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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.
Well, for those who wondered where I've been all the years: I had big problems accessing this site from my smartphone. Now it seems it works better (however, writing this from my PC at home, I rarely use now)...I've left my job at the handicapped transport service and applied successfully for a regional EMS management position for the main EMS provider over here. So, eventually, I'm back in "real" EMS. However, not on the street...The same way goes my assignment as (lowly) paid EMS chief-on-scene daytime position, it was associated with my now former office job. It now changes back to a volunteer evening/weekend shift service again, just as the last 20 years... Thus, I still will experience some of the mass casualty calls as officer, just not on daily base.My "family's problems" are not solved, yet. We're still waiting for the final approvement of a proper treatment for a rare sickness (not for me). This may take up a lot of time I otherwise would spend on the internet. We had several hard years managing our family with this burden, but at least now there is hope.I'm still serving shifts as "jumper" medic on the street and in our local very active volunteer first responder team. Since this forum is better accessible now, I may get more active again in discussions here. Plus having to share more inside experience from a "real" EMS position again. See you!
Finally, managed to get back in here again. On the topic: in Germany, I know the first mobile stroke unit was on the road in November 2008 in the german state of Saarland as a partnership between the local University hospital and the German Red Cross (largest EMS provider in Germany). Website in english: http://www.mobile-stroke-unit.org/en/ The Berlin fire department started ~2011 with a mobile stroke unit (reference: http://www.berliner-feuerwehr.de/technik/fahrzeuge/rettungsdienstfahrzeuge/sonderfahrzeuge/stroke-einsatz-mobil-stemo/ in german). It crashed in a vehicle accident March 2015 (reference: http://www.berliner-zeitung.de/polizei/unfall-in-tiergarten-berlins-teuerstes-feuerwehrauto-hat-einen-totalschaden,10809296,30156902.html in german), wrecking roughly 1 million Euro. However, I don't know any results.
30 years in EMS and I fairly quickly came down to 3 pairs of examination gloves in my pocket, 1 pair of scissors and a pen light on my belt. No more heavy tools - cutting seat belts is possible with the scissors and our O2 tanks can be opened by an attached hand wheel, no tool necessary for that. However, I'm considering to enhance the number of gloves (on trauma calls I put on two pairs of gloves, then I can get rid of one pair after the messy first minutes without fiddling and losing time to slip into another "clean" pair).
OK, I have to confess: I carry a small swiss army knife on my private keychain, which contains a very small blade, a can opener, a small screwdriver, tweezers and a toothpick. But all those tools were in use between calls only, so far.
German ALS ambulances have to be equipped with a second stretcher holder, to be folded down from a sidewall or to be placed in holders in the side wall. I used them more than once to transport two laying patients. No young medics nowadays believe this, but I have a copy of the old equipment standards to prove.
Then there were those rolling central vein catheters (you have to apply them like turning the wheel of a fishing line). Suddenly vanished somehow, after we stopped punctuating central veins on each and every CPR pt. around end of 1980ies.
(Hey, I just realised, in September this year I'll be 30 years in EMS)
I long was suspicious about the HAIX hype most of my colleagues are into, more or less I was getting things done with other brands. Just some itches here and there. Now since a month I have a pair of "HAIX airpower XR1" and I'm into this hype, too. They are perfect fitting (which is not easy with my feet), expert quality and simply great to wear. No itches!
I'm glad my employer bought them. In the US online shop they're listed for nearly ~240$, see http://www.haix.com/us/products/rescue/haix-airpower-xr1 (click on "buy now"). But they're worth it!
- Your favourite county where EMS is disconnected from Fire agencies?
Hence programs could start in the end of 2014.
My current plan is to start the German "Rettungsassistent" (very narrow scope of practice comp. to a US-Paramedic) this November.
You're aware that's the last chance to enter a "Rettungsassistent" course? From January 2015 the new 3-year "Notfallsanitäter" is the only professional education (beside physician) you can start in the EMS field and you have to be associated to an EMS agency for that.
What if you're failing med school? You can't use a US paramedic training in germany much (at least legally). But as "Rettungsassistent" you're able to get the "Notfallsanitäter" by taking the state exam within the next seven years. You would be fully certified for german EMS then. Which is pretty promising, the job conditions seem to get much better soon.
Depends a bit what you plan in your future. If you want to get a job in the US, then a paramedic license there would be the best choice. If you're just curious about the US and confident to get through med school you may take the cool experience in the states. But If you'd like to stay in Germany for your later life and want to have a fully accepted profession there, maybe the german education would be the better way to go. And starting until December 2014 you have the chance for a shortcut towards the new professional level.
Whatever you do, good luck and share your experiences in EMTcity.
Just wondering: there is a study about trauma victims' better outcome when transported fast opposite to beeing "ALS" treated on scene for extended time (just as we needed a study about this, but well...) AND there is the need to treat patients on the spot of an active shooting scene? Really?
I don't get it. What about simply getting victims out to the staged ambulances? Every police officer with basic first aid training and maybe some additional lectures in how to carry patients can do this pretty good.
We know this same procedure in other hazardous situations: rescue the patients from the hot zone by people who are equipped to survive the given hazards as fast as possible. THEN give them reasonable treatment and transport to appropriate facility. Why change this just when the hot zone is no spilled hazmat but an active shooting scene?
Bad thing is: this just STARTS here...my last 20 years in german EMS before 2009 (when they started equipping our units with them) I lived well without any backboard.
However they prove useful in certain situations, but not in all - just as any tool in our hands.
Still glad, ED nurses haven't much to tell us here...
Sadly, not necessarily: vacuum mattresses are standard here since the 1970ies, but since backboards were introduced a few years ago, it gets more common to strap down each and every trauma patient on them. I'm fighting against it wherever I can, but can't argue much on-scene when I'm not happen to be the responsible medic. Discussions are fruitless. It's something new and therefore it HAS to be used. ITLS procedures seem to promote this (really?) and a recent external ITLS trainer giving some update lessons countered my arguments with some blunt statements instead of logic and/or evidence. Kind of frustrating how most colleagues follow this "new" paradigm of backboarding here.
I'm working my way back into EMS, so I decided to start reading here again. Missed you all a lot!
What has changed? I'm now getting paid for covering the daytime (monday-friday) on-scene officer-in-charge duty. I did it fulltime since my boss (and EMS director) got sick last december and he now isn't allowed to do this task any more due to actual health conditions. I was just the right person (having all the needed qualifications and experience) at the right place (available at the office during work hours). Contract was fixed last week. It's only an additional task to my current office job, but beside beeing more EMS related again, it includes a pay upgrade and a company car...
Really? How come that? How do you do this?
Just wondering if that's really in your "job description" or if I just don't understand something.
BTW: I see my task in EMS to
safely get to the scene dispatch already was suspicious enough to assign a valuable resource (my crew & my ambulance) to,
assess the situation and
decide if it's either an emergency to be treated immedeately, an issue which has to be transported to hospital or a doctor's office, something we "just" need some ambulatory help (and call a doctor for house visits or point to an open doctor's office - they have to provide 24/7 coverage here), another thing we may offer help (lift patient back into rolling chair, call police, ...) or nothing at all (false alarm, ...).
Doing whatever my findings in #2/#3 needs.
Preparing for next call. Goto #1.
Glad, my system has all those options in #3 and let me decide (if the public or dispatch didn't before). This opens a bunch of possibilities to provide the needed level of care, and yes, you have to be very sure about what you do. Maybe this system is close to this community paramedicine thing mentioned here, just that it's not me who provides that but the regional physicians association.
Oh, to answer the OP's question: I'm neither an EMT nor a medic, technically, since those job titles don't exist in my country. I'm a german Rettungsassistent (2 years education, highest level of non-physician emergency care in Germany, so somehwat compareable to a Paramedic in the U.S.). Living in Germany's most southern state: Upper Bavaria, near citiy of Munich. So much for my excuse for lack of understanding, bad grammar and funny spelling. In english AND german...
We once had an excercise where the fluid actually froze in the line. But this was most probably due to the fact, that we didn't used i.v. bag heaters AND the lines weren't running (after all, it just was an excercise - cannulas were applied and connected just for fake). And it was a cold november wind blowing over a large airfield. It never occured to me since then. I think, a steadily running fluid is not very likely to freeze - above a certain temperature...
Could be tested easily, though.
BTW: a lot of the "victims" were sick afterwards. They were from army and federal police and those tagged black were ordered to "play death" in very loud voice by their superiors allthough shivering from cold. We even weren't allowed to give the "death bodies" blankets...
We carry this in our MCI truck. Heats up a tent in minutes:
Meanwhile there are much smaller units, could be stored in a small compartment, needs just to be fueled from a diesel canister, just like this one:
Both of them could be used to heat up locally, even outside, when ouput flow is somewhat directed. Disadvantage would be operating them in hazardous or explosive environments...(as a flipped over car could provide)...