Prähospitale Kapnometrie als Qualitätsindikator der Schwerverletztenversorgung Eine erste Auswertung aus dem TraumaRegister DGU

Wilharm, A.; Kulla, M.; Baacke, M.; Wagner, F.; Behnke, M.; Lefering, R. und Trentzsch, H. (2019): Prähospitale Kapnometrie als Qualitätsindikator der Schwerverletztenversorgung Eine erste Auswertung aus dem TraumaRegister DGU. In: Anasthesiologie & Intensivmedizin, Bd. 60: S. 419-432

Abstract

Background: The end-tidal capnometry allows the continuous position control of the endotracheal tube and ventilation of ventilated trauma patients. It is of high value for quality and safety. The Trauma-Register DGU (R) has recently registered its prehospital application. The aim of this study is to explore application and effects of prehospital capnometry. Methods: The database is the Trauma-Register DGU (R). Inclusion criteria were admission via the shock room and complete information on airway management. Documentation completeness, frequency and type of application as well as effects of capnometry on clinical course and outcome were analysed descriptively. To identify situations that affect the frequency of use, subgroups have been formed (e.g. rescue facilities, injury pattern, injury severity, prehospital care time, etc.). Additionally, the consequences of a lack of capnometry on the clinical course and outcome were analysed. Results: 43,470 cases were included. Data on prehospital capnometry were available in 62.3%. The frequency of use in 27,099 cases was as follows: 82.9% after endotracheal intubation and 26.9% after alternative airway management using the supraglottic airway. This is independent of means of transport and injury patterns. Significant effects on clinical outcome, outcome or lethality could not be established. A significant impact on clinical course, outcome and mortality could not be proven. However, there is a tendency for higher mortality when prehospital capnometry is not used and patients had severe craniocerebral injuries. Conclusions: Although current guidelines recommend capnometry for the monitoring of ventilated trauma patients, it has to be stated that capnometry has either not been documented or not been performed in a relevant percentage of patients, especially when alternative methods of airway management were applied. The degree of fulfilment of this important indicator of care quality and patient safety should be further increased. Their importance must continue to be emphasised in education and training.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0170-5334
• Sprache: Deutsch