Challenges for the Weisses Kreuz EMS   

• Scattered villages
• Typical alpine landscape
• Shifting weather conditions
• Steep and winding mountain roads 

The region’s main EMS Weisses Kreuz (White Cross) was established in 1965 with the aims to:   

• Provide help for ill and injured people
• Ensure safe transportation to the hospitals 

The Training    

The paramedics undergo thorough training at the Weisses Creuz’s own ambulance school and the training is carried out in accordance with national- and regional standards. The training consists of three levels, each with a final exam.    

Top paramedics undergo the following training:    

• 260 hours of theoretical training
• A minimum 160 hours of practical training
• Annual refresher training and recertification within specific disciplines  

The Weisses Creuz provides special training for a group of paramedics, nurses, and physicians to have this group prepared to operate under extreme weather conditions that from time to time occur up in the high Alps.   

Focusing Quality Assurance    

Weisses Kreuz adopted medical simulation training as soon as patient manikins became available, and today both SimMan and SimBaby are actively used for training. The training sessions are AV recorded and relevant video clips analyzed during subsequent debrief sessions, which help augment the learning outcomes generated from the actual training.  

To enable continuous skill improvement and to ensure safe and optimal patient care, Weisses Kreuz introduced Q-CPR; a concept that, via sensors placed onto the patient’s chest, provides (Italian Resuscitation Council compliant) feedback on the quality of compressions delivered during resuscitation. Thanks to this new technology, Weisses Kreuz is now able to ensure quality treatment within yet another field.   

Projects aiming to increase chance of survival

In addition to providing EMS to the local population of South-Tyrol, Weisses Kreuz is also concerned with the millions of tourists who visit the area every year. A sincere ambition to promote safety and improve clinical outcomes, spurred the organization to launch the following project:   

• Dissemination of CPR training in the population
• Dissemination of First Aid knowledge

A minimum of 4000 school children will annually be using the self-directed MiniAnne/CPRAnytime program to learn and practice CPR. This endeavour will be followed up with research conducted by Professor Uwe Kreimeier, MD; Associate professor at the University of Munich Hospital, and his team. 

To encourage more people to gain First Aid knowledge, Weisses Creuz introduced a free-of-charge smart First Aid guide for the iPhone and/or iPod Touch. The application, which also works on other smart-phones, comes in the German, Italian and English languages. The application: http://itunes.apple.com/WebObjects/MZStore.woa/wa/viewSoftware?id=295175159&mt=8 has so far been downloaded more than 250 000 times worldwide.

Organization of the EMS

The dispatch centers are staffed by personnel (including physicians) capable of assessing the resources needed for each emergency. As Italian ambulance personnel are delegated fewer patient care related tasks than seen elsewhere, emergency physicians will assist them (using either smaller, well equipped ‘rendezvous’ vehicles or helicopters) when further medical assistance is required. Emergency ambulances are staffed by two paramedics and sometimes a nurse and normally equipped by the state-of-the-art emergency equipment, such as HeartStart MRx with 12 lead ECG, capnography, SpO2 /BP and QCPR (Quality CPR). Most of the transportation ambulances are equipped by emergency products such as defibrillators and Stiffneck collars.

The Weisses Creuz is now among the largest EMS on the European Continent. The head quarters and main ambulance station are located in the capital of Bolzano-Bozen. In addition to the administration, training facilities and workshops, the main base for the air ambulance is also located here.

The Region

The Province of Bolzano-Bozen, also referred to as South Tyrol, is an autonomous province in northern Italy, situated to the south of Austria, directly within the Alps.

The territory is entirely mountainous and the province is noteworthy of its large number of valleys.  Between the official languages Italian and German, the latter is more commonly spoken. The area is inhabited by half a million and visited by another 13 million tourists every year. The two main cities, Bolzano and Merano, administer large sized hospitals, and another six smaller hospitals are strategically located across the region.