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Prospektive Analyse der Indikation von Notarzteinsaetzen

dc.contributor.advisorHeise, Daniel PD Dr.
dc.contributor.authorArnoldt, Mauricio Sebastian
dc.titleProspektive Analyse der Indikation von Notarzteinsaetzende
dc.title.translatedProspective analysis of the indication for the deployment of an emergency physiciande
dc.contributor.refereeHeise, Daniel PD Dr.
dc.description.abstractengThe frequency of emergency calls for the emergency physician has increased considerably over the past few decades. The decision to deploy an emergency doctor is made by the rescue coordination centre with help of the use of an indication catalogue with operational keywords. Despite indications of potential disadvantages, this strategy has so far hardly been seriously questioned. A prospective analysis was therefore carried out in which the involvement of an emergency physician was divided into medically indicated and non-medically indicated. The classification criterion was the implementation of original medical actions, either the transportation of a patient by a physician for medical reasons or the administration of medication. In this work, it was proven that in almost a third of the missions of the emergency physician neither of the mentioned actions was carried out. The previous assessment of the indication for the involvement of an emergency physician using the NACA-score is indeed indicative, but the most common NACA-score III is not suitable for this purpose. Further consideration of the results of this investigation illustrates the need to revise the alerting strategy for physicians by the rescue coordination centre to achieve a more selective deployment of the emergency doctors. One possible approach would be to revise the indication catalogue, which would be possible due to new developments in emergency medicine, such as telemedicine and the enhancement of the regular competencies of the paramedics (Notfallsanitätern). The care of complex traumatized patients and pediatric emergencies should remain mandatory indications for the emergency doctor. For the majority of non-traumatological situations, however, the deployment criteria should be reconsidered. Psychiatric urgencies are a particular example of this. Although strategic deployment reasons play the main role in the selection of a rescue vehicle occupied by doctors (NEF or RTH), our results show that the rescue helicopter is used more selectively regarding the medical indication. As our data shows, thanks to the enhancement of their regular competencies, paramedics could act independently in many acute situations even without an emergency doctor aside and thus assume a filter function for a more targeted deployment of the emergency physician. For complex emergencies, it has been proven that the involvement of a physician leads to better survival rates and less pronounced sequelae after an event. In the preclinical care of emergency patients, the emergency doctor will remain indispensable as the most highly qualified instance, but this role will change in the future given the developments in emergency
dc.contributor.coRefereeBlaschke, Sabine Prof. Dr.
dc.subject.gerNotarzt, Rettungsdienst, Alarmierungsstrategie, NACA-Scorede
dc.subject.engemergency physician, emergency medical service, NACA-scorede
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullAnästhesiologie / Intensivmedizin / Notfallmedizin / Analgesie - Allgemein- und Gesamtdarstellungen (PPN619875917)de

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