[Intensive care of patients with [infarct-related] cardiogenic shock : Abridged version of the S1 guideline]

[Clinical acute and emergency medicine curriculum-focus on internal medicine : Recommendations for advanced training in internal medicine in the emergency department]

In Germany, physicians qualify for emergency medicine by combining a specialty medical training-e.g. internal medicine-with advanced training in emergency medicine according to the statutes of the State Chambers of Physicians largely based upon the Guideline Regulations on Specialty Training of the German Medical Association. Internal medicine and their associated subspecialities represent an important column of emergency medicine. For the internal medicine aspects of emergency medicine, this curriculum presents an overview of knowledge, skills (competence levels I-III) as well as behaviours and attitudes allowing for the best treatment of patients. These include general aspects (structure and process quality, primary diagnostics and therapy as well as indication for subsequent treatment; resuscitation room management; diagnostics and monitoring; general therapeutic measures; hygiene measures; and pharmacotherapy) and also specific aspects concerning angiology, endocrinology, diabetology and metabolism, gastroenterology, geriatric medicine, hematology and oncology, infectiology, cardiology, nephrology, palliative care, pneumology, rheumatology and toxicology. Publications focussing on contents of advanced training are quoted in order to support this concept. The curriculum has primarily been written for internists for their advanced emergency training, but it may generally show practising emergency physicians the broad spectrum of internal medicine diseases or comorbidities presented by patients attending the emergency department.

[Intensive care of patients with [infarct-related] cardiogenic shock : Abridged version of the S1 guideline]

BACKGROUND

Cardiovascular diseases and (infarct-related) cardiogenic shock are among the most frequent causes of death in Germany. Adequate clinical care often poses great challenges for hospitals. The complex care of patients in a multi-professional team places high demands on all those involved in the care process. Since nurses in particular are in close contact with patients and play a decisive role in shaping and controlling therapy, a national (intensive) care guideline is urgently needed.

METHODS

Within the framework of the guideline programme of the Association of the Scientific Medical Societies in Germany (AWMF), an S1 guideline was developed with the participation of six professional societies and published in May 2022. The guideline group defined relevant topics, which were processed through a systematic literature search in peer-reviewed journals. Based on the S1 classification, no separate evidence review was conducted. A formal consensus-building process was used to classify the recommendations.

RESULTS

The guideline contains 36 recommendations ranging from nursing care in the central emergency department to the cardiac catheterisation laboratory, intensive care unit and follow-up care. In addition, recommendations are made on the necessary qualifications and structural requirements in the respective areas in order to ensure a high-quality (nursing) care process.

CONCLUSION

This is the first national intensive care guideline. It is aimed at nurses involved in the care of patients with (infarct-related) cardiogenic shock. The guideline is valid until 30.12.2026.