Telemedizin aus dem Notarztwagen verbessert die Versorgungsstruktur bei Herzinfarkt

Zusammenfassung

Die Nutzung der EKG-Telemetrie führt zu einer verbesserten Herzinfarktversorgung [17], [18]. Nur durch eine flächendeckende Etablierung von Herzinfarktnetzen, die qualitätsmäßig überwacht und mit telemetriebasierten Behandlungspfaden ausgestattet sind, kann eine weitere Senkung der Mortalität bei Patienten mit akutem STEMI erreichten werden. Um das Ziel einer flächendeckenden Telemetriemöglichkeit zu gewährleisten, ist auch von den Kostenträgern eine entsprechende Unterstützung gefordert. Die Grundbausteine der Telemedizin aus dem Notarztwagen sind somit vorhandene verlässliche Technik, funktionierende Algorithmen und eine hohe Akzeptanz durch die Beteiligten. Das Erreichte muss durch regelmäßige Feedback-Veranstaltungen und Schulungsmaßnahmen permanent reevaluiert und ggf. angepasst werden.

Abstract

The use of ECG-transmission of patients with STEMI to the cardiology intervention center at first medical contact shortens door-to-balloon times, reduces infarct size, limits ejection fraction reduction and shortens length of hospital stay. Network organization is recommended for optimal STEMI management to offer primary percutaneous intervention (PCI) to the maximum proportion of patients within the recommended time spans. As ECG diagnosis alone lacks on sensitivity and specificity an additional phone contact between EMS (emergency medical system) and interventional center may be recommended. High technical standards as well as acceptance of treatment guidelines in a network organization are prerequisites for successful use of telemedicine. Delays to treatment are the most readily available measurable index of quality of care in STEMI and have to be monitored regularly to ensure that quality of care indicators are met and maintained over time.

Schlüsselwörter

Telemedizin - akutes Koronarsyndrom - STEMI - EKG-Übertragung

Key words

telemedicine - ACS - STEMI - ECG-transmission

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