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 19 of 59

EMSWORLD.com | MARCH 2018 19 education. Use of defibrillators became a standard requirement in the early 1980s, but apart from that no additional skills were requested or allowed, not even blood sugar checks—these were considered bodily harm if performed by a nonphysician and could lead to consequences from the employer or even legal prosecution. In 1993 efforts to standardize education for all ambulance personnel resulted in the first drafts of a law aimed at a three-tiered education, the highest level similar to that of nurses. But conflicts of interest prohib- ited its realization for over nine years—res- cue organizations feared the loss of their volunteers, the resulting need to create hundreds of jobs, and therefore massive financial burdens; the federal states' gov- ernments feared enormous financial reper- cussions because of the need to refinance their ambulance service organizations; and physician associations were also wary. Finally, in 2002 the National Act on Para- medics passed the parliament and regu- lated the education of all ambulance staff, both volunteers and employed personnel: • Basic ambulance personnel: 100 hours of class, 160 hours practical training (i.e., running calls with the ambulance); • Emergency ambulance personnel: 160 hours of class, 40 hours internship at a hospital, 280 hours practical training; • Emergency ambulance personnel with additional skills: basic pharmacology, IV skills, and intubation skills and arti- ficial ventilation (with class hours and internships). Organizations were free to offer educa- tion to the third level, and soon regional dif- ferences appeared: The Lower Austrian Red Cross, for example, does not offer courses in intubation and ventilation skills and also does not acknowledge/allow the exercise of these skills if acquired elsewhere (which stands in contrast to federal law and might be considered illegal, though no lawsuit has yet been filed). Vienna's MA70 aims to train as many of its professionals as possible in all the skills. The Upper Austrian Red Cross does not offer any level 3 skills education and does not allow exercise of those skills. The hospital internships proved to be unexpectedly useful. Both nurses and ambulance personnel now get a glimpse of the other side. A new appreciation for both sides' professional counterparts arose, and long-lasting problems at the emergency department handover declined drastically. Ambulance Doctors For once physicians were a step ahead: The law allowing doctors to work as prehospital emergency physicians was passed in 1992. Requirements are: • Graduation from medical school; • Either a three-year internship to become a general practitioner or a five- or six-year internship for a specialty; • 60 hours of classes concerning prehospital emergency medicine, including hands-on training plus exam: I. Continuous education necessary every other year (two days of classes and hands-on training); • Another 60 hours of classes and exercises For More Information Circle 20 on Reader Service Card

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