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2015 | OriginalPaper | Buchkapitel

4. Das Medizinische Notfallteam – Beispiel für ein Alarm-basiertes Interventionsteam

verfasst von: Felix Kork, Claudia Spies, Michael Haase

Erschienen in: Akute Nierenschädigung

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Das klassische Reanimationsteam wird gerufen, wenn der Notfall – zumeist ein Herz-Kreislauf-Stillstand oder eine intubationspflichtige Ateminsuffizienz – bereits eingetreten ist. Medizinische Notfallteams hingegen werden bereits bei frühen Warnzeichen (z. B. Tachykardie >140/min oder Bradykardie <40/min) alarmiert und versorgen vital bedrohte Patienten auf der Normalstation, bevor der Notfall eintritt.
Aufgrund positiver Ergebnisse durch eine Frühbehandlung von Patienten mit kritischen Vitalparameter-Abweichungen und den internationalen Empfehlungen zur innerklinischen Reanimation ist die Einführung von medizinischen Notfallteams in vielen Ländern bereits umgesetzt worden. Im Folgenden berichten wir, was Medizinische Notfallteams sind, wie und warum sie die Versorgung potentiell kritisch Kranker auf den Normalstationen von Krankenhäusern verbessern können und welche Rolle sie als mögliches Vorbild für die Versorgung von Patienten mit akuter Nierenschädigung zukünftig einnehmen können.
Literatur
Zurück zum Zitat Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PW. The impact of the use of the Early Warning Score (EWS) on patient outcomes: a systematic review. Resuscitation. 2014;85:587–594 CrossRefPubMed Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PW. The impact of the use of the Early Warning Score (EWS) on patient outcomes: a systematic review. Resuscitation. 2014;85:587–594 CrossRefPubMed
Zurück zum Zitat Bellomo R, Goldsmith D, Uchino S, et al. A prospective before-and-after trial of a medical emergency team. The Medical journal of Australia. 2003;179:283–287 PubMed Bellomo R, Goldsmith D, Uchino S, et al. A prospective before-and-after trial of a medical emergency team. The Medical journal of Australia. 2003;179:283–287 PubMed
Zurück zum Zitat Bellomo R, Goldsmith D, Uchino S, et al. Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med. 2004;32:916–921 CrossRefPubMed Bellomo R, Goldsmith D, Uchino S, et al. Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med. 2004;32:916–921 CrossRefPubMed
Zurück zum Zitat Chan PS, Jain R, Nallmothu BK, Berg RA, Sasson C. Rapid Response Teams: A Systematic Review and Meta-analysis. Arch Intern Med. 2010;170:18–26 CrossRefPubMed Chan PS, Jain R, Nallmothu BK, Berg RA, Sasson C. Rapid Response Teams: A Systematic Review and Meta-analysis. Arch Intern Med. 2010;170:18–26 CrossRefPubMed
Zurück zum Zitat Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005;16:3365–3370 CrossRefPubMed Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005;16:3365–3370 CrossRefPubMed
Zurück zum Zitat Deakin CD, Nolan JP, Soar J, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation. 2010;81:1305–1352 CrossRefPubMed Deakin CD, Nolan JP, Soar J, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation. 2010;81:1305–1352 CrossRefPubMed
Zurück zum Zitat Dean BS, Decker MJ, Hupp D, Urbach AH, Lewis E, Benes-Stickle J. Condition HELP: a pediatric rapid response team triggered by patients and parents. Journal for healthcare quality : official publication of the National Association for Healthcare Quality. 2008;30:28–31 Dean BS, Decker MJ, Hupp D, Urbach AH, Lewis E, Benes-Stickle J. Condition HELP: a pediatric rapid response team triggered by patients and parents. Journal for healthcare quality : official publication of the National Association for Healthcare Quality. 2008;30:28–31
Zurück zum Zitat Deja M, Hommel M, Weber-Carstens S, et al. Evidence-based therapy of severe acute respiratory distress syndrome: an algorithm-guided approach. J Int Med Res. 2008;36(2):211–221 CrossRefPubMed Deja M, Hommel M, Weber-Carstens S, et al. Evidence-based therapy of severe acute respiratory distress syndrome: an algorithm-guided approach. J Int Med Res. 2008;36(2):211–221 CrossRefPubMed
Zurück zum Zitat Featherstone P, Smith GB, Linnell M, Easton S, Osgood VM. Impact of a one-day inter-professional course (ALERT) on attitudes and confidence in managing critically ill adult patients. Resuscitation. 2005;65:329–336 CrossRefPubMed Featherstone P, Smith GB, Linnell M, Easton S, Osgood VM. Impact of a one-day inter-professional course (ALERT) on attitudes and confidence in managing critically ill adult patients. Resuscitation. 2005;65:329–336 CrossRefPubMed
Zurück zum Zitat Fischer H, Schneider-Klimanek S, Breckwoldt J. „Medical emergency team” und Reanimationsteam. Notfall + Rettungsmedizin. 2010;13:762–768 CrossRef Fischer H, Schneider-Klimanek S, Breckwoldt J. „Medical emergency team” und Reanimationsteam. Notfall + Rettungsmedizin. 2010;13:762–768 CrossRef
Zurück zum Zitat Goldhill DR, McNarry AF. Physiological abnormalities in early warning scores are related to mortality in adult inpatients. Br J Anaesth. 2004;92:882–884 CrossRefPubMed Goldhill DR, McNarry AF. Physiological abnormalities in early warning scores are related to mortality in adult inpatients. Br J Anaesth. 2004;92:882–884 CrossRefPubMed
Zurück zum Zitat Harrison GA, Jacques T, McLaws ML, Kilborn G. Combinations of early signs of critical illness predict in-hospital death-the SOCCER study (signs of critical conditions and emergency responses). Resuscitation. 2006;71:327–334 CrossRefPubMed Harrison GA, Jacques T, McLaws ML, Kilborn G. Combinations of early signs of critical illness predict in-hospital death-the SOCCER study (signs of critical conditions and emergency responses). Resuscitation. 2006;71:327–334 CrossRefPubMed
Zurück zum Zitat Herod R, Frost SA, Parr M, Hillman K, Aneman A. Long term trends in medical emergency team activations and outcomes. Resuscitation. 2014;85:1083–1087 CrossRefPubMed Herod R, Frost SA, Parr M, Hillman K, Aneman A. Long term trends in medical emergency team activations and outcomes. Resuscitation. 2014;85:1083–1087 CrossRefPubMed
Zurück zum Zitat Hillman KM, Bristow PJ, Chey T, et al. Duration of life-threatening antecedents prior to intensive care admission. Intensive Care Med. 2002;28:1629–1634 CrossRefPubMed Hillman KM, Bristow PJ, Chey T, et al. Duration of life-threatening antecedents prior to intensive care admission. Intensive Care Med. 2002;28:1629–1634 CrossRefPubMed
Zurück zum Zitat Hillman K, Chen J, Cretikos M, et al. Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. Lancet. 2005;365:2091–2097 CrossRefPubMed Hillman K, Chen J, Cretikos M, et al. Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. Lancet. 2005;365:2091–2097 CrossRefPubMed
Zurück zum Zitat Jacques T, Harrison GA, McLaws ML, Kilborn G. Signs of critical conditions and emergency responses (SOCCER): a model for predicting adverse events in the inpatient setting. Resuscitation. 2006;69:175–183 CrossRefPubMed Jacques T, Harrison GA, McLaws ML, Kilborn G. Signs of critical conditions and emergency responses (SOCCER): a model for predicting adverse events in the inpatient setting. Resuscitation. 2006;69:175–183 CrossRefPubMed
Zurück zum Zitat Jones D, Bellomo R, Bates S, et al. Long term effect of a medical emergency team on cardiac arrests in a teaching hospital. Crit Care. 2005;9:R808–815 CrossRefPubMedCentralPubMed Jones D, Bellomo R, Bates S, et al. Long term effect of a medical emergency team on cardiac arrests in a teaching hospital. Crit Care. 2005;9:R808–815 CrossRefPubMedCentralPubMed
Zurück zum Zitat Kause J, Smith G, Prytherch D, et al. A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom–the ACADEMIA study. Resuscitation.2004;62:275–282 CrossRefPubMed Kause J, Smith G, Prytherch D, et al. A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom–the ACADEMIA study. Resuscitation.2004;62:275–282 CrossRefPubMed
Zurück zum Zitat Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int 2012;Supplement:1–138 Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int 2012;Supplement:1–138
Zurück zum Zitat Kim HC, Yoo JW, Lim SY, et al. Mortality after in-hospital cardiopulmonary resuscitation: multicenter analysis in Korea. J Crit Care. 2013;28:942–946 CrossRefPubMed Kim HC, Yoo JW, Lim SY, et al. Mortality after in-hospital cardiopulmonary resuscitation: multicenter analysis in Korea. J Crit Care. 2013;28:942–946 CrossRefPubMed
Zurück zum Zitat Kopterides P, Siempos, II, Tsangaris I, Tsantes A, Armaganidis A. Procalcitonin-guided algorithms of antibiotic therapy in the intensive care unit: a systematic review and meta-analysis of randomized controlled trials. Crit Care Med. 2010;38:2229–2241 Kopterides P, Siempos, II, Tsangaris I, Tsantes A, Armaganidis A. Procalcitonin-guided algorithms of antibiotic therapy in the intensive care unit: a systematic review and meta-analysis of randomized controlled trials. Crit Care Med. 2010;38:2229–2241
Zurück zum Zitat Lassnigg A, Schmid ER, Hiesmayr M, et al. Impact of minimal increases in serum creatinine on outcome in patients after cardiothoracic surgery: do we have to revise current definitions of acute renal failure? Crit Care Med. 2008;36:1129–1137 CrossRef Lassnigg A, Schmid ER, Hiesmayr M, et al. Impact of minimal increases in serum creatinine on outcome in patients after cardiothoracic surgery: do we have to revise current definitions of acute renal failure? Crit Care Med. 2008;36:1129–1137 CrossRef
Zurück zum Zitat Lenkeit S, Ringelstein K, Graff I, Schewe JC. [Medical emergency teams in hospitals]. Medizinische Klinik, Intensivmedizin und Notfallmedizin. 2014;109:257–266 Lenkeit S, Ringelstein K, Graff I, Schewe JC. [Medical emergency teams in hospitals]. Medizinische Klinik, Intensivmedizin und Notfallmedizin. 2014;109:257–266
Zurück zum Zitat Liotta M, Olsson D, Sartipy U, Holzmann MJ. Minimal changes in postoperative creatinine values and early and late mortality and cardiovascular events after coronary artery bypass grafting. Am J Cardiol. 2014;113:70–75 CrossRefPubMed Liotta M, Olsson D, Sartipy U, Holzmann MJ. Minimal changes in postoperative creatinine values and early and late mortality and cardiovascular events after coronary artery bypass grafting. Am J Cardiol. 2014;113:70–75 CrossRefPubMed
Zurück zum Zitat Loekito E, Bailey J, Bellomo R, et al. Common laboratory tests predict imminent medical emergency team calls, intensive care unit admission or death in emergency department patients. Emergency medicine Australasia: EMA. 2013;25:132–139. Loekito E, Bailey J, Bellomo R, et al. Common laboratory tests predict imminent medical emergency team calls, intensive care unit admission or death in emergency department patients. Emergency medicine Australasia: EMA. 2013;25:132–139.
Zurück zum Zitat McGaughey J, Alderdice F, Fowler R, Kapila A, Mayhew A, Moutray M. Outreach and Early Warning Systems (EWS) for the prevention of intensive care admission and death of critically ill adult patients on general hospital wards. Cochrane Database Syst Rev. 2007:CD005529 McGaughey J, Alderdice F, Fowler R, Kapila A, Mayhew A, Moutray M. Outreach and Early Warning Systems (EWS) for the prevention of intensive care admission and death of critically ill adult patients on general hospital wards. Cochrane Database Syst Rev. 2007:CD005529
Zurück zum Zitat Niven DJ, Bastos JF, Stelfox HT. Critical care transition programs and the risk of readmission or death after discharge from an ICU: a systematic review and meta-analysis. Crit Care Med. 2014;42:179–187 CrossRefPubMed Niven DJ, Bastos JF, Stelfox HT. Critical care transition programs and the risk of readmission or death after discharge from an ICU: a systematic review and meta-analysis. Crit Care Med. 2014;42:179–187 CrossRefPubMed
Zurück zum Zitat Porter CJ, Juurlink I, Bisset LH, Bavakunji R, Mehta RL, Devonald MAJ. A real-time electronic alert to improve detection of acute kidney injury in a large teaching hospital. Nephrol Dial Transplant. 2014;29:1888–1893 CrossRefPubMed Porter CJ, Juurlink I, Bisset LH, Bavakunji R, Mehta RL, Devonald MAJ. A real-time electronic alert to improve detection of acute kidney injury in a large teaching hospital. Nephrol Dial Transplant. 2014;29:1888–1893 CrossRefPubMed
Zurück zum Zitat Ray EM, Smith R, Massie S, et al. Family alert: implementing direct family activation of a pediatric rapid response team. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2009;35:575–580 Ray EM, Smith R, Massie S, et al. Family alert: implementing direct family activation of a pediatric rapid response team. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2009;35:575–580
Zurück zum Zitat Schein RM, Hazday N, Pena M, Ruben BH, Sprung CL. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest. 1990;98:1388–1392 CrossRefPubMed Schein RM, Hazday N, Pena M, Ruben BH, Sprung CL. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest. 1990;98:1388–1392 CrossRefPubMed
Zurück zum Zitat Schiemann A, Hadzidiakos D, Spies C. Managing ICU delirium. Curr Opin Crit Care. 2011;17:131–140 CrossRefPubMed Schiemann A, Hadzidiakos D, Spies C. Managing ICU delirium. Curr Opin Crit Care. 2011;17:131–140 CrossRefPubMed
Zurück zum Zitat Smith GB. In-hospital cardiac arrest: is it time for an in-hospital 'chain of prevention'? Resuscitation. 2010;81:1209–1211 CrossRefPubMed Smith GB. In-hospital cardiac arrest: is it time for an in-hospital 'chain of prevention'? Resuscitation. 2010;81:1209–1211 CrossRefPubMed
Zurück zum Zitat Smith AF, Wood J. Can some in-hospital cardio-respiratory arrests be prevented? A prospective survey. Resuscitation. 1998;37:133–137 CrossRefPubMed Smith AF, Wood J. Can some in-hospital cardio-respiratory arrests be prevented? A prospective survey. Resuscitation. 1998;37:133–137 CrossRefPubMed
Zurück zum Zitat Steil GM, Deiss D, Shih J, Buckingham B, Weinzimer S, Agus MS. Intensive Care Unit Insulin Delivery Algorithms: Why So Many? How to Choose? Journal of diabetes science and technology. 2009;3:125–140 CrossRefPubMedCentralPubMed Steil GM, Deiss D, Shih J, Buckingham B, Weinzimer S, Agus MS. Intensive Care Unit Insulin Delivery Algorithms: Why So Many? How to Choose? Journal of diabetes science and technology. 2009;3:125–140 CrossRefPubMedCentralPubMed
Zurück zum Zitat Thomas M, Sitch A, Dowswell G. The initial development and assessment of an automatic alert warning of acute kidney injury. Nephrol Dial Transplant. 2011;26:2161–2168 CrossRefPubMed Thomas M, Sitch A, Dowswell G. The initial development and assessment of an automatic alert warning of acute kidney injury. Nephrol Dial Transplant. 2011;26:2161–2168 CrossRefPubMed
Zurück zum Zitat Winters BD, Weaver SJ, Pfoh ER, Yang T, Pham JC, Dy SM. Rapid-response systems as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158:417–425 CrossRefPubMed Winters BD, Weaver SJ, Pfoh ER, Yang T, Pham JC, Dy SM. Rapid-response systems as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158:417–425 CrossRefPubMed
Zurück zum Zitat Wood KA, Ranji SR, Ide B, Dracup K. Rapid response systems in adult academic medical centers. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2009;35:475–482 Wood KA, Ranji SR, Ide B, Dracup K. Rapid response systems in adult academic medical centers. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2009;35:475–482
Zurück zum Zitat Weisbord SD, Chen H, Stone RA, et al. Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography. J Am Soc Nephrol. 2006;17:2871–2877 CrossRefPubMed Weisbord SD, Chen H, Stone RA, et al. Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography. J Am Soc Nephrol. 2006;17:2871–2877 CrossRefPubMed
Metadaten
Titel
Das Medizinische Notfallteam – Beispiel für ein Alarm-basiertes Interventionsteam
verfasst von
Felix Kork
Claudia Spies
Michael Haase
Copyright-Jahr
2015
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-642-45080-8_4

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