Emergency Medical Service最新文献

{"title":"Pre-hospital management of acute pericarditis based on a case study","authors":"D. Gałuszka, J. Kasperowicz, K. Ślusarczyk","doi":"10.36740/emems202302110","DOIUrl":"https://doi.org/10.36740/emems202302110","url":null,"abstract":"Aim: Indication of appropriate treatment of the emergency medical team towards a patient with acute pericarditis being a life-threatening condition. \u0000Material and method: The retrospective study included two men to whom EMT (Emergency Medical Team) was called for chest pain and in the second case due to the correlation of chest pain, ECG changes and pathological results of ultrasensitive cardiac troponin and CRP. Both patients developed acute pericarditis as a result of the infection they were currently undergoing. In this paper, the case study method was used. The research material was obtained through the analysis of medical rescue cards, EMT departure order cards and hospital treatment information cards. \u0000Conclusions: Among cardiac patients with stenocardial pain, regardless of age and other factors, an examination should always be carried out and discriminatory diagnostics should be implemented, m.in. for suspected acute pericarditis. Medical interview, in particular epidemiological history, plays an important role.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130153749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSESSMENT OF THE IMPACT OF ACCREDITATION STANDARDS ACCORDING TO THE ONE OF LODZ HOSPITAL MANAGEMENT STAFF","authors":"Ewa Kaniecka, Justyna Jakubczyk, Monika Białas, Agata Białas, A. Staszewska, D. Timler, Anna Rybarczyk-Szwajkowska","doi":"10.36740/emems202202106","DOIUrl":"https://doi.org/10.36740/emems202202106","url":null,"abstract":"Aim: To find out opinion of hospital management staff on impact of accreditation standards on management of medical entity. \u0000Material and methods: The study was conducted from March to April 2021 in one of hospital in Lodz. A total of 22 people (management, heads of hospital wards, heads of departments and ward nurses) were invited in the study, 16 people competed the questionnaire and submitted it for analysis. The study was conducted using the questionnaire, which was built of 19 quantitative and qualitative questions. \u0000Results: In opinion of the respondents, the most often used accreditation areas in management process are standards in area of Care Continuity, second in area of Patient Rights, and third in area of Patient Care. The majority of the respondents rated highly and very highly impact of the used standards on their management activities. Active participation of the process of continuous improvement of accreditation standards was confirmed by 12 respondents. In opinion of 11 respondents, the implementation and maintenance of accreditation standards affects the effectiveness of management tasks, while 5 people don’t agree with this influence. In the same way the respondents assessed impact of the implementation of accreditation on the quality and safety of provided health services (11 people indicate correlation; 5 people have a different opinion). Twelve out of sixteen respondents confirmed and justified that accreditation is needed in hospital. \u0000Conclusion: In opinion of the respondents performing managerial functions, the process of maintaining and continuous improvement of individual accreditation standards is understood and desirable among the management staff of the hospital.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126341120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperosmolar Hyperglycemic State (HHS) – The Management in the Emergency Department","authors":"Agnieszka Ciastkowska-Berlikowska, D. Zawadzki","doi":"10.36740/emems202103107","DOIUrl":"https://doi.org/10.36740/emems202103107","url":null,"abstract":"Introduction: The hyperosmolar hyperglycemic state (HHS) poses a direct threat to the health and life of the patient. It is most common in patients with type 2 diabetes, and it is associated with high mortality. For this reason, HHS requires a quick diagnosis and implementation of the correct treatment. Mortality due to HHS ranges from 5% to 16%. It is about ten times higher than in diabetic ketoacidosis. This is due to the underlying cause of hyperglycemia, the severity of dehydration, and often the advanced age and comorbidities.\u0000The aim: The study aimed to develop the correct management strategy for the medical staff in the Emergency Department (ED) for a patient with the suspected HHS.\u0000Material and methods: The research material was obtained from the analysis of the patient’s medical records during his stay in the ED and from the emergency medical card and the order of the EMS team to dispatch to this 62-year-old patient due to the deterioration of verbal and logical contact and unassessed glucose values. The study used an individual case study method.\u0000Results: Combating hyperglycemia, replenishing water deficit, correcting electrolyte disturbances, as well as diagnostics and initial therapy of comorbidities are the priorities in providing medical care to a patient with suspected HHS.\u0000Conclusions: The medical staff in the ED followed guidelines on HHS management.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128693643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to ecological innovations in resuscitation training. Does made of cardboard has to mean single-use?","authors":"Filip Jaśkiewicz","doi":"10.36740/emems202302105","DOIUrl":"https://doi.org/10.36740/emems202302105","url":null,"abstract":"Aim: To assess the initial usefulness of an innovative, ecological manikin made of cardboard and coconut fiber, which is intended for resuscitation training. \u0000Material and methods: The study was conducted with the use of a mechanical chest compression device and assistance of human subjects. The first phase quantified the initial durability of the manikin. Phases two and three initially assessed manikins’ mechanical properties, its resistance to repetitive chest com¬pression training, and the quality of chest compressions performed on the tested manikin. \u0000Results: 268 and 49 participants took part in the first and the second phase of the study, respectively. The total number of chest compressions performed on the manikin was 30.736 and 4.928, respectively. The number of mechanical chest compressions reached 75.000 in phase three. The mean compression depth ranged between 47.1 ± 1.4 and 52.7 ± 0.6 mm, and the compression force ranged from 577 ± 10.0 to 686 ± 187 N. The rate of compressions ranged from 99.5 to 133/min, and the percentage of complete chest recoil ranged from 62.1 ± 20.3% to 100%. \u0000Conclusions: The tested ecological manikin invented for the purpose of resuscitation training provides the parameters necessary for students to master the ability to deliver high-quality chest compressions in terms of depth, rate, full recoil and force needed to perform chest compressions in a large adult. Durability tests showed that a manikin made of ecological materials can also be used multiple times, for many training groups.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123556526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KNOWLEDGE OF IN-HOSPITAL CARDIOPULMONARY RESUSCITATION AMONG NURSING STAFF","authors":"Sylwia Mirecka, Ł. Czyżewski","doi":"10.36740/emems202204103","DOIUrl":"https://doi.org/10.36740/emems202204103","url":null,"abstract":"Aim: To assess the knowledge of medical personnel about in-hospital cardiopulmonary resuscitation and to compare it with the current European Resuscitation Council Guidelines. Furthermore, the study intended to investigate the respondents’ preferences and experiences associated with performing cardiopulmonary resuscitation. \u0000Material and methods: The study included 248 nurses working in conservative and surgical wards. The research used an author-designed survey questionnaire, which was made available in electronic form. It consisted of 20 closed single-choice questions. Participation in the study was anonymous and voluntary. \u0000Results: A high level of knowledge of in-hospital CPR was found in 30.6%, average in 50.4% and low in 19%. Re¬spondents with work experience of ≤2 years (43.2%) and 3-10 years (36%) were significantly more likely to have a high level of knowledge of in-hospital CPR than those with longer work experience, especially 11-25 years (13.6%), p<0.0001. Most of respondents reported that the type of equipment used for defibrillation did not matter to them (42.3%), while 27.8% preferred the use of a defibrillator spoon, and 29.8% preferred the use of self-adhesive elec¬trodes for defibrillation. The majority of respondents (70.2%) used 1 mg undiluted epinephrine during CPR. A dose of 1 mg epinephrine after 10-fold dilution in 0.9% NaCl solution was used by 20.2% of respondents. \u0000Conclusions: The study showed an average level of knowledge on in-hospital cardiopulmonary resuscitation. A signif¬icantly higher level of knowledge was found in younger respondents, those with shorter work experience and higher education, and among men. The type of equipment used during defibrillation did not matter for most respondents. It was also found that the vast majority of respondents had participated in or witnessed cardiopulmonary resuscitation at least once, and more than half knew the professional qualifications gained after a qualification course and speciali-sation in anaesthesia and intensive care nursing.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128604935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COOLING THE BURN WOUND AMONG THE CHILDREN AND TEENAGERS IN THE FIREFIGHTER PRACTICE","authors":"L. Marzec, Ł. Czyżewski, Łukasz Dudziński","doi":"10.36740/emems202301105","DOIUrl":"https://doi.org/10.36740/emems202301105","url":null,"abstract":"Aim: The analysis of the cases of cooling the burns by NFRS firefighters. \u0000Material and methods: The data of Decision Support System of State Fire Brigade made accessible by the State Fire Bureau of the Operation Planning was analyzed concerning cooling the burns among the children between 1.01.2019-31.12.2020. 49 incidents were analyzed in terms of the mechanism, localiza¬tion, depth, extend of the burns, season of the year and day. \u0000Results: Burns were cooled in 1211 out of 126241 casualties, including 1023 of 7616 in fires and 188 of 118625 in local threats. Burn were cooled in 49 children out of 1211 casualties- 23 in local threats and 26 in fires. Cooling burns more often concerned in thermal (45), contact burns (27), I/II (48), up to 10% TBSA (32), in boys (25), 14-17 years (18), in October (9), from 1-11 p.m. (27) and in IV quarter of the year (19). \u0000Conclusions: 1. Among the injured the minor ones with the burns are not often cases. 2. Cooling the burns is more often associated with those ones injured in the fires and in boys. 3. Among the injured up to 17 years cooling the burns is more often seen during afternoon and autumn-winter season. 4. The fire¬fighters more often cool thermal, contact, superficial ones of minor burns and concerning different parts of the body within the upper its parts.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129962918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of selected socio-demographic factors on the cardiopulmonary resuscitation effectiveness","authors":"Ewelina Iwanicka, Paweł Więch, Magdalena Magoń, E. Guty, Grzegorz Kucaba, Marek Muster","doi":"10.36740/emems202201105","DOIUrl":"https://doi.org/10.36740/emems202201105","url":null,"abstract":"Aim: To assess the influence of selected socio-demographic factors on the CPR effectiveness performed by the police officers during the service. \u0000Material and methods: An observational, pilot study was conducted on a group of 90 police officers working in Rzeszów poviat. Each officer performed a 2-minute CPR on a dedicated Resusci Anne QCPR training phantom. The obtained parameters for chest compressions and ventilation were recorded using a dedicated SimPad SkillReporter tablet. Statistical analysis was performed using the Statistica 13.1 software. \u0000Results: The analysis of the obtained results concerning the influence of sociodemographic variables on the quality of CPR showed that both age, sex and work seniority significantly differentiated the selected parameters of chest com¬pressions. Being an older man predisposed to deeper chest compressions. Women performed chest relaxation more ef¬fectively. Younger policemen provided chest compressions at a frequency recommended by the European Resuscitation Council (ERC) guidelines. The above variables did not differentiate the groups in terms of ventilation. \u0000Conclusions: The age, sex and work seniority of the surveyed policemen significantly influenced the performance of chest compressions with no differences in ventilation parameters.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124597448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A PATIENT WITH CHEST PAIN AND ST-SEGMENT ELEVATION ON A RESTING ECG – A CASE STUDY","authors":"Agnieszka Ciastkowska-Berlikowska, D. Zawadzki","doi":"10.36740/emems202202110","DOIUrl":"https://doi.org/10.36740/emems202202110","url":null,"abstract":"The study aimed to discuss selected causes of chest pain in patients with ischemic changes on the resting ECG. The Emergency Medical Service (EMS) team was dispatched to a 49-year-old patient reporting crushing, retrosternal chest pain radiating to the left upper limb. The research material was obtained from the analysis of the patient’s medical records during his stay in the Emergency Department (ED), the Interventional Cardiology Department, as well as from the medical emergency card and the dispatch order of the EMS team. The study used an individual case study method. An urgent qualification for coronary angiography and percutaneous coronary intervention is the priority in providing healthcare service to a patient with the suspected acute coronary syndrome with ST-segment elevation. The ED staff followed the guidelines on management of acute coronary syndrome with ST-segment elevation.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122026423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROGNOSTIC VALUE OF EARLY WARNING SCORES IN PREDICTING IN HOSPITAL MORTALITY AMONG COVID-19 PATIENTS IN AN EMERGENCY DEPARTMENT","authors":"Sławomir Butkiewicz, P. Dobosz, Anna Tuka, Robert Gałązkowski, P. Rzońca","doi":"10.36740/emems202301101","DOIUrl":"https://doi.org/10.36740/emems202301101","url":null,"abstract":"Aim: The emergence of a new pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a surge of new patients requiring hospitalisation. The rapid identification of patients with severe SARS-CoV-2 infection has become a key challenge for healthcare systems. The aim of the study was to assess the prognostic value of early warning scores in predicting mortality in COVID-19 patients. \u0000Material and methods: The study involved a retrospective analysis of the medical records of 2,449 patients with COVID-19 admitted to emergency care, for whom five early warning scores were calculated based on the data obtained. \u0000Results: In order to assess the usefulness of NEWS, NEWS2, MEWS, SEWS and qSOFA in predicting in-hospital mortality in COVID-19 patients, AUC (area under the ROC curve) values were calculated. They were, respectively: 0.76 (95% CI 0.72-0.79), 0.75 (95% CI 0.72-0.79), 0.64 (95% CI 0.60-0.69), 0.61 (95% CI 0.57- 0.66) and 0.55 (95% CI 0.50-0.59). \u0000Conclusions: NEWS demonstrated the highest discriminatory power, indicating that it can be used to predict in-hospital mortality in COVID-19 patients.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122150858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CASES OF STIGMATIZATION AND DISCRIMINATION AGAINST HIV AND HCV\u0000PATIENTS BY MEDICAL PERSONNEL – COMPARATIVE SURVEYS","authors":"Maciej Rogala, Ewa Donesch-Jeżo","doi":"10.36740/emems201903102","DOIUrl":"https://doi.org/10.36740/emems201903102","url":null,"abstract":"Introduction: Research results indicate that in Poland stigmatization and discrimination against HIV patients is occurring on the part of medical personnel. This phenomenon is characterized by a poorer treatment of patients due to infection, impediments to access to health services or refusing to provide medical care. the aim: The aim of the work was to analyze attitudes and the communication process between the patient and medical staff both before receiving health services as well as during the process of providing these services in order to investigate the causes and nature of the phenomenon of stigmatization and discrimination against patients with HIV and HCV by representatives of various medical professions. Material and methods: The study was conducted among patients with diagnosed HIV – the primary group and among patients with HCV – the control group. A total of 160 patients with HIV and HCV were investigated at the two outpatient clinics of the University Hospital in Krakow. The research used the author’s questionnaires of a comparative nature. results: Doctors, dentists, dental technicians, nurses and midwives are among the group of medical workers, who stigmatize and discriminate against patients diagnosed with HIV, which is manifested by the impediments or refusal to grant health services after the patient has provided information about the virus. The refusal to grant services to patients was often accompanied by the inducing guilt in patients due to having infection. Some patients withdrew themselves from health services despite the occurrence of medical need due to earlier ill-treatment by medical personnel. Patients, among the reasons for refusal, pointed to the personnel’s excuses for too long queues of patients, lack of appropriate qualifications or appropriate technical capabilities. Similar attitudes, though much less frequently and to a lesser extent, were noted in patients with HCV, constituting a control group in this study. This type of attitude, manifested by stigmatization and discrimination against patients, was not observed among paramedics, who are the group of medical professionals particularly often exposed to contact with potentially infectious material and therefore to an increased risk of infection. Conclusions: The cases of stigmatization and discrimination against patients with diagnosed HIV and HCV by medical personnel occur solely due to the patients’ infection with the virus. Cases of refusal are accompanied by anxiety and a sense of threat of infection, which may be related to the state of knowledge of the prevention of viral infections. Resignation of patients from medical care despite the need for health due to previous negative experiences in such situations, impediments in granting medical care or refusal to provide health services may have negative health consequences for these patients, and in the longer term, generate higher costs for the health care system due to the abandonment of earlier pro-healt","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"220 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115984132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}