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Emergency medical service by the Helsinki City Rescue Department

In Helsinki, the Hospital District of Helsinki and Uusimaa (HUS) is responsible for arranging the emergency medical services in its area, based on the Health Care Act. The HUS region has been further divided into seven organisational areas, of which Helsinki is the largest in operations. The Helsinki City Rescue Department acts as the producer of emergency medical services in the Hospital District of Helsinki and Uusimaa’s HUH Emergency Medicine and Services (EMS).

The EMS operations are controlled and supervised by HUH Emergency Medicine and Services (EMS)’s doctor responsible for emergency medical care. The director of EMS operations of emergency medical services is in charge of the emergency medical service production of the Rescue Department. Non-urgent emergency medical care duties distributed through the Emergency Centre (112) are the responsibility of a private service producer, in accordance with a separate agreement. Currently, the private service producer is Med Group.

Ambulances, fire engines and other auxiliary units prepared for emergency medical services are located in the eight on-land rescue centres of the Rescue Department and, in summer, also in Suomenlinna. The closest possible ambulance is always called for urgent duties, regardless of which centre the closest available unit belongs to. In very high-risk assignments, the closest rescue unit with the same treatment staff and equipment as ambulances will be called to the scene as first response.

Treatment personnel

Approximately 510 employees of the Rescue Department work in the operative sector and around 350 of them work regularly in emergency medical care duties. The staff has received training customised for the needs of the capital city for both rescue operations and emergency medical care duties as a cooperation of the Helsinki Rescue School, Helsinki Metropolia University of Applied Sciences, emergency medical care unit of HUH Emergency Medicine and Services (EMS) and the emergency medical services of the Rescue Department. Mainly, the emergency medical services are based on firefighter-paramedics, but the group also contains around 20 full time paramedics. The length of one shift is 24 hours, of which the ambulance duty is 12 hours.

EMS physician (ambulance doctor)

EMS physician is in charge of the operative management of emergency medical care services and the treatment of high-risk patients. Mainly, this is done by instructing the basic and treatment level units treating the patient through phone, radio and electronic management system. Through these, the EMS physician gives more specific treatment instructions in individual situations.

In addition to this, an EMS physician operating at the physician staffed MICU (Mobile Intesive Care Unit) will manage the most difficult and demanding emergency medical care assignments, of which there are, on average, 7 per day. In exceptional situations and during disasters, the EMS physician will act as the medical director of field operations.

EMS Supervisor

The EMS Supervisors act as the situational leaders of the emergency medical services of their hospital districts, in accordance with the instructions compiled by the doctor in charge of emergency medical services and the situation-specific instructions of the EMS physician. The duties of the EMS Supervisor also include managing the most difficult and demanding emergency medical care assignments, if the EMS physician is carrying out other duties.

Duties

Helsinki has around 640,000 residents and during office hours, the estimated number of population is over 700,000.  In relation to the population number, there are more young adults and less children than elsewhere in the country.  A little less than a quarter of the Helsinki residents live alone and over 70% of all residents are between 16 to 64 years in age.  Various social problems, as well as problems caused by alcohol or other intoxicants, are focused on the capital city area. The busy traffic causes challenges for emergency medical services in Helsinki, where there are tram lines and metro traffic in addition to car and bus traffic. Additionally, the ports and the close vicinity of Helsinki-Vantaa Airport bring their own risks.  The capital city often hosts state visits, meetings and large-scale sports and culture events and the emergency medical care is also part of these events’ security arrangements.

In 2016, the number of urgent emergency medical care assignments was 69,695.  The largest group of assignments (around 40%) were problems of basic vital signs (chest pain, difficulties with breathing, apoplexy, unconsciousness, lifelessness) and one individual group of assignments were different injuries caused by falling (around 15%).

Disasters and situations with many patients

The Helsinki emergency medical service prepares for disasters and situations with many patients with compiled guidelines and annual exercises.   The ambulances and fire engines are equipped with equipment for classifying patients and the central station has a disaster unit with treatment equipment for around hundred patients.  In addition to this, the department has CBRN (Chemical, Biological, Radiological and Nuclear) inflatable tents for cleaning people for both walking patients and patients on stretchers, in case of, for example, chemical, biological or radiation accidents (CBNR situations).

Competence management

The emergency medical care service of the Rescue Department manages the daily work shift training and complementary training of the operative staff, which is planned together with the staff and with the HUH Emergency Medicine and Services (EMS). It also manages, in part, the degree training.  The content for training comes from several different sectors, which include the EMS core processes and the feedback received from the staff, customers and interest groups.  The contents of training are also affected by changing treatment instructions, legislation, IT and treatment equipment, for example.  The competence level is measured every other year through tests.

 

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