The Province of Bolzano-Bozen, also referred to as South Tyrol, is an autonomous province in northern Italy, situated to the south of Austria, directly within the Alps.
Its territory is entirely mountainous and the province is noteworthy for its large number of valleys. Between the official languages Italian and German, the latter is more commonly spoken. The area is inhabited by half a million people and visited by another 13 million tourists every year. The two main cities, Bolzano and Merano, administer large sized hospitals, and another six smaller hospitals are strategically placed around the region.
Challenges for the Weisses Kreuz EMS
Scattered villages in a typical alpine landscape with shifting weather conditions combined with steep and winding mountain roads present the EMS with constant challenges. The region’s main EMS, Weisses Kreuz (White Cross) was established in 1965 with the aim to provide help for ill and injured people and to ensure safe transportation to the hospitals. The Weisses Kreuz is now among the largest EMS on the European Continent.
The head quarters and main ambulance station are located in the capital of Bolzano-Bozen. In addition to the administration centre, training facilities and workshops, the main base for the air ambulance is also located here.
Organization of the EMS
The dispatch centres are staffed by personnel (including physicians) capable of assessing the resources needed for each emergency. As Italian ambulance personnel are delegated fewer patient care related tasks than seen elsewhere, emergency physicians will assist them (using either smaller, well equipped ‘rendezvous’ vehicles or helicopters) when further medical assistance is required. Emergency ambulances are staffed by two paramedics and sometimes a nurse and are normally equipped with state-of-the-art emergency equipment, such as HeartStart MRx with 12 lead ECG, capnography, SpO2 /BP and QCPR (Quality CPR). Most of the transportation ambulances are equipped with emergency products such as defibrillators and Stifneck collars.
The paramedics undergo thorough training at the Weisses Kreuz’s own ambulance school and the training is carried out in accordance with national and regional standards. The training consists of three levels, each with a final exam. Top paramedics have 260 hours of theoretical training, and a minimum 160 hours of practical training. Refresher training and recertification within specific disciplines are required on an annual basis. The Keisses Kreuz provides special training for a group of paramedics, nurses, and physicians to ensure that they are prepared for operations under extreme weather conditions that can occur in the high Alps.
Weisses Kreuz adopted patient simulators as soon as these were available, and both SimMan and SimBaby are now actively used for training. Every scenario is audio-visually recorded and the DVD is analysed during subsequent debrief sessions for the purpose of augmenting learning outcomes generated form the simulation training.
Weisses Kreuz has a strong focus on quality assurance. The service has developed a professional training division that, in addition to providing basic EMT and Paramedic training, has also taken measures to ensure that the already acquired knowledge and practical skills are maintained. To enable continuous skill improvement and to ensure safe and optimal patient care, Weisses Kreuz decided to introduce QCPR; a concept that, via sensors placed onto the patient’s chest, provides feedback on the quality of compressions delivered during resuscitation (in compliance with the Italian Resuscitation Council guidelines). Thanks to this new technology, Weisses Kreuz is now able to ensure consistent high quality CPR therapy.
Projects aiming to increase chance of survival
In addition to providing EMS to the regular population of South-Tyrol, Weisses Kreuz is also concerned with the millions of tourists who visit the area every year. With a sincere ambition to promote safety and improve clinical outcomes, the organization has launched several projects:
1. Disseminating CPR training in the population
A minimum of 4000 school children will annually be using the self-directed MiniAnne/CPRAnytime program to learn and practise CPR. This endeavour will be followed up with research conducted by Professor Uwe Kreimeier, MD; Associate Professor at the University of Munich Hospital, and his team.
2. Disseminating First Aid knowledge
To encourage more people to gain First Aid knowledge, Weisses Creuz introduced a free-of-charge smart First Aid guide for the iPhone and/or iPod Touch. The application, which also works on other smart-phones, comes in the German, Italian and English languages. The application has so far been downloaded more than 250 000 times worldwide. Click to download the APP here: http://itunes.apple.com/WebObjects/MZStore.woa/wa/viewSoftware?id=295175159&mt=8