Für unsere Mitleser nochmal auf Englisch. Falls die Übersetzung nicht korrekt sein sollte bitte nicht böse sein / For our coreaders over again on English. If the translation should not be correct please not be angry
The civil rescue service (briefly: RD, RettD, in Austria the rescue) has to help the job, round-the-clock in medical emergencies of all kind – injuries, poisoning and illnesses – by the application of certified rescue specialist staff and the suitable rescue means quickly and properly and to save life. Besides, it is distinguished between:
* to the ground-engaged RD with the areas of responsibility of Emergency rescue and certified sick person's transport
* of the aerial rescue,
* to the alpine rescue service
* and the water rescue service,
and the special organisations of the mountain rescue or water rescue hand over the patient after the rescue to the other care to the general rescue service.
In Germany the rescue service after the federalism principle of the basic law is a land thing and is regulated, hence, by federal state laws. Besides, for the realisation of the rescue service the countries fall back on different subsidiary models. The countries put down the duties again by law on the administrative districts or towns free of circle (in Bavaria on so-called purpose associations for rescue service fire alarm (ZRF)). To follow of this job, the local authority districts themselves put staff and equipment of the rescue service or pursue own rescue service enterprises, or transfer this, provided that available, to the full time forces of her fire brigade or award the rescue service to organisations under private law who produce her achievements mostly as a charitable association or charitable limited liability company (gGmbH) (the most frequent model in Germany) or private-economic enterprises.
Rescue service in use application.
The ground-engaged rescue service is perceived by order of the local authority districts by:
* municipal rescue service enterprises (the administrative district carries out the rescue service independently with full time or full-time forces)
* the fire brigade with full time or full-time forces
* the relief organisations
* German Red Cross and Bavarian Red Cross
* Maltese auxiliary service
* Maltese Knight's accident help
* Working-class Samaritan's bundle
* German life Rettungs society
* private rescue service enterprises
The aerial rescue is fulfilled together by the operators of the rescue helicopters as well as medical centres and relief organisations. Bearers of the aerial rescue are the respective federal states. The mountain rescue perceives the mountain rescue service, the water rescue the German life Rettungs society (DLRG), the water guard in the German Red Cross and the working-class Samaritan's bundle (ASB). The sea need rescue on the North Sea and the Baltic Sea guarantees the German society to the rescue of castaway (DGzRS).
The application forces are alarmed by the in each case responsible rescue directing centre / Integrated directing centre and are co-ordinated.
The financing of the reproach is regulated differently, for the patient's transport the health insurance of the patient arises as a rule.
Transfer with the Schaufeltrage
The structures are to be separated from the individual-medically straightened patient's care of the rescue service with the mass attack of injured person (MANV) who distinguishes himself by the fact that primarily enough application forces are not for the coping of the damage situation on site. The medical application management in such an event is incumbent upon the leading emergency doctor (LNA). The organizational leader rescue service (OrgL/OLRD) takes over the coordination of the rescue means on site and in cooperation with the LNA the distribution of the patients on the rescue means, around them bring in suitable hospitals. Besides, the regular rescue service is supported by assistants and female assistants who are summarised into application unities (EE) or quick task forces (SEG) and are alarmed when required. These groups are able to create on site structures (for example, a place of treatment) to the patient's care and can shorten thus the time free of treatment. The rescue draught of the medical care of the patient on site is also called stay and play (stabilisation of the patient on site by next transport in a suitable clinic) - in contrast to scoop and run (Immediate transport of the patient and treatment only during the transport or in the aim clinic). The latter system is applied, e.g., in the USA.
In Germany communal projects also exist under the rescue organisations. DLRG and water guard put application diver who become flown by the helicopter accident places. Besides, there are cooperations between the fire brigade which holds ready the material and the vehicle (such a called device carriage water rescue (GWW)) and the water rescue which puts the staff.
Because many local groups of the relief organisations or the voluntary fire brigades own in the country application vehicles, these are used increasingly also as facilities of the local first help (ridge Responder or assistant on site) if an emergency happens in their immediate nearness. In cities some occupational fire brigades are also used for this purpose if the location of a fire engine is closer than that of the next rescue vehicle. They form the connection between the first help and rescue service. They take over the patient's care at emergency-medical level and the bridging structure of the time up to the arrival of a regular Rettungsmittels.
Since beginning of the 1990s is the psychosocial care of application forces after extremely incriminating applications, e.g., to child deaths, and the care of affected people after a damage event, e.g., members after a fruitless revival, the job of crisis intervention services (KIT) and the emergency spiritual welfare (NFS).
Currently there are approx. 47,000 full-time employees in the German rescue service. Besides, it concerns for the most part rescue assistant (professional education) which put the primary occupation of rescue means. Other qualification degrees are paramedics, rescue assistants and according to land rescue service law, perhaps, orderly.
* The ill transport carriage (KTW) is used for the certified sick person's transportation. That is if no acute emergency is given, for example when somebody must be delivered illness-partly or on account of an injury to a hospital. Moreover, it is also used of the KTW to move illness-affected or age-affected people under medical supervision to treatments in medical practises or Rehaeinrichtungen. If the next RTW is not available, a KTW can be also used as primary rescue means.
* The rescue car (RTW) is sent to emergencies with which the life or the health of the patient are endangered. He differs in his least equipment considerably from an ill transport carriage. In some federal states of Germany at least one rescue assistant is prescribed for the occupation of a rescue car. However, this is different from country to country – Lower Saxony, e.g., demands merely "two suitable people". It is therefore a job of the local authority districts to fix a standard to which the commissioned rescue service organisations must keep. In Austria a RTW is usually taken with at least one emergency orderly. The RTW is used when required also for the certified sick person's transportation.
* The Mehrzweckfahrzeug (MZF) is sent also like the RTW to emergencies with which the life or the health of the patient are endangered. He is used in some federal states, in the meantime, as a crossing between KTW and RTW. The equipment corresponds in contrast to the emergency ambulance used in Austria in the emergency-medical area fully to that of the RTW. Indeed, he orders of Krankentransportspezifische additional equipment as for example a full Tragestuhl (in contrast to the RTW, - according to removal and equipment - ordinarily only about a small Klapptragestuhl for shorter distances ordered). On the Tragestuhl of the MZF the patient can also sit during the transport without having to be transferred in the vehicle. The occupying orientates itself by that of the RTW, because he is used by the directing centre primarily as such and is allotted only when required on account of the equipment also as a KTW. Thus becomes, e.g. in Saarland on many rescue guards as the 2nd vehicle a MZF reproached, in order thus two fields of work (emergency rescue and sick person's transport) by a vehicle to be able to serve. On smaller guards there is partially only one MZF to save the acquisition of a KTW.
* The fire-fighting Rettungs vehicle (LRF) puts a mixture on RTW and minimum one
However, fire engine, is used primarily as a RTW. The carried along fire-fighting equipment, should serve, for example, with smaller traffic accidents to hold possible vehicle fires under control.
In the date system becomes of the RTW at the emergency place by the getting on emergency doctor the NAW.
emergency doctor's application vehicle
* The emergency doctor's application vehicle (NEF) is mostly a passenger car which carries the emergency doctor regardless of the remaining vehicles to the application. Also this vehicle disposes of a comprehensive medical-technical emergency equipment which in Germany the German Institute for Standardization 75079 corresponds. Against the RTW or also the KTW there is no European norm, because the emergency doctor's system is represented only in few countries. The occupying usually exists of the emergency doctor and a driver who has at least the qualification of a paramedic, often, nevertheless, also a qualification of the rescue assistant (in few federal states also reaches a so-called suitable person), in Austria the driver must be a qualified emergency orderly.
* The emergency doctor's carriage (NAW) corresponds to a RTW with an emergency doctor aboard as well as additional equipment which is not usually reproached on RTW (e.g., Thoraxdrainageset, ZVK set or special drugs to the BtMG are defeated). A NAW is usually stationed in a hospital, so that the doctor can fast get on. Nevertheless, it also seems that the NAW goes first from the rescue guard to the hospital to take up the doctor. The doctor is also sometimes stationed during his business hours in the rescue guard, how the other NAW staff.
* The intensive transport carriage (ITW) (also Intensive-mobile called) is mostly a special vehicle which was altered in a rolling intensive care unit. Herewith it is possible to move intensive-liable patients of clinic to clinic. The occupying passes of three or more people, under it at least one doctor.
* The rescue helicopter (RTH), also emergency doctor's helicopter (NEAR) called, is an airplane which carries primarily an emergency doctor regardless of the remaining application vehicles to the application. Moreover, he is used with certain clinical pictures or injury patterns as a means of transportation. He is taken as a rule with a pilot, a doctor with „technical instruction proof of rescue service“ or to a doctor with the additional name Emergency medicine (emergency doctor) and one in Avionik and flight navigation trained rescue assistants (crew HEMS Member).
* The intensive transport helicopter (ITH) is a high-capacity helicopter which is equipped as an intensive transport carriage. The ITH is used above all by urgent transfers by patients about bigger distances. For Auslandsrückholungen of patients equipped airplanes are often used also especially.
* Engine lifeboats (MRB) serve the protection of events, the search for people as well as the transport of patients, assistants and material on the water.