HUNGARIAN RESCUE HISTORY
THE ESTABLISHMENT OF THE HUNGARIAN NATIONAL AMBULANCE SERVICE (NAS) AND ITS PREDECESSORS.
The Hungarian National Ambulance Service is the largest provider of emergency rescue ambulances and patient transfer ambulances in Hungary. The precursor to the National Ambulance Service dates back to the last quarter of the nineteenth century. The predecessors to the National Ambulance Service were established in 1887 as the Budapest Volunteer Ambulance Corps. It later expanded nationally after World War I in 1926 as the National Rural and Metro Ambulance Corps and was responsible for serving the countryside outside of Budapest. The EMS Agency was officially established in 1948 when the Budapest Volunteer Ambulance Corps and the National Rural and Metro Ambulance Corps were merged. Today The Hungarian National Ambulance Service is the evolution of over 129 years of experience, development, and emergency medicine science and knowledge.
Since its founding, the Hungarian National Ambulance Service has become stronger and expanded further. The NAS has more than tripled the number of ambulance stations, expanded its workforce by more than 20 fold, and increased its vehicle fleet more than 6 fold.
THE OPERATIONAL STRUCTURE OF THE NAS:
To create a more efficient operational structure, the NAS’s operations were broken down by County in the 1960s, with the local operational command being assumed by the regional Medical Director. The Central Command of the NAS had jurisdiction over the entire NAS’s operations; however, regional directors had jurisdiction over their County’s operations for local matters. In 2005, to better conform with the European Union norms, the County regional structure was reorganized into seven regional units under central control with local directors and medical directors in charge of regional issues and operations.
AMBULANCE STATIONS:
When the Hungarian NAS was established, it had a network of 76 stations scattered throughout the country. From the 1960s to the late 1980s, the network of ambulance stations underwent significant expansion. Today, Hungary is covered by 253 ambulance stations that have an average response time of 15 minutes or less to most populated areas, which fully conforms to the European Union directives on emergency medical response. The various types of ambulances and their degree of staffing and equipment are categorized into “A”, “B”, or “C”. Dispatching the units nationwide is a challenging task performed by nineteen regional centers that receive the emergency calls and send out the appropriate level of emergency response. Hungarian NAS ambulances run over 38 million kilometers annually, with over 7,500 NAS personnel responding to over one million calls for assistance.
TEACHING AND SCIENCE:
The Hungarian NAS is the country’s premier authority on setting standards for emergency medicine. From the 1950s to the 1970s, the NAS was responsible for training the majority of its staff who were not physicians, including Ambulance Officers, Nurses and Paramedics. In 1975 the national government mandated that the education of health care workers occur in the country’s higher education system so that responsibility was transferred away from the NAS; however, the continuing education and specialty training responsibilities remained with the EMS Agency. Today, various health science curricula are taught at universities in Pécs, Nyíregyháza and Szombathely. Previously, ambulance nurse training was only available through the NAS which lay outside of the regular education system. In 1979 the Ministry of Education accredited the field of emergency medicine as a stand-alone discipline and embedded the training into the regular curriculum of health education for physicians.
The Hungarian NAS model is based on the Franco-German model, utilizing paramedics and physicians in the field with a wide scope of practice. Great advances were made in Hungary over the decades in the field of Emergency Medicine thanks to the hard work of the Budapest Volunteer Ambulance Corps, the establishment of an Emergency Specialist Rescue Unit (ROKO) and, before its termination, the NAS Hospital. The decades of experience and medical knowledge that has been tried and tested by the EMS Agency and its medical board has created the cutting edge NAS that functions today.
There are two publications available in Hungary that deal with the science behind emergency medicine and the interesting work of the Ambulance Service. The first is a scientific publication, Magyar Mentésügy (Hungarian Rescue) which is published by the Hungarian Board of Emergency Medicine in conjunction with the Hungarian NAS. The second, Mentők Lapja (Ambulance Life), is published by the NAS and deals with interesting cases and everyday topics affecting the workers of the NAS.
AMBULANCE FLEET:
The fleet of vehicles used by the Ambulance Service of the NAS has expanded proportionally with the Ambulance Station network nationwide. In 1948, when the various volunteer services nationwide were conglomerated into a national network, the newly formed NAS had a fleet of 140 vehicles. Today, the fleet consists of more than 1000 vehicles of which 753 are in service 24 hours a day, seven days a week. The NAS also operates its own maintenance garage responsible for keeping the vehicles and much of the equipment in perfect operational order. In addition to “standard” ambulances, the NAS operates a small fleet of specialized vehicles including adult and paediatric physician rendezvous cars, paramedic rendezvous cars, several paediatric specialist emergency ambulances, multiple casualty units for large emergencies, mobile intensive care units for transferring critically ill patients between hospitals, and world renowned motorcycle and scooter response units (MRUs).
In 1958, the NAS established its Aerial Operations Unit responsible for the rescue and transport of critically ill patients by helicopter and fixed winged aircraft. Until the EMS Agency received its first fleet of rescue helicopters, the agency would fly very sick patients on commercial aircraft using medical personnel as chaperones. The Aerial Operations Unit is an independently run non-profit charity governed by the NAS. The nonprofit operates seven air rescue stations nationwide (Miskolc, Budaörs (Budapest), Pécs, Balatonfüred, Sármellék, Debrecen and Szentes). At present, the Aerial Operations Unit operates AS-350B and EC-135 T2 helicopters from sunrise to sunset every day.