Delegation of medical treatment to paramedics in the Bavarian Emergency Medical Service

Background After a recent change in German paramedic education, paramedics are qualified to independently conduct medical treatment according to standard operating procedures (SOP) in the otherwise physician-based German Emergency Medical Services (EMS). These SOP are delegated by the local medical director of EMS. This article summarizes the SOP system in the state of Bavaria, Germany. Methods Within an iterative group process, eligible standard emergencies were identified and corresponding SOP were designed. The authors focused on the principles of clarity, delineation of critical emergencies, compliance with guidelines and current evidence, patient safety, restriction to the general competence level of paramedics, statewide uniformity, and legal security. Results Five SOP for "injured person," "isolated limb injury," "isolated burn injury," "hypoglycemia," and "suspected sepsis" were designed. Subsequently, these algorithms were agreed upon by all medical directors in the state of Bavaria. The SOP system is accompanied by a systematic quality management program. Discussion The Bavarian SOP system stands out from that of other federal states with regard to its clear differentiation from critical emergency scenarios with EMS physician involvement and its statewide uniformity. Quality assurance efforts focus on the compliance of paramedics with the SOP and on the SOP safety and effectiveness.     «

Background After a recent change in German paramedic education, paramedics are qualified to independently conduct medical treatment according to standard operating procedures (SOP) in the otherwise physician-based German Emergency Medical Services (EMS). These SOP are delegated by the local medical director of EMS. This article summarizes the SOP system in the state of Bavaria, Germany. Methods Within an iterative group process, eligible standard emergencies were identified and corresponding SOP...     »