A Scottish Perspective of Pre-hospital Care and Emergency Medicine in Norway - Part 4

Dr Zoë Smeed

I am a ST5 Emergency Medicine trainee in Edinburgh, Scotland.  After receiving the Robin Mitchell Travel Fellowship, I have been given a fantastic opportunity to explore the Pre-hospital and Emergency care services in Oslo, Norway.  The Robin Mitchell Travel Fellowship was set up to commemorate Dr Robin Gordon Mitchell, an Emergency Medicine Consultant in Edinburgh and is open by application to all Scottish Emergency Medicine trainees to pursue a 4-6 week placement away from their base hospital, within the setting of Emergency Medicine or another associated clinical specialty to enhance their clinical experience and expertise.

This week I have been back working with the Physician Ambulance based at Ulleval Hospital, Oslo, working alongside the doctor "Lege" (typically a Consultant Anaesthetist), and Senior Paramedic (see part 1 of my blogs for more info). 

I also spent a day working alongside the "Ambulanse Leder" (Ambulance Leader or Controller) who is based at the Pre-hospital physician ambulance centre.  The Ambulance Leader is responsible for co-ordinating all ambulances and ambulance staff around the Oslo area, and is the Ambulance Controller for multiple casualty/significant incidents/major incidents.  The Ambulance Leader attends several incidents a day, including road traffic incidents, house fires, stabbings/shootings and one under's (people jumping under trains), co-ordinating the ambulance response whilst working alongside the other emergency services.  Part of their job also involves offering medical/psychiatric support for ambulance staff and also bystanders after traumatic events.  

In Norway, the Police have overall command of Major Incidents both in the hot (bronze) zone and controlling the outer cordon.  There are close links between the Ambulance, Police and Fire Leaders who meet up at least once a month.  Additionally all ambulance, police and fire personnel undergo the same major incident management course to improve cohesion of these services during potential major incidents. 

The highlight of my week was joining forces with the Fire Brigade and being called on a mission to one of the more isolated parts outside Oslo to provide critical medical care to patient ... by boat!  Due to the geographical challenges within Norway it can often be quicker to reach more remote areas by other means of transport than road and the Fire Brigade boat is often used.  Throughout Norway there are several boats used to provide medical care and transport patients.  The Fire Brigade boat is fully equipped with medical equipment, a stretcher, oxygen and additionally equipment for water rescue, including diving equipment.  It is frequently involved in both rescue missions and additionally medical missions.  Whizzing through the water whilst the sun set across the Oslo Fjords is certainly an experience I won't forget!   

Now, as my travel fellowship sadly draws towards the end, I am travelling up the western coast of Norway, then flying to Svalbard - high up in the Arctic Circle; its main town Longyearbyen being approximately 2,047km from Oslo and 1,318km from the North Pole.  Whilst on my travels I am hoping to meet up with the Air Ambulance Helicopter Service in Svalbard, to explore further the logistics of working in such a remote environment.

On my return to Oslo I will spend some time working at Ullevål Hospital.  I will end my fellowship doing a presentation about the Scottish Pre-hospital services, the Emergency Department and training in Emergency Medicine.  

Until next time, thanks for reading!