Ambulance service

from Wikipedia, the free encyclopedia
Ambulance and ambulance vehicle
The " Star of Life "
The rescue chain

The ambulance service is the professional pre-clinical medical help for emergency patients. Its task is to help quickly and properly in all kinds of medical emergencies - injuries , poisoning and illnesses  - through the use of qualified rescue personnel and the appropriate rescue equipment , and to save lives and alleviate suffering. A distinction is made between:

The special organizations of mountain or water rescue hand over the patient after the rescue for further care to the general rescue service.

The Star of Life has established itself as an international identification symbol for the rescue service, although in some countries (including Germany and Austria) it is trademarked by individual organizations.

As rescue means all devices and measures to save is called human life.

history

The first early structural approaches for emergency services can already be found in the Napoleonic era. First of all, people responsible for caring for the injured had to be found who went into battle. Although doctors were an established profession, the armies were not accompanied by doctors. This was not yet common at the time. So you had to rely on others or their abilities. Hairdressers and barbers formed the "rescue service". They were practically the only ones who dealt with human anatomy. They stayed at a safe distance during the fighting. When the first wounded, they ran into the battlefield in wooden carts and transported the wounded away. There is no historical agreement about the specific options for supply at the time, but the hygienic conditions must have been catastrophic.

Contrary to some common perception, the officially sponsored and in the general public consciousness today taken for granted "Rescuing people from mortal danger" and in medical emergencies was only a phenomenon of the late 18th and early 19th centuries. At the end of the 18th century, the first official rescue ordinances emerged in the individual German countries, in which life saving was declared the duty of every citizen and rewards were offered for successful resuscitation of "apparent deaths" and which also contained contemporary instructions on providing assistance and saving lives.

At the end of the 19th century, most major German cities had organized health transport systems. Private companies, civilian Samaritan associations, medical columns of the German Red Cross (DRK) and / or the fire brigade were commissioned with the implementation. The motorization of patient transport began after the First World War . In the spring of 1943, an attempt was made to standardize the ambulance transport system in Germany through a National Socialist “Führer Decree”, which, according to the will of the Nazi leadership, was to be assigned exclusively to the German Red Cross, which was brought into line. The outcome of the Second World War ended this attempt.

After the time of National Socialism and the German Reich, the occupying powers transferred the handling of the patient transport and thus also the emergency rescue to the municipalities (for example in the British occupation zone ) or to the denazified and newly founded DRK. In the 1950s, more and more concessions were granted to private entrepreneurs, especially outside the big cities, to ensure the transport of sick people and, in the absence of other regulations, also to ensure rescue from accidents.

Exercise by the Polish ambulance service

The increasing density of road traffic led to a steady increase in the number of accidents from around the end of the 1950s. In addition, from the mid-1960s onwards, new findings and improved principles in the treatment of emergency patients and the further developments in vehicle and device technology derived therefrom came. The existing emergency services in Germany could not keep up with these new requirements and, since the 1960s, a deplorable “emergency emergency” has developed in the public eye. This unbearable situation led from the mid-1960s to the increased commitment of administrative experts, doctors and aid organizations and finally to the official reorganization of the rescue service from the early 1970s. Private initiatives and especially the Björn Steiger Foundation have taken great care in setting up the appropriate infrastructure with emergency telephones and vehicles. Since these goals have now been achieved, this foundation is committed to the fight against sudden cardiac death and tries to spread lay defibrillators (AED) across the board .

Ambulance service in Europe

Care of an emergency patient

112 has been agreed as the Europe-wide uniform emergency number for all kinds of requests for help, which are then forwarded to the responsible body if necessary. In addition, there are still numerous different nationally and locally valid emergency numbers in Europe .

There are Europe-wide standards, for example, for

Some rescue service organizations are also certified according to European quality management standards (ISO 900x). These organizations guarantee that a certain standard will be adhered to, from the procurement of materials to the treatment of the patient.

There are no EU or Europe-wide guidelines for compliance with certain deadlines. At most, there is the recommendation of an aid period of between ten and twenty minutes, which the member states are allowed to change up or down independently.

Ambulance service in Germany

General

Ambulance service on duty
Interior of an ambulance

In Germany the rescue service is often abbreviated with RD or RettD .

Legal bases

In Germany, according to the federal principle of the Basic Law, the rescue service is a state matter and is therefore regulated by state laws.

Services

According to § 60 SGB ​​V , insured persons are entitled to reimbursement of the costs incurred through the services of the rescue service. A claim to the services of the rescue service itself cannot be derived from this. The services of the rescue service are regulated by the rescue service laws of the federal states. The ambulance service includes emergency rescue, medically accompanied patient transport and ambulance transport in accordance with state law:

  • Emergency rescue includes ground or airborne emergency medical care, as well as any subsequent emergency transport.
  • The medically accompanied patient transport includes ground or air transport, where the patient requires medical care or supervision for compelling medical reasons (or intensive care transport ).
  • Ambulance transport includes the transport of patients who, in connection with the transport, require care by medical specialists or the special facility of a life-saving appliance, or for whom this can be expected due to their condition.

Agency, supervision and implementation

In the case of public law implementation , the districts or municipalities are responsible for the rescue service by state law (“municipal compulsory task”). In Bavaria in particular, it is common practice to combine the organizations in special-purpose associations for rescue services and fire brigade alarms.

There are three possible implementation models:

  • The municipal rescue service is carried out by the public sector itself with its own employees. In this case, there is no need for an advertisement.
  • In the case of the tendering model , a form of public-private partnership , implementation is carried out by the organizations that are remunerated directly by the municipalities as sponsors. The model is mainly used in the central, northern and eastern federal states. According to the European Court of Justice (ECJ), this model is subject to the European procurement directives (judgment of April 29, 2010 - C-160/08).
  • With the service concession model , also a form of public-private partnership, the executors settle accounts directly with the health insurance companies as cost bearers. According to a ruling by the ECJ (ruling of March 10, 2011 - C-274/09), European public procurement law was not applicable to this model. This has changed with the implementation of the new Concession Awarding Directive 2014/23 / EU. Their application is, however, controversial in detail because of the area exception and the achievement of the threshold values. The concession model is used in the rescue service laws in Baden-Württemberg, Bavaria, Hamburg, Hesse and Rhineland-Palatinate. After a change in its rescue service law, Lower Saxony leaves the municipal authorities the choice of choosing between the models in their rescue service areas.

In the case of implementation under private law, the agency is responsible for overseeing the implementers. This will automatically settle the costs with the health insurance companies.

financing

The financing of the provision is regulated differently. According to § 133 SGB ​​V , if there is no state law regulation, contracts are concluded with the executors. The patient's health insurance usually pays for patient transport.

Alerting

The emergency services are alerted and coordinated by the responsible rescue control center / integrated control center . Various aids, such as radio signal receivers and special control center programs, are used in the control centers.

execution

Organizations

The ground-based rescue service is perceived by:

The air rescue in Germany is shared by the operator of the rescue helicopter met and clinics and charities. The respective federal states are responsible for air rescue. The mountain rescue perceives the mountain rescue service . Water rescue is operated by the Deutsche Lebens-Rettungs-Gesellschaft (DLRG), the water rescue service in the German Red Cross and the Arbeiter-Samariter-Bund (ASB). The rescue at sea on the North and Baltic Seas is carried out by the German Society for the Rescue of Shipwrecked People (DGzRS).

Move with the scoop stretcher

Types of use

A distinction is made between primary (emergency rescue) and secondary ( intensive care and patient transport ) operations. In Bavaria, secondary missions are further divided into patient transports and patient transports accompanied by a doctor (intensive care transport, transfer with a transfer doctor or hospital doctor).

There is no strict separation of the types of use. If the circumstances so require, suitable vehicles for intensive care and patient transport can also be used in emergency rescue - and vice versa as a makeshift.

Emergency rescue

Emergency rescue is regulated by law within the framework of services of general interest in every federal state and includes the rescue service in the narrower sense. The classification of the severity of illnesses or injuries takes place using evaluation schemes, for example the NACA score . The following common means of transport are available for emergency rescue:

Intensive care and ambulance transport

The regulation of intensive care and ambulance transports takes place differently in the federal state laws. Ambulance transports are mostly organized under private law. The following rescue devices are used for laying:

On-site helpers

A first responder vehicle

In large- scale countries in particular, the emergency doctor and ambulance may take longer to travel to. A closer distribution of the rescue guards usually fails due to financial feasibility. Therefore, in underserved areas, helpers (including first responders) are provided by aid organizations and volunteer fire brigades with volunteer helpers as so-called professional first aid . As a link, they bridge the therapy-free interval until a regular rescue aid arrives . A provision in the context of general interest does not take place.

Emergency psychosocial care

Since the beginning of the 1990s, the psychosocial care of emergency services after extremely stressful assignments, e.g. B. child deaths, and the care of affected persons after a damaging event, z. B. Relatives after an unsuccessful resuscitation, the abandonment of crisis intervention services (KIT) and emergency pastoral care (NFS). Emergency psychosocial care is also not part of public services.

Employee

According to a survey by the Federal Statistical Office , a total of around 67,000 full-time or part- time employees were active in the rescue service in 2016 . The majority of these employees in the rescue service are male (around 75%) and around 70% are employed full-time. In addition, numerous voluntary workers and volunteers ( Federal Volunteer Service , Voluntary Social Year , formerly also community service) are deployed.

education

The paramedic (RettAss or RA) was until 2014 the paramedic law the only nation-wide vocational training. After a one-year transition phase, the emergency paramedic (NotSan) has been the only apprenticeship in this industry since January 1, 2015 . He is gradually replacing the job of paramedic.

There is a rough regulation of the requirements for paramedic training via state laws or an agreement between the states . As rescue workers (RH) graduates will understand the basic training course for paramedics. Some countries have different rules of their own. As medical assistants (SanH) such persons are called, which have undergone a non-uniformly regulated, basic medical training.

occupation

The following table shows the minimum qualification required by law for the crews of rescue equipment:

state KTW Ambulance NEF
driver Transport guide driver Transport guide driver
Baden-Württemberg RH RS RS Emergency San / RettAss Emergency San / RettAss
Bavaria suitable person RS suitable person Emergency San / RettAss RS
Berlin SanH (60h) RS RS Emergency San / RettAss Emergency San / RettAss
Brandenburg RS RS RS Emergency San / RettAss Emergency San / RettAss
Bremen RH RS RS Emergency San / RettAss Emergency San / RettAss
Hamburg RS RS RS Emergency San / RettAss Emergency San / RettAss
Hesse SanH (48h) RS RS / NotSan trainee in the 2nd – 3rd Apprenticeship year Emergency San / RettAss NotSan / RettAss / RS (2 years of professional experience)
Mecklenburg-Western Pomerania RS RS RS / NotSan trainee with acceptance by ÄLRD Emergency San / RettAss Emergency San / RettAss
Lower Saxony suitable person RS suitable person NotSan / RettAss (until December 31, 2022) suitable person
North Rhine-Westphalia RH (NRW) RS RS / RettAss iP NotSan (a) / RettAss NotSan (a) / RettAss
Rhineland-Palatinate RH (RP) RS / RettAss iP RS / RettAss iP / NotSan trainee after successful RS equivalence test (6th month) Emergency San / RettAss Emergency San / RettAss
Saarland
Saxony RH RS RS Emergency San / RettAss Emergency San / RettAss
Saxony-Anhalt RS Emergency San / RettAss RS / RettAss iP Emergency San / RettAss RS
Schleswig-Holstein RS / NotSan trainee from the 19th month of training RS100 RS100 / NotSan trainee from the 19th month of training NotSan / RettAss (until December 31, 2023) Emergency San / RettAss
Thuringia RS RS RS Emergency San / RettAss NotSan / RettAss / RS (2 years of professional experience)
(a) compulsory from January 1, 2027
  • RettAss iP = trainee as paramedic in internship
  • RS100 = paramedic with operational experience is someone who has completed at least 100 assignments in emergency rescue after completing their training. (Rescue Service Act SH §2 Paragraph 7)
  • NotSan = paramedic
  • ÄLRD = Medical Director Rescue Service

Major events and disasters

The structures in the case of mass casualties (MANV) and especially in the event of a disaster , which are characterized by the fact that there are primarily not enough emergency services on site to deal with the damage situation and / or there is a considerable need for coordination, must be distinguished from the patient care of the rescue service, which is oriented towards individual medicine .

Rapid action groups

The regular rescue service is supported by helpers who are grouped into emergency units (EE) or rapid response groups (SEG) and alerted if necessary. These groups are able to create structures on site (e.g. a treatment center) for patient care and thus shorten the treatment-free time.

In Germany there are also joint projects among rescue organizations. DLRG and Wasserwacht provide operational divers who are flown to accident sites by helicopter. In addition, there is cooperation between the fire brigade, which keeps the material and the vehicle (a so-called water rescue equipment trolley (GWW)) ready, and the water rescue, which provides the personnel.

Mass casualty

The medical operations management in such an event is incumbent on the medical operations management, in which the chief emergency doctor (LNA) and organizational head of the rescue service (OrgL / OLRD) participate. These take over the coordination of the rescue equipment on site and the distribution of the patients to suitable hospitals.

Disaster

The determination of the disaster as well as the uniform operational management of all deployed forces under official management is regulated in the disaster control laws of the federal states and is usually the responsibility of the authority manager of the affected district or the urban district. For the operational management of the forces on site, particularly suitable managers are used by this, in Bavaria for example the aforementioned local operations manager (ÖEL). Among other things, the medical emergency management (consisting of the chief emergency doctor and organizational manager) and their resources are subordinate to him.

Major events

A paramedic service is provided at events .

Emergency emergency service

Too heavy load in the emergency service staff can be scheduled from fire trucks to ambulances or emergency services by forces of the civil protection supported. In Berlin, this is triggered as soon as 90 percent of the ambulances are in use. This happened 41 times in 2018, resulting in delayed arrival times.

Ambulance service in Austria

Ambulance and emergency ambulances
Emergency doctor vehicle from Graz
Johanniter ambulance

General

In Austria (referred to as rescue for short ), the rescue service and the fire brigade are a matter for the municipality. It is regulated in state laws. In contrast to the fire brigade, the municipalities usually do not carry out the rescue service themselves. The only exceptions are the Viennese professional rescue service and the Admont Voluntary Fire & Rescue Department . Usually the municipalities commission existing rescue service organizations. Therefore, the emergency services are often responsible for several communities. The rescue service can be reached nationwide on the emergency number 144, the alpine emergency number on 140. All rescue services can be called via the European emergency number 112.

In addition to full-time employees, civil servants and numerous voluntary employees are deployed in ambulance and ambulance services.

Organizations

The most important organization that carries out the rescue service in Austria is the Austrian Red Cross . In addition to this, there are also organizations that are represented at different locations locally, such as the Arbeiter-Samariter-Bund Austria , the Malteser Hospitaldienst Austria , the Johanniter-Unfall-Hilfe and others. Smaller associations or commercial services such as the Green Cross or the Austrian Rescue Service (ÖRD) can also have contracts with the municipalities to carry out the rescue service. Although it used to be common in Austria for the voluntary fire brigade to also carry out the rescue service ( see also: History of the medical system at the Austrian fire brigades ), today it is unique in Admont in Styria that the fire brigade operated public medical services with an emergency department becomes. In addition, is the Linz Chemicals Park by the local company fire rescue official supplies.

In rural areas in particular, the organizations carry out both the rescue service and the ambulance transport. The first responder system is also occasionally used there in cooperation with the fire brigade and the police.

Alerts are either sent via their own control centers or via integrated control centers that coordinate several organizations (e.g. 144 emergency call Lower Austria , control center Tyrol ).

In the case of special subtasks, such as emergency medical services or air rescue , we work together with other institutions. In rural areas in particular, the emergency doctors are provided by local hospitals. In the field of air rescue, the Red Cross works together with the ÖAMTC in the Christophorus air rescue association . But there is also cooperation with private companies (e.g. Air Rescue Austria Flugrettungs GmbH or SHS Helikopter in Tyrol), which provide the helicopters with the necessary flight personnel.

The Austrian Mountain Rescue Service and the Austrian Water Rescue are independent organizations that are almost exclusively carried out by volunteers. The tasks of water rescue are partly taken over by the local rescue organizations.

A special case is the rescue service in Kleinwalsertal in the state of Vorarlberg . It is carried out by the Bavarian Red Cross , see Walser rescue .

Disaster relief

In contrast to Germany, there are no independent disaster relief units in Austria, but the corresponding funds are provided by the regular rescue services. The high proportion of volunteer workers in the rescue and ambulance services enables the mobilization of sufficient personnel reserves.

education

The training in the rescue service was reorganized in 2002. With the Paramedic Act (SanG), a distinction was made between paramedics and emergency paramedics for the first time . Emergency paramedics undergo more extensive training and can acquire so-called emergency skills, such as the placement of a peripheral vein access, the administration of certain emergency medication and endotracheal intubation . These activities, which are usually reserved for the emergency doctor , may be used when an emergency doctor is not available and less invasive measures are not sufficient.

Vehicles in the rescue service

Depending on the federal state, the rescue and ambulance services are more or less separated. Accordingly, there are systems with standardized emergency ambulances , with ambulances (RTW) and patient transport vehicles (KTW) or mixed systems. All vehicles are manned by at least two paramedics; at RTW, at least one more highly qualified paramedic (if possible with emergency skills) is employed or this is mandatory. For example, ambulances are manned by at least one paramedic in Vienna and at least during the day in Vorarlberg.

In the event of serious medical problems, an emergency doctor is called in - either with an emergency doctor's vehicle ( NAW), in which the patient can also be transported, or with an emergency doctor's vehicle (NEF) that only brings the doctor and an emergency paramedic to the scene. The manning of an ambulance is required by law to have at least one paramedic, one paramedic and one emergency doctor, but as a rule two paramedics or qualified nurses in anesthesia or intensive care medicine are on board in addition to the emergency doctor.

In addition to the actual rescue service (with emergency doctors), there is also the so-called medical radio service (ÄFD) in Austria . Using the emergency number 141, general practitioners can be called to visit the house nationwide outside of the usual office hours (→ Medical Emergency Service ).

KTW Ambulance NAW NEF
RS X X - -
RS (driver) X X (X) (X) Vorarlberg
NFS - (X) X X
NCCR with emergency competence - (X), X in Vorarlberg, Vienna (X) (X)
Graduate nursing staff - - - -, X in Vorarlberg
Emergency doctor - - X X

Ambulance service in Vienna

In the federal capital Vienna , the municipal department 70 ( Viennese professional rescue ) is in charge of the implementation of the rescue service, operates the emergency call control center and arranges the rescue equipment. However, the rescue organizations Red Cross , Arbeiter-Samariterbund , Johanniter-Unfall-Hilfe , Malteser Hospitaldienst Austria provide a not inconsiderable contingent of additional ambulance and ambulance vehicles, which are integrated into the emergency control system and are dispatched directly by the professional rescue service. By GPS , touchscreen - data radio and connected thereto navigation system can at all times the nearest vehicle to be directed to the site.

The above-mentioned, under the motto "Four for Vienna" as well as the Green Cross and the Social Medical Service Austria, complement the supply network especially in the outskirts and together carry out more than a quarter of all incoming rescue transports via the emergency number 144. In addition, the several hundred ambulances of the six organizations, which are equipped with defibrillator and vacuum mattress without exception , are included in the first responder system and can be requested by the professional rescue around the clock via the control centers of the individual aid organizations.

Most of the emergency medical operations are carried out in the rendezvous system by the 13 emergency medical vehicles of the Vienna professional rescue service. The rescue helicopter C9 is manned by medical personnel from the Viennese professional rescue service and if necessary, helicopters from other federal states can be requested.

Ambulance service in Graz

In Graz as the provincial capital of Styria and the second largest city in Austria, similar to Vienna, there are some special features of the emergency services, which largely result from the organizational differences between rural and urban emergency services. The city of Graz has always commissioned the Austrian Red Cross Styria to carry out the rescue service in the city area. Similarly, all the surrounding communities have given the Red Cross the same order. At the same time, the state government entrusts the Red Cross with the organization and implementation of the ground-based emergency medical services in the greater Graz area.

Location of the rescue guards

Due to the fact that the city has already grown far beyond its official limits, especially in the south, and the "unofficial" urban area thus also includes several surrounding communities in the so-called "bacon belt", the rescue service is provided by two rescue stations in the urban area and four other guards ensured in the adjacent surrounding communities. As a result, vehicles are often used by surrounding guards for operations in the urban area. In addition, two state hospitals, the West location of the LKH Graz Süd-West together with the UKH in the northwest and the LKH University Clinic in the northeast of the city are used as "informal" rescue stations during the day, as the transport destination for most missions is in one of these two clinics and thus rescue equipment is almost always on site after the patient has been handed over or is left there, which can then be used for operations. In addition, there are two emergency medical stations (also at the state hospitals) and an air ambulance station (NAH) in the greater area.

"Jumbo" special solution

An emergency ambulance (NFW) called "Jumbo" within the organization.

All emergency medical operations are carried out in the rendezvous system , with the emergency doctor either being brought to the scene of the incident (NEF) or by helicopter. Another specialty of the Graz rescue service are the so-called "Jumbos", which are specially equipped ambulances, which are manned with "ambulance doctors" (medical students in higher semesters with training as " emergency paramedics with special emergency skills NKI" and other training) and with which actually low-priority missions requiring an emergency doctor are processed in order to keep the frequency of use for the actual emergency doctor system lower or to reduce it to absolutely necessary operations.

Coordination & Cooperation

In addition to the fleet of ambulances and ambulances of the Red Cross, the Malteser Hospitaldienst Austria provides an ambulance and two ambulances, which are connected to the central control center of the Red Cross in the district of Straßgang and are therefore integrated into the ambulance service of the Red Cross. All vehicles are equipped with GPS , touchscreen - data radio and it connected navigation system equipped, so the nearest vehicle of affiliates may at any time be directed to the site. Other organizations such as the Arbeiter-Samariterbund as well as private providers such as the Green Cross also maintain guards in the city area, but due to the contractual situation (commissioning of the Red Cross) they are not technically involved in the rescue service and emergency medical services, in particular via the state control center of the Red Cross , involved, but still legally permissible with rescue and emergency transports and with the implementation of patient, blood or organ transports.

See also

Ambulance service in Switzerland

Swiss emergency ambulance , e.g. protection and rescue in Zurich
The Swiss Air Rescue Service ( REGA) plays an important role in Switzerland . In addition to REGA, there are other air rescue organizations such as Air Zermatt and Air-Glaciers

General

In Switzerland, rescue services are the responsibility of the cantons and, in some cases, the municipalities. There are also cantonal regulations and laws. The ambulance service is available nationwide on the emergency number 144. The rescue services in Switzerland can be of a public nature or operated on a private basis. Half of the rescue services are affiliated with a hospital. Liberalism also prevails in Switzerland when it comes to rescue services. There are big differences and different legal bases between the individual rescue organizations. There are around 130 emergency services in Switzerland.

A special feature of the Swiss rescue service is the ability to alert rescue helicopters directly. The emergency number 1414 is available for this purpose. The emergency number is queried throughout Switzerland, with the exception of Valais, from the REGA operations center at Kloten Airport . Since the helicopter rescue in Valais is not carried out by REGA, the emergency number is 1415. In almost all other countries, a rescue control center decides whether a rescue helicopter is used. The Swiss-wide emergency service number is 144 and is called a medical emergency number. Switzerland has a nationwide network of air rescue stations. In contrast to other countries, the helicopters are also ready for use at night. The helicopters are suitable for night flights and have residual light amplifiers (night vision devices). The helicopters also carry out animal rescues.

Emergency service vehicles for major events in Switzerland, e.g. protection and rescue in Zurich

Major events and disasters

Here, too, this is largely regulated by the cantons. In the canton of Zurich, for example, the rescue service from Protection and Rescue Zurich is responsible for coping with it. The responsible rescue service takes on the rescue service management of the event and coordinates the operations of the locally based rescue services. In order to fulfill this task, larger rescue services have special operational equipment (e.g. trucks with disaster material, command vehicles, treatment centers, etc.). Every rescue service in the canton has also stationed material for larger events (e.g. smaller trailers). The fire brigades in some cantons also maintain medical units that are deployed during major events.

Ambulance service in South Tyrol

In South Tyrol, the rescue service is entrusted to state, public and private corporations. The rescue service is offered nationwide via the emergency number 118 and processed by the state emergency call center , which alerts other organizations such as the fire department if necessary. In addition to the classic rescue services in the field of ground rescue, there are also numerous specialized rescue services (e.g. mountain rescue) in South Tyrol. In addition, a total of three rescue helicopters (one of which is only seasonal) are stationed in South Tyrol because of the difficult-to-access alpine terrain.

The ethnic component in South Tyrol is also worth mentioning, which in the recent historical development of the country has led to linguistically separate rescue services with the same tasks and objectives being developed in the same territory. While the “ Landesrettungsverein Weißes Kreuz ”, founded in 1965 , operates nationwide, the state-sponsored “ Italian Red Cross ” operates mainly in those places with a high proportion of Italian-speaking citizens.

Ambulance service in the USA and Canada

Ambulance in New York City in action
American ambulance

The ambulance service in the USA and Canada differs fundamentally from the "Franco-Germanic model" that is practiced in Germany, Austria, France, South Tyrol, but also partly in Switzerland.

In contrast to the emergency doctor system, in which both doctors and non-medical staff work together pre-clinically, emergency care in the Anglo-American countries is entirely in the hands of paramedics , who usually undergo extensive training and perform many activities, for example in Germany and Austria are only reserved for doctors ( chest drains , rapid sequence induction, etc.). The principle of the fastest possible transport to a hospital with medical care only taking place there is also called load and go . The paramedics can train to become critical care paramedics and certified flight paramedics, which are deployed on rescue helicopters and critical care transfers. In the USA, the rescue helicopters without doctors are manned by paramedics and flight nurses.

See also

Portal: Rescue Service  - Overview of Wikipedia content on the subject of rescue service

literature

Training literature

  • Dietmar Kühn, Jürgen Luxem, Klaus Runggaldier (eds.): Ambulance service today. Elsevier, Munich 2007, ISBN 978-3-437-46192-7 . (Including online bonus material)
  • B. Gorgass , FW Ahnefeld , R. Rossi, H.-D. Lippert, W. Krell, G. Weber: The rescue service textbook. 8th edition. Springer Verlag, Heidelberg / Berlin 2007, ISBN 978-3-540-72277-9 . (including online access)
  • Christoph Redelsteiner et al. (Ed.): The manual for emergency and paramedics. 1st edition. Braumüller, Vienna 2005, ISBN 3-7003-1467-1 .
  • Kersten Enke (ed.), Bernd Domres (co-founder): Textbook for preclinical emergency medicine: LPN. 5 volumes. 3rd, revised and expanded edition. Stumpf and Kossendey, Edewecht / Vienna 2005, ISBN 3-938179-04-X .
  • R. Rossi, B. Gorgaß, FW Ahnefeld: The rescue service examination. 6th edition. Springer Verlag, Heidelberg / Berlin 2007, ISBN 978-3-540-46656-7 .
  • M. Bärnthaler, P. Hansak, B. Petutschnigg (Eds.): Textbook for emergency paramedics. Rescue Medicine Law. 3. Edition. Verlag Pachernegg, Purkersdorf 2005, ISBN 3-902156-05-8 .
  • P. Hansak, B. Petutschnigg, M. Böbel, HP Hündorf, J. Veith (Eds.): LPN-San Austria. Textbook for paramedics, training paramedics, company paramedics and army paramedics in Austria. 3. Edition. Verlag Stumpf and Kossendey, Edewecht 2008, ISBN 978-3-938179-42-0 .

System literature

  • R. Schmiedel, H. Behrendt, E. Betzler: Regulations for the requirement planning emergency service. Mendel Verlag, Witten 2012, ISBN 978-3-943011-05-0 .
  • H. Behrendt: Personnel requirements and duty roster design. 1st edition. Publishing company Stumpf and Kossendey, Edewecht 2006, ISBN 3-938179-30-9 .
  • H. Behrendt, K. Runggaldier: Statistics for the rescue service. A general introduction. Publishing company Stumpf and Kossendey, Edewecht 2005, ISBN 3-938179-01-5 .
  • M. Boschung: The ground-based rescue service - in the field of tension between state tasks and regulated private-sector activity. Zurich 2010, ISBN 978-3-7255-6024-0 .
  • Werner Gerdelmann, Heinz Korbmann, Stefan Erich Kutter: Ambulance and rescue services. Loose-leaf work, status: 2007, Erich Schmidt Verlag, ISBN 978-3-503-01549-8 .
  • M. Nüßen: Right in the ambulance service. Legal advisor for rescue workers. 2008. Published as website http://www.recht-im-rettungsdienst.de/
  • R. Schmiedel, H. Behrendt, E. Betzler: Requirements planning in the rescue service. Locations · Vehicles · Personnel · Costs. Springer-Verlag, Berlin / Heidelberg / New York 2004, ISBN 3-540-21222-1 .
  • R. Schmiedel, HP Moecke, H. Behrendt: Optimization of rescue service operations. Practical and economic consequences. (= Reports of the Federal Highway Research Institute. People and Safety. Issue M 140). Wirtschaftsverlag NW, Bergisch Gladbach / Bremerhaven 2002, ISBN 3-89701-878-0 .

Reports, Statistics & Standards

  • H. Behrendt: Figures for the rescue service - An overview of the most important key figures in the rescue service. Mendel Verlag, 2008, ISBN 978-3-930670-44-4 .
  • R. Schmiedel, H. Behrendt: Services of the rescue service 2004/05. Analysis of the performance level in the rescue service for the years 2004 and 2005. Wirtschaftsverlag NW Verlag für neue Wissenschaft, 2007, ISBN 978-3-86509-723-1 .
  • R. Schmiedel, H. Behrendt: Services of the rescue service 2000/01. Compilation of infrastructure data on the rescue service 2000 and analysis of the performance level in the rescue service for the years 2000 and 2001. Wirtschaftsverlag NW Verlag für neue Wissenschaft, 2002, ISBN 3-89701-925-6 .
  • DIN (Hrsg.): Rescue service: Norms  - DIN pocket book 257. 2nd edition. Beuth, Berlin / Vienna / Zurich 2000, ISBN 3-410-14558-3 .
  • DIN (Ed.): Rescue Service: Norms  - DIN-Taschenbuch 257. Beuth, Berlin / Vienna / Zurich 2004, ISBN 3-410-15843-X (CD-ROM).

vehicles

  • Wolfgang Jendsch: Emergency vehicles of the medical and rescue services: u. a. Emergency medical rescue services, air rescue, water rescue DLRG and DGzRS, mountain rescue / mountain rescue, disaster control. Motorbuch Verlag, Stuttgart 2009, ISBN 978-3-613-03099-2 .
  • Udo Paulitz: 100 years of medical and ambulance vehicles - from the beginning of the 20th century until today. Kosmos, 2003, ISBN 3-440-09293-3 .
  • Alex Buchner: The Army Medical Service - organization, equipment, operations. Nebel Verlag, 2003, ISBN 3-89555-095-7 .

history

  • Holger Frerichs: From the sick basket to the Friesland rescue service. Documents on the history of patient transport and emergency rescue in the district of Friesland from 1884 to 2004. Verlag Lüers, Jever 2005, ISBN 3-9809226-5-0 .
  • Ralf Bernd Herden: Red Rooster and Red Cross - Chronicle of the history of fire extinguishing and rescue services. BoD, Norderstedt 2005, ISBN 3-8334-2620-9 .
  • Nils Kessel: History of the ambulance service 1945–1990. From the “people of life savers” to the job description “paramedic” . Peter Lang Verlag, Frankfurt 2008, ISBN 978-3-631-56910-8 .
  • Heinrich Klingshirn: The long way to a modern rescue service. Selected lectures 1980–2006 . With an afterword by Peter Sefrin. W. Wolfsfellner MedizinVerlag, Munich 2011, ISBN 978-3-933266-84-2 .

Movies

Individual evidence

  1. ↑ a b Alex Lechleuthner: tenders in the rescue service: where is the journey going? In: Ambulance Service. 2006, p. 936 ff.
  2. ↑ ECJ: Procurement law is not applicable to rescue service concession models. ( Memento from March 13, 2013 in the web archive archive.today )
  3. ↑ NRettDG in the version of October 2, 2007 (Nds.GVBl. No. 31/2007, p. 473), amended by the law of February 22, 2012 (Nds.GVBl. No. 3/2012, p. 18).
  4. ↑ Graduations in emergency rescue .
  5. ↑ Table (configurable): GPR, health workers by gender, type of employment and occupation . In: Federal health reporting . Federal Statistical Office (Destatis). January 24, 2018. Archived from the original on April 28, 2018. Retrieved on April 28, 2018.
  6. ↑ Version of the RDG BW from November 19, 2009
  7. ↑ a b Rescue Service Plan 2014 of the Ministry of the Interior of Baden-Württemberg , see page 49. New requirement since Rescue Service Plan 2014 (previously "suitable person"); previously as a second person - deployed persons have grandfathering.
  8. ↑ Version of the BayRDG from July 2008
  9. ^ Law on the rescue service for the state of Berlin (Rescue Service Act - RDG). Retrieved March 24, 2019 .
  10. ^ State law - Justice - Portal Hamburg. In: landesrecht-hamburg.de. June 9, 1992, accessed March 24, 2019 .
  11. ↑ Ordinance on the implementation of the Hessian Rescue Service Act. (PDF) Retrieved March 24, 2019 .
  12. ^ Law on the rescue service for the state of Mecklenburg-Western Pomerania of June 1, 1993 .
  13. ↑ Version of the NRettDG from December 2012
  14. ↑ VORIS § 10 NRettDG | State standard Lower Saxony | - Personnel | Lower Saxony Rescue Service Act (NRettDG) in the version of October 2, 2007 | valid from: 21.12.2016. Retrieved July 24, 2018 .
  15. ↑ § 4 Rescue Act NRW (RettG NRW) of November 24, 1992 in the version of March 25, 2015 ( GV.NRW. P. 305 )
  16. ↑ State law on the rescue service as well as emergency and patient transport (Rescue Service Act - RettDG) in the version of April 22, 1991. Last change on December 31, 2010
  17. ^ Saarland: Landesrecht - Saarland.de. In: sl.juris.de. February 9, 1994, accessed March 24, 2019 .
  18. ↑ Saxon State Rescue Service Ordinance (SächsLRettDPVO) of December 5, 2006
  19. ↑ juris GmbH: State Law Saxony-Anhalt § 18 RettDG LSA | State standard Saxony-Anhalt | - Life-saving appliances, occupation | Emergency Services Act of the State of Saxony-Anhalt (RettDG LSA) of December 18, 2012 | valid from: 09.11.2017. Retrieved September 18, 2018 .
  20. ↑ with special requirements: 160h rescue station internship, attendance at 2 deliveries as part of the clinical internship and BOS radio briefing
  21. ^ Juris GmbH: State Law Saxony-Anhalt RettDG LSA | State standard Saxony-Anhalt | Complete edition | Emergency Services Act of the State of Saxony-Anhalt (RettDG LSA) of December 18, 2012 | valid from: 01/01/2013. Retrieved September 17, 2018 .
  22. ↑ Thuringian Rescue Service Act (ThürRettG) of July 16, 2008
  23. ^ "Berlin is on fire" protest The Berlin fire brigade is in a state of emergency . In: Der Tagesspiegel , April 3, 2018: “But a state of emergency is declared in the emergency services when 90 percent of the ambulances are on the move. Then firefighters are rescheduled from the turntable ladder and the fire engine to ambulances. "
  24. ↑ German Fire Brigade Association , working group of heads of professional fire brigades : Fire brigade in the rescue service - communal, strong, close to the people! : "If many people need help at the same time: peak load reserves in the fire brigade ... then the fire brigades use reinforcement levels in their rescue service. Due to the multifunctionality of the emergency personnel, a fire brigade with rescue service is able to react quickly to critical clusters of operations (parallel operations) by deploying additional rescue vehicles with fire protection personnel. "
  25. ↑ State of Hessen : Medizinischer Katastrophenschutz in Hessen , p. 40: "Damage incidents with an increased number of emergency patients represent a state of emergency below the disaster threshold according to No. 1.2 of the rescue service plan if this means that it is no longer possible to dispose according to the principles of standard care is. "For these cases," a step-by-step support of the rescue service by emergency services of the disaster control "is provided.
  26. ↑ About us . Admont Volunteer Fire Brigade , accessed September 6, 2010.
  27. ^ BTF Chemical Park Linz. Retrieved February 3, 2020 .
  28. ↑ Mission statistics of the Berufsretter-Wien ( Memento from December 8, 2011 in the web archive archive.today )
  29. ↑ Rega alarm number: 1414
  30. ↑ Rega missions for alpine animals
  31. ↑ Guide to medical elements in fire services

Web links

Wiktionary: Ambulance service  - explanations of meanings, word origins, synonyms, translations
This version was added to the list of articles worth reading on October 23, 2005 .