[Strategies for quality assessment of emergency helicopter rescue systems. The Graz model].
OBJECTIVE
Preclinical emergency medical treatment necessitates a comprehensive interdisciplinary knowledge by the emergency physician as well as a high level of manual dexterity. The quality of treatment therefore depends on the level of education and continuous training in emergency medical techniques. Based on an evaluation of the frequency of life-saving interventions by a physician-staffed rescue helicopter system, strategies for in-hospital training of relevant skills are suggested.


METHODS
At the outset, 10 important areas of treatment (e.g. intubation, chest tube etc.) and their frequency in emergency medical services were defined as the standard to be attained by emergency physicians within 1 year. The selection of the areas of treatment was based to some extent on international recommendations. The actual frequencies of the prehospital interventions were compared to the required minimum numbers by retrospective analysis of the helicopter rescue database (NACA-X).


RESULTS
During the observation period of 1 year, 20 emergency physicians responded to 956 prehospital emergency calls. A life-threatening condition requiring an on-site intervention occurred in only 521 (54.5%) patients, so that the majority of physicians did not perform the required minimum number of interventions. In order to maintain their level of skill, the emergency physicians were required to undertake additional training at the local university hospital.


CONCLUSIONS
The frequency of on-site life-saving interventions in emergency medicine is insufficient to fulfill the quota necessary to maintain adequate training of emergency physicians. Only a link-up program at a hospital for primary care can ensure an adequate training level.
Prause
G
G
Universitätsklinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Graz, Auenbruggerplatz 29, 8036 Graz, Osterreich. gerhard.prause@meduni-graz.at
Wildner
G
G
Kainz
J
J
Bössner
T
T
Gemes
G
G
Dacar
D
D
Magerl
S
S
D017732:Air Ambulances / Q000592:standards*; D002983:Clinical Competence; D016208:Databases, Factual; D004632:Emergency Medical Services; D006801:Humans; D010820:Physicians; D011785:Quality Assurance, Health Care; D018635:Rescue Work / Q000592:standards*; D012189:Retrospective Studies