Lower Austria plans expanded emergency paramedic system

Lower Austria plans to reorganise its emergency doctor system from April 1, 2027, with 11 of the current 32 emergency doctor bases no longer operating in their present form, ORF reports. The number of RTW-C locations staffed by higher-trained emergency paramedics will increase significantly.

There will initially be 26 RTW-C locations from April 2027, with a gradual expansion to 86 planned by 2030. All emergency doctor bases that are not retained will be converted into RTW-C locations.

Each RTW-C location must be staffed by an emergency paramedic with additional training in intravenous access and infusions, known as NKV. This is one of the highest levels of paramedic training in Austria.

Green Party state spokeswoman Helga Krismer said the legal basis for the change was still missing, referring to the more than 20 year old Paramedics Act, which is currently being renegotiated at federal level.

Michael Halmich, chairman of the Austrian Society for Ethics and Law in Emergency Medicine, disagrees. He said a new Paramedics Act was not essential for introducing the new system and that there was no general legal gap.

Halmich said the existing law had been created when paramedics were mainly responsible for taking patients quickly to hospital. However, it had also provided emergency powers for paramedics in critical situations.

“The good thing is that the law allows this, with the sole drawback that paramedics have very limited training in this area, and it often depends on their own initiative whether they acquire these skills,” Halmich said.

The Red Cross and the Workers’ Samaritan Federation of Austria, which will operate the future RTW-C locations in Lower Austria, also say the change does not require a new law.

Wolfgang Frühwirt, the Red Cross’s Lower Austria emergency services commander, said the organisation had already been expanding RTW-C operations since 2021 and had gained extensive experience. The new system therefore did not need to be tested, he said, because established procedures and operational tactics were already available.

Hannes Sauer, president of the Workers’ Samaritan Federation in Lower Austria, said the training required for the new duties had been under way for years. He said the organisation would have enough paramedics for its locations, including a reserve of full-time and volunteer staff undergoing the necessary training.

Paramedic training begins with the standard rescue paramedic qualification and progresses to emergency paramedic training, followed by additional qualifications in pharmacology, intravenous access and infusions, or intubation.

Of the roughly 10,500 paramedics working for the Red Cross, 1,622 already have NKV certification or a higher qualification. The Workers’ Samaritan Federation has 294 such paramedics among its approximately 1,700 staff.

The Red Cross said one remaining challenge was ensuring that the required staff would be available for RTW-C locations in every region.