Emergency medical services in Norway
Encyclopedia
Emergency medical services
in Norway
are operated both by the government
(financed through the four Service Delivery Regions, each with its own Regional Health Authority
) and private organizations such as the Red Cross and commercial transportation companies. In most circumstances, emergency ambulance service is organized by a local Health Trust
, and may be operated directly, or contracted to private providers, such as national transportation companies, for which ambulances are just a part of their business operations.
, Southern Norway Regional Health Authority
, Western Norway Regional Health Authority
, and Northern Norway Regional Health Authority
) which provide most healthcare in Norway. Services may be provided directly by the Trust or its member hospitals, but are typically outsourced. In many locations in Norway, the provision of land ambulance service is contracted to private operators, most typically large scale transportation companies operating a variety of types of service. Namsos Trafikkselskap
(NTS) is an example of a private company participating in this type of arrangement for service delivery. While the majority of such arrangements are currently with Norwegian-based companies, this is changing, and international companies, such as Falck
are beginning to contract for services in some areas. Such services may operate 24 hours per day in larger centers, but in remote and rural locations are still frequently staffed by 'on-call' personnel after normal business hours. Even in areas with directly operated emergency ambulances, non-emergency transportation is more likely to be conducted by commercial transportation companies. Norway currently operates on the Franco-German model of EMS care, with some limitations on the permitted skills of EMS personnel, and physician response to emergencies being quite commonplace.
. Participants in the air ambulance
scheme include the Royal Norwegian Air Force
330 Squadron, and also one privately owned company (Lufttransport
) and one not-for-profit foundation (Norsk Luftambulanse
). The relationship with the private company and the foundation are contractural, and currently extend to 2014.
, among other locations.
followed by two-year internships. This program has been offered since 2003, and is inspired by American EMS training. The system currently has individuals working at the Basic, Intermediate and Advanced levels, and for vehicles providing ALS service, the crew configuration is typically 1-ILS, 1-ALS. Those EMTs already working in the field, and with sufficient experience, are permitted to 'fast track' the new training, completing a degree with the equivalent of a single year of full time education. Only those EMTs completing this education process are permitted to use the title "Paramedic
". While the program is not yet mandatory on a national level, it is considered to be a prerequisite for employment in the Oslo
region. Norway has also come up with the proposal to add qualified nurses on the ambulances, as other countries in Europe have done within its system.
standard CEN 1789
(types A-C) for ambulances, as issued by the European Committee for Standards. These standards include the types of vehicles used, their design, performance, testing, basic equipment, and markings or livery
. As with all European Standards, compliance is voluntary, but has been mandated by the Norwegian government.
Emergency medical services
Emergency medical services are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency...
in Norway
Norway
Norway , officially the Kingdom of Norway, is a Nordic unitary constitutional monarchy whose territory comprises the western portion of the Scandinavian Peninsula, Jan Mayen, and the Arctic archipelago of Svalbard and Bouvet Island. Norway has a total area of and a population of about 4.9 million...
are operated both by the government
Norwegian Ministry of Health and Care Services
The Royal Norwegian Ministry of Health and Care Services is a Norwegian government ministry in charge of health policy, public health, health care services and health legislation in Norway....
(financed through the four Service Delivery Regions, each with its own Regional Health Authority
Regional Health Authority
A regional health authority is a state enterprise responsible for specialist healthcare in one of four regions of Norway. Responsibilities of the RHFs include patient treamtment, education of medical staff, research and training of patients and relatives...
) and private organizations such as the Red Cross and commercial transportation companies. In most circumstances, emergency ambulance service is organized by a local Health Trust
Health Trust
Health trust or HF is a health enterprise owned by one of the four regional health authority in Norway, with responsibility for performing a geographic and/or specialist activities of operations on behalf of the regional health authority. There are 43 HFs in Norway, each led by a board of...
, and may be operated directly, or contracted to private providers, such as national transportation companies, for which ambulances are just a part of their business operations.
Land ambulance
Land ambulance service provision is funded by the national government, and provided by means of one of the four Regional Health Authorities (Southern and Eastern Norway Regional Health AuthoritySouthern and Eastern Norway Regional Health Authority
Southern and Eastern Norway Regional Health Authority is the largest of the four Regional Health Authorities in Norway. It covers the counties of Akershus, Aust-Agder, Buskerud, Hedmark, Oppland, Oslo, Telemark, Vest-Agder, Vestfold and Østfold...
, Southern Norway Regional Health Authority
Southern Norway Regional Health Authority
Southern Norway Regional Health Authority is a defunct Regional Health Authority that covered the counties of Aust-Agder, Buskerud, Telemark, Vest-Agder and Vestfold in Norway, as well as the national hospitals in Oslo...
, Western Norway Regional Health Authority
Western Norway Regional Health Authority
Western Norway Regional Health Authority is a state-owned Regional Health Authority responsible for operating the hospitals in the counties of Rogaland, Hordaland and Sogn og Fjordane in Norway. Based in Stavanger the authority operates five health trusts that operate nine hospitals...
, and Northern Norway Regional Health Authority
Northern Norway Regional Health Authority
Northern Norway Regional Health Authority is, in population, the smallest of the four Regional Health Authorities in Norway. It covers the counties of Finnmark, Nordland and Troms...
) which provide most healthcare in Norway. Services may be provided directly by the Trust or its member hospitals, but are typically outsourced. In many locations in Norway, the provision of land ambulance service is contracted to private operators, most typically large scale transportation companies operating a variety of types of service. Namsos Trafikkselskap
Namsos Trafikkselskap
Namsos Trafikkselskap is a public transport company in Trøndelag, Norway. The company operates ferries, local bus services, truck transport and ambulance services...
(NTS) is an example of a private company participating in this type of arrangement for service delivery. While the majority of such arrangements are currently with Norwegian-based companies, this is changing, and international companies, such as Falck
Falck
- People :* Jeremias Falck , Baroque painter* Anton Reinhard Falck , Dutch statesman* Johan Peter Falck , Swedish botanist* Wolfgang Falck , German Luftwaffe aviator* Hildegard Falck , German athlete...
are beginning to contract for services in some areas. Such services may operate 24 hours per day in larger centers, but in remote and rural locations are still frequently staffed by 'on-call' personnel after normal business hours. Even in areas with directly operated emergency ambulances, non-emergency transportation is more likely to be conducted by commercial transportation companies. Norway currently operates on the Franco-German model of EMS care, with some limitations on the permitted skills of EMS personnel, and physician response to emergencies being quite commonplace.
Air ambulance
As Norway has a very scattered population with many small towns and villages that are located far from hospitals and treatment centers, land ambulances are supplemented by both helicopters and fixed wing aircraft. These are organized nationally, under the title Norwegian Air AmbulanceNorwegian Air Ambulance
The Norwegian Air Ambulance is the air ambulance service in Norway organised through the government owned limited company Luftambulansetjenesten . The service provides helicopter emergency medical service and fixed wing air ambulance operations.Dedicated planes are provided at six airports, and...
. Participants in the air ambulance
Air ambulance
An air ambulance is an aircraft used for emergency medical assistance in situations where either a traditional ambulance cannot reach the scene easily or quickly enough, or the patient needs to be transported over a distance or terrain that makes air transportation the most practical transport....
scheme include the Royal Norwegian Air Force
Royal Norwegian Air Force
The Royal Norwegian Air Force is the air force of Norway. It was established as a separate arm of the Norwegian armed forces on 10 November 1944. The RNoAF's peace force is approximately 1,430 employees . 600 personnel also serve their draft period in the RNoAF...
330 Squadron, and also one privately owned company (Lufttransport
Lufttransport
Lufttransport is a Norwegian helicopter and fixed-wing airline that operates primarily air ambulance helicopters and planes for the Norwegian and Swedish governments...
) and one not-for-profit foundation (Norsk Luftambulanse
Norsk Luftambulanse
Stiftelsen Norsk Luftambulanse is a Norwegian non-profit foundation that promotes and implements measures to provide emergency medical assistance...
). The relationship with the private company and the foundation are contractural, and currently extend to 2014.
Marine ambulance
Norway's very nature and the fact that many communities are better accessed by water than by land have resulted in the use of dedicated, high speed water ambulances. Such services may be provided directly, or may be contracted out to a larger marine transportation company. Water ambulances may be found in Oslo and StavangerStavanger
Stavanger is a city and municipality in the county of Rogaland, Norway.Stavanger municipality has a population of 126,469. There are 197,852 people living in the Stavanger conurbation, making Stavanger the fourth largest city, but the third largest urban area, in Norway...
, among other locations.
Staffing
Ambulances are usually staffed by two emergency medical technicians. Ambulances in Norway have traditionally been manned by EMTs with only 2 or 3 month courses in acute emergency medicine, however, an increasing focus on the importance of prehospital medicine has resulted in such courses being phased out, in favor of a far more comprehensive 2+2 year education process. At a national level, effort is being made to reduce the number of ambulances staffed by personnel on home call, but this arrangement still occurs fairly frequently in rural areas.Training
EMTs newly entering the field are now recommended to have two years of training at Vocational schoolVocational school
A vocational school , providing vocational education, is a school in which students are taught the skills needed to perform a particular job...
followed by two-year internships. This program has been offered since 2003, and is inspired by American EMS training. The system currently has individuals working at the Basic, Intermediate and Advanced levels, and for vehicles providing ALS service, the crew configuration is typically 1-ILS, 1-ALS. Those EMTs already working in the field, and with sufficient experience, are permitted to 'fast track' the new training, completing a degree with the equivalent of a single year of full time education. Only those EMTs completing this education process are permitted to use the title "Paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
". While the program is not yet mandatory on a national level, it is considered to be a prerequisite for employment in the Oslo
Oslo
Oslo is a municipality, as well as the capital and most populous city in Norway. As a municipality , it was established on 1 January 1838. Founded around 1048 by King Harald III of Norway, the city was largely destroyed by fire in 1624. The city was moved under the reign of Denmark–Norway's King...
region. Norway has also come up with the proposal to add qualified nurses on the ambulances, as other countries in Europe have done within its system.
Vehicles
Norwegian ambulances are required to comply with the European UnionEuropean Union
The European Union is an economic and political union of 27 independent member states which are located primarily in Europe. The EU traces its origins from the European Coal and Steel Community and the European Economic Community , formed by six countries in 1958...
standard CEN 1789
CEN 1789
CEN 1789:2007 is the European Union standard for ambulances and medical transportation vehicles. This European standard specifies requirements for the design, testing, performance and equipping of road ambulances used for the transport and care of patients...
(types A-C) for ambulances, as issued by the European Committee for Standards. These standards include the types of vehicles used, their design, performance, testing, basic equipment, and markings or livery
Livery
A livery is a uniform, insignia or symbol adorning, in a non-military context, a person, an object or a vehicle that denotes a relationship between the wearer of the livery and an individual or corporate body. Often, elements of the heraldry relating to the individual or corporate body feature in...
. As with all European Standards, compliance is voluntary, but has been mandated by the Norwegian government.