Swiss Air-Rescue

Swiss Air-Rescue counts on ITRIS Medical AG

Where Everything Has to be Right, there Can be no Compromise

It is one of Switzerland’s most well-known institutions and its teams inspire rock-solid confidence. Swiss Air-Rescue Rega brings professional medical assistance to more than 10,000 patients from the air every year. To perform its duty to the best of its abilities, it keeps its aircraft, helicopters and all devices contained therein up-to-date. Thus, extensive experience, personal commitment and first-class technology complement each other – which, in many cases, is life-saving.

An important device that is on board during every Rega operation is the MEDUMAT Standard² ventilator with Chest Compression Synchronized Ventilation (CCSV) from WEINMANN Emergency Medical Technology, exclusively represented in Switzerland by ITRIS Medical AG. A ventilation mode specifically for resuscitation was developed for the device. Integrated in MEDUMAT Standard², CCSV applies a pressure-controlled mechanical breath synchronized with each chest compression. This revolutionary method avoids the disadvantages of conventional ventilation modes while also demonstrably improving gas exchange and hemodynamics.

Rega has been using the latest generation of devices since the beginning of this year. It has become smaller and significantly lighter, now just 2.5 kg including the battery – “Advantages that we particularly appreciate as every kilogram matters in operations with the rescue helicopter, and the total weight of the equipment greatly influences the performance of the helicopter,”  explains Markus Reichenbach, lead paramedic of Rega and base leader in Mollis (GL).

Present throughout Switzerland – Ready for Action at all Times

Rega operates 12 helicopter bases distributed throughout Switzerland and a partner base, enabling it to reach any location – except in the canton of Wallis – within 15 minutes’ flying time. Globally, it has three ambulance jets in operation and repatriates patients from anywhere in the world. On average, Rega crews assisted 29 patients per day last year. With 15,958 organized operations, Rega was more in-demand than ever in 2017 – both in Switzerland and abroad. This equates to one operation every 33 minutes.

Both the rescue helicopter and the ambulance jets were in the air more frequently in 2017 than in the previous year: 11,774 operations with helicopters (+6.5 %) and 886 jet operations (+3.3 %) were organized by the Operations Center. In the process, Rega crews treated a total of 10,788 patients (+7.1 %) – no wonder that Rega is held in such high regard. Around 3.4 million patrons support the independent, non-profit foundation, enabling it to provide its valuable service to the benefit of the Swiss population.

Example Location: Ready for Take-Off in Mollis for over 40 Years

Helicopter have been taking off on operations in Mollis since 1974: back then the helicopter firm Heli-Linth started to fly rescue missions on behalf of Rega. Since Easter 2010, Rega has been operating the Mollis base itself and its own AgustaWestland Da Vinci rescue helicopter is stationed in the canton of Glarus between the beginning of December and Easter. From experience, the majority of accidents occur in the winter months and the base in Glarus is correspondingly often used to treat injured winter sports enthusiasts.

The team is supplemented by two paramedics and two pilots from Rega. Added to this are the physicians who are put at Rega’s disposal by Glarus Cantonal Hospital within the framework of a special cooperation, as well as a pool of freelance medical specialists, a total of 8 experts in service of people who are injured or ill. The number of rescue missions carried out varies depending on both the season and the weather. Consequently, Rega 12 – as the Glarus base is known in radio speak – is also on stand-by from May to October.

Putting in Heart and Soul for 21 Years

Markus Reichenbach is a true professional with many years of experience. As a qualified electrician, he completed his training to become a paramedic at the age of 25 at the hospital known at the time as Spital Saanenland. There he carried out ground rescue operations by ambulance. This was followed by a year at the Anesthesia Department of Obwalden Cantonal Hospital. In 1997, the enthusiastic paramedic joined Rega where, as lead paramedic since 2003, he is responsible for the training and development of the 43 Rega paramedics. Two days a week he works at the Rega headquarters at Zürich Airport. “Clerical work is also important”, he says, “but my heart beats for rescue operations.” He is equally happy organizing the necessary courses and regular training for the 13-strong base crew. “We want to provide our patients with optimal assistance. This also includes equipment that constantly meets the latest requirements,” says Reichenbach.

Our interviewee carries out this life-saving task together with Rega’s chief physician. A proven partnership between Rega and ITRIS Medical AG has existed for nearly 10 years. The maintenance, certification and calibration of the medical technology devices in use – in addition to the MEDUMAT Standard² ventilator, this also includes the associated monitor and a defibrillator – is carried out by ITRIS affiliate HOSPITEC AG. “We can count on this,” declares Markus Reichenbach, “and this is especially important because, although the airworthiness of our devices has been tested in accordance with standard DO160F, they are subjected to strong vibrations as well as wet and cold conditions during frequent and demanding operations. It is also crucial that there is absolutely no electro-magnetic interference between the devices and the helicopter controls – there can be no compromise when it comes to safety.”

A New Dimension in Resuscitation

With the CCSV technology used in Rega helicopters, WEINMANN Emergency Medical Technology is revolutionizing the science of ventilation during resuscitation. A "real" ventilation mode for use during CPR was hardly available before. One thing is certain: While in decades past, conventional ventilation was used almost exclusively during CPR, so CCSV is now the first ventilation mode designed specifically for resuscitation. For the first time, mechanical breaths with a regulated peak pressure are delivered synchronously with chest compressions. CCSV is also compatible with existing automatic chest compression devices. As a result, you can concentrate more on your patients.

With the automatic detection of chest compressions, the focus is on the patient. If a patient needs resuscitation, there is no time to lose. With CCSV, starting ventilation in parallel with chest compressions is faster and easier than ever before. Paramedics can begin ventilation without first setting the frequency or tidal volume – and the time-consuming calculation of the tidal volume is no longer necessary. CCSV detects chest compressions and automatically begins ventilating the patient. This means user support at the highest level.

When the patient stabilizes, they can continue to be ventilated in a controlled manner in the helicopter and flown to the next suitable hospital. If a cardiac arrest occurs en route, chest compression is started again. MEDUMAT Standard² is the first ventilator that instantly detects chest compressions and automatically switches back to CCSV resuscitation ventilation. In this way, Rega crews do not waste any precious time adjusting the ventilation parameters.

See More for Greater Safety

Being light, easy to handle and robust is one thing, user-friendliness and increased transparency is something else completely. “After just a short period using the new ventilators we are already highly satisfied,” says Markus Reichenbach. MEDUMAT Standard² also offers a completely new perspective on modern emergency and transport ventilation. It clearly displays all the important respiratory parameters and an overview of ventilation curves. The familiar operation – patient selection, for example – allows intuitive handling, whilst the initiation of ventilation by inputting height ensures that resuscitation starts simply and in compliance with guidelines.

Controls and symbols arranged in a clear way to provide an overview, as well as effective audible and visual alarms, are further details ensuring the highest levels of patient safety. The advanced features also offer new perspectives. The integration of a robust flow measurement with side-stream capnography and the presentation of curves in the display provide ideal monitoring of the patient. MEDUMAT Standard² can also be customized for individual circumstances and users by means of the various optional modes also available. In addition to IPPV, the modes also encompass the following options: CPR (for cardiopulmonary resuscitation), RSI (for support during induction of anesthesia), Demand and CPAP (optionally with ASB). The volume-controlled modes of SIMV, S-IPPV and Inhalation and  the pressure-controlled modes of PCV, aPCV, BiLevel + ASB and PRVC + ASB, as well as a CO2 monitoring mode can still be enabled as options. All settings are based on current specifications, e.g. resuscitation in accordance with ERC Guidelines. However, they can also be customized on request.

Transport Ventilation Made “Easy”

MEDUMAT Standard² is suitable not only for emergency ventilation, but also for optimal care during transport of patients already being ventilated. This is where the advantages of the smallest and lightest transport ventilator of its class come into their own. Equipped with pressure-controlled ventilation modes, monitoring options such as pressure, flow and CO2 curves and the display of major ventilation parameters, MEDUMAT Standard² is a compact partner for ground and air rescue services.

Years of Research Used by Numerous Emergency Medical Teams

“As representatives of Switzerland, we are delighted with the continuous further developments by WEINMANN Emergency Medical Technology,” remarks Markus Werder, CEO of ITRIS Medical AG, expressing his satisfaction.

“Our German partners are committed to continuous improvement of the resuscitation process. While volume-controlled ventilation has been the gold standard in cardiopulmonary resuscitation for decades, CCSV now offers an even more significantly improved level of support. The innovative ventilation mode is the result of many years of scientific research to optimize ventilation during resuscitation. We are delighted that this new technology is now used by Rega as it surely also will be in future by numerous emergency medical services on the ground.”

For Markus Reichenbach, the new devices in Rega helicopters mean greater safety. Thus, the hard everyday work of the rescue crews is made just a little easier. “This is highly valuable,” sums up the lead paramedic and base leader, “as human lives are at stake in every operation. Consequently, the latest technology that helps us in our duty is always welcome.”