Natural disasters challenge for Emergency and Rescue Services- lessons learned Przemyslaw Gula MD PhD, Edyta Szafran Institute for Emergency Medicine. Krakow, Poland.

In the period 2008–2010 Poland experienced series of natural disasters including 3 large scales flooding, 2 periods of extremely high snowfalls followed by low temperature periods and finally local flush flooding in different locations. The time of each disaster elapsed from several days up to 6 weeks. All of them had severe impact on local infrastructure by destroying road systems, communication as well as healthcare and fire brigade facilities. The rescue efforts required evacuation, Search and Rescue operations, providing medical care and shelter. The most problems occurred in following areas: - large scale evacuation - collapse of communication systems (including 112 dispatch) - inadequate number of specialized rescue equipment (helicopters, vehicles, boats, snowmobiles, etc.) - providing EMS in affected areas - necessity of evacuating hospitals. The lessons learned showed the need for following changes: - strong trans regional coordination in means of facilitation of utilizing civil protection and military recourses - unification of operative procedures for all actors of the response operation - improvement of communication systems and reducing their vulnerability on environmental factors - establishing regional crisis management and control centers, covering the emergency response activities in affected areas - need of large-scale use of HEMS as well as Police and military helicopters in natural disasters - need for better supply in specialized rescue equipment including recue motorboats, 4 wheels drive recue vehicles and ambulances, snowmobiles, quads in local response units. The main rule of commanding the entire operation is subsidiary. Local coordinating structures should be supported by regional and central governments by supplying necessary recourses. However the operational command should be unified and include all participating units and organizations.