Ambulance and emergency care services. A handbook for drawing up an alarm procedure. Helsinki 2005. 56pp. Handbooks of the Ministry of Social Affairs and Health, Finland; ISSN 1236-116X; 2005:23. ISBN 952-00-1850-6 (print), ISBN 952-00-1851-4 (PDF)

The purpose of the reformed emergency response centre operations is to ensure the provision, availability and quality of emergency response centre services equitably throughout the country, as well as to intensify the co-operation of the relevant authorities. The task of the centres is to evaluate the urgency of each request and the available resources also in regard to the duties falling within the responsibility of social and health care. It is question of securing important basic values in social and health care: securing the access to help and emergency care for those in need of it as well as an appropriate use of the ambulance and emergency care resources according to the existing agreements.

Adequate steering of ambulance service and quality emergency care and their appropriate use are of great importance for those in need of urgent health care as well as for the population in the entire area concerned. A precondition is that the local authorities have organised sufficient preparedness for ambulance and emergency care services in their area as laid down in the Primary Health Care Act and the Ambulance Service Decree. Another precondition is that the organisation and maintenance of the services is realised in co-operation with the hospital districts in the region and the different ambulance and emergency care service providers.

This handbook is designed to assist the responsible health care authorities in drawing up an alarm procedure for emergency response centres guiding the availability of emergency care services as well as a uniform and appropriate use of the available resources. The handbook is divided into three parts. The first part describes the organisation of the operations and maintenance of preparedness based on the relevant legislation as well as factors related to quality. The second part deals with the reform of the emergency response centre system, purpose of the operations, duties, and the evaluation of the urgency of tasks falling within the responsibility of the health care authorities. The third part presents the recommendations on what the alarm procedure for an emergency response centre must include.

The recommendations on the content of an alarm procedure have been summarised under the following headings:

• Responsible authorities at the health centre and in the hospital district

• Definition of areas of operation and responsibility

• Extra preparedness areas according to agreement

• Provider of regional ambulance and emergency care services

• Communication and alarm connections

• Medical preparedness classifications approved by the health centres and the hospital district

• Principles for use and calling emergency care services with a doctor attending

• Restrictions on calling care-level ambulance service/emergency care units for non-emergency duties and for transfers of patients from a care institution to another

• Separate instructions for transfers from a care institution to another

• Management arrangements for emergency care

• Operational principles for the preparedness levels and resource guidance in case of reduced preparedness levels and deficit of resources of a long duration

• Preparedness for ambulance and emergency care required by duties under the leadership and/or operational responsibility of other authorities

• Principles for calling and use of special vehicles

• Calling voluntary emergency response service

• Responses included in an alarm procedure.

Key words: ambulance service, care, emergency care, evaluation, instructions, emergency response centres