The assessment of the kinematics of the rescuer in continuous chest compression during a 10-min simulation of cardiopulmonary resuscitation.

BACKGROUND: In pursuit of improvement in cardiopulmonary resuscitation (CPR), new technologies for the measurement and assessment of CPR quality are implemented. In our study, we assessed the kinematics of the rescuer during continuous chest compression (CCC-CPR). The proper performance of the procedure is a survival predictor for patients with cardiac arrest (CA). The purpose of the study was a prospective assessment of the kinematics of the rescuer's body with consideration given to the depth and rate of chest compression (CC) as the indicator of properly performed CC maneuver by professional and non-professional rescuers during a simulation of a 10-min CCC using a manikin. METHODS: Forty participants were enrolled in the study. CCC-CPR was performed in accordance with the 2015 AHA guidelines on a manikin positioned on the floor. Kinematic data on the movement were obtained from the measuring system (X-sens MVN Biomech) transmitting information from 17 inertial sensors. Measurement data were imported to the author's program RKO-Kinemat written in the Matlab and C # environments. Two groups of results were distinguished: Group I-results of CC with the depth of ≥ 40 mm and Group 2-CC results with the depth of < 40 mm. RESULTS: The multiple regression model demonstrated that the path length, left knee flexion angle, and left elbow flexion angle were the essential elements of the rescuer's kinematics that facilitated achieving and maintaining the normal depth of CC. CONCLUSIONS: We believe that raising the rescuer's hips by moving the center of the rescuer's body over the point of sternal compression increases the value of the CC force vector, thereby increasing the depth of CC. In addition, we observed that, during an effective CC, the rescuer was unable to maintain arms straight and, in consequence, a slight elbow flexion was observed. It, however, did not influence the quality of the maneuver.

[Application of long term subcutaneously implanted access into the central veins system of "PORT" type in the Clinic of Pediatry, Pediatric Hematology and Oncology in Zabrze--15 year own observations]. / Zastosowanie dlugoterminowego, implantowanego podskórnie akcesu do ukladu zyl centralnych typu "PORT" w Klinice Pediatrii, Hematologii i Onkologii Dzieciecej w Zabrzu--15 lat obserwacji wlasnych.

INTRODUCTION: Long term disease treatment in children is a very special medical problem due to a necessity of maintaining an efficient venous access for many months and even years. Vascular ports applied in those children improved the conditions of treatment and a quality of life, additionally, made the job of personnel taking care of them easier. MATERIAL AND METHODS: The study presents own experience in long-term venous access into the central veins system, so called vascular ports, gathered for 15 years of using them in children with hemato-oncogical diseases. The analysis of 309 of implanted vascular ports was done taking into consideration the maintenance and complications. Ports were implanted in 300 children with oncological diseases. The received results are presented in numbers and percentage. RESULTS: Mean time of port insertion has decreased in comparison to earlier studies by 35 days and now is 722 days, median 658 days, however, minimal and maximal time of port insertion has changed respectively 7 and 2099 days. The total time of port insertion in this period was 232 536 days. The observation showed 31 (10.03%) cases of complications, out of which the most common were set infection (16 - 5.18%), catheter occlusion by a clot (7 - 2.27%) and "spontaneous" catheter move out of vessel lumen (3 - 0.97%), migration of a torn-off catheter into the right heart ventricle (2 - 0.65%). CONCLUSIONS: 1. Application of vascular ports enabled a long-term and intensive chemotherapy in children with oncological and hematological diseases. 2. Application of vascular ports bears a minor risk of complications, the most dangerous observed complication was a replacement of a torn-off catheter into the right heart ventricle.

Central venous access ports in children treated for hematopoietic malignancies.

During past 10 years 234 central venous access ports (CVAP) were implanted in 225 patients at the Department of Pediatric Hematology and Oncology in Zabrze. Mean exposure time was 745 days and total implantation time reached 173,768 days. Complications were encountered in 17 patients (7.6%). This mainly concerned central venous line infection, which led to removal of 10 CVAP (4.4%). The remaining complications necessitating removal of the CVAP consisted mainly of mechanical problems (catheter fracture, occlusion, and erroneous implantation to artery). In the opinion of the authors, subcutaneously implanted CVAP are a safe and effective option for high-dose chemotherapy deliverance in childhood cancer patients.

[The application of transversostomy in colorectal cancer surgery]. / Rola odbarczajacej transwersostomii w chirurgii raka jelita grubego.

UNLABELLED: Defunctioning stomas (ileostomy and transversostomy) are the most common methods of the decompression of distal digestive tract. The aim of this study was to assess the results of transverse loop colostomy in colorectal cancer patients. MATERIAL AND METHOD: Between 1998 and 2007, 119 patients with colorectal cancer underwent transversostomy. In 97 patients the colostomy was formed during the primary operation as a planned prevention from further complications (1st group) and in 22 previously operated patients due to postoperative complications as a second procedure (2nd group). RESULTS: In the study group, there were 2 deaths in the perioperative period due to the anastomosis leakage and the intraabdominal sepsis. Three patients required reconstructive operation because of the colostomy stenosis and further 3 due to colostomy prolapse. There were also several cases of superficial wound infection after termination of transversostomy. Almost 78 patients in total had the restoration of digestive tract continuity performed, prevalently from the 1st group. CONCLUSIONS: 1. In our opinion transversostomy is an effective solution for the proximal faecal diversion especially at high risk of anastomosis insufficiency or with present anastomosis leak. 2. In our study group, the incidence of complications (such as: chyme loss or dyselectrolytemia) in patients with performed transversostomy was low, thus we find it recommendable for the colon decompression.

[Long-term central venous catheters (ports) in adults cancer patients--one center experience]. / Dlugoterminowy dostep zylny typu "port" u doroslych pacjentów leczonych na oddziale onkologicznym--obserwacje wlasne.

UNLABELLED: The purpose of the study was to present the complications concerning the long-term central catheters (ports) used for cancer patients receiving chemotherapy. MATERIAL AND METHODS: From 2000 to 2007, twenty nine patients (25 women and 4 men), mean age 47 years received ports. RESULTS: In the study group of patients the average time of support with the ports was 439 days. Nine patients (31%) had complications: 5 of them had the infections (local infections), 3 patients had catheter occlusions and 1 of them had local skin necrosis. The central venous catheters were removed in the cases. Ten ports were still used.

[Developmental anomaly of superior vena cava as a reason hampering vein-port catheter implantation]. / Nieprawidlowy splyw ukladu zyly glównej górnej jako przyczyna uniemozliwiajaca wszczepienie portu naczyniowego.

Occasionally unexpected technical difficulties occur during Port-A-Cath implantation and the central venous catheterization. We described a case of superior vena cava developmental anomaly diagnosed during Port-A-Cath implantation.