Abstract
In patients up to the age of40 years old severe trauma is the most frequent cause of death in Germany. According to the current S3 guidelines on treatment of polytrauma and the severely injured, since 2011 the presence of a shock room coordinator should be considered, who can improve the survival of patients by optimized treatment quality and times. The aim of the present study was to analyze various parameters of shock room treatment for polytraumatized patients before and after implementation of ashock room coordinator for treatment of polytrauma. To ensure an adequate period of time between the implementation of the shock room coordinator in 2011, data from 2009 and 2012 were included for comparative purposes. All scanned protocols of shock room treatment in the period from 1 January 2009 to 31 December 2009 and from 1 January 2012 to 31 December 2012 were inspected and evaluated. In total 213 shock room treatments from 2009 and 420 from 2012 were included. The mean number of shock room treatments in 2009 was 17.8 per month and in2012 the mean number was 35per month. The mean number of shock room treatments was nearly doubled in comparison (p < 0.001). The mean time for shock room treatment in 2009 was 74.8 min and in 2012 the mean time was 69 min and was therefore reduced by 5.8 min (p = 0.56). The treatment of polytraumatized patients in the presence of ashock room coordinator and after implementation of the standard operating procedure (SOP) was neither statistically nor clinically relevantly shortened.
Highlights
In patients up to the age of 40 years old severe trauma is the most frequent cause of death in Germany
The mean number of shock room treatments was nearly doubled in comparison (p < 0.001)
Zur weiteren Veranschaulichung werden dreizehn Fallbeispiele in einem separaten Kapitel beschrieben
Summary
Anhand von Berechnungen aus dem Jahr 2008 kann in Deutschland jährlich von bis zu 38.000 Schwerverletzten (Mehrfachverletzungen und/oder Polytrauma) ausgegangen werden [1, 2]. Der Faktor Zeit ist ein Parameter, welcher in entscheidender Weise über das Überleben des Patienten mitentscheidet [6]: So sinkt bei Patienten mit intraabdominellen Blutungen und Volumenmangelschock die Überlebenswahrscheinlichkeit um 1 % mit jeder Verzögerung einer Notfalllaparotomie um 3 min [6]. Inwieweit die Anwesenheit eines Schockraumkoordinators das Überleben der Patienten verbessert, ist weiterhin Gegenstand von Diskussionen [6,7,8]. Dass es durch die Einführung eines Schockraumkoordinators zu verbesserten Versorgungs- und Behandlungsabläufen kam [9]. Ziel der vorliegenden Arbeit war zu prüfen, ob es nach klinikinterner Implementierung der geforderten Neuerungen im Rahmen der S3-Leitlinie Polytrauma mit Einsatz eines Schockraumkoordinators zu einer zeitlichen Optimierung des Behandlungsablaufes kam
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