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Organisation der innerklinischen Reanimation in peripheren Krankenhausbereichen

Organization of in-hospital resuscitation in peripheral hospital areas

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Zusammenfassung

Hintergrund

Zur Gewährleistung eines leitlinienorientierten Ablaufs von Reanimationen muss ein Krankenhausträger strukturelle Vorkehrungen treffen. Neben Intensiv- und Intermediärstationen für besonders gefährdete Patienten ist für die peripheren Krankenhausbereiche in der Regel ein Reanimationsteam eingerichtet.

Auf der anderen Seite müssen in den peripheren Krankenhausbereichen Strukturen geschaffen werden, damit die Zeit bis zum Eintreffen des Reanimationsteams kurz gehalten und mit möglichst effektiven Maßnahmen überbrückt wird.

Im vorliegenden Beitrag sollen daher die Organisationsprinzipien von Reanimationsteams ebenso wie die notwendigen Bedingungen in den peripheren Krankenhausbereichen behandelt werden.

Methoden

Vor dem Hintergrund der international zugänglichen Literatur werden Überlegungen zu technischen, logistischen und ausbildungsbezogenen Standards angestellt.

Ergebnisse

Unter evidenzbasierten Kriterien müssen Ziele eines Reanimationskonzepts für periphere Krankenhausbereiche sein: (a) die Zeit bis zum Eintreffen eines Reanimationsteams und (b) die Zeit bis zur Defibrillation zu verkürzen; dazu müssen entsprechende logistische und technische Voraussetzungen geschaffen werden. Außerdem muss (c) die Qualität der Basisreanimation, insbesondere der Thoraxkompressionen, durch das ersteintreffende Personal optimiert werden; dazu ist es erforderlich, (d) ein Trainingskonzept für periphere Krankenhausbereiche zu entwickeln und zu institutionalisieren.

Abstract

In order to guarantee resuscitation procedures according to guidelines, hospitals need to establish the necessary structural framework. In contrast to intensive care units and intermediate care units where monitoring and expertise is easily available, peripheral hospital areas are covered by cardiac arrest (CA) teams.

Therefore structures need to be established in peripheral areas which aim at bridging the time to arrival of the CA team.

This article describes the organizational principles of CA teams and of the structures necessary for initial CA management on peripheral wards.

Based on scientific evidence the following criteria are of importance: (a) minimizing the time to arrival of the CA team, (b) minimizing the time to defibrillation, (c) improving the quality of basic life support by hospital ward personnel, especially chest compressions and (d) establishing a training concept for peripheral ward personnel.

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Authors and Affiliations

  1. Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité – Universitätsmedizin Berlin; Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    J. Breckwoldt MME-D

  2. Notfallmaßnahmen am Fachhochschulcampus Wien, Studiengang Radiologietechnologie, Arbeitsgruppe für innerklinische Reanimation des ARC, Wien, Österreich

    S. Schneider-Klimanek

  3. Universitätsklinik für Anästhesie, Allgemeine Intensivmedizin und Schmerztherapie,Klinische Abteilung für Herz-Thorax-Gefäßchirurgische Anästhesie und Intensivmedizin, AKH Wien, Währingergürtel 18-20, 1090, Wien, Österreich

    H. Fischer

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  1. J. Breckwoldt MME-D
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  2. S. Schneider-Klimanek
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  3. H. Fischer
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Correspondence to J. Breckwoldt MME-D.

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Breckwoldt, J., Schneider-Klimanek, S. & Fischer, H. Organisation der innerklinischen Reanimation in peripheren Krankenhausbereichen. Notfall Rettungsmed 13, 754–761 (2010). https://doi.org/10.1007/s10049-010-1305-z

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