"Fundamental Change"
In just 6 months, the University Hospital Essen became one of the most modern Emergency Departments in Europe. In 1,000 square meters around 50 staff work in 13 treatment and examination rooms as well as 3 emergency rooms. Prof. Dr. Clemens Kill is the director of the new Emergency Center at the University Hospital Essen. We spoke with the emergency expert.
Prof. Dr. Kill, what makes the new Central Emergency Department (ZNA) North at the
University Hospital Essen so special?
We could start from scratch with the planning. This allowed us to design our ZNA consistent to Emergency Room procedures. Not only is the set up exemplary with 3 emergency rooms, one of them with computerized tomography, more than a dozen fully equipped treatment rooms and separated infection area, but the medical technical equipment is also extraordinary. Wherever possible, we have integrated digital support systems right from the beginning. But the space and technology is not everything. The medical care in our ZNA also supports the newly founded Centre for Emergency Medicine of the University Hospital Essen. As an independent center with an interdisciplinary team of senior physicians, this ensures optimum care – around the clock of course.
What exactly does the Director of the Centre for Emergency Medicine do?
My task spectrum includes all emergency medicine areas of the Essen University Medical Center, in particular the design of the Emergency Department. Of course, this means a lot
of planning and communication, but also answering alot of detailed questions, so that every useful innovation can be integrated and so that a high-quality facility such as our
new Emergency Room is constantly advancing.
You work with the corpuls3 in your new Emergency Department. What advantages do you see with the corpuls3 in clinical use?
Basically, in an Emergency Room, similar emergency situations happen as in the pre-clinical area. This suggests the use of pre-clinically proven technology
in-clinic. All of our emergency physicians in the Emergency Room have years
of operational experience with corpuls3.
This increases confidence in critical situations. Due to the widespread use in the
ambulance service in Essen and the surrounding area, defi-adhesive electrodes, for example, can continue to be used at the change-over from the rescue service
to the emergency room, which saves time and costs. The modularity of
the Patient Box and Monitor make transportation easier and it is particularly
helpful in X-ray and CT examinations to use the Monitor, including the user interface, outside the radiation protection area, thus being able to monitor the patient optimally.
We routinely use the corpuls3 in the treatment of critically ill patients. Therefore,
we have a total of four fully equipped corpuls3's available.
How do you foresee the role of telemedicine in the future – especially in relation to the German Rescue Service?
We will have to start making fundamental changes to the Rescue Service
in Germany in order to be able to cope with the steadily increasing number of missions and the rising demands on performance and quality. In my opinion, one of the core topics will be the more targeted use of emergency medical systems for acutely, critically ill and injured emergency patients. Many minor missions could, I am sure, be handled by emergency medical staff without an Emergency Physician at the job site without any decrease in quality or safety if there is direct access available to a TeleMedic with live data. With such telemedical support not only for example, could medicine administration in emergency patients be safeguarded without danger to life, but also the ever-increasing number of unnecessary transports from less severe missions could be avoided in
the emergency rooms. In my opinion, it is important for the blanket implementation of telemedical systems that communication and data transmission is possible without the need to carry additional devices.
In recent years you have made a name for yourself in scientific research and published numerous publications with your team – some involving the corpuls3.
To what extent do you support software products like corpuls.web ANALYSE and corpuls.web REVIEW in your analysis?
The corpuls documentation and analysis tools make data analysis very easy for scientific projects in the lab or in the clinic as well as for quality assurance. The long-term availability of all data including high-resolution graphical curves is also extremely valuable in the routine of emergency care both preclinical and in-clinic, as we can subsequently process case reports for interesting and even unforeseen events and also use them for training purposes.
As well as the corpuls3 you use the thorax compression device – corpuls cpr in the ZNA. What do you think of it?
We always use corpuls cpr when a patient arrives in the emergency room under ongoing resuscitation. The cpr is especially helpful in the emergency room when we have to do a VA-ECMO under resuscitation. With it, the best possible chest compression can be achieved without the use of personnel. For critically unstable patients in which a cardiac arrest can occur again at any time after resuscitation, we place the baseplate under them when transferring them as a precaution as this does not hinder further care.
With the ever-increasing volume of emergency calls, new challenges are being presented to the rescue services and emergency physicians, TeleMedics and telemedicine solutions like corpuls.web are the future.
If you had a wish, what would the industry need to develop to facilitate your work as an intensive care and emergency physician, as well as to increase patient survival?
My biggest wish would be to make the most important devices for emergency care much smaller and lighter and to make the operation more intuitive and consistent. If we look at the development, for example, of communication technology in the past ten years, where we all have extremely efficent smartphones and tablet PCs, medical technology is lagging far behind. Here we urgently need "smart technology" that is optimized for the user.