Emergency Paramedic Act

Basic data
Title:	Law on the profession of paramedic and paramedic
Short title:	Emergency Paramedic Act
Abbreviation:	EmergencySanG
Type:	Federal law
Scope:	Federal Republic of Germany
Issued on the basis of:	Art. 74 para. 1 no. 19 GG
Legal matter:	Special administrative law
References :	2124-24
Issued on:	May 22, 2013 ; ( BGBl. I p. 1348 )
Entry into force on:	predominantly 1st of January 2014
Last change by:	Art. 2a G of 14 December 2019 ; ( Federal Law Gazette I p. 2768, 2787 )
Effective date of the ; last change:	December 21, 2019 ; (Art. 3 G of December 14, 2019)
GESTA :	M023
	Please note the note on the applicable legal version.

The Emergency Paramedic Act (NotSanG) is a German federal law on the occupation of the emergency paramedic , a rescue service qualification level above the paramedic for use in emergency rescue . It is mainly concerned with training to become an emergency paramedic and is supplemented by the training and examination regulations for emergency paramedics (NotSan-APrV).

aims

The aim of the law was to reform training under the Paramedic Act . As part of this reform, the training period is to be extended significantly to three years and the emergency skills are to be replaced by regular skills. Another aim of this reform is to improve the comparability of rescue service training in the federal states and in the European Union. In order to improve the quality of training in the rescue service schools, uniform quality requirements have been laid down in the law for the rescue service schools. These are above the previous requirements.

Emergence

The draft of the law was published by the federal government on May 25, 2012. The members of the expert group in the Federal Ministry of Health were asked to comment by June 22, 2012. The law was passed in the Federal Cabinet on October 10, 2012 and approved by the Bundestag Health Committee on February 27, 2013. A vote in the Bundestag took place on February 28, 2013, the Bundesrat voted for the law on March 22, 2013. The announcement in the Federal Law Gazette took place on May 27, 2013.

Such a reform is welcomed by the German Rescue Service Association and the Federal Association of Medical Directors Rescue Service . Both associations claim to have suggested such a reform earlier in a similar way.

Transitional arrangements

According to the will of the legislature, as part of the transitional regulations, paramedics are given the opportunity to obtain permission to use the professional title of emergency paramedic by participating in a supplementary examination or the state examination by December 31, 2023. For that are necessary

Successful completion of a supplementary examination with at least five years of professional experience
with at least three years of professional experience, participation in a 480-hour course and successful completion of the subsequent supplementary examination
with less than three years of professional experience, participation in a 960 hour course and successful completion of the subsequent supplementary examination

In the version of the notice of the Emergency Paramedic Act of May 22, 2013, it was provided that the professional experience had to be fulfilled before the law came into force on January 1, 2014. With the amendment of the Emergency Paramedic Act of April 4, 2017, this cut-off date regulation was repealed, so that professional experience gained as a paramedic after January 1, 2014 is also taken into account.

Alternatively, there is the possibility of taking the state examination by December 31, 2023 without additional courses and thus obtaining permission to use the professional title of emergency paramedic. With the amendment to the law of December 21, 2019, the deadline for making use of these transitional regulations was extended once from the original seven years to ten years after the law came into force.

Furthermore, it is possible to shorten the training period through previously acquired training with equivalent qualifications.

Problem of emergency competence

The goal of replacing the so-called emergency competence, which was usually carried out within the framework of Section 34 of the Criminal Code, with standard competencies, has not been achieved. The "emergency competence problem" persists.

In an emergency, the "1c measures" (Section 4, Paragraph 1c NotSanG) had to be used by non-medical emergency personnel before the law was passed as part of the "emergency competence". In this respect, there has been no change here.

The "2c measures" (§ 4 Paragraph 2c NotSanG) are to be carried out according to the NotSanG "within the framework of [...] cooperation". However, this is a contradiction in terms. Paragraph 2c is continued and restricts the measures to the procedures prescribed by the physicians responsible, but these orders then in turn limit independence. In addition, the training in accordance with Section 4, Paragraph 2, Clause 1 of the NotSanG only "should enable [in particular]" to carry out defined measures. In the specific case, however, this is only a provision for the training objective and not an allocation of competencies. "Of course, a training specification only makes sense if there is a legal basis for applying what has been learned" (: Slide 17), which is not the case here. "Comparable laws, for example the law on the professions in nursing , contain express permissions to practice medicine. The introduction of such powers in the NotSanG was rejected several times in the legislative process" (: Slide 22). An advance or general delegation of measures, which would have to be used here, is not known in current legal doctrine or case law. In addition, not every measure can be delegated. Furthermore, an indication must be made by a doctor, so it is almost impossible to define meaningful processes with the current legal situation in which emergency paramedics do not have to provide any indications.

However, the proposal by the Federal Council (printed matter 428/19) of September 11, 2019 to make a corresponding adjustment to the NotSanG would not change the legal situation significantly. The same applies to the proposal by the Federal Government (Committee Document 19 (14) 108.1).

In this respect, the old problem for the rescue personnel that they may not be able to incorporate what they have learned into daily professional practice or only with sensitive restrictions continues to exist for emergency paramedics.