Reinhard Schmiedel, Manfred Unterkofler

• Gegenstand der Untersuchung ist die Bestandsaufnahme des Versorgungsniveaus für Notfallpatienten einer Region sowie die Überprüfung der Frage, ob dieses Versorgungsniveau bedarfsgerecht unter Einhaltung der gesetzlichen Vorgaben sichergestellt wird. Aus den Ergebnissen der Untersuchung der Eintreffzeiten für 19 Notarztsysteme wird ein Handlungsbedarf abgeleitet,der sich auf die Optimierung der bestehenden Rettungssysteme konzentriert. Für die zukünftige Planung wird ein Maßnahmenkatalog formuliert, derzu einer Verbesserung der Notfallversorgung in der untersuchten Region führt.
• The survey's objective is to record the present level of care for emergency patients in the area of Franken, as well as to examine the question whether this level is guaranteed according to demand and in conjunction with legal provisions. Franken, the area which has been examined, is situated in northeastern Baden-Württemberg and comprises 6 regional systems of emergency medical services (EMS). The first step was to examine to what extent the stipulated time-standard for EMS is maintained under the given circumstances. The analysis of how an area-wide service is granted led to the conclusion that the deployment of rescue stations, from a static point of view (time-of arrival-isochronous), is sufficient to handle emergency cases according to the state standards. Only a more differentiated analysis of the non-static conditions in the level of care shows that the state standards are not met. The analysis of actual times-of-arrival within 19 service systems of emergency physicians also leads to the conclusion that an area-wide network, which meets the state- time-standards, is not at all given at the present time. The system of rescue helicopters also does not bring enough relief as the ground-based network of physician staffed EMS still, exhibits faster times-of-arrival. The main objective of state plans is to supply EMS to all parts of the state at a similarly high level. The result is that improvements have to concentrate initially an optimizing the present system. This is especially relevant for the following parts of the system: Optimizing the function of the dispatch centers, expanding ground-based emergency services, developing strategies for a more effective use of ambulances and optimizing the additional use of EMS-helicopters that are available. Taking the dispatch centers as an example, it is shown that, only by optimizing dispositions, a significant potential for improvements in EMS can be realized. Stationing an additional EMS-helicopter in the area of Franken has not been approved, because large parts of the region are located in the primary radius (50 km) of the rescue helicopters situated in Ochsenfurt and Stuttgart. A list of measures is proposed for future plannings which lead to improvements in the level of care for emergency patients in the area of Franken by expanding and optimizing the present ground-based structure of the EMS within the legal framework given by the state.