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J Emerg Med. 2006 Jan;30(1):111-5.

Analysis and applicability of the Dutch EMS system into countries developing EMS systems.

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Department of Emergency Medicine, Clara Maass Medical Center/Saint Barnabas Health Care System, Belleville, New Jersey 07109, and Department of Emergency Medicine, Albert Einstein College of Medicine, New Hyde Park, NY, USA.


Development of an Emergency Medical Services (EMS) system is a challenging task for administrators, government agencies, and politicians. Factors such as the political climate, governmental support, and monetary resources heavily influence and shape the development of an EMS system. There are various systems in place to meet the functional needs and abilities of different regions while maintaining the basic principle of providing fast attention to those in need, and transportation to a definitive care facility. In this report, we describe the current Dutch EMS system in Amsterdam and the methods of daily pre-hospital health care delivery used, while exploring its potential applicability in developing nations. The Dutch EMS system is a nurse-driven triage system, both at the dispatch level and at the treatment level. Of the approximate yearly 165,000 calls received at the dispatch center, 40% of the requests were triaged based on national protocols such that no emergency ambulance dispatching was necessary. Furthermore, 30% of patients were treated at the scene, and did not subsequently require emergency transport to a definitive care facility.

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