Gries A, Helm M, Martin E
Klinik für Anaesthesiologie-Bereich Notfallmedizin, Ruprecht-Karls-Universität Heidelberg.
Anaesthesist. 2003 Aug;52(8):718-24. doi: 10.1007/s00101-003-0548-1. Epub 2003 Jun 28.
Against the background of an ever-increasing shortage of financial support, closure of smaller hospitals and shortage of personnel in the medical branch, the necessity of the Federal emergency system is being increasingly called into question. In reality the number of missions which are relatively indicated are clearly increasing nationwide: an emergency doctor is not absolutely necessary in many situations. However, for complex emergency situations in Germany, an emergency medical system must remain an integral component of the preclinical care system in addition to the well-trained rescue service personnel. Hereby it is less important to have more emergency medical doctors, but more important to have a higher emergency medical qualification, possibly by a reduction in the density of emergency service stations. By the introduction of a ranked assistance system and the inclusion of "first responders", the time period before the arrival of the highly qualified emergency medical doctor can be bridged by qualified paramedics and general practitioners. The impulse of the legislators, assimilation of the rescue service acts, restructuring of rescue service catchment areas and the introduction of integrated demand-oriented control stations with a consequent quality management system as well as the implementation of a medical leader rescue system can reduce costs and further improve the quality of the emergency medical rescue system.
在财政支持日益短缺、小型医院关闭以及医疗部门人员短缺的背景下，联邦应急系统的必要性正日益受到质疑。实际上，全国范围内相对需要应急服务的任务数量明显在增加：在许多情况下，急诊医生并非绝对必要。然而，对于德国的复杂紧急情况，除了训练有素的救援服务人员外，紧急医疗系统必须仍然是临床前护理系统的一个组成部分。因此，拥有更多的急诊医生并非那么重要，更重要的是提高紧急医疗资质，可能通过减少急救服务站的密度来实现。通过引入分级援助系统并纳入“第一响应者”，合格的护理人员和全科医生可以在高素质急诊医生到达之前的时间段内提供过渡性帮助。立法者的推动、救援服务法案的同化、救援服务覆盖区域的重组、引入具有相应质量管理系统的综合需求导向控制站以及实施医疗领导救援系统，可以降低成本并进一步提高紧急医疗救援系统的质量。
