Jung Christian, Bernhard Michael
Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
Cardiovascular Research Institute Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf.
Dtsch Med Wochenschr. 2024 Aug;149(17):1034-1038. doi: 10.1055/a-2105-9849. Epub 2024 Aug 15.
In the emergency department, patients with potential or confirmed cardiovascular diseases constitute a significant portion of the overall patient population. Monitoring for cardiovascular surveillance of these patients, until and during the diagnostics and acute therapy often presents an interdisciplinary and interprofessional challenge. This is partly due to the limited number of monitoring spaces in emergency departments. Therefore, it is crucial to establish a differentiated indication for cardiovascular monitoring. Despite limited monitoring resources, ensuring high patient safety is paramount. The correct approach holds significant prognostic importance. For patients requiring extended monitoring, especially using invasive systems, close personnel monitoring is essential, in addition to appropriate staffing and medical equipment. The overarching goal for such patients is to ensure prompt transfer to a suitable destination unit. The provision of an intensive care bed for further care within one hour is aimed for according to the directive of the Federal Joint Committee on staged emergency care in hospitals. Often, at the beginning of the emergency department visit, a definitive diagnosis is not yet established - this is addressed accordingly with symptom-oriented considerations. The present review article focuses on the practical Implementation and modalities of monitoring, as well as its application in a selection of cardiovascular diagnoses in the emergency department.
在急诊科,患有潜在或确诊心血管疾病的患者在总体患者群体中占很大比例。对这些患者进行心血管监测,直到诊断和急性治疗期间,往往是一项跨学科和跨专业的挑战。部分原因是急诊科的监测空间有限。因此,为心血管监测建立差异化的指征至关重要。尽管监测资源有限,但确保患者的高安全性是首要任务。正确的方法具有重要的预后意义。对于需要长期监测的患者,尤其是使用侵入性系统的患者,除了配备适当的人员和医疗设备外,密切的人员监测至关重要。此类患者的总体目标是确保及时转至合适的目的地科室。根据医院分级急诊护理联邦联合委员会的指令,目标是在一小时内提供重症监护床位以进行进一步护理。通常,在急诊科就诊开始时,尚未确立明确诊断——对此会根据以症状为导向的考虑进行相应处理。本综述文章重点关注监测的实际实施和方式,以及其在急诊科一系列心血管诊断中的应用。