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01 May 2025 | Country Update
Reorganization plan for gynecology and obstetrics emergency departments
5.5. Emergency care
The INEM is the Ministry of Health’s organization responsible for the coordination and functioning of an integrated medical emergency system in mainland Portugal (Azores and Madeira have their own system). This system ensures the rapid and appropriate delivery of emergency care. The main tasks of the INEM include: providing medical aid at the scene; assisting transportation of patients to the appropriate hospital; and ensuring the coordination between the various participants in the system. Through the European Emergency Number (112) the INEM has at its disposal several means to respond rapidly and efficiently, at any time, to emergency care situations. To deliver effective medical care in the case of an accident or sudden disease, the INEM uses the following services: Urgent Patients’ Orientation Centre (Centro de Orientação de Doentes Urgentes, CODU); Urgent Patients’ Orientation Centre for Situations Occurring at Sea (Centro de Orientação de Doentes Urgentes-Mar, CODU-Mar); Anti-poison Information Centre (Centro de Informação Antivenenos); and a high-risk newborn transportation subsystem.
In practice, if a health emergency occurs, people should call 112, inform the operator about the situation and location and hang up when the operator tells them to do so. If it is a health-related emergency, the call will be passed on to the CODU, which has permanent medical assistance and central operators with specific training to receive the help request, manage the triage and advise before aid arrives and correctly select the adequate rescue means. At the same time, CODU prepares the hospital reception for the arrival of the patients. The CODU also has at its disposal various rescue means, including field communication and resources such as ambulances, catastrophe intervention cars and medical emergency helicopters. There is no fee paid by patients for these services. The National Authority for Civil Protection (Autoridade Nacional de Protecção Civil) and the Ministry of Interior have predicted an increase in rescue means and professionals in the INEM, along with better coordination with fire safety services that usually support the CODU’s actions in patient transportation and emergency rescue. This prompted a reorganization of the INEM’s activities, which allowed the creation of an integrated system of medical emergencies to ensure that the injured and victims of sudden disease receive ready and effective health care provision, namely through aid at the locale of occurrence, assisted transportation of victims to the hospital and the coordination between hospitals, as stated in the Organic Law of INEM (Decree-Law No. 34/2012, of 14 February 2012). Results show the increase of activity with 85 new emergency officers and 70 technical assistants with function at CODU; in addition, emergency resources were in action 1 196 563 times in 2015, accounting for a 5% increase compared with 2014. The years 2009–2014 were characterized by full coverage of continental Portugal by the CODU. The number of emergency calls decreased by 11.9% but the number of times INEM ambulances were called for duty increased by 44.7% during this six-year period (INEM, 2015). Transportation of patients, along with emergency unit activity (vehicles and helicopters) has also increased in a similar percentage range.
References
Portugal. Ministry of Health. Ordinance no. 325/2024/1, of 13 December. Diário da República n.º 242/2024, Série I de 2024-12-13. https://diariodarepublica.pt/dr/detalhe/portaria/325-2024-900079878
https://www.sns.gov.pt/noticias/2024/12/13/reorganizacao-de-urgencias-de-obstetricia-e-ginecologia