Paramedic

Paramedics (in Germany abbreviated to RettSan or RS ) are persons trained for the rescue service and ambulance transport. During the training, the basics of emergency medicine and techniques for rescuing seriously injured or ill people are learned.

The training to become a paramedic is defined differently in Germany, Austria and Switzerland.

The vernacular often calls any non-medical emergency personnel paramedics . When used in this sense, the expression - just like the more general term " paramedic " - is not linked to the actual qualification of the helper.

Paramedic in Germany

education

The training is based on the "principles for training personnel in the rescue service" of the federal-state committee "rescue services" of September 20, 1977, is regulated by law in most federal states, but not by federal law. It comprises at least 520 hours and is divided into four parts:

• First of all, at least 160 hours of theoretical basics are learned (the course is also referred to as a " rescue (service) helper " course in some federal states ). The contents covered include basic knowledge of anatomy and physiology, general contents and measures of emergency medicine (resuscitation, airway management, basics of medication administration, etc.), special emergency knowledge of important specialist areas (internal medicine, surgery, neurology, psychiatry, pediatrics, etc.), and other topics on the structure of the rescue service as well as legal and technical content. Practical exercises in emergency techniques are also an integral part of the training.
• A further 160 hours are spent on a clinical internship in the areas of emergency ambulance, intensive care unit and anesthesia, in which further medical measures such as preparing an infusion, assistance with intubation, handling medication, patient monitoring, (clinical) patient documentation, etc. are taught.
• There is also a 160-hour internship at an ambulance, usually a recognized training rescue station with prescribed internship shifts and the associated documentation on ambulance vehicles ( KTW), ambulances (RTW) or emergency doctor vehicles (NEF).
• The last part of the training is a final course of at least 40 hours with a final exam with written, oral and practical parts.
• Rhineland-Palatinate: A new regulation has been in force since June 1, 2020: The duration of the theoretical block at the beginning of the training is increased by 80 hours to 240 hours, while the duration of the clinical internship is reduced by 80 hours to 80 hours. Transitional regulations apply to training courses that have already started.

Training objective: In general, the training should enable them to be used in emergency rescue as a driver of an ambulance (acquisition of the C1 driving license, which is increasingly required for this, is not part of the training) and to assist the more highly qualified paramedic or paramedic in the care of emergency patients (for example preparation and assistance with intubation, taking an ECG, blood pressure and blood sugar measurement, preparing medication and infusions), until the arrival of an emergency paramedic, paramedic or emergency doctor, to carry out life-saving measures (for example clearing and keeping the airways free, resuscitation including defibrillation) with semi-automatic defibrillators, storage, administration of oxygen, breastfeeding threatening bleeding) and patients who are not emergency patients but still require care, to be looked after independently in qualified ambulance transport . In some federal states, according to the State Rescue Service Act, paramedics can also be used as drivers of emergency medical vehicles, but sometimes only paramedics who have a certain amount of professional experience on the ambulance.

Paramedics are trained by aid organizations and at private rescue service schools. In North Rhine-Westphalia it is possible to attend a shortened RS course that builds on the " Rescue worker NRW ". Costs: the courses are often chargeable, the total cost of the training is around 1500 euros. In some cases, graduates of a voluntary social year (FSJ) get their paramedic training financed and, in return, work in the rescue service for the remainder of the FSJ (total duration 12 months) for pocket money for the aid organization. Voluntary helpers are rarely financed for their training, but they usually go through an internally regulated and much shorter qualification.

The Hessian Ministry of Social Affairs took a completely new path in 2011 with the approval of an innovative state model project at a grammar school in Rodgau, Offenbach district, which was awarded the Federal “Helping Hand” award in 2013 by the Federal Ministry of the Interior. Based on a cooperation between the Offenbach District Rescue Service, the DRK Rescue Service Offenbach gGmbH, the Johanniter Unfallhilfe Rodgau and the Rodgau Volunteer Fire Brigade, pupils from the Claus-von-Stauffenberg-Schule, a grammar school, subject and Trained across grades after successfully completing the basic course for volunteer fire brigades and the fire service paramedic course to become paramedics according to APORettsan of May 5, 2011 under the supervision of the Darmstadt Regional Council.

Further training to become a paramedic based on the paramedic was possible until December 31, 2014 in accordance with Section 8 (2) Paramedic Act (RettAssG) and the transitional regulation in the Emergency Paramedic Act (NotSanG).

In the military field, the equivalent professional training is that of the emergency medical technician , which is not to be confused with the qualification of the same name but alien to its nature in the civilian field. The Bundeswehr recognizes the training to become a paramedic, which is also the basis for the training to become an emergency medical technician , under ATN 1001369 (paramedic).

Areas of activity

Paramedics are used in Germany in the rescue service, in qualified ambulance transport as a transport driver on an ambulance and in emergency rescue as part of the crew of an ambulance, ambulance or ambulance vehicle. With the latter, it is part of their tasks to initiate the care of the patient and to support the emergency doctor and paramedic (or paramedic) in restoring or maintaining vital body functions and making the patient fit for transport.

Advanced training

Depending on the regulations of the individual federal states, the company or the aid organization, a paramedic must provide evidence of at least 30 hours of advanced training in the rescue service each year so that he can continue to be used in the rescue service or ambulance transport.

Differentiation from the paramedic / paramedic

The emergency paramedic is one of the rescue specialists and is the highest non-medical qualification in the rescue service . Since January 1, 2014, he has replaced the paramedic as a job description.

The paramedic is not a recognized training occupation, its qualification is a certificate. The Federal Fiscal Court only recognizes the paramedic as vocational training within the meaning of tax law. The 'paramedic' certificate can be obtained as part of a 520-hour course (13 weeks for a 40-hour week). The emergency paramedic must complete three years of full-time training or a maximum of five years part-time; the qualification is a profession . For the paramedic, a two-year training period consisting of 1,200 hours of specialist training at a state-recognized paramedic school and in a suitable hospital with a state examination and practical training at a recognized rescue station totaling 1,600 hours was required. For paramedics, among others, there was the possibility of a shortened training to become a paramedic.

Paramedic in Austria

education

The training to become a paramedic comprises 260 hours and is divided into two parts, the theoretical training of 100 hours and a 160-hour rescue service internship. A clinical internship is not planned. The training ends with a theoretical and practical examination before an examination board. For reasons of labor law, full-time paramedics also have to complete a 40-hour professional module that deals with in-depth legal studies and the organization of the Austrian health system.

Paramedics are usually trained by the relief organizations ( Red Cross , Samaritan Association , Johanniter , Maltese , Green Cross etc.) or by the armed forces as part of basic military service. There are no private rescue service schools like in Germany.

Medical service training (paramedics, emergency paramedics ) has only been legally regulated and recognized by the state in Austria since 2002 by the Paramedic Act, a federal law. There is no automatic recognition of foreign training courses in Austria. In order to gain recognition, a nostrification from the Federal Ministry for Health and Women is required.

Areas of activity

Paramedics are deployed in Austria in qualified ambulance transport and rescue services. Your task is to look after the patient during the transport, to provide assistance in acute situations and to carry out emergency life-saving measures. In addition, every Austrian paramedic receives in-depth training in major accidents and disasters.

The better trained emergency paramedics (training based on the paramedic, a further 480 hours from 160 hours of theory, 40 hours in a hospital and 280 hours in the emergency doctor system, of which up to 120 hours can also be served in the hospital and an examination) often come in working with a emergency physician at the emergency doctor's vehicle , ambulance or rescue helicopter used.

Advanced training

The paramedic's authorization to work is limited to two years and is suspended if no further training courses of at least 16 hours have been attended during this period (Section 50. (1) SanG) and the knowledge of cardiopulmonary resuscitation including defibrillation by a qualified person Doctor (§ 51. (1) SanG). (Section 26 SanG)

The entitlement is revived if the obligation for further training (Section 50) is subsequently demonstrably fulfilled to the extent that it is missing and the knowledge of cardiopulmonary resuscitation including defibrillation (Section 51, Paragraph 1) has been checked by a qualified doctor. (Section 26 SanG)

The right to exercise the profession or activities of the paramedic expires if the total number of advanced training hours to be made up (Section 50 SanG) exceeds 100 hours. (Section 26 SanG)

Paramedic in Switzerland

education

A qualified paramedic is a relatively young occupation. This training, recognized by the SRK , lasts three years and can be used with existing medical training, e.g. B. as a dipl. Nursing specialist HF or transport paramedic FA can be shortened by one year. The qualified paramedic ensures preclinical patient care independently or in cooperation with other specialists (e.g. emergency doctor ). The training is roughly comparable with the German emergency paramedic .

Since 2005, the new graduates have graduated with a qualified paramedic HF . HF stands for " higher technical school ". Since the vocational training reform by the Federal Office for Professional Education and Technology , the profession has been a tertiary education.

Only candidates with a completed Matura , technical secondary school or apprenticeship with an EFZ qualification are admitted to the training .

Competencies

The competencies are determined by the medical director of the rescue service and cannot be compared with those in the rest of German-speaking countries. In most rescue services, the dipl. Paramedic reflex-free patients with laryngeal intubation and analgesia with ketamine or opiates such. B. perform fentanyl , morphine and pethidine independently. These competencies can e.g. B. monitored by internal audits. Every rescue service has made arrangements for its operation, for an emergency doctor or other specialists (e.g. a midwife ) to be called out or to be asked .

Overarching legal regulations

According to a ruling by the European Court of Justice ( ECJ ) in Luxembourg on October 4, 2004, paramedics who work for an ambulance service are generally not allowed to work longer than 48 hours a week. This upper limit applies including on- call duty .

See also

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

literature

Training literature

Excerpt from the standard training literature:

• Bodo Gorgaß, Friedrich W. Ahnefeld: The paramedic. Education and training . With the collaboration of T. Graf-Baumann. With a contribution on legal aspects by H. Roth. Springer Berlin-Heidelberg-New York 1980. ISBN 0-387-08731-1 .

• Luxem, Kühn, Runggaldier (eds.): Rescue Service RS / RH . Elsevier, Urban and Fischer, Munich, 3rd edition (April 2013), ISBN 3-437-48042-1 .
• Markus Böbel, Hans-Peter Hündorf, Roland Lipp (eds.): LPN-San: textbook for paramedics, company paramedics and rescue workers. Stumpf & Kossendey, 3rd edition (March 2012), ISBN 978-3-938179-97-0 .

Web links

Wiktionary: Paramedic  - explanations of meanings, word origins, synonyms, translations

Germany:

• Paramedic in Berufenet the Federal Employment Agency

Switzerland:

• Paramedic HF on Berufsberatung.ch

Individual evidence

1. ↑ PDF at www.notfallrettung.com ( Memento of the original from November 12, 2013 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. 
2. ↑ See Kühn / Luxem / Runggaldier: Rescue Service. 3rd edition 2004, p. 803f.
3. ↑ ASB Mainz: Draft - Ordinance on the training and testing of paramedics in Rhineland-Palatinate (RettSan-APrV). Retrieved July 6, 2020 . 
4. ↑ For more information, see Markus Henkel, Frank Naujoks, Silke Ley, Hans-Uwe-Kellner: Rescue service training: Between general school and practice. In: Ambulance Service. Journal for Preclinical Emergency Medicine 38 (2015), pp. 30–36.
5. ↑ Law on the occupation of the emergency paramedic and the amendment of other regulations of May 22, 2013 ( Federal Law Gazette I p. 1348 )
6. ↑ List of recognized training occupations. Federal Institute for Vocational Training, accessed on March 13, 2018 . 
7. ↑ Judgment of October 27, 2011 - VI R 52/10 , BGH NJW 2012, 799, 800
8. ↑ Recognition of paramedics  ( page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. , accessed June 12, 2017.  
9. ↑ ECJ, judgment of October 5, 2004, associated cases C-397/01 to C-403/01