Psychiatrische Notfälle aus der Sicht von Notärzten

Pajonk, Frank-Gerald; Biberthaler, Peter; Cordes, O.; Moecke, H.

doi:10.1007/s001010050600

Cited by 30 publications

(4 citation statements)

References 5 publications

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“…In contrast to the internalized uncertainty of the inexperienced PSs, experienced PHEPs most frequently stated that they felt insufficiently qualified to handle psychiatric emergencies. Pajonk et al already identified a possible deficit in the qualification of German PHEPs for the treatment of psychiatric emergency patients some 20 years ago [ 18 ]. To improve their skills in the treatment of psychiatric emergencies, PHEPs stated in a survey that they were willing to complete a one-day internship in a psychiatric hospital [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…The criteria for obtaining the additional qualification in emergency medicine do not differ in principle between university hospitals and smaller hospitals due to centrally organized training courses and exams. Therefore, according to the current evidence, it can be assumed that the qualification deficit of PHEPs in the treatment of psychiatric patients, which has already been addressed, exists independently of their experience [ 6 , 7 , 18 ]. The level of training of the psychiatrists surveyed in the participating psychiatric hospitals is not known.…”

Section: Discussionmentioning

confidence: 99%

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Medical experience as an influencing parameter in emergency medical care for psychiatric emergencies: retrospective analysis of a multicenter survey

Schick,

Mayer,

Hensel

et al. 2023

BMC Emerg Med

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Background Prehospital care of psychiatric patients often relies on the medical experience of prehospital emergency physicians (PHEPs). The psychiatrists (PSs) involved in the further treatment of psychiatric patients also often rely on their experience. Furthermore, the interaction between PHEPs and PSs is characterized by interaction problems and different approaches in the prehospital care of the psychiatric emergency. Objectives To analyze the phenomenon of “medical experience” as a cause of possible interaction-related problems and assess its impact on the prehospital decision-making process between prehospital emergency physicians and psychiatrists. Methods The retrospective data analysis was conducted between November 2022 and March 2023. Medical experience was defined as follows, based on the demographic information collected in the questionnaires: For PHEPs, the period since obtaining the additional qualification in emergency medicine was defined as a surrogate marker of medical experience: (i) inexperienced: < 1 year, (ii) experienced: 1–5 years, (iii) very experienced: > 5 years. For PSs, age in years was used as a surrogate parameter of medical experience: (i) inexperienced: 25–35 years, (ii) experienced: 35–45 years, (iii) very experienced: > 45 years. Results Inexperienced PSs most frequently expressed anxiety about the psychiatric emergency referred by a PHEP (27.9%). Experienced PHEPs most frequently reported a lack of qualifications in handling the care of psychiatric emergencies (p = 0.002). Very experienced PHEPs were significantly more likely to have a referral refused by the acute psychiatric hospital if an inexperienced PS was on duty (p = 0.01). Experienced PHEPs apply an intravenous hypnotic significantly more often (almost 15%) than PSs of all experience levels (p = 0.001). In addition, very experienced PHEPs sought prehospital phone contact with acute psychiatry significantly more often (p = 0.01). Conclusion PHEPs should be aware that the PS on duty may be inexperienced and that treating emergency patients may cause him/her anxiety. On the other hand, PHEPs should be receptive to feedback from PS who have identified a qualification deficiency in them. Jointly developed, individualized emergency plans could lead to better prehospital care for psychiatric emergency patients. Further training in the prehospital management of psychiatric disorders is needed to minimize the existing skills gap among PHEPs in the management of psychiatric disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medical experience as an influencing parameter in emergency medical care for psychiatric emergencies: retrospective analysis of a multicenter survey

Schick,

Mayer,

Hensel

et al. 2023

BMC Emerg Med

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“…Die Qualifikation von Rettungsassistenten und Notärzten unterliegt nach wie vor sehr starken Schwankungen [12]. Während der Nachholbedarf für psychiatrische Notfälle zumindest bereits erkannt ist [10,19], sind psychische Ausnahmezustände bisher wenig von Notärzten thematisiert worden. Während der Nachholbedarf für psychiatrische Notfälle zumindest bereits erkannt ist [10,19], sind psychische Ausnahmezustände bisher wenig von Notärzten thematisiert worden.…”

Section: Basiskrisenintervention -Notarzt Oder Rettungsassistent?unclassified

Psychiatrische Notfälle und psychosoziale Krisen

Poloczek

Schmitt

Pajonk³

2001

Notfall & Rettungsmedizin

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ZusammenfassungDie Therapie psychosozialer Krisen ist keine Notarztindikation im klassischen Sinne. Dennoch kommen Notärzte und Rettungsassistenten tagtäglich mit akuten Belastungssituationen in Kontakt.Hier besteht die Chance,die potentielle Entstehung von psychiatrischen Erkrankungen und ihre Folgen frühzeitig zu erkennen und den Betroffenen präventive Hilfe anzubieten.Der nachfolgende Artikel beschreibt anhand einer "psychischen Rettungskette" ein Modell, wie Ersthelfer und professionelle Rettungsdienste einen Beitrag zur Verhinderung von chronischen Erkrankungen leisten können.Er stellt die These zur Diskussion, dass durch die Einbindung von Kriseninterventionsdiensten, Notfallseelsorge und psychosozialen Hilfsdiensten in akutmedizinische Strukturen ein nicht zu unterschätzender Beitrag zur Gesundheitsförderung geleistet werden kann und gibt Hilfestellung zur Umsetzung erster wichtiger Schritte.

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“…Psychiatrische Notfälle stellen für die im Rettungsdienst Tätigen selbst eine schwere psychische Belastung dar [3,4]. Das eigene Risiko für eine posttraumatische Belastungsstörung oder eine Depression beträgt rund 10 %, wobei eine vorbestehende psychiatrische Störung das Risiko um das 5-bis 6-Fache erhöht [5].…”

Section: Introductionunclassified