[Problems of hygiene with life-saving equipment (author's transl)]

The problem of hygiene in the life-saving service has so far been a rarely discussed question. An ambulance used as a life-saving vehicle cannot be expected to measure up to the hygienic standards of an aseptic operating theatre. Keeping the level of pathogenic germs in ambulances low, is fundamental to the medical emergency service at large. The staff, including the physician, on emergency duty are most likely to come into contact with hospital germs. At any rate, care must be exercised so that pathogens are prevented from being transmitted from one patient to another. As far as cleaning is concerned, Figs. 3, 4 and 5 exemplifiy the problem of the so-called wet germs figs. 6, 7, 8 and 9 show the impression preparations from the hands of the physician on emergency duty, from the bed covering, from the medical apparatus and from the floor. The results yielded by 208 impression preparations from the staff and ambulance are supplemented by determining the air-borne germs and by 40 swabs taken from grooves, edges and dust accumulated in the ambulance. Further, the water containers were examined for clean and dirty water, as well as the damp areas as breeding places for "wet and puddle germs". This has already resulted in establishing several factors which justify the adoption of selective hygienic measures, but all those concerned are clear that the measures envisaged must also be practicable. Too little is ineffective, but too much detracts from the credibility of sanitary argumentation. In the near future, however, in order to be able to establish a generally valid set of measures, similar examinations must be carried out on a broad basis and under differing conditions in respect of physicians, medical staff, site and ambulance. Until this has been done, the examination results presented can only be regarded as provisional or as offering guidance data which need further supplementation.