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Citation
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Unterpertinger R, Schmelzer P, Martini J, Putzer G, Gasteiger L, Thaler M, Hell T, Voelckel W. Anaesthesiologie 2022; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Tyrol, a province of Austria with about 760,000 inhabitants, was one of the first regions in Europe, along with northern Italy, to be affected by the pandemic spread of the coronavirus in spring 2020. A lockdown with far-reaching restrictions in all areas of life occurred from 16 March 2020. Restrictions were imposed in the areas of gastronomy, trade and free mobility as well as in recreational sports. The ski resorts were closed and due to the strong winter tourism in Tyrol, this meant that about 340,000 people left the region. In the province of Tyrol comprehensive emergency medical care is provided by 13 ground-based emergency medical systems (NEF) in combination with air rescue (16 emergency medical helicopters, some of which are seasonal). Normally, this system provides emergency medical care for approx. 1 million people; however, in spring 2020 during the first lockdown, the number of people to be cared for was approx. 30% less. In order to protect the emergency medical teams as best as possible from infections and thus the system from failures, the Integrated Control Center Tyrol (Landesleitstelle Tirol GmbH) adapted the release order for emergency medical resources. The aim of the study is to describe the influence of the pandemic in spring 2020 on the emergency medical services in Tyrol in comparison to the three preceding years.
METHODS: A retrospective survey of all emergency helicopter missions and ground-based emergency physician missions in Tyrol in the period 15 March 2020-15 May 2020, as well as in the same period of the previous years 2017-2019, was conducted. Detailed figures on medical procedures and patient-related data were collected from 6 ÖAMTC helicopter bases. In addition, all ground-based emergency physician missions from all 13 physician systems including appeal mission diagnoses were collected in the same period.
RESULTS: The total number of emergency helicopter missions and ground-based emergency physician missions showed a significant decrease during the observational period (67.3% and 39.8%, respectively). In the area of ground-based emergency medical resources, there was a significant increase in respiratory and CNS diseases during the observational period. The range of emergency helicopter missions showed a significant shift from sports and leisure missions to internal medicine and neurological emergencies and the duration of missions was significantly longer. The NACA score was higher with a significant decrease in NACA 3 scores in favor of NACA 4 and 5. The circulatory status of patients during the observational period was significantly more often documented as unstable. Hypertension, impending shock and circulatory arrest occurred more frequently in the trend. Cardiac massage, oxygen administration, circulatory drugs and specific monitoring were used more frequently in 2020. Analgesics were administered less frequently. In air rescue, there was no infection of rescue workers in the field.
CONCLUSION: The first pandemic wave in Tyrol and the consecutive lockdown from 16 March 2020 had a massive impact on emergency medical care in Tyrol, both quantitatively and in terms of the spectrum of operations and emergency medical interventions. The decline in patient numbers was highly relevant, especially in air rescue and can be explained in part by the discontinuation of tourism, the general exit restrictions and the restrictive disengagement order. This decline primarily affected patients in the NACA 3 category and the analgesic administration measure. The patients treated had a higher NACA score and the emergency procedures were more extensive during the observational period. The measures to protect the emergency helicopter team from infections were presumably successful as no infections occurred.
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Hintergrund
Während der ersten Phase der COVID-19-Pandemie im Frühjahr 2020 erfolgte in Tirol (Österreich) ein Lockdown ab dem 16.03.2020 mit weitreichenden Einschränkungen in allen Lebensbereichen.
Ziel der Untersuchung ist die Darstellung des Einflusses der Pandemie im Frühjahr 2020 auf die Notarzteinsätze in Tirol im Vergleich zu den 3 vorangehenden Jahren.
Methoden
Es erfolgte eine retrospektive Erhebung der gesamten Notarzthubschraubereinsätze und bodengebundenen Notarzteinsätze in Tirol im Zeitraum vom 15.03.2020 bis zum 15.05.2020 sowie in den gleichen Zeiträumen der Vorjahre 2017-2019. Detaillierte Zahlen zu medizinischem Vorgehen und patientenbezogene Daten wurden von 6 Hubschrauberstützpunkten des ÖAMTC erfasst. Außerdem wurden die Einsatzdiagnosen der bodengebundenen Notarztmittel erfasst.
Ergebnisse
Die Gesamtzahl der Notarzthubschraubereinsätze und bodengebundenen Notarzteinsätze aller Stützpunkte zeigte im Beobachtungszeitraum einen signifikanten Rückgang. Das Einsatzspektrum der betrachteten Notarzthubschrauber zeigte eine signifikante Verschiebung hin zu internistischen und neurologischen Notfällen; der NACA-Score war höher. Analgetikagabe fand seltener statt. In der Luftrettung kam es zu keiner Ansteckung von Rettungskräften im Einsatzbetrieb.
Schlussfolgerung
Die erste COVID-19-Pandemie-Welle im Frühjahr 2020 in Tirol zeigte sowohl quantitativ als auch in Bezug auf Einsatzspektrum und notärztliche Maßnahmen deutliche Auswirkungen auf die Notarzteinsätze. Der Rückgang der Patientenzahlen betraf v. a. die Luftrettung. Der Rückgang betraf primär Einsätze im Sport- und Freizeitbereich (NACA 3), allen voran die Maßnahme der Analgetikaverabreichung. Im bodengebundenen Bereich kam es zu einer Umverteilung der Notarzteinsätze auf die RTW bei gleicher Gesamtzahl der Rettungseinsätze.
Language: de |