COMBINED AMBULANCE AND FIRE SERVICE Situation in Luxembourg

ACTORS IN THE FIELD Civil Protection Fire Brigade of the City of Luxembourg SAMU Luxembourg Air Rescue (LAR) Private Operators CITY OF LUXEMBOURG FIRE BRIGADE 2

CIVIL PROTECTION Covering: • Area of ~ 2. 100 km 2 • Population of ~ 350. 000 inhabitants Training Missions: CITY OF LUXEMBOURG FIRE BRIGADE • 17. 688 emergencies • 11. 524 non-urgent transports 3

SAMU (MEDICAL TEAM) 3 stations Based in hospital CITY OF LUXEMBOURG FIRE BRIGADE Operating in rendez-vous system 4

SAMU (MEDICAL TEAM) CITY OF LUXEMBOURG FIRE BRIGADE 5

LUXEMBOURG AIR RESCUE (LAR) 3 Helicopters CITY OF LUXEMBOURG FIRE BRIGADE 3 Fixed wing aircraft 6

LUXEMBOURG AIR RESCUE (LAR) CITY OF LUXEMBOURG FIRE BRIGADE 7

LUXEMBOURG CITY FIRE BRIGADE Covering: • Area of ~ 350 km 2 • Population of ~ 160. 000 resident people • Population of ~ 260. 000 people in total (daytime) CITY OF LUXEMBOURG FIRE BRIGADE 8

LUXEMBOURG CITY FIRE BRIGADE Missions: 12. 427 emergencies 1. 883 non-urgent transports CITY OF LUXEMBOURG FIRE BRIGADE 484 Fires 1509 Rescue- and other technical interventions 9

MANPOWER IN OPERATIONAL SERVICE 160 firefighters 40 firefighters per shift (4 shifts) CITY OF LUXEMBOURG FIRE BRIGADE ~ 27 firefighters on duty per shift 10

HISTORICAL OVERVIEW First public ambulance service in Luxembourg (1922) Very low quality of assistance to the victims up to 1985 (scoop and go) Training of the firefighters no more than a simple firstaid training CITY OF LUXEMBOURG FIRE BRIGADE 11

HISTORICAL OVERVIEW First on-field tests (late 1979 -1983) New type of ambulances (1985) Better training for fire-fighters (from 1986 on) and Special training for fire-fighters dealing in preclinical medical care New law concerning preclinical medical care (Loi SAMU 1986) CITY OF LUXEMBOURG FIRE BRIGADE 12

TRAINING Training in Belgium (1986) • Ambulancier SAMU • 520 hours • Mainly for assistance of the doctor Switch to the training of « Rettungssanitäter » in Germany (1993) Cooperation with the Hamburg Fire Brigade for the training of « Rettungsassisent » (2002) CITY OF LUXEMBOURG FIRE BRIGADE 13

COMPETENCES Intubation Venous puncture Semi-automatic defibrillation Preparation of medicaments Administration of certain medicaments under certain well definded conditions CITY OF LUXEMBOURG FIRE BRIGADE 14

TRAINING IN TOTAL Full firefighting training including enhanced first aid training (1080 hours) CITY OF LUXEMBOURG FIRE BRIGADE First module of 520 hours paramedics training Second module of 1200 hours paramedics training (including inservice-training and in-hospitaltraining) 15

OVER A PERIOD OF 15 YEARS Load up, give first aid, an carry as quickly as possible to the next hospital (scoop and go) Give complete preclinical medical care such as provided in the emergency rooms of hospitals and stabilize the condition of the victim (stay and play) CITY OF LUXEMBOURG FIRE BRIGADE 16

PROBLEMS STILL TO SOLVE Legal basis CITY OF LUXEMBOURG FIRE BRIGADE • Fire-fighters giving certain medical assistance are operating in a « grey zone » • Some doctors fully support other do not • Strong headwind coming from the union of the nurses 17

MAIN DIFFICULTIES Training is very extensive During this additional training firefighters are away from their station for a long time CITY OF LUXEMBOURG FIRE BRIGADE Difficulty for fire-fighters to be up to date in both fields: firefighting and paramedic Financial impact is not unimportant (mainly training costs) 18

MAIN ADVANTAGES Everybody knows each others role on an incident Polyvalence Everybody knows each others technical means • their quantity • there quality Tactical approach is common Better stressresistance on the scene CITY OF LUXEMBOURG FIRE BRIGADE 19

ECONOMIC ADVANTAGES In a world of constant budget cuts and rationalizations it is easier to maintain actual personal strength CITY OF LUXEMBOURG FIRE BRIGADE The peak of one « service » is covered by the other 20

CONCLUSIONS « All inclusive » service for the citizen Conclusions Image of the profession Economic CITY OF LUXEMBOURG FIRE BRIGADE 21

Thank you for your attention Questions? CITY OF LUXEMBOURG FIRE BRIGADE 23