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Case Reports
. 2021 Jan;70(1):34-39.
doi: 10.1007/s00101-020-00872-w. Epub 2021 Jan 15.

[When emergency physician and tele-emergency physician save life together : A case description on the application of prehospital telemedicine for ventricular tachycardia with hemodynamic instability]

[Article in German]
A Follmann  1   2 , H Schröder  3   4 , G Neff  5 , R Rossaint  3 , F Hirsch  3   4 , M Felzen  3
Affiliations
Case Reports

[When emergency physician and tele-emergency physician save life together : A case description on the application of prehospital telemedicine for ventricular tachycardia with hemodynamic instability]

[Article in German]
A Follmann et al. Anaesthesist. 2021 Jan.

Abstract
in English, German

Telemedicine has already entered the rescue service in some regions of Germany. This case description is about a telemedical emergency physician case where an emergency doctor was also at the scene of the emergency. The patient had a life-threatening ventricular tachycardia and became hemodynamically unstable. The emergency physician was still inexperienced and overwhelmed by the complex situation. She decided to contact the tele-emergency medical services (tele-ems) and could then be instructed to perform intraosseous access, drug treatment and electrical cardioversion in the unstable patient. The cooperation with the tele-ems physician enabled the still inexperienced emergency physician to perform a guideline-compliant treatment and to transport the stabilized patient to the hospital in a timely manner.

Die Telemedizin ist in einigen Regionen Deutschlands bereits fester Bestandteil des Rettungsdienstes. Dieser Fallbericht handelt von einem Telenotarzteinsatz, bei dem die initiale Telekonsultation durch eine an der Einsatzstelle befindliche Notärztin erfolgte. Der Patient hatte eine lebensbedrohliche ventrikuläre Tachykardie mit zunehmender Kreislaufinstabilität. Dies stellte für die noch unerfahrene Notärztin eine extrem herausfordernde Einsatzsituation dar. Sie entschied sich, telemedizinische Unterstützung in Anspruch zu nehmen. So konnte sie angeleitet werden, bei dem instabilen Patienten einen i.o.-Zugang, eine medikamentöse Therapie und eine elektrische Kardioversion durchzuführen. Die Zusammenarbeit mit dem Telenotarzt ermöglichte der noch unerfahrenen Notärztin, eine leitlinienkonforme Therapie durchzuführen sowie den Patienten zeitnah stabilisiert ins Krankenhaus zu transportieren.

Keywords: Emergency medicine; Second opinion; Supervision; Telemedicine; Ventricular tachycardia.

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