T Viergutz1, O Rohrer, C Weiss, J Braun, A Kalenka. 1. Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland, tim.viergutz@umm.de.
Abstract
BACKGROUND: Over the past decade the number of air rescue missions has increased continuously. The reasons for this are still discussed at great length. In addition to the demographic changes to becoming an increasingly older and sicker society, the political reform in the healthcare system with a simultaneous reduction and concentration of hospitals and formation of centers is also under discussion. AIM: The key questions to be answered are, therefore, can the increasing demands on the emergency physician really be explained by an increasing number of severely ill and injured patients? Is a proportion of the missions really not indicated because they do not involve immediately life-threatening "acute medical" emergencies and are caused by a lack of alternative paramedical service infrastructures, unavailability of a general practitioner or the only temporary availability of medical on-call standby services? MATERIAL AND METHODS: This study therefore analyzed the alterations of a possible change with respect to the spectrum of missions and the utilization of air rescue services in the metropolitan area of Stuttgart. All primary missions of the rescue helicopter (RTH) "Christoph 41" (based in Leonberg) from 2006 to 2011 were included in the study and compared to the data from 1987 to 1992. RESULTS: The indications for missions and the spectrum of patients for the RTH Christoph 41 have changed over the last 25 years. The proportion of emergency trauma cases has significantly decreased and missions for non-trauma cases have increased. The proportion of patients with life-threatening conditions has increased. Despite the change in the spectrum of missions, emergency physicians are confronted with a greater number of patients with life-threatening conditions than 25 years ago. The patients treated were on average clearly older than the patients who were treated by the air rescue service 25 years ago. CONCLUSION: The changes in the spectrum of missions up to more emergencies involving non-trauma patients and older patients must be taken into consideration during training and advanced training.
BACKGROUND: Over the past decade the number of air rescue missions has increased continuously. The reasons for this are still discussed at great length. In addition to the demographic changes to becoming an increasingly older and sicker society, the political reform in the healthcare system with a simultaneous reduction and concentration of hospitals and formation of centers is also under discussion. AIM: The key questions to be answered are, therefore, can the increasing demands on the emergency physician really be explained by an increasing number of severely ill and injured patients? Is a proportion of the missions really not indicated because they do not involve immediately life-threatening "acute medical" emergencies and are caused by a lack of alternative paramedical service infrastructures, unavailability of a general practitioner or the only temporary availability of medical on-call standby services? MATERIAL AND METHODS: This study therefore analyzed the alterations of a possible change with respect to the spectrum of missions and the utilization of air rescue services in the metropolitan area of Stuttgart. All primary missions of the rescue helicopter (RTH) "Christoph 41" (based in Leonberg) from 2006 to 2011 were included in the study and compared to the data from 1987 to 1992. RESULTS: The indications for missions and the spectrum of patients for the RTH Christoph 41 have changed over the last 25 years. The proportion of emergency trauma cases has significantly decreased and missions for non-trauma cases have increased. The proportion of patients with life-threatening conditions has increased. Despite the change in the spectrum of missions, emergency physicians are confronted with a greater number of patients with life-threatening conditions than 25 years ago. The patients treated were on average clearly older than the patients who were treated by the air rescue service 25 years ago. CONCLUSION: The changes in the spectrum of missions up to more emergencies involving non-traumapatients and older patients must be taken into consideration during training and advanced training.
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