title: International EMS Systems: the Nordic countries.
abstract: Emergency medicine service (EMS) systems in the five Nordic countries have more similarities than differences. One similarity is the involvement of anaesthesiologists as pre-hospital physicians and their strong participation for all critically ill and injured patients in-hospital. Discrepancies do exist, however, especially within the ground and air ambulance service, and the EMS systems face several challenges. Main problems and challenges emphasized by the authors are: (1) Denmark: the dispatch centres are presently not under medical control and are without a national criteria based system. Access to on-line medical advice of a physician is not available; (2) Finland: the autonomy of the individual municipalities and their responsibility to cover for primary and specialised health care, as well as the EMS, and the lack of supporting or demanding legislation regarding the EMS; (3) Iceland is the only country that has emergency medicine (EM) as a recognised speciality but there is a need for more fully trained specialists in EM; (4) Norway: the ordinary ground ambulance is pointed out as the weakest link in the EM chain and a health reform demands extensive co-operation between the new health enterprises to re-establish a nation-wide air ambulance service; (5) Sweden: to create evidence based medicine standards for treatment in emergency medicine, a better integration of all part of the chain of survival, a formalised education in EM and a nation wide physician staffed helicopter EMS (HEMS) cover.
authors.affiliation: Norwegian Air Ambulance, Box 27, Høvik, N-1322, Norway. audun.langhelle@snla.no
authors.forename: Audun
authors.initials: A
authors.lastname: Langhelle
authors.forename: Hans Morten
authors.initials: HM
authors.lastname: Lossius
authors.forename: Tom
authors.initials: T
authors.lastname: Silfvast
authors.forename: Hjalti Már
authors.initials: HM
authors.lastname: Björnsson
authors.forename: Freddy K
authors.initials: FK
authors.lastname: Lippert
authors.forename: Anders
authors.initials: A
authors.lastname: Ersson
authors.forename: Eldar
authors.initials: E
authors.lastname: Søreide
mesh_terms: D004631:Emergency Medical Service Communication Systems / Q000458:organization & administration; D004632:Emergency Medical Services / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005387:Finland; D006801:Humans; D007055:Iceland; D038622:Internationality; D012537:Scandinavian and Nordic Countries