Standardized operating procedures for (invasive) medical procedures by paramedics Status quo of implementation

Introduction Recently German legislation provided the basis for its prehospital emergency system (EMS) to expand the competence of paramedics on the scene. In this context standard operating procedures (SOPs) describe the type, extent and process of medical procedures to be performed. The formulation of these SOPs and the determination of the associated educational efforts provides a challenge for the responsible medical directors (aLRD) due to medical, legal and organizational reasons. The aim of this study was the assessment of the number and scope of SOPs and the corresponding training in the German EMS. Methods We conducted an online survey interviewing German aLRD about the status of implemented SOPs in their districts and the associated efforts to guarantee ongoing training. Results Of 192 aLRD in Germany 189 were reached by our invitation to participate in this study and 73 (39%) completed the questionnaire. More than 75% of the German EMS districts have established SOPs for i.v. or i.o. access as well as for time-critical medical conditions like acute coronary syndrome, cardiopulmonary resuscitation, stroke and polytrauma. Furthermore, many districts have a considerable amount of other SOPs in use. In most German EMS districts SOPs are trained once a year. In addition to theoretical training, 67% conduct simulator training and 30% in-hospital training. Discussion Medical coordinators for EMS districts in Germany support the expansion of competence of paramedics on the scene. The methods of associated education vary, but in general refresher training is being conducted every 12 months.