Ambulance Services in Hong Kong are provided by the Hong Kong Fire Services, in co-operation with two other voluntary organisations, the Auxiliary Medical Service and the Hong Kong St. John Ambulance.
Public hospitals have charged HK$100 for treatment at accident and emergency departments since 2002. About 2.2 million use the service each year. Waiting time varies between one hour and more than five hours. In 2017 it was decided to increase the cost to HK$180 with an expansion of the fee waiver mechanism. The actual cost per patient is about HK$1,230.[ when? ] [1] HK$1,390 in 2017-2018 [2]
The ambulance service from the Hong Kong Fire Service pledges to have an arrival of an ambulance at the street address from the time of call within 12 minutes. [3]
The Hong Kong Fire Service is the statutory provider of emergency ambulance service in Hong Kong, as mandated by regulations from the Legislative Council. The service has a considerable history, but only amalgamated into a single unified service in 1979, when previous government ambulance operations were merged with those of the fire service. The service employs some 2200 people and operates approximately 256 emergency ambulances and 35 motorcycles from 36 depots, located strategically around the Hong Kong territory. [4] In 2006, the service responded to more than 575,000 emergency calls, and transported approximately 514,000 people to hospital. [5] In addition, the service operates a number of rapid response vehicles, and four heavy truck-based Mobile Treatment Centres. The service provides emergency transport to the 17 publicly operated Hong Kong Hospital Authority facilities which operate Accident and Emergency departments. The service follows the Anglo-American model (as opposed to the Franco-German model) [6] of EMS service provision. It is rare to see a physician at the scene of an emergency.
The statutory service is supplemented by two organisations – St. John Ambulance, a charity organisation and the Auxiliary Medical Service, a government-run voluntary service. Both of these services focus primarily on providing coverage to special events, and on public education, although both have written agreements with the statutory service to provide additional ambulances during a disaster.
In Hong Kong, all air ambulance service is provided by the Government Flying Service; a joint service providing aviation support to all departments of the government. [7] The service operates from two bases (the current and former Hong Kong airports, Hong Kong International Airport and Kai Tak Airport. While the service employs a number of different types of aircraft, those used for both air ambulance service and search and rescue service are primarily of the Puma and Super-Puma types. The physical terrain is such that most level areas are densely populated and heavily built up. As a result, air ambulance operations usually involve those communities which are isolated either in the mountains, or on offshore islands, with an occasional rescue at sea or medevac flight from a ship. It used to have ambulance crew with basic life support equipment from Hong Kong Fire Service Department (HKFSD) abroad when mission needed. Under the "Air Medical Officer" (AMO) programme, helicopters are equipped with advanced medical apparatus and medical personnel from GFS Auxiliary Section can administer emergency treatment in the air since 2000. GFS Auxiliary Section is a group of 24 volunteer doctors and 27 volunteer nurses from hospitals who specialised in Accident and Emergency (A&E) medicine. Enlisted as auxiliary officers, they operate as part of the aircrew on non-risky rescue missions during 09:30–18:30 at weekends (Fri-Mon) and public holidays when the majority of recreational accidents occur. This programme aims to provide a higher level of medical care to the injured right on the spot and during transit to hospital. During 2011, the flight doctors and nurses flew a total of 405 hours in 573 operations. Nowadays, the programme is not enough to support current heavy demand on air medical emergency basis 24x7, 365 days a year. To be qualified as flight paramedic, some of standing Air Crewman Officers (ACMO) is recently receiving pre-hospital care training from Hospital Authority (HA) as well as Hong Kong Fire Service Department.
The majority of ambulances in Hong Kong are originally of British design; a reflection of Hong Kong's long association with Britain. As a result, the design of the majority of ambulances approximately corresponds to the European Standard CEN 1789 as published by the European Committee for Standards [8] with respect to vehicle design and equipment, although not with the visual identity provisions. Until recently, most vehicles corresponded with the European Class B design, although current vehicle acquisitions more closely resemble the Class C design. Given that Hong Kong has never been a member of the European Community, it appears likely that the approximate compliance is coincidental. In addition, the service operates a handful of vehicles for isolated areas where the full-sized ambulances have difficulty in travelling. These are known locally as 'village ambulances'. In terms of visual identity, most ambulances in Hong Kong are white in body colour, with the newest addition to the fleet being yellow in colour, similar to the British design and standard. All ambulances in service are equipped with flashing blue lights and with sirens. The emergency ambulances operated by the Hong Kong Fire Service display red livery, while those of the voluntary agencies display green livery. All of the emergency ambulances of the Hong Kong Fire Service carry advanced life support (ALS) equipment, while those of the volunteer agencies do not. All Hong Kong ambulances carry Automatic External Defibrillators (AED).
Although the Hong Kong Fire Service maintains that its ambulances provide paramedic service, the current highest level of training is what most would recognise as a US EMT-Intermediate level, including IV therapy, airway management using Combitube, defibrillation, and a limited range of drugs, given orally or by injection. [9] The exact corresponding qualifications are the Canadian province of British Columbia's EMA 1 and 2 levels (EMR and PCP in British Columbia Canada). New recruits for Ambulanceman/Ambulancewoman and Probationary Ambulance Officer undergo 26 weeks of training at the Hong Kong Fire Service Ambulance Command Training School (FSACTS) in Ma On Shan, NT. [10] This provides them with an enhanced Basic Life Support level of training. An additional two weeks of training is provided to motorcycle operators. Once training is completed and a suitable amount of experience is obtained, the candidate will be provided with an additional six weeks of training, elevating them to the Intermediate level. This training is conducted in co-operation with the Justice Institute of British Columbia, and has been granted equivalency. [11] Hong Kong has aspirations to offer full ALS services, and have recently completed a study of how such services are trained and provided internationally. [12]
As with many things in Hong Kong, the dispatch of emergency vehicles continues to be influenced by the British legacy. The telephone number for emergency services throughout Hong Kong is 999, just as in Britain. All 999 calls are answered by the Hong Kong Police Force. If an ambulance is the only response required, the call is passed directly to Hong Kong Fire Services dispatchers. If the call information is complex, as with a traffic accident, the police dispatchers will notify the ambulance service when they suspect that ambulances might be required. Both ambulances and fire apparatus are co-dispatched by the Hong Kong Fire Service dispatchers. [13] The system operates technologies and decision support software that are approximately equivalent with those found in Europe and North America.
The objective of the Hong Kong Fire Service is to have an ambulance on the scene of an emergency within twelve minutes of receiving the request, 24 hours per day. They are currently achieving that objective on more than 93 percent of all emergency calls. The current dispatch system in Hong Kong does not categorise ambulance calls by medical acuity, although there are plans to introduce this measure in the future. [14]
Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS.
An emergency medical technician is a medical professional that provides emergency medical services. EMTs are most commonly found serving on ambulances and in fire departments in the US and Canada, as full-time and some part-time departments require their firefighters to be EMT certified.
An ambulance is a medically-equipped vehicle used to transport patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medical emergencies by emergency medical services (EMS), and can rapidly transport paramedics and other first responders, carry equipment for administering emergency care, and transport patients to hospital or other definitive care. Most ambulances use a design based on vans or pickup trucks, though others take the form of motorcycles, buses, hearses, aircraft and boats.
A medical director is a physician who provides guidance and leadership on the use of medicine in a healthcare organization. These include the emergency medical services, hospital departments, blood banks, clinical teaching services, and others. A medical director devises the protocols and guidelines for the clinical staff and evaluates them while they are in use.
The City of Toronto Paramedic Services is the statutory emergency medical services provider in Toronto, Ontario, Canada. The service is operated as a division of the City of Toronto, under the Community & Social Services cluster. The service is funded by the municipal tax base, and operates similarly to other municipal divisions, such as the Toronto Parks, Forestry & Recreation division, or the Toronto Water division, but retains operational independence from other divisions. While under municipal government control, it is subject to provincial legislation and licensing. It is not the only service provider in its area; private-for-profit medical transport services also provide routine, non-emergency transports and coverage for special events, but the statutory emergency medical system is the only provider permitted to service emergency calls.
The Hong Kong Fire Services Department is an emergency service responsible for firefighting and rescue on land and sea. It also provides an emergency ambulance service for the sick and the injured and gives fire protection advice to the public. It is under the Secretary for Security who heads the Security Bureau.
Auxiliary Medical Service (AMS) is a voluntary medical and health services provider in Hong Kong. Its mission is to supply effectively and efficiently regular services to maintain the health and well-being of people in Hong Kong.
A nontransporting EMS vehicle is a vehicle that responds to and provides emergency medical services (EMS) without the ability to transport patients. For patients whose condition requires transport, an ambulance is necessary. In some cases they may fulfill other duties when not participating in EMS operations, such as policing or fire suppression.
Louisville Metro Emergency Medical Services is the primary provider of pre-hospital life support and emergency care within Louisville-Jefferson County, Kentucky. LMEMS is a governmental department that averages 90,000 calls for service, both emergency and non-emergency, each year.
In the United States, emergency medical services (EMS) provide out-of-hospital acute medical care and/or transport to definitive care for those in need. They are regulated at the most basic level by the National Highway Traffic Safety Administration, which sets the minimum standards that all states' EMS providers must meet, and regulated more strictly by individual state governments, which often require higher standards from the services they oversee.
Winnipeg Fire Paramedic Service (WFPS) provides fire and EMS services to the City of Winnipeg, Manitoba. It operates from 27 fire stations, and 3 administration offices across the city.
Emergency medical services in Canada are the responsibility of each Canadian province or territory. The services, including both ambulance and paramedic services, may be provided directly by the province, contracted to a private provider, or delegated to local governments, which may, in turn, create service delivery arrangements with municipal departments, hospitals, or private providers. The approach, and the standards, vary considerably between provinces and territories.
Emergency Medical Service in Germany is a service of public pre-hospital emergency healthcare, including ambulance service, provided by individual German cities and counties. It is primarily financed by the German public health insurance system.
Emergency medical services in the Netherlands is a system of pre hospital care provided by the government in partnership with private companies.
Emergency medical services in Australia are provided by state ambulance services, which are a division of each state or territorial government, and by St John Ambulance in both Western Australia and the Northern Territory.
State Medical Rescue in Poland is a system of free public emergency healthcare established by Ustawa o Państwowym Ratownictwie Medycznym, including ambulance service and Emergency Departments (EDs). While in Polish public hospitals and clinics NFZ common public insurance is required, PRM medical services in ambulances and EDs are completely free for everyone. Since 2018 emergency ambulances that operates in PRM, that is Polish 112 and 999 emergency numbers, are operated by public entities only.
Emergency medical services in Iceland include the provision of ambulance service. They provide all emergency ambulance service for a population of in excess of 320,000 people in one of the most sparsely settled countries in Europe. The system is government-funded for the first 85 percent of cost, with 15 percent being charged to the individual as a deterrent fee. All services in Iceland are provided by the Icelandic Red Cross, with individual ambulances often co-located with local fire brigades.
The National Ambulance Service is the statutory public ambulance service in Ireland. The service is operated by the National Hospitals Office of the Health Service Executive, the Irish national healthcare authority.
Emergency Medical Service in Austria is a service of public pre-hospital emergency healthcare, including ambulance service, provided by individual Austrian municipalities, cities and counties. It is primarily financed by the Austrian health insurance companies.
The New York City Fire Department Bureau of Emergency Medical Services is a division of the New York City Fire Department (FDNY) in charge of emergency medical services for New York City. It was established on March 17, 1996, following the merger of the FDNY and New York City Health and Hospitals Corporation's emergency medical services division. FDNY EMS provides coverage of all five boroughs of New York City with ambulances and a variety of specialized response vehicles.