Brazil: Ambulance and Emergency Medical Services

The toll-free number for emergency ambulance services in Brazil is 192.

Yes, mostly. (Bloem, 9) For a large proportion of the country calls to 192 are received at a Regulation Center where Communication Operators take calls (acting as medical regulation assistants) and identify the nature of your emergency, immediately transferring call to a dispatching physician. The physician then determines appropriate resource response:

• Can refer caller to public health center
• Mobilize BLS and/or ICU-ALS ambulance

The physician remains in communication with the public hospital and keeps track of bed availability.

GROUND AMBULANCE IN BRAZIL

ALAGOAS

Maceió

• Alerta Médico: +55 82 3221-5555
• Prosaúde Maceió: +55 82 98191-9090
• SOS Unimed: +55 82 3597-2200
• Transaúde: +55 82 99971-7778

AMAZONAS

Manaus

• Bio Care: +55 92 3584-4136
• Manaus Resgate: +55 92 99357-4354
• Salvare: +55 92 3237-9660
• Vida Resgate: +55 92 3081-2456

BAHIA

Salvador

• Cuidabem: +55 71 3276-4964
• Disque Ambulância: +55 71 3371-5058
• Expressmed Emergências Médicas: +55 71 3276-3402
• Unividas Remoçes: +55 71 4114-0120
• Vitalmed Medical Emergency Services Ltda: +55 71 2202-8686

Vitória da Conquista

• Ultravida Ambulâncias: +55 77 3429-6000

CEARÁ

Caucaia

• Nordeste Emergências e Soluçes Médicas: +55 85 3387-1950

Fortaleza

• Anjos do Resgate-Emergências Médicas: 2675-9673 / 2674-7398
• Easy Life Emergências Médicas: +55 85 3048-5300
• EMN – Emergências Médicas do Nordeste: +55 85 3307-8000
• EMS Ambulâncias: +55 85 3253-0404
• Grupo Sat Atendimento Médico: +55 85 3261-2220 / +55 85 4009-0909
• Unicare Emergency: +55 85 3452-2999
• VIP Saúde: +55 85 3231-4400

DISTRITO FEDERAL (BRASILIA)

Guará

• Samedi: +55 61 3401-1106
• WMED UTI-Móvel: +55 61 3567-8863

Riacho Fundo I

• Samedi: +55 61 3401-1106

Saa Qd 1

• Vida UTI Móvel: +55 61 3248-0008

Sobradinho

• isLife: +55 61 4101-2431

Taguatinga

• Saúde & Vida Remoçes: +55 61 3548-7512

ESPIRITO SANTO

Guarapari

• S.O.S. Vida Emergências: +55 27 3262-9375

Serra

• Remocenter: +55 27 3064-1801

Vila Velha

• Proviva: +55 27 3063-7372
• Vitória Emergências: +55 27 3329-4242

Vitória

• Nunes Remoçes Emergências Médicas: +55 27 3323-3945
• SANSIM: +55 27 3324-1000
• Save Remoçes: +55 27 3200-3886

GOÍAS

Goiânia

• Ambulância Anjos da Guarda: +55 62 98485-6245
• Flash Med Uti Móvel: +55 62 3093-3100
• SOS Vida: +55 62 3941-9197
• Vida Goiás UTI Móvel: +55 62 3281-3030

MARANHÃO

São Luis

• Clinica Vitalmed: 42-3215
• SAFEMED: +55 98 3312-3152
• URGMED: +55 98 3231-8008

MINAS GERAIS

Belo Horizonte

• Disque Ambulância: +55 31 3221-5190
• Mater Dei: +55 31 3292-6000
• Medical Save Ambulâncias: +55 31 3463-7222

Curvelo

• Unimed Gerais de Minas: +55 38 3722-3198

Pouso Alegra

• Unimed Sul Mineira: +55 35 3449-1800

Pte Nova

• Unimed Ponte Nova: +55 31 3817-2314

Uberlândia

• Mais Saúde Ambulância: +55 34 99972-4963
• Phoenix Serviços Médicos: +55 34 3219-5550

MATO GROSSO DO SUL

Campo Grande

• Pro Mais Saúde: +54 67 3043-0333
• QualiSalva:  +54 67 2106-1545

Dourados

• Qualicare: +54 67 9955-3935

MATO GRASSO

Cuiabá

• Help Vida: +55 65 3622-0000
• S.O.S Resgate: +55 65 3052-0101

PARÁ

Belém

• SouTransVida: +55 91 98145-0070

Marabá

• LEX Ambulância: +55 94 3322-2604

PARAÍBA

Campina Grande

• Transvida Ambulancia Particular: +55 83 98869-9434

João Pessoa

• S.O.S. Ambulância: +55 83 3221-2525
• Transmed: +55 81 3426-8247

PARANÁ

Curitiba

• Brasil Emergências Médicas: +55 41 99527-0745
• Disk Ambulância: +55 41 3255-3126
• Ecco Salva Emergências Médicas: +55 41 3242-1212
• Imperador Emergências Medicas: +55 41 99708-6975
• Plus Santé: +55 41 3342-5900
• Summus Emergências: +55 41 3071-0699
• Vida Emergências Médicas: +55 41 3343-5151

Pinhais

• A Emergências Médicas: +55 41 3557-0010

Ponta Grossa

• Unimed Ponta Grossa: +55 42 3220-3900

Toledo

• Ambulâncias Previna: +55 45 99919-1386

Umuarama

• Same Ambulância: +55 44 3622-2727

PERNAMBUCO

Petrolina

• Transmed: +55 81 3074-3213

Recife

• Ambulancia Recife: +55 81 99600-0099
• Mais Vida Serviços de Saúde: +55 81 3061-0564
• Safety Med: +55 81 3034-5002
• Transmed: +55 81 3074-3213

São Lourenço da Mata

• Disk Ambulância: +55 81 3525-0555

PIAUÍ

Teresina

• Transmed Ldta: +55 86 3234-8778

RIO DE JANEIRO

Barra de Tijuca

• Grupo Safety: +55 21 2446-4856

Belford Roxo

• Life Line Saúde: +55 21 2776-4901

Benfica

• Resgate Plus: +55 21 3860-2673

Campo Grande

• Express Remoçes: +55 21 2415-6244
• RM Resgate Médico: +55 22 2724-2335
• Unimed Campos: +55 22 2101-0650

Grajau

• ABC Remocor: +55 21 2570-3030

Niterói

• Lefe Ambulâncias: +55 21 2704-4447

São Cristóvão

• SAVIOR Medical Service: +55 21 3171-3000
• Vida Medical Emergencies: +55 21 3248-3030

Taquara

• Grupo Safety: +55 21 2446-4866

Vila Isabel

• CTICOR: +55 21 2587-5000

RIO GRANDE DO NORTE

Natal

• Natal Resgate: +55 84 98801-2512
• PRESAE: +55 84 3091-3911
• Translife: +55 84 3231-5442

RIO GRANDE DO SUL

Caixas do Sul

• Resgate Sul Emergências Médicas: +55 54 3028-8524

Porto Alegre

• Ambulância SOS Vida: +55 51 3228-0624
• MAE Emergências Médicas: +55 51 3332-8584
• Pró Vida Remoçes: +55 51 3339-6011
• Remosul Ambulâncias: +55 51 3318-4503
• RS Ambulâncias: +55 51 3384-4438

RORAIMA

Porto Velho

• Instruaud: +55 69 3222-6281
• Life Emergências Médicas: +55 69 3212-1008

SANTA CATARINA

Criciúma

• Lan Ambulâncias: +55 48 99979-9668
• Policlínica Medicar: +55 48 9982-6043

Florianópolis

• Help Emergências Médicas: +55 48 3031-2900

Itajaí

• Plantomed: +55 47 3348-6269

Joinville

• Help Emergências Médicas: +55 47 3026-8200
• Ideal Emergências Médicas LTDA: +55 47 3433-2883

São João

• Homedical: +55 47 99223-2300

São José

• Homedical: +55 47 99223-2300

São Pedro de Alcântara

• União Urgências: +55 48 3277-0067

SERGIPE

Aracaju

• D’Ávilamed Emergências Médicas: +55 79 3217-8085
• MedSalva Emergências Médicas: +55 79 3211-4255
• Prosaúde: +55 79 3211-9900

SÃO PAULO

Barra Funda

• Bem Emergências Médicas: +54 11 3871-7600

Bela Vista

• Remoçes Fadinis: +55 11 3141-0467

Bom Retiro

• Ambulância Globo Vida: +55 11 2362-4100
• Med Salva Urgências Médicas: +55 11 3225-2255

Brás

• Dez Emergências

Brooklin

• JP-Salva

Campinas

• Bem Emergências Médicas: +55 11 3871-7600
• Medicar Emergências Médicas: +55 11 3348-1008

Campos Elíseos

• Doctor Emergency Ltda: +55 11 3427-0471

Casa Verde

• Equilíbrio Ambulâncias: +55 11 2337-7338
• Manchete Médica Ltda.: +55 11 3393-7310

Cruzeiro

• Anjos de Resgate: +55 12 3211-7790

Jd Cruzeiro

• Vital Med Clínica Medica: 222-8888 / 345-8888

Osasco

• Intensiva Remoçes Terrestres: +55 11 3604-2400

Pinheiros

• Ambulância SP: +55 11 7741-5471

Santos

• Bem Emergências Médicas: +55 13 3221-2227
• Brasil Emergências: +55 13 3324-0200

São José dos Campos

• Emercor: +55 12 3942-8666

Taubaté

• Life Corp do Brasil: +55 12 3432-2222

Vila Bertioga

• MS Emergências: +55 11 2268-0490

Vila Carrao

• S.O.S. Ambulâncias: +55 11 2137-2111

Vila Formosa

• MS Serviços de Remoçes: +55 11 7822-5972
• Starex Emergencias Medicas: +55 11 2361-8295

AIR AMBULANCE IN BRAZIL

The National System for Civil Defense and Protection (Sistema Nacional de Proteção e Defesa Civil) is overseen by the Ministry of National Integration

Yes, responders on SAMU 192 ambulances in Brazil are trained, though there is less certainty about qualifications with many smaller private EMS agencies.

For SAMU responders:

• Basic team consists of a driver and a nurse technician capable of providing basic life support and using an automated external defibrillator (AED).
• Advanced team consists of a driver, a nurse and a physician trained in advanced life support.
• Rapid support team consists of a driver, a physician and advanced support equipment to complement the basic unit team 

TRAINING CENTERS

• RIO DE JANEIRO
  • Rio Emergência
• SÃO PAULO
  • Instituto de Ensino e Saúde de São Paulo Ltda (IESSP)

SAMU 192 services are delivered by three types of ambulance in Brazil:

• USB – Basic life support ambulance, staffed by emergency medical technicians
• USA – Advanced life support ambulance, staffed nurses and doctors
• Rapid intervention vehicles – Staffed by physicians to provide care on-scene, particularly in urban areas where congestion is high

SAMU 192 also operates air ambulances by helicopter, though not uniformly across the country. Private air ambulance in Brazil is more commonly used.

SAMU 192 services are offered to citizens free of charge, with funding provided by federal, state and municipal governments.

Currently parts of Brazil are experiencing a Yellow Fever outbreak, and the Zika outbreak is also a concern.

According to the US Centers for Disease Control and Prevention (CDC), different groups of travelers will require different vaccinations for travel in Brazil:

• All Travelers:
  • Measles-mumps-rubella (MMR) vaccine
  • Diphtheria-tetanus-pertussis vaccine
  • Varicella (chickenpox) vaccine
  • Polio vaccine
  • Your yearly flu shot
• Most Travelers:
  • Hepatitis A
  • Typhoid
• Some Travelers:
  • Hepatitis B
  • Malaria
  • Rabies
  • Yellow Fever

Read more about travel in Brazil at the CDC website: https://wwwnc.cdc.gov/travel/destinations/traveler/none/brazil (Last accessed: Aug. 7th)

1980s – Emergency care provided by Military Fire Department (CBM) utilizing Anglo-American model

• “US model of ambulance medical care began to be used by the Military Fire Department (CBM) in the late 1980s, with such professionals working as emergency medical technicians and providing care for traumas. The state of Rio de Janeiro was pioneer in this mode of care and has remained a benchmark by virtue of other emergency care initiatives it has developed” (O’Dwyer, 2013)

SAMU Serviço de Atendimento Móvel de Urgência (Mobile Emergency Care Service)

• Three main stages of emergency care development (Machado)
  • 1998-2003: Federal regulation
    • “Produced the rules and defined the resources for the regulation of care services essential for tackling morbidity and mortality indicators” (O’Dwyer, 2013)
    • 2000 – Report to Congress describes lack of regulation:
      • “The Health Care Secretary (…) stood at the opening of congress and said that there actually was no medical emergency policy established in the Ministry and that he was open to hold discussions (…) we worked enthusiastically through congress to make a report and a national proposal to be submitted to the Ministry (O’Dwyer)
      • “Communities of specialists (health professional networks and councils) pieced together alternatives for emergency medical service and were able to exert influence on the Ministry of Health in the early 2000s, resulting in the first regulatory standards being established for the field” (Machado)
  • 2004-2008 – Major expansion of SAMU services
    • “In Rio de Janeiro, pioneer state in pre-hospital care provided by the Fire Department, the first regionalized SAMU of Brazil, named Metropolitan II, was installed in 2004 to service 7 municipalities and almost 2 million people.” (O’Dwyer, 2013)
  • 2009-Present: Implementation of stationary Emergency Care Units (UPA)
    • “A proposal currently exists to expand the SAMU to cover 100% of the population by 2018.” (O’Dwyer, 2013)
    • High degree of variation in the transition process from FD-based EMS to SAMU-192 strategy (O’Dwyer 2013)
    • 24hr/day, any location
      • Staffed by Physicians, Nurses, Nursing Assistants and Rescuers
    • 70 SAMU services established/operating in Brazil (Timerman, 357)
      • 320 towns in 22 states
• 2015, September – Emergency Medicine officially recognized as a specialty by Brazilian government

Lead Agency: SAMU 192 is overseen by Ministry of Health but is managed locally with varying levels of support and integration with regional and state authorities.

SAMU Legislation

• DECRETO Nº 5.055, DE 27 DE ABRIL DE 2004.
• PORTARIA Nº 2.657, DE 16 DE DEZEMBRO DE 2004 (Regulação Médica)
• PORTARIA Nº 1.010, DE 21 DE MAIO DE 2012. (Implantação do Serviço de Atendimento Móvel de Urgência)
• PORTARIA Nº 1.473, DE 18 DE JULHO DE 2013
• PORTARIA Nº 356, DE 8 DE ABRIL DE 2013

OTHER AGENCIES

• General Coordination of Emergency Services (CGUE)
• National Emergency Service Steering Committee
• Brazilian Cooperative Network for Emergencies (RBCE)

• Bloem C: “Emergency Medicine in Brazil.” American Academy of Emergency Medicine 2008;15(6):9-11.
• Cardoso RG et al: “Helicopter emergency medical rescue for the traumatized: experience in the metropolitan region of Campinas, Brazil.” Rev Col Bras Cir. 2014 Jul-Aug;41(4):236-44
• Machado CV, Salvador FGF, O’Dwyer G: “Mobile Emergency Care Service: analysis of Brazilian policy (O Serviço de Atendimento Móvel de Urgência no Brasil: uma análise da política nacional).” Revista de Saúde Pública 2011;45(3):519–528.
• Nielsen K, Mock C, Joshipura M, Rubiano AM, Zakariah A, Rivara F. “Assessment of the Status of Prehospital Care in 13 Low- and Middle-Income Countries.” Prehospital Emergency Care. 2012:10;16(3):381–9.
• Nogueira LC Jr et al: “Reducing Emergency Medical Service response time via the reallocation of ambulance bases.” Health Care Management Science. 2016 Mar;19(1):31-42
• O’Dwyer G et al: “Mobile prehospital emergency care: an analysis of implementation in the State of Rio de Janeiro, Brazil.” Ciênc. saúde coletiva 2016;21(7):2189-2200.
• O’Dwyer G, Mattos RA: “The SAMU, the regulation in the State of Rio de Janeiro and integral care according to managers of the three government levels (O SAMU, a regulação no estado do Rio de Janeiro e a integralidade segundo gestores dos três níveis de governo).” Physis 2012, 22(1):141–160.
• O’Dwyer G, Konder MT, Machado CV, Alves CP, Alves RP. “The current scenario of emergency care policies in Brazil.” BMC Health Serv Res. 2013;13(1):70.
• Ortiaga AM et al: “Evaluation of the Mobile Emergency Care Service in Santa Catarina State, Brazil.” Cad Saude Publica. 2016 Dec 15;32(12):e00176714
• Semensato G, Zimerman L, Rohde LE. “Initial evaluation of the Mobile Emergency Medical Services in the city of Porto Alegre, Brazil.” Arq. Bras. Cardiol. 2011;96(3):196–204.
• Tannebaum RD, Arnold JL, De Negri Filho A, Spadoni VS: “Emergency Medicine in Southern Brazil.” Annals of Emergency Medicine 2001;37(2):223-8.
• Timerman S, Gonzalez MMC, Zaroni AC, Ramires JAF: “Emergency medical services: Brazil.” Resuscitation 2006;70:356-9.