Certified first responder

Helpers on site ( HVO), International First Responder (FR ), ( also paramedics on site ( SanvO ), in Bavaria officially called Ersthelfergruppen or local institutions organized first aid, in Hesse advance helper, in North Rhine -Westphalia emergency responders (NRW) ), is an extension of the rescue chain. A helper on the ground is at least in advanced first aid and usually fundamentally ambulance or rescue official trained person who is intended to bridge the time in an emergency until the arrival of a rescue agent with qualified basic medical measures. In English, the name is first responder ( FR Abbr ) are common, literally translated, this means first responder. The term is sometimes also used in Germany and Austria.

First responders on the other hand refers to anyone who happens to be there in an accident and provide assistance.

  • 7.1 General Education
  • 7.2 particularity in Bavaria
  • 7.3 particularity in Hesse
  • 7.4 particularity in North Rhine -Westphalia
  • 8.1 Communication means
  • 8.2 Clothing
  • 8.3 Medical Supplies
  • 8.4 vehicle

Term

In Germany the term " first responder " was initially mostly used by fire departments. He is now but also common in organizations, there, however, the German -language term " on-site helper " will be used. The meaning is in the German-speaking synonymously, which is a contrast to the Anglo-American world, where first responders are partly better qualified than most workers on site. There is also the term " paramedic on site". This should be made clear that the assigned staff has completed a controlled, medical service training and assistance, a level well above the laity help achieve (that's at the other names even so, only it is not emphasized by the term ).

The Bavarian State Ministry of the Interior shall designate the helpers on site Ersthelfergruppen or local institutions organized first aid. In Hesse there is now the official name of advance -helper and the Hessian Ministry of Social Affairs makes recommendations for training and personal suitability out. In North Rhine -Westphalia, the helpers are legally designated spot as emergency workers, which is not absolutely identical with the eponymous Maltese education.

In military parlance, the term of the First Responders also increasingly established. Thus, there are three different levels of training of the so-called Combat First Responder ( Einsatzersthelfer ), so for most official paramedical trained staff that arrives first traumatized in a ( poly) soldiers or is already in place for soldiers of the Bundeswehr.

Tasks

The helper on site

  • Provides qualified first aid,
  • Explores the situation,
  • Is a qualified report to the emergency dispatch center and
  • Has a rescue means
  • Bridges the aid benefit-free interval until the arrival of the emergency services
  • Where appropriate, support the life-saving appliances
  • Documents the use

Meaning and purpose

First Responder to shorten the time between the occurrence of the emergency and the first medical care (so-called therapy -free interval ). Qualified activities are carried out faster, the lower the healing process and the shorter on average, the subsequent necessary treatment time.

It is assumed that decrease with each minute of ventricular fibrillation ( a common form of cardiac arrest ) is not treated with cardiopulmonary resuscitation, the chances for a successful recovery by ten percent. After six to eight minutes to lack of oxygen supply results in serious irreversible damage to the brain. However, since alone already takes the discontinuation of the emergency call and the scheduling in the emergency control center two minutes, and plus the auxiliary period of up to twelve minutes or under certain circumstances, more may be, the forces of an ambulance reach possibly only 14 minutes after the occurrence of ventricular fibrillation the patient to use a defibrillator - in cardiac arrest with ventricular fibrillation, this is critical for a revival. The later carried out resuscitation and the use of a defibrillator, the greater the risk that the patient - if he survives - a heavy care case.

A resuscitation could but (especially an Automated External Defibrillator ) may be initiated after a few minutes of lay people as first responders with an instruction in first aid, medical service and possibly present a training organization and equipment. By shortening the time limit in which many patients can fully recover even after a heart attack or a stroke. When disasters and accidents of the First Responder is also responsible for a more concrete assessment of the situation at the accident and from recovering on bad radio or a mobile phone forces, so that a more effective scheduling of assistance is possible.

Origin

The result from this facility is the realization that the organized rescue service are often too long to of use in order to avoid serious injury of emergency patients, however, the lack of emergency frequency in this area does not justify the establishment of additional ambulance station.

Background is probably also the fact that in many areas, mostly rural volunteer assistants of various organizations and groups are already established on site. So was and is always also happens that a help -seeker contacted a local well-known qualified volunteers of a charity or private fire service through the phone. This came as part of his extended help to the scene of the emergency power requirement - of course not without the appropriate rescue coordination center about what is going to be informed. These citizens help was and is of course not uncritical seen by the rescue coordination centers, because here is the use does not run at the first among their coordination. On the other hand, this behavior of citizens is also very common in acute medical emergencies and comprehensible.

Especially in the USA, with its large and relatively sparsely populated area counties, the local structures and the availability of organized forces in the form of a volunteer fire department and police patrol cars have been used early to take the initial steps leading to the arrival of the emergency services with very long travel times. Even members of the American Women's Voluntary Service Organization worked as a helper.

For similar reasons precursor originated in Germany in the early days of the emergency service of modern design in the early 1970s: The ambulance service was not yet developed to the same extent as today - was often the local volunteer fire department alone for long at the scene active and therefore asked members of a local disengage with charity. The alarm was often very tedious, since neither portable Pager phones were available yet sufficient. With the shortening of the rescue services auxiliary terms, this concept was meaningless.

It was not until the mid-1980s volunteer units of civil protection were equipped with portable radio pagers increasingly. It suggested this possibility to reinstate for a quick on-site assistance.

In 1986, the German Red Cross District Association of Karlsruhe eV undertook a first pilot test of modern times in Germany, which was published in a professional journal. The BRK local group Glonn justified then in 1988, also one of the first teams in Germany and presented the idea and the integration with a fast- group on a congress before, she is continuously today. From the mid- 1990s, this type of assistance then spread very wide area.

Reasons for this are:

  • The alarm means were now suitable and available ( since the early 1990s: transition from largely siren alarm on Pager, availability of mobile phones ).
  • The idea was accepted, some pilot projects could show good results.
  • The legalities were largely resolved after controversial discussions (eg insurance, car licenses).
  • The fire brigades ( the largest emergency response organization ) recognized the opportunity to create an interesting application for committed helpers just for little stressed units in remote areas. The aid agencies discovered this device as a motivating and useful service to their local associations.

Today, the system is recognized.

Organization

The organization is not uniformly regulated, it is based on the voluntary commitment of the organizations that they represent. For this reason, there is no uniform across Outfit or training provision for this service ( internal organizational arrangements, there will very likely result in North Rhine -Westphalia there is a recommendation of the country's national advisory council for organized emergency aid). Frequently off-duty honor and full-time ambulance service employees are working.

There are several alternative features of the different forms of organization:

Alerting

Alarmed is the establishment by the competent control center via SMS or Pager.

Use indication

The use indications are regulated differently locally, usually comes the FR / HVO used when the next regular life-saving equipment takes much longer than the FR / HVO and thus the risk that necessary help does not arrive quickly enough. This indication is usually in all emergency operations.

This may be the case and is the main reason for the existence of FR / HVO also in compliance with the statutory time limit in by the emergency service. Especially valuable is the bridging of the arrival time if the regular rescue service is busy with caring for other patients or bound by an insert action or longer needs due to weather conditions or similar unusual amount of time to get there.

A rescue means of regular emergency service is always used in addition to on-site helper; FR / HVO is only complement, not a replacement of the emergency services.

Directions to site

As First Responders are not part of the emergency services can not succeed based on prevailing legal opinion applicable only to vehicles of the emergency service requirements for special rights in accordance with § 35 para 5a Highway Code. Thus First responders are on the journey to the site basically no special rights (exception: First Responders are members of an authorized body or organization, eg fire brigade - for this is usually to § 35 para 1 traffic regulations considered relevant ). However, the anfahrende First responders can rely on general emergency regulations, which are normalized inter alia, in § 16 and § 34 of the Criminal Code Administrative Offences Act. In moderation, can thus be ( etc. Exceeding the maximum speed) criminal or administrative offense legally justified a violation of traffic regulations. In Bavaria there is a control of the Interior Ministry, which allows the use of special signaling equipment for service vehicles of the first responder units under certain conditions. Right of way is First responders only mandatory grant when on connected special signaling systems (blue light and siren ) have.

Service times

The offer of the FR / HVO is usually a purely voluntary performance of the organization, which usually relies on volunteer work. Therefore, the standby time in some places on the nights (eg from 18:00 bis 6:00 clock clock ) and weekends / holidays are limited. However, the vast majority of helpers from local groups are available 24 hours a day, 365 days a year on standby and back out when an emergency happens and they can move out at the time.

The alarm by the control center is often still around the clock, but it is not sure that anyone really disengages then. The regular ambulance service comes dutifully always used, that is, the patient gets at least the help that is regulated by law (State Emergency Services Act, etc.) - when the FR / HVO to disengage, then he gets an optional additional service.

Training

General education

Prerequisite for participation in the service is a basic medical training (such as paramedics ). This includes, most likely, the constant ( re) certification for early defibrillation. Often additional courses for workers on site are offered with customized learning content. Internships in the regular ambulance service improve the safety in use and promote good cooperation on the ground.

Focus of education and training are ( from BRK policy for on-site helper of 2002):

  • Assistance in severe injuries ( polytrauma )
  • Particular emergency, pediatric emergencies
  • Self-protection
  • Resuscitation and early defibrillation
  • Cooperation with the monitoring station

Another common feature is the rescue official recognized training for rescue workers or paramedics as part of a helper on-site activity. Some states have their own recommendations or regulations regarding the minimum qualifications of workers on site (eg Bavaria and Hesse, the two-stage, and North Rhine -Westphalia, single-stage ) was adopted. Most regular medical training meet at least the lowest level of job profile.

Peculiarity in Bavaria

According to the directive of the Ministry of Interior in Bavaria, there are two levels of qualification for contributors in Ersthelfergruppen. The first stage includes a 48 -hour medical service training (similar to paramedic training at the Red Cross ). In the case of a larger spectrum of applications, a more comprehensive, 80 - hour course is recommended. This corresponds for example to the theory of education of paramedics use ( in Maltese ), or on-site helper - qualification of St. John (which is based on a 60-hour paramedic course ). Other aid organizations have developed similar modular training programs.

Peculiarity in Hesse

In Hesse there are two stages of pre - helpers. The basic pre- helpers - First Aid ( pre helper EH ) completed an 8 Lessons comprehensive pre -helper training in addition to a 16- hour first aid course and must annually undergo appropriate refresher training. The second stage comprises the pre -helper SAN with a 48-hour medical training. A 24- hour emergency service internship is recommended. The pre -helper SAN have extensive equipment and applications.

Particularity in North Rhine -Westphalia

In North Rhine -Westphalia is the large, 16- hour first aid course entry requirement for further hands-on training. Emergency workers to demonstrate at least a 16 -hour paramedic training and a 6-hour training with the AED. This 22 -hour training is supplemented by at least 10 hours Case study training and a 2-hour final exam. The emergency responders training of Maltese goes beyond these requirements normally beyond.

Equipment

Means of communication

  • At least mobile phone
  • Pager
  • If possible: car radio or even handheld radio

Clothing

  • At least one safety vest
  • Possible use of clothing (helmet, anorak, jacket / pants or overalls, boots )

Medical Supplies

  • Medical case, DIN 13155 or emergency kit according to DIN 13232
  • Additional equipment with oxygen
  • Automated External Defibrillator ( AED).
  • Possible, emergency equipment for infants and young children (according to DIN 13233 )

Vehicle

Are used

  • Organization 's vehicles: from cars without special signaling system until the ambulance or fire truck
  • Private car, the helper, possibly also equipped with a removable roof bouncing in use (without special signaling system )

Financing

Ongoing costs due mainly:

  • Calls
  • Consumables
  • Operating costs for vehicles

FR / HVO rarely receive public subsidies, as their assistance is not required by law ( not a compulsory exercise of the municipality, such as fire brigade). The costs incurred can not be settled by the insurance. The FR / HVO teams are largely funded by donations.

Aid agency Emergency management
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