[Practical training for paramedics : Transformation at the Leipzig University teaching hospital]

[From volunteer work to critical care paramedic : The history of an ongoing process of professionalisation]

BACKGROUND

For 4 years, the profession of critical care paramedic has been established in Germany. As a result, nonmedical rescue service personnel receive a 3-year apprenticeship for the first time. This also led to a revaluation of functions and responsibilities within this occupational field.

OBJECTIVES

Which medical and social processes contributed to the establishment of the occupational profile of a critical care paramedic? How did training methods change over the last 50 years and which debates helped to shape the development of the occupational field?

MATERIALS AND METHODS

The article at hand is based on an interpretation of archival primary sources of the parties observed. Moreover, it is also predicated on a qualitative content analyses of the secondary literature focusing on the subject area of nonmedical rescue service personnel.

RESULTS

In the 1960s, a professionalisation process for paramedics was initiated after realising that rapid medical treatment on location can have a positive impact on the healing process. The debate on the training for paramedics has been influenced by longstanding negotiations between different parties about the question of which tasks could be ascribed to nonmedical rescue service personnel.

CONCLUSIONS

In the larger context, the discussions about the tasks of critical care paramedics are centered around the question of delegation and, respectively, the substitution of medical tasks usually assigned to physicians. The academization of the profession that is currently emerging will continue to lead to conflicts with the medical profession.

[Future of emergency medicine in Germany 2.0]

In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment. Now after 15 years, the authors have critically assessed the development postulated in 2003 and reevaluated it. Which aspects could be developed further and become firmly established, what is still open and which questions in preclinical and clinical emergency treatment of the population will occupy us in the coming 15 years? With a critical eye to the past, the present contribution aims to capture the essential and new topics and open questions and provide a fresh perspective for the future of emergency medicine. Regulation at the state level or even lower levels of government often stand in contrast to more sweeping and economically effective approaches at the federal level. Prehospital emergency medicine in Germany is on the whole well-positioned with respect to facilities and personnel; however, as far as the economic situation and the utilization of available systems are concerned, there is still substantial room for improvement.