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Erschienen in: Notfall + Rettungsmedizin 3/2019

11.06.2018 | Leitthema

Früherkennung von Sepsis − die Perspektive Rettungsdienst

Herausforderungen in Diagnostik und Therapie

verfasst von: Dr. G. Cajöri, M. Lindner, Prof. Dr. M. Christ

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 3/2019

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Zusammenfassung

Sepsis ist eine lebensbedrohende (Multi‑)Organdysfunktion, die durch eine fehlgesteuerte Immunreaktion des Wirts auf eine Infektion ausgelöst wird. Die Inzidenz der Sepsis nimmt zu und ist mit hoher Morbidität und Mortalität assoziiert. Im Gegensatz zu anderen Schwergewichten der Präklinik wie plötzlicher Herztod, Polytrauma, Myokardinfarkt oder Schlaganfall ist Sepsis schwierig zu erkennen. Außerdem fehlen vielerorts genaue Abklärungsalgorithmen für Patienten mit Sepsis. Deswegen treten Verzögerungen bei Diagnosefindung und zielgerichteter Behandlung auf. Seit der Überarbeitung der Sepsis-Definition (Sepsis-3-Kriterien) wird empfohlen, den qSOFA (Quick Sepsis Related Organ Failure Assessment) als diagnostischen Screening-Test einzusetzen. Dieser beinhaltet die Überprüfung von Vigilanz, Atemfrequenz und systolischem Blutdruck. Sepsis-Bundles, also Untersuchungen und Therapiemaßnahmen, die innerhalb definierter zeitlicher Vorgaben abgearbeitet werden müssen, könnten auch für die präklinischen Professionals implementiert werden, bedingen aber Anpassungen der geltenden Algorithmen und des mitgeführten Materials. Ergänzende diagnostische Tests wie eine Bedside-Laktatmessung oder eine etCO2-Messung könnten in Zukunft die Qualität der präklinischen Sepsis-Diagnostik möglicherweise weiter verbessern.
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Metadaten
Titel
Früherkennung von Sepsis − die Perspektive Rettungsdienst
Herausforderungen in Diagnostik und Therapie
verfasst von
Dr. G. Cajöri
M. Lindner
Prof. Dr. M. Christ
Publikationsdatum
11.06.2018
Verlag
Springer Medizin
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 3/2019
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-018-0468-x

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