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Echtzeit-Feedback-Systeme zur Verbesserung der Reanimationsqualität

Real-time feedback systems for improvement of resuscitation quality

  • Notfallmedizin
  • Published:
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Zusammenfassung

Die Qualität der Basismaßnahmen hat einen direkten Einfluss auf das Überleben von Reanimationspatienten. Beobachtungsstudien mit professionellem Rettungsfachpersonal ergaben, dass die empfohlenen Qualitätsparameter der Reanimationsleitlinien nicht erreicht werden. Echtzeit-Feedback-Systeme zur Reanimation können einen Beitrag zur Qualitätsverbesserung leisten. Diese Systeme messen über einen sternalen Sensor mit Beschleunigungs- und Druckmessern die durchgeführten Thoraxkompressionen und über die thorakale Impedanz des EKG die Beatmungen in Echtzeit während einer laufender Reanimation. Bei Abweichung vom geforderten Ideal (z. B. Eindrücktiefe zu flach oder Hyperventilation) geben diese Systeme Korrekturen über visuelle oder akustische Rückmeldungen. Feedback-Systeme bieten verschiedene Nutzungsmöglichkeiten: Im Trainings- und Ausbildungssektor kann durch Feedback-Technologie die Qualität der Reanimation nachhaltig verbessert werden. Aktuelle Literatur weist darauf hin, dass auch im klinischen Gebrauch Echtzeit-Feedback-Systeme in Kombination mit intensiver Schulung und Nachbesprechung die Qualität und den Erfolg von Reanimationen verbessern können. Durch die Speicherung der Reanimationsdaten bieten diese Systeme auch die Möglichkeit, die Qualität von Reanimationsversuchen retrospektiv auszuwerten.

Abstract

The quality of chest compression is a determinant of survival after cardiac arrest. Therefore, the European Resuscitation Council (ERC) 2010 guidelines on resuscitation strongly focus on compression quality. Despite its impact on survival, observational studies have shown that chest compression quality is not reached by professional rescue teams. Real-time feedback devices for resuscitation are able to measure chest compression during an ongoing resuscitation attempt through a sternal sensor equipped with a motion and pressure detection system. In addition to the electrocardiograph (ECG) ventilation can be detected by transthoracic impedance monitoring. In cases of quality deviation, such as shallow chest compression depth or hyperventilation, feedback systems produce visual or acoustic alarms. Rescuers can thereby be supported and guided to the requested quality in chest compression and ventilation. Feedback technology is currently available both as a so-called stand-alone device and as an integrated feature in a monitor/defibrillator unit. Multiple studies have demonstrated sustainable enhancement in the education of resuscitation due to the use of real-time feedback technology. There is evidence that real-time feedback for resuscitation combined with training and debriefing strategies can improve both resuscitation quality and patient survival. Chest compression quality is an independent predictor for survival in resuscitation and should therefore be measured and documented in further clinical multicenter trials.

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Notes

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Authors and Affiliations

  1. Arbeitsgruppe Forschung in der Notfallmedizin (AGFiN), Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude: A1, 48149, Münster, Deutschland

    R.P. Lukas, H. Van Aken, P. Engel & A. Bohn

  2. Ärztliche Leitung Rettungsdienst, Berufsfeuerwehr der Stadt Münster, Münster, Deutschland

    A. Bohn

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  1. R.P. Lukas
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  2. H. Van Aken
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  3. P. Engel
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  4. A. Bohn
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Correspondence to R.P. Lukas.

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Lukas, R., Van Aken, H., Engel, P. et al. Echtzeit-Feedback-Systeme zur Verbesserung der Reanimationsqualität. Anaesthesist 60, 653–660 (2011). https://doi.org/10.1007/s00101-011-1909-9

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  • DOI: https://doi.org/10.1007/s00101-011-1909-9

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