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[急诊医学中的重症监护医学相关方面]

[Aspects of intensive care medicine in emergency medicine].

作者信息

Behringer W, Dodt C, Eisenburger P, Laggner A N

机构信息

Zentrum für Notfallmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07749, Jena, Deutschland.

Notfallzentrum, München Klinik Bogenhausen, München, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2020 Nov;115(8):625-632. doi: 10.1007/s00063-020-00741-9. Epub 2020 Oct 12.

Abstract

Emergency medicine and intensive care medicine have many similarities. In this review, we will first discuss the terminology of emergency medicine in a hospital in terms of a uniform designation as a department for emergency medicine or emergency department. Emergency medicine and intensive care medicine are a location-independent concept of patient care in the sense of the recognition, treatment and diagnosis of acute health disorders. Emergency medicine covers the entire range of disease severity, while intensive care medicine focuses on organ replacement and organ preservation, uses highly specialized technology for this purpose and treats only the seriously ill. The treatment of seriously ill patients in the emergency departments requires special intensive care medical knowledge both by the physicians and nursing staff. In the medical field, the curriculum for the European emergency medicine specialist takes into account all aspects necessary for the diagnosis and treatment of critically ill patients. For the nursing sector, Germany has had its own recognized specialty training program in emergency medicine for several years. However, the treatment of critically ill patients in emergency departments also requires that the emergency departments be adequately equipped. In this regard, there is an urgent need for statutory quality criteria that are concrete and structured. We know from the literature that intensive care competence in emergency departments reduces the admission rate to intensive care units and the mortality of all emergency patients. The concept of intensive care units in the emergency department is gaining popularity in the USA and should also be evaluated for implementation in the German-speaking countries.

摘要

急诊医学和重症医学有许多相似之处。在本综述中,我们将首先从统一指定为急诊医学科或急诊科的角度讨论医院中急诊医学的术语。急诊医学和重症医学是一种与地点无关的患者护理概念,涉及对急性健康障碍的识别、治疗和诊断。急诊医学涵盖了疾病严重程度的整个范围,而重症医学专注于器官替代和器官保护,为此使用高度专业化的技术,且仅治疗重症患者。急诊科对重症患者的治疗需要医生和护理人员具备特殊的重症医学知识。在医学领域,欧洲急诊医学专家的课程考虑了重症患者诊断和治疗所需的各个方面。在护理领域,德国多年来一直有自己认可的急诊医学专业培训项目。然而,急诊科对重症患者的治疗还要求急诊科有足够的设备。在这方面,迫切需要具体且结构化的法定质量标准。我们从文献中了解到,急诊科的重症护理能力可降低重症监护病房的收治率和所有急诊患者的死亡率。急诊科重症监护病房的概念在美国越来越受欢迎,在德语国家也应评估其实施情况。

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