Gries A, Bernhard M, Helm M, Brokmann J, Gräsner J-T
Zentrale Notaufnahme, Universitätsklinikum Leipzig, Leipzig, Deutschland.
Abt X, Anästhesie und Intensivmedizin, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland.
Anaesthesist. 2017 May;66(5):307-317. doi: 10.1007/s00101-017-0308-2.
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment. Now after 15 years, the authors have critically assessed the development postulated in 2003 and reevaluated it. Which aspects could be developed further and become firmly established, what is still open and which questions in preclinical and clinical emergency treatment of the population will occupy us in the coming 15 years? With a critical eye to the past, the present contribution aims to capture the essential and new topics and open questions and provide a fresh perspective for the future of emergency medicine. Regulation at the state level or even lower levels of government often stand in contrast to more sweeping and economically effective approaches at the federal level. Prehospital emergency medicine in Germany is on the whole well-positioned with respect to facilities and personnel; however, as far as the economic situation and the utilization of available systems are concerned, there is still substantial room for improvement.
2003年，一篇关于德国院前急救医学未来的文章发表在《麻醉医师》杂志上。当时，德国的急救医学几乎完全被定义为院前紧急救援，如今已有所发展，院内领域越来越受到关注。当时的主要目标是将院前管理与顺利过渡到医院入院及后续医院护理相联系，并进一步优化从实际紧急情况到病因治疗的救援链。如今15年过去了，作者对2003年提出的发展进行了批判性评估并重新审视。哪些方面可以进一步发展并稳固确立，哪些仍未解决，以及在未来15年里，针对人群的临床前和临床急救治疗中的哪些问题将困扰我们？带着对过去的批判性眼光，本文旨在梳理关键的新主题和未解决的问题，并为急救医学的未来提供新视角。州一级甚至更低层级政府的监管往往与联邦层面更全面、更具经济效率的方法相悖。德国的院前急救医学在设施和人员方面总体处于有利地位；然而，就经济状况和现有系统的利用而言，仍有很大的改进空间。
