The Ambulance-staff in the Netherlands

[Dutch-EMT]

In the Netherlands we don't know the different levels of EMS education.
There is always an standard ambulancecrew in the whole country.

An ambulanceteam is always an ambulancedriver and an ambulance-nurse
(in Dutch called Ambulancechauffeur and Ambulanceverpleegkundige).

Ambulancedriver
To become an ambulancedriver you must have a First-Aid diploma and a drivers-licence for trucks above 3500kg (called a C-drivers-licence).
Working in the healthcare is recommended.

The ambulancedriver, ofcourse, drives the ambulance.
He assists the ambulancenurse at the scene. Skills the drivers are trained for are for example:
- prepare medication and infusion
- prepare for oxygentherapy, assist by intubation
- Spinal care and stabilisation
- fracture immobilisation
- link the patiënt to the monitor
- in case of an large accident coördinate till an ambulance officer arrives.

Ambulancenurse
To become an ambulancenurse you must have finished a nursingschool, wich is in the netherlands a 4-years studie. After the nursing school you must be working for at least one year in a hospital before the nurse can apply to get educated as an ER-nurse (1½ yr study), Intensive-care-nurse (1½ yr study), Coronarycare nurse (1½ yr study) or Anesthetisc-nurse (3 yr study).
These studies all contain an ALS-training.
When the nurse has been working for at least one year as a specialist-nurse, he/she can apply to the function of ambulancenurse.

The ambulancenurse works mostly together with a ambulancedriver.
Sometimes the ambulancenurse works alone (as rapid-responder on a bike or in a normal rescue car/van).
The ambulancedriver works with protocols and a standard set of medication and equipment. There is no contact with a doctor during the treatment by the ambulance-nurse. When a patiënt is in very bad condition, the ambulancenurse can ask for back-up by a MMT (Mobile medical team).
This MMT (an emergency doctor and emergency-nurse) assists the ambulancenurse. Sometimes the emergency-centre sends the MMT before the arrival of an ambulance, on ground of the emergency call.

Study and protocols for ambulance staff
In the Netherlands there is only one educations for ambulance-staff.
Its called SOSA (Foundation of education ambulancestaff). There is also one protocol, used in the whole country (LPA: Countywide protocols ambulancecare). The SOSA-education is a study wich takes a year.

When you want to work as ambulancenurse in the Netherlands it takes 6½ years of studie and 2 years of working-experience after the studies to become an ambulancenurse.

 

[Scott33]

One of the most advanced EMS systems on the planet as far as educational requirements go. Thanks for posting.

 

[atropine]

Thats cool there called ambulance drivers, makes sense I think.

 

[squrt29batt12]

That sounds pretty impressive. It also sounds like a pretty damn expensive operation to run daily lol.

 

[Richard]

Nice write up!

 

[MrBrown]

Gosh darn it, Europe is so efficent!

Brown is impressed, now, who wants to go to Oktoberfest?

Rhein Control hello its Medivac, descending VFR, 1200, changing local traffic

 

[jjesusfreak01]

Gosh darn it, Europe is so efficent!

Brown is impressed, now, who wants to go to Oktoberfest?

Rhein Control hello its Medivac, descending VFR, 1200, changing local traffic

Thats all we need, drunk Brown with a drunk pilot trying to medevac a drunk patient from Oktoberfest.


That does sound like a fairly good system over there in the Netherlands. There doesn't appear to be a huge amount of room in the back of that ambulance. Do you have multiple medical personnel in the back with critical patients, like ROSC arrest patients, or is it always just a nurse and the patient?

 

[Dutch-EMT]

Thats all we need, drunk Brown with a drunk pilot trying to medevac a drunk patient from Oktoberfest.


That does sound like a fairly good system over there in the Netherlands. There doesn't appear to be a huge amount of room in the back of that ambulance. Do you have multiple medical personnel in the back with critical patients, like ROSC arrest patients, or is it always just a nurse and the patient?

In the worst case scenario the MMT-doctor drives with the ambulance-nurse to the hospital. During resuscitation a second ambulance-nurse steps in the back of the ambulance. A resuscitation call always needs 2 ambulances.
The back of the ambulance is large enough for two crewmembers.

 

[llavero]

It is very similar to the work that develops in Spain with the private ambulances.
Thank you for the information.

 

[Dutch-EMT]

In the Netherlands we see the next ambulances:

Mercedes Benz E-class

Volkswagen with T5 base

Mercedes Emergency Sprinter

Chevrolet GMT series

Mercedes ambulance with BOX-system

Ford Ambulance (the largest one who's driving in the Netherlands)

Volvo V70 Ambulance

VZA Ambulances (Amsterdam in different collours)

Chevrolet GMT Series

Mercedes Sprinter Box

 

[MrBrown]

Brown likes box

New Zealand is moving from the box ....

... to the van

.... but what Brown really wants to drive around at 120 miles an hour is this:

 

[Dutch-EMT]

Damn, Brown, What a shame that the box is getting replaced by the van.

Here in NL the chevy's and Ford are all getting replaced by Mercedes Sprinter Van's. Just because repair and servicecosts are much much cheaper and the engines of American cars use a lot of fuel.
It's all about reducing costs!!!

 

[RNL]

A resuscitation call always needs 2 ambulances.

Sounds expensive...in Poland in case of a resuscitation call the specialized team with doctor on board in usually sent

 

[Kthanid]

Continental Europes 45-60% income tax rates are what pays for this stuff. Not a misprint, In Denmark for example at the top tax bracket you are losing around 60c in the dollar to the tax man.

I'd take lower taxes and a community college/on-the-job trained paramedic any day thanks.

 

[clibb]

Continental Europes 45-60% income tax rates are what pays for this stuff. Not a misprint, In Denmark for example at the top tax bracket you are losing around 60c in the dollar to the tax man.

I'd take lower taxes and a community college/on-the-job trained paramedic any day thanks.

But at the same time you have no medical bills for ambulance, surgery, or whatever you need. You also get PAID time off of work to recover and to make sure you have recovered 100%. Plus you don't have to pay for college.
Sweden has the highest taxes and that's 56%. Denmark is second. So no, you don't lose 60c to the dollar in Denmark.

 

[Dutch-EMT]

Continental Europes 45-60% income tax rates are what pays for this stuff. Not a misprint, In Denmark for example at the top tax bracket you are losing around 60c in the dollar to the tax man.

I'd take lower taxes and a community college/on-the-job trained paramedic any day thanks.

In Netherlands we have one of the best social structures of the world.
We know the health insurance laws, so everybody must have ensurance in health. When people retire, the state pays about €750-800,= (when age is 65yrs) and retirement funds make it to about 90% of the last earned salary for the rest of their lifes.
That means that everyone gets €750 to €800,= and everybody with a job must fund in retirement-funds so they have a good salary when retire.
When people don't retire on age of 65, but work till 67yrs, the retirement income will be 100%.

 

[SerumK]

How is that social system looking longterm financially? Will it be self sustaining? Or will it go bankrupt?

 

[Dutch-EMT]

How is that social system looking longterm financially? Will it be self sustaining? Or will it go bankrupt?

This system is depending on the economy. The funds have a lot of income by investments. And those incomes are decreased. After WorldWar II, there was a babyboom. Those people getting old now, so there are more people use the pensionfunds/retirementfunds.
But it must be selfsustaining. It's not goïng bankrupt.

We are goïng offtopic

 

[Kthanid]

But at the same time you have no medical bills for ambulance, surgery, or whatever you need. You also get PAID time off of work to recover and to make sure you have recovered 100%. Plus you don't have to pay for college.
Sweden has the highest taxes and that's 56%. Denmark is second. So no, you don't lose 60c to the dollar in Denmark.

Figures and opinions and stats vary for all the countries with Denmark ranked 1st, 2nd(the stats you looked at most likely) or 4th just to name a few. Feel free to split hairs with another search if you want.

The gist is these countries are expensive as hell.

And of course they have a lot of free services, its exactly what the taxes pay for of course. No argument there.

In Denmarks case you can also throw in the free schooling and free adult learning camps the Danes have (like adventure training stuff and just learning stuff for fun) and the huge payouts you get if you are sacked and the countries who have lenghty maternity leave... for the husband(!)

My opinion does not change one jot.

I'll take lower taxes over an exorbitant state funded safety blanket hands down.

One thing the UK is learning and Australia apparently is that the free everything system they enjoy does not work quite as well as we hoped. We have the biggest boom in private medical and private medical insurance ever occurring currently, which is obviously people choosing other than the state funded system.

The 'free college/University' system now requires funding from its huge international student load paying full fees to stay afloat. 25% of student numbers at some Uni's are international(eg $25,000 a year per foriegn student).

And as we all found if you happen to be retiring just when the stockmarket crashes all the state funded care you amassed can be wiped out forever if your fund fails. Anyone here from Iceland or Greece like to comment

Europe is only surviving because its so highly networked it can shuffle money fast enough between countries to try and plug gaps. Also we can con the poorer half aka 'Eastern Europe' for huge sums if they want to "get into the European Union" with us.

I don't think the US is actually in as bad shape because at least the wound is lanced and its all its debt is on the table now.

Europe can't say whether its system is self sustaining until the rest of the baby boomers retire.

Back to the thread, be careful what you wish for yanks with the 'hallowed ground' of 'free care' we Euro's quote. You may just get it...

 

[jjesusfreak01]

The EMS system in the Netherlands is great, but its hard to compare it to a place like the US. My state (North Carolina) is 3.5x larger than The Netherlands but with 1/6th the population density. When you combine that with the good network of roads across The Netherlands and the fairly flat terrain, you can see how it is possible for the Dutch to have an EMS system that employs more highly educated (and presumably higher paid) emergency workers.