RHÖN-KLINIKUM AG
Bad Neustadt ad Saale (ots)
More minor operations, fewer emergency doctors and rescue workers and a lack of alternative care structures: there is an urgent need for action to prevent the rescue system from collapsing. A controversial discussion about the future of emergency medicine at the 16th Emergency Medicine Forum at the RHÖN-KLINIKUM Campus Bad Neustadt.
Around 600 participants from all over Germany, including medical and emergency medical staff, rescue service employees, medical specialists and interested parties, learned about the topic of emergency medicine at the 16th Emergency Medicine Forum at the RHÖN-KLINIKUM Campus Bad Neustadt last Saturday in specialist lectures, a practical demonstration, workshops and case presentations pure. As part of the panel discussion, a balance sheet and inventory of the current situation in the rescue service was taken: In addition to challenges and problems, possible solutions for a necessary, appropriate and economical supply in the rescue service were discussed.
Status Quo – emergency care on campus
“We are being overwhelmed with patients,” emphasizes Prof. Bernd Griewing, Chief Medical Officer and Chief Representative of RHÖN-KLINIKUM AG. The campus currently guarantees a supply beyond the basic catchment area. The primary goal: to treat patients quickly, purposefully and effectively – whether in emergency medicine, on an outpatient or inpatient basis. “This works on campus thanks to bundled medical competencies in one place and excellent interdisciplinary cooperation: Short distances, short communication, excellent treatment competence through all specialist departments and teamwork benefit the patients – even in an emergency,” says Sandra Henek, Managing Director at RHÖN -KLINIKUM Campus Bad Neustadt. In 2022, the Bad Neustadt campus treated around 27,000 patients via the central emergency room – 41% of them were subsequently treated as inpatients.
Emergency care at the limit
“Emergency care is undoubtedly at its limit. Everyone who is active experiences this every day, and that is at the expense of the patient,” says Priv. Dr. medical Michael Dinkel MBA, chief physician of the clinic for anesthesia and intensive care at the RHÖN-KLINIKUM Bad Neustadt campus and state chairman of the professional association of German anesthesiologists (BDA) Bavaria. In addition to Uwe Kippnich, coordinator of security research at the Bavarian Red Cross (BRK) and Dr. Georg Kochinki, the medical director (ÄLRD) in the Schweinfurt rescue service area, belongs to Dr. Dinkel to the main organizers of the emergency forum.
The gap between the demand for rescue services and the supply of supply capacities is threateningly wide. “According to the Bavarian rescue service report, the number of operations without an emergency doctor – the so-called minor operations – has increased by 30% in the last 10 years. We are also seeing a change in the population’s attitude towards entitlement. The emergency doctor is often called even though it is not a medical emergency acts,” explains Dr. Spelt. As a result, “the real, time-critical emergency patient has to wait because the emergency services are treating the ‘nosebleed’,” says Kippnich.
The lack of attractiveness of the emergency doctor service due to a lack of appreciation and heterogeneous wage structures within Germany as well as uncontrolled hospital cancellations also fuel this problem. “In Bavaria, around 30% of the emergency doctor shifts are not manned at some locations. Hospitals are constantly unable to take patients, so patients have to be driven across the country,” says intensive care physician Dr. Spelt.
Adjusting screws for an improved emergency care situation
At the panel discussion, the panelists dealt with the topic of “emergency care at the limit”. On the part of politics, Sabine Dittmar, MdB, Parliamentary State Secretary at the Federal Minister of Health, took part and answered questions from the participating experts. New care structures, a changed awareness on the part of the population and service providers and the expansion of the rescue chain to include emergency rooms and intensive care units could rectify this problem. The solution ideas in detail:
Create new supply structures: It requires new supply structures, e.g. B. cross-sectoral emergency care through telemedical networking, the introduction of community emergency paramedics or the tele-emergency doctor. “Since 2005, the Bad Neustadt campus and the BRK Rhön-Grabfeld have been successfully implementing the so-called Stroke Angel project – a telemedical connection between the emergency services and the hospital,” reports Prof. Griewing. The aim is to admit and refer stroke patients in a timely manner. “The telemedicine project has been tried and tested here for many years,” Prof. Griewing continues. Kippnich describes that with the help of the qualified paramedic in non-life-threatening operations, the resources in the rescue service could be relieved. “The emergency paramedic makes an initial assessment on site and decides whether he will take care of the problem himself, e.g. placing a bladder catheter, or whether it is a case for the emergency services.”
Increase the health literacy of the population and control demand via control centers: “It must be clear to the population when they should contact the emergency services or contact another body,” says Dinkel. In order to also relieve the emergency rooms, according to Dr. Schneider, chief physician of the central emergency room at the RHÖN-KLINIKUM Bad Neustadt campus, cross-sector control centers are to be established. “The patient uses parallel care structures because he can at the moment. There must be a number that can make a qualified initial assessment and put the patient on to the right place.”
Greater transparency of hospitals: The heart attack patient who initially ends up in a clinic without a left heart catheter loses important time. “Why aren’t hospitals obliged to disclose their list of services, what care they can provide and what not?” says Dr. Spelt. The head of hospital coordination in Lower Franconia, Dr. Michael Mildner, goes even further and questions the fact why bottlenecks in clinics and the resulting cancellations are not made transparent.
Adding drones to the rescue chain: Prof. Bernd Griewing and Uwe Kippnich venture a look into the future: Drones could possibly establish themselves as a new link in the rescue chain, for example to transport vital medicines or emergency equipment. “This means that medicines or laboratory-relevant sample material can be transported very quickly by air to peripheral or remote areas,” says Kippnich.
Finally, everyone agrees that the goal should be needs-based, nationwide, evidence-based, data-supported emergency care.
practice demonstration: rescue with the turntable ladder
How important the correct procedure is when working in emergency care was shown using the example of an impressive turntable ladder operation “Rescuing an emergency patient with the turntable ladder from the roof of the campus”. The use of the turntable ladder for the fire brigade is a proven means of rescuing people from apartments that are difficult to access or in the case of complex care at great heights. The deployment strategy and new technology were presented live in the practical interaction of the fire brigade and aid organizations. The rescue service’s new mobile stretcher, the so-called “Power-Load”, was presented. The practical demonstration again showed the established, excellent cooperation between the authorities and organizations with security tasks (BOS). The following were involved in the exercise situation on campus: the Bad Neustadt volunteer fire brigade, the BRK rescue service, the Technical Relief Agency (THW) Mellrichstadt and the Bad Neustadt police. This forms the basis for successful emergency patient care. “Our goal is to ensure the survival of as many patients as possible and not to cause any additional cardiac injuries by taking the right approach, adapted and coordinated to the operational situation,” says Kippnich, who organized the practical demonstration with district fire chief Christian Stubenrauch (district fire inspection district of Rhön-Grabfeld).
The RHÖN-KLINIKUM Campus Bad Neustadt, one of five locations of RHÖN-KLINIKUM AG, stands for cross-sector medical care in rural areas. On one hospital site, the campus interlocks outpatient and inpatient offers with a large number of medical and preventive services that were previously spatially separated: resident specialists, clinics of different disciplines such as cardiac medicine, orthopedic surgery or neurology work hand in hand with nursing and rehabilitation . The digital networking of all actors involved in the treatment process – with innovative IT solutions and communication systems – is indispensable. www.campus-nes.de
Press contact:
RHÖN-KLINIKUM Campus Bad Neustadt | Corporate Communications Advisor
Katrin Maria Schmitt
T. +49 9771 66-26100 | [email protected]
Original content from: RHÖN-KLINIKUM AG, transmitted by news aktuell