Emergency medical services in Spain
Encyclopedia
Emergency Medical Services in Spain (Servicios de Emergencias Médicas, SEM) (EMS) are public services usually provided by regional Governments.
Spain has 17 autonomous communities with 17 regional Health Departments. The National Health System
is the agglomeration of these 17 Health Departments. So each autonomous community has its own regional EMS that depend on Regional Health Department. Some EMS have their own staff and vehicles, others outsource the vehicles and staff to private companies. Public EMS departments usually outsource the vehicles and BLS
staff. ALS
staff are usually government employees.
In addition, Madrid Ceuta Melilla cities have local EMS too (e.g. SAMUR
-Madrid).
There are also Emergency Medical Services in some fire departments: cities of Barcelona, Sevilla, Valencia, Zaragoza, Malaga, Bilbao, and Madrid and Catalonia communities.In these also IEMS work doctors and nurses with firefighters in advanced life support (ALS) ambulances or helicopters.
Furthermore, non-profit organizations (Spanish Red Cross, DYA) and Civil Defense
Groups provide ambulances (usually BLS) with volunteers
for some situations (disasters, mass incidents, special events: sports, concerts,...)
In addition there are fast vehicles (non-ambulance) for emergency interventions:
Before 2007 there was not a national standard for EMT (TES/Técnico en Emergencias Sanitarias) education, so each region had their own rules (courses from 60 to 600 hours or sometimes only a first aid course; no reciprocity between regions; differents terms: TTS-Técnico de Transporte Sanitario, ATTS-Auxiliar de Transporte Sanitario, ATA-Auxiliar de Transporte en Ambulancia, TEM-Técnico en Emergencias Médicas,...). Since 2007 there is a 2 years training occupational course (vocational-Community College)
In Spain, the emergency dispatch is a physician regulated system. Each region has its own emergency call center with phone operators (telefonistas), emergency medical dispatchers (gestores de recursos/coordinadores/locutores), medical-regulators (physician) and sometimes nurses.
Organization
Spanish organization for medical emergencies is a Public Health Integrated EMS (IEMS) like in other european ( Italy, Germany, Austria, etc ) or American countries (like Chile or Brazil) that have a network of SAMU/IEMS Medical Emergency Regulation Centers (MERC). Emergency Primary Care and GP are fully integrated in Spanish IEMS .Spain has 17 autonomous communities with 17 regional Health Departments. The National Health System
Spanish National Health System
The Spanish National Health System is the agglomeration of public health services that has existed in Spain since it was established through and structured by the Ley General de Sanidad of 1986...
is the agglomeration of these 17 Health Departments. So each autonomous community has its own regional EMS that depend on Regional Health Department. Some EMS have their own staff and vehicles, others outsource the vehicles and staff to private companies. Public EMS departments usually outsource the vehicles and BLS
Basic life support
Basic life support is the level of medical care which is used for patients with life-threatening illnesses or injuries until the patient can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by...
staff. ALS
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...
staff are usually government employees.
In addition, Madrid Ceuta Melilla cities have local EMS too (e.g. SAMUR
Samur
Samur is a specialized and highly qualified emergency system of Madrid, Spain. The name stands for S.A.M.U.R....
-Madrid).
There are also Emergency Medical Services in some fire departments: cities of Barcelona, Sevilla, Valencia, Zaragoza, Malaga, Bilbao, and Madrid and Catalonia communities.In these also IEMS work doctors and nurses with firefighters in advanced life support (ALS) ambulances or helicopters.
Furthermore, non-profit organizations (Spanish Red Cross, DYA) and Civil Defense
Civil defense
Civil defense, civil defence or civil protection is an effort to protect the citizens of a state from military attack. It uses the principles of emergency operations: prevention, mitigation, preparation, response, or emergency evacuation, and recovery...
Groups provide ambulances (usually BLS) with volunteers
Volunteering
Volunteering is generally considered an altruistic activity, intended to promote good or improve human quality of life, but people also volunteer for their own skill development, to meet others, to make contacts for possible employment, to have fun, and a variety of other reasons that could be...
for some situations (disasters, mass incidents, special events: sports, concerts,...)
Types of ambulances
Spanish Integrated EMS is a physician-and Public health led system (like in France, Italy, Portugal, Belgium, Luxembourg,Germany, Chile, Brazil.... ), with physicians, emergency nurses and technicians in the field. It's a two-tiered response system (Advanced Life Support-ALS or MICU with physicians and nurses, and Basic Life Support-BLS with technicians). There are differents types of ambulances.| Type | Spanish term | Physician | Emergency Nurse | EMT (driver included) | Comments |
|---|---|---|---|---|---|
| ALS Ambulance (Advanced Life Support Ambulance or MICU) | Ambulancia de SVA / UVI móvil | ||||
| ILS Ambulance (Intermediate Life Support Ambulance) | Ambulancia de SVI / SVE | ||||
| BLS Ambulance (Basic Life Support Ambulance) | Ambulancia de SVB | ||||
| Non-Caring Ambulance | Ambulancia no-asistencial | ||||
| HEMS (Helicopter Emergency Medical Service) | Helicóptero de Emergencias Médicas |
In addition there are fast vehicles (non-ambulance) for emergency interventions:
- RRU (Rapid Response Units / VIR: Vehículo de Intervención Rápida), staffed by a driver/technician and a physician (sometimes an emergency nurse).
- Logistics and communications vehicles for disasters.
Training
| Profession | Level of education | Years | Postgraduate Education | Level of skills |
|---|---|---|---|---|
| Emergency Physician (Médico de Emergencias) | University (Degree in Medicine) | 6 years | Master of Emergency Medicine (1–2 years), Medical Specialty (4–5 years): Cardiology, Anesthesiology, Family Medicine, Intensive Care Medicine,... | ALS |
| Emergency Nurse (Enfermero de Emergencias) | University (Degree in Nursing) | 4 years | Master of Emergency Nursing (1–2 years) -optional in several regions. Nursing Specialty (2 years) (currently developing): Community nursing, Medical/Surgical Nursing,... | ILS/ALS |
| EMT/Emergency Medical Technician (EMT-basic) (TES/Técnico en Emergencias Sanitarias) | Vocational/Community college (since 2007) | 2 years | ||
| BLS+AED | ||||
| Patient Transport Assistant, Patient Transport Technician, rescuer, life guard (Auxiliar de Transporte Sanitario, Técnico de Transporte Sanitario, socorrista) | Non official education before 2007/Private courses/Red Cross Courses | 4–8 weeks | ||
| First Aids |
Before 2007 there was not a national standard for EMT (TES/Técnico en Emergencias Sanitarias) education, so each region had their own rules (courses from 60 to 600 hours or sometimes only a first aid course; no reciprocity between regions; differents terms: TTS-Técnico de Transporte Sanitario, ATTS-Auxiliar de Transporte Sanitario, ATA-Auxiliar de Transporte en Ambulancia, TEM-Técnico en Emergencias Médicas,...). Since 2007 there is a 2 years training occupational course (vocational-Community College)
Telephone number
The emergency dial is 112 (European Emergency Number). in all regions. However, the emergency number for medical services, 061, is available in several regions.In Spain, the emergency dispatch is a physician regulated system. Each region has its own emergency call center with phone operators (telefonistas), emergency medical dispatchers (gestores de recursos/coordinadores/locutores), medical-regulators (physician) and sometimes nurses.