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Erstsichtung in der Notaufnahme – Status quo und Zukunftsperspektiven

Triage in emergency departments—status quo and future perspectives

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Zusammenfassung

Nach dem jüngsten Beschluss des Bundesministeriums der Justiz und für Verbraucherschutz (18.05.2018) wird eine strukturierte Triage in Notaufnahmen bundesweit verpflichtend sein. Folglich müssen Notaufnahmen, die bislang noch kein Erstsichtungskonzept in ihre Arbeitsabläufe aufgenommen haben, dies bald nachholen. Nach Ländern wie Großbritannien, Kanada oder Australien, wo die Triage schon seit Langem in die Notfallabläufe integriert ist, müssen nun auch die Notaufnahmen in Deutschland eine Erstsichtung implementieren. Von den vier international etablierten Systemen – Emergency Severity Index (ESI), Manchester Triage Scale (MTS), Canadian Triage and Acuity Scale (CTAS) und Australasian Triage Scale (ATS) – werden in Deutschland gegenwärtig überwiegend der ESI und die MTS angewendet. Der Grund ist, dass für beide Systeme eine validierte deutsche Übersetzung vorliegt. Da eine zunehmende Verbreitung der Erstsicherung zu erwarten ist, gewinnen verständlicherweise auch geeignete Schulungs- und Implementierungspläne an Bedeutung. Darüber hinaus erfordert die immer engere Verzahnung von ambulanter und stationärer Notfallversorgung Konzepte, die eine sichere Zuweisung der Patienten zum richtigen Versorgungssektor ermöglichen. Im vorliegenden Beitrag wird ein gangbarer Lösungsansatz vorgestellt.

Abstract

According to the latest resolution of the German Federal Ministry of Justice and Consumer Protection (Bundesministerium der Justiz und für Verbraucherschutz, 18.05.2018), structured triage will be mandatory in emergency departments nationwide. This means that emergency departments that have not yet integrated a triage concept into their process will have to do so in the near future. Following countries such as the United Kingdom, Canada or Australia, where triage has already been integrated into the emergency process for a long time, emergency departments in Germany are now bound to implement triage as well. Of the four internationally established systems Emergency Severity Index (ESI), Manchester Triage Scale (MTS), Canadian Triage and Acuity Scale (CTAS) and Australasian Triage Scale (ATS), ESI and MTS are currently predominantly used in Germany, which is due to the fact that there is a validated translation in German for both systems. The presumed increased use of triage naturally also means an increase in the importance of appropriate training and implementation concepts. In addition, the increasing integration of outpatient and inpatient emergency care will require concepts that allow patients to be safely allocated to the appropriate care sector. A possible approach is presented in this article.

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Authors and Affiliations

  1. Zentrale Notaufnahme, Klinikum Fürth, Jakob Henle Str. 1, 90766, Fürth, Deutschland

    U. Klinger &  H. Dormann

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  1. U. Klinger
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Correspondence to U. Klinger.

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U. Klinger und H. Dormann sind Instruktoren des ESI Train©‑Konzeptes des Klinikums Fürth und erhalten eine Vergütung für die Durchführung von ESI Train©‑Seminaren.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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C. Dodt, München

H. Dormann, Fürth

A. Lechleuthner, Köln

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Klinger, U., Dormann, H. Erstsichtung in der Notaufnahme – Status quo und Zukunftsperspektiven. Notfall Rettungsmed 22, 589–597 (2019). https://doi.org/10.1007/s10049-019-0572-6

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