Emergency medical services in Spain

Emergency Medical Services in Spain (Servicios de Emergencias Médicas, SEM) (EMS) are public services usually provided by regional Governments.^[1]

Organization

Spanish organization for medical emergencies is a Public Health Integrated EMS (IEMS) that has a network of SAMU/IEMS Medical Emergency Regulation Centers (MERC = SAMU in international appellation). 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 is the agglomeration of these 17 Health Departments. So each autonomous community has its own regional IEMS 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, some 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 Catalonia community.In these EMS 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,...)

Standards

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^[2], and Basic Life Support-BLS with technicians). There are differents types of ambulances.^[3]

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

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)^[4]

Telephone number

The emergency dial is 112 (European Emergency Number).^[5] 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.

Curiosities

In Spain, the law (motor vehicle code) only allows the police vehicles to use blue lights. Ambulances have to use amber lights. However some ambulances use red/amber, white/amber, blue/amber, blue/red although this is illegal. In 2006, the Spanish Parliament approved a motion to amend the law, but the motor vehicle code has not changed yet.^[6]

See also

Spanish National Health System

Sources

External links

• SAMU 061 de Baleares [1]
• 061 Aragón
• 061 Cantabria
• 061 Galicia
• 061 Murcia
• EPES 061
• SAMUR
• SEM
• SUMMA 112

SAMU