Lithuania: Ambulance and Emergency Medical Services

DIAL 112 TO CALL AN AMBULANCE IN LITHUANIA

Historically, emergency services were accessible through three distinct numbers:

• Dial 01 for Fire and Rescue Services
• ŸDial 02 for Police
• Dial 03 for Ambulance Services

GROUND AMBULANCE IN LITHUANIA

AIR AMBULANCE IN LITHUANIA

An ambulance in Lithuania is typically staffed by two or three persons of different training and skill levels, including physicians, nurses (“feldsher”) and paramedic/driver. In bigger cities, licensed specialist physicians are often employed in private ambulance services.

In rural areas, ambulance teams typically consist of:

• Nurse/Feldsher, (“Field Barber”) are nurses qualified to perform certain medical procedures
• Paramedic/Driver – The Ministry of Health has developed a national standard for paramedics in ambulance service including medical competence requirements

GROUND AMBULANCE IN LITHUANIA

In 2008, there were reported Ÿ63 EMS stations nationwide, staffed by 265 day teams and 210 night teams. The Ministry of Health has set response times goals of 15 minutes in urban systems and 30 minutes in rural systems.

Hospital bypass policies were not operated, with patient info provided to dispatch center but patient usually transported directly to nearest hospital. ŸMobile intensive care units (MICUs) are also available for inter-facility transport

AIR AMBULANCE IN LITHUANIA

Ÿ“In general only ground ambulances are available” (Vaitkaitis 2008)

• The Air Force, which has helicopters, can participates in search and rescue operations as well as for donor organ transplantation. These helicopters are staffed by medical crews with ALS level training
• The need for a more robust helicopter service is debated because country is mostly low-lying with hospitals usually within a 50km radius

The majority of the country’s hospitals serve populations of less than 60,000, resulting in “insufficient case load to maintain full emergency services… [and] until 2005 there was no national system for in-hospital organization of emergency departments” (Vaitkaitis, 331)

In the past few years, the ŸMinistry of Health has set requirements for emergency departments, but the majority are still only able to carry out functions of admission/registration before passing patients on to specialists where emergency care is typically provided on wards and ICU. For example:

• Resuscitation patients are referred to intensive care
• Trauma patients are referred to surgery
• Urgent case are referred direct to operating theater

Acute specialists do provide consultation in the emergency departments  but consultations with different specialists remains the standard and can be time-consuming

One hospital (Kaunas Univ. Hosp.) meets international criteria for Level I trauma center, but specialties needed in one hospital for trauma care are often spread between multiple hospitals resulting in increased inter-facility transfers.

Common Emergencies in Lithuania

• Floods

Vaccinations for Lithuania

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

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

Read more about travel in Lithuania at the CDC website: https://wwwnc.cdc.gov/travel/destinations/traveler/none/lithuania (Last accessed: Aug. 7, 2017)

2002 – Standards for EMS system were adopted by Ministry of Health, known as “Concept of Ambulance Services”, which required changes in the whole country’s EMS systems, including:

• Re-equipment of ambulances
• Establishing paramedics
• Developing emergency departments at hospitals

Emergency medical and ambulance services are overseen by the Lithuanian Ministry of Health.

• Dambrauskas Ž et al: “How the changes in the system affect trauma care provision: The assessment of and implications for Lithuanian trauma service performance in 2007-2012.” Medicina (Kaunas). 2017;53(1):50-57.
• Lunevicius R, Rahman MH: “Assessment of Lithuanian trauma care service using a conceptual framework for assessing the performance of health system.” European Journal of Public Health. 2012;22(1):26-31
• Marozas R et al: “The ability of Lithuanian ambulance services to provide first medical aid in trauma cases.” Medicina (Kaunas). 2007;43(6):463-71.
• ŸVaitkaitis D: “EMS Systems in Lithuania.” Resuscitation 2008;76:329-332.