Christ Michael, Mueller Christian
Department of Emergency and Critical Care Medicine, Paracelsus Medical University, Nuremberg, Germany
Department of Cardiology, University Hospital, Basel, Switzerland.
Eur Heart J Acute Cardiovasc Care. 2016 Apr;5(2):141-9. doi: 10.1177/2048872615581501. Epub 2015 Apr 22.
The Emergency Department is the first point of healthcare contact for most patients presenting with signs and symptoms of acute heart failure (AHF) and thus, plays a critical role in AHF management. Despite the increasing burden of AHF on healthcare systems in general and Emergency Departments in particular, there is little guidance for implementing care and disease management programmes. This has led to an urgent call for action to prioritize and improve the management of patients with AHF presenting to the Emergency Department. At a local level, hospitals are urged to develop and implement individual multidisciplinary AHF management programmes, which include detailed care pathways and the monitoring of management adherence, to ensure that care is based on the pathophysiology and causes of AHF. Multiple disciplines, including emergency medicine, hospital medicine, cardiology, nephrology and geriatrics, should provide input into the development of a multidisciplinary approach to AHF management in the ED and beyond, including in-hospital treatment, discharge and follow-up. This will ensure consensus of opinion and improve adherence. The benefits of standardized, multidisciplinary care have been shown in other areas of acute and chronic diseases and will also provide benefit for AHF patients presenting to Emergency Departments.
急诊科是大多数出现急性心力衰竭（AHF）体征和症状患者的首个医疗接触点，因此在AHF管理中发挥着关键作用。尽管AHF给整个医疗系统尤其是急诊科带来的负担日益加重，但在实施护理和疾病管理项目方面几乎没有指导意见。这导致迫切需要采取行动，将急诊科AHF患者的管理作为优先事项并加以改善。在地方层面，敦促医院制定并实施个体化的多学科AHF管理项目，其中包括详细的护理路径以及对管理依从性的监测，以确保护理基于AHF的病理生理学和病因。多个学科，包括急诊医学、医院医学、心脏病学、肾脏病学和老年医学，应参与制定急诊科及其他地方（包括住院治疗、出院和随访）AHF管理的多学科方法。这将确保意见一致并提高依从性。标准化多学科护理的益处已在其他急慢性疾病领域得到证明，也将使到急诊科就诊的AHF患者受益。
