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Medizinische Notfallteams im Krankenhaus

Medical emergency teams in hospitals

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Medizinische Klinik - Intensivmedizin und Notfallmedizin Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Der innerklinische Notfall stellt eine zunehmende Herausforderung für das Risikomanagement eines Krankenhauses dar und bislang gibt es in Deutschland keine allgemein verbindlichen Empfehlungen für ein innerklinisches Notfallmanagement. Die Zeitverzögerung bei der Erkennung und Behandlung des kritisch Kranken auf den Bettenstationen führt häufig zu schwerwiegenden Zwischenfällen. Das Konzept der traditionellen Reanimationsteams greift regelhaft zu kurz, da sie erst nach Eintritt einer akuten Verschlechterung bzw. des Herz-Kreislauf-Stillstands aktiviert werden.

Zielsetzung

Die Einführung eines Rapid-response-Systems mit präventivem Ansatz basierend auf einem medizinischen Notallteam (MET) stellt eine unverzichtbare Verbesserung des innerklinischen Notfallmanagements dar. Dafür genügt nicht allein die Umbenennung und Umstrukturierung des bisherigen Reanimationsteams zu einem MET. Vielmehr bedarf es der Einführung standardisierter präventiver Alarmierungskriterien und strukturierter Abläufe, einer Standardisierung der Ausbildung und der Notfallausrüstung in der Klinik sowie der Bereitstellung eines an die Intensivstation angebundenen MET.

Schlussfolgerung

Für ein Krankenhaus mit bisher etabliertem Reanimationsteam bedeutet dies einen grundlegenden Paradigmenwechsel mit einem nachhaltigen, interdisziplinären und institutionalisierten Prozess des Umdenkens und Reorganisierens. Ein klares Bekenntnis und andauernde gemeinsame Anstrengungen des Krankenhausträgers und aller Klinikmitarbeiter ist hierfür Voraussetzung.

Abstract

Background

In-hospital emergencies represent an increasing challenge with regard to risk management in hospitals and until now, no binding recommendations for in-hospital emergency management are available in Germany. Time delays in the detection and treatment of critically ill patients on the wards often lead to serious adverse events. The concept of traditional resuscitation teams is not adequate, because they are initiated only after acute deterioration or cardiac arrest has already occurred.

Objective

The introduction of a rapid response system with a preventive approach based on a medical emergency team (MET) represents an essential improvement in the management of in-hospital emergencies. However, it is not sufficient to simply rename and restructure the existing resuscitation team to a MET. Rather, the introduction of standardized preventive alarm criteria and structured processes, standardization of training and emergency equipment in the clinic, and the provision of a MET associated with the intensive care unit are required.

Conclusion

For a hospital with an already established resuscitation team, this represents a fundamental paradigm shift to a sustainable, interdisciplinary, and institutionalized process of rethinking and reorganizing. A clear commitment and ongoing joint efforts of the hospital management and all hospital staff are prerequisite for this.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Lenkeit, K. Ringelstein, I. Gräff und J.-C. Schewe geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland

    S. Lenkeit, K. Ringelstein, I. Gräff & J.-C. Schewe

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  1. S. Lenkeit
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  2. K. Ringelstein
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  3. I. Gräff
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  4. J.-C. Schewe
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Correspondence to S. Lenkeit.

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Lenkeit, S., Ringelstein, K., Gräff, I. et al. Medizinische Notfallteams im Krankenhaus. Med Klin Intensivmed Notfmed 109, 257–266 (2014). https://doi.org/10.1007/s00063-014-0369-9

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  • DOI: https://doi.org/10.1007/s00063-014-0369-9

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