International EMS systems: Greece
Section snippets
Background
Greece is a fairly small country with an area of 131,957 km2 and a population of 10,964,020. There are some important features and characteristics of geography and the distribution of the population, which are of importance for EMS organisation. Around 72.8% of the Greek population (7.98 million) live in cities. Athens and Thessaloniki are the two largest cities with 4 million and 1 million inhabitants, respectively. A large proportion of the 27.2% rural population (2.98 million) live on
The history of the Greek EMS
An EMS system as we know it today did not exist in Greece until 1987. A first aid station was established in 1915 by the charity group “Sotir” (Saviour) next to the parliament in Athens. From 1932 to 1988, the Samaritans from the Hellenic Red Cross founded several first aid stations with their own ambulances in Athens, Thessaloniki and Patras. In 1965, the Social Insurance Institute (IKA) created IKA first aid stations with their own ambulances in parallel with the Samaritans in Athens,
The Greek EMS structure
The Greek EMS, in Greece called Ethniko Kentro Amesis Boitheias (EKAB), National Centre for Emergency Care, was established in 1987 by national law 1579, which was passed in 1985. According to paragraph 2 of article 7 of this law “The purpose of EKAB is the coordination of immediate help in emergencies and of emergency medical care to the citizens and the transportation of these citizens to health care facilities”. EKAB is a national public organisation with its headquarters in Athens. It is
EMS training and education
At the same time as the foundation of EKAB in 1987, a training centre was established and education centres were founded at almost all EKAB stations.
Until 1989, all EMTs received 40 h of basic education, similar to first responder training.
In 1989, a basic EMT training programme was introduced under regulation of the Ministry of Health. The basic EMT training is conducted over a year and consists of 1000 h of teaching. Subjects covered include assessment of the critically ill, triage and
EMS dispatch
All EKAB stations have their own dispatch centres, which are equipped with a telephone centre, radio and a computer network for data entry and processing. The division for aeromedical transportation also possesses a telemedicine system.
In general, there are two types of dispatchers: one to answer telephone calls from the public and the other to communicate via radio with the units in the field. In addition to the basic training programme as an EMT, dispatchers undergo additional education
EMS aeromedical transport
EKAB also has an aeromedical transportation division with its operational centre in Athens and a base in Rhodes. The three helicopters, owned by the Ministry of Health, have been given to the Air Force, and aeromedical transport is carried out under the management and with additional helicopters and aeroplanes of the Air Force. There is one physician and one dispatcher at the operational centre in Athens for the administrative and medical support of the aeromedical assets and three physicians
EMS: facts and figures
Nationwide EKAB employs 2183 EMTs and 128 physicians. There are plans to employ 300 additional EMTs and 55 physicians during 2004 [10]. EKAB owns 435 basic ambulance cars, 77 advanced MICUs, 16 motorcycles and three helicopters. EKAB plans to invest in another 270 basic ambulance cars, 25 MICUs, 10 motorcycles, two mobile coordination units, and two units equipped for disaster medicine.
EKAB receives approximately 550,000 calls annually, of which 76.7% are emergencies. About 85% of these get an
Emergency departments
In all healthcare facilities (Hospitals, District Hospitals and Health Care Centres), Emergency Departments (ED) have either been built or are planned. There is no specialty of Emergency Medicine in Greece although recently, an Emergency Medicine Society has been founded. The emergency cases are usually sorted into surgical or medical emergencies and are treated by appropriate specialists. In life-threatening situations, anaesthetists are immediately involved (in those facilities with
EMS: the future
EKAB is expanding by buying new vehicles (Fig. 1), motorcycles and equipment, as well as modernising existing equipment. At the same time, new physicians and EMTs are being recruited. One of the major goals is the expansion, building and staffing of new EKAB stations in smaller cities, because rural areas are a priority for the provision of improved medical care, especially emergency care. For the larger cities, where traffic is a contributing factor to longer response times, more motorcycles
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