Poster Rettungsdienst Israel 2010 PP 2003 KORREKTUR

ILS
Fürstenfeldbruck
Emergency medical service in Germany –
represented by the EMS of the Red Cross Dachau
C.Guenzel 1,3, B.Krach 1,2, A.Pichler 1,2, R. Schmid 1,2 , F.Scharf 1,2,4, M.Kaufer 1,4,F. Schoesser 1,2, K.Wilhelm 1,3
Fig.1
Duration
EMS provider and qualification:
In Germany the emergency medical service is provided by
different healthcare organisations like Red Cross, Malteser,
Johanniter, Fire Departments and private organisations.
Schedule
It is a two tyred emergency physician (Notarzt; NA) based EMS
system.
The emergency physician (Notarzt) is a MD with at least two
years of experience as well as a further education and training
in emergency medical aid.
For the emergency personnel there are two different kinds of
qualification, Rettungsassistent (RA) and Rettungssanitäter
(RS).
The apprenticeship is regulated by law. It is provided by private
schools and organized as shown in fig. 1.
Rettungssanitäter (RS)
Rettungsassistent (RA)
520 h
2 years
1st year:
160h Theory courses
1000h Theory courses
160h Hospital internship 520h Hospital internship
160h EMS internship
160h EMS internship
40h Final course/exam 2nd year:
1600h EMS internship
Duties and
responsibilities EMT on BLS ambulance
unit
Assistant on ACLS
ambulance units
Responsible paramedic on
ACLS Unit
Assistant of emergency
physician (NA)
Fig.2¹
Notarzt (NA)
MD, additional 2 years
80h
Theory courses
24 months Clinical expirience
6 months ER/ICU expirience
Additional 50 EMS calls on
ACLS Standard
Responsible emergency
physician in EMS
Fig.3¹
80% of the emergency personnel are in regular occupation
while the other 20% work on honorary basis for one of the
organisations.
The RA may perform following actions if the NA is not available:
•
•
•
•
i.v. line
defibrillation (VF, pVT)
intubation without relaxant
application of selected drugs
(epinephrine, glucose, ß2 mimetics, atropine, saline infusion)
EMS dispatchment and vehicles:
Fig.4
Vehicle categories Krankentransport
wagen (KTW)
Rettungswagen
(RTW) Fig. 2
Notarzteinsatzfahrzeug (NEF) Fig. 3
Human resources 2 Rettungssanitäter 1 Rettungsassistent 1 Notarzt
1 Rettungssanitäter 1 Rettungssanitäter
Duties and
responsibilities
Planned patient
transport
Emergency calls
with or without NEF
Life threatening
emergencies according
to dispatch catalogue
Air rescue:
The ground based rescue team is further supported by the air rescue if
necessary or ordered through the medical team on scene. Germany has one
of the densest air rescue systems (Fig. 5). The stations are divided in 50 km
parameters. The rescue helicopter is dispatched by the ILS for fastest
possible access to the scene if the NEF is deployed otherwise or the
presumed setting indicates the necessity.
Also the quick transfer of the patient to specialized clinics and trauma centres
is carried out. Most of the stations are for primary rescue operations, in
addition to this some of the helicopters are also equiped for ICU interhospital
transfers.
All rescue helicopters are staffed with a Rettungsassistent, a Notarzt and the
flight crew.
Operational service is conducted by the ILS (Integrated operations centre for
fire and rescue services), which answers the incoming emergency calls and
dispatches the fire brigades and ambulance units.
The emergency number 112 was taken into service with the introduction of
the ILS in Bavaria in 2007. 112 is the European emergency number,
reachable everywhere in the European Union.
The ILS Fürstenfeldbruck is responsible for four districts in northwestern
Munich region with about 2300 square kilometres and 600 thousand
citizens.
It is regulated by law that the EMS units are staffed and dispatched like
shown in Fig. 4 and furthermore that every place in a district has to be
reached in at most 12 minutes by a RTW.
Fig.5²
Literature/picture sources:
1)Fig. 2, 3 Bavarian Red Cross Dachau
2)Fig. 5 ADAC Luftrettung GmbH München
Special thanks to all EMS personnel of the Bavarian Red Cross Dachau and all other involved in raising the data needed for this publication
1 Förderverein Rettungsdienst Dachauer Land e. V. 2 Bavarian Red Cross Dachau 3 MVZ Dachau 4 Integrated Command Center FFB