EMS in Poland is public and financed by the government. Ambulance services, together with hospital ER's and emergency dispatch centers, form the integrated system of emergency medical rescue. Emergency call number is 999 or 112.
Ambulance services in majority are operated by publicly-funded agencies, and are either independent or, in smaller towns, attached to hospitals. A number of stations is contracted and run by private companies.
Ambulance types:
-Specjalistyczny (Specialistic). Crew: doctor, 2 paramedics (interchangable with EMS nurse; typically nurse + paramedic), optionally driver. National regulations allow for a 3-crew type 'S' ambulances but most ambulance services retain the driver. Basically an ICU on wheels, these ambulances are supposed to respond to most serious calls.
-Podstawowy (Basic)
two paramedics (or paramedic and nurse) and a driver (also optionally). Dispatched mostly to non-life threatening calls, although when there's no 'S' ambulance available in the area (which is often), paramedics are dispatched to all kinds of calls. Medical direction is unavailable to the paramedics in most of Poland, so we're all on our own there. In need, 'S' ambulance or HEMS may be called to support the paramedic crew.
Proportion of P to S ambulances averages between 4/1 to 1/1 in some areas.
-HEMS. Crew: pilot, doctor and paramedic/nurse. Currently re-equipping from old Mi-2 Plus helicopters to EC-135. Operates from 17 bases all over Poland, additional bases are planned to be opened soon. HEMS responds to serious emergency calls but also transports critical patients between hospitals.
- Transport ambulances - provided mostly by private companies. Crew and equipment varies depending on what kind of transports they do. This may range from ambulances in full 'S' or 'P' standard together with the ability to use sirens, to the van with a single untrained driver and seats only.
Ambulance crew:
- EMS doctor. 6 years of study, then 5 years of specialisation in either: emergency medicine, anesthesiology, surgery, internal diseases, orthopedics or pediatrics.
- Ratownik Medyczny (paramedic).
Education is either:
- paramedic school - 2 years (2100hrs), of which one semester is internship in ambulance services, ER, ICU, operating ward, EMS dispatch centre and fire departments.
- BA degree in paramedic science - 3 years, 2100hrs of profession-related material (+ another 1700hrs of unrelated, useless crap).
Education ends with national exam. Skills and competences are equal for both ways of becoming a paramedic.
Competences:
- assessing patient's condition and deciding on appropriate action.
- advanced airway management: LM, LT, intubating patients in cardiac arrest, cricothyrotomy
- IV, IO
- 12 lead ECG
- manual defibrillation
- needle decompression of tension pneumothorax
- fracture immobilsation and spinal care
- oxygen
- administering drugs: aspirin (p.o.), amiodarone, atropine, clemastine, clonazepam, diazepam, drotaverine, epinephrine, flumazenil, furosemide, glucagon (i.m.), glucose 5%, glucose 20%, nitroglycerin (s.l.), hydrocortisone, magnesium, ketoprofen, lidocaine, metoclopramide, morphine, naloxone, NS, multi electrolyte solution, salbutamol (inhalation), Ringer's solution.
Competences under doctor's supervision:
-intubating patients other than in cardiac arrest, using paralytics; cardioversion and electrostimulation; assisting at minor surgery (suturing, inserting drains); inserting stomach tube, stomach lavage; inserting urinary catheter; administering all other drugs.
- EMS nurse.
Education takes 3 years of university study (BA degree), then 2,5 years of specialisation in: emergency medicine, anesthesiology, surgery, cardiology or pediatrics. Or a short 'qualification course' in one of the above after 3 years of experience in the EMS.
EMS nurse has competences equal to paramedic.
- EMS driver.
No specific education is required. Most of ambulance drivers are trained in BLS and assisting medical crew. Some are certified paramedics themselves.
Ambulance services in majority are operated by publicly-funded agencies, and are either independent or, in smaller towns, attached to hospitals. A number of stations is contracted and run by private companies.
Ambulance types:
-Specjalistyczny (Specialistic). Crew: doctor, 2 paramedics (interchangable with EMS nurse; typically nurse + paramedic), optionally driver. National regulations allow for a 3-crew type 'S' ambulances but most ambulance services retain the driver. Basically an ICU on wheels, these ambulances are supposed to respond to most serious calls.
-Podstawowy (Basic)
two paramedics (or paramedic and nurse) and a driver (also optionally). Dispatched mostly to non-life threatening calls, although when there's no 'S' ambulance available in the area (which is often), paramedics are dispatched to all kinds of calls. Medical direction is unavailable to the paramedics in most of Poland, so we're all on our own there. In need, 'S' ambulance or HEMS may be called to support the paramedic crew.
Proportion of P to S ambulances averages between 4/1 to 1/1 in some areas.
-HEMS. Crew: pilot, doctor and paramedic/nurse. Currently re-equipping from old Mi-2 Plus helicopters to EC-135. Operates from 17 bases all over Poland, additional bases are planned to be opened soon. HEMS responds to serious emergency calls but also transports critical patients between hospitals.
- Transport ambulances - provided mostly by private companies. Crew and equipment varies depending on what kind of transports they do. This may range from ambulances in full 'S' or 'P' standard together with the ability to use sirens, to the van with a single untrained driver and seats only.
Ambulance crew:
- EMS doctor. 6 years of study, then 5 years of specialisation in either: emergency medicine, anesthesiology, surgery, internal diseases, orthopedics or pediatrics.
- Ratownik Medyczny (paramedic).
Education is either:
- paramedic school - 2 years (2100hrs), of which one semester is internship in ambulance services, ER, ICU, operating ward, EMS dispatch centre and fire departments.
- BA degree in paramedic science - 3 years, 2100hrs of profession-related material (+ another 1700hrs of unrelated, useless crap).
Education ends with national exam. Skills and competences are equal for both ways of becoming a paramedic.
Competences:
- assessing patient's condition and deciding on appropriate action.
- advanced airway management: LM, LT, intubating patients in cardiac arrest, cricothyrotomy
- IV, IO
- 12 lead ECG
- manual defibrillation
- needle decompression of tension pneumothorax
- fracture immobilsation and spinal care
- oxygen
- administering drugs: aspirin (p.o.), amiodarone, atropine, clemastine, clonazepam, diazepam, drotaverine, epinephrine, flumazenil, furosemide, glucagon (i.m.), glucose 5%, glucose 20%, nitroglycerin (s.l.), hydrocortisone, magnesium, ketoprofen, lidocaine, metoclopramide, morphine, naloxone, NS, multi electrolyte solution, salbutamol (inhalation), Ringer's solution.
Competences under doctor's supervision:
-intubating patients other than in cardiac arrest, using paralytics; cardioversion and electrostimulation; assisting at minor surgery (suturing, inserting drains); inserting stomach tube, stomach lavage; inserting urinary catheter; administering all other drugs.
- EMS nurse.
Education takes 3 years of university study (BA degree), then 2,5 years of specialisation in: emergency medicine, anesthesiology, surgery, cardiology or pediatrics. Or a short 'qualification course' in one of the above after 3 years of experience in the EMS.
EMS nurse has competences equal to paramedic.
- EMS driver.
No specific education is required. Most of ambulance drivers are trained in BLS and assisting medical crew. Some are certified paramedics themselves.