What happens when you are seriously injured or ill from the moment you call 113 until you arrive at the appropriate treatment facility? You encounter one or more parts of the emergency medical chain. The chain consists of a number of highly skilled professionals, resources, and measures. Together, they ensure that you receive help when it is most urgent.
Doctor, rescue worker, and pilot from the ambulance helicopter in Trondheim are on their way out with an intensive care patient. However, the emergency medical chain consists of more than just air ambulance.
The emergency medical chain consists of, among other things, general practitioners, municipal out-of-hours services, and out-of-hours service centres, the health enterprise's emergency medical communication centre (AMK centre), ambulance vehicles, boats, and emergency departments in hospitals.
What many do not know is that YOU can become an important part of the emergency medical chain. If you encounter someone in need of assistance, you as a first responder are the very first link in the chain.
When you call 113, you will receive all the help and support you need.
In Norway, we have a two-part emergency service.
The main function of these two centres is to determine exactly what kind of help you need.
Sometimes it may be advice and guidance over the phone or via video, while other times it may involve a combination of a doctor’s car, ambulance, ambulance boat, air ambulance, or air ambulance service.
Medical operator Trine Horven at the AMK centre at St. Olav's Hospital is committed to addressing all callers with professional confidence, respect, and care.
To provide appropriate and equal assistance to all callers, the AMK centres use the Norwegian Index for Medical Emergency Assistance. This is a tool and a list of various situations and criteria divided into three categories: Acute, urgent, or routine.
In addition to ensuring that help is on the way, the operator aims to gather necessary information about the incident and the patient to provide the best possible assistance. For each situation, information cards have been prepared that describe what the operator should ask about, provide guidance on, and what assistance should be initiated.
In the vast majority of acute and urgent cases, an ambulance is dispatched to assist the patient.
In 2023, there were 325,000 emergency missions involving ambulances in Norway (Source: SSB).
Ambulance personnel can come right into your home with advanced medical equipment if you need it.
Here, Elena is checking the ECG (electrocardiogram) on a man with breathing difficulties.
A few floors up in the AMK centre, they have received a patient assignment that requires a helicopter. Air ambulance coordinator Håvard Lund is tasked with notifying the crew of the ambulance helicopter in Trondheim.
The air ambulance coordinator (LA coordinator) is responsible for notifying the crew at the helicopter base and coordinating the mission with collaborating resources.
Another very important task is to obtain the flight route and estimated landing time, record the number of people on board during all helicopter movements, and implement necessary measures if contact with the helicopter is lost.
We currently have four AMK centres with LA coordinators in Norway:
When the helicopter crew is not on a mission, they often practise. Here are rescue worker Peder, pilot Andreas, and doctor Oddvar fully engaged in practising what to do with a baby who is not breathing.
Air ambulances can be used for the transfer of patients where air transport is necessary based on a medical assessment.
While helicopters are the resource most frequently used for missions transporting patients from home or the scene of an accident to hospital, air ambulances have the most missions transferring patients from smaller to larger hospitals, returning them to their local hospital, as well as for specialised transports.
Air ambulances in Northern Norway have far more emergency missions than in Southern Norway. When air ambulances are used for primary missions in the north, the urgency is often high. The largest proportion of these missions occurs in Finnmark.
Ambulance missions with helicopter, plane, and rescue helicopter
In the event of a suspected stroke, treatment begins in the ambulance. Intravenous fluids are usually administered to improve blood circulation to the brain, and oxygen is provided via a nasal cannula to ensure adequate oxygen supply to the brain, which may have reduced blood flow if oxygen saturation is too low.
Upon arrival at the emergency department, a neurological examination, blood pressure measurement, pulse check, ECG, blood sampling, and imaging of the brain using CT are carried out immediately.
A review of the base structure for the air ambulance service in 2020 shows that approximately 99 per cent of the population can now be reached by doctor-staffed air ambulance within 45 minutes.