How to transport a polar bear, and other idiosyncrasies in providing emergency medical services in the Arctic

Six hundred miles north of mainland Norway, deep in the Arctic Circle, the Svalbard archipelago spans over 60 000 km², with a population of just 2596. Longyearbyen, the “capital city,” has a small hospital to provide primary and emergency care. The hospital has 24 staff,1 including three doctors and at least one surgeon. Longyearbyen also has a fire department that has one ambulance with a stretcher.

With few roads and rugged terrain, Svalbard has two search and rescue helicopters that also provide helicopter emergency medical service (HEMS)—and unusual transfer missions.2 Each helicopter crew includes a medical rescue technician, and one has an anaesthetist. The helicopters carry the same equipment as mainland HEMS bases, including a handheld ultrasound machine and blood products.2 Annually the crews conduct over 80 missions, mostly search and rescue or as primary responders to medical emergencies. Authorities have recorded fewer than five cardiac …