Rendezvous system

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Ambulance and ambulance vehicle

The rendezvous system is an operation tactic in which two units are alerted to the same incident location in order to provide help together.

Ambulance service

In the rescue service , the rendezvous system refers to the separate arrival of the ambulance and the emergency doctor , with an emergency doctor delivery service, to the same emergency location. The two rescue service units meet at the scene of action ( rendezvous ) and the crews work together.

This procedure was conceived and implemented for the first time in 1964 by the emergency doctor Eberhard Gögler, a surgeon at Heidelberg University Hospital . It is now widely used.

Ambulance delivery

Ambulance vehicle, ambulance and rescue helicopter

In contrast to the compact system with an emergency doctor's vehicle (NAW), the emergency doctor is brought to the emergency site in a separate vehicle.

An emergency doctor feeder is a motor vehicle or aircraft with which the emergency doctor arrives at the emergency site.

This is usually used for this

less common

An emergency doctor can also be brought to the scene using any other rescue equipment or emergency vehicle from other emergency services ( police , fire brigade ).

Pros and cons

advantages
  • The emergency doctor vehicle is usually more agile and faster than an ambulance. In addition, it reaches some locations better because of its smaller dimensions.
  • Until a suitable rescue device arrives, the emergency doctor and the paramedic (or paramedic ) can take over primary care.
  • In the event of an emergency without an emergency doctor's indication, the ambulance can move out on its own so that the emergency doctor is still available for the entire area of ​​operation.
  • If it turns out at the place of use that the patient can be transported to the hospital by ambulance without medical supervision , the emergency doctor is immediately available for further assignments by the emergency doctor vehicle.
  • The emergency doctor is available earlier, he can leave the ambulance and drive to the next emergency location with the emergency doctor vehicle (follow-up operation).
  • This enables the emergency doctor to treat a large area of ​​operation; In rural areas in particular, the area of ​​use of an emergency doctor's vehicle usually includes the areas of use of several ambulances that are stationed at different rescue stations.
disadvantage
  • If the need for an emergency doctor only emerges at the place of use, this must be re-alarmed, which is time-consuming.
  • The provision of another vehicle with personnel and equipment is necessary.

special cases

Rendezvous point

Depending on the situation, a rendezvous point will be agreed when the rescue team has prepared the patient for transport and the arrival of the emergency doctor is delayed. This clear meeting point is usually on the way to the destination clinic; if the route is clearly defined and the lanes are not structurally separated from each other , this meeting can also happen by simply meeting them.

Return journey with special rights - tracking of the ambulance vehicle

Ambulance and tracking of the ambulance vehicle

If the emergency doctor determines at the place of use that a transport to the hospital using the special rights is necessary, it is sometimes customary to have the emergency doctor vehicle follow immediately with special rights. This should enable optimal patient care at all times. In addition, it should be avoided that the emergency doctor has to wait for the emergency doctor vehicle in the event of a follow-up call after the patient has been handed over in the hospital. Legally, however, such an approach is in a gray area, as there has not yet been a ruling by a German court. In three federal states, only decrees have been issued by the authorities. For example, "for all emergency vehicles of the rescue services and the fire brigades in North Rhine-Westphalia, the decree stating that the blue flashing light and the emergency horn must not be used on return journeys from operations and exceptions are only permitted in cases where safety due to a longer absence of the emergency vehicle." is seriously questioned in the area of ​​operation. "In Brandenburg, the following decree from Bavaria applies:" ... The right of way may also be claimed when returning from the operation, if this is absolutely necessary to restore operational readiness in individual cases. " In all three countries, the decision in individual cases is the responsibility of the respective control center and should only be made in the event of disasters or similar major incidents in favor of the deployment with special rights. The decision to return the ambulance with special rights is not affected by the decrees. It is the responsibility of the emergency doctor alone.

Sections 35 (special rights) and 38 (blue flashing light and yellow flashing light) of the road traffic regulations (StVO) are ultimately decisive for all special rights driving in Germany . Their interpretation is controversial with regard to the practice described here, both among lawyers and in the specialist literature.

Proponents argue with the peculiarity of the rendezvous system, which is about the flexible use of the emergency doctor. The emergency doctor and the ambulance (the ambulance after boarding the emergency doctor) consequently formed a unit that should not be separated. This is expressly the case when “in the NEF [abbr. for emergency doctor vehicle , note d. Ed.] For spatial reasons, medical aids and emergency medication are carried with them, which are in the ambulance [abbr. for " ambulance ", note d. Ed.] Are not available and there is a certain likelihood that the emergency doctor will have to resort to these aids and emergency medication during the transport trip. ”Furthermore, there would be one especially in urban areas, due to the higher traffic volume and the higher number of traffic lights Too long (temporal) distance between the emergency doctor and the emergency vehicle. A mission is only considered to be over for all involved when the patient has been handed over to the hospital.

Opponents of such an operational practice do not see a unity between the ambulance and the ambulance vehicle as a given. The use of the ambulance vehicle is concluded when the site is reached. Its tracking behind an ambulance driving with special rights violates the StVO. In addition, a trip under special rights is always associated with an increased risk, which is shown here as not proportionate. Loss of time during a follow-up operation, resulting from the distance between the ambulance and the ambulance, is usually only minor, since the ambulance can make use of special rights, but at the same time has to drive gently in the interests of the patient. In addition, the emergency doctor's vehicle is driven from the follow-up alarm with special rights, so that the emergency doctor can be reached and picked up quickly.

Return journey with special rights - driving in front of the emergency doctor vehicle

Another special case is the practice of not letting the faster emergency doctor vehicle follow you on a return trip to the hospital with special rights, but rather allowing it to drive ahead. It is intended to support the ambulance in enforcing the right of way. This should ensure that the patient is transported as gently, smoothly and at the same time as quickly as possible. More precisely, the ambulance vehicle should help to reduce the further health burden caused by a so-called transport trauma (especially in the case of heart attacks, multiple trauma or spinal injuries). The use thus serves to avert serious damage to health, i.e. is legitimized by the StVO. Furthermore, the road users are warned earlier by the emergency doctor vehicle driving ahead and can thus better adapt to the unfamiliar traffic situation. In addition, it is common practice in some cases to use the emergency doctor's vehicle as an "intersection clearer". To do this, it hurries ahead, stops in the middle of the intersection and is supposed to keep the area free for the ambulance.

The driving up of the emergency medical vehicle with special rights is also considered controversial and in parts even dangerous. It is true that it is argued that the ambulance, the patient (medical and traffic engineering) and the other road users are more safe. Nevertheless, the use of special rights for the emergency doctor vehicle is also here for the same reasons as above in a legal gray area. In addition, when the road users concerned are “kept clear” of intersections, the unclear situation of an emergency doctor vehicle parked at the otherwise free intersection with the blue light switched on could lead to irritation and consequent misconduct. The ambulance vehicle attracts everyone's attention here. The approaching ambulance could be overlooked more easily and its horn could be assigned incorrectly. In addition, there is an increased number of overtaking maneuvers if the ambulance vehicle that is unlocking again wants to pass the ambulance.

fire Department

In the fire brigade, the rendezvous system means the simultaneous alerting of at least two separate fire brigade units for operations. This means that several complete teams with equipment are on site as quickly as possible. It is possible that the vehicles of a fire fighting , rescue or hazardous goods train are not stationed at one location, but only come into contact with each other in the rendezvous system when they are needed.

Web links

Individual evidence

  1. 50 years of ambulances - the "rendezvous system" conquers the world (ÄrzteZeitung, accessed on October 14, 2015)
  2. ^ Müller, Dieter 2006: Special rights and right of way for journeys back from the place of use. In: Bundesleitung der Deutschen Polizeigewerkschaft im DBB (DPolG) (Ed.) 2006: Polizeispiegel No. 9, 40th year, September 2006. Berlin: Pages 19 and 22 with the reference to the regulation according to No. 2.3 of the circular of the Ministry for Transport, Energy and State Planning - III B 2 - 21-31 / 2010 -, the Ministry of the Interior - 73 - 52.07.01 - and the Ministry of Health, Social Affairs, Women and Family - III 8-0713.2.6.2 / 1 - from 5. March 2004 (MBl. NRW. P. 383). ( Memento from August 1, 2014 in the Internet Archive ) (PDF; 1.7 MB)
  3. ( Page no longer available , search in web archives: Müller, Dieter 2006: special rights and right of way for return journeys from the place of use. In: Federal Management of the German Police Union in the DBB (DPolG) (Ed.) 2006: Polizeispiegel No. 9, 40th year, September 2006. Berlin: Page 19 ) (PDF; 1.7 MB)@1@ 2Template: Dead Link / www.dpolg.de
  4. ( Page no longer available , search in web archives: see Müller, Dieter 2006: Special rights and right of way for return journeys from the place of use. In: Federal line of the German Police Union in the DBB (DPolG) (Ed.) 2006: Polizeispiegel No. 9, 40. Volume, September 2006. Berlin: Page 22 ) (PDF; 1.7 MB)@1@ 2Template: Dead Link / www.dpolg.de
  5. Joint circular of the Ministers for Urban Development, Housing and Transport, Minister of the Interior, Minister for Labor, Social Affairs, Health and Women No. 12/1993 - Road Traffic Law, Rescue, Disasters and Civil Protection - of June 15, 1993.