Mannheim. With blue lights flashing, Daniel Schwenger paves the way to the next operation in downtown Mannheim with his ambulance. The paramedic and his colleague Victor Derek have been called to an elderly man whose family noticed he was paralyzed. The control center could not rule out a stroke. The two men must hurry. Now it is time to carry out the so-called fast examination. Ask the patient to grin and puff out their cheeks. It is also important to ensure that the man speaks clearly and can raise his arms. “We don’t have any evidence of a stroke now, but we’re going to take him to the hospital because of circulatory problems,” says Derek.
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The 28-year-old and his colleague of the same age have been working for the Red Cross (DRK) in Germany for years Mannheim, where three other aid organizations are involved in the rescue service. The organizations have already counted 14,000 deployments this year. Their work is based on the state rescue service plan published last September, the effectiveness of which is now being judicially reviewed by a group of local politicians and emergency doctors. You have submitted a norm control application to the Administrative Court in Mannheim, which will be heard on Friday before the 6th Senate.
“I’m not making friends with it,” says Green City Councilor Chris Rihm, one of the initiators of the application. Because it is directed against the Green-led state government. From the point of view of the former paramedic and active operations manager in the rescue service, patient care has worsened rather than improved with the new guidelines.
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A thorn in the side of him and his fellow campaigners is the reform of the aid period, which the country has set at twelve minutes in 95 percent of cases. So far, according to the rescue service law: “For emergency medical reasons, the help period should not be more than ten, at most 15 minutes.” The decisive factor here was the period of time from receipt of the emergency message in the integrated control center until help arrived at the emergency location on the streets. Now the stopwatch runs from the end of the acceptance by the dispatcher to the arrival of the help at the emergency site – for Rihm a “sleight of hand” that actually extends the help period by one to two minutes.
So far, most of the rescue service areas have failed to meet the prescribed values: last year, only Mannheim, Böblingen, Göppingen, Ludwigsburg and Rems-Murr reached or exceeded the mark of ten to 15 minutes in 95 percent of all cases. Mannheim came to 95.6 percent. In most other districts, the values had fallen in 2022. In this respect, Derek is not critical of the new twelve-minute deadline for his area.
In rural areas, however, colleagues would have to drive up to 20 minutes to the scene of an emergency or vehicles would be withdrawn from other rescue areas, where new gaps would then arise. “One reason is that there are fewer and fewer accepting clinics,” says Derek. Some things could possibly be caught with volunteer helpers and the use of rescue helicopters.
But the relatively good values in Mannheim don’t keep the critics from going before the judge. “We’re only the best among the bad guys,” says Rihm. And the people in Baden-Württemberg are worse off than in other federal states. “If I were to fall down here in the border triangle, I’d rather fall down in Rhineland-Palatinate or Hesse than here,” says Rihm.
DRK regional director Marc Groß, on the other hand, can live with the new requirement: “This is an appropriate but also ambitious value.” He does not want to comment on the pending proceedings, but he is convinced that the Interior Ministry’s “promise for the future” is achievable. But everyone would have to do their homework for this: the country with possible investments in new rescue stations in rural areas and health insurance companies and hospitals with digital solutions for accessing patient data already in the ambulance. In addition, the state legislature must allow other health professions, such as a community paramedic, in order to avoid incorrect deployments by the emergency services.
Groß also welcomes the expanded competencies for paramedics laid down in the state rescue service plan, who are now allowed to administer more medication such as antihypertensives and painkillers and carry out smaller invasive procedures such as venous access. That day, Derek and Schwenger take advantage of their newfound freedom and put a cannula in a boy who was injured in a streetcar accident.