Emergency medical services, also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilization for serious illness and injuries and transport to definitive care.
Emergency Medical Services In South Africa
Land Ambulance
Emergency ambulance service is provided by each South African province. The government-operated ambulance system, also known in the Western Cape as METRO (Medical Emergency Transportation and Rescue Operations) provides emergency medical care as well as various rescue options (land, air and sea) to the public. In addition to the paid responders, the government system is supplemented in many areas by volunteers.
In cases where volunteers are used, the standards for operation are set by the provincial Health Department, which also provides vehicles, equipment, and operating expenses.
Operations are normally administered at the local level through the Emergency Management Service, which oversees police and fire protection as well. The co-location of ambulances with fire apparatus is common in South Africa, although they are two independent services. The national emergency number for ambulances in South Africa is 10 177.
These publicly operated services are supplemented by three private-for-profit ambulance companies, NetCare 911and ER24, and life response 24/7 of which operate nationally, and by a variety of local private services, such as AmbuStat.
The statutory services and private companies are further supplemented by voluntary ambulance services, including the South African Red Cross, and St. John Ambulance. All are required to meet the same standards as the public services with respect to staff qualifications. These services are self-dispatching and do not participate in the national emergency number scheme.
Air Ambulance
Public air ambulance service is provided by the Red Cross Air Mercy Service from bases in the Western Cape and KwaZulu-Natal. The system operates both helicopters and fixed wing turboprop aircraft.
The Eastern Cape is covered by two bases, one in East London and another in Port Elizabeth. The contract is run by NAC Helicopters on behalf of the Eastern Cape Department of Health. NAC utilise two Bell Longrangers IV.
Private emergency air ambulance service is also provided by Netcare 911 operating nationally with both Fixed Wing (Jet aircraft) and Rotary Wing (Helicopters) Aircraft.
Private air ambulance charters are also available from a number of aircraft charter companies throughout the country.
Rescue
In Kwa Zulu Natal, Life response 24/7 assists with technical rescue and carries out the technical rescue needs in the province in conjunction with the South African Police Service Search and Rescue Division. Rescuetech also has access to its own fleet of aircraft, both fixed and rotary wing, for use in aerial searches and the transport of rescue crews to remote locations.
In Kwa Zulu Natal, Life response 24/7 assists with technical rescue and carries out the technical rescue needs in the province in conjunction with the South African Police Service Search and Rescue Division. Rescuetech also has access to its own fleet of aircraft, both fixed and rotary wing, for use in aerial searches and the transport of rescue crews to remote locations.
Training
In South Africa there are currently 3 different levels of proficiency in Short course training:
BAA or Basic Ambulance Assistant – This is a Basic Life Support (BLS) certification, and approximately the equivalent of the US EMT-B. This is the minimum qualification to be a crew member of an ambulance in South Africa. Training includes a 160-hour course consisting of lectures and practical simulations. The lectures cover basic anatomy and physiology, basic life support (including both CPR and first aid), emergency care, the use of ambulance equipment, including Automated External Defibrillators (AED), and various medico-legal issues.
AEA or Ambulance Emergency Assistant – This is an Intermediate Life Support (ILS) certification, and generally close to the same scope of the US EMT-I in most skills but the South African counterparts have more training, with some added skills. To apply for this training, candidates must have a minimum of 1,000 hours of practical experience as a BAA and they must pass an entrance exam to be eligible for the course.
As an alternative route to certification, those completing the more advanced tertiary qualifications may challenge the examination and be certified as an AEA after successfully completing their first or second year of training. Training at this level consists of a 470-hour course, consisting of 240 hours of lectures and practical simulations, and 230 hours of experiential learning. AEA’s are qualified to practice various invasive techniques such as IV therapy, needle Cricothyroidotomy and needle Thoracocentesis, as well as Electrocardiogram interpretation, manual external defibrillation, and are allowed to administer various drugs.
CCA or Critical Care Assistant and the “National Diploma” – These Advanced Life Support (ALS) candidates must complete a 1,200-hour course to qualify as a CCA in addition to prior BAA and AEA qualifications. This level usually takes more than 4 years to complete. The ND is a three-year, full-time study at college. CCA and ND are both registered as a Paramedic with the Health Professions Council South Africa and they can continue to do an additional 1 yr postgraduate study to obtain the Btech degree.
Below are two new university qualifications;
ECT or Emergency Care Technician – This mid-level course is of two years duration, and exits on a level just above what many know as Intermediate Life Support (ILS), but similar to Advanced Life Support (ALS), yet without advanced airway management manoeuvres. Students who pass this course are eligible to apply to the HPCSA to be registered in the category of Emergency Care Technician (ECT).
BTech/BEMC or The bachelor’s degree Technology or bachelor’s degree in Emergency Medical Care – This is a four-year professional degree, and students who complete this degree are eligible to be registered with the HPCSA as Emergency Care Practitioner (ECP), which has an additional scope of practice over the Critical Care Assistant and the National Diploma qualifications.
The two additions in stand-alone capabilities are Thrombolysis and Rapid sequence induction. ECPs are also trained in the rescue disciplines offered by their institutions, normally up to the level of Advanced Rescue Practitioner. Example: High Angle II, Motor Vehicle, Fire Search and Rescue, Aviation, Confined Space, Structural Collapse, Industrial and Agricultural, Trench, Aquatic Rescue, etc. The advantage of the Btech qualification is that it is a university qualification that is consistent with the international industry trend.
What are examples of emergency medical services in South Africa ?
2.1 Government ambulance service.
2.2 Fire- or police-linked service.
2.3 Charity ambulance service.
2.4 Private ambulance service.
2.5 Combined emergency service.
2.6 Hospital-based service.
2.7 Internal ambulances.
What is an emergency medical service provider in South Africa ?
Emergency medical services (EMS) workers provide pre-hospital emergency medical care. Their duties create an inherent risk for on-the-job injuries and illnesses. Research shows that EMS workers have high rates of fatal injuries and nonfatal injuries and illnesses. EMS Provider Infographic.
Is ambulance service free in South Africa?
“If an uninsured patient is not experiencing a life-threatening emergency, they have access to the provincial emergency services which will render stabilisation and transportation to a hospital if required, at no cost to the patient.”
Where do emergency medicine physicians work in South Africa ?
Emergency physicians generally practise in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics.
How much does a private ambulance cost in South Africa?
Can you afford an ambulance in South Africa?
| Advanced Life support | ||
|---|---|---|
| Metropolitan Area | Up to 45 Minutes | – |
| Up to 60 Minutes | R4,281.29 | |
| Every 15 Minutes thereafter | R1,070.32 | |
| Long Distance | Per km (>100km) with patient | R53.41 |