Feedback number
The response number (RMZ) is a numerical code used in the emergency services of several German federal states. It reflects the condition of a patient at the time of the arrival of a rescue aid and is considered an instrument of quality assurance in the rescue service.
history
Based on a draft by the medical director of the rescue service in the Main-Kinzig district, this aid was introduced in 2005 for quality assurance in the state of Hesse. By decree of the Hessian Ministry of Social Affairs (suspected) diagnoses in the rescue service are categorized by a fixed scheme. This is intended to improve quality assurance in this area.
construction
The RMZ consists of a nine-digit numerical code, which is made up of the so-called feedback indication (RMI, three-digit: basic illness or the injury pattern) and the feedback code (RMC, six-digit: condition of the patient when the rescue aid arrives).
| 1 | 2 | 3 | 4th | 5 | 6th | 7th | 8th | 9 |
| Feedback indication (RMI) | Feedback code (RMC) | |||||||
| awareness | breathing | Cycle | injury | neurology | pain | |||
Amendments
In some cases, districts have introduced different RMZs; so there are B. in the Main-Kinzig district an additional number for the age of the patient and a number for the order of arrival (1 = 1st vehicle at the scene, 2 = 2nd vehicle at the scene, etc.). In addition, another figure for the patient's weight was introduced there in 2007.
For the coordination office for secondary missions of the state (KST); at the Frankfurt am Main fire brigade, 700 numbers were introduced for the RMI.
In Bavaria, the RMZ was introduced on April 1, 2007 for emergency medical services; here it has five positions.
Procedure
Every rescue equipment indicates the RMZ at the end of the deployment or after the deployment to the control center.
All rescue equipment involved in the operation indicate their own RMZ, because the patient's condition may have changed spontaneously between the arrival of the ambulance and the arrival of the emergency doctor. B. improved by measures of the rescue service - the emergency doctor may find a different condition when he arrives. If both rescue devices arrive at the same time, the RMZ will of course not differ significantly.
Coding of feedback indication (RMI)
| Main group | Subgroup | 2nd subgroup | Explanation |
|---|---|---|---|
| Ineligible RMI | |||
| 000 | no patient available | ||
| 110 | primary determination of death (from emergency response) | ||
| 111 | Inquest (planned) | ||
| 121 | Rea attempt without ROSC * | ||
| 122 | .... with ROSC * (death at EO) | ||
| 123 | .... with ROSC * (then death on transport) | ||
| resuscitation | |||
| 124 | Resuscitation ongoing | ||
| 130 | Resuscitation successful | ||
| Injuries / accidents | |||
| Intensive surgery | |||
| 201 | Transfer intensive care with doctor | ||
| 202 | Transfer to intensive care without a doctor | ||
| Surgery IMC | |||
| 203 | Postponement of IMC with doctor | ||
| 204 | Postponement of IMC without a doctor | ||
| Neurosurgery - Intensive | |||
| 205 | Transfer intensive care with doctor | ||
| 206 | Transfer to intensive care without a doctor | ||
| Multiple | |||
| 210 | other combined injuries | ||
| 211 | Multiple trauma with TBI | ||
| 212 | Multiple trauma without TBI | ||
| 213 | Emergency room indication after the accident | ||
| head | |||
| 214 | Face / head injury | ||
| 215 | Face / head injury with eye involvement | ||
| 216 | Face / head injury with ENT or maxillofacial involvement | ||
| 221 | Head SHT open | ||
| 222 | Head SHT closed | ||
| thorax | |||
| 230 | other thoracic surgical injuries | ||
| 231 | Thorax penetrating | ||
| 232 | Thorax closed / blunt | ||
| 233 | Pneumothorax | ||
| abdomen | |||
| 240 | other visceral surgical emergencies | ||
| 241 | Penetrating abdomen | ||
| 242 | Abdomen closed / blunt | ||
| 243 | acute abdomen (not traumatic) | ||
| 244 | appendicitis | ||
| Spine | |||
| 251 | with neurological failures | ||
| 252 | without neurological failures | ||
| 253 | WS / disc not traumatic with neurological failures | ||
| 254 | WS / disc not traumatic without neurological deficits | ||
| pool | |||
| 261 | Pelvis penetrating | ||
| 262 | Pelvis closed / blunt | ||
| Limbs / bruise / dislocation | |||
| 270 | other combined limb injuries | ||
| 271 | Extremities open | ||
| 272 | Extremities closed | ||
| 273 | Femoral neck | ||
| 274 | dislocation | ||
| hand | |||
| 275 | Hand injury | ||
| 276 | Hand amputation | ||
| 277 | Finger amputation | ||
| 278 | Limb amputation | ||
| Physically / chemically | |||
| 281 | Burns / scalds | ||
| 282 | Chemical burns (external) | ||
| 283 | Lightning strike / high voltage trauma | ||
| vessel | |||
| 290 | other vascular surgical emergencies | ||
| 291 | Extremities with vascular / nerve damage | ||
| 292 | Aortic aneurysm | ||
| 293 | Ischemia of extremities (acute) | ||
| Diseases | |||
| Internal medicine - intensive | |||
| 301 | Transfer intensive care with doctor | ||
| 302 | Transfer to intensive care without a doctor | ||
| Internal Medicine - IMC | |||
| 303 | Postponement of IMC with doctor | ||
| 304 | Postponement of IMC without a doctor | ||
| Breathing / lungs (other) | |||
| 310 | other respiratory emergencies | ||
| 311 | Shortness of breath (unclear) | ||
| 312 | Obstruction (asthma / COPD) | ||
| 313 | Hemoptysis / hemoptysis | ||
| 314 | (Bolus) aspiration | ||
| 315 | Bronchitis / pneumonia | ||
| 316 | Hyperventilation | ||
| 317 | Smoke gas / irritant gas (not 761!) | ||
| 318 | Spontaneous pneumothorax | ||
| 319 | (Nearly) drowning | ||
| Interior (other) | |||
| 320 | other internal emergencies | ||
| 321 | Anaphylaxis / intolerance reaction | ||
| 322 | Syncope / collapse | ||
| 323 | hypertension | ||
| 324 | Hypotension | ||
| 325 | thrombosis | ||
| 326 | unclear fever | ||
| 327 | Heat exhaustion / heat stroke | ||
| 328 | Hypothermia / frostbite | ||
| 329 | Desiccosis | ||
| cardiology | |||
| 330 | other cardiac emergencies | ||
| 331 | STEMI <12h (ECG secured) | ||
| 332 | STEMI> 12h (ECG secured) | ||
| 333 | acute coronary syndrome (other) | ||
| 341 | Arrhythmia / rhythm disturbances | ||
| 342 | bradycardiac arrhythmias | ||
| 343 | tachycardiac arrhythmias | ||
| 344 | Electrical accident (low current) | ||
| 347 | cardiogenic shock | ||
| 348 | Heart failure / pulmonary edema | ||
| 349 | Pulmonary embolism | ||
| Gastroenterological | |||
| 350 | other gastroenterological emergencies | ||
| 351 | upper GI bleeding | ||
| 352 | lower GI bleeding | ||
| 353 | unclear abdomen (not 243) | ||
| 354 | infectious gastroenteritis | ||
| 355 | other gastroenteritis | ||
| 356 | Chemical burn / ingestion (internal) | ||
| 357 | Colic (not 711!) | ||
| Intoxications | |||
| 360 | other intoxications | ||
| 361 | alcohol | ||
| 362 | Drugs / narcotics | ||
| 363 | Mixed intoxication alcohol / drugs / medication | ||
| 364 | Food | ||
| 365 | Medication | ||
| 366 | Pesticides | ||
| 367 | animal poisons / poisonous plants | ||
| Infections | |||
| 370 | other infectious emergencies | ||
| 371 | defined infectious disease | ||
| 372 | meningitis | ||
| 373 | TBC | ||
| 374 | septic shock | ||
| Highly contagious | |||
| 379 | highly contagious disease | ||
| Diabetology | |||
| 391 | diabetic emergency | ||
| 392 | Hyperglycemia | ||
| 393 | Hypoglycemia | ||
| neurology | |||
| Neurology - Intensive | |||
| 401 | Transfer intensive care with doctor | ||
| 402 | Transfer to intensive care without a doctor | ||
| Neurology - Diseases | |||
| 410 | other neurological emergencies | ||
| 411 | Seizure with known convulsions | ||
| 412 | first-time seizure | ||
| 413 | Headache | ||
| 414 | unclear unconsciousness | ||
| Apoplexy / TIA / cerebral bleeding | |||
| 421 | Apoplexy / TIA / bleeding <6 h | ||
| 422 | Apoplexy / TIA / bleeding 6–24 h | ||
| 423 | Apoplexy / TIA / bleeding 24–72 h | ||
| 424 | Apoplexy / TIA / bleeding> 72 h | ||
| psychiatry | |||
| 430 | other psychiatric emergencies | ||
| 431 | Suicide attempt (threatening) | ||
| 432 | Suicide attempt | ||
| 433 | Disorientation | ||
| 434 | psychiatric admission | ||
| 435 | psychiatric admission according to §10 HFEG | ||
| 436 | state of emergency psychiatric | ||
| Paediatrics | |||
| Pediatrics - Intensive | |||
| 501 | Transfer intensive care with doctor | ||
| 502 | Transfer to intensive care without a doctor | ||
| Neonatology | |||
| 503 | Relocation - Incubator | ||
| Pediatric | |||
| 510 | other pediatric emergencies | ||
| 511 | pediatric - shortness of breath | ||
| 512 | Croup / pseudo croup | ||
| 513 | pediatric febrile seizure | ||
| 514 | pediatric epilepsy | ||
| 515 | acute childish hip pain | ||
| Obstetrics | |||
| 520 | other emergencies during pregnancy | ||
| 521 | Delivery / onset of birth <37 weeks of gestation | ||
| 522 | Childbirth / onset of birth> = 37th week of pregnancy | ||
| 523 | premature labor activity | ||
| 524 | preclinical birth | ||
| 525 | preclinical premature birth | ||
| 526 | Eclampsia | ||
| 527 | vaginal bleeding during pregnancy | ||
| Gynecological | |||
| 530 | other gynecological emergencies | ||
| 531 | vaginal bleeding | ||
| 532 | Lower abdominal pain | ||
| 533 | Sex offense | ||
| Other operations and transport | |||
| 601 | Transport to a defined service (KT) | ||
| 602 | dialysis | ||
| 603 | Cardiac catheter | ||
| 604 | CT | ||
| 605 | MRI | ||
| 606 | Endoscopy | ||
| 607 | PEG change | ||
| 608 | Baby carrier | ||
| 621 | Relocation (not intensive) or medical assistance | ||
| 622 | Relocation (not intensive) with the accompaniment of a doctor | ||
| 630 | Return transport | ||
| 631 | Discharge from inpatient treatment (KT) | ||
| 640 | Social assistance (e.g. as part of a home emergency call) | ||
| 650 | Complaint-free person affected (e.g. generally available) | ||
| 660 | other operations without transport | ||
| 670 | other uses with transport | ||
| geriatrics | |||
| 702 | Geriatric induction | ||
| Skin-and venereal diseases | |||
| 703 | Skin-and venereal diseases | ||
| urology | |||
| 710 | other urological emergencies | ||
| 711 | Renal ureteral colic | ||
| 712 | Testicular pain | ||
| 713 | Urinary retention | ||
| 714 | Hematuria | ||
| 715 | Catheter change | ||
| 716 | Condition after catheter loss | ||
| eyes | |||
| 720 | other ophthalmic emergencies | ||
| 721 | Eye injury with foreign body | ||
| 722 | Eye injury without a foreign body | ||
| 723 | acute eye disease | ||
| Throat, nose, ears | |||
| 730 | other ENT emergencies | ||
| 731 | Epistaxis | ||
| 732 | Barotrauma | ||
| 733 | Sudden hearing loss | ||
| Mouth and jaw face | |||
| 741 | MGK briefing | ||
| Nuclear Medicine / Hematology | |||
| 751 | Radiation trauma | ||
| Hyperbaric medicine | |||
| 761 | Carbon monoxide poisoning | ||
| 762 | decompression sickness | ||
| Emergency situations | |||
| 770 | other emergency situation |
ROSC - Return of spontaneous circulation (return of a spontaneous circulation)
Coding of feedback code (RMC)
| code | awareness | breathing | Cycle | injury | neurology | pain |
|---|---|---|---|---|---|---|
| 1 | inconspicuous | inconspicuous | inconspicuous | no | inconspicuous | none (0) |
| 2 | somnolent | easily disturbed | easily disturbed | light | known disorder | easy (1–3) |
| 3 | threatened | imminent serious disorder | imminent serious disorder | conceivable | serious disorder | medium (4–6) |
| 4th | comatose I-III | badly disturbed | badly disturbed | heavy | acute disorder | strong (7–9) |
| 5 | comatose IV | Apnea | pulseless | Multiple trauma | progressive disorder | extreme (10) |
literature
- W. Lenz, M. Luderer, G. Seitz, M. Lipp: The disposition quality of a rescue control center . In: Emergency & Rescue Medicine , 2000, 3, pp. 72–80, doi : 10.1007 / s100490050203 .
- A. Reineke, W. Lenz, A. Hackstein: Feedback numbers in the QM system control center . In: H. Möcke, H. Marung, S. Oppermann (Hrsg.): Practical Guide Quality and Risk Management in Rescue Services . MWV , Berlin 2013, pp. 209-213, ISBN 978-3-941468-73-3 .
Web links
- RMZ as an app on Google Play
- RMZ as an app on iTunes
- IVENA eHealth PZC search as an app on iTunes