emergency service
Emergency medical service (CHG), and General Medical emergency service , medical service , medical emergency , even in Germany cash emergency medical service , contract medical emergency (falling) service or cash medical service (KAB), in Austria doctors radio service (AEFD), in international usage duty standby called, is a Representation of the attending physician or the family doctor outside of normal consultation hours and is intended for illnesses whose treatment cannot wait until the next working day.
The medical emergency service treats patients whose illness is too urgent to wait until the next regular consultation hour of a doctor, but not so urgently that it is necessary to notify the emergency services . The emergency medical service is often performed by resident doctors.
Emergency service centers
Since the medical emergency service is usually carried out by changing doctors with different areas of responsibility, there is usually an emergency service center as the first point of contact for patients.
The tasks of emergency service centers are:
- Placement of substitute doctors for the family doctor
- Telephone consultations
- Coordination of the substitute doctors who make house calls, announcement of open doctor's offices and emergency offices at certain times.
Emergency services also keep contact with the emergency services and the emergency rooms of hospitals and refer cases of medication at night and willingness pharmacies .
Differentiation from the emergency doctor
Due to the similarity of names, the medical emergency service is often confused with the emergency doctor , who is part of the rescue service. Similarly, the patients of the medical emergency service are often confused with emergency patients .
The medical emergency service is provided by resident doctors from almost all disciplines. He represents the general practitioners outside their regular opening hours. Accordingly, the emergency medical service is the contact in urgent but not acutely life-threatening cases. Depending on the requirements, care is provided in the premises of the medical emergency service or as a home visit. Depending on the local organization and the number of patients, a home visit usually takes place within one to three hours.
The care of acute life-threatening illnesses, however, is the responsibility of the emergency doctor in cooperation with the rescue service personnel. In contrast to the medical emergency service, emergency doctors are specially trained in emergency medicine and, depending on the federal state, must have acquired the emergency medical service certificate or the additional qualification in emergency medicine . The emergency doctor can be reached around the clock and must be able to reach the site within a few minutes of receiving the emergency call, the so-called assistance period .
With a few exceptions, the medical emergency service is organizationally separated from the rescue service.
Demarcation from the emergency room
Most hospitals have an emergency room as a continuously open ambulance service. The medical emergency service specifically means the extramural sector, i.e. outside the hospitals. This involves general medical diagnostics, serious emergencies are forwarded to the ambulance service, which then takes over the transfer to the emergency room. The emergency medical service is also intended to relieve the hospitals' outpatient departments of minor cases that are not part of the core competence of the hospital, such as inpatient treatment .
In particular, the emergency department is to be separated from the emergency practices of the medical emergency service. In many places, the emergency medical service is provided by central emergency practices. These are often located on the premises or within a hospital, but organizationally separated from the emergency room.
If this organizational and spatial separation of outpatient emergency care has been abolished, one speaks of a portal practice . Hospital employees and employees of the Association of Statutory Health Insurance Physicians sit next to each other at a counter or counter. Here, the common triage takes place with the aim of properly forwarding the patient either to the hospital outpatient department ( central emergency room ) or to the resident doctor on duty , usually in the adjoining room ("emergency service practice"). In both cases, in- patient hospital treatment can then be prescribed by the respective doctor . There is a common waiting area for the patients. In times of low traffic, the counter activities at reception, including triage, are sometimes even carried out by a medical assistant alone.
National
Germany
Every resident doctor in Germany is obliged to participate in the emergency medical service. The legal basis are the health professions laws of the federal states, which establish this public service obligation. The further details are regulated in the professional regulations of the medical associations and in the emergency service regulations. The medical emergency service in Germany is also part of the freezing order, the doctors 'associations under Section 75 paragraph 1 SGB V. (therefore it is called in Germany often from the so-called. Kassenärztlichen emergency or physicians' emergency service ).
Other expressions for this are: General medical emergency or emergency or standby service or collegial general practitioner substitute service outside of the normal working hours of the practice. In the GDR , the service was called Urgent Home Visiting Service - DHD . It was a Rapid Medical Aid Division - SMH .
Because of the risk of confusion with the ambulance or emergency medical service , the National Association of Statutory Health Insurance Physicians has switched to speaking of the medical "on-call service". "Emergency service" is still in the legal texts.
Accessibility by telephone
In almost all federal states there are meanwhile state-wide switching centers for the mediation of the medical on-call service (e.g. Thuringia, Bavaria, Hesse, Brandenburg, Schleswig-Holstein, Saxony). The nationwide uniform number 116117 has been in existence since April 2012 .
In urgent but not life-threatening cases outside of normal practice hours, callers can use the nationwide number 116117 to refer to a general practitioner on call in their area , according to the postal code . The phone number is free of charge from both landline and mobile networks. A fax form is available for the hearing and speech impaired.
The number 116117 was reserved throughout the EU by the European Commission in 2009 for on-call duty for medical assistance in non-life-threatening situations. The initiative came from the Brandenburg Association of Statutory Health Insurance Physicians. In Germany this number was assigned to the National Association of Statutory Health Insurance Physicians. Germany is the first country in the EU to introduce the number.
The number was launched nationwide on April 16, 2012. The number was later activated in Baden-Württemberg, Saarland and parts of Rhineland-Palatinate and Hesse.
The emergency medical service also makes house calls if necessary; the decision about the actual necessity is up to the doctor's assessment. Usually ambulatory patients are called to the practice. The emergency practices can be visited during opening hours without prior registration. Exceptions are emergency medical consultations; these specialists (e.g. pediatricians, ophthalmologists and ENT doctors) usually arrange the treatment appointment with the patient by telephone.
In recent years, numerous centrally located emergency practices have been established across Germany, with at least two doctors on duty, one for the patients who come to the practice and one for home visits. The emergency practices can usually be visited without making an appointment in advance.
The costs for using the medical emergency service are billed as for a normal doctor's visit and borne by the patient's statutory health insurance or private health insurance .
In contrast to the ambulance service, the costs for operating the infrastructure, e.g. B. Premises and facilities for emergency practices and call centers, vehicles and non-medical employees, not provided by health insurances or public bodies such as districts, cities and municipalities, but allocated monthly to the doctors who are obliged to perform emergency services and these are either directly from the fee statements of the statutory health insurance associations deducted or sent as a notification of fees for doctors who work exclusively in private practice. Only the travel costs in the so-called driving service are reimbursed; the doctors give in billing (including rallies at (distance between pick-up location of the doctor and patient's home)) so-called double kilometers.
Austria
In addition to the actual rescue service (with emergency doctors ), the Medical Radio Service ( ÄFD ) or medical emergency service with the emergency number 141 has existed in Austria since 1968 , which is operated by the Austrian Medical Association or the Austrian Red Cross , but not nationwide. In Tyrol , the corresponding facility is called a general medical on- call service.
In Vienna, you are cared for by general practitioners via the emergency number 141, who clarify reported complaints and illnesses in advance or advise patients. If necessary, a home visit is made, whereby these doctors are usually supported in their work by a paramedic (also a driver). In Linz, the supply works in the same way.
In Lower Austria, the emergency calls 141 and 144 were merged in 2010 after allegations of diagnostic errors, so that both emergency numbers are handled equally by the 144 Lower Austria emergency call . Since April 1, 2013, the Europe-wide service call 116 117 for the emergency call Lower Austria has been activated.
Web links
Individual evidence
- ↑ Willibald Pschyrembel: Clinical Dictionary . 267th edition. De Gruyter, Berlin / Boston 2017, ISBN 978-3-11-049497-6 , p. 1282.
- ↑ Emergency numbers. City of Erkrath, accessed on January 28, 2015 : "Medical emergency service: for Alt-Erkrath and Unterfeldhaus: Central emergency practice (in the Evgl. Düsseldorf hospital)"
- ↑ Sibylle Raudies: "Portal practice for emergencies at Bergmannsheil as a model", in: Westdeutsche Allgemeine Zeitung (WAZ.de) of October 10, 2017 ("common registration counter", " a reception counter for the hospital emergency department and the emergency services of the resident doctors") ).
- ↑ Information page of the Association of Statutory Health Insurance Physicians and the National Association of Statutory Health Insurance Physicians
- ↑ Medical on-call service Fax form for the hearing and speech impaired for non-life-threatening situations
- ↑ Decision of the EU Commission 2009/884 / EG (PDF) , accessed on April 16, 2012
- ↑ tagesschau.de ( Memento from April 12, 2012 in the Internet Archive ), accessed on April 10, 2012
- ↑ http://www.aeiou.at/aeiou.stamp.1993.930219a
- ^ Wiener Ärztefunkdienst ( Memento from January 4, 2010 in the Internet Archive ) , aekwien.at
- ↑ Emergency numbers 141 and 144 merged on ORF Niederösterreich of June 29, 2010, accessed on April 10, 2012
- ^ Introduction of the standardized EU number 116 117 on the Lower Austria emergency number , accessed on October 6, 2013
