Performance of the Emergency Service Results of a Nationwide Analysis of the German Red Cross in 2014

摘要

Emergency rescue is an obligatory part of the emergency service. Against the background of continuous annual increases and demographic trends with altered mobility and multimorbidity, the medical services were scrutinized as part of a nationwide analysis. To date, 3,127 deployments were evaluated by means of an online survey tool, of which 2,540 were primarily missions carried out according to the assessment of the control center. In 587 deployments, first the family doctor or the medical emergency service was called, and in 88.9% of these cases, an emergency life-saving equipment was used. In the definitional sense of emergency patients, only 22.2% (NACA IV-VII) represented primary emergency cases, and 34.4% could not be classified as emergencies (NACA I-II) after the event. In the future, an increase in the geriatric patient collective must be reckoned with. With increasing age (over 70 years), there was an increase in the proportion of life-threatening damage (51.2%). In 54.7% of emergencies, no emergency physician was called as the rescue personnel saw no indication for it. In 8.8% of emergency cases, the emergency physician was called later. Out of a total of 85.6% of deployments, the proportion of acute illness in the area of cardiovascular system was 25.8%, followed by neurological diseases (14.2%) and respiratory disorders (8.2%). The proportion of polytrauma on the cut-off date was 0.9%. Establishment of a peripheral venous access was the most frequently carried out emergency care measure (42.3%), but this was done only in 78.6% of severe cases. Invasive measures were carried out in 1.4%. In 5.7% of these cases, this was done by emergency medical services personnel with competence in emergency medicine. When rescue operation was ordered by a physician, in 8.4% superior life-saving equipment was necessary instead of the prescribed ambulance, and out of these, 54.5% of cases represented category NACA III medical disorder. The targeted use of emergency rescue can be achieved by better information provided by the call operator and the doctors and through targeted processing in the control center. Since hospital admission was not necessary in all emergency situations, it would be economical to create continuously accessible ambulatory care facilities in addition to primary care by GPs. In the present analysis, we have identified shortcomings in the performance of emergency rescue operations and reveal the possibilities of optimization.