Andrea Bernardes

University of Sao Paulo, Brazil

Title: Pre-hospital care service in Brazil: Policies and advances


Andrea Bernardes is a registered nurse and obtained Ph.D. from the College of Nursing at Ribeirao Preto, University of Sao Paulo, Brazil (USP-RP). She is currently a faculty member in the Department of General and Specialized Nursing. She has completed her Ph.D. in 2005 from University of Sao Paulo in Brazil and postdoctoral studies in 2010 from University of Alberta in Canada. She is a researcher in the nursing management and emergency fi elds. She is a member of the Health Human Resources Observatory and has published several articles, contributed to chapters in published books in Brazil and presented at numerous conferences and symposia.


Law nº8080 (1990) regulates the Unifi ed Health System in Brazil and deals with the conditions for promotion, protection and recovery of health, as well as the organization and functioning of health services. Aft er that year, some services began to be organized, aiming to assist the victims of health problems outside the hospital environment; therefore started the Pre-Hospital Care Service. Based on the model idealized in France, was created the Mobile Emergency Service in Brazil (SAMU-192), whose pioneering cities were Ribeirao Preto and Porto Alegre. Despite the advances proposed by the legislation, few changes were observed during this period. However, several decrees were created in order to organize this system. In 2002, the "Decree GM/ MSnº2048-Technical Regulations of the Emergency State System" was published, which gives technical guidelines for non-hospital emergency units, inter-hospital transportation, and general guidelines for a regionalized network of care for emergencies. In the years that follow the publication of this decree, emergency becomes a priority in Brazil. But there was still the need to ensure integral care, or, to ensure access to patients from primary care to higher complexity services. A landmark to reach integral care was the Decreenº.4.279/GM/MS(2010), which prioritizes the organization and implementation of Health Care Networks, having as main guidelines the classification of risk, quality and resolution in care. Th us, Brazil has used strategies to achieve integral care and has invested in improving the quality of care in emergency are whose demand has increased greatly.

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