Resuscitation Register
The German Resuscitation Register (GRR) is an online database for the uniform recording of preclinical resuscitation data, in-hospital emergency data and further care data for patients with cardiovascular arrest in Germany , Austria , Switzerland and Luxembourg . It offers quality management for both out-of-hospital resuscitation and in-hospital emergency care.
background
The sudden cardiac death in adults with coronary heart disease is responsible for 60% of deaths. Often, sudden cardiac death is the first manifestation of coronary heart disease. Epidemiological data in Europe indicate a frequency of 50 to 66 resuscitation treatments per 100,000 population per year. With a population of 460 million in the European Union, there are at least 230,000 resuscitations per year. In this respect, resuscitation treatment represents a particular challenge for the organized rescue service . Despite ongoing efforts at all levels of care, the success rate after resuscitation is still poor today. As a quality management tool, the German Resuscitation Register is intended to provide doctors and emergency services with the information they need to increase their CPR success rates.
The GRR of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) started at the German Anesthesia Congress in May 2007 in Hamburg. At the end of 2017, over 180,000 data records were stored in the online database, on which quality management, benchmarking and scientific publications can be based. The data represent a supplied population of around 25 to 30 million inhabitants in Germany.
Data acquisition
The data is collected anonymously. For this reason, an assignment and evaluation to individual pre- and intra-clinical registry participants is not possible. In accordance with the specifications of the Utstein-Style protocol, the resuscitation data set “first aid” was initially developed and later supplemented with the data sets “continued care” and “long-term course”. The hospital module clinical follow-up care records the findings, diagnostic and therapeutic measures of the first 24 hours of in-hospital treatment such as B. EKG , X-ray , ultrasound examination , laboratory, bronchoscopy and thrombolytic therapy, PTCA , bypass surgery or therapeutic hypothermia treatment, as well as other data on hospital treatment up to discharge or death of the patient.
The module on the long-term course after resuscitation records the duration of survival and the quality of survival at the times of hospital discharge, 30 days and 12 months after the resuscitation treatment
Additional modules on special issues or patient groups during resuscitation, such as The modules, for example telephone resuscitation, further pediatric care or temperature management, were developed together with participants from other specialist societies and other experts.
On the basis of these data sets, a central web-based database was created under the auspices of the DGAI. The data can be entered directly into this database via the Internet after appropriate registration . Feedback is implemented as well as regular reporting . In addition, different recording systems have been developed which take into account the various documentation options in emergency medical services. Paper logs - as pure resuscitation register logs - or combination logs for emergency medical services, which contain the MIND data as well as the additional resuscitation data, are used. Furthermore, electronic documentation systems can import the data directly into the online database with the help of a certified interface. The regionally recorded data is fed in either directly via the Internet or by transmitting the data previously stored locally via an interface for data import.
Benchmarking, evaluations and analyzes
With the help of core data, a comparability between the individual participants, but also across national borders, can be established. If this core data is missing, both the evaluation and the comparison are difficult. The core data set here are u. a. the suspected cause and location of the event as well as the first derived ECG rhythm and the possible success of the measures are used.
Defined times are also documented, which also allow conclusions to be drawn about the efficiency of the overall system. The time of the collapse, the receipt of the emergency call at the rescue control center, the arrival of the first rescue equipment, the start of CPR, the first defibrillation, the time of intubation and tactical data such as the time of the start of transport and the arrival at the clinic are recorded. With the evaluation of this data, the recommendations and guidelines made by the International Liaison Committee on Resuscitation (ILCOR) and the related major continental resuscitation organizations American Heart Association (AHA) and European Resuscitation Council (ERC) and their recommendations can be used Applicability checked and the effects of different resuscitation efforts compared.
The resuscitation register provides all participants with extensive online evaluation options for their data. The comparison with the population and the best participants ( anonymized ) offers the opportunity to analyze one's own performance and to identify strengths and weaknesses ( benchmarking ). In addition, annual reports are created for the participating centers, which supplement the online evaluations in the form of a comprehensive quality report.
In addition, monthly reports (pre-clinical participants) / quarterly reports (intra-clinical participants) and annual reports are created for the participating centers, which supplement the individual online evaluations. In addition to these evaluation options, there is the possibility of grouping participants together in clusters at regional or supra-regional level and carrying out cluster-specific evaluations. This is particularly useful for grouping federal states or federal states.
Organization and financing
The German Resuscitation Register is under the patronage of the Federal Ministry of Health. At national level, it is recommended by the Federal Association of Working Groups of Emergency Doctors in Germany (BAND), by state working groups of emergency doctors and the German Resuscitation Council. The German Resuscitation Register guarantees scientific support within the nationwide campaign "Save a life - 100pro reanimation". It represents Germany in the European Resuscitation Register (EuReCa: European Registry of Cardiac arrest), which is operated by the European Resuscitation Council (ERC).
The coordination office is located at the Institute for Rescue and Emergency Medicine at the University Medical Center Schleswig-Holstein, Campus Kiel. The project is financed by the annual fee of the participating locations and the DGAI. No compensation is provided for the doctors involved. This is justified with the need for quality management in accordance with the Social Code , which results in an obligation to record quality in patient care.
Individual evidence
- ↑ J.-T. Gräsner, M. Messelken, M. Fischer, T. Rosolski-Jantzen, J. Bahr: DGAI-Resuscitation Register . In: The emergency doctor . tape 24 , no. 1 , February 2008, ISSN 1438-8693 , p. 1-5 , doi : 10.1055 / s-2007-986208 .
- ↑ German Resuscitation Register. Retrieved January 3, 2019 .
- ↑ Participation of rescue services in the German Resuscitation Register ( Memento of the original from December 14, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
literature
- Gräsner JT, Wnent J, Seewald S, Neukamm J, Fischer M .: First aid and trauma management: results from the German resuscitation registry. Anesthesiol Intensivmed Emergency Med Schmerzther. 2012 Nov; 47 (11-12): 724-32. PMID 23235904
- Gräsner JT et al .: The DGAI CPR registry - the datasets "hospital care" and "long-term process". Anesthesiol Intensivmed Emergency Med Schmerzther. 2008 Oct; 43 (10): 706-9. PMID 18958824
- Ilper H, Kunz T, Walcher F, Zacharowski K, Byhahn C .: An online emergency physician survey - demography, education and experience of German emergency physicians. German Med Wochenschr. 2013 Apr; 138 (17): 880-5. PMID 23592344
- Neukamm J, et al .: The impact of response time reliability on CPR incidence and resuscitation success: a benchmark study from the German Resuscitation Registry. Crit Care. 2011; 15 (6): R282. PMID 22112746
- Gräsner JT, et al .: German Resuscitation Registry Working Group, Trauma Registry of the German Society for Trauma Surgery (DGU). Cardiopulmonary resuscitation traumatic cardiac arrest - there are survivors. An analysis of two national emergency registries. Crit Care. 2011; 15 (6): R276. PMID 22108048
- Kulla M, Helm M, Lefering R, Walcher F .: Prehospital endotracheal intubation and chest tubing does not prolong the overall resuscitation time of severely injured patients: a retrospective, multicentre study of the Trauma Registry of the German Society of Trauma Surgery. Emerg Med J. 2012 Jun; 29 (6): 497-501. PMID 21795295
- Gräsner JT, et al .: German Resuscitation Registry Study Group. ROSC after cardiac arrest - the RACA score to predict outcome after out-of-hospital cardiac arrest. EUR Heart J . 2011 Jul; 32 (13): 1649-56. PMID 21515626