# Portuguese EMS



## HMartinho (Mar 15, 2012)

Hi everyone, I’ll show you the Portuguese EMS. Once again, sorry about  my English (English learned at school).

What are the different levels of technicians?

-	Certified first responder: They have a 50 hours training, and can take vital signs (pulse, BP(manually and automatic), respiratory rate, temperature, pulse oximetry and capillary blood glucose), BLS (some can use AED), OPA, oxygen therapy, physical assessment, usual first aid, basic trauma skills.

-	EMT: Equivalent to American EMT-B. We have 210 hours training, and can take vital signs as CFR can, BLS + AED, OPA/NPA, oxygen therapy, first aid techniques, trauma skills, oxygen therapy, can give ASA, glucose and assist patient medications under medical control, 3 lead  cardiac monitoring  (but we can not interpret rhythms).

-	Emergency Pre-hospital nurse: 4 years in nursing university, with additional training in critical care, med-surgical nursing, anesthesiologist nursing and/or ILS, ALS, ACLS, PHTLS, PEPP, TNCC, etc. They can do all that EMT do, and are allowed to perform manual defib, cardioversion, pacing, interpreting ecg rhythms, 12 lead ecg, start IV lines, fluids therapy, i.v. glucose, glucagon, give medications (some medications need med control authorization), perform ET intubation, superglottic airways, needle decompression etc. In other words, pre-hospital nurses  can perform ILS and some ALS techniques.

-	Pre-hospital emergency physician: 6 years university in medicine, residence and internship and additional training in anesthesiology/intensive care/ intern medicine and/or ALS,ACLS, ATLS, PHTLS etc. They can do all the ALS techniques including advanced surgical airways and chest tube insertion.

What units we have?

-	BLS ambulances: Staffed by 2 EMT’s or 1 EMT – 1 CFR. This units can provide BLS+AED skills.

-	ILS ambulances: Staffed by 1 nurse and 1 EMT. That level of nurse can start IV’s, give emergent cardiac drugs, thrombolysis, anti-arrhythmic drugs, some analgesics ( paracetamol I.V.,  Fentanyl) and fluids.   Usually, the ambulance is equipped with vent, lifepak 12 and infusion pump.

-	ALS units (rapid response car): In Portugal that units are known as VMER. Are staffed by 1 nurse and 1 physician and are equipped as real intensive care units.
Note: In these units, nurses can do the same procedures that doctor can, except the surgical procedures. 

-	ALS helicopter: Staffed by 1 physician, 1 nurse and 2 pilots. That unit are similar to rapid response car.

-	Neonatal/pediatric interfacility transport units: Staffed by 1 neonatologist physician, 1 nurse and 1 EMT (driver). This units are equipped with a neonatal incubator, vent, infusion pumps, emergent drugs etc. It is like a mobile NICU.

-	vehicle for intervention in disaster : Used in mass casualty situations.

We have psychologists working in pre-hospital care too.

Here are some pictures:

BLS units

http://www.google.pt/imgres?q=ambul...5&tbnw=184&start=0&ndsp=11&ved=1t:429,r:5,s:0

ILS units: 

http://www.google.pt/imgres?q=ambul...t=10&ndsp=15&ved=1t:429,r:5,s:10&tx=153&ty=51

ALS units: rapid car response:

http://www.google.pt/imgres?q=vmer&...4&tbnw=179&start=0&ndsp=12&ved=1t:429,r:2,s:0

Neontal interfacility transport units:

http://www.google.pt/imgres?q=ambul...1&tbnw=204&start=0&ndsp=10&ved=1t:429,r:0,s:0

ALS helicopter:

http://www.google.pt/imgres?q=helic...3&tbnw=177&start=0&ndsp=12&ved=1t:429,r:4,s:0

Mass casualty units:

http://www.google.pt/imgres?q=viatu...9&tbnw=222&start=0&ndsp=11&ved=1t:429,r:1,s:0

http://www.google.pt/imgres?q=viatu...bnw=208&start=11&ndsp=18&ved=1t:429,r:15,s:11


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## Steveb (Mar 15, 2012)

Really nice ambulances Thanks for the interesting info.


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