Zusammenfassung
Die Task Force „Chest-Pain-Unit“ (CPU) der Deutschen Gesellschaft für Kardiologie erarbeitete Richtlinien für Mindestvoraussetzungen, die erfüllt sein müssen, um als CPU zertifiziert zu werden. Wichtige Voraussetzungen sind unter anderem ein Herzkatheterlabor mit einer ständigen Verfügbarkeit (365 Tage/24 h), mindestens 4 Überwachungsplätze, eine 24-h-Anbindung an ein Notfalllabor sowie in Bezug auf die Bildgebung, die Möglichkeit zur Echokardiographie, CT und MRT (bei Verdacht auf Aortendissektion) und zur Abdomensonographie. Leitliniengerechte Behandlungspfade für den Patienten mit Brustschmerz und dem Verdacht auf ein akutes Koronarsyndrom (STEMI, NSTEMI und der instabilen AP) sollen vorliegen, um unnötige stationäre Behandlungen, aber auch den Patienten gefährdende Entlassungen zu vermeiden. Die Transferzeiten von der CPU in das Herzkatheterlabor sollen den Zeitraum von 15 min nicht überschreiten. Das betreuende Pflegepersonal und die Ärzte sollen durch ein spezielles Schulungsprogramm ausgebildet werden. Das ärztliche Personal sollte ausreichende Kenntnisse im Bereich der Echokardiographie und der internistischen Intensivmedizin besitzen. Die CPU muss von einem Kardiologen geleitet werden, und die CPU kann aus der Notfallversorgung nicht abgemeldet werden.
Abstract
The Chest Pain Unit (CPU) Task Force of the German Cardiac Society has elaborated prerequisites for a CPU certification program. To become a certified CPU, a facility must have 24-h cath lab capabilities, 24-h access to clinical chemistry, at least four intermediate care beds, and the capability for echocardiography, computed tomography (CT), magnetic resonance imaging (MRI) and abdominal ultrasound. The transfer time from the CPU to the cath lab should not exceed 15 minutes. The facility must demonstrate well-defined processes to evaluate moderate- and low-risk patients with chest pain that minimize unnecessary admissions and inappropriate discharges. This means that CPUs must have well-defined pathways when an acute coronary syndrome (ACS) patient arrives at their facility, including ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), unstable angina (UA) and low-risk patients. Nurses and doctors in the CPU should have education and training opportunities and undergo practice drills. Doctors should have a sound knowledge of echocardiography and intensive care medicine. The Chest Pain Unit must be headed by a cardiologist.
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Die Autoren F. Breuckmann und F. Post trugen gleichermaßen zu dieser Arbeit bei.
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Breuckmann, F., Post, F., Giannitsis, E. et al. Kriterien der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung für „Chest-Pain-Units“. Kardiologe 2, 389–394 (2008). https://doi.org/10.1007/s12181-008-0116-7
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DOI: https://doi.org/10.1007/s12181-008-0116-7