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.

Issue link: https://emsworld.epubxp.com/i/944334

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Page 20 of 59

EMS AROUND THE WORLD 20 MARCH 2018 | EMSWORLD.com for ambulance doctors in charge at mass- casualty events: I. Continuous education necessary every four years (two days of classes and hands-on training). Finances Modern emergency ambulance services are hardly ever cost-effective; neither fund- ing from the communities and states nor membership fees and donations covers the expenses. Insurance pays only for the transport of the patient, not the material used—so regardless of whether a simple bandage was applied or resource-heavy care was necessary, insurance reimburses the same (very low) amount. If there is no transport (if there's no true emergency or, for example, after an unsuccessful CPR), there is no refund at all. And billing the patient is not (yet) popular. Future Outlook Calling an ambulance for a ride to a hospi- tal is free in Austria, so it is often used (and abused) for nonemergencies; patients still seem to think the wait time at the ER is less than at the family doctor. Changes in demo- graphics (growing elderly population) and declining numbers of available physicians add to the still-increasing number of (often unnecessary) ambulance transports, thus aggravating organizations' financial prob- lems. Many ambulance calls are the result not of acute medical emergencies but of social isolation or lack of home care or nurs- ing facilities. If ambulance personnel had a broader education and more skills, backed by law, many unnecessary hospitalizations could be avoided. Lower Austria and the St. Pol- ten University of Applied Sciences have taken the first steps in this direction, offering a new three-year course that combines a bachelor's in nursing and EMT education and qualifica- tion; the first students will graduate in 2018. This could hopefully be the beginning of a whole new era for ambulance personnel and nurses, opening up options in commu- nity healthcare and moving toward a holistic primary social and healthcare system. RESOURCES 1. Redelsteiner C. Von der „Rettung" zum mobilen präklinischen Dienst. Der Rettungsdienst auf dem Weg zu einem Paradigmen—und Strategiewechsel? Soziales Kapital, 2015; http://soziales-kapital.at/index.php/sozialeskapital/ article/view/361. 2. Reisinger A. Rettungsdienst in Österreich (Medical Rescue Services in Austria), master's thesis, 2012. 3. Weinert S. Die Patientenübergabe: Schnittstelle und Schwachstelle zwischen Rettungsdienst und Gesundheitseinrichtung. Taschenbuch, 2010. 4. Weinert S, et al. 10 Jahre Notarztwagen Mödling, 1999. ABOUT THE AUTHOR Susan Ottendorfer is senior emergency physician in charge at the County Hospital Moedling (Lower Austria). She began her EMS career in 1979 as a volunteer EMT for the Austrian Red Cross. She has served as medical director for 144 Notruf Niederoesterreich, Lower Austria's emergency dispatch center, since 2005, and as an emergency physician at the Vienna International Airport's medical center since 1996, becoming its interim medical director in 2015. Help patients arrive warm. For More Information Circle 21 on Reader Service Card

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