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Einsätze des innerklinischen Notfallteams eines überregionalen Maximalversorgers

Datenanalyse für den Zeitraum 2013–2016 im nordrhein-westfälischen Raum

Deployment of the in-hospital emergency team in a tertiary care university hospital

Data analysis for the time period 2013–2016 in North-Rhine/Westphalia

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Zusammenfassung

Hintergrund

Bei etwa 10 % aller hospitalisierten Patienten kommt es zu unerwarteten Zwischenfällen, die mit einer erhöhten Letalität einhergehen. Die Etablierung von innerklinischen Notfallteams nimmt deshalb immer höheren Stellenwert in der interdisziplinären Notfallversorgung einer Klinik ein. Dabei variiert die Versorgung der Patienten ja nach Krankenhäusern und Regionen.

Ziel der Arbeit

Die Versorgung innerklinischer Notfallpatienten des Universitätsklinikums Köln im Vierjahreszeitraum von 2013 bis 2016 soll analysiert und deskriptiv dargestellt werden.

Material und Methode

Grundlage der vorliegenden Datenanalyse waren innerklinische Notfalleinsätze des Universitätsklinikums Köln („5555-Team“ der Klinik für Anästhesiologie und Operative Intensivmedizin). Im Untersuchungszeitraum vom 01.01.2013 bis zum 31.12.2016 wurde jeder telefonische Alarm bezüglich des Einsatzstichworts, des Einsatzorts sowie der Einsatzzeiten in einem standardisierten Protokoll dokumentiert. Die Datenanalyse erfolgte retrospektiv und deskriptiv. Ein Ethikvotum war nicht erforderlich. Die Registrierungsnummer auf ClinicalTrials.gov lautet NCT03786445.

Ergebnisse

Insgesamt wurden 1664 Notfallanrufe im Analysezeitraum ausgewertet. Im Studienverlauf von 2013 bis 2016 stiegen die Anzahl der Einsätze insgesamt um 11,4 %, die gesamte Einsatzzeit um 29,5 % und die durchschnittliche Einsatzzeit um 14,3 % an. Das führende Einsatzstichwort war „Kollaps/Synkope“ und machte 29 % des Ausrückegrunds aus. Bei steigenden Pflegetagen innerhalb des Versorgungsgeländes waren 6,5 % der Einsätze Reanimationsbehandlungen. Das Einsatzaufkommen sank zum Wochenende um 50 % im Vergleich zum Einsatzaufkommen an Wochentagen.

Schlussfolgerung

Über die letzten 4 Jahre zeigte sich eine deutliche Steigerung der Einsatzzahlen, der gesamten Einsatzzeit und der durchschnittlichen Einsatzdauer. Der führende Alarmierungsgrund war in den Jahren 2013–2016 das Stichwort „Kollaps/Synkope“. Jeder 17. Einsatz war eine Reanimation. Die Inzidenz von Herz-Kreislauf-Stillständen sank im Verlauf des Analysezeitraums.

Abstract

Background

Recent studies demonstrated that in-hospital emergencies are linked to a higher patient mortality. In approximately 10% of patients an unexpected incident occurs during the hospital stay. Therefore, the establishment of in-hospital medical emergency teams (MET) is becoming more important in the interdisciplinary emergency treatment. The aim of this study was an analysis of medical documentation, operational tactics and procedures taken by MET of the University Hospital of Cologne in a 4-year period ranging from 2013 to 2016.

Material and methods

A retrospective analysis of 1664 emergency forms from MET activities at the University Hospital of Cologne from 1 January 2013 to 31 December 2016 was carried out. Every MET activation call via the emergency telephone number (5555) and subsequent emergency treatment was recorded using a standardized documentation form. The registry number on ClinicalTrials.gov is NCT03786445.

Results

There were 1664 emergency team calls in the whole study period. Between 2013 (404 calls) and 2016 (461 calls) the number of calls increased by 11.4%. The total mission time of the MET increased in the study period from 8342 min (2013) to 10,800 min (2016, +29.5%) and the average mission time increased from 2013 (35 min) to 2016 (40 min) by 14.3%. The primary reason for activation was collapse or syncope and was the underlying cause for 29% of calls. The number of deployments for emergencies at weekends was 50% of those during weekdays and 6.5% of the calls were for cardiopulmonary resuscitation (CPR).

Conclusion

Analysis of data revealed that the number of MET calls, total operating time and average deployment time increased from 2013 to 2016. The primary reason for MET activations was collapse or syncope and every 17th deployment was for cardiopulmonary resuscitation. The incidence of in-hospital cardiac arrests decreased during the study period.

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Authors and Affiliations

  1. Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland

    J. Schmitz, S. Kerkhoff, D. Sander, G. Schulz & J. Hinkelbein

  2. Klinik für Anästhesiologie, Intensiv- und Notfallmedizin, Evangelisches Klinikum Niederrhein, Duisburg, Deutschland

    T. Warnecke

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  1. J. Schmitz
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  2. S. Kerkhoff
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  4. G. Schulz
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Correspondence to J. Schmitz.

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Interessenkonflikt

J. Schmitz, S. Kerkhoff, D. Sander, G. Schulz, T. Warnecke und J. Hinkelbein geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Schmitz, J., Kerkhoff, S., Sander, D. et al. Einsätze des innerklinischen Notfallteams eines überregionalen Maximalversorgers. Anaesthesist 68, 361–367 (2019). https://doi.org/10.1007/s00101-019-0586-y

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  • DOI: https://doi.org/10.1007/s00101-019-0586-y

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