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About Bernhard

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  • Occupation Rettungsassistent

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  • Gender Male
  • Location State of Bavaria, Germany, Europe

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Bernhard's Activity

  1. Bernhard added an answer to a question Why do we transport dead people?   

    I'm glad we have the right to pronounce death on scene. Medics may decide due to "safe" signs of death, as rigor mortis, livor mortis and non survivable injuries plus asystolie. Working a code for some time with no effort (ROSC) is up to the emergency physician we then have available on scene.
    As far as I know I never had ever worked someone who now shows an appallic syndrome. Either they died soon after or they survived. Secondary survival rate has dramaticallly increased with new CPR algorithms, in my starting years (end of 1980ies) this was more or less randomly. I at the moment recall just one patient before 2000, where the neighbour started CPR:this neighbour was a seasoned medic, his assisting daughter an experienced anaesthetics nurse, basic equipment available for them plus the ALS station and receiving hospital just a few minutes away. As I entered the room, the patient already was e.t.'d, we just had to attach ECG and provide defibrillations. Patient left hospital a week later, totally recovered. Since then I had a few saves, more and more since ~2000 when we started using AHA/ERC algorithms.
    Actually, to answer the question in the topic, yes, I once transported a death person. Transporting bodies is ruled out in our states EMS law (and was back then, but it is time.barred anyway...here's the story:
    We had a call in the church just neside the station. With service in full progress we CPR'd between all those praying people, somewhat scary (but not the first time for me, yes, they already talked about me to write a book). We moved into the ambulance, then pronounced dead after some while. Chaplain came into the ambulance and said a few words. Dispatch notified us about enhanced arrival time for the hearse car (sp?), so the supervisor, who was on scene in another role, felt the urge for a decision.
    His first suggestion was to drop the body off in our station so we were available again. I talked him out of that.
    The chaplain notified, that he had the keys for the local morgue, which happened to be just around the corner beside the cemetary. So the supervisor decided to take this opportunity...and we drove the body in our ALS ambulance slowly into the cemetary. Just as we arrived there, the hearse car arrived.
    Disclaimer: things have changed since then, I never would do this anymore (meanwhile, I'm supervisor myself, maybe this call was one of the reasons), it was totally against the law, noone has ever found out and all went well. At least I learned (talked a bit with them), the burial services are quick enough to wait on-scene.
    People are very pragmatic here - next time I'll tell the story about the other chaplain calling us, as he found out that the dead person wasn't medically cleared, up to his arrival...
    To adresse another perspective mentioned here: After having some incidents I took a crisis intervention class to be trained to handle the relatives. Was an eye-opener! Never would like to work in crisis-intervention myself, but I use the skills to handle non-medical situations since then. I strongly suggest such a training to all young medics!
    (BTW: have a happy new year, everyone!)
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  2. Bernhard added a post in a topic Syrian Refugees   

    Canadian Red Cross already helps us out here. A report from a refugee camp by a canadian Red Cross worker: http://www.redcross.ca/blog/2015/11/translating-the-refugee-crisis--stories-from-germany
    The camp she talks about is just in the neighbour county, not far away from me.
    By the way, to EMTCity administrators: I find it totally inappropriate to automatically set links into postings. My term "summer clothes", describing a deadly risk to refugee children was linked to an Amazon site with a cheering girl selling "Lovely Baby Girl's Summer Clothes Denim Dress + Cotton Coat + Belt Outfits Sets". Not funny.
    Apart from beeing totally inappropriate in the given context, inserting links in someone's posting generally is no good netiquette, since it may appear as if I had set the link. Financing the site is OK, but not changing someones texts and intention for the sake of money. If this won't be stopped, I'll be out of activity here soon. Really.
    EDIT: it just happened with this text, too. "Link added by VigLink" is the caption. Please stop that!
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  3. Bernhard added a post in a topic Syrian Refugees   

    You're welcome!
    Scariest thing at the moment is, that winter time here is just coming. We have a relatively warm autumn, usually we should have got the first frost and snow by now. However, it will come soon.
    Then, and this will be a tough call, we will have real winter. Winter in Germany and Austria (two of the main passing countries for refugees) is a real threat to outdoor life. Ice covered surfaces, several meters (1 meter = 3 feet) of snow, strong winds and freezing cold of about -5 to -10° Celsius (23 to 14° Fahrenheit) is just a usual daily phenomenon here between November and April.
    We already experience infectious rates up to 100% on incoming refugees, first with childrens, soon after on all others in the camp. I dare not to imagine if it gets real cold and icy. This sure will be deadly to refugees, all of them walking, not beeing sufficiently sheltered on all their way and wearing summer clothes. Especially children. I fear we'll face another escalation of this humanitarian disaster just at our gates.
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  4. Bernhard added a post in a topic Syrian Refugees   

    Just my point of view, more or less from inside: We're dealing with refugees from Syria and other countries at a daily basis as Germany is as well a main European target for their getaway and a main transit country to other european nations. I live in close relation to the south-eastern borders (just an hour away), had helped building shelters, organized food logistics and am one of those responsible to organize EMS upgrades (i.e. additional ambulance stationing) due to the situation. I have access to the daily reports from our central communication and information center organizing the first shelter areas and transport logistics at the borders.
    At the moment, there are more than 5'000 refugees per day crossing our borders, far more still at the gate. Volunteers and paid helpers including police and military do a hell of a work to meet the needs of them. Families, females and males, unaccompanied young people from all ages, newly born (actually several births in our shelters or in trains) up to senior level (allthough rarely far over 50 years old) had a rough time to get here.
    I know stories from their decision to flee, including seeing or beeing target of barbarous cruelty, leaving relatives and property behind, to crossing the mediterrean sea by totally unsuitable boats up to wandering through countries they don't understand and which are more or less hostile or totally overextended in their capability of help at best.
    Fact 1: they need immedeate help.
    Fact 2: they don't want to flee, they're forced.
    Fact 3: if there is peace for them and their families in their home countries, they would be happy to get back.
    It's not a Middle-East or European problem, it's a humanitarian task for all of us, globally!
    The organization that called itself "Islamic State" is just some fascist entity with a fake religious motivation, bringing hate and harm to humans. This has to be stopped! But while politicians sort things out how to do that, there are humans, women, men, children who need help. Talking about 10'000 or 25'000 people is a joke. That's what we do in a few days. Week per week, month per month. I recently checked our state wide logbook, the first entry is from October 2014, when the first camp was built and the event starts to be coordinated by a central body. Over a year ago now!
    Still now politicians talk about "coordinating the refugee wave" (hell, it's already become a normal state for all those working on it). Still now politicians talk about what has to be done to stop this. Unfortunately, a lot of them talk about building just more fences. A good question I heard in a talkshow was: "If you build fences, do you care for the bodies that will pile up before them?" (followed by silence for a few minutes).
    I'm glad that the UN conference last weekend obviously had some outcome: cutting finance flow for IS and building up a joint effort fight the cause. Refugees are "just" a symptom, which makes them not less important.
    For those who think refugees are a direct terrorist threat, please answer just a short quiz what you would do as a terrorist wanting to enter a country:
    You will take a stressful route through land & mountains, enter a inappropirate rubber boat to cross the mediterrean see with a high probability to sink, stay in refugee camps where all other people will hate you because you are the cause of their trouble, then getting away from police registration with nothing more on you than your clothes and your knapsack, just for joining a terror cell after your 2 week walk (I know refugees who needed a year) ORYou will take the money from drug trade and stolen property, buy a fake passport, enter a comfortable airplane or rent a fine middle class car, then traveling to your destination in a relaxed state of mind just as a normal tourist would do.Option 1 or 2? For me, it's pretty clear. As of now, the story about the terrorist in Paris who has entered by a refugee route seems to be fake (fake passport/identity theft). I can't rule that out, especially when young refugees experience a hostile environment in their country of destination - and yes, they sure are vulnerable to fascist indoctrination. Just as anyone else - remember, we in Germany have learnt a lesson there...
    I know a bunch of young males here in my village ("unattended underaged refugees", actually from 13 to 18 years old) who are very ambitious in learning the language of their new country, wanting to get a job and are integrated in the local sports community (actually ~8 of them attending training in the local football team). They have all a past, I wouldn't wish to my child, never. Yet, they are more or less happy, cheerful kicking the ball on the local training ground, which is just a few streets away from my home. Seems it works, at least a bit, to give them hope.
    The final solution will be difficult: bombing and/or sending ground troops won't help, it just would heat up the conflict, give more justification to IS and hit innocent civilians. Personally, I don't see a military solution to a multi-facet problem. I don't know how and when it will be solved, but I sincerely hope, it will get done.
    As long as politicians sort that out, we have to care for those who are in immedeate danger at our gates. Taking and caring for several 1'000 refugees is a start. Remember: We here cope with 5'000 - 10'000 refugees per day, and we're even not the first contact country in the European Union. Yes, we need help. But far more, THEY need help!
    Thank you for listening!
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  5. Bernhard added a post in a topic How many patients have you intubated this year?   

    2015, until now: 2 ET, ~5 supraglottic myself. Assisted when partners applied one on a few more. And I have an office job...
    Primarily I choose the supraglottic (we use Larynxtubus here), ET only when supraglottic doesn't work for some reason.
    On one instance my supraglottic AND ET attempt wasn't succesful, so this is not counted above. HEMS doctor eventually was able to push another one in after several tries. We got a fairly good CO2 reading, but it didn't help: hospital later diagnosed a high c-spine fracture and totally confused airway situation, pronounced dead in the ER (44 y/o motorcyclyst, head against street sign post as we found out later).
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  6. Bernhard added a post in a topic 2800 addresses where you can't go without PD   

    Here dispatch has address specific information, which may include potential risks, mainly used for hazmat info - don't know if any of that contains potential violence. Decision usually is based on type of call. It's very rare, that a police unit is dispatched with EMS just because of a suspicious address.
    I didn't read the attached thesis: Is there a process in the Scottish Ambulance Service to delete the flag when there apparently is no danger anymore?
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  7. Bernhard added a post in a topic TWIAGE - new app coming   

    Just to prove that this is no wizardry: Our working telemetry system over here already consists of
    having status access to hospital capacity,informing the hospital about incoming patients (estimated arrival time, main diagnosis),sending basic patient data to the receiving hospital (ECG, vital values) andusing the data in other computer systems for invoice management and secure archival.From scene we still use radio to request target hospital and relate first patient information to EMS dispatch center (who are medically trained, at least EMT level). But then, dispatch can access a web based communication platform: receiving hospital can be picked by a click and is informed about incoming patients (ETA, main diagnosis etc.) by a monitor in their ER. Hospitals regularly update their status in this platform, so EMS dispatch centers can see which hospital is open/closed for specific treatments at the moment. It still is a pilot project in Munich, but runs for about two years quite successfully, so it probably will cover whole state of Bavaria someday soon. Works really nice!
    BTW, without the dispatch access every interested citizen (including you!) can at least see actual capacities of the hospitals: http://www.ivena-muenchen.de (German language).
    For providing the hospital with information: ECG strip can be sent to the receiving hospital, this includes other information from the monitor like heart rate, NIBP, SpO2, CO2 and temperature (if attached). This is in use for several years now.
    Additionally, since a while we have tablet computers for call reports (http://www.rettungsdienst.brk.de/aktuelles/innenminister-informiert-sich-beim-brk-ueber-telematik-ii/@@images/0195d053-00ad-4e96-ba3d-bd69acc603b8.jpeg). They even can receive above mentioned data from ECG by bluetooth, so this is included in the report with the click of a button. At the moment the report has to be printed when arriving at the hospital (compatible printer on every ambulance and in several hospitals), stored data in the tablet then is used invoice management and for archive purposes. This already is working in the whole state of Bavaria/Germany and all contracted EMS agencies/companies (~1500 units).
    I don't see a benefit in sending the tablet data to the receiving hospital, because it has to be entered first and thus may delay patient care. From experience it's already a tough job to have the computer patient report ready when arriving at the hospital, especially with patients in bad condition, where you need your hands on the patient and not on some tablet. A short information to the dispatch center by radio and them entering the information into the system works just as well.
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  8. Bernhard added a post in a topic Funniest EMS stories   

    Let's see. Last week I
    was mistaken for a towing service by a very confused young police officer at scene of a vehicle accident,was target of heavy flirting by a 89 year old woman at a nursing home, fallen out of bed, vomited, short of breath/possible aspiration - but instantly fell in love with me,rescued a cat from a tree (OK, this wasn't a real call, just spotted the cat in distress on a private walk).We'll see what follows next week. 
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  9. Bernhard added a post in a topic Old folks Still here?   

    We're in chat. Where is everyone else?  
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  10. Bernhard added a post in a topic Old folks Still here?   

    BTW: I'm still in chat now at this very moment.
    Oktoberfest was nice, I visitied with my new workplace colleagues. I didn't serve a shift this year, though. Friends reported it was relatively calm, just the usual ~400 patients per day..
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  11. Bernhard added a post in a topic Old folks Still here?   

    That's 3:30 AM on friday over here...(UTC+2). I'll do my very best...
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  12. Bernhard added a post in a topic My Pants Have No Pockets!   

    I support the "inverse rule of things in the pocket".
    Today I carry (beside pager, id, money and keys):
    3 pairs of gloves (using at least 2 for trauma calls = 1 inner layer, 1 outer layer to remove if bloody plus 1 reserve pair of gloves to replace layer 2).A pen.Optionally scissors and a pen light in a belt holster, but I don't use them much any more. I'm getting older, i guess.
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  13. Bernhard added a post in a topic Old folks Still here?   

    I'll be there...
    See you!
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  14. Bernhard added a post in a topic What is the dumbest question anyone has asked you?   

    Beside those already mentioned here:
    * "When does your next call come in?" (that's easy: the moment I want to go to toilet or get something to eat)
    * "It's an exercise, isn't it?" (when complaining about the reserved parking place in front of or first responder station is blocked by that individual)
    * "Why are you here?" (because your dispatch called our dispatch, dear police officer)
    * "Why are you here?" (because our dispatch called both of us out, dear fire captain)
    * "Why are you here?" (because some of your family called our dispatch center, dear patient)
    * "Why are you here?" (good question, anyway)
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  15. Bernhard added a post in a topic Philadelphia, state ask 500 medics to help (work for free!) during pope's visit   

    Having been responsible for a vollie unit once, when the Pope visited my area, I may add my experience: We responded with an ALS ambulance and two EMTs, cost free. They had nothing to do on-scene. However, it was a huge motivational success for those attending volunteer members (each even given a medal later on by the associated Order of Malta EMS organization here) PLUS we could earn some media coverage and significant public relation attention.
    All this is worth real money...
    At least, the Pope doesn't fly in on a regular basis.
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