I became a paramedic in 2000 and one year later, I started working on an emergency ambulance (“R” class in Poland). My colleague Dr. Piotr Kołodziej and I often thought about how much more convenient it would be to use motorcycles to get to patients in a more timely manner.
In 2002, Piotr made a friend at the local Harley Davidson dealer who donated a Harley Davidson Dyna Super Glide T Sport for a three-month trial with Gdansk (Poland) EMS.
To get the motorcycle into service, we had to improvise many things that are standard on an EMS motorcycle today. We painted the regular white fog lights blue to make the emergency lights, we found a secondhand siren that we affixed to the bike that was much larger than it should’ve been—since it was meant for a car—and we didn’t have proper motorcycle clothing, only an old helmet I had laying around.
It was my first time riding such a big motorcycle. Until that time, my experience was riding small 350cc motorcycles. We didn’t have a proper rider training program, so it was basically just “get on and go.” My first ride on this big bike was with a passenger who was filming the experience for a local television station.
For this first trial period, we rode with two emergency personnel on the bike: a paramedic and an EMS doctor. Our EMS Harley was equipped with all the equipment found on a high-level “R” class ambulance, except the stretcher and the infusion pump. With the equipment, two large riders and the bike, it was about half a ton moving through the city streets in traffic with improvised lights and siren.
We decided to continue the program for a second year with a few changes. The bike would only have one emergency responder—either a paramedic or doctor who was comfortable riding a bike—and we upgraded the improvised lights and siren to something with better visibility and sound. It was easier to maneuver through traffic, but working alone was a totally different experience than anyone was accustomed to.
In 2003, our MRU participated in the Polish National EMS Competition and we finished with a respectably good standing, proving to the Polish EMS community that and EMS bike does have a place in EMS services in Poland.
After we met with our Hungarian colleague through IMRUA who was riding a new Honda ST1300, I decided that the future of the Gdansk MRU was going to be on a similar type of bike. It handled well, was comfortable and could store more equipment.
In 2012, we realized that goal by finding sponsors. With some money and support from the local EMS service and from the sale of the Harley, Gdansk EMS acquired a new Honda ST1300. After two years one of the city council politicians found funding for a second Honda ST1300, which now makes up the full fleet of Gdansk EMS MRUs.
Gdansk MRU Operations
There are now nine motorcycle paramedics in Gdansk. The Gdansk MRUs operate from the beginning of June to the end of August. In 2018, we hope to operate from the beginning of May to the end of September. Between June 1 through August 31, two motorcycles are on duty every day during daylight hours.
In Poland, there are four professional MRU teams, with two new teams starting this year for a total of six in various cities around Poland. If the Polish government enacts a proposed EMS law, all communities with a population of 200,000 or more will be required to have one MRU in operation from May 1 through Sept. 30 starting in 2018, and all communities with a population of 400,000 or more will have at least two units in operation during that same timeframe.
I began my service in EMS and Fire at the tender age of 16. That makes it more than 25 years now of responding to the tones. I’ve worked in myriad roles: volunteer first aid, EMT, paramedic, firefighter, beach lifeguard, air ops, boat ops and as an emergency physician on a fast motorcycle response unit (MRU) in Hungary—by far my favorite job.
Quick response motorcycles offer an efficient and highly effective platform for both EMS and fire departments whose present resources are stretched too thin due to increasing call volumes and stagnant budgets. More than half the countries on the planet utilize two-wheeled vehicles in some fashion to respond to emergencies.
Hungary was the first country worldwide to mount emergency physicians on very well-equipped fast response motorcycles that quickly worked their valuable way to the top of a tiered EMS system.
In addition to working on the MRU, I’m also the president and founder of the International Fire and EMS Motorcycle Response Unit Association (IMRUA), a trade organization working on improving the working environment of MRUs around the world and increasing awareness of this very effective, efficient form of EMS and fire response.
A Memorable Call
One of my most memorable experiences from my years of service in an MRU occurred August 2016 during my last shift of the season just outside of Budapest, Hungary.
It was an uneventful and rather boring shift that was about to end when I was dispatched at the last minute to a cardiac arrest located over 12 miles away in gridlocked traffic. And as it goes, it was a poorly marked building with the patient on the second floor, all the way in the back of the building. I made it to the scene and took all my equipment up to find the crew of a BLS unit doing CPR. I made a quick assessment and attached my monitor. I delivered the first shock less than 10 minutes after my initial dispatch.
After a few rounds of CPR, starting intraosseous access, pushing cardiac meds and two more additional shocks, return of spontaneous circulation (ROSC) was achieved. The 12-lead revealed a massive ST-elevation myocardial infarction (STEMI) and after just a few minutes, the heavyset male started showing signs of cerebral hemorrhage. It was now apparent that the fall from his myocardial infarction (MI) caused a hemorrhagic cerebral injury.
Things were going south quickly. He needed to be sedated and his airway secured, but due to the trismus of his muscles of mastication, rapid sequence intubation (RSI) would have to be initiated.
I decided that a simple ambulance was insufficient and I called the helicopter. RSI was initiated to secure the patient’s airway for transport. The patient survived with a good outcome and no neurological deficit—due in part to the fact that the EMS bike was quick and nimble through dense traffic and was equipped with enough medicine and gear to take care of even the most critically ill patients.
A Wealth of Experience
For more than five years I’ve had the opportunity to work half the year in the U.S. as a paramedic for American Medical Response (AMR) in Santa Barbara, Calif., and as a prehospital EMS physician in Europe. This rare tenure has allowed me real-time exposure and the ability to compare and contrast various prehospital medicine systems, protocols, treatments and the countless changing issues affecting our work and delivery of patient care.
I’ve gained valuable experience helping several dozen EMS and fire departments worldwide as a consultant, gaining invaluable insight into the advantages and disadvantages of various EMS and Fire models around the world. I hope to use this breadth of knowledge and experience to advance the field of prehospital emergency medicine into the 21st century and beyond.
MRUs offer an efficient and highly effective platform for both EMS and fire departments whose present resources are stretched too thin due to increasing call volumes and stagnant budgets. Over half the countries on the planet utilize two-wheeled vehicles in some fashion to respond to emergencies.
The 5th biannual International Fire and EMS Motorcycle Response Unit Association (IMRUA) Congress is being held in Gdansk, Poland, Sept. 22–24, 2017. If your department could benefit from the use of motorcycle response units (MRUs), then this congress is for you. Along with providing actual exposure to MRUs and their riders from around the world, other topics such as emergency caesarean section in an unsalvageable poly-traumatic patient will be presented. For more information about our organization and the 2017 IMRUA Congress, please visit www.imrua.eu.