Poster Rettungsdienst Israel 2010 PP 2003 KORREKTUR
Transcription
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