Bernhard

Oh, I still remember how she appeared here. We had a few chats in the chatroom. Very sad. All the good wishes from here to her family and especially to her son.

Thanks! My original copy of Hill Street Blues is on LP, but no working record player here any more... Feeling old, will try youtube. BTW and back on topic, on youtube several videos show the shooting. "Our" hostage situation didn't get much publicity (which is good), but was scary the first hour, though. Those who like to watch a lot of emergency vehicles responding to a real incident may take a look here, somewhere in between my countie's crisis intervention team arrives (video shows ~41 minutes of police, EMS, fire and disaster response units arrving at Munich scene of shooting...looks a bit chaotic, but I'm confident they had a plan ):

Update: Identity of the assasin is now known, it was a 18 y/o school kid. Beside having iranian roots in the family there is no evidence of a radical islamic background. Police found a lot of literature about school shootings including scientific (psychological) books, apparently he was fascinated by school shootings, especially about the incident in Winnenden/Germany (in 2009 a former student entered the school and fired). He was in psychiatric treatment for severe depression but probably had an additional drug addiction (which still is subject to investigation). The pistol (reportedly a Glock) was obviously from illegal sources, since the serial number was removed. He carried several 100 rounds of ammunition in a knapsack. Latest news articles report 27 surviving patients and 9 victims dead plus the assassin, who committed suicide after beeing chased by police. Initially, two plain clothes cops followed him and shot multiple rounds, which may have lead to the public assumption of facing three terrorists. There exists video material showing an civilist arguing with the assasin in crude language (where the assasin states "I'm German!" and beeing rised in a lower class part of town) and of shots fired at him from a distance with unclear impact (the assassin stumbles, then hides behind a structure, later police reports stated that he didn't receive a hit by law enforcement). Other suspicions: the mass shooting in Norway has had it's fifth anniversary on this day, where a right-wing extremist detonated a bomb in Oslo and shot participants of a worker's party youth summer camp on the island of Utoya. As the assasin there the Munich gun man focused on young people (plus: with foreign appearance). My subjective situation assessment as of now: a mentaly ill person commited an enhanced suicide and is fascinated enough from school and extremist shootings so he tried something similar. In those days now people tend to make an "terrorist" assumption soon, which obviously is not the background in this case. My report ends here, I will leave the topic open for discussion, especially on EMS related questions (however, I didn't receive a report about EMS response, yet). Feel free to ask!

Update: "our" hostage situation at Munich airport was a more or less relationship problem between a man, his boss at an airport company and his wife involving a fake pistol. Totally unrelated to the Munich shooting, just happened at the same evening and seemed to fit in a large terrorism scheme. Wasn't. The Munich shooting slowly turns out to be not terrorism related as well, instead the fatal "extended suicide" of a psychical sick person. However, police still investigates. The incident was spooky, since reports came in from multiple shootings throughout Munich (just like in Paris last year), which indicated a coordinated terrorist attack. All false alarms, as it turned out, often triggered by social media reports. Or a totally unrelated incident like the amateur hostage situation my unit was dispatched to. Some overly hysteric people have a platform there. And some wanna-be's use that: on youtube you find more "shooting in Munich" videos than really exist. Sometimes footage from the tragic 1972 terrorist attack on the Olympic games in Munich, where several israelic athletes were killed (which lead to the foundation of highly professional counter terrorism units in german police). Others just take some other shooting videos, even training videos and excercise documentation and turn them into "raw footage from Munich". Sick. Generally, life in Munich or Germany as a whole is rather safe. Shootings or criminal deeds involving a weapon are rare, counted in lower tenths per year (whole Germany!). The vast majority of EMS/medics/doctors here will never see a gunshot wound their entire life, if not beeing from a suicidal deer hunter. However, police is prepared very well, as they showed yesterday night. But we have our share of mentally instable persons as well. How the person now got a gun is part of the investigation, permit isn't easy to obtain (though possible). The single man attacking in a train last week in Würzburg (another city in Bavaria) used an axe - most probably just another young man (17 y/o) with mental problems, just happened to be a refugee from Afghanistan with probable severe psych trauma and an internet connection (still under investigation, there are signs he was a follower of IS/daesh but just in the sense of a sports team fan). Mental problems, access to a sharp or loaded device, internet connection, news reports of brutality elsewhere and hot humid weather obviously are a bad mix. Unfortunately this affects the political discussion concerning refugees in a critical way. Some seem to forget the fact, that those refugees fled from brutality and terrorism. But they are instrumentated (sp?) by politicians, some of those beeing mentally very suspicious themselves. Difficult situation... By the way it seemed that the offender from yesterday made very clear, he's not a refugee, there exists an eye-witness video where he states in perfect german language with slightly bavarian accent "I'm a German!". We'll see. Myself I'm impressed of the very good incident management by the police. They quickly activated massive forces and had a superb crisis communication on multiple channels, which helped keeping the situation on a rather calm level. Cooperation with EMS was totally proffessional, the danger prevention/response system here clearly worked throughout all emergency services.

Hi all! Recently I wanted to check back to this site to see what's going on. Didn't happen due to several time restraints, life and so on. But with the shootings this night in my neighbouring city Munich (Bavaria/Germany) I just wanted to check in to say I'm fine. 22-JUL-2016, ~18:00 (local time, UTC+2): an armed man opened fire near a fast food restaurant in a shopping mall in Munich. In the following there were reports of a team of assassins and multiple attacks in the city, which couldn't be confirmed. Local police, EMS and fire department responded. Regional mutual support was asked for. Public transport in Munich was stopped. 22-JUL-2016, 18:29: First alarm for several units in our (neighbouring) county, including incident command, just for staging. I wasn't on duty, so just listened to the radio and our internal communication. Our crisis intervention team was called to assist in Munich directly. 22-JUL-2016, 20:20: My local volunteer disaster respond unit was called out into a staging area, I joined the team (2 vehicles, carrying up to 10 staff and material for ~25 patients including tent, stretchers and so on). 22-JUL-2016, ~22:00: A hostage situation at the Munich airport (MUC) was reported. My unit was part of the troop dispatched there. Soon after our arriving it was reported that the offender was arrested, two victims were transported. However, I can't confirm the actual situation beeing a real hostage threat or something else. If, it most probably was totally unrelated to the shooting in Munich. Police and EMS cleared the scene, my unit wasn't involved. After a while we were allowed to return into the original staging area. 22-JUL-2016, ~23:30: In the staging area we got information through regular TV news sources. 23-JUL-2016, ~00:45: We were released and returned back to our stations. Now it's 03:00, I'm home and listening to local news reports. Official status is now: ~21 wounded (~3 life threatening and 13 minor wounded still in hospital treatment) + 10 death, including suspected individual (shot himself). Around 100 persons were psychologically counseled. Around 2300 police officers were activated. EMS/medical disaster response staff not yet counted, I think at least about 1000. My subjective view: calm and professional response by police, EMS and fire - career and volunteer units. In short time a real lot of responders could be activated, including special law enforcement/counter terrorism units including other regions, federal units (GSG9) and even foreign teams (COBRA/Austria). EMS and medical disaster units were organized and responded well, locally and from other regions in Bavaria. At the moment, Germany tests a disaster public information software for smartphones, Munich is one of the testing areas. Worked well, information was quick and instructive ("terrorsim alert, stay at home, close doors"). Munich police has a very professional social media unit on Twitter (@PolizeiMuenchen) and Facebook. This channels provided even more useful information by reliable sources. Social media, though somewhat helpful, showed it's bad side, too. A lot of false reports, speculations and rumors were transmitted and created some information chaos. However, established news media (papers/online papers, TV, radio) delivered good information and avoided too much sensationalism. Citizens stayed rather calm. Public transport is activated again now. Assassin was a 18 y/o Munich resident from German/Iran origin, shot himself near the shopping mall after beeing chased and shot at by police. That's what I experienced myself and know from news reports and public police sources in this minute. Evaluation and investigations are in progress... Stay safe out there! Bernhard @Moderation: there is no other international section apart from CAN/UK/AUS, so I'm putting this in the general section. Please feel free to put this where it fits better.

We recently restructured our non-transport first responder squad's bags. Beeing the one who restructured the equipment from hard cases to backpacks (knapsack) years ago I was surprised to find how much the backpack makes in weight. A new member (military tactical EMS background) gave the idea to reduce weight, so we now have a very light backpack with no additional pockets. Just using the simple design reduced weight from around 18 kilograms to around 10 kilograms, carrying much the same as before. OK, we dropped out the O2 tank to an extra bag, but a significant weight reduction just came from choosing a light weight knapsack without much extras. It contains all relevant material for advanced aid to a single patient, including i.v., airway and drugs. Now we have an easy to handle 10kg knapsack, a ~3 kg O2 tank bag and a LP15. What did I learn? Don't underestimate the packaging itself!

I used to program one of those online games (called a multi user dungeon, entirely text based). Non-profit and open-source though. That was the state of mind of most of us computer nerds back then. Bad choice, as seen from 25 years later... However, we revived it, it's online again and presented at vintage computer festivals. It's nice to login from time to time or do some developer meetings together with those folks from university. Boy, they're looking old now.

I'm glad we have the right to pronounce death on scene. Medics may decide due to "safe" signs of death, as rigor mortis, livor mortis and non survivable injuries plus asystolie. Working a code for some time with no effort (ROSC) is up to the emergency physician we then have available on scene. As far as I know I never had ever worked someone who now shows an appallic syndrome. Either they died soon after or they survived. Secondary survival rate has dramaticallly increased with new CPR algorithms, in my starting years (end of 1980ies) this was more or less randomly. I at the moment recall just one patient before 2000, where the neighbour started CPR:this neighbour was a seasoned medic, his assisting daughter an experienced anaesthetics nurse, basic equipment available for them plus the ALS station and receiving hospital just a few minutes away. As I entered the room, the patient already was e.t.'d, we just had to attach ECG and provide defibrillations. Patient left hospital a week later, totally recovered. Since then I had a few saves, more and more since ~2000 when we started using AHA/ERC algorithms. Actually, to answer the question in the topic, yes, I once transported a death person. Transporting bodies is ruled out in our states EMS law (and was back then, but it is time.barred anyway...here's the story: We had a call in the church just neside the station. With service in full progress we CPR'd between all those praying people, somewhat scary (but not the first time for me, yes, they already talked about me to write a book). We moved into the ambulance, then pronounced dead after some while. Chaplain came into the ambulance and said a few words. Dispatch notified us about enhanced arrival time for the hearse car (sp?), so the supervisor, who was on scene in another role, felt the urge for a decision. His first suggestion was to drop the body off in our station so we were available again. I talked him out of that. The chaplain notified, that he had the keys for the local morgue, which happened to be just around the corner beside the cemetary. So the supervisor decided to take this opportunity...and we drove the body in our ALS ambulance slowly into the cemetary. Just as we arrived there, the hearse car arrived. Disclaimer: things have changed since then, I never would do this anymore (meanwhile, I'm supervisor myself, maybe this call was one of the reasons), it was totally against the law, noone has ever found out and all went well. At least I learned (talked a bit with them), the burial services are quick enough to wait on-scene. People are very pragmatic here - next time I'll tell the story about the other chaplain calling us, as he found out that the dead person wasn't medically cleared, up to his arrival... To adresse another perspective mentioned here: After having some incidents I took a crisis intervention class to be trained to handle the relatives. Was an eye-opener! Never would like to work in crisis-intervention myself, but I use the skills to handle non-medical situations since then. I strongly suggest such a training to all young medics! (BTW: have a happy new year, everyone!)

Canadian Red Cross already helps us out here. A report from a refugee camp by a canadian Red Cross worker: http://www.redcross.ca/blog/2015/11/translating-the-refugee-crisis--stories-from-germany The camp she talks about is just in the neighbour county, not far away from me. By the way, to EMTCity administrators: I find it totally inappropriate to automatically set links into postings. My term "summer clothes", describing a deadly risk to refugee children was linked to an Amazon site with a cheering girl selling "Lovely Baby Girl's Summer Clothes Denim Dress + Cotton Coat + Belt Outfits Sets". Not funny. Apart from beeing totally inappropriate in the given context, inserting links in someone's posting generally is no good netiquette, since it may appear as if I had set the link. Financing the site is OK, but not changing someones texts and intention for the sake of money. If this won't be stopped, I'll be out of activity here soon. Really. EDIT: it just happened with this text, too. "Link added by VigLink" is the caption. Please stop that!

You're welcome! Scariest thing at the moment is, that winter time here is just coming. We have a relatively warm autumn, usually we should have got the first frost and snow by now. However, it will come soon. Then, and this will be a tough call, we will have real winter. Winter in Germany and Austria (two of the main passing countries for refugees) is a real threat to outdoor life. Ice covered surfaces, several meters (1 meter = 3 feet) of snow, strong winds and freezing cold of about -5 to -10° Celsius (23 to 14° Fahrenheit) is just a usual daily phenomenon here between November and April. We already experience infectious rates up to 100% on incoming refugees, first with childrens, soon after on all others in the camp. I dare not to imagine if it gets real cold and icy. This sure will be deadly to refugees, all of them walking, not beeing sufficiently sheltered on all their way and wearing summer clothes. Especially children. I fear we'll face another escalation of this humanitarian disaster just at our gates.

Just my point of view, more or less from inside: We're dealing with refugees from Syria and other countries at a daily basis as Germany is as well a main European target for their getaway and a main transit country to other european nations. I live in close relation to the south-eastern borders (just an hour away), had helped building shelters, organized food logistics and am one of those responsible to organize EMS upgrades (i.e. additional ambulance stationing) due to the situation. I have access to the daily reports from our central communication and information center organizing the first shelter areas and transport logistics at the borders. At the moment, there are more than 5'000 refugees per day crossing our borders, far more still at the gate. Volunteers and paid helpers including police and military do a hell of a work to meet the needs of them. Families, females and males, unaccompanied young people from all ages, newly born (actually several births in our shelters or in trains) up to senior level (allthough rarely far over 50 years old) had a rough time to get here. I know stories from their decision to flee, including seeing or beeing target of barbarous cruelty, leaving relatives and property behind, to crossing the mediterrean sea by totally unsuitable boats up to wandering through countries they don't understand and which are more or less hostile or totally overextended in their capability of help at best. Fact 1: they need immedeate help. Fact 2: they don't want to flee, they're forced. Fact 3: if there is peace for them and their families in their home countries, they would be happy to get back. It's not a Middle-East or European problem, it's a humanitarian task for all of us, globally! The organization that called itself "Islamic State" is just some fascist entity with a fake religious motivation, bringing hate and harm to humans. This has to be stopped! But while politicians sort things out how to do that, there are humans, women, men, children who need help. Talking about 10'000 or 25'000 people is a joke. That's what we do in a few days. Week per week, month per month. I recently checked our state wide logbook, the first entry is from October 2014, when the first camp was built and the event starts to be coordinated by a central body. Over a year ago now! Still now politicians talk about "coordinating the refugee wave" (hell, it's already become a normal state for all those working on it). Still now politicians talk about what has to be done to stop this. Unfortunately, a lot of them talk about building just more fences. A good question I heard in a talkshow was: "If you build fences, do you care for the bodies that will pile up before them?" (followed by silence for a few minutes). I'm glad that the UN conference last weekend obviously had some outcome: cutting finance flow for IS and building up a joint effort fight the cause. Refugees are "just" a symptom, which makes them not less important. For those who think refugees are a direct terrorist threat, please answer just a short quiz what you would do as a terrorist wanting to enter a country: You will take a stressful route through land & mountains, enter a inappropirate rubber boat to cross the mediterrean see with a high probability to sink, stay in refugee camps where all other people will hate you because you are the cause of their trouble, then getting away from police registration with nothing more on you than your clothes and your knapsack, just for joining a terror cell after your 2 week walk (I know refugees who needed a year) OR You will take the money from drug trade and stolen property, buy a fake passport, enter a comfortable airplane or rent a fine middle class car, then traveling to your destination in a relaxed state of mind just as a normal tourist would do. Option 1 or 2? For me, it's pretty clear. As of now, the story about the terrorist in Paris who has entered by a refugee route seems to be fake (fake passport/identity theft). I can't rule that out, especially when young refugees experience a hostile environment in their country of destination - and yes, they sure are vulnerable to fascist indoctrination. Just as anyone else - remember, we in Germany have learnt a lesson there... I know a bunch of young males here in my village ("unattended underaged refugees", actually from 13 to 18 years old) who are very ambitious in learning the language of their new country, wanting to get a job and are integrated in the local sports community (actually ~8 of them attending training in the local football team). They have all a past, I wouldn't wish to my child, never. Yet, they are more or less happy, cheerful kicking the ball on the local training ground, which is just a few streets away from my home. Seems it works, at least a bit, to give them hope. The final solution will be difficult: bombing and/or sending ground troops won't help, it just would heat up the conflict, give more justification to IS and hit innocent civilians. Personally, I don't see a military solution to a multi-facet problem. I don't know how and when it will be solved, but I sincerely hope, it will get done. As long as politicians sort that out, we have to care for those who are in immedeate danger at our gates. Taking and caring for several 1'000 refugees is a start. Remember: We here cope with 5'000 - 10'000 refugees per day, and we're even not the first contact country in the European Union. Yes, we need help. But far more, THEY need help! Thank you for listening!

2015, until now: 2 ET, ~5 supraglottic myself. Assisted when partners applied one on a few more. And I have an office job... Primarily I choose the supraglottic (we use Larynxtubus here), ET only when supraglottic doesn't work for some reason. On one instance my supraglottic AND ET attempt wasn't succesful, so this is not counted above. HEMS doctor eventually was able to push another one in after several tries. We got a fairly good CO2 reading, but it didn't help: hospital later diagnosed a high c-spine fracture and totally confused airway situation, pronounced dead in the ER (44 y/o motorcyclyst, head against street sign post as we found out later).

Here dispatch has address specific information, which may include potential risks, mainly used for hazmat info - don't know if any of that contains potential violence. Decision usually is based on type of call. It's very rare, that a police unit is dispatched with EMS just because of a suspicious address. I didn't read the attached thesis: Is there a process in the Scottish Ambulance Service to delete the flag when there apparently is no danger anymore?

Just to prove that this is no wizardry: Our working telemetry system over here already consists of having status access to hospital capacity, informing the hospital about incoming patients (estimated arrival time, main diagnosis), sending basic patient data to the receiving hospital (ECG, vital values) and using the data in other computer systems for invoice management and secure archival. From scene we still use radio to request target hospital and relate first patient information to EMS dispatch center (who are medically trained, at least EMT level). But then, dispatch can access a web based communication platform: receiving hospital can be picked by a click and is informed about incoming patients (ETA, main diagnosis etc.) by a monitor in their ER. Hospitals regularly update their status in this platform, so EMS dispatch centers can see which hospital is open/closed for specific treatments at the moment. It still is a pilot project in Munich, but runs for about two years quite successfully, so it probably will cover whole state of Bavaria someday soon. Works really nice! BTW, without the dispatch access every interested citizen (including you!) can at least see actual capacities of the hospitals: http://www.ivena-muenchen.de (German language). For providing the hospital with information: ECG strip can be sent to the receiving hospital, this includes other information from the monitor like heart rate, NIBP, SpO2, CO2 and temperature (if attached). This is in use for several years now. Additionally, since a while we have tablet computers for call reports (http://www.rettungsdienst.brk.de/aktuelles/innenminister-informiert-sich-beim-brk-ueber-telematik-ii/@@images/0195d053-00ad-4e96-ba3d-bd69acc603b8.jpeg). They even can receive above mentioned data from ECG by bluetooth, so this is included in the report with the click of a button. At the moment the report has to be printed when arriving at the hospital (compatible printer on every ambulance and in several hospitals), stored data in the tablet then is used invoice management and for archive purposes. This already is working in the whole state of Bavaria/Germany and all contracted EMS agencies/companies (~1500 units). I don't see a benefit in sending the tablet data to the receiving hospital, because it has to be entered first and thus may delay patient care. From experience it's already a tough job to have the computer patient report ready when arriving at the hospital, especially with patients in bad condition, where you need your hands on the patient and not on some tablet. A short information to the dispatch center by radio and them entering the information into the system works just as well.

Let's see. Last week I was mistaken for a towing service by a very confused young police officer at scene of a vehicle accident, was target of heavy flirting by a 89 year old woman at a nursing home, fallen out of bed, vomited, short of breath/possible aspiration - but instantly fell in love with me, rescued a cat from a tree (OK, this wasn't a real call, just spotted the cat in distress on a private walk). We'll see what follows next week.