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AuthorSchlafer, Otmardc.contributor.author
Date of accession2016-08-16T09:55:57Zdc.date.accessioned
Available in OPARU since2016-08-16T09:55:57Zdc.date.available
Year of creation2015dc.date.created
Date of first publication2016-08-16dc.date.issued
AbstractBACKGROUND: Adequate prehospital and inhospital primary care is a decisive factor in the successful treatment of multiple trauma patients. For optimization of treatment algorithms the implementation of a medical quality management is of utmost importance. The aim of this study was to extend quality management by including data on process quality. METHODS: A retrospective study of primary rescue missions of the Helicopter Emergency Medical Service (HEMS) Christoph 22 in Ulm over a period of 2.5 years was performed. In a detailed analysis of filter criteria, in which relevant deviations from the recommendations (not fulfilled in  > 10% of the cases) occurred, process data was included (vital data, measurements and events). RESULTS: In the study population (n = 298, males 71.8%, mean age 39.8 ± 21.8 years) 2 filter criteria were identified in which relevant deviations where observed: time management where prehospital treatment time  ≤ 60 min in 36% of the cases was not fulfilled and circulatory management where the systolic blood pressure, detected with Riva-Rocci method (RR(sys))  ≥ 120 mmHg on hospital admission in patients with severe head trauma was not fulfilled in 45% of the cases. In patients with deviations in time management, prehospital treatment time was prolonged (75.6 ± 18.3 min versus 50.5 ± 6.7 min; p < 0.01) caused by a prolonged on scene attendance time (34.1 ± 22.1 min versus 20.6 ± 9.2 min; p < 0.01) and transport time (17.3 ± 9.4 min versus 13.3 ± 4.8 min; p < 0.01). In entrapment trauma prehospital treatment time was expanded (44% versus 10%; p < 0.01). Patients in whom circulatory management deviations were observed were more often in shock on arrival at the scene (RR(sys)  ≤ 90 mmHg: 60% versus 30%; p < 0.01), more often hypoxemic [pulse oximeter oxygen saturation (S(p)O(2)) ≤ 90%: 36% versus 19%; p < 0.05] and more often sustained a trauma to the chest as well as to chest and abdomen/pelvis (69% versus 52% and 42% versus 28%, respectively; p < 0.05). Furthermore, the infusion volume of colloids was higher (1241 ± 810 ml versus 753 ± 359 ml; p < 0.05) and the combined usage of small volume resuscitation and catecholamines was more often necessary (42% versus 25%; p < 0.05). CONCLUSIONS: Including process data of prehospital mission data recording facilitates an extended medical quality management.dc.description.abstract
Languagededc.language.iso
PublisherUniversität Ulmdc.publisher
LicenseStandarddc.rights
Link to license texthttps://oparu.uni-ulm.de/xmlui/license_v3dc.rights.uri
KeywordTracer-Diagnose Polytraumadc.subject
KeywordPräklinische Notfallmedizindc.subject
KeywordErweitertes medizinisches Qualitätsmanagementdc.subject
Dewey Decimal GroupDDC 610 / Medicine & healthdc.subject.ddc
MeSHMultiple trauma; Diagnosisdc.subject.mesh
MeSHEmergency medicinedc.subject.mesh
TitleErweitertes medizinisches Qualitätsmanagement am Beispiel der Tracer-Diagnose Polytrauma. Eine Pilotstudie aus dem Bereich des Luftrettungsdienstesdc.title
Resource typeDissertationdc.type
Date of acceptance2015-12-18dcterms.dateAccepted
RefereeGebhard, Floriandc.contributor.referee
RefereeHelm, Matthiasdc.contributor.referee
DOIhttp://dx.doi.org/10.18725/OPARU-4086dc.identifier.doi
PPN1658532368dc.identifier.ppn
URNhttp://nbn-resolving.de/urn:nbn:de:bsz:289-oparu-4125-7dc.identifier.urn
GNDPolytraumadc.subject.gnd
GNDNotfallmedizindc.subject.gnd
GNDLuftrettungdc.subject.gnd
GNDTracerdc.subject.gnd
GNDQualitätsmanagementdc.subject.gnd
FacultyMedizinische Fakultätuulm.affiliationGeneral
InstitutionBundeswehrkrankenhaus Ulm (BWK)uulm.affiliationSpecific
Shelfmark print versionW: W-H 14.483uulm.shelfmark
Grantor of degreeMedizinische Fakultätuulm.thesisGrantor
DCMI TypeTextuulm.typeDCMI
TypeErstveröffentlichunguulm.veroeffentlichung
CategoryPublikationenuulm.category
University Bibliographyjauulm.unibibliographie


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