GLOWSAFE do a Paramedic version of their vests, using Glowsafe technology, which is virtually indestructible. Vests are EN 471 class 2 compliant and can either be flashing or on permanently. More expensive than a conventional vest, but you don't need to be in a car's headlights for it "to work".
http://www.glow-safe.com/features_safety_vests.html