Rescue Service in Europe: Poland

Rescue service in Europe: System of medical rescue in Poland

History

A group of doctors in Kraków / Cracow, with the support of local councillors, organised the first rescue service in Poland in 1890 following several dangerous fires. Students of higher semesters of the medical faculty of the Jagiellonen University actively worked as volunteers in this service. Thus, the „Krakowskie Ochotnicze Towarzystwo Ra-tunkowe / Voluntary Rescue Society in Kraków / Cracow" originated, which began its activity on 6 June 1891. This date is seen as the date of origin of the first rescue service in Poland.

In the 90s of the 20th Century the existing stations of the State Rescue Service were converted into “Independent Public Departments of the Health System”. New private medical companies also emerged which work within the framework of the system of rescue services.

Since 1997 the rescue and extinguishing units – which are united within the framework of the system of rescue and extinguishing services of the country – have also been working in the field of medical rescue services: State and volunteer fire services as well as the company fire services.

Legal base

The system “Państwowe Ratownictwo Me-dyczne / State Medical Rescue Service” (PRM) is currently being formed for the purpose of guaranteeing the efficient and effective realisation of the responsibility of the state to initiate medical rescue activities for each person for whom there is a risk to his life and health. Its organisation is regulated in the initiated “Law Governing the State Medical Rescue Service”. The previously existing rescue units are being reorganised in accordance with the requirements of the law.

Organisation

At present the system “State Medical Rescue Service” is undergoing a phase of organisation.

The following services are to be named finally:

1. Central emergency department (CPR)
2. Teams of the medical rescue service
3. Rescue departments in the hospitals (SOR).

Organisational units of the system

Central emergency departments

At present the network of the central emergency departments is undergoing a phase of introduction. The tasks of the central emergency departments are currently assumed by the control stations of various services, frequently the units of the state fire service.

The objective is for the central emergency department (CPR) to become an integrated control station of all rescue services, which records and selects reports about dangerous situations for life, health, assets or the environment, sends necessary information to first aid services, but also is to be dispose of all services of the system of rescue and extinguishing services of the country (state fire service) and of other services and systems for promoting rescue services.

At present, the nationwide emergency number of the rescue service 999 or also the European number 112 can be dialled from the fixed-line telephone network. Only the European number 112 can be reached from mobile networks. The number 112 is a new number which functions together with the already existing numbers 999 (rescue service), 998 (state fire service) and 997 (police). The direct call to the services, from which help is expected, substantially reduces the response time. The number 112 should then be called if the danger cannot be identified or in case the situation requires the intervention of several services (e.g. road accident).

The objective is that the tasks of the central emergency departments in conjunction with the medical rescue service are to be performed by medical managers who have at least a middle school education in the professions nurse, midwife or emergency medical technician and who have completed training at the place work within the meaning of a certain programme.

Groups of the medical rescue service – types and demands from the personnel

The following groups of the medical rescue service operate within the framework of the system “State Medical Rescue Service”:

Reanimation groups – “R”, also includes newborn and paediatric groups – “N"

• Doctors
  Specialist for rescue medicine or specialist for anaesthesiology and intensive care therapy or a doctor, who is just training in specialisation in the field of rescue medicine or anaesthesiology and intensive care therapy, after at least two years of specialisation or a surgeon or paediatrician or doctor for internal diseases or an accident surgeon or an accident surgeon of the musculoskeletal system Nurses
• Rescue service nurse or nurse in anaesthesiology or surgery or paediatrics or a nurse with a completed qualification course in the field of rescue services or in the field of anaesthesiology and intensive care therapy, who has at least three-year practical experience in such specialist departments or in specialist departments for internal diseases or in specialist departments for first aid or also in the emergency department or in the rescue service.
• Emergency medical technicians
• Drivers
• other requirements: the group principally consists of four persons

Accident groups “W”

• Doctors
• Specialist for rescue medicine or a doctor with authorizations, determined for doctors in the groups “R”
• Nurses
• Nurses, specialised in the field of rescue service nursing or a nurse, who has the authorizations, required for nurses in the groups “R” or an emergency medical technician.
• Drivers
• Other requirements: The group principally consists of three persons.

Groups of air rescue “RL”

• Doctors
• Rescue doctor or a doctor, who is training in a specialisation in the field of rescue medicine – after at least two years period of this specialisation, a doctor with a specialisation of at least grade I in the field of anaesthesiology and intensive care therapy, general surgery, paediatric surgery, internal diseases or paediatrics.
• Nurses
• Rescue service nurse or a nurse, who has the authorizations for nurses in the groups “R” or an emergency medical technician;
• Other
• Person with authorization to control and to operate an aircraft, based on separate regulations, who has at least been trained in first aid.

Rescue departments of hospitals

A rescue department in a hospital (SOR) is an organisational unit of the hospital, which provides health services 24 hours a day on seven days a week, admits patients and undertakes medical rescue surgery.

At present, the doctors on duty of the respective hospital departments form the medical staff of the SOR. The planned objective is to employ a specialist in internal medicine, a surgeon, an anaesthetist and a doctor of rescue medicine full time. The requirements from the nursing personnel are analogue – specialisation in rescue service nursing.

Air rescue

In 1999, the Ministry for Health created the helicopter squad as a service of the medical rescue service HEMS (Helicopter Emergency Medical Service) and formed an organisational unit with the name “Independent Public Work of the Health Protection Air Rescue”. The created service, directly financed by the Ministry for Health, forms a uniform structure, consisting of 15 regional HEMS bases and four transport groups. Doctors and emergency medical technicians work at each HEMS base: The two helicopters were equipped with medical appliances and medication, which are required for assistance in case of risk to life and health in road accidents or other incidents or in case of assignments with acute diseases.

Financing

The pre-hospital health services, provided within the framework of the medical rescue activities, are financed from parts of the state budget. The basis is contracts, which were concluded with the administrators of the units (groups of medical rescue service). The services of the groups of the medical rescue service are remunerated in the form of flat rates for whole day on call duty. The transports carried out by the units of air rescue by order of the units of the health service are financed within the framework of the general health insurance.