Rescue service in Europe: The Netherlands

Basic statutory principles

In 1971 the basic version of the Rescue Service (Wet Ambulancevervoer) was passed and was introduced step-by-step up to 1979. The aim of the law, the establishment of a region-wide system of regional headquarters for all rescue services and ambulance companies in the sphere of responsibility of the provinces, could be implemented by the end of the seventies.

Organisation

Approximately 80% of transportation is carried out by private rescue services and 5% are managed by the Red Cross. There are also local rescue services and those managed by hospitals. The assistance period is stipulated as a guideline. The rescue aid must have reached the work location within 15 minutes after notification of the emergency has been received at the regional headquarters. The standard emergency number 06-11 for the fire brigade, police and rescue services has existed since the middle of the nineties. The emergency calls are organised via a telephone exchange and forwarded to the respective work locations.  

Regional headquarters

The regional headquarters are independent organisations which are set up by the municipalities and coordinate over 600,000 ambulance operations and emergency rescues across the country. In rural areas the duties of the regional headquarters are carried out by the fire brigade headquarters. The manager of the regional headquarters is in this case a fire brigade employee. In other cases the managers are trained medical orderlies, if possible with rescue service experience. In general, a nursing assistant must be present at each regional headquarters round the clock. A doctor is employed as a manager or advisor for medical questions at the regional headquarters.

Involvement of doctors

There is no system of emergency doctors in the Netherlands. Doctors are active at major damage incidents, as medical advisors or managers at the regional headquarters or in the rescue service. They are especially responsible for preparing schedules/protocols (standing orders) in collaboration with the rescue service and regional hospitals. These protocols are not legally prescribed, but have proved to be very worthwhile as a guiding principle for support at the scene of the incident. There are no standard training regulations for medical personnel in the rescue service.     

Air rescue

In the Netherlands helicopters without medical personnel in attendance are used to transport patients from the islands and to transfer newborn children.

Personnel / training

There is no standard profile for non-medical personnel in the rescue service. Various institutions and organisations are involved in the rescue system, primarily the SOSA (Stichting Opleidingen en Scho-ling ten behoeve van de Ambulancehulpverlening = Foundation for Training and Further Training for Rescue Services), which has worked out standard guidelines for training in the rescue service and is active in the training of non-medical first aid personnel in the rescue service.  

The statutory minimum requirement for rescue service personnel is an approximately 30-hour first aid course. In addition, voluntary participation in a reanimation course is required as a rule. The training for the rescue service contains general nursing with additional special nursing training from the fields of intensive care (IC) and cardiology (CCU), including a practical year. The total range of training opportunities is being reviewed with the aim of ensuring a satisfactory level of rescue service provision through a nursing diploma and an adequate rescue service course.