Emergency medical services in Spain

Emergency Medical Services in Spain are public services usually provided by regional Governments.

Organization

Spanish organization for medical emergencies is a Public Health Integrated EMS that has a network of SAMU/IEMS Medical Emergency Regulation Centers. Emergency Primary Care and GP are fully integrated in Spanish IEMS.
Spain has 17 autonomous communities with 17 regional Health Departments. The National Health System is the agglomeration of these 17 Health Departments. So each autonomous community has its own regional IEMS that depend on Regional Health Department. Some EMS have their own staff and vehicles, others outsource the vehicles and staff to private companies. Public EMS departments usually outsource the vehicles and BLS staff. ALS staff are usually government employees.
In addition, some cities have local EMS too.
There are also Emergency Medical Services in some fire departments: cities of Barcelona, Sevilla, Valencia, Zaragoza, Malaga, Bilbao, and Catalonia community. In these EMS, doctors and nurses work with firefighters in advanced life support ambulances or helicopters.
Furthermore, non-profit organizations and Civil Defense Groups provide ambulances with volunteers for some situations

Standards

National Minimum Staff Requirements

New legislation was published in June 2012.

Type	Old Royal Decree 619/1998	New Royal Decree 836/2012	Comments
Type A: Patient Transport Ambulance	A driver and an assistant', when the type of service so requires	A driver, both with a PCP	'Before the new legislation was enacted each region had their own training requirements for drivers and assistants: Courses from 60 to 600 hours 'This is a certificate for employees who worked before the development of the new national qualification of EMT-B
Type B: BLS Ambulance	A driver and at least one other person with appropriate training'	2 EMT-B , one of them a driver	Before the new legislation was enacted each region had their own training requirements for drivers and technicians: Courses from 60 to 600 hours
Type C: ALS Ambulance	A driver, an emergency physician and an emergency nurse	An EMT-B/driver and an emergency nurse

Usual types of ambulances and their staff

Spanish EMS is a physician led system with physicians, emergency nurses and technicians in the field. It's a two-tiered response system.
In addition there are fast vehicles for emergency interventions:

RRU, staffed by a driver/technician and a physician.
Logistics and communications vehicles for disasters.

File:Ambulancias.JPG|Spanish Red Cross Ambulances
File:Ambulancia Cruz Roja Española en Orihuela.jpg|Spanish Red Cross Ambulance
File:Ambulancias DYA Las Arenas.jpg|DYA Ambulances
File:DYAako Donostiako anbulantzia.jpg|DYA Ambulance

Training

Before 2007 there was not a national standard for EMT education, so each region had their own rules. Since 2007 there is a 2 years training occupational course

Telephone number

The emergency dial is 112 (European Emergency Number). in all regions. However, the emergency number for medical services, 061, is available in several regions.
In Spain, the emergency dispatch is a physician regulated system. Each region has its own emergency call center with phone operators, emergency medical dispatchers, medical-regulators and sometimes nurses.

Curiosities

In Spain, until August, 1st 2018, the law only allowed the police vehicles to use blue lights. Ambulances and fire engines had to use amber lights. However some ambulances used red/amber, white/amber, blue/amber, blue/red lights although this was illegal. Since that date, all emergency vehicles have to use blue lights. Vehicles that had amber lights have to change them within a maximum time period of two years..