Views From RETTmobil

RETTmobil may be the most important EMS conference and trade show you've never heard of. If you haven't, don't worry: In this special feature, several top North American attendees will fill you in.

The conference and trade show, which showcases the latest in safety and rescue innovations for EMS providers from across Europe (it translates to mobile rescue), filled 13 exhibition halls and drew 23,000 people to this year's incarnation at a former military base in Fulda, Germany, to see advances in equipment, clothing and vehicles. The EMS Safety Foundation led a delegation of North American providers, who supplemented their show experiences with a special workshop featuring speakers on vehicle safety and ergonomics and EMS head protection. The Foundation also conducted a pair of Webinars, one of which is available at Objective Safety.

In this article, three members of the Foundation's RETTmobil delegation discuss their impressions and what they found most interesting and potentially helpful to their own jurisdictions. For more: www.rettmobil.org.

Innovations From RETTmobil--Secure Stretchers and Safer Seating

By Kevin W. Peters, AAS, NREMT-P

After almost 30 years in EMS, I felt fairly confident I'd experienced most of the spectrum of equipment and technology in this industry. For two years I have served as full-time safety and compliance officer for Carilion Clinic Patient Transportation (CCPT). CCPT is a regional transport and EMS agency in southwest Virginia, with 240 employees providing care through 35 ambulances and two helicopters. My 15-year affiliation with Carilion Clinic and its dedication to a culture of safety introduced me to Dr. Nadine Levick, CEO of Objective Safety and research director the EMS Safety Foundation. Levick has helped bring attention to the lack of evidence pertaining to ambulance transport safety for the provider, patient and public. In the U.S. there are very few standards that specify how an ambulance is built and engineered for occupant safety. The standards in many other developed countries, including most of Europe and Australia, are much higher. This could help explain these nations' significantly lower ambulance-crash fatality rates compared to the U.S.

The EMS Safety Foundation coordinated a group of 24 individuals from across the United States and Canada to attend this year's RETTmobil 2009 event and see what Europe is doing in the name of safety. One of the largest EMS conferences in Europe, RETTmobil has been held for the past nine years in Fulda, Germany, on the site of an old U.S. Army helicopter base. With 13 exhibit halls and more than 70,000 square yards of exhibit space, there was plenty of room for exhibitors to show their wares. While there were many brand names we didn't recognize, there were many we did. In addition, two outside tracks allowed people to experience the handling characteristics of different vehicles in paved and off-road environments.

One interesting aspect was the vast differences in equipment available in Europe that is not available in the United States. One example is EMS stretchers. Here, stretcher and mounting systems are designed to only withstand 2,200 foot-pounds of force prior to their locking system failing--roughly equivalent to 74 pounds moving at 30 mph. The empty stretcher weighs more than that! In Europe, seats, seatbelts, stretchers, medical equipment and their mounting systems are able to endure loads 10 times the force of gravity over a crash impulse window of less than 100 milliseconds without failure. In the U.S., we tend to secure our stretchers with a single point of contact and a rack that only prevents the wheels from rolling too far forward. In Europe, there are three points of contact, each of which restrains motion on at least two axes.

Some stretcher mounts even allow minimal-lift or lift-free loading into the ambulance. Others offer patients a more comfortable suspension system to ride on. Of all the stretcher mounting systems I saw, only one vendor had the typical hook-and-rack system we are familiar with. It was part of a display on what not to use.