Treatment of severely injured patients by emergency physicians from different medical specialties : A retrospective multicenter investigation of data from the ADAC Air Recue Service and the German TraumaRegister DGU

• Published in: Der Unfallchirurg Vol. 125; no. 12; pp. 967 - 974
• Main Authors: Gäßler, Michael, Ruppert, Matthias, Lefering, Rolf, Bouillon, Bertil, Wafaisade, Arasch
• Format: Journal Article
• Language: German
• Published: Germany 01.12.2022
• Subjects: Emergency service; Intubation; Polytrauma; Medical specialty; Emergency medicine
• ISSN: 1433-044X; 2731-703X
• DOI: 10.1007/s00113-021-01094-4

The level 3 guidelines on treatment of patients with severe/multiple injuries provide a defined framework for an appropriate treatment of these patients. It is presumed that prehospital diagnostic and therapeutic decisions are affected by the clinical expertise and the medical disciplines of the emergency physicians. Retrospective, multicenter study based on data from the ADAC Air Recue Service and the TraumaRegister DGU®. In the study period 2011-2015, a total of 11,019 seriously injured patients were included. They were treated by emergency physicians from the following disciplines: anesthesiology (ANÄ), internal medicine (INN) and surgery (CHIR). Of the patients 81.9% were treated by ANÄ, 7.6% by INN and 10.5% by CHIR. Preclinically, 40.5% of patients were intubated (ANÄ 43.0%, INN 31.2%, CHIR 28.3%; p < 0.001), 5.5% received pleural decompression (ANÄ 5.9%, INN 4.2%, CHIR 2.8%; p = 0.004),and 10.8% were treated with catecholamines (ANÄ 11.3%, INN 8.3%, CHIR 8.3%; p = 0.022). Unconscious patients were intubated in 96.0% (ANÄ 96.1%, INN 97.7%, CHIR 93.9%; p = 0.205). The mortality was not influenced by the medical specialty of the emergency physician. In this air rescue cohort differences in indications for invasive procedures were observed between the groups. This may be caused by their clinical background. Using the example of intubation, it has been shown that guideline recommendations were closely followed irrespective of the medical specialty of the emergency physician.