This means nothing to me…oh Vienna!

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Schloss Schönbrunn. And snow, lots of it, in fact!

 

Actually, it meant quite a lot – so enough of the reference to 80’s pop music. I chose Vienna for my birthday destination because….well, I don’t really know. I had been before, couldn’t remember much – I believe I had not hit my teens yet, and as such it was a few earth rotations around the sun ago.

Vienna turns out to be a beautiful place, with spectacular old buildings, scrumptious food and a sophisticated yet laid-back cultured vibe. I can only recommend that you should visit it, and eat, drink and be merry there. I’m not one for much repetition, so I’ll leave you to check out my other halves delectable musings here.

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 Through conference attendances I had got to know some lovely Austrian Paramedic folk. As one does when visiting a country of foreign friends, one calls up (well, emails) in advance to organise a coffee together and the next thing you know you have a shift on an ALS response vehicle booked. Can’t help myself – and I count myself especially lucky as my other half is not only tolerant of such fun outings, but actively encourages me to do them (which she planned to turn in to some time to pursue her own interests, like watching some equine practice prancing. I might be losing some brownie points here, but I really can’t warm myself to horses. They have big teeth and don’t talk).

My alarm went off at 5am. Early? Yes. Girlfriend snuggled beside me on the mattress all warm and cozy? Tick. Could I have done with a bit more sleep? Indeed…but I was up and showered and ready to go in no time, excited by the prospect of experiencing another ambulance service!

After finding a little local bakery that mercifully opened early enough for me to buy all the danish (read: viennese) pastries within the city limits, I was fed and watered and awake to jump in to my Wiener Rettung (Viennese Rescue) experience. Now only to find out where I have to go…

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The Entrance Sign

As has often been the case in the past, someone saw me confused & pondering in front of the new building (the main building was closed and locked and dark), let me in and in a friendly manner pointed me in the right direction.

After a quick tour around the building (nice and modern, with beds, a comfortable communal, kitchen and outdoor area), and I am introduced to the Paramedic I will be following for half the shift. I say half a shift, as I only wanted to spend a coupe of hours to gain some insight, and not a whole day; it turned out to be a quarter of a shift, as the guys and girls in Vienna still do 24hr shifts, with the possibility of 15-20 jobs in that time frame. Phew!

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My ride for the day.

I was going out on the ALS response car that morning, with a Paramedic driving, and an emergency doctor treating. When I say Paramedic, I mean a person who is trained in emergency care, and – at the highest level – can intubate and cannulate. Nevertheless, they are still very transport focussed, and paramedics take a backseat in clinical care, leadership and development – most likely because the system is so heavily focussed on doctors as advanced providers. Even worse, Vienna is the only city in Austria that has an entirely career based ambulance service – the rest of the countries ambulance services release heavily on volunteer input. Often, I was told,  the ambulances are staffed with two volunteers with lower qualifications. Vienna is fighting this, and trying to bring forward the concept of a paramedic services within the country. They are doing a fine job it seems within Austria, but in an international comparison there are some areas where they are lacking.

But don’t write them off just yet, they have some interesting things to show to the world! They have just started a new level of Paramedic within the service. Qualified Paramedics are undergoing a three year course to further their knowledge and experience in such areas as critical care, primary care (community paramedicine), and field supervision (teaching and quality assurance), and they are building the course on input from a variety of international best practices – so hats off to them! I am looking forward to seeing them progress, and hopefully joining the international Paramedic playing field in due course.

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The ambulance garage. Obviously.

I went out on three jobs all together, including a 20+ minute run to backup a cardiac arrest. Not only was the job on the other side of the city, but it had also just started snowing heavily – and with heavily I mean approximately 15cm (6 inches) of snow in one morning. A standing and sliding ovation to the Paramedic I was with who safely navigated the traffic that morning.

And now, a few impressions, facts a figures from my shift:

Vienna runs approximately 35 ambulances throughout the day, additionally 6 ALS response units staffed by a Paramedic and a Doctor. The ambulances are staffed with three people – a wheeler, a healer and a dealer (OK, I made that rhyme up…one person drives, one attends and one is an additional pair of hands). This can get quite cramped inside the van conversion ambulances they use – working on a sick patient, there were two paramedics, a doctor and myself squeezed around the patient, and we could barely close the door. The service is considering in to larger vehicles for the future I have been told.

The Wiener Rettung only do emergency work, all patient transport is done by private and/or not for profit organisations such as the Red Cross or the Samaritans.

In the event of a cardiac arrest, the closest vehicle is sent – including the above mentioned patient transport vehicles or as well as the police as first responders. They are backed up by an ambulance and an ALS response car. The fire brigade are not involved at all – they were apparently invited, but declined.

There are no response time targets to be upheld, but a unit that has been alerted from station must be mobile within 2 minutes during the day, and three minutes at night.

Joining the service is an interesting path, one that I had not heard of before, some interesting ideas. After being accepted, either as a rookie to Paramedicine, or even as a qualified member, you start off doing station duties. You get to work, put on your uniform, and you clean and restock vehicles, inside and out. This is to get to know how the station operates, picking up the culture (e.g. cleanliness) and where everything is kept in the vehicles. If there is a staff shortage on that day, you will also man the ambulance if need be. After a period of station duties, you then progress to permanent on road duties.

After five years as a Paramedic, one can apply to work in the control room – this is often done by those who have injured themselves on the job and cannot work on the road, or those who have done their decades of work and prefer the slightly more controlled environment. Calltaking (via AMPDS) and dispatch is done at the same desk by the same person.

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Goodbye Vienna, hope to see you again soon!

I had a great time in Vienna, and being allowed to experience their ambulance system was the cherry on top of the trip. I would like to sincerely thank all involved for giving up their time in showing me around and meeting me, it was very appreciated.

Finally, I would urge everyone working in the field of paramedicine to consider visiting other services when they are on holiday. Not only do you get great insights and make some new friends, but you also get to see the area you are visiting from a local paramedics perspective – a view that is quite different than that of a tourist. Give it a go, I’d be very interested in your experiences.

For those wanting more information:

Tired

I’m awake, I’m away
I’m confined, I’m astray
I’m a rebel, I obey
When I’m tired.

I’m switched, I’m flipped
I’m down, I’m dipped
I’m quiet, tight lipped
When I’m tired.

I’m lonely, I’m horny
I’m passive, I’m thorny
I’ll listen, so bore me
When I’m tired.

I long for the days where I drift along
Not from fatigue, but from song
Immersed in the warm, sweet scent of life
But then it grips me, and stabs me like a knife.

I’m automatic, I’m robotic
I’m static, postraumatic
I’m erratic, far from ecstatic
When I’m tired