Due to the overload of the emergency services and the permanent state of emergency at the Berlin fire brigade, no more ambulances should now be sent to lighter cases. In an internal message sent on Monday, the emergency call quality management of the control center specifies when an ambulance no longer has to drive off.
The two-page letter that is available to the Tagesspiegel lists several case scenarios in which, despite a 112 emergency call, the ambulance should no longer come – but the callers are referred to the Association of Statutory Health Insurance Physicians (KV).
This also includes the so-called allergic reaction without breathing or swallowing difficulties. The somewhat swollen mosquito bite is also noted under this code in the computer system. So far, the fire department’s query system had specified that an ambulance with blue lights had to be dispatched.
Fire chief Karsten Homrighausen also found out about this last weekend during a nightly visit to the control center and before that during a night shift at the rescue service – and has now apparently intervened.
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Specifically, the changes revolve around a system called Snap – a standardized emergency call query protocol. If an emergency call comes in under the number 112, the system gives the employees in the control center standardized questions.
Depending on the answers, the system spits out codes that specify how to proceed – whether an ambulance with blue lights or just an ambulance has to go as emergency transport. The rescuers are also dispatched in the event of non-specific abdominal pain – after all, 9,000 calls a year.
The staff council and the unions had been calling for such changes for a long time. The reason is the overload. A state of emergency is now being declared almost every day for the emergency services. The situation has escalated this year: in 2020 there were 64 states of emergency, in 2021 178 times – this mark was already reached halfway through 2022.
One reason for this is the numerous trifles to which the ambulances have to drive. Then sometimes not a single free ambulance is available.
After a turbulent staff meeting and criticism of fire chief Homrighausen, the internal administration had increased the pressure on the fire department management. Both in the fire brigade and with Interior Senator Iris Spranger (SPD), the problem is now a top priority.
A new, four-person steering group from the interior administration is examining the details and is to develop proposals to counteract the long-term crisis within three months. In addition, the operational codes are to be subjected to a broad examination.
In addition, the internal administration wants to curtail the powerful position of medical director Stefan Poloczek, so the rescue service law has to be changed. Poloczek is considered the most persistent advocate of the Snap query system. The time when the medical director was untouchable is now over, according to the internal administration.
Although a task force had been developing proposals since September 2021 on the instructions of the internal administration, Poloczek was not the only one opposed to far-reaching changes that would have led to a relaxation in the rescue service. Numerous suggestions, which even showed success in tests, seeped into the administration. But now the pressure has become too great and the situation is escalating.
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The German Fire Brigade Union Berlin-Brandenburg (DFeuG) welcomed the adaptation of the codes. “This can only be the beginning, but it’s a good start,” said DFeuG spokesman Manuel Bart on Monday. The persistence of the union in the matter has paid off.
These are the first adjustments in the protocol system “in the direction of an emergency rescue service tailored to the occasion”. But there are still tons of codes that you have to look at again. Therefore, there is no time to rest.” Barth also called for a network for people “who have legitimate concerns beyond the need for an emergency service and need help without overloading the emergency rescue service”. There is still a lot to do in this regard.
The police union (GdP) also made a statement. “The code adjustments make perfect sense because we are talking about a large number of cases that have been loaded with an RTW without it being really needed,” said GdP spokesman Benjamin Jendro.
But it is a pity that it only took a “permanent state of emergency and a de facto state of emergency”. It is to be hoped that the Association of Statutory Health Insurance Physicians can also take on the increasing number of forwarded cases and patients – “and in the end drive fewer ambulance services from the Berlin fire brigade to the paper cut and torn toenail”.
