Aktuelle Ergebnisse notfallmedizinischer Forschung 2013/2014

Kernaussagen

• Patienten nach Reanimation profitieren nicht unbedingt von dem frühen Beginn einer prähospitalen Kühlung. Die Zieltemperatur scheint eine Rolle zu spielen.

• Supraglottische Atemwegshilfen können zum Einsatz kommen, wenn der Notarzt oder das Rettungsdienstfachpersonal wenig Routine mit der ETI besitzt und ein Intubationsversuch wenig Aussichten auf Erfolg bietet.

• Morphin verhindert u. U. die Wirkung von Clopidogrel beim akuten Myokardinfarkt.

• Eine einheitlich anwendbare Definition des kritisch Schwerverletzten bedarf noch weiterer Überprüfungen und Modifikationen der einzelnen Kriterien, um die sehr heterogene Gruppe der Traumapatienten für epidemiologische, ökonomische und qualitätsmanagementbezogene Fragestellungen ausreichend gut differenzieren zu können.

• Eine unzureichende bzw. fehlende Blutungskontrolle ist in der Versorgung von Schwerverletzten die Hauptursache der vermeidbaren Todesfälle.

• Ein negatives CT nach relevantem Unfallmechanismus ist kein Ersatz für klinische Überwachung und Verlaufskontrollen.

• Für ein Schockraum-CT spricht, dass eine kurze Distanz vom Schockraum zum CT ein unabhängiger Prädiktor für ein besseres Überleben ist. Der Vorteil könnte darin bestehen, dass sich dadurch auch die Wege zu einer lebensrettenden Intervention verkürzen.

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