Poland

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General

Capital – Warsaw

Land Size – 312,685 sq km

Population – 38,463,689

Language(s) – Polish 97.8%, other and unspecified 2.2% (2002 census)


Wroclaw, Poland – Decommissioned ambulance; © Maciej Kielan – Flickr, with permission


Prehospital Care


Overview


History

  • “Kraków has one of the oldest civil municipal ambulance stations in the world (the third after Vienna and Budapest) founded in 1891” (Hladki, 216)
  • “A first responder service based on ambulance teams, Helicopter Emergency Medical Services and emergency departments has been functioning since the end of World War II in co-operation with the State Fire-fighting service” (Hladki, 214)
  • State Emergency Care and Fire-fighting System (SECAFS)
    • Created in 1995 to standardize rescue functions formerly carried out by State FD
    • Coordinates rescue functions at catastrophes and natural disasters (in cooperation withother emergency management agencies and responders)
  • 1999 – Formation of “uniform, integrated and modern Polish emergency medical care system … to improve the rescue service under SECAFS guidelines” (Hdalki, 215)
    • Main priorities:
      • Improvement of emergency patient transport
      • Decrease in deaths during prehospital care
      • Reducing transport times
  • 1999 – 2002 – “Integrated Emergency Care” program
    • Provision of adequate number of ambulances to provide response times w/in 9min (urban) or 15mins (rural) in at least 50% of cases
      • Required total of 1,140 ambulances for entire country
    • Creation of 130 dispatch centers
    • Building of 278 emergency departments (1 ED/150,000 inhabitants) and 16 pediatric EDs


EMS System Model

  • Anglo-American and Franco-German elements
  • Prehospital/Ambulance service provided by EMS branch of SECAFS
    • Prehospital staff include MDs, RNs and Paramedics
    • “Currently all fire-fighters are licensed paramedics” (Hladki, 214)


Lead Agency

  • State Emergency Care and Fire-fighting System (SECAFS)


Nysa, Poland – ZSD Nysa ambulance (military); © Phillip J. Simpson – Flickr, with permission


Funding

  • “Emergency medical care is 99% state-financed” (Hladki, 214)


Levels of Care

  • Ambulance types – distinguished by letters painted on vehicle body
    • “Generally, ambulances are stationed in ambulance bases collocated with hospital emergency departments, in ambulance stations outside hospitals and in fire-fighting units” (Hladki, 216)
    • “R” – Resuscitation Ambulance
      • Used for life-threatening conditions
      • Staffed by:
        • MD (Emergency medicine specialist, anaesthesiologist or internist in specialty emergency medicine training), paramedic and emergency nurse OR
        • 2 Paramedics and an ambulance driver
    • “W” – Accident Ambulance
      • Also called “primary ambulance”
      • Dispatched where Resuscitation ambulances are not necessary or otherwise unavailable
      • Staffed by:
        • MD and emergency nurse/paramedic (who are specifically licensed for rescue interventions)
        • Team may exclude doctor
      • Equipment on “R” and “W” ambulances are “nearly identical” (Hladki, 216)
    • “P” – Transport Ambulance
      • Transports patients not requiring prehospital interventions or blood transfusions
      • Staffed by:
        • Paramedic and driver (since 2007, without doctor)
    • “N” – Neonatal Ambulance
      • Transports neonates and infants


Education & Training

  • “Since 2002, undergraduate courses have been run for paramedics in medical universities and colleges” (Hladki, 215)
    • BLS/AED
    • ILS, ALS, EPLS/PALS, BTLS/ATLS


Medical Direction


Specialty Services

  • HEMS
    • Separate from EMS branch, subordinate to Minister of Health
    • 16 permanent bases & 2 seasonal
    • 18 Mi-2puls helicopters (rescue)
  • Additional motorcycle response vehicles with paramedic available in some cities
  • Additional emergency services provided by SECAFS
    • Marine S&R
    • Mining Rescue Service
    • Police
    • Border Guard
    • Vol. Mountain S&R
    • Vol. Water Rescue Service
    • Polish Red Cross
  • “International Championships in Emergency Medical Care and Road Rescue are organised annually in Poland providing opportunities to improve rescue skills” (Hladki, 215)


Dispatch & National Emergency Telephone #s

  • 999; 998; 112
  • Dispatch centers run by SECAFS
    • Total of 155 centers
  • Provide courses for medical dispatchers


Emergency Medicine & Emergency Care

  • Recognized as specialty in 2000
  • SECAFS – Emergency Care
    • 11 hospitals, “10 of which are owned by the Ministry of Interior Affairs and Administration” (Hladki, 214)


Disaster


References


Links

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