Architecture of emergency medical services in GermanyPart I: Integration into the public protection system
Introduction and problem statementEmergency medical services (EMS) in Germany are regulated according to the EMS state law and are seen as part of civil protection system as well as of services for the public [3].The development of EMS from simply an ambulance service to a, according to experts, complete third pillar of emergency medical services in Germany (beside the other two pillars: outpatient and inpatient care) began in post-war Germany in the 1950s-1970s. Ambulance services were basically simply small vehicles, some with two stretchers. The drivers working as the emergency personnel only had, if at all, a few hours of limited training in first aid, which qualified them as "suitable personnel. " Nevertheless, even then, the ambulance service personnel's task was twofold. On the one hand, they transported sick people in the course of transport orders (socalled arranged ambulance service), and on the other hand, there were trips to accidents or emergencies (so-called non-arranged ambulance service, today's emergency ambulance service). Thus, with respect to EMS, the ambulance service was only responsible for transporting patients and those who were injured, it This is the English version of the article Architektur des Rettungsdienstes in Deutschland. Teil I: Einordnung in das System der operativen Gefahrenabwehr Notfall Rettungsmed (2019) 22:136-146. The German version can be found under