Healthcare services for pre-hospital emergencies and management of emergency healthcare transportation
The healthcare service process gets started with a call to 112 or 061 that is answered in one of the 3 operation rooms in SEM’s healthcare coordination centre (CECOS).
Operators receive and handle the calls with the assistance of medical personnel and determine priorities according to the specific pathologies, assigning the most appropriate resources for in situ assistance or resolving the matter through healthcare advice provided over the telephone.
When the call requires mobilization of resources, an assistance team is sent to the place of the incident in order to provide assistance, stabilize the patient and, if necessary, transfer the patient to a healthcare centre.
This assistance may be provided in different places:
- In the home
- Enclosed areas (workplace, sports facilities)
- Public thoroughfares (streets, roads, highways, motorways)
- Healthcare and Primary Care Centres
- Open spaces (rural areas, mountains)
Intra-hospital transfer of critical patients
SEM coordinates the transfer of critical patients (adult and pediatric) from a hospital that lacks the adequate diagnostic or therapeutic means for treating the patient to another centre with the necessary technical and human resources. It determines the type of hospital according to the specific pathology, arranges for a bed, mobilizes resources and carries out the transfer assisted by a SEM team to guarantee the patient’s stability at all times.
In this case, the professionals from the sending hospital are responsible for initiating the process by requesting SEM’s services.
SEM has a special unit for services whose objective is to provide healthcare coverage when there is a foreseeable risk (large events, sports events, protests...) and to provide assistance support to teams throughout Catalonia in the event of multiple-victim accidents, catastrophes or situations where there is a risk of nuclear, biological or chemical contamination.
It is now responsible for planning and implementing the healthcare assistance mechanisms of the different Emergency Plans of the Government of Catalonia, with a direct link to the Civil Protection Office.
Healthcare support programmes
SEM is increasingly participating and collaborating with the Department of Health and the Servei Català de la Salut (CatSalut) in different healthcare assistance programmes, including:
- EMSE Programme (Multidisciplinary Team for Specialized Support). Programme in the mental health field whose objective is to improve on-going assistance for patients with serious mental health disorders, through the detection of cases outside of the regular mental health network and their reintroduction therein.
- Private hospital services purchase programme when, due to saturation of public beds, this is necessary.
- Activation and coordination code programmes between levels that allow for accelerating the process of identification and transfer of patients with determined pathologies, with the objective of improving survival and subsequent quality of life. Currently the following codes are operational in Catalonia:
Patients with acute myocardial infarction (IAM). The activation of this code entails coordination between SEM and the receiving hospital in a pre-alert manner, offering patients suffering from an acute myocardial infarction the option of receiving the best treatment possible. In this case, the best treatment is “opening the coronary artery” that is blocked (reperfusion of the occluded artery), in accordance with current therapeutic standards. This reperfusion procedure is recommended through the administration of a drug or opening the artery surgically in a specialized healthcare centre (catheterization/angioplasty).
This code currently is operational in all of Catalonia.
Patients with a brain vascular accident (ICTUS). When the SEM coordination centre identifies an ICTUS case that, according to the consensus criteria of the Brain Vascular Disease Master Plan for Catalonia, requires the activation of this code, SEM pre-alerts a receiving hospital with the capacity to diagnose and treat these patients. This “pre-alert” allows, the same as other codes, the receiving centre to be prepared in such a way that the patient can be attended to with priority, given the seriousness of his or her condition.
Currently this code is operational in all of Catalonia.
Patients with serious polytrauma. Following the same system as the rest of the codes, SEM identifies, through the assistance offered by ambulance teams, patients that have suffered a serious trauma. As soon as the seriousness of the patient’s condition is identified, the patient is considered a priority, in line with specific treatment needs, and transferred to the optimum centres for providing a definitive response.
Currently the code is operational in the metropolitan area of Barcelona and will soon be extended to the reference areas of other hospitals.
HEART STOPPED Code
This is a very specific code, as it identifies patients that do no recover their vital functions after having suffered cardio respiratory failure. In some of these cases, cardiopulmonary resuscitation may be performed during a certain period of time so that these patients can be considered potential organ and tissue donors as long as their families give their authorization. To this end, SEM pre-alerts the receiving hospital, l’Hospital Clínic de Barcelona, which activates the necessary mechanisms for receiving the patient. Then it contacts the family and, as soon as the family consent is obtained and the absence of legal conflicts is confirmed, it puts the organ donation programme in place.
Currently this code is only operational in Barcelona and part of the southern metropolitan area.