Description of the prehospital emergency healthcare system in Norway

Abstract

Background: Norway has a long coastline, steep mountains, and wide fjords, which presents some challenges to the prehospital emergency healthcare system. In recent years, the prehospital emergency medical services (EMS) have undergone significant changes, structurally, in terms of professionalisation of the services and in the education level of the personnel. In this article, we aim to describe the current structure for handling prehospital medical emergencies.

Methods: For healthcare, Norway is divided into four Regional Health Authorities, consisting of 19 Health Trusts, where 18 have an EMS. There is a dedicated medical emergency number, 113, that terminates in 16 emergency medical communication centres. The use of air and boat ambulances, in addition to traditional ambulances, seeks to meet the challenges in the EMS system.

Strengths and limitations: The Norwegian EMS is an advanced system with highly educated staff; however, this level of care comes with an equally high cost.

Conclusion: The Norwegian EMS can handle emergencies nationwide, providing advanced care at the scene and during transport. The geography and demography challenge the idea of equal care, but the open publishing of data from national quality registries seeks to identify and address potential differences.

Keywords: Cardiac arrest registries; Dispatch; Emergency medical communication centres (EMCC); Emergency medical services (EMS); Out-of-hospital cardiac arrest (OHCA); Prehospital.

Fig. 1

The colours indicate the four Regional Health Authorities (RHA). Grey; Northern Norway RHA, Yellow; Central Norway RHA, Blue; Western Norway RHA, Green; South-Eastern Norway RHA. EMCC for Svalbard is in Tromsø, the northernmost EMCC centre with flight following.

Fig. 2

The number of patients (Y-axis) per year (X-axis) that have been successfully resuscitated by an automated external defibrillator (AED). The figure is a reprint from the yearly report from the Norwegian Cardiac Arrest Registry and is used with permission from the registry.

Fig. 3

Placement/distribution of hospitals and airborne resources. The colours indicate the four Regional Health Authorities (RHA). Grey; Northern Norway RHA, Yellow; Central Norway RHA, Blue; Western Norway RHA, Green; South-Eastern Norway RHA.

Fig. 4

Response times in minutes for all the individual Health Trusts (Helseforetak (HF)) in Norway in 2022. Median response time was 9 minutes. The boxes are 25–75 percentiles, and the whiskers are 10 and 90 percentiles. The figure is a reprint from the yearly report from the Norwegian Cardiac Arrest Registry and is used with permission from the registry.