive care and emergency medicine , IPPV ventilation ( intermittent positive pressure ventilation ) is used, whereby the ventilator tries to keep the respiratory volume constant and to do this varies the ventilation pressure . The patient's breathing efforts, called triggers, are recognized and supported in a synchronized manner.

With assisted spontaneous breathing , the patient himself generates a breathing gas flow at the beginning of the inhalation , which the ventilator recognizes (so-called flow trigger). The speed is recorded by the device in liters per minute. If the breathing gas flow generated by the patient exceeds the pre-set threshold, i.e. the set trigger level, the breathing device presses breathing air into the ventilated person for a certain time at the pre-set higher pressure, thus making it easier to breathe.

Triggers in neurology

In trigeminal neuralgia, the following can act as triggers for the pain: chewing, speaking, swallowing, brushing your teeth, touching the face, cold drafts or movements of the facial muscles.

The cluster headache can be triggered by a number of triggers, such as alcohol, heat, noise and many others.

Triggers in orthopedics

In orthopedics , locally limited muscle hardening in the skeletal muscles can act as triggers that are locally sensitive to pressure and from which transmitted pain can originate. To eliminate the so-called myofascial pain syndrome that is trigger point therapy applied.

Triggers are not to be confused with trigger points (synonym: tender points ), circumscribed, approx. 1 cm large points in the muscles (including the tendon attachments) that are painful under “normal” palpatory pressure. However, outside of the palpated point, they can “trigger” referred pain in the affected muscle and / or in the associated region. See also fibromyalgia .

Triggers in nursing

Controlled emptying of the bladder is a common problem in paraplegic patients . The urinary bladder can be emptied by rhythmically tapping (triggering) the bladder area.

Triggers in Psychiatry and Psychology

In psychiatry , a key stimulus can trigger a flashback . The affected person has a sudden, intense reliving of a past experience or earlier emotional states triggered by the trigger , this can be so strong that the person is unable to recognize it as a memory and literally experiences it as a current event.

As intrusion re remembering and reliving is psycho traumatic events in the Psychotraumatology understood. Intrusions are considered a symptom of post-traumatic stress disorder (PTSD), but also of obsessive-compulsive disorder , which are usually triggered by a trigger.

See also : trigger warning

Triggers in dentistry

In dentistry , factors causing parafunctions ( bruxism ), for example incorrect contact between the teeth , are called triggers.

Individual evidence

1. ↑ G. Bollig, S. Mohr, J. Raeder: McArdle's disease and anesthesia: case reports. Review of potential problems and association with malignant hyperthermia. In: Acta anaesthesiologica Scandinavica. Volume 49, Number 8, September 2005, pp. 1077-1083, ISSN  0001-5172 . doi: 10.1111 / j.1399-6576.2005.00755.x . PMID 16095447 . (Review).
2. ↑ Bolz, A. and W. Urbaszek: Technology in cardiology: An interdisciplinary presentation for engineers and medical professionals . Springer-Verlag, Berlin Heidelberg 2002, p. 369-370 .
3. ↑ L. Reisner SENELAR: The Danish anesthesiologist Bjørn Ibsen - a pioneer of long-term ventilation on the upper airways. Dissertation to obtain a doctorate in medicine from the human medicine department of the Johann Wolfgang Goethe University in Frankfurt am Main.
4. ↑ Hans Walter Striebel: The anesthesia: Volume I, Basics - Forms of general anesthesia - Local and regional anesthesia - Special features - Anesthetic problems; Volume II, secondary diseases - specialist anesthesia - recovery room - immediate life-saving measures - appendix . Schattauer Verlag, November 29, 2013, ISBN 978-3-7945-2942-1 , p. 219–.
5. ↑ S. Katusic, CM Beard et al. a .: Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-1984. In: Annals of neurology. Volume 27, Number 1, January 1990, pp. 89-95, ISSN  0364-5134 . doi: 10.1002 / ana.410270114 . PMID 2301931 .
6. ↑ Blue ao: A new cluster headache precipitant: increased body heat. In: Lancet. 354 (9183), Sep 18, 1999, pp. 1001-1002. PMID 10501368 .
7. ^ Carl Joachim Wirth, Wolf-Eberhard Mutschler, Dieter Kohn, Tim Pohlemann: Practice of orthopedics and trauma surgery . Thieme, 11 December 2013, ISBN 978-3-13-159763-2 , p. 368–.
8. ↑ Triggerpoints ( Memento of the original from June 29, 2017 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. , German Society for Rheumatology . Retrieved June 14, 2017. 
9. ^ Christian Hampel: Overactive bladder - Current treatment strategies for practice. 1st edition. UNI-MED, Bremen 2005, ISBN 3-89599-901-6 , pp. 63-67.
10. ↑ Ulrich Lotzmann: Oral parafunctions and abrasion of the teeth. In: Dentistry up2date. 6, 2012, p. 175, doi: 10.1055 / s-0031-1298423 .

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