Emergency medical services (EMS)

The first early structural approaches to rescue services can already be found in the Napoleonic era. First of all, people responsible for caring for the wounded had to be found to go into battle with them. Although doctors were established as a profession, armies were not accompanied by physicians. This was not common practice at the time. So one had to rely on others or their skills. Barbers and barbers formed the "rescue service". They were practically the only ones who dealt with human anatomy. During battles they remained at a safe distance. When there were the first wounded, they ran to the battlefield with wooden carts and transported the wounded away. There is no historiographical consensus about the concrete possibilities of care at that time, but the hygienic conditions must have been catastrophic.

Contrary to many a common perception, the officially promoted and nowadays self-evident in the general public consciousness "rescue of people from danger to life" and in medical emergencies was only a phenomenon of the late 18th and early 19th century. At the end of the 18th century, the first official rescue ordinances came into being in the individual German states, in which life-saving was declared to be the duty of every citizen and rewards were offered for successful resuscitations of "apparent dead", and which also contained contemporary instructions for assistance and life-saving.

At the end of the 19th century, most large German cities had an organized ambulance system. Private companies, civilian Samaritan associations, ambulance crews of the German Red Cross (DRK) and/or the fire brigade were charged with carrying out the service. The motorization of patient transport began after the First World War. In the spring of 1943, a National Socialist "Führer decree" attempted to standardize the ambulance service in Germany, which the Nazi government wanted to be assigned exclusively to the German Red Cross. The outcome of the Second World War put an end to this attempt.

After the period of National Socialism and the German Reich, the occupying powers initially transferred the provision of ambulance services and thus also emergency rescue to the municipalities (for example in the British occupation zone) or to the denazified and newly founded German Red Cross. In the 1950s, concessions were increasingly awarded to private companies, especially outside the major cities, to provide ambulance services and, in the absence of other regulations, to provide emergency rescue services.

The increasing density of road traffic led to a steady rise in the number of accidents from around the end of the 1950s. In addition, from the mid-1960s onwards, there were new findings and improved principles in the treatment of emergency patients and the resulting further developments in vehicle and equipment technology. The existing rescue system in Germany was unable to keep pace with these new requirements, and since the 1960s a deplorable "rescue emergency" has developed, also in the perception of the public. From the mid-1960s, this unbearable situation led to increased commitment on the part of administrative experts, medical professionals and aid organisations, and finally to the official reorganisation of the rescue service from the early 1970s onwards. During these years, private initiatives and especially the Björn Steiger Foundation also put a lot of effort into building up the appropriate infrastructure with emergency call points and vehicles. Since these goals have now been achieved, this foundation is committed to combating sudden cardiac death and is trying to distribute layman's defibrillators (AEDs) throughout the country.

112 has been agreed as the standard emergency number throughout Europe for all types of requests for assistance, which are then forwarded to the appropriate body if necessary. In addition, there are still numerous different nationally and locally valid emergency numbers in Europe.

Europe-wide standards exist, for example, for

• Emergency service clothing (DIN EN 443, DIN EN 471, DIN EN 659)
• Vehicles for patient transport (DIN EN 1789)
• Ambulance stretchers (DIN EN 1865)

Some rescue service organisations are also certified according to European quality management standards (ISO 900x). These organisations thus guarantee to maintain a certain standard, from the procurement of materials to the treatment of the patient.

There are no EU or even Europe-wide guidelines for adherence to certain response times. At most, there is a recommendation for a response time of between ten and twenty minutes, which the member states are free to vary upwards or downwards.