Bieler D, Schweigkofler U, Waydhas C, Wagner F, Spering C, Kühne C A
Klinik für Unfallchirurgie und Orthopädie, Wiederherstellungs- und Handchirurgie, Verbrennungsmedizin, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Straße 170, 56072, Koblenz, Deutschland.
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.
Unfallchirurgie (Heidelb). 2023 Jul;126(7):511-515. doi: 10.1007/s00113-023-01306-z. Epub 2023 Mar 14.
It is estimated that in total almost 10 million people are injured in accidents in Germany every year, most of which are in the household milieu and leisure sector. It is estimated that of these more than 32,000 seriously injured patients are admitted to the emergency room every year. It is recommended that the decision of the prehospital treatment team or the first examiner in the hospital as to whether a potentially severely injured patient should be admitted via the emergency room of the hospital should be based on a catalogue of criteria.
Against the background of the update of the S3 guidelines on the treatment of multiple trauma/severely injured patients and on the basis of the current literature, an overview with respect to the composition of the team and the criteria for which an emergency room team is or should be activated is given.
Alerting the emergency room team is still recommended if a certain injury pattern is present or if a prehospital intervention is necessary. The B‑criteria based on the course of the accident or mechanism, which have recently been the subject of increasing criticism, have been adapted. Recommendations for geriatric patients could also be formulated.
Compared to the S3 guidelines from 2016 the emergency room alarm criteria could be revised on the basis of new literature and have been included in the revised guidelines. There is no doubt that further optimization. e.g., based on prehospital algorithms or using point of care diagnostics, are possible and desirable in the future.
据估计,德国每年总计有近1000万人在事故中受伤,其中大部分发生在家庭环境和休闲领域。据估计,每年有超过32000名重伤患者被送往急诊室。建议院前治疗团队或医院的首诊医生就是否应通过医院急诊室收治潜在重伤患者的决定应基于一套标准。
在更新关于多发伤/重伤患者治疗的S3指南的背景下,基于当前文献,对团队组成以及急诊室团队启动或应启动的标准进行了概述。
如果出现特定损伤模式或需要进行院前干预,仍建议通知急诊室团队。基于事故过程或机制的B标准最近受到越来越多的批评,现已进行了调整。还可为老年患者制定相关建议。
与2016年的S3指南相比,急诊室警报标准可根据新文献进行修订,并已纳入修订后的指南。毫无疑问,未来进一步优化,例如基于院前算法或使用即时检验诊断是可能且可取的。