Air Ambulance Services in Poland

The use of aircraft for the transport of patients in Poland dates to 1924. At that time military aviation was expanded by sections of “sanitary” units dedicated to patient transport. The outbreak of World War II interrupted this undertaking until 1955, when sanitary transport was reactivated in a systemic way for civilians. A dozen or so teams were created, and in later years helicopters were also introduced. These units were controlled by regional authorities.

This form of sanitary aviation was maintained until 1999, when the Minister of Health Franciszka Cegielska established a new air ambulance unit within the Ministry of Health.

Currently the structure of Poland’s air ambulance service consists of 21 permanent helicopter EMS bases deployed all over Poland and one seasonal base for the summer in Koszalin. Moreover, the airport Fryderyk Chopin in Warsaw hosts an air transport team. The service (in Polish LPR) has 27 Airbus EC135/H135 helicopters and two Piaggio P.180 Avanti planes.

Within its statutory framework, the air ambulance service carries out the following tasks:

• Emergency medical services—Medical rescue operations (flights to the places of accidents and sudden illness);
• Air sanitary transport—Transport of patients requiring medical care between hospitals;
• Air medical transport from outside the country (i.e., transport to Poland of Polish citizens, victims of accidents or sudden illness that occurred outside Poland);
• Air medical transport outside the country.

Helicopters of the LPR perform about 9,000 missions annually. The HEMS crew includes a pilot, a paramedic/nurse, and a doctor. Since the inception of the LPR, its crews and aircraft have transported more than 113,000 patients.

HEMS Bases

In 2009 the air ambulance service changed out its fleet of helicopters. Worn-out Soviet Mil Mi-2 models were replaced with 23 Eurocopter EC135s. In 2015, thanks to EU funds, four more helicopters were purchased, making it possible to create four new bases in the country. This resulted in increased reach and availability and shortening the time to medical assistance reaching patients, including people injured in traffic accidents. More than 20% of all flights involve those wounded in road accidents.

The replacement of the helicopter fleet was accompanied by the construction of new ground infrastructure. As part of a 2007–2013 operational program, authorities modernized 10 HEMS bases and one technical service station. Upgrades include hangars, fuel stations, aprons, takeoff and landing spaces, and operational and social facilities. Designed with input from crews, the layout of the bases facilitates their functioning. With the helicopter apron, fuel station, and social-operational rooms are in immediate proximity, it is possible to regain post-rescue readiness to perform additional operations more quickly. Doctors and paramedics can restock missing medicines and equipment in the shortest possible time, and the pilots efficiently fill the fuel. 

In addition, the the project made it possible to introduce uniform operational standards to the bases, increase the efficiency of using modern helicopters, increase the availability of services offered, increase environmental protection, and secure the facilities and aircraft against access by unauthorized people. The total value of the project is almost $19 million U.S., 85% of which came from EU funds and the rest from the Ministry of Health. 

Expanding Capabilities

Operational capabilities have increased with the delivery of new EC135 helicopters, which have allowed coverage to extend overnight at some bases. Currently LPR has four 24-hour bases, nine that work regular hours from 0700 to 2000, and others that are on call from sunrise until sunset.

On July 31, 2008, a cooperation agreement was signed between the air ambulance service and the state fire service, regulating cooperation between the institutions and facilitating joint training, including the safety of night helicopter landing by PSP rescuers. This was one of the elements of preparation for the new fleet of helicopters.

In September 2011 a cooperation agreement was signed between the director of LPR and the president of the Mountain Volunteer Rescue Service to enable even better use of the new EC135s. The agreement allows the use of climbing techniques in rescues. A rope is attached to a special beam at the side of the helicopter, where the rescuer can be dropped to the injured directly from the helicopter’s deck. This allows the victim to be picked up and transported to a safe place. Thanks to this, it is easier to reach places that are inaccessible from the ground. Such cooperation is invaluable in mountainous regions.

Training

LPR puts a lot of emphasis on training its crews. A detailed training schedule for all crew members is prepared each year. A flight simulator—part of a 2008 agreement between the health minister and Eurocopter consortium—perfectly represents the EC135 cabin and is extremely useful in the training process.

Five times cheaper than using a real helicopter for training, this device allows training for situations that are too risky to be performed on a real helicopter. The aviation training center where the flight simulator is used has its own staff, which deals with the device’s technical service.

World Youth Day 2016

Four additional helicopters were directed to Krakow for World Youth Day in 2016. In addition to the permanent base functioning at the Kraków-Balice airport, a temporary base was created at the container haven in the Czyżyny area of Kraków. The helicopter emergency teams worked around-the-clock shifts to provide medical security adequate to the size of the ceremony. Two HEMS helicopters were redirected to the Częstochowa-Rudniki airfield to be on duty there.

In an emergency situation it was possible to call HEMS crews in the vicinity of Kraków to serve at neighboring bases. Collectively up to 11 machines could have appeared within 70 minutes.

The coverage was designed to take into account the safety of both residents and arriving tourists. A team of specialists working on security preparations included representatives of the LPR. The team monitored the availability of hospital beds, operating units, and intensive care units across 12 provinces in real time. If it was necessary to transport patients outside of the Małopolskie or Śląskie voivodships (administrative areas), a so-called “air bridge” was formed, enabling the use of both military and LPR aircraft.

For more on EMS in Poland: www.emsworld.com/article/219576. 

Robert Gałązkowski has been head director of the Polish LPR (Lotnicze Pogotowie Ratunkowe) since 2008. He is a lecturer at the Medical University of Warsaw and in 2018 became director of the university’s Paramedic Department. He’s also an assistant professor at in the Medical Rescue Department at the Siedlce University of Natural Sciences and Humanities. 

Robert Rajtar is a medical rescuer with 14 years of service experience in hospital emergency department and EMS teams in Poland and Germany. He is an employee of the provincial emergency service station in Szczecin (branch Myślibórz).