At the Berlin fire brigade it starts again: state of emergency in the emergency rescue – three times a day.
Employees of the rescue service of the Berlin fire brigade transport a patient.imago stock&people
It’s best not to have a heart attack in Berlin this month. Or a stroke. Because it starts again: At the Berlin fire brigade, the crises in the rescue service are piling up. In January, many had the impression that the situation had calmed down. But in March, the “AZ rescue service”, the state of emergency, was declared 13 times.
The situation is reminiscent of the chaotic past year, when in Berlin at times not an ambulance (RTW) was free and even turntable ladders were sent out for first aid.
It was initially quiet after New Year’s Eve. Because holidays and days off were taken, sick leave was low. And in January and February – no one knows why – there are generally fewer emergency calls. A luxurious number of ambulances were ready. But on March 13, according to information from the Berliner Zeitung, things started again when it said: “Emergency rescue service”. This continued in the days that followed. On March 20 there were two states of emergency and on March 30 three times – from 10.07 a.m. to 2.29 p.m., from 5.38 p.m. to 7.24 p.m. and late in the evening from 9.34 p.m. to 11.13 p.m. March ended on Friday evening with another state of emergency.
A state of emergency is declared when the emergency services are at least 80 percent full and the specified ten minutes between the emergency call and arrival cannot be met. Then the cars have to be manned by employees who are actually assigned to fire engines, which is at the expense of firefighting.
Ambulances can now be staffed differently
Because of these grievances, the House of Representatives changed the Emergency Services Act in January – which made politicians and some firefighters happy. Because the change in the law made it possible to issue a regulation according to which the functions of the rescue service can now be changed “in special situations” in order to increase the number of RTW.
This Tuesday, fire chief Karsten Homrighausen sent an internal message with explanations within his authority. According to this, the first stage of the regulation comes into force if the forecasts show that at least ten percent of the staff is missing. Then “anyone who has completed training as a paramedic and who has been regularly deployed in the rescue service in the last two years can be deployed”. In plain language, this means that when the rescue service is busy, an ambulance no longer needs to be manned by an emergency paramedic. Paramedics have higher qualifications than paramedics.
The information also shows that if more than 20 percent of the staff is missing, the 2nd stage of the regulation can be proclaimed. Paramedics can then also be deployed on emergency medical vehicles and intensive care transport vehicles. So far, an emergency doctor has been assisted by a more highly qualified emergency paramedic.
Firefighters are calling for the end of standardized emergency queries to the 112
The regulation is intended to free up staff to fill more RTW. But that doesn’t go down well with everyone. “Instead of pushing down the number of operations, the existing personnel are combined and thrown into the rescue service battle. Those with less formal qualifications are then suddenly good enough to fill the gaps again,” says a member of the Berlin brennt association, in which firefighters have organized themselves. The most recent measures are not suitable for solving the fundamental problems. Too few staff will no longer be caused by pushing back and forth.
At the Berlin fire brigade, the ambulances are divided into several classes – such as the RTW C, which drives to urgent emergencies such as chest pain or shortness of breath. And there is the RTW B, which drives to a broken leg or a cut, sometimes with and sometimes without the flashing blue light. According to Manuel Barth, that’s what makes of the German fire brigade union around a quarter of the assignments. According to Barth, for this “basic life support”, as it is called in technical jargon, it is sufficient to simply send paramedics. So far, however, this is only possible if the regulation is drawn. The aim must be to anchor this permanently in the rescue service. “Because in the next few years there will be fewer emergency paramedics, if only because of the retirement,” he says. That is why it needs event-related and not maximum care. “This includes having paramedics on the RTW B on a regular basis and establishing this basic life segment. But this is only acutely permitted by the ordinance, i.e. only in the case of a declared understaffing,” says Barth.
The Berlin club is on fire calls, on the other hand, for the number of unnecessary missions to be reduced. For example, the standardized emergency query protocol (Snap) should be abolished at 112, which contains a fixed list of questions. The German fire brigade union doesn’t think much of it, preferring a “proper use” of Snap.
The 2016 amendment to the Rescue Service Act caused a massive increase
There are various reasons for the constant bottlenecks in the emergency services. On the one hand, there is the Rescue Service Act, which was changed in 2016 at the instigation of the Greens. At that time, the rescue service was no longer only responsible for immediate danger to life, but also for dangers that could threaten health. This caused a massive increase in bets. State fire director Karsten Homrighausen therefore told the Berliner Zeitung in January: “We should limit ourselves to life-threatening situations.”
On the other hand, there is a permanent lack of personnel at the fire brigade. Above all, there is a lack of paramedics. This should be countered with recruitment and training offensives. However, the training takes years. In addition, there is great competition within the federal states because there are also no emergency paramedics elsewhere. And so Berlin has been training for other federal states for years. New emergency paramedics migrate because the pay and prospects are better elsewhere and the apartments are cheaper.
There are also homegrown reasons for the bottlenecks in emergency rescue. For example, the employees have to take the rest of their vacation time within a third – currently by the end of April – and have done the overtime that they accumulated on New Year’s Eve, for example. Experience has shown that this leads to staff shortages, as is currently the case again. And it’s likely to get even worse this month. Also this month, in April, there was already a “state of emergency rescue service”: On Saturday it started at 8:55 p.m. and ended at 11:30 p.m.
