Imagination at Work

Editor’s Note:JEMS Editorial Board member Wayne Zygowicz recently traveled to Germany to serve as an EMS Safety Foundation delegate during the RETTmobile European Emergency Services Exhibition 2009. This article summarizes what he learned at the conference. At the end of this article is a list of hisfrom-the-conference blog, which appeared onJEMS Connect.

Like most people who work in the fire service or EMS, I occasionally enjoy getting away from patients, paperwork, alarm tones and the stresses related to emergency work. What better way to relax than to attend a conference or trade fair, visit a new place, network and see what’s new or improved, bigger or better, and more efficient and safer in the industry.

I got my chance while speaking at EMS Today in Baltimore this year. It was there that I met Dr. Nadine Levick, founder of theEMS Safety Foundation, a not-for-profit “think tank” consortium and institute that strives to increase the safety of prehospital care and transport for the patient, provider and public. Dr. Levick graciously extended an invitation to me to become a safety foundation delegate by attending the RETTmobile European Emergency Services Exhibition 2009. I learned the RETTmobile (translated to “mobile rescue” in English) conference and trade fair brings 23,000 people and 300 international exhibitors to”žFulda,”žGermany each year. They present innovative safety and rescue products in13 exhibition halls on a 70,000-square-meter fairground that used to be an old air force base.

A month later, I joined the other delegates in Fulda, Germany (I speak no German) to discover what new EMS and fire innovations are being used overseas.

I’ve always been interested in ambulance construction and product safety, so this was right up my alley. I hoped I would see some fresh and unique equipment and ideas, but I always thought”žAmerica had the best innovations and best-trained responders, used state-of-the-art equipment, and provided the highest level of patient care, customer service and safety for our patients and ourselves. So I left with the preconceived notion that if we weren’t using it here in the good old U.S. it probably wasn’t worth looking at — or it didn’t exist. Boy, I was not only wrong but naÅ’ve!

Safety Is No Accident
On the first day, I experienced the show’s international flavor, with vendors from around the world displaying their emergency products. As I walked through the exhibit halls and talked with the sales people, one thing quickly became apparent: Europeans are serious”ž”ž about the health, safety and welfare of their first responders. Ambulance design is regulated by the government and based on testing, science and data to meet the Common European Community (CEN) standard, EN-1789.

Safety is built into everything Europeans do. From bullet trains to fuel efficient cars, ambulances and fire apparatus, safety and efficiency are a way of life in Germany. Surely there’s a lesson to be learned here when you considered the number of American first responder careers cut short from back injuries caused by lifting patients and heavy rescue equipment.

The attendant seating in the patient treatment area is front or rear facing only, which is a much safer riding position than side facing, and all seats are equipped with a passenger restraint systems. Medical equipment, including stretchers, is contained in well-engineered receptacles, crash tested and rated to 10 Gs of force by law. Equipment is ergonomically designed so responders rarely have to lift people or gear. Cots have automatic loading systems. Wheelchairs climb stairs mechanically, and lifting patients or equipment is almost always avoided. There’s no doubt that European providers work smarter than their American counterparts,

Many Americans see Europeans as flashy dressers who lead the way in fashion and style, and the stereotype holds true when it comes to their first responder clothing and vehicles. Their rescue clothing is light, durable and highly visible while response vehicles are covered on all sides with high-visibility”žmarkings of bright orange, red and lime green. While Americans tend to prefer red fire trucks, white ambulances and black bunker gear, these time-honored traditions add little in the way of responder safety. On the other hand, European high-visibility equipment is easier to see in all lighting conditions and adds an element of safety that hasn’t yet been realized in the US. And although most American first responders wouldn’t get many style points for looking like Big Bird on scene, would we even care what color gear we were wearing if we knew it reduced our chances of getting run over at a crash scene or attending another funeral for a responder?

In addition to having more visible clothing and vehicles, European ambulances are lighter, faster, safer and more fuel efficient than ours. You really can’t appreciate those facts until you’ve taken a Mercedes Benz ambulance out on the test track and experienced their maneuverability and stopping capabilities. It truly was“The Ultimate Driving Experience.”“ž It’s no different on the fire side either. All other specialized equipment, used for Hazmat, extrication and dive/rescue events, are brought to the scene in specialized containers lifted mechanically onto a transport vehicle. Europeans believe in quick, fast and efficient mobility. It made me think that they’re really onto something; think for a second about any compartment on a”žU.S. ambulance or fire truck. Specialized equipment, often seldom used, is crammed in every nook and cranny. It takes up space and adds weight, requiring a bigger vehicle.

A number of leading EMS manufactures that we use in America operate very successful businesses in Europe and were at the conference. Although many of their products were the same as what’s used here (except for buttons labeled in German), some aren’t even”žmarketed in the U.S. Many of these are are made in America, crash tested and rated to meet European standards, but aren’t used in the U.S. I found this a little surprising and annoying at the same time. When I asked one sales representative why, what they said upset me. They told me their European clients have safety standards that American consumers don’t seem to care about.”ž

Built for the Road Ahead
Much of the small equipment we use daily in our ambulances has been improved overseas; it’s lighter in weight and much more efficiently designed. For example, although the usual brand name cardiac monitors were on display, some smaller companies offered lightweight units with break-apart modules separating the monitor from the defibrillator. Also, nobody sold or displayed any type of hard, spine-immobilizing backboards. The common method of spinal immobilization in Europe is the vacuum mattress. Maneuver the patient onto a soft mattress, suck out the air with a pump and you’ve filled every void under the patient while providing picture perfect spinal control. The mattresses come in all sizes and shapes from infant to adult. Extremity splints are also fashioned out of the same durable material.

Break Out of the Ordinary
It was an honor and a privilege to join the EMS Safety Foundation and the other delegates from around the world at RETTmobile 2009. The adventure really opened my eyes and forced me think outside the box about responder safety, efficiency and product design. This journey was about discovery, information sharing and knowledge transfer with the goal of making EMS and fire service delivery safer for our customers and providers. Many things I saw firsthand at RETTmobile could benefit our first responders back here in the States if we could just put aside our history and tradition for a moment to break out of the ordinary. We should show that we care about these safety options that are available in Europe by expressing our desire for manufacturers to have them here in the U.S“ž The equation seems pretty simple; work smarter, not harder, to be safer and more efficient.

Although most people will never venture all the way to Germany to attend the RETTmobile conference (even though travel to Europe is reasonably priced, the people are nice and the food is good), we must continually strive for better ways of delivering emergency services in the U.S. We also must constantly improve safety for our responders with testing, data and facts. And in this, we could learn a thing or two from our European counterparts. They seem to have it pretty well dialed in.”ž

Wayne’s Blogs from the RETTMobile Conference
The Mother of Invention – Science vs. Tradition
The Ultimate Driving Experience
Live From RETTmobile 2009
Planes, Trains and Automobiles
The Amazing Race
Castles, Cafes and EMS Innovations
For more on ambulances, visit our Ambulance and Specialty Vehicle page.

Wayne M. Zygowicz,BA, EMT-P, is the EMS chief for Littleton (Colo.) Fire Rescue. He has been involved in EMS and the fire service for 25 years. He also serves as a member of the JEMS Editorial Board. Contact him

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