Gräff I, Dolscheid-Pommerich R C, Ghamari S, Baehner T, Goost H
Interdisziplinäres Notfallzentrum, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
Institut für Klinische Chemie und Klinische Pharmakologie, Universitätsklinikum Bonn, Bonn, Deutschland.
Med Klin Intensivmed Notfmed. 2018 Jun;113(5):418-425. doi: 10.1007/s00063-017-0311-z. Epub 2017 Jun 6.
The emergency department (ED) is increasingly becoming the primary care unit of patients who are no longer able to meet the necessary minimum requirements for a healthy life. In the emergency medical care of these patients, fixation errors and stereotyped thinking can distract from serious illnesses, which can be tended by emergency medicine. This group of patients, with their multifactorial problems, represents a special challenge for the staff of the ED. The aim of this study is to improve the quality of the care for a special patient group.
A monocentric retrospective observation study was conducted at the University Hospital Bonn (UKB). On the basis of case studies, the emergency medical care of this special patient group was examined in the ED.
Over the period of 7 years (2009 to 2016), 17 patients in a state of total neglect could be examined. The endpoints identified, during the emergency care, are the therapy of life-threatening diseases, laboratory pathologies, introduction of infectious protective measures, initiation of diagnostic measures, measures to be initiated within different departments (operating room, intensive care unit) and outcome.
Patients in a state of total neglect require interdisciplinary primary care at a hospital with extended care structures. The apparent primary impression of these patients must not lead to a fixation error. Due to the often not obtainable history of the patient's and the complex appearance of these patients, the evaluation should be carried out according to a defined algorithm in the emergency room.
急诊科日益成为那些无法满足健康生活必要最低要求的患者的初级护理单位。在对这些患者的急诊医疗护理中，固定思维错误和刻板印象思维可能会使人们忽视严重疾病，而这些疾病可由急诊医学进行治疗。这群存在多因素问题的患者对急诊科工作人员来说是一项特殊挑战。本研究的目的是提高对这一特殊患者群体的护理质量。
在波恩大学医院（UKB）进行了一项单中心回顾性观察研究。基于病例研究，在急诊科对这一特殊患者群体的急诊医疗护理进行了检查。
在7年期间（2009年至2016年），对17名被完全忽视的患者进行了检查。在急诊护理期间确定的终点包括对危及生命疾病的治疗、实验室病理情况、引入感染防护措施、启动诊断措施、在不同科室（手术室、重症监护室）启动的措施以及结果。
被完全忽视的患者需要在具有扩展护理结构的医院接受跨学科初级护理。这些患者表面的初步印象绝不能导致固定思维错误。由于患者的病史往往难以获取且这些患者情况复杂，在急诊室应按照既定算法进行评估。
