Zusammenfassung
Hintergrund
Innerklinische Notfälle und Reanimationen werden durch Notfallteams bearbeitet. Ziel der vorliegenden Untersuchung war es, die Voraussetzungen, Zahl, Art und Weiterbehandlung von innerklinischen Notfällen zu analysieren.
Material und Methode
In einer retrospektiven Untersuchung wurden die innerklinischen Notfälle in den nichtintensivmedizinischen Bereichen der chirurgischen Klinik eines Universitätsklinikums vom 01.01.2007 bis zum 30.06.2010 ausgewertet. Mit einem eigenständig entwickelten und 2006 eingeführten Notfallprotokoll wurden die allgemeinen patienten- und notfalleinsatzbezogenen Daten, der Einsatzort, die Zuordnung des Patienten zur operativen Fachabteilung, die Art des Notfalls und die Beschreibung der Notfallsituation sowie der Verlegungsort des Patienten durch das hausinterne Notfallteam erhoben.
Ergebnisse
In dem 3,5-jährigen Untersuchungszeitraum wurden 235 Notfalleinsätze dokumentiert. Innerklinische Notfälle traten mit einer Häufigkeit von 4/1000 Patientenaufnahmen/Jahr auf. Bei 31,5% aller Notfalleinsätze lag ein Herz-Kreislauf-Stillstand vor. Es wurden 54,5% der behandelten Patienten einem intensivmedizinischen Versorgungsbereich zugeführt.
Schlussfolgerung
Die Aufgaben des Notfallteams einer chirurgischen Universitätsklinik gehen vor dem Hintergrund des operativen Versorgungsauftrags weit über die Anforderungen eines reinen Reanimationsteams hinaus. Das Einsatzspektrum umfasst Notfälle aus dem kompletten Spektrum der perioperativen Medizin. Es bedarf weiterer größerer Studien mit standardisierten multizentrischen Erhebungen, um die Notfallversorgung in deutschen Kliniken zu analysieren.
Abstract
Background
Emergency treatment and resuscitation within hospitals are managed by so-called medical emergency teams (MET). The present study examined the circumstances, number, initial treatment and further hospital course of in-hospital emergency cases at a level 1 university hospital.
Methods
A retrospective study of in-hospital emergencies on the surgical wards of a university hospital including all non-intensive care areas from January 2007 to June 2010 was carried out. A self-developed documentation protocol which was introduced in 2006 was used by the MET to document general patient characteristics and details of the emergency treatment. These data included the place where the emergency situation arose, the patient’s assignment to a surgical discipline, a detailed description of the emergency situation, the effectiveness of basic life support measures as well as the further hospital course of the patient.
Results
A total of 235 emergency cases were documented within the study period of 3.5 years. The frequency of in-hospital emergencies was 4/1,000 admitted patients per year. Cardiac arrest was encountered in 31,5%. Out of all patients 54,5% were admitted to an intensive care unit.
Conclusion
The tasks of a MET at a surgical university hospital go beyond mere cardiopulmonary resuscitation. Emergency cases within the full spectrum of perioperative complications are encountered. Further multicenter studies with standardized protocols are required to analyze the management of German in-hospital emergencies.
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L. Reinhardt und M. Bernhard haben zu gleichen Teilen zu der Arbeit beigetragen.
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Reinhardt, L., Bernhard, M., Hainer, C. et al. Innerklinische Notfälle in einer chirurgischen Universitätsklinik. Chirurg 83, 153–162 (2012). https://doi.org/10.1007/s00104-011-2125-5
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DOI: https://doi.org/10.1007/s00104-011-2125-5