Innovative techniques in out-of-hospital emergency medicine in Germany. A five year follow-up internet survey among medical emergency service directors

Background: To guarantee contemporary medical emergency medicine, technical innovations undergo a continuous riskbenefit-analysis by the medical directors of the emergency services (MEDS) in the individual emergency medical service districts. Besides medical evidence and economic aspects, application security has to be assured. Following a first online-based survey regarding the technical configuration of the particular emergency medical service district in 2009, we present a follow up online survey. Method: The survey was carried out as an anonymous nationwide online survey among the MEDS in Germany after postal approach and twofold recall by email. The evaluations of actual and scheduled availability of modern medical technology in the administered emergency medical districts were assessed. Focuses were airway management, acute coronary syndrome, cardiogenic shock, cardiopulmonary resuscitation, trauma and operational documentation. Results were analysed descriptively and compared to the data of the prior survey in 2009. Results: Mails were sent to a total of 192 MEDS, 189 of whom were reached. 73 (39%) filled out the total survey. Enclosed MEDS were predominantly located in rural areas. In comparison to the preceding survey the follow-up documents an increasing availability of video laryngoscopes, ultrasound devices, automatic mechanical compression devices for cardiopulmonary resuscitation and digital documentation assists. Extraglottic respiratory assist devices represent a standard equipment, non-invasive ventilation can be performed in the majority of the districts. Extracorporeal-Life-Support-Systems are marginally used. Conclusion: The survey results provide an update of the evaluation, availability and distribution of modern technical devices in Germany's emergency medical districts. The comparison allows conclusions about current trends in prehospital emergency medicine in Germany.