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Deutsches Reanimationsregister der DGAI

The German Resuscitation Registry of the DGAI

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Zusammenfassung

Hintergrund

Der „plötzliche Herztod“ ist mit einer Inzidenz von mehr als 100 pro 100.000 Einwohner und Jahr eine sehr häufige Todesursache in Deutschland. Das Überleben nach „plötzlichem Herztod“ und Reanimation – auch nach anderen Ursachen – ist nicht ausschließlich als schicksalhaft zu begreifen, denn Notarzt- und Rettungsdienste in Deutschland und Europa unterscheiden sich hinsichtlich ihrer Versorgungsqualität eklatant.

Methoden

Analyse und Auswertung des Deutschen Reanimationsregisters der Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) sowie klinischer Studien.

Ergebnisse

Beste Ergebnisse lassen sich nur erzielen, wenn die gesamte Rettungskette optimiert wurde. Dies beginnt mit Laien- und Telefon-CPR (kardiopulmonale Reanimation), erfordert die Einhaltung einer medizinisch definierten Hilfsfrist, die optimierte Durchführung der Basismaßnahmen sowie die optimale notärztliche Betreuung noch vor Erreichen des Krankenhauses. Lässt sich der Patient präklinisch stabilisieren, ist er in ein „Cardiac-Arrest-Zentrum“ einzuliefern, sodass sowohl die therapeutische Hypothermie als auch eine perkutane koronare Intervention zeitnah durchgeführt werden können. Das Deutsche Reanimationsregister konnte von der DGAI zu einem wichtigen Werkzeug des Qualitätsmanagements für die Behandlungskette nach „plötzlichem Herztod“ und Reanimation – auch nach anderen Ursachen – entwickelt werden. Es richtet sich an die verantwortlichen Ärztlichen Leiter der Notarzt- und Rettungsdienste. Die Analyse der Reanimationsbehandlungen erlaubt Rückschlüsse auf die Struktur-, Prozess und Ergebnisqualität des Teilnehmers im Vergleich zu Vorhersageparametern und den Resultaten anderer Teilnehmer.

Schlussfolgerungen

Somit lassen sich eine Stärken- und Schwächenanalyse für den Notarzt- und Rettungsdienst erstellen und gezielt Maßnahmen einleiten, die zum Wohle der Patienten die Versorgungsqualität steigern.

Abstract

Background

Sudden cardiac arrest is a leading cause of death in Germany with an incidence of more than 100 deaths per year and 100,000 of population. The survival after out-of-hospital cardiac arrest (OHCA) and resuscitation is not always inevitable, because emergency medical services (EMS) systems in Germany and Europe differ strikingly in terms of their quality of care.

Methods

Analysis of the German Resuscitation Registry of the DGAI and of clinical trials.

Results

The best results can be achieved only if the entire chain of survival has been optimized. This begins with layperson- and telephone-CPR, adherence to a medically defined response time, the optimized implementation of basic life support measures and optimal emergency medical care by physicians before reaching the hospital. If it is possible to stabilize the patient prior to reaching the hospital, he or she should be transported to a “Cardiac Arrest Centre”, so that both the therapeutic hypothermia and percutaneous coronary intervention can be carried out promptly. The German Resuscitation Registry (GRR) of the DGAI (German Association for Anesthesiology and Intensive Care Medicine) was developed as an important tool for total quality management in the treatment of OHCA. It is addressed to the responsible medical director of the EMS systems. Analysis of the GRR allows conclusions to be made concerning the structure, process and outcome of the participating EMS system compared to forecast parameters and the results of other participants.

Conclusions

This enables a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis for the EMS system to be performed and should result in the initiation of targeted measures that both increase survival rates after OHCA and the quality of care.

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Compliance with Ethics Guidelines

 

Conflict of interest

M. Fischer declares that he has no conflict of interest.

 

This article does not contain any studies with human or animal subjects.

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Authors and Affiliations

  1. Klinik für Anästhesiologie, Operative Intensivmedizin, Schmerztherapie und Notfallmedizin, ALB FILS KLINIKEN GmbH, Klinik am Eichert, 73006, Göppingen, Deutschland

    M. Fischer & M. Messelken

  2. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

    J. Wnent

  3. Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

    S. Seewald

  4. Amt 37 – Berufsfeuerwehr, Rettungsdienst, Münster, Deutschland

    A. Bohn

  5. Intensivverlegungsdienst Mecklenburg-Vorpommern gGmbH, Parchim, Deutschland

    T. Jantzen

  6. Notfallmedizin am Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

    J.-T. Gräsner

Authors
  1. M. Fischer
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  2. M. Messelken
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  3. J. Wnent
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  4. S. Seewald
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  5. A. Bohn
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  6. T. Jantzen
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  7. J.-T. Gräsner
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Corresponding author

Correspondence to M. Fischer.

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Fischer, M., Messelken, M., Wnent, J. et al. Deutsches Reanimationsregister der DGAI. Notfall Rettungsmed 16, 251–259 (2013). https://doi.org/10.1007/s10049-013-1694-x

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