Status quo zur Gestellung leitender Notärzte (LNA)

BACKGROUND: The organisation and deployment of leading emergency physician groups (LNA) in Germany show considerable regional differences. To date, reliable nationwide data on structures, training, and operational implementation have been lacking. The aim of this study was to assess the current status of LNA deployment and to identify optimisation potential for uniform standards. METHODS: During the 2024 annual meeting of the Federal Associations of Medical Directors of Emergency Services (BV-ÄLRD), an anonymised online survey was conducted. Structural, organisational, training, and operational parameters of LNA groups were collected. Data analysis was descriptive. RESULTS: A total of 59 datasets from 13 federal states were evaluated. Most LNA groups cover counties (47%) or combined urban-rural areas (15%) with 100,000-500,000 inhabitants (81%). Seventy-six per cent maintain a fixed group, 17% two groups. Furthermore, 51% of LNA services are scheduled on a rotating basis, and financial compensation is predominantly provided as fixed allowances (80%). Most LNA are specialists (93%) and hold the additional qualification in emergency medicine (84%). An LNA course according to German Medical Association (BÄK) specifications is established in 100% of cases. In addition, 91% receive complete protective equipment. Deployment is mostly defined in special alarm plans (97%). Only 58% document deployments using structured protocols. Digital applications are used to a limited extent (15%). Personnel and structural challenges were repeatedly reported in the free-text responses. CONCLUSION: The study demonstrates a heterogeneous implementation of LNA structures in Germany. There is optimisation potential particularly regarding standardisation of digital integration and securing personnel resources. The results provide a basis for further development of national standards.