Die interdisziplinäre Notaufnahme im Zusammenspiel mit Chest Pain Units, Brustschmerzambulanzen und Cardiac Arrest Centern

Zusammenfassung

Die notfall- bzw. akutmedizinische Versorgung der Bevölkerung von Patienten gewinnt mehr und mehr an Bedeutung. In Deutschland stellen sich zum Beispiel pro Jahr hunderttausende Patienten mit Brustschmerzen in Notaufnahmen vor, wobei sich bei ca. 5 – 20% ein akutes Koronarsyndrom nachweisen lässt. Zudem werden pro Jahr 75 000 prähospitale Reanimationen durchgeführt, von denen mehr als 60% kardial bedingt sind. Die primäre Anlaufstelle dieser kardialen Patienten ist in der Regel eine Notaufnahme, die, wenn möglich, Strukturen vorhalten soll, um diese Patienten rasch und effizient zu diagnostizieren und zeitnah lebensrettende Maßnahmen einzuleiten. Gefordert werden heutzutage, dass der interdisziplinären Notaufnahme Chest Pain Units (CPU), Stroke Units, Brustschmerzambulanzen (BSA) und, falls möglich, Cardiac-Arrest-Zentren (CAC) angegliedert sind, die es wiederum ermöglichen, durch eine optimale interdisziplinäre Betreuung durch Internisten, Neurologen und Anästhesisten die Prognose der Patienten durch Diagnostik und Therapie zu optimieren. In unserem Übersichtsartikel wollen wir uns auf die Interaktionen der interdisziplinären Notaufnahme mit den CPU, BSA und CAC fokussieren.

Abstract

The emergency or acute medical care of the population is gaining more and more importance. In Germany, hundreds of thousands patients present every year with chest pain in emergency departments. Of these about 10 – 20% show an acute coronary syndrome. In addition, 75 000 pre-hospital resuscitations are performed each year, of which more than 60% are cardiac-related. These patients are primarily delivered to an emergency department, which should provide structures to quickly and efficiently diagnose and initiate life-saving interventions. Nowadays, the emergency room should be affiliated with chest pain units, stroke units, chest pain relief centers and, if possible, cardiac arrest centers (CAC), which enable interdisciplinary care by internists, neurologists and anesthesiologists to substantially improve patients prognosis via a rapid diagnostic process and initiation of optimal therapy. In our review, we will focus on the interactions of the emergency department with the CPU, BSA and CAC.

Graphical Abstract. Bildliche Darstellung der möglichen Interaktionen/Schnittstellen zwischen der interdisziplinären Notaufnahme (NA), der Chest Pain Unit (CPU), der Brustschmerzambulanz (BSA) und dem interdisziplinären Schockraum als einem möglichen Teil eines Cardiac Arrest Centers am Beispiel von Mainz. Die Universitätsmedizin Mainz hat aktuell noch kein Cardiac Arrest Center implementiert.

Schlüsselwörter

interdisziplinäre Notaufnahme - Brustschmerz - Chest Pain Unit - Brustschmerzambulanz - kardiogener Schock - Cardiac Arrest Center

Key words

interdisciplinary emergency room - chest pain unit - triage - cardiac arrest center - cardiogenic shock

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