Kopschina C, Stangl R
Abteilung für Unfallchirurgie, Orthopädisch Unfallchirurgische Klinik Wichernhaus, Krankenhaus Rummelsberg, Schwarzenbruck.
Unfallchirurg. 2008 Aug;111(8):641-4. doi: 10.1007/s00113-008-1481-1.
With the emergence of a trauma network in the metropolitan area of Nuremberg, Germany, the question arose whether prehospital trauma management and emergency department management could be better integrated. A training scheme was designed for prehospital trauma care by the rescue services of the Workers' Samaritan Federation Germany (ASB), the Bavarian Red Cross, Maltese Ambulance, St. Johns Ambulance, representatives of the emergency physicians, and physicians of Rummelsberg Hospital.
A detailed search of the international literature was done for all subjects regarding prehospital trauma management, and the American training systems (ITLS, PHTLS) were studied. The review was followed by a critical evaluation of the reality of on site-care, and the German and American systems were compared.
A 2-day course with 6 sessions (accident place and kinetics, trauma investigation, pathologies, resuscitation, practical training, and evaluation) was developed, adapted from the Advanced Trauma Life Support (ATLS) algorithm. Special attention was given to the integration and position of the emergency physician in Germany, as well as to the defined authority of the rescue services.
Conversion into practice was facilitated by teamwork. The course is free of charge to all rescue services and members of the concept group. With a qualified prehospital system that works smoothly with the ATLS concepts, improved prehospital care for trauma patients seems possible.
随着德国纽伦堡大都市地区创伤网络的出现,出现了院前创伤管理和急诊科管理能否更好整合的问题。德国工人慈善联合会(ASB)、巴伐利亚红十字会、马耳他救护车、圣约翰救护车、急诊医师代表以及鲁默尔斯贝格医院的医生为院前创伤护理设计了一项培训计划。
对所有关于院前创伤管理的主题进行了详细的国际文献检索,并研究了美国的培训系统(ITLS、PHTLS)。随后对现场护理的实际情况进行了批判性评估,并比较了德国和美国的系统。
根据高级创伤生命支持(ATLS)算法制定了一个为期2天、共6节课程(事故现场与动力学、创伤检查、病理学、复苏、实践培训和评估)。特别关注了德国急诊医师的整合与地位,以及救援服务的明确权限。
团队合作促进了向实践的转化。该课程对所有救援服务机构和概念组的成员免费。有了一个与ATLS概念顺利配合的合格院前系统,改善创伤患者的院前护理似乎是可能的。