Advanced life support units in Spain: the situation in 2008

Pesqueira Alonso EE, Juliani Izquierdo P

Objective: To determine the number of emergency advanced life support teams

currently operating in Spain, their locations, the proportion of the population served, the

population density, and the territorial extension covered in the different autonomous

communities.

Method: Descriptive study of the Spanish situation as of January 1, 2009. Public

information sources were used to identify the number and locations of advanced life

support teams. The data gathered were complemented with information obtained by

interviewing the staff of hospital emergency departments and dispatch centers. The

concept of advanced life support team was defined and the study was limited to teams

providing initial care. Population and territorial extension data were taken from the latest

official census published by the Spanish National Institute of Statistics in December

2008.

Results: We identified 362 teams meeting the defined criteria; 327 use road transport

ambulances and 35 use helicopter ambulances. We found advanced life support teams

operating at a ratio of 1 to 127 308 inhabitants (0.78/100 000 population), with ratios

varying from 1 to 63 000 (1.58/100 000 population) to 1 to 232 000 (0.43/100 000

population). Geographically, we found 1 team for every 1400 km2 (7.2/10 000 km2) on

the average, with a range of 1 unit for every 129 km2 (77.2/10 000 km2) to 1 unit for

every 5200 km2 (1.9/10 000 km2). Density averaged 12 persons per square kilometer

attended by a unit, with a range in density of 1 to 31 per square kilometer attended.

Conclusions: 1) There is considerable disparity between different Spanish autonomous

communities with regard to use of advanced life support units, the territorial extension

covered, populations served, and density. 2) The differences in coverage by life support

units are unrelated to population, territory, or population density. 3) The differences can

be attributed to disparity in criteria applied when planning and to factors related to

geography and climate, communication infrastructure or other unstudied variab

Juliani Izquierdo P, Pesqueira Alonso EE