EMERGENCY MEDICAL AND AMBULANCE SERVICES IN BRAZIL

AT-A-GLANCE

DIAL 192 TO CALL AN AMBULANCE IN BRAZIL

  • The past 10 years has seen a rapid expansion of the public EMS systema, “SAMU 192,” now active in all Brazilian states with 175 call centers covering 1,955 municipalities — approximately 65% of Brazil’s total population
  • The government’s goal is to provide access to SAMU 192 for 100% by 2018
  • There is a substantial and growing presence of private sector EMS providers, largely for transfers and subscription-based emergency care at home (Phone numbers listed below)
  • Despite successes of SAMU 192, there are still high rates of transport to hospital via private vehicle across the country

EMS Coverage Map - Brazil
EMS Coverage Map: Brazil

Return to the Global EMS Database home page

HOW CAN I CALL AN AMBULANCE IN BRAZIL?

HOW DO I CALL FOR HELP?

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

CAN I CALL FOR HELP ANYWHERE?

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.

WHAT OTHER EMERGENCY NUMBERS CAN I CALL?

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

BAHIA

Salvador

Vitória da Conquista

  • Ultravida Ambulâncias: +55 77 3429-6000

CEARÁ

Caucaia

Fortaleza

DISTRITO FEDERAL (BRASILIA)

Guará

Riacho Fundo I

Saa Qd 1

Sobradinho

Taguatinga

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

ESPIRITO SANTO

Guarapari

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

Serra

Vila Velha

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

Vitória

GOÍAS

Goiânia

MARANHÃO

São Luis

MINAS GERAIS

Belo Horizonte

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

MATO GROSSO DO SUL

Campo Grande

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

Dourados

MATO GRASSO

Cuiabá

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

PARÁ

Belém

Marabá

  • LEX Ambulância: +55 94 3322-2604

PARAÍBA

Campina Grande

João Pessoa

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

PARANÁ

Curitiba

Pinhais

Ponta Grossa

Toledo

Umuarama

  • Same Ambulância: +55 44 3622-2727

PERNAMBUCO

Petrolina

Recife

São Lourenço da Mata

  • Disk Ambulância: +55 81 3525-0555

PIAUÍ

Teresina

RIO DE JANEIRO

Barra de Tijuca

Belford Roxo

Benfica

Campo Grande

Grajau

Niterói

São Cristóvão

Taquara

Vila Isabel

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

Porto Alegre

RORAIMA

Porto Velho

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

SANTA CATARINA

Blumenau

Criciúma

Florianópolis

Itajaí

Joinville

São João

São José

São Pedro de Alcântara

SERGIPE

Aracaju

SÃO PAULO

Barra Funda

Bela Vista

Bom Retiro

Brás

  • Dez Emergências

Brooklin

  • JP-Salva

Campinas

Campos Elíseos

Casa Verde

Cruzeiro

Jd Cruzeiro

Osasco

Pinheiros

Santos

São José dos Campos

Taubaté

Vila Bertioga

Vila Carrao

Vila Formosa

AIR AMBULANCE IN BRAZIL

WHAT ABOUT IN DISASTERS?

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

ARE THE RESPONDERS TRAINED?

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

HOW WILL I BE TRANSPORTED?

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.

WHERE WILL I BE TRANSPORTED TO?
HOW WILL I PAY?

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

ADDITIONAL INFO

COMMON EMERGENCIES AND VACCINATIONS

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)

GOVERNMENT OVERSIGHT

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

OTHER AGENCIES

  • General Coordination of Emergency Services (CGUE)
  • National Emergency Service Steering Committee
  • Brazilian Cooperative Network for Emergencies (RBCE)
HISTORY OF AMBULANCE SERVICES IN BRAZIL

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
REFERENCES
  • 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.
LINKS

SCOREBOARD

Road Traffic Injury Deaths
(per 100,000 population)

  • Brazil
  • Russia
  • United States

[Source: 2015 Global Status Report on Road Safety, WHO]

Reported Homicides
(per 100,000 population)

  • Brazil
  • Russia
  • United States

[Source: 2014 Global Status Report on Violence Prevention, WHO-UNDP]

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