Community Cardiac Arrest as a Challenge for Emergency Medical Services in Poland.

The problem of cardiac arrest, particularly out-of-hospital cardiac arrest (OHCA), is the subject of continuous research. The aim of this study was to analyze the use of an automated external defibrillator (AED) during the resuscitation of an adult in public places in Poland between 2015 and 2020. A retrospective analysis of the selected documentation obtained from AED distributors, the medical records obtained from the emergency call center, and the emergency medical teams was conducted. During the analysis period, there were 100 cases of recorded and documented use of AEDs in OHCAs in public places. In 70% of the cases, defibrillation was performed with an AED. This result could be higher, but the study's methodology and limited access to data only allowed for this result. In Poland, there are no legal acts on the registration of automatic external defibrillators and their implementation. Appropriate registries should be introduced nationwide as soon as possible. Due to the inadequacy of the medical records of the emergency medical teams to record the use of automated external defibrillators by a bystander to an incident, changes to these documents should be pursued. Based on such a small cohort, it is not possible to conclude that the return of spontaneous blood circulation is correlated with the use of AEDs and public access to defibrillation PADs.

Network of Automated External Defibrillators in Poland before the SARS-CoV-2 Pandemic: An In-Depth Analysis.

INTRODUCTION: Sudden cardiac arrest (SCA), which causes more than half of all cardiovascular related deaths, can be regarded as a common massive global public health problem. Analyzing out-of-hospital cardiac arrest (OHCA) cases, one of the key components is automatic external defibrillators (AEDs). AIM: The aim of this study was to analyze the use and distribution of AEDs in Polish public places. MATERIALS AND METHODS: The data were analyzed by using the Excel and R calculation programs. RESULTS: The data represents 120 uses of automatic external defibrillators used in Polish public space in the period 2008-2018. The analysis describes 1165 locations of AEDs in Poland. It was noted that the number of uses in the period 2010-2016 fluctuated at a constant value, with a significant rise in 2017. When analyzing the time of interventions in detail the following was noted: the highest percentage of interventions was observed in April, and the lowest in November; the highest number of interventions was observed on a Friday, while the least number of interventions was observed on a Sunday; most occurred between 12:00 to 16:00, and least between 20:00 to 8:00. CONCLUSIONS: The observed growth in the number of cases of AED use in public places is associated with the approach to training, the emphasis on public access to defibrillation, and, therefore, the growth of social awareness. This study will be continued. The next analysis would include 2020-2022 and would be a comparative analysis with the current research.

Management Decisions: The Effectiveness and Size of the Emergency Medical Team.

In Poland, often for economic reasons, the staffing of medical rescue teams is limited to the legally required minimum. This gives rise to problems related to the effectiveness and efficiency of medical rescue teams. A literature review did not find any sources addressing the issue of the verification of the effectiveness of paramedic teams depending on the personnel composition of units. The aim of the study was to analyze the effectiveness of resuscitation depending on the size of the medical rescue team, comparing the work of two- and three-person teams. In total, 100 two-person teams and an analogous number of three-person units were studied. Statistical analyses were performed using the IBM SPSS Statistics 24 package. The results showed that the assessment of the condition of the victim as well as the ability to assess the heart rhythm and monitor the condition during advanced measures were more effective in three-person teams; three-person teams also used oxygen more frequently during advanced life support (ALS). Most of the elements influenced the quality of resuscitation and it can be unequivocally stated that the work of three rescuers is more efficient and definitely more effective.

Evaluation of Capillary Blood Gases in Medical Personnel Caring for Patients Isolated Due to SARS-CoV-2 in Intensive Care Units before and after Using Enhanced Filtration Masks: A Prospective Cohort Study.

The dynamically changing epidemiological situation caused by the SARS-CoV-2 virus is associated with the increased burden and fatigue of medical personnel. The aim of the study was to evaluate: (1) oxygen and carbon dioxide blood pressure and saturation levels in medical personnel caring for patients isolated due to SARS-CoV-2 in ICUs; (2) adverse symptoms reported by medical personnel after leaving the isolation zone. DESIGN: A Prospective Cohort Study. METHODS: The project was implemented in the first quarter of 2021. Medical personnel working with patients isolated due to SARS-CoV-2 in the ICU of three hospitals were eligible for the study. The participants of the study were subjected to two analyses of capillary blood by a laboratory diagnostician. RESULTS: In the studied group of medical personnel (n = 110) using FFP2/FFP3 masks, no significant differences (p > 0.05) were found between the parameters of geometric examination performed before and after leaving the isolation ward of the hospital. After working in the isolation ward, nurses reported malaise (somnolence, fatigue, sweating, dizziness) more often than paramedics (44% vs. 9%; p = 0.00002). The risk of ill-being in nurses was approximately nine times higher than in paramedics (OR = 8.6; Cl 95%: 2.7 to 26.8) and increased with the age of the subjects (OR = 1.05; Cl 95%: 1.01 to 1.08). CONCLUSION: FFP2/FFP3 filter masks did not worsen blood oxygenation in medical staff caring for patients isolated due to SARS-CoV-2 in the ICU. The presence of subjective symptoms such as fatigue may be due to lack of adequate hydration.

Analysis of the Way and Correctness of Using Automated External Defibrillators Placed in Public Space in Polish Cities-Continuation of Research.

Immediate resuscitation is required for any sudden cardiac arrest. To improve the survival of the patient, a device to be operated by witnesses of the event-automated external defibrillator (AED)-has been produced. The aim of this study is to analyze the way and correctness of use of automated external defibrillators placed in public spaces in Polish cities. The data analyzed (using Excel 2019 and R 3.5.3 software) are 120 cases of use of automated external defibrillators, placed in public spaces in the territory of Poland in 2008-2018. The predominant location of AED use is in public transportation facilities, and the injured party is the traveler. AED use in non-hospital settings is more common in male victims aged 50-60 years. Owners of AEDs inadequately provide information about their use. The documentation that forms the basis of the emergency medical services intervention needs to be refined. There is no mention of resuscitation performed by a witness of an event or of the use of an AED. In addition, Poland lacks the legal basis for maintaining a register of automated external defibrillators. There is a need to develop appropriate documents to determine the process of reporting by the owners of the use of AEDs in out-of-hospital conditions (OHCA).

Comparative Analysis of the Effectiveness of Performing Advanced Resuscitation Procedures Undertaken by Two- and Three- Person Basic Medical Rescue Teams in Adults under Simulated Conditions.

(1) Objective: Paramedics as a profession are a pillar of the State Medical Rescue system. The basic difference between a specialist and a basic team is the composition of members. The aim of the study was to benchmark the effectiveness of performing advanced resuscitation procedures undertaken by two- and three-person basic emergency medical teams in adults under simulated conditions. (2) Design: The research was observational. 200 two- and three-people basic emergency medical teams were analyzed during advanced resuscitation procedures, ALS (Advanced Life Support) in adults under simulated conditions. (3) Method: The study was carried out among professionally active and certified paramedics. It lasted over two years. The study took place under simulated conditions using prepared scenarios. (4) Results: In total, 463 people took part in the study. The analysis of the survey results indicates that the efficiency of three-person teams is superior to the activities performed by two-person teams. Three-person teams were quicker to perform rescue actions than two-person teams. The two-person teams were much quicker to assess the condition of victims than the three-person teams. The three-person teams were more likely to check an open airway. The three-person teams were more efficient in assessing the heart rhythm and current condition of victims. It was demonstrated that three-person teams were more effective during electrotherapy. The analysis demonstrated that three-person teams were significantly faster and more efficient in chest compressions. Three-person teams were less likely to use emergency airway techniques than two-person teams. The results indicate that three-person teams administered the first dose of adrenaline significantly faster than two-person teams. For the "call for help", the three-person teams were found to be more effective. (5) Conclusion: Paramedics in three-person teams work more effectively, make a proper assessment of heart rhythm and monitor when taking advanced actions. The quality of ventilation and BLS in both groups studied is insufficient. Numerous errors have been observed in two-person teams during pharmacotherapy.

Use of Public Automated External Defibrillators in Out-of-Hospital Cardiac Arrest in Poland.

Background and objectives: National medical records indicate that approximately 350,000-700,000 people die each year from sudden cardiac arrest. The guidelines of the European Resuscitation Council (ERC) and the International Liaison Committee on Resuscitation (ILCOR) indicate that in addition to resuscitation, it is important-in the case of so-called defibrillation rhythms-to perform defibrillation as quickly as possible. The aim of this study was to assess the use of public automated external defibrillators in out of hospital cardiac arrest in Poland between 2008 and 2018. Materials and Methods: One hundred and twenty cases of use of an automated external defibrillator placed in a public space between 2008 and 2018 were analyzed. The study material consisted of data on cases of use of an automated external defibrillator in adults (over 18 years of age). Only cases of automated external defibrillators (AED) use in a public place other than a medical facility were analysed, additionally excluding emergency services, i.e., the State Fire Service and the Volunteer Fire Service, which have an AED as part of their emergency equipment. The survey questionnaire was sent electronically to 1165 sites with AEDs and AED manufacturers. A total of 298 relevant feedback responses were received. Results: The analysis yielded data on 120 cases of AED use in a public place. Conclusions: Since 2016, there has been a noticeable increase in the frequency of use of AEDs located in public spaces. This is most likely related to the spread of public access to defibrillation and increased public awareness.

[The role of medical segregation during mass events and its use on the example of rescue operations after a construction disaster on the premises of the international katowice fair].

The rules related to the conduct of emergency and medical services during the occurrence of a mass event are described in the Act on State Emergency Medical Services of 8 September 2006 and the notice issued by the Ministry of Health. The biggest disaster in Poland was the event of 2006 at the International Katowice Fair located on the border between Katowice and Chorzów. The tragedy covered a hall with an area of about 1 ha, in which there were about 700 people. It is worth noting that the described event was the first test of such scale for the first in Poland Voivodship Center for the Coordination of Medical Rescue. This was also the main reason for work on the shape of the Rescue Act. Contemporary segregation techniques date back to Napoleonic times. In the eighties of the twentieth, the Simple Triage and Rapid Treatment (START) segregation system was developed, which is widely used in the original version or modified in many countries, including Poland. Other systems of segregation include the Triage SIEVE system (popular in Australia and Great Britain), Triage SORT and the STM System. Providing medical help must be based on the principles of rational and logical scale of damage, determination of the number of people injured in an accident, as well as on the basis of ethical standards. Effectiveness of segregation determines the detection of the deterioration of the injured person's condition and allows him to be moved to a higher segregation group to get help faster. The basic assumption of medical segregation, however, is to select persons who are in immediate danger of life from those who are injured.