DREAM JOB: Dr Florian Hoffmann mobile emergency paediatrician in Munich Ready for action round the clock: the BMW X3 for the mobile paediat- is based at Munich's main fire station.Even when he wos ‘at schoo! Florian Hoffman's ‘amtition was to become a poeditrician: "There's ‘nothing better than seeing o crying child smile again.” The BMW X3 is zig-zagging its way through the traffic, overtaking on the inside, switching to the oncoming lane at hold-ups, its siren scattering vehicles left and right, the blue light bringing other drivers to an abrupt halt. The car brakes sharply at ared light, inches its way across the intersection, then accelerates off again. Assistant Danie! Guice is driving against the clock ~ as fast as possible, but as carefully as necessary. Sitting next to him, Dr Florian Hoffmann is already slipping on his latex gloves. “Child unconscious” is the message that has just come through to the switchboard for Florian 1.76.1, the Munich mobile paediatric emergency service. An unconscious child can mean one whose life is in danger, so the team has wasted 1 time in hitting the road. The X3 halts at an apartment block in the Blumenau district of the city, and in a matter of seconds Hoffmann is sprinting Up to the fourth floor with his equipment. The door is already open, and he swiftly appraises the scene that meets him in the living room: a two-and-a-half-year-old gir is lying exhausted and weak on the sofa; but she has regained consciousness. Her dis- traught mother is standing over her with tears in her eyes, her hands shaking, her voice trembling, Dr Hoffmann squats down next to the litte gil and runs his, hand over her brow and cheek, noticing her high tempera ture. Using his ‘magic red torch’ - the pulsoxymeter he measures her pulse and the oxygen saturation level of her blood; and with his ‘magic white light’ - a small hand-torch he checks her eye reflexes. While he is doing all this he talks to the child gently, reassuring her. His calm manner Quickly reduces the tension in the room, “twas just a febrile convulsion,” he explains to the mother. It's a dramatic event - the child goes blue in the face, becomes unconscious and its entire body convulses. It also appears to stop breathing. But fortunately itis usually all over in a few minutes. in rare cases, however, the convuisions can continue and become life-threatening, Today this litte girl has not suffered any damage, but the mother is advised to take her to hospital for further tests just in case, to make sure that the convulsions have not been caused, for example, by meningitis. ‘ebrile convulsions usually only occur in children under the age of five,” explains Dr Hoffmann during the drive back. "Nobody really knows what causes them.” There is a whole range of illnesses that are unique to children - which is why it is wrong to regard them merely as small adults in medical terms. Children are patients with special needs that call for specific forms of treatment. For example, it requires a lot of experience to intubate an infant or to presoribe the right dose of medicine for a small child. An ordinary emer- gency doctor does not have the necessary specialist training, That is why, in collaboration with the city's fire service and four local children’s cinics, a mobile emergency paediatric service was set up in Munich in 1990. Since 1997 the service has been available on a round-the-clock basis and is now widely regarded as 2 model worldwide. A total of some 30 hospital-based paediatricians are involved in the scheme, each sacrificing one day of his or her leisure time per month to be on 24-hour call On average the service, which covers the entire city of Munich and surrounding area, is called out five or six times a day, or approximately 2,000 times a year. 70 per cent of the patients attended to are below the age of six. A good two thirds of callouts are for illness, and just under one third involve accidents. “Of course a mobile emergency service lke this generates extra costs,” says Dr Hoffmann, “After all, itis an addition to the normal emergency medical service provided. But it has already saved the lives of a lot of children who might not have survived a dangerous illness or serious accident or would have been left damaged for the rest of their ives.” BMW supports this internationally unique rescue service and helped fund the acquisition of the X3 as the emergency vehicle. The Sports Activity Vehicle is ideal forthe job. “Thecar's so easy to handle and very agile,” says senior fireman and rescue assistant Daniel Guice (48). “I's highly manoeuvrable and has good acceleration - which means we can get through city traffic very quickly. The elevated seating position also gives us @ good view of the road and the four-wheel drive means that even rough tracks pose no problem if we have to venture out into the countryside.” Guice has been working for the emergency service for 22 years. Together with some of his colleagues, he even underwent special taining offered by BMW for driving the X3. The emergency vehicle travels some 45,000 kilometres every year, 20,000 of these at high speed with its blue light flashing. “™m glad the X3iis such a safe vehicle,” says Dr Florian Hoffmann. “Some drivers become very Unpredictable when an emergency vehicle with a flashing ight and siren approaches.” ea Even as a young boy, Florian Hoffmann wanted to become a doctor. He used to spend alot of time with younger children acting as a ‘protector’ for his tte sister. So it was @ logical step for him to train as a paediatrician, The 35-year-old works in the intensive care unit of a Munich children's clinic and since 2004 has also operated as a mobile emergency paeciatrician. “There's no denying i's hard work sometimes — and at times also emotionally stressful. But it’s still a dream job for me,” says Hoffmann. “In most cases it’s not a matter of lfe or death but rather just a question of solving an acute problem, taking rapid action or alleviating pain. There's nothing better than seeing a crying child smile again.” We ae interrupted by another emergency cal: “Child with breathing difficulties.” A two-year-old boy with a milk allergy has eaten a piece of cheese when his mother wasn't looking. When the rescue team arrives he has gone red in the face, one eye is swollen, he is having difficulty breathing and is clearly in a state of panic. While Danie! Guice prepares the inhalation equipment, the little boy is given a tiny dose of antinistamine and cortisone to deal with the allergic reaction. “Here comes the magic steam,” says Dr Hoff- mann encouragingly, “then everything wil be all right.” The little boy seems to understand that these strange men are here to help him and begins to relax visibly. While he dutifully inhales, Danie! Guice gets a litle teddy bear out of his, rucksack. They have been donated by a charity and are taken along on all their emergency deployments. “Here's alittle present for you for being so brave,” says Guice. The toddler stretches his hand out cautiously, closes his fingers around the teddy bear and hugs it. The medicine is beginning to take effect and his face, which only a few minutes. before had been contorted with fear and pain, begins to take on a smile, Mission accomplished. Every minute counts: Dr Hoffmann Checks the equipment while Guice, his assistant, sides down the pole.