Infrastructure of emergency medical services.: Comparison of physician-staffed ambulance equipment in the state of Baden-Wuerttemberg in 2001 and 2005

Background. A survey amongst emergency physician bases in the federal state of Baden-Wuerttemberg in 2001 concerning equipment available for airway management and the treatment of acute coronary syndromes showed striking differences with respect to implementation of European norms and international recommendations. The survey was repeated in 2005 to evaluate the development of the equipment in physician-staffed ambulance systems. Methods. A questionnaire was sent to all emergency physician bases (ground ambulance and helicopter) registered with the Ministry of Health in Baden-Wuerttemberg. Questions encompassed availability of options to verify correct tracheal tube position (e.g. capnometry), supraglottic airway devices as alternatives to mask ventilation and tracheal intubation, 12-lead ECG and fibrinolytic agents. Results. In 2001, 116 out of 127 bases (91.3%) participated and in 2005, 107 out of 120 bases (89.2%) returned the questionnaire. With availability in 97.2% of bases, prevalence of supraglottic airway devices is almost state-wide (2001: 54.3%, p < 0.001, Fisher's exact test). The topics verification of tracheal tube position (2005: 73.8%, 2001: 26.7%, p < 0.001), 12-lead ECG (2005: 89.7%, 2001: 52.6%, p < 0.001) and fibrinolytic therapy (2005: 59.8%, 2001: 12.9%, p < 0.001) showed noticeable increases in the corresponding availability, however, distinct regional structural deficits were still present in 2005. Conclusion. A favourable trend could be found concerning the equipment of physician-staffed ambulances state-wide. Further efforts must be undertaken to ensure the complete implementation of legal requirements and international recommendations concerning provision of medical equipment.