Interkontinentale Repatriierung von Intensivpatienten im Linienflugverkehr – eine deskriptive Analyse einer einzigartigen Transportmodalität
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Philipps-Universität Marburg
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Abstract
Due to the rising number of airplane passengers, the number of passengers with chronic illnesses is also increasing. The exacerbation of underlying diseases, but also accidents and severe illnesses far from home can make a medically intensive treatment in another country necessary. Since 1996, conducting repatriations of such critically ill patients has also been possible with the Patient Transport Compartment (PTC) on board long-distance airliners of the Deutsche Lufthansa AG (DLH) in normal flight operations. This possibility is unique in civilian scheduled air services.
From a total of 650 transports in the years 2000 to 2009 as well as 2011, 583 protocols have been evaluated for the first time. The aim was to record retrospectively and systematically the quality of the documentation of intercontinental repatriations of severely injured or ill patients and to analyse and evaluate it with regards to medical, structural and qualitative aspects. Subsequently, the implementation of a structural change was also evaluated, and recommendations for action were formulated.
It was noted that the personal and formal conditions for a high-quality documentation, with data usable for quality control, patient care and research, are in place. However, the documentation itself was not implemented with a correspondingly high standard. The data consistently contain shortcomings with regard to completeness and traceability, eventually leading to relative information loss during transport. Additionally, it became clear that the significance of the documented medical parameters has as little influence on the quality of the documentation as the patient ́s state. The documentation of patients requiring ventilation does not significantly differ from that of other patients.
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Contrary to expectations, the structural shift of the documentation responsibility to the “constant” members of the PTC-Medical-Crew and the associated training courses did not give rise to any positive changes.
Despite these results, relatively high speed and medically safe repatriation in the PTC on board of long-distance airliners is feasible. A relation between the documentation having proven insufficient and a heightened mortality of the transported patients cannot be deduced from the data.
Further training measures for the PTC-Medical-Crew with regard to the relevance of a sufficient documentation for the patients seem appropriate. The introduction of electronic documentation systems and the development of an English-language intensive care transport protocol in accordance with the German interdisciplinary Association for intensive care medicine (DIVI) are also to be considered, to prevent information loss due to insufficient documentation. Regular sample-based verifications of the measures implemented are necessary to achieve a continuous quality improvement and thus lasting improvements in patient safety.
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Created: 2018Issued: 2018-12-10Updated: 2018-12-10
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
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DoctoralThesis
DFG-subjects
InterkontinentalIntensivtransportDokumentationsqualitätDokumentation
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610
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Lindert, Benjamin: Interkontinentale Repatriierung von Intensivpatienten im Linienflugverkehr – eine deskriptive Analyse einer einzigartigen Transportmodalität. : Philipps-Universität Marburg 2018-12-10. DOI: https://doi.org/10.17192/z2018.0459.