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Das ABC des lebensbedrohlichen Kindernotfalls

The ABC of life-threatening pediatric emergencies

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Zusammenfassung

Reanimationen sind seltene Ereignisse im Kindesalter. Häufiger ist der Kinderarzt mit einem unter Umständen lebensbedrohlich erkrankten Kind mit zunächst noch unklarer Diagnose konfrontiert. Das Erkennen des kritisch kranken Patienten und die rasche Therapie von respiratorischer und kardiozirkulatorischer Dekompensation bestimmen wesentlich die Prognose. Durch rechtzeitige Intervention kann eine Reanimationssituation ggf. verhindert werden. Sollte eine kardiopulmonale Wiederbelebung notwendig werden, haben die Basismaßnahmen höchste Priorität. Notfallsituationen in der Kinderheilkunde sind durch eine hohe kognitive Belastung gekennzeichnet. Standardisierte Algorithmen erleichtern deshalb ein strukturiertes Vorgehen. Durch ein wiederkehrendes, praxisorientiertes Training sowohl der fachlich-medizinischen Fertigkeiten als auch der „nicht-technischen“ Fähigkeiten wie Kommunikation, Teamarbeit und Ressourcenausnutzung ließe sich die Versorgungsqualität kritisch kranker Kinder nachhaltig verbessern.

Abstract

Resuscitation is extremely rare in pediatric practice. It is far more likely that a pediatrician will be confronted with an infant or child with a life-threatening illness of unclear etiology. Both the recognition of critical illness and implementation of rapid, effective intervention to reverse hypoxia and hemodynamic instability can prevent further deterioration and markedly improve the prognosis. Prompt intervention can possibly help avoid a situation in which resuscitation is necessary. When faced with a child in cardiopulmonary arrest, meticulous attention to basic life support has highest priority. Acute life-threatening emergencies in children involve a high cognitive load for providers and standardised algorithms promote a systematic approach. Periodic training in both medical management and non-technical skills such as communication, teamwork and use of resources plays a key role in effectively improving the quality of care in critically ill children.

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Danksagung

Der Dank der Autoren gilt Dr. Bertram Schädle für die Fotoarbeiten sowie Dr. Axel Bosk und Dr. Christoph Eich für die Bereitstellung von Abbildungen.

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Dr. O. Heinzel hat Vortragshonorare von der Fa. Laerdal Medical GmbH, Deutschland erhalten. Alle drei Autoren sind Mitglieder der Arbeitsgruppe „PAEDSIM – Teamtraining für pädiatrische Notfälle und bieten Simulationstraining an.

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Authors and Affiliations

  1. Klinik für Kinder- und Jugendmedizin, Abt. II, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland

    O. Heinzel

  2. Tübinger Patienten-Sicherheits- und Simulationszentrum TüPASS, Klinik für Anaesthesiologie und Intensivmedizin, Universitätsklinikum Tübingen, Tübingen, Deutschland

    O. Heinzel & W.J. Eppich

  3. Abt. für Allgemeine Pädiatrie und Neonatologie, Univ. Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Wien, Österreich

    J.Chr. Schwindt

  4. Children’s Memorial Hospital, Division of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago/IL, USA

    W.J. Eppich

Authors
  1. O. Heinzel
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  2. J.Chr. Schwindt
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  3. W.J. Eppich
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Correspondence to O. Heinzel.

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Heinzel, O., Schwindt, J. & Eppich, W. Das ABC des lebensbedrohlichen Kindernotfalls. Monatsschr Kinderheilkd 157, 801–816 (2009). https://doi.org/10.1007/s00112-009-2053-3

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  • DOI: https://doi.org/10.1007/s00112-009-2053-3

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