System Analysis of Patient Management During the Pre- and Early Clinical Phase in Severe Head Injury

Baethmann, A.; Chapuis, D.; Wirth, A.; Reulen, H. J.; Steiger, Hans‐Jakob; Stummer, Walter; Hölzel, Dieter; Lackner, Ch.; Assal, J. P.; Belg, A.; Schrödel, M.; Muller, Nancy; Ueblacker, Peter; Chlistalla, A.; Schneider, G.-H.; Schweiberer, L.; Dietz, Hans-Georg; Trappe, A.; Göbel, W.-E.; Jaksche, H.; Messner, V.; Grumme, Th.; Wenger, Peter; Müller, Hans‐Werner; Stolpe, E.; Döffinger, J.; Lumenta, Christianto B.; Gerstner, Werner; Prokscha, G.; Sackerer, Dieter; Hofner, F.; Eisenstein, Toby K.; Lenz, Georg; Preisz, Anne; Rothmeier, F.; Kirmayer, U.; Böhme, Michael; Horak, W; Weeß, Th.

doi:10.1007/978-3-7091-6391-7_16

Cited by 7 publications

(10 citation statements)

References 6 publications

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“…Trotz Anwendung etablierter Schockraumalgorithmen gab die Zeitanalyse des Schockraumversorgung in der eigenen Klinik bei 250 polytraumatisierten Patienten Mittelwerte, die deutlich von den Vorgaben abwichen [1,2,5,7,13,14].…”

Section: Materials Und Methodenunclassified

Zeitoptimiertes modernes Schockraummanagement unter Einsatz digitaler Techniken

et al. 2002

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Emergency room management means time management. A time and four color based algorithm is described to improve workflow, follow up of diagnostic procedures and initial treatment. As a result introducing the time based interdisciplinary emergency algorithm within 60 minutes all necessary treatment and diagnostic procedures were completed. This algorithm is an effective tool to improve emergency room treatment.

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Section: Materials Und Methodenunclassified

Zeitoptimiertes modernes Schockraummanagement unter Einsatz digitaler Techniken

et al. 2002

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“…Este, em princípio, pode ser evitado com procedimentos de monitorização e intervenção terapêutica. Além disso, uma melhor evolução do TCE-grave depende da maior eficiência na conduta e tratamento, visando inibir o dano cerebral secundário 3 .…”

Section: Revisão Da Literaturaunclassified

“…Grande parte dos autores refere dois fatores distintos como determinantes do prognóstico de TCE: a extensão e a gravidade do dano primário ao cérebro no momento do trauma, e as manifestações do dano cerebral secundário, de origem intra e extracraniana 3 . é próximo à faixa etária encontrada em nosso trabalho 30 .…”

Section: Revisão Da Literaturaunclassified

“…Anualmente meio milhão de pessoas requerem hospitalização devido ao TCE nos Estados Unidos, destas 75 a 100 mil morrem no decorrer de poucas horas após a agressão e 70 a 90 mil apresentam lesão irreversível de alguma função neurológica após lesão cerebral 38 . O TCE, com ou sem politraumatismo associado, é a mais importante causa de morbimortalidade grave acima dos 45 anos de idade 3 .…”

Section: Introductionunclassified

“…Na Alemanha, 9.300 pacientes vítimas de acidentes morrem por ano decorrente de trauma cerebral grave 3 . Aqueles que sobrevivem freqüentemente sofrem de seqüelas debilitantes como epilepsia, distúrbios da fala, déficit motor e sensitivo, distúrbios na personalidade e outras lesões neurológicas irreversíveis.…”

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Arq Bras Neurocir

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Präklinische Versorgung von Traumapatienten in der Luftrettung

Schlechtriemen

Schaefer²,

Stolpe

et al. 2002

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In a retrospective study of mission data of ADAC Air Rescue of the years 2000 and 2001 the quality of preclinical care of 1,946 patients with severe head injuries and 1,878 polytraumatized patients was examined. The actual preclinical care of these patients was compared with a catalogue of eleven thesis-like recommendations. These recommendations were previously derived from corresponding publications of national and international specialist companies and were introduced in a binding manner by the senior doctors of the participating air rescue centres. The results of the study show that 73.3% of the severe head injuries were preclinically intubated and 94.4% were supplied with oxygen, 82.2% were analgosedated. 94.8% could be delivered to the hospital of destination. 65.9% had a systolic blood pressure of >120 mmHg upon admission to the hospital. 71.4% of severe head injury victims were equipped with a cervical support, 23.3% had the blood pressure documented. 47.3% reached the hospital of destination in less than 60 minutes. Among polytraumatic patients the intubation was performed in 75.7%, the supply with oxygen in 90.7%, 88.6% of the patients were analgosedated. 78.7% of patients suffering from concomitant head injuries were provided with a cervical support and only 22.8% had a blood sugar measurement documented. A concomitant severe thorax trauma was treated by a thorax drainage in 59.2%. 35.6% of the polytraumata reached the hospital of destination in less than 60 minutes. The work describes the preclinical patient care of severe head injuries and polytraumata, pointing out deficits and presenting optimization possibilities, particularly in the area of training. Furthermore, the work shows the concept of the medical quality management in an air rescue enterprise. The total evaluation of all air rescue centres participating in data collection forms the basis of an external quality comparison. The data evaluation of a single station makes regional strengths and weaknesses visible, deficits can be proven and proposals for optimization be developed. The presentation of the time history of data yields continuous standard information on the state of the patient care at the relevant air rescue location and enables the analysis of improvement concepts based on the updated data.

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System Analysis of Patient Management During the Pre- and Early Clinical Phase in Severe Head Injury

Cited by 7 publications

References 6 publications

Zeitoptimiertes modernes Schockraummanagement unter Einsatz digitaler Techniken

Zeitoptimiertes modernes Schockraummanagement unter Einsatz digitaler Techniken

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Präklinische Versorgung von Traumapatienten in der Luftrettung

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