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EN
Introduction. The Charlson Comorbidity Index (CCI) is a comorbidity scale used widely throughout the world. Despite its widespread use, its relationship with patient readmission to the Emergency departments (ED) has not been evaluated previously. Aim. To show whether there is a correlation between the CCI score and the number of repeated admissions to ED and that the CCI score can be used as a predicted factor for the serious patients. Material and methods. This was a prospective observational cross-sectional study. Age, gender, vital signs of the patients who agreed to participate in the study was recorded. Numbers of ED readmissions of patients within six months after discharge and CCI scores have been recorded. Results. The study was completed with 1420 patients. The admission rates of patients in the ED in the six months were significantly higher in the CCI 5+ group than in other groups (p<0.05) There was a positive correlation between the number of visits and CCI scores (p<0.01; C>0). Conclusion. We believe that the CCI scoring system can be used by ED clinicians to predict the risk of readmission of patients after discharge from ED.
EN
Emergency medicine serves providing both pre-hospital medical services directly at emergency site and during transportation, and hospital emergency services at hospital emergency wards that result from previous rescue activities. Filling in medical documents is akey element ofparamedic’s activities indifferent of employing institution; as in Poland they are kept predominantly in paper form a cyberattack risk is low in this case. Keeping correct and proper medical records plays key role in ensuring both patient’s medical safety and paramedic’s formal and legal safety, including cases of suspected medical error. It is troublesome because ofcharacteristics of paramedic’s job that include in particular multitasking, time andresponsibility pressure and resulting in stress.
EN
Authors in this article deal with the ethical aspects of nursing care for acute conditions from the perspective of ethical and legal standards. Today's time already think about this problem through various schemes, regulations, standards and codes. One of the main subjects that are concerned by ethics is nursing. Here, thanks to everyday work with peole, must everything work for the benefit of morality. Code of Ethics sets and modifies certain rules in spe- cific fields. They determine or recommend certain patterns of behaviour. For nurses indicate the direction the International Council of Nurses. Here it is described that the nurse has a duty to care for the health, alleviate suffering, prevent disease and restore health. Emergency medicine is in these modern times pushing the boundaries of therapy. From this point of view implies not only respect to the rights of critically ill patient and their implementation in intensive care. This is happening despite the efforts and need for constant professionalism and conditions of available methods and procedures. Provi- sion of acute care medicine is today very complex.
PL
Wstęp. Wraz z rozwojem cywilizacji lawinowo wzrasta liczba zagrożeń i nieprzewidzianych wypadków, a wśród nich zatruć. Zarówno przypadkowe jak i celowe narażenie na substancje szkodliwe są problemem nie tylko oddziałów toksykologii, ale także pracowników systemu ratownictwa medycznego. Cel pracy. Celem pracy była analiza zatruć pod względem rodzaju i ciężkości wśród pacjentów leczonych w Klinicznym Oddziale Intensywnej Terapii i Anestezjologii z Ośrodkiem Ostrych Zatruć Szpitala Wojewódzkiego nr 2 im. św. Jadwigi Królowej w Rzeszowie w latach 2011–2013 oraz czynników mających wpływ na częstość występowania zatruć. Materiał i metodyka. Badania przeprowadzono na podstawie oddziałowych zestawień zbiorczych pacjentów leczonych z powodu zatrucia. Na podstawie udostępnionych danych wyodrębniono płeć, wiek, rodzaje ciężkości zatruć, rodzaj zatrucia, efekt terapii, tryb przyjęcia oraz wypisu. Wszystkie wykresy i tabele wykorzystane w pracy wykonano za pomocą programu statystycznego IBM SPSS Statistic. Wyniki. Liczba pacjentów leczonych z powodu zatruć w oddziale wzrastała w poszczególnych latach z 332 do 491. Częściej hospitalizowani byli mężczyźni a najczęstszą przyczyna pobytu było zatrucie alkoholem etylowym lub inne stany związane z nadużyciem tego alkoholu. Zaobserwowano wzrost liczby ciężkich zatruć w poszczególnych latach z 5,12% w 2011 do 11% w 2013. Zaobserwowano również wzrost liczby pacjentów kierowanych z niniejszego oddziału do dalszego leczenia w innym szpitalu. Wnioski. Stwierdzono sukcesywny wzrost liczby hospitalizowanych pacjentów oraz ciężkości zatruć. Częściej zatruciom ulegali mężczyźni, a najczęstszą przyczyną zatrucia jest alkohol etylowy. Bardzo mały odsetek zatruć zakończył się zgonem. Ponad połowa zatrutych leczyła się na choroby współistniejące. Do SOR i do oddziału toksykologii pacjenci najczęściej przywożeni byli przez zespoły ratownictwa medycznego.
EN
Introduction. The number of accidents and emergencies, among them poisonings, is currently increasing rapidly. Both accidental and intentional exposure to toxic substances is not only the problem of toxicology departments but also emergency medical system. Aim of study. The aim of the study was to analyze poisonings in terms of a type and severity among the patients treated at the Department of Toxicology of St. Hedvig Provincial Hospital No.2 in Rzeszów in 2011-2013 and factors affcting the incidence of poisonings. Material and methods. The study analyzed cumulative statistics from a hospital department on intoxicated patients. Sex, age, type and severity of poisoning, effct of therapy, the way of admission and discharge were collected from the available data. All graphs and tables in the paper were elaborated by means of IBM SPSS Statistic software. Results. The number of patients treated for poisoning in the branch increased during researched period from 332 to 491. Men were hospitalized more often than women and the most common cause of the stay was ethanol poisoning or other conditions associated with alcohol abuse. The increase in the number of severe poisonings in the subsequent years from 5.12% in 2011 to 11% in 2013 was observed. The increase in the number of patients referred for further treatment to another hospital was also noted. Conclusions.The increase in the number of hospitalized patients and the severity of poisonings was found. The men were more often prone to poisonings and the most common reason of poisoning was ethyl alcohol. A very small percentage of the poisonings was fatal. More than a half of intoxicated patients had comorbidities. Most frequently patients were transported to the emergency department and the department of toxicology by emergency medical service.
EN
Objectives Few studies focus on out-of-hospital cardiac arrests in the occupational setting. Therefore, this study describes the presence and use of an automated external defibrillator (AED) at Belgian workplaces during the period 2012–2014. Material and Methods A self-constructed questionnaire was developed and sent to internal prevention counselors. Results In total, 767 companies filled out the questionnaire. An AED was available in 48.8% of the companies. Presence mainly depended on the number of persons present in the company (both workers and non-workers (e.g., visitors, clients)) and on some occupational cardiovascular risks but was often not based on a well-conducted risk analysis. Training of workers and AED maintenance were provided appropriately. An AED was used for shocking 23 times of which 10 persons survived. Conclusions Acquiring an AED in the occupational setting is seldom based on a well-conducted risk analysis. Therefore, instructions and criteria are needed to come to a rational decision. Furthermore, a registry on AED utilization in the workplace (e.g., with data on long-term survival) should be set up. Int J Occup Med Environ Health 2018;31(5):603–611
EN
Objectives It is commonly known that ergonomics in emergency medical services (EMS) is very important. Emergency medical services workers are exposed to different conditions and they should perform a variety of tasks. Material and Methods The aim of the work has been to analyze the angular position of elbows and forces generated by the upper limbs during cardiopulmonary resuscitation with and without the CPRmeter based on feedback technology. Ten male paramedics and 10 male non-paramedics, in a kneeling position, performed cardiopulmonary resuscitation (CPR) on an Ambu Megacode manikin placed on the ground. Measurements were taken after 1 min and 4 min following the beginning of the trial. The angular position of the elbows was evaluated with a BTS Smart DX 7000 motion capture system. Kistler platforms 9286BA were used for measuring forces. Results In the paramedic group, one statistically significant difference was observed in the mean difference between maximal and minimal right elbow angle in the 1st min without the device vs. the mean difference in the 4th min without the device. In the paramedic group, a 25% force decrease was observed after 4 min of resuscitation in trials without the CPRmeter in comparison to the 1st min. In trials with the CPRmeter, the force parameters were similar in the 1st and 4th min and more stable. No statistically significant differences were noticed in the control group. Conclusions The CPRmeter has influence on the magnitude of the forces applied by the upper limbs and on the optimization of the rescuer effort during cardiopulmonary resuscitation. The CPRmeter had no influence on the position of the upper part of the kinematic chain. Int J Occup Med Environ Health 2017;30(6):909–916
EN
The aim of the article is to show the possibilities of applying the traditional rules of ordo caritatis in contemporary bioethical dilemmas. After the synthetic showing of its essence, attempt was made to its application to specific situations related to biomedical practice. The focus is primarily on the issues of medical emergency situations and difficult access to medical services. It has been shown that the principle of the order of love in conjunction with other principles of medical interventions, including in particular the principle of proportionality can be an important criterion for the evaluation procedure.
PL
Celem artykułu jest ukazanie możliwości zastosowania klasycznej zasady ordo caritatis we współczesnych dylematach bioetycznych. Po syntetycznym ukazaniu jej istoty podjęto próbę jej aplikacji do konkretnych sytuacji związanych z praktyką biomedyczną. Skupiono się przede wszystkim na zagadnieniach medycyny ratunkowej oraz na sytuacjach utrudnionego dostępu do świadczeń medycznych. Wykazano, że zasada porządku miłości w połączeniu z innymi zasadami ingerencji medycznych, w tym przede wszystkim z zasadą proporcjonalności, może stanowić istotne kryterium oceny postępowania.
EN
Introduction: The publication presents the issue of aggression addressed to paramedics working in medical emergency teams. Material and methods: The study included 50 paramedics who completed a questionnaire carried out by the authors. The survey was voluntary and anonymous. Results: During 12 months prior to the study, 96% of responders experienced aggression during working in the State Medical Rescue System in Poland. The most frequent form of aggression was verbal aggression. 22% of participants experienced assault and their health was damaged as a result of patient’s aggressive behaviour. However, most of the respondents did not report this fact to the police. Conclusions: An aggression against medical personnel is a significant problem of State Medical Rescue System in Poland. It requires systemic changes as well as an individual support for units affected by this problem.
PL
Wprowadzenie: W publikacji przedstawiona została problematyka agresji skierowanej przeciw ratownikom medycznym pracującym w zespołach ratownictwa medycznego. Materiał i metoda: Badanie przeprowadzono metodą ankietową w grupie 50 ratowników medycznych. Badanie miało charakter dobrowolny i anonimowy. Wyniki: 96% ratowników medycznych uczestniczących w badaniu zadeklarowało, że w ciągu ostatniego roku, w czasie pracy w systemie Państwowego Ratownictwa Medycznego, spotkało się z agresją. Najczęstszą formą agresji była agresja słowna. U 22% uczestników badania w wyniku agresji doszło do uszczerbku na zdrowiu. Większość ankietowanych nie zgłosiła jednak przypadków agresji policji. Podsumowanie: Zjawisko agresji wobec personelu medycznego jest istotnym problemem Państwowego Ratownictwa Medycznego w Polsce i wymaga interwencji oraz zmian na poziomie systemowym, a także indywidualnej pomocy osobom dotkniętym tym zjawiskiem.
EN
BackgroundEmergency medical staff (EMS) are a professional group at a high risk of burnout and an imbalance between work and private life, the so-called work–life balance (WLB). This affects their mental state and physical health. The aim of the study was to assess the relationship between the number of hours of work and the state of health as well as coping with the stress among emergency medical staff, as factors conditioning the maintenance of WLB.Material and MethodsThe study involved 129 people employed in the medical emergency sector. The study was conducted as a diagnostic survey using tools such as: the Mini-COPE Inventory for Measuring Coping with Stress, a specially designed questionnaire regarding the work schedule, and sociodemographic data.ResultsThe examined people were able to manage stress in an active way, and they most often rated their health as good. Most of the respondents also received family support, and both men and women declared it. However, only about half of the respondents declared their satisfaction with the income earned. The correlation between the number of hours and age was r = –0.156 (p = 0.077), and that between the number of hours and physical health r = –0.12 (p = 0.171).ConclusionsGenerally, EMS are able to cope with stress and are satisfied with the support they receive from their families. However, the number of on-call times at work has a negative impact on their health status, which, together with a lack of satisfaction with the financial situation, may contribute to disturbed WLB. Further research on the WLB phenomenon, along with monitoring the number of working hours of people employed in emergency medicine, are recommended.
PL
WstępPracownicy sytemu Państwowego Ratownictwa Medycznego (PRM) są grupą zawodową narażoną na duże ryzyko wypalenia zawodowego i zaburzeń równowagi między życiem zawodowym a prywatnym (work–life balance – WLB). Rzutuje to na ich zdrowie psychiczne i fizyczne. Celem badania była ocena zależności między liczbą przepracowanych godzin a stanem zdrowia i radzeniem sobie ze stresem jako czynnikami warunkującymi utrzymanie WLB u pracowników ratownictwa medycznego.Materiał i metodyW badaniu wzięło udział 129 osób zatrudnionych w PRM. Badanie przeprowadzono metodą sondażu diagnostycznego z wykorzystaniem Inwentarza do pomiaru radzenia sobie ze stresem (Mini-COPE) oraz autorskiego kwestionariusza dotyczącego grafiku pracy badanych i ich danych socjodemograficznych.WynikiBadane osoby w sposób aktywny potrafiły radzić sobie ze stresem i najczęściej oceniały swój stan zdrowia jako dobry. Większość badanych otrzymywała również wsparcie ze strony rodziny, jednak zadowolenie z osiąganego dochodu deklarowało już tylko około połowy z nich. Korelacja między liczbą przepracowanych godzin a wiekiem wyniosła r = –0,156 (p = 0,077), między liczbą przepracowanych godzin a subiektywną oceną zdrowia fizycznego była na poziomie r = –0,121 (p = 0,171).WnioskiPracownicy systemu PRM potrafią radzić sobie ze stresem i są zadowoleni z otrzymywanego wsparcia ze strony rodziny. Duża liczba dyżurów w pracy wpływa negatywnie na odczuwany przez badanych stan zdrowia, co wraz z brakiem zadowolenia z sytuacji finansowej może przyczyniać się do zaburzenia WLB. Zaleca się dalsze badania nad zjawiskiem WLB i monitorowanie liczby godzin pracy osób zatrudnionych w PRM.
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