Regional care concept 'acute coronary syndrom' in the Heidelberg emergency service region - Two case reports [Versorgungskonzept 'akutes koronarsyndrom' des rettungsdienstbereichs Heidelberg - Zwei fallberichte]

摘要

In these two case reports, we describe the implementation of a regional care concept in the Heidelberg emergency service region for the prehospital management of acute coronary syndrome. In the first case report, a 65 years old man suffered from an extensive anterior myocardial infarction. The early doctor-doctor-telephone call with the cardiologist on duty of the Department of Cardiology lead to the decision not to use a prehospital thrombolysis in favor of a catheter intervention. In the second case report, also in the case of an extensive anterior myocardial infarction, a prehospital thrombolysis was per formed immediately after the doctor-doctor-telephone call. An important reason for this decision was the expected loss of time for this patient, treated prehospital in a remote location on scene. Both case reports depict that the recently implemented regional care concept leads to a tooth system, both in different specialities and between prehospital emergency services and the hospital. Problems at the interface between the prehospital emergency services and the hospital can be reduced through the implementation of such regional care concepts. Through process triggered algorithms it is possible to reach individual and optimal results for the patient.