For doctors requesting transport

Medical air transport is carried out by:

1. Medical air rescue team during the day:

• a rapid track procedure R, ready to take off in 30 minutes
• a slow track procedure S, ready to take off in 30 minutes – with an agreement from the Director of the Department

2. Medical air rescue team during the night:

• a rapidtrack procedure R, ready to take off in 60 minutes
• a slow track procedure S, ready to take off in 60 minutes – with an agreement from the Director of the Department

3. Medical air transport team:

• a rapid track procedure R, ready to take off in 60 minutes
• a slow track procedure S

4. Medical air transport is carried out between health care centers.
5. Medical air transport using a rapid track procedure R is a flight carried out to help a patient in a sudden state, which requires intensive care during the flight, when delayed help might constite a threat to the patient’s life or health.
6. Medical air transport using a slow track procedure S is a planned ahead service of medical air transport, carried out by a medical air transport team in cases when the distance between the airports (registered in the “Aeronautical Information”) closest to the current and the target location of the patient exceed 250km (according to the road maps) or in accordance with signed agreements.
7. Medical air transport of patients, who are not in a sudden need of care, in cases when the patient is being transported to the facility allowing further treatment and there are no medical counter-indications, are to be carried out using the slow track procedure S. In these cases, the transport is only going to be carried out in accordance to Polish Medical Air Rescue capabilities. In special cases, medical air transport type S might be carried out by the medical air rescue team with and agreement from the Director of the Department.
8.  Medical air transport is carried out in the presence of a doctor or other medical staff.

The order for medical air transport is issued by the doctor taking care of the patient.

1. To be filled in block letters written order to fly, the currently existing printing (application form for transport DOCTORS).
2. Listed by ordering order for the flight has to be certified by the director of the prison or the authorized person, and faxed to the Operational Centre PMAR. If a hospital or other health care facility is not possible to send orders by fax may be adopted in order by PMAR by phone on a recorded line.
3. The original order to fly with an order for the further transport of the wheel should pass the team PMAR.
4.  Lack of these documents makes it impossible acquisition of the patient by a team PMAR.
5. The dispatcher or medical doctor PMAR can ask the doctor to ask for a copy of the results of laboratory tests and diagnostic imaging and card observation of hospital stay current and previous excerpts.
6. Organization of transport from the place of residence of the patient to the aircraft belongs to the Customer.
7. Each time the ordering physician air medical transport is obliged to take into account the balance of risks and benefits to the patient, and if in doubt contact the dispatcher medical PMAR doctor or the nearest branch or a subsidiary PMAR.
8. The final decision on the acquisition of a patient by a medical team PMAR take Doctor HEMS / EMS after the examination and hearing the patient’s condition.

1. The basis for accepting a medical flight request is a thoroughly filled out written request for a flight, on a valid form, issued by the person requesting it, certified by the director or an authorised person and sent via fax to the Polish Medical Air Rescue Operations Center. If a hospital or another medical facility can’t send a request via fax, it’s allowed to accept the request through a recorded phone call.
2. Original copy of the request and the request for further ground transport have to be handed on to the Polish Medical Air Rescue team.
3. Every time a doctor is requesting a medical flight, they have to consider the risk and reward ratio for the patient’s health. When in doubt, they should contact the medical dispatcher in Polish Medical Air Rescue Operations Center or a doctor from the closest Polish Medical Air Rescue branch or department.

1. The hospital or other medical facility requesting the medical air transport bears the cost of the direct use of the medical air transport teams in accordance with the Article. 161 d, paragraph. 5 of the Act of 27 August 2004 on health care services financed by the public funds. The costs include the cost of fuel, route charges and landing. The cost of the direct use of medical air transport teams includes:

• in case of transport operations carried out by a helicopter: flight departing from the start at the base and ending after the landing in the base after finishing the transport of a patient or a biological material used for the health services, which require special transport conditions,
• in the case of transport operations carried out by a plane: flight with a patient on board or with biological materials used for the health services, which require special conditions of transport.

2. Readiness of the team to carry out a medical air transport is financed is accordance with the Act of 27 August 2004 on health care services financed by the public funds from the state budget, from the part at the disposal of the Minister of Health.
3. Costs generated by the ground transport, ie. transportation between the hospital and the aircraft are to be covered by the Requester.
4. The amount and the rules of payment are regulated by the price list approved by the Director of Polish Medical Air Rescue. Information about the cost can be given by the dispatcher of the Polish Medical Air Rescue Operations Center.

1. The doctor requesting the transport, or another doctor appointed by him, is required to prepare the patient for the medical air transport. Detailed instructions may give the medical dispatcher or a doctor from the Polish Medical Air Rescue.
2. Required documents for the medical air transport:

• written request for the flight, on a valid form, signed and stamped by a doctor
• written request for the ground transport, signed and stamped by a doctor (if there’s a need for such transport)
• patient’s personal documents
• patient’s medical documents, properly secured against damage
• referral to the hospital.

3. Medical procedures (recommendations):

• securing the peripheral vein puncture and possibly central arterial lines, drains, catheters, drainage;
• pneumothorax drainage; change from an active drain a to passive;
• reducing the number of infusions with infusion pumps to a maximum of two;
• setting up new tanks for a gastric probe, a catheter for the bladder, the stoma;
• draining the fluids from the respiratory tract (if necessary);
• inspecting bandages and putting on new bandages;
• immobilising fractures;
• ending the infusion of antibiotics and other substances that are not applied in a continuous infusion in order to maintain vital functions;
•  performing laboratory tests (glucose, electrolytes, blood gases, morphology) – in justified cases, on patients with impaired glucose metabolism, fed parenterally, premature infants, newborn children;
• leaving a patient on an empty stomach for at least 2 hours before the scheduled flight.

4. Polish Medical Air Rescue reserves the right to order or perform medical procedures to prepare the patient for transport in the place of pick up.
5. In cases of transport of a patient who receives medication not included in the standard Medical Manual of Polish Medical Air Rescue, the Requester is responsible for providing the patient with a medicine for the duration of the transport.
6. Polish Medical Air Rescue strives to transport a patient requiring intensive care in the “bed-to-bed” system.

1. For a medical air transport with an incubator qualified are premature babies and infants born on time with a mass not exceeding 5000 grams.
2. Medical air transport of preemies and newborns is performed only by the HEMS/EMS teams with a transport incubator. Polish Medical Air Rescue has 4 incubators on its disposal.
3. Incubators are prepared for continuous operation.
4. Transfer of preemies and newborns takes place in the medical facility from which they are taken.
5.  Transport rescue team with a transport incubatort to and from the medical facility is the responsibility of the Requester. This does not apply to the cooperation with the “N” teams (neonatal carriages).

1. EMS team characteristics :

• ready to take off in 60 minutes;
• radius of operations up to 1000 km;
• medical facilities: ALS standard , transport monitor (ECG, NIBP, 2xIBP, SaO2, EtCO2, T), transport incubator;
• crew: two pilots, paramedic (EMT or nurse), physician;
• operating timed – 24h;
• aircraft: Piaggio 180 Avanti .

2. HEMS team working on a medical air transport characteristics:

• ready to take off up to 30 minutes;
• radius of operation up to 130km;
• medical facilities: ALS standard;
• crew: pilot, paramedic (EMT or nurse), physician;
• operating time – 24h (Warsaw, Gdańsk, Wrocław, Kraków), 7:00 – 20:00 (Olsztyn, Szczecin, Poznań, Białystok, Lublin), from sunrise to 30 minutes before sunset, or from 7:00 to 20:00 (other bases);
• aircraft: EC 135.

Situations not qualifying for a medical air transport:

1. patients expected to not survive the transport;
2. patients with a sudden cardiac arrest;
3. patients in the II phase of childbirth;
4.  patients who might be a danger to the transport team.

1. Requests might be denied by the Polish Medical Air Rescue Operations Center dispatcher, on the basis of:

• medical report;
• operational situation;
• incompatibility with previous agreements and the Organisational Regulations of the Polish Medical Air Rescue.

1. Information about the disqualification is send in writing to the Requester by the Polish Medical Air Rescue Operations Center dispatcher.
2. The Requester has the right to appeal, in writing, against the request denial to the Polish Medical Air Rescue Director.