Zusammenfassung
Das akute Koronarsyndrom stellt eine der häufigsten Indikationen im Notarztdienst
dar. Zeigen sich im EKG ST-Hebungen, weist dies auf einen akuten Herzinfarkt hin,
bei dem keine Zeit verloren werden darf. Ziel ist eine möglichst rasche Rekanalisierung
des verschlossenen Infarktgefäßes. Das in Deutschland verfügbare, notarztbegleitete
Rettungssystem bietet ausgezeichnete Vorraussetzungen für die Durchführung einer prähospitalen
Thrombolyse bei akutem Herzinfarkt. Bis heute ist diese jedoch nur in wenigen Zentren
etabliert. Vor allem bei eingeschränkter Verfügbarkeit einer Akutintervention sehen
die aktuellen Leitlinien der kardiologischen Gesellschaften eine prähospitale Thrombolyse
als erforderlich an. Im Landkreis Sömmerda wurde erstmals im Land Thüringen die prähospitale
Thrombolyse bei akutem Herzinfarkt als Kooperation zwischen Rettungsdienst und Internisten
flächendeckend etabliert. Bei bisher 57 behandelten Patienten erwies sich die prähospitale
Thrombolyse als sicher und gut durchführbar.
Summary
Acute coronary syndrome is one of the most common problems encountered by the emergency
physician. If the ECG reveals ST-segment elevations, an acute infarction must be presumed,
which brooks no further delay. The immediate aim is the fastest possible recanalisation
of the occluded arteries. The Germany emergency medical rescue system with emergency
physician offers an excellent basis for the implementation of prehospital thrombolysis
in acute infarction cases. Currently, however, this has been established in only a
few centres. The current guidelines of the cardiological societies consider prehospital
thrombolysis mandatory, in particular in view of the limited availability of acute
intervention options. For the first time in Thuringia, in the Landkreis of Sömmerda,
prehospital thrombolysis in acute myocardial infarction has been established throughout
the entire region in the form of cooperation between the emergency medical rescue
service and internists. To date, 57 patients have been so treated, and prehospital
thrombolysis has been shown to be both safe and readily implementable.
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Anschrift des Verfassers
PD Dr. med. Gerhard Oltmanns
DRK-Krankenhaus Sömmerda gGmbH
Abteilung für Innere Medizin
Bahnhofstr. 36
99610 Sömmerda