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Crossborder airmed services—A step toward Europe
Conclusion: By first defining an alpine standard operation procedure and then maintaining intensive alpine training, both paramedics and physicians are able to perform advanced alpine rescue missions without facing inappropriate risks.
Mountain Rescue with Helicopters HerbertForster, MD, Bay Bergwacht, Buchenberg,Germany Our mountains have become a big playground for a variety of sports. Some have been performed for decades, like hiking, climbing, and skiing. Some are rather new, like paragliding or canyoning. All,these different sports are more or less dangerous, and the alpine environment has its own specific hazards. So our mountain rescue teams are faced with many accidents, that bring special problems in a mountain area. Any emergency case in the mountains has its own rules, which are characterized by location, time, technical training, emergency medicine, organization, and communication. In the past few decades, many things have changed in mountain rescue, but we should be aware that there is still a lot work to be done. I think a meeting like this gives us all a chance to learn from each other to benefit victims in the mountains.
The Rescue of a Multitraumatized, HypotermYoung Woman--a MultidisciplinaryAlpine Operation A. Ersson, MD, Dept. of Anaesthesiaand IntensiveCare, HelsingborgHospital Swedenand NorwegianAir Ambulance A 14-year-old female was on a mountain trekking tour. When crossing a small glacier, she lost her footing and slid toward a cleft, where she fell approximately 35 meters onto sharp rocks. Immediately after the fall, bystanders had brief verbal contact with the girl, but shortly the contact was lost. An HEMS rescue team reached the victim 2 hours after the accident, and medical rescue personnel immediately went down to the patient. She then was deeply hypothermic and comatose. She was situated in a pool of water and continuously soaked by dripping water from the surrounding ice. The primary survey revealed severe impairment of vital functions. The patient had shallow spontaneous breathing, distant heart and respiration sounds, irregular bradycardia, and a weak response to pain. Her pupils had a slow response to light and were semidilated. She exposed numerous evidence of multiple traumas to her head, thorax, and extremities. Her airway was immediately secured, an IV cannula was inserted, and a rigid neck collar and a KED vest immobilized her. Blankets were used as environmental protection. Because of sudden heavy rain and great amounts of water cascading down into the cleft, controlled extrication had to be abandoned, and the patient was hoisted to the surface using a double sling. She then was brought by air to the nearest trauma facility, where she was successfully resuscitated and discharged 2 months later without sequel. In this presentation, the rescue operation is discussed in terms of medical and technical rescue interventions, timing, planning, and liaison among the different parts of the HEMS rescue crew.
CrossborderAir Rescue LadislavMika, Dip/Eng, Ministry of Transportand Communications of the CzechRepublic, P.O.Box9, NabreziL. Svobody12, 110 15 Prague 1 Our attention is aimed at the conclusion of bilateral agreements regarding the HEMS cooperation and facilitation for border crossing by helicopter rescue missions. In order to achieve 116
such needed rapid mutual assistance and its effectiven missions between neighboring countries, respective agreements could facilitate these rescue missions. In order to achieve maximum effectiveness and speed of rescue flights between neighboring states, the following basic reciprocal facilitation procedures should be ensured: • Request for rescue flights should be transmitted directly between respective centers of air rescue services of neighboring states. • No customs documents should be required and issued for standard equipment of helicopters/airplanes inclusive of health and technical equipment, and medication needed for realization of rescue flights should not be liable to import and export fees. • Border crossing should be realized without passport control. The respective passport and customs authorities of contracting states should be informed within 12 hours at the latest after finishing the flight. • Landing and takeoff should be carried out without prior permit at any place where the injured person or patient waits for transport. • Both parties should clarify in advance details on places of contact, professional requirements for medical personnel of air rescue service, and system of financing. These proposed measures should facilitate border crossing and contribute to the quicker and more effective performance of rescue missions. Due to the further growth in tourist and business industries and bilateral contacts between neighboring countries, a model of bilateral agreement was prepared and could be beneficial for all parties involved and significantly facilitate rescue missions.
CrossborderAirmed Services--A Step Toward Europe SusanneMatzke-AhLAOAC-LuftrettungGMBH,Am Westpark8, MOnchen,Germany81373 All European countries operate an emergency system. Some of the emergency systems are similar; some are rather different in view of their structure, staff training, equipment, alert procedures, and legal or technical issues. Language is another barrier. Germany shares its borders with nine countries. European borders will not only disappear where travel, customs, and similar issues are concerned. If we aim to achieve synergies for Euregional areas, borders must also disappear or at least become more open where our greatest good--human life--is concerned. Even in Germany different rescue systems are in operation based on similar but not identical legislation of the 18 German states. Such legislation normally is harmonized by the German Federal and InterState Rescue Services Committee. German air med services have been designed to operate at a national level to prevent assistance from being stopped by state boundaries. For 30 years the nonprofit company ADAC Luftrettung GmbH has operated in various German states, with a current total of 34 rescue and intensive care helicopters in cooperation with various partners. A wealth of experience is an ideal basis for ADAC Luftrettung to provide fast crossborder assistance from the air. In cooperation with our partner clubs ANWB and TCB, the Euregio Meuse-Rhine, and the Aachen district responsible for air med operations in the Belgium, Netherlands, and Germany border area, the stationing of the "Christoph Europa 1" helicopter in WLirselen near Aachen was the first milestone to achieve this aim. This example will be an important incentive for establishing a crossborder air med service. July-September 2000 19:3 Air Medical Journal
Mountain Rescue with Helicopters HerbertForster, MD, Bay Bergwacht, Buchenberg,Germany Our mountains have become a big playground for a variety of sports. Some have been performed for decades, like hiking, climbing, and skiing. Some are rather new, like paragliding or canyoning. All,these different sports are more or less dangerous, and the alpine environment has its own specific hazards. So our mountain rescue teams are faced with many accidents, that bring special problems in a mountain area. Any emergency case in the mountains has its own rules, which are characterized by location, time, technical training, emergency medicine, organization, and communication. In the past few decades, many things have changed in mountain rescue, but we should be aware that there is still a lot work to be done. I think a meeting like this gives us all a chance to learn from each other to benefit victims in the mountains.
The Rescue of a Multitraumatized, HypotermYoung Woman--a MultidisciplinaryAlpine Operation A. Ersson, MD, Dept. of Anaesthesiaand IntensiveCare, HelsingborgHospital Swedenand NorwegianAir Ambulance A 14-year-old female was on a mountain trekking tour. When crossing a small glacier, she lost her footing and slid toward a cleft, where she fell approximately 35 meters onto sharp rocks. Immediately after the fall, bystanders had brief verbal contact with the girl, but shortly the contact was lost. An HEMS rescue team reached the victim 2 hours after the accident, and medical rescue personnel immediately went down to the patient. She then was deeply hypothermic and comatose. She was situated in a pool of water and continuously soaked by dripping water from the surrounding ice. The primary survey revealed severe impairment of vital functions. The patient had shallow spontaneous breathing, distant heart and respiration sounds, irregular bradycardia, and a weak response to pain. Her pupils had a slow response to light and were semidilated. She exposed numerous evidence of multiple traumas to her head, thorax, and extremities. Her airway was immediately secured, an IV cannula was inserted, and a rigid neck collar and a KED vest immobilized her. Blankets were used as environmental protection. Because of sudden heavy rain and great amounts of water cascading down into the cleft, controlled extrication had to be abandoned, and the patient was hoisted to the surface using a double sling. She then was brought by air to the nearest trauma facility, where she was successfully resuscitated and discharged 2 months later without sequel. In this presentation, the rescue operation is discussed in terms of medical and technical rescue interventions, timing, planning, and liaison among the different parts of the HEMS rescue crew.
CrossborderAir Rescue LadislavMika, Dip/Eng, Ministry of Transportand Communications of the CzechRepublic, P.O.Box9, NabreziL. Svobody12, 110 15 Prague 1 Our attention is aimed at the conclusion of bilateral agreements regarding the HEMS cooperation and facilitation for border crossing by helicopter rescue missions. In order to achieve 116
such needed rapid mutual assistance and its effectiven missions between neighboring countries, respective agreements could facilitate these rescue missions. In order to achieve maximum effectiveness and speed of rescue flights between neighboring states, the following basic reciprocal facilitation procedures should be ensured: • Request for rescue flights should be transmitted directly between respective centers of air rescue services of neighboring states. • No customs documents should be required and issued for standard equipment of helicopters/airplanes inclusive of health and technical equipment, and medication needed for realization of rescue flights should not be liable to import and export fees. • Border crossing should be realized without passport control. The respective passport and customs authorities of contracting states should be informed within 12 hours at the latest after finishing the flight. • Landing and takeoff should be carried out without prior permit at any place where the injured person or patient waits for transport. • Both parties should clarify in advance details on places of contact, professional requirements for medical personnel of air rescue service, and system of financing. These proposed measures should facilitate border crossing and contribute to the quicker and more effective performance of rescue missions. Due to the further growth in tourist and business industries and bilateral contacts between neighboring countries, a model of bilateral agreement was prepared and could be beneficial for all parties involved and significantly facilitate rescue missions.
CrossborderAirmed Services--A Step Toward Europe SusanneMatzke-AhLAOAC-LuftrettungGMBH,Am Westpark8, MOnchen,Germany81373 All European countries operate an emergency system. Some of the emergency systems are similar; some are rather different in view of their structure, staff training, equipment, alert procedures, and legal or technical issues. Language is another barrier. Germany shares its borders with nine countries. European borders will not only disappear where travel, customs, and similar issues are concerned. If we aim to achieve synergies for Euregional areas, borders must also disappear or at least become more open where our greatest good--human life--is concerned. Even in Germany different rescue systems are in operation based on similar but not identical legislation of the 18 German states. Such legislation normally is harmonized by the German Federal and InterState Rescue Services Committee. German air med services have been designed to operate at a national level to prevent assistance from being stopped by state boundaries. For 30 years the nonprofit company ADAC Luftrettung GmbH has operated in various German states, with a current total of 34 rescue and intensive care helicopters in cooperation with various partners. A wealth of experience is an ideal basis for ADAC Luftrettung to provide fast crossborder assistance from the air. In cooperation with our partner clubs ANWB and TCB, the Euregio Meuse-Rhine, and the Aachen district responsible for air med operations in the Belgium, Netherlands, and Germany border area, the stationing of the "Christoph Europa 1" helicopter in WLirselen near Aachen was the first milestone to achieve this aim. This example will be an important incentive for establishing a crossborder air med service. July-September 2000 19:3 Air Medical Journal