EMS World

MAR 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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Page 18 of 59

EMS AROUND THE WORLD 18 MARCH 2018 | EMSWORLD.com Vienna Municipal Ambulance Service (MA70)—In contrast to the four autono- mous nonprofit organizations mentioned above, the professional Vienna ambu- lance service is part of Vienna's municipal authority, has no volunteers, and does not offer nonemergency patient transport services. More than 40 ambulance doc- tors and around 700 EMTs and paramed- ics provide EMS for Austria's capital 24/7, in 12-hour shifts out of 12 rescue stations evenly spread all over Vienna. MA70 also offers hospital-to-hospital intensive care transports with a special transporter for ICU beds and neonatal intensive care trans- port. In addition MA70 has a disaster unit for mass-casualty events. There are also a few small private organi - zations, such as the Green Cross and private helicopter services, that operate on a local basis. Traditionally VW buses such as the Bulli, Samba, and the T3, T4, and T5 have been the most common ambulance vehi- cles in Austria. Mercedes Sprinters are also used. The large MICUs, VW LTs or Mercedes, are gradually being replaced by small physi- cian cars such as the VW Passat or similar. The Austrian Automobile Organization (sis- ter organization to the American Automo- bile Association) provides 16 helicopters for emergency medical services and transport all over Austria. In 2016 these "yellow angels" took off 17,814 times, an average of 49 calls a day. Since last year a few of these helicop- ters have been equipped with night-vision goggles, allowing them to answer calls even after dark. Dispatch and Call Centers Children learn the national emergency num- bers in kindergarten: 1-2-2 for fire, 1-3-3 for police, and 1-4-4 for rescue (medical emer- gency)—they are in alphabetical order and easy to memorize. In contrast to many other European nations, 1-1-2 is routed to the police and does not serve as a medical emergency number. Until the turn of the century, each 1-4-4 emergency call was routed to the local EMS station, where calls usually were answered on a "you call, we haul, that's all" basis. Technical improvements (computerized work stations), enhanced mobility (cell phones), and legal considerations (liabil- ity) led to the implementation of central- ized dispatch centers responsible for whole federal states. Lower Austria's emergency dispatch cen- ter (Notruf Niederoesterreich), for example, is a nonprofit limited liability company jointly owned by the Lower Austria government (66%) and rescue organizations. It serves a population of approximately 1.65 million inhabitants and dispatches more than 1,100 resources (more than 800 ambulances but also first-responder groups; water, moun- tain, and cave rescue groups; and crisis intervention teams) from more than 200 local branches all over Lower Austria. Notruf Niederoesterreich registered 1.6 million calls in 2016; of these, 250,000 were emergency calls via 1-4-4, more than 61,000 came in via 1-4-1 (the after-hours physician hotline), and the rest via other different hotlines and patient transport service numbers. Notruf Niederoesterreich implemented the AMPDS (Advanced Medical Priority Dis- patch System) in 2003 and in 2008 became the first central European dispatch center to receive ACE (Accredited Center of Excel- lence) status from IAED (the International Academies of Emergency Dispatch). In addi- tion, ECNS (a nurse-based telephone triage system) was successfully implemented in 2016, considerably reducing ambulance dispatches to nonemergencies. Legal Basis According to Austrian law each community/ municipality is responsible for basic emer- gency services (mainly fire and ambulance) within its borders; communities are free to carry these tasks out themselves or sign contracts with recognized organizations. All Austrian communities maintain their own fire brigades, but only two run their own ambu- lance services (Admont and Vienna). All others have signed contracts, mostly with the Red Cross and/or Samaritans, paying for this service through a per-capita quota, the so-called "ambulance Euro," and more-or-less regular additional funds, usu- ally earmarked for the acquisition of new vehicles. Furthermore, Austrian law regulates that qualified prehospital medical emergency services (i.e., doctor-equipped ambulances) lie within the responsibility of each federal state. Of course, the federal states also have a choice: Either outsource and pay (again, Red Cross and Samaritans) or employ the physicians themselves and lend them to the organization that provides the vehicles. Lower Austria, for example, uses both options: In districts with hospitals, the Lower Austria government (which owns and runs all 27 state hospitals) employs emergency physicians; in districts without hospitals, the organizations get paid for providing the doctors. For a very long time there were no laws concerning the education of volunteer ambulance personnel. Each organization created its own internal regulations; only employed staff had to comply with a law from 1961 that basically granted them the status of an unskilled worker with minimum A new Austrian ambulance and a physician car of the type that takes doctors to emergency scenes. (Photo: Siegfried Weinert, Consultants for Professional Rescuers/Emergency Media Service)

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