Agnieszka Gonczaryk, J. Chmielewski, A. Strzelecka, Ewa Zięba, Tomasz Wójcik, Magdalena Florek-Łuszczki
Aim: Infection with biological factors is a significant issue which occurs during the undertaking of professional tasks in the daily work of paramedics in Emergency Response Teams. Due to the volatile conditions of the work environment, paramedics as an occupational group are at a higher risk of exposure to biological factors (e.g., hepatotropic viruses (HBV, HCV); human immunodeficiency virus (HIV); Mycobacterium tuberculosis bacteria; influenza virus; or contempo-rarily the SARS-CoV, MERS-CoV and SARS-CoV-2 coronaviruses). The possibility of infection grows in situations where work safety and hygiene regulations are not followed. The aim of the following work is the evaluation of the compli¬ance with hygienic standards and the knowledge regarding the prophylaxis of infection among paramedics. Material and methods: The study was carried out between May and September of 2019, with the use of diagnostic survey methodology on 238 (223 male, 15 female) paramedics in mobile Emergency Response Teams from the Maso¬vian voivodship. The mean age was 39.03±9.27 years for males, and 31.93±7.76 years for females. Results: 59.66% of the participants (n = 142) report always following the recommended hygiene procedures. 50.85% (n = 121) of the participants indicated hands playing a significant role in the spread of infection. Co-workers followed hygiene procedures at a satisfactory level for 53.78% (n =128) of the participants. Conclusions: There is a wide range of factors which limit respecting hygiene procedures, the most important of which being sudden and unforeseeable situations. Issues of the broadly understood hand hygiene practice should be a con¬stant element of prophylaxis in ERTs.
{"title":"SELF-EVALUATION OF THE COMPLIANCE WITH HAND HYGIENE REGULATIONS BY PARAMEDICS IN EMERGENCY RESPONSE TEAMS","authors":"Agnieszka Gonczaryk, J. Chmielewski, A. Strzelecka, Ewa Zięba, Tomasz Wójcik, Magdalena Florek-Łuszczki","doi":"10.36740/emems202204102","DOIUrl":"https://doi.org/10.36740/emems202204102","url":null,"abstract":"Aim: Infection with biological factors is a significant issue which occurs during the undertaking of professional tasks in the daily work of paramedics in Emergency Response Teams. Due to the volatile conditions of the work environment, paramedics as an occupational group are at a higher risk of exposure to biological factors (e.g., hepatotropic viruses (HBV, HCV); human immunodeficiency virus (HIV); Mycobacterium tuberculosis bacteria; influenza virus; or contempo-rarily the SARS-CoV, MERS-CoV and SARS-CoV-2 coronaviruses). The possibility of infection grows in situations where work safety and hygiene regulations are not followed. The aim of the following work is the evaluation of the compli¬ance with hygienic standards and the knowledge regarding the prophylaxis of infection among paramedics. \u0000Material and methods: The study was carried out between May and September of 2019, with the use of diagnostic survey methodology on 238 (223 male, 15 female) paramedics in mobile Emergency Response Teams from the Maso¬vian voivodship. The mean age was 39.03±9.27 years for males, and 31.93±7.76 years for females. \u0000Results: 59.66% of the participants (n = 142) report always following the recommended hygiene procedures. 50.85% (n = 121) of the participants indicated hands playing a significant role in the spread of infection. Co-workers followed hygiene procedures at a satisfactory level for 53.78% (n =128) of the participants. \u0000Conclusions: There is a wide range of factors which limit respecting hygiene procedures, the most important of which being sudden and unforeseeable situations. Issues of the broadly understood hand hygiene practice should be a con¬stant element of prophylaxis in ERTs.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114985737","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}
Pub Date : 2021-04-17DOI: 10.31435/RSGLOBAL_SR/30042021/7535
Iyad Alghzawi
The aim: The purpose of this study was to evaluate of white blood cells ratios in patients with ACS in association with arterial hypertension and 2 type Diabetes Mellitus. Material and Methods: In this observational cohort trial we observed of 184 patients with ACS. All patients were randomized into four groups: 1st group – 42 patients with ACS without AH or DM; 2nd group – 56 patients with ACS and previous AH; 3rd group – 42 patients with ACS and 2 type DM; and 4th group – 44 patients with ACS and AH and DM. We studied of leukocytes count and their subpopulation ratios: neutrophils to lymphocytes ratio (NLR), neutrophils to monocytes ratio (NMR), neutrophils to lymphocytes+monocytes ratio (N/LMR), lymphocytes to monocytes ratio (NMR). Results: The mean white blood cells count was significant higher in patients with ASC, compared with control group (p<0.001). In patients with ACS the elevated NMR and NLR were observed: 15.04±1.28 vs 11.09±0.43 in control group (p<0.05), and 3.34±0.20 vs 2.60±0.06 (p<0.05), respectively. No significant differences between WBC ratios were revealed in observed patients with ACS with or without AH and/or DM. Conclusion: ACS is characterized of raised NLR and NMR which could be indicators of poor prognosis
目的:本研究的目的是评估与动脉高血压和2型糖尿病相关的ACS患者的白细胞比率。材料和方法:在这项观察性队列试验中，我们观察了184例ACS患者。所有患者随机分为四组:第一组- 42例ACS患者，无AH或DM;第二组:56例ACS合并既往AH患者;第三组:ACS合并2型糖尿病42例;第4组为44例ACS、AH和DM患者。研究白细胞计数及其亚群比:中性粒细胞与淋巴细胞比(NLR)、中性粒细胞与单核细胞比(NMR)、中性粒细胞与淋巴细胞+单核细胞比(N/LMR)、淋巴细胞与单核细胞比(NMR)。结果:ASC患者的平均白细胞计数明显高于对照组(p<0.001)。ACS患者核磁共振(NMR)和NLR升高:对照组为15.04±1.28 vs 11.09±0.43 (p<0.05)，对照组为3.34±0.20 vs 2.60±0.06 (p<0.05)。观察到的ACS合并AH和/或dm患者的WBC比值无显著差异。结论:ACS以NLR和NMR升高为特征，可作为预后不良的指标
{"title":"White Blood Cells Ratios in Patients with Acute Coronary Syndromes in Association with Hypertension and Diabetes Mellitus","authors":"Iyad Alghzawi","doi":"10.31435/RSGLOBAL_SR/30042021/7535","DOIUrl":"https://doi.org/10.31435/RSGLOBAL_SR/30042021/7535","url":null,"abstract":"The aim: The purpose of this study was to evaluate of white blood cells ratios in patients with ACS in association with \u0000arterial hypertension and 2 type Diabetes Mellitus.\u0000Material and Methods: In this observational cohort trial we observed of 184 patients with ACS. All patients were randomized into four groups: 1st group – 42 patients with ACS without AH or DM; 2nd group – 56 patients with ACS and previous AH; 3rd group – 42 patients with ACS and 2 type DM; and 4th group – 44 patients with ACS and AH and DM. We studied of leukocytes count and their subpopulation ratios: neutrophils to lymphocytes ratio (NLR), neutrophils to monocytes ratio (NMR), neutrophils to lymphocytes+monocytes ratio (N/LMR), lymphocytes to monocytes ratio (NMR).\u0000Results: The mean white blood cells count was significant higher in patients with ASC, compared with control group (p<0.001). In patients with ACS the elevated NMR and NLR were observed: 15.04±1.28 vs 11.09±0.43 in control group (p<0.05), and 3.34±0.20 vs 2.60±0.06 (p<0.05), respectively. No significant differences between WBC ratios were revealed in observed patients with ACS with or without AH and/or DM.\u0000Conclusion: ACS is characterized of raised NLR and NMR which could be indicators of poor prognosis","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129906948","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}
T. Gaszyński, Bartosz Borkowski, Karolina Przybyt-Sibelska, Krzysztof Chmiela
Aim: To compare the effectiveness of ventilation of each of three methods: mouth-to-mouth ventilation using a foil face mask with a filter pad, mouth-to-mask technique with a pocket face mask and bag valve mask ventilation using a self-inflating bag and a face mask, performed during CPR by qualified non-medical rescuers. Material and methods: Ventilation effectiveness was assessed on manikin and compared for mouth-to-mouth, mouth-to-mask and bag valve mask ventilation method. 46 qualified non-medical rescuers-lifeguards participated in the study. Tidal Volume of 0,4-0,7L was considered as effective. The length of chest compressions pauses was recorded. The ventilation methods were also evaluated subjectively by participants in the questionnaire. Results: Effectiveness 90,75% vs. 92,38% vs. 69,5%; average number of effective rescue breaths: 7,26 vs. 7,39 vs. 5,65; average length of chest compressions pause: 7,7s vs. 8,1s vs. 9,9s for MTM, MPFM and BMV respectively. MPFM method was considered as the easiest, the second in terms of the difficulty in use was MTM, and BMV was described as the most difficult to use. Conclusions: Artificial ventilation using the pocket mask, in the course of resuscitation performed by one qualified non-medical rescuer, e.g. the water lifeguard, is an effective method ensuring adequate tidal volume and is more effective than mouth-to-mouth method and bag valve mask ventilation.
目的:比较三种方法的通气效果:在心肺复苏术中由合格的非医疗救援人员进行的口对口通气:使用带过滤垫的铝箔口罩进行口对口通气，使用口袋口罩进行口对口通气，使用自充气袋和口罩进行袋阀式面罩通气。材料和方法:在人体模型上评估通气效果，并比较口对口、口对面罩和袋阀面罩通气方法的通气效果。46名合格的非医疗救援救生员参与了这项研究。0,4-0,7 l潮汐量被认为是有效的。记录胸外按压暂停时间。参与者还在问卷中对通风方法进行主观评价。结果:有效率9075% vs. 92,38% vs. 69,5%;平均有效抢救呼吸次数:7,26次vs. 7,39次vs. 5,65次;平均胸外按压暂停时间:MTM、MPFM和BMV分别为7.7 s、8.5 s和9.9 s。MPFM法最简单，MTM法使用难度次之，BMV法使用难度最高。结论:在一名有资质的非医疗救援人员(如水上救生员)实施的复苏过程中，使用口袋口罩进行人工通气是一种有效的方法，可以保证足够的潮气量，比口对口法和袋阀面罩通气更有效。
{"title":"A COMPARISON OF MOUTH-TO-MOUTH, MOUTH-TO-POCKET FACE MASK AND BAG VALVE MASK VENTILATION DURING LIFEGUARDS’ CPR: A MANIKIN STUDY","authors":"T. Gaszyński, Bartosz Borkowski, Karolina Przybyt-Sibelska, Krzysztof Chmiela","doi":"10.36740/emems202101107","DOIUrl":"https://doi.org/10.36740/emems202101107","url":null,"abstract":"Aim: To compare the effectiveness of ventilation of each of three methods: mouth-to-mouth ventilation using a foil face mask with a filter pad, mouth-to-mask technique with a pocket face mask and bag valve mask ventilation using a self-inflating bag and a face mask, performed during CPR by qualified non-medical rescuers.\u0000Material and methods: Ventilation effectiveness was assessed on manikin and compared for mouth-to-mouth, mouth-to-mask and bag valve mask ventilation method. 46 qualified non-medical rescuers-lifeguards participated in the study. Tidal Volume of 0,4-0,7L was considered as effective. The length of chest compressions pauses was recorded. The ventilation methods were also evaluated subjectively by participants in the questionnaire. \u0000Results: Effectiveness 90,75% vs. 92,38% vs. 69,5%; average number of effective rescue breaths: 7,26 vs. 7,39 vs. 5,65; average length of chest compressions pause: 7,7s vs. 8,1s vs. 9,9s for MTM, MPFM and BMV respectively. MPFM method was considered as the easiest, the second in terms of the difficulty in use was MTM, and BMV was described as the most difficult to use.\u0000Conclusions: Artificial ventilation using the pocket mask, in the course of resuscitation performed by one qualified non-medical rescuer, e.g. the water lifeguard, is an effective method ensuring adequate tidal volume and is more effective than mouth-to-mouth method and bag valve mask ventilation.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121356226","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}
M. Szlagor, R. Bobiński, M. Mikulska, Tomasz P Ilczak, Michał Ćwiertnia, P. Białoń, Robert Kijanka, Arkadiusz Stasicki, Katarzyna Styrkosz, M. Kawecki
Infections of the skin and soft tissue are among the most common infections. They are diverse in terms of the extent of the changes, the severity of development and disease group etiological factors. There are a broad range of such infections, from superficial skin infections to deep necrotizing soft tissue infections which are so serious that they can lead to permanent disability or even death. Paramedics are often the first link in the chain of medical treatment for a patient with necrotizing soft tissue infection, which is why it is vital for them to be familiar with the alarm symptoms which indicate that urgent hospitalization is necessary. A key issue for Medical Response Teams when treating patients with skin and soft tissue infections is distinguishing infections that require surgical intervention – a priority for paramedics, from those that require only preventative treatment. It must be remembered that failure to take the correct decisions regarding treatment and logistics can significantly reduce a patient’s chances of survival.
{"title":"FULMINANT SOFT TISSUE INFECTIONS CAUSED BY AEROBIC BACTERIA – A PARAMEDIC’S PERSPECTIVE","authors":"M. Szlagor, R. Bobiński, M. Mikulska, Tomasz P Ilczak, Michał Ćwiertnia, P. Białoń, Robert Kijanka, Arkadiusz Stasicki, Katarzyna Styrkosz, M. Kawecki","doi":"10.36740/emems202101108","DOIUrl":"https://doi.org/10.36740/emems202101108","url":null,"abstract":"Infections of the skin and soft tissue are among the most common infections. They are diverse in terms of the extent of the changes, the severity of development and disease group etiological factors. There are a broad range of such infections, from superficial skin infections to deep necrotizing soft tissue infections which are so serious that they can lead to permanent disability or even death. Paramedics are often the first link in the chain of medical treatment for a patient with necrotizing soft tissue infection, which is why it is vital for them to be familiar with the alarm symptoms which indicate that urgent hospitalization is necessary. A key issue for Medical Response Teams when treating patients with skin and soft tissue infections is distinguishing infections that require surgical intervention – a priority for paramedics, from those that require only preventative treatment. It must be remembered that failure to take the correct decisions regarding treatment and logistics can significantly reduce a patient’s chances of survival.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115025834","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}
Pub Date : 2021-03-01DOI: 10.36740/iemems202102104
T. Chernii, Daria Fokina
Aim: To study the formation of pathological brain systems and their transformation during treatment in patients with acute and chronic cerebral ischemia, using the method of quantitative EEG with wavelet analysis. Material and methods: In the period from 2016 to 2020, 120 people aged 40 to 68 years with CSI and IS were comprehensively examined in dynamics. Patients underwent quantitative EEG (qEEG) with wavelet analysis on days 1, 7, 14, 21, 28. In addition to the protocol, one group of patients received ethylmethyhydropyridoxine succinate. Results: The formation of a new system with a decrease or disappearance of the dominant frequency in the delta range, the appearance of a dominant frequency in the theta range and a subdominant frequency in the alpha range indicates the restoration of brain function. The applied course of neurometabolic therapy leads to such a change in the EEG wavelet graphs after 3-4 weeks in 86.6% of patients. And in the control group, similar changes occur during this period only in 53.3% of patients. Conclusions: To assess the effectiveness of treatment of acute and chronic cerebral ischemia, it is advisable to use a complex of amplitude-time representation of an EEG signal using continuous wavelet transform. The effectiveness of neuromethobolic therapy aimed at eliminating mitochondrial dysfunction can be assessed using the method of quantitative EEG with wavelet transformation, to study the formation and destruction of stable pathological brain systems in patients with cerebral ischemia.
{"title":"POSSIBILITIES OF DIAGNOSIS AND TREATMENT OF ACUTE AND CHRONIC BRAIN ISCHEMIA","authors":"T. Chernii, Daria Fokina","doi":"10.36740/iemems202102104","DOIUrl":"https://doi.org/10.36740/iemems202102104","url":null,"abstract":"Aim: To study the formation of pathological brain systems and their transformation during treatment in patients with acute and chronic cerebral ischemia, using the method of quantitative EEG with wavelet analysis.\u0000Material and methods: In the period from 2016 to 2020, 120 people aged 40 to 68 years with CSI and IS were comprehensively examined in dynamics. Patients underwent quantitative EEG (qEEG) with wavelet analysis on days 1, 7, 14, 21, 28. In addition to the protocol, one group of patients received ethylmethyhydropyridoxine succinate.\u0000Results: The formation of a new system with a decrease or disappearance of the dominant frequency in the delta range, the appearance of a dominant frequency in the theta range and a subdominant frequency in the alpha range indicates the restoration of brain function. The applied course of neurometabolic therapy leads to such a change in the EEG wavelet graphs after 3-4 weeks in 86.6% of patients. And in the control group, similar changes occur during this period only in 53.3% of patients.\u0000Conclusions: To assess the effectiveness of treatment of acute and chronic cerebral ischemia, it is advisable to use a complex of amplitude-time representation of an EEG signal using continuous wavelet transform. The effectiveness of neuromethobolic therapy aimed at eliminating mitochondrial dysfunction can be assessed using the method of quantitative EEG with wavelet transformation, to study the formation and destruction of stable pathological brain systems in patients with cerebral ischemia.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114564806","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}
Тetiana Znamenska, Оlha Vorobiova, Т. Holota, Y. Marushko, V. Pokhylko
Aim: To analyze the literature on the processes of formation of endogenous and exogenous carnitine, its metabolism and function in the newborn. Material and methods: The literature data and international clinical recommendations for pathological conditions leading to primary and secondary carnitine deficiency have been retrospectively analyzed. A clinical case of a child with suspected systemic carnitine deficiency is presented. Conclusions: Depending on the reasons that led to carnitine deficiency, there are primary and secondary carnitine deficiency. Primary carnitine deficiency is a rare condition that can lead to metabolic decompensation, muscular and cardiac myopathy, and sudden death. Secondary carnitine deficiency can be caused by a genetically determined congenital metabolic defect, insufficient substrate intake, acquired disorder, immaturity of the biochemical pathway in premature infants, renal failure or iatrogenic exposure. Familiarization with the main causes of carnitine deficiency in newborns will more effectively detect and correct the clinical manifestations of this condition.
{"title":"THE IMPORTANCE OF CARNITINE AND ITS METABOLISM IN NEWBORN: LITERATURE REVIEW AND CLINICAL CASE","authors":"Тetiana Znamenska, Оlha Vorobiova, Т. Holota, Y. Marushko, V. Pokhylko","doi":"10.36740/emems202102107","DOIUrl":"https://doi.org/10.36740/emems202102107","url":null,"abstract":"Aim: To analyze the literature on the processes of formation of endogenous and exogenous carnitine, its metabolism and function in the newborn.\u0000Material and methods: The literature data and international clinical recommendations for pathological conditions leading to primary and secondary carnitine deficiency have been retrospectively analyzed. A clinical case of a child with suspected systemic carnitine deficiency is presented.\u0000Conclusions: Depending on the reasons that led to carnitine deficiency, there are primary and secondary carnitine deficiency. Primary carnitine deficiency is a rare condition that can lead to metabolic decompensation, muscular and cardiac myopathy, and sudden death. Secondary carnitine deficiency can be caused by a genetically determined congenital metabolic defect, insufficient substrate intake, acquired disorder, immaturity of the biochemical pathway in premature infants, renal failure or iatrogenic exposure. Familiarization with the main causes of carnitine deficiency in newborns will more effectively detect and correct the clinical manifestations of this condition.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126625955","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}
Aim: To evaluate different types of combined anesthesia in surgical correction of congenital malformations in infants and to develop a prediction model of the association of risk factors and fatal cases in chosen methods of anesthesia care. Material and methods: The retrospective study included newborns and infants with congenital malformations, who received and continued phased surgical treatment. Determination of risk factors was performed by the method of simple logistic regression with the calculation of the odds ratio (OR), 95% confidence interval (95% CI). Results: A total of 150 children were included in the study. The risk factors for deaths in the surgical correction of congenital malformations in children have been established, a prognostic model has been created. Conclusions: To prevent fatal cases in various types of surgery and options for anesthesia care of newborns and infants with CM, it is advisable to more closely monitor the cerebral, peripheral oximetry at all stages of treatment and timely correct the impaired condition of the child.
{"title":"PREDICTION MODEL OF PROBABILITY ESTIMATE OF FATAL CASES IN INFANTS WITH CONGENITAL MALFORMATIONS IN SURGICAL INTERVENTIONS","authors":"Alexey O. Vlasov, I. A. Holovanova","doi":"10.36740/emems202102101","DOIUrl":"https://doi.org/10.36740/emems202102101","url":null,"abstract":"Aim: To evaluate different types of combined anesthesia in surgical correction of congenital malformations in infants and to develop a prediction model of the association of risk factors and fatal cases in chosen methods of anesthesia care.\u0000Material and methods: The retrospective study included newborns and infants with congenital malformations, who received and continued phased surgical treatment. Determination of risk factors was performed by the method of simple logistic regression with the calculation of the odds ratio (OR), 95% confidence interval (95% CI).\u0000Results: A total of 150 children were included in the study. The risk factors for deaths in the surgical correction of congenital malformations in children have been established, a prognostic model has been created.\u0000Conclusions: To prevent fatal cases in various types of surgery and options for anesthesia care of newborns and infants with CM, it is advisable to more closely monitor the cerebral, peripheral oximetry at all stages of treatment and timely correct the impaired condition of the child.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128078877","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}
I. Gladchuk, O. Nazarenko, A. Volyanska, V. Kozhakov
Aim: Analysis of modern medical care for women with ovarian hemorrhage, determination of the main diagnostic criteria that influence the choice of treatment tactics and further prognosis of the outcome of treatment of ovarian apoplexy. Material and methods: The provision of medical care to 888 women with ovarian apoplexy. Depending on the volume of hemoperitoneum, all patients were divided into three groups.: Group I – 480 (54.0%) women in whom intraabdominal bleeding did not exceed 200 ml; Group II – 283 (31.8%) patients with hemoperitoneum ranged from 200 to 500 ml; Group III – 125 (14.1%) patients with hemoperitoneum volume greater than 500 ml. Results: According to the data of the transvaginal US , a linear dependence was observed between the level of free liquid and the volume of hemoperitoneum (r=0.63, p<0.05). In 792 (89.2%) patients the diagnosis of apoplexy of the ovary and intraperitoneal hemorrhage was made to surgical intervention- on the basis of clinical picture and US data. The most frequently performed hemostatic operation was resection of the ovary – 477 (77.2%) interventions. The average volume of hemoperitoneum discovered in patients with AO, in absence of the adhesive process was (273.5±21.3) ml, whereas in patients with the expressed adhesive process of the small pelvis organs it was (141.4±35.5) ml. The cause of AO was the corpus luteum or cyst of the corpus luteum in more than the half of the cases – 348 (56.3%). Conclusions: The manifestation of the clinical symptoms in apoplexy of the ovaries depends on the volume of intraperitoneal hemorrhage. The application of laparoscopy as a main therapeutic and prophylactic method in AO allows to preserve, and sometimes to restore the reproductive function of a woman and to reduce the rate of the disease relapse development.
{"title":"MODERN CONCEPT OF RENDERING AID TO WOMEN WITH OVARIAN HEMORRHAGES","authors":"I. Gladchuk, O. Nazarenko, A. Volyanska, V. Kozhakov","doi":"10.36740/emems202102105","DOIUrl":"https://doi.org/10.36740/emems202102105","url":null,"abstract":"Aim: Analysis of modern medical care for women with ovarian hemorrhage, determination of the main diagnostic criteria that influence the choice of treatment tactics and further prognosis of the outcome of treatment of ovarian apoplexy.\u0000Material and methods: The provision of medical care to 888 women with ovarian apoplexy. Depending on the volume of hemoperitoneum, all patients were divided into three groups.: Group I – 480 (54.0%) women in whom intraabdominal bleeding did not exceed 200 ml; Group II – 283 (31.8%) patients with hemoperitoneum ranged from 200 to 500 ml; Group III – 125 (14.1%) patients with hemoperitoneum volume greater than 500 ml.\u0000Results: According to the data of the transvaginal US , a linear dependence was observed between the level of free liquid and the volume of hemoperitoneum (r=0.63, p<0.05). In 792 (89.2%) patients the diagnosis of apoplexy of the ovary and intraperitoneal hemorrhage was made to surgical intervention- on the basis of clinical picture and US data. The most frequently performed hemostatic operation was resection of the ovary – 477 (77.2%) interventions. The average volume of hemoperitoneum discovered in patients with AO, in absence of the adhesive process was (273.5±21.3) ml, whereas in patients with the expressed adhesive process of the small pelvis organs it was (141.4±35.5) ml. The cause of AO was the corpus luteum or cyst of the corpus luteum in more than the half of the cases – 348 (56.3%).\u0000Conclusions: The manifestation of the clinical symptoms in apoplexy of the ovaries depends on the volume of intraperitoneal hemorrhage. The application of laparoscopy as a main therapeutic and prophylactic method in AO allows to preserve, and sometimes to restore the reproductive function of a woman and to reduce the rate of the disease relapse development.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133570195","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}
Paulina Pisaniak, Joanna Żołądź, Aleksander Tarczon, Dorota Ozga
Aim: Stigmatization is about making a division – people are grouped into better and worse, people with mental disorders are very often perceived as different, which is why they are largely stigmatized. Mental illnesses are a growing problem among the society of developed countries, therefore, the problem of stigmatization of these people has also become noticeable, which may adversely affect their mental condition and the convalescence process. The aim of the study is to assess the degree of stigmatization of mentally ill people by paramedics. Material and methods: An original questionnaire was used to collect the data, distributed from February 15, 2020 to April 7, 2020. among paramedics working in various medical rescue units and in units cooperating with the National Medical Rescue system. We collected 91 respondents replied. The research was a pilot study. Results: Paramedics are a professional group that does not show any particular signs of stigmatization in relation to the mentally ill, but single responses were obtained, which may indicate a given respondent’s lack of understanding for the mentally ill. Conclusions: In order to prevent stigmatization of the mentally ill, it is very important to educate not only paramedics, but also representatives of other medical professions who have contact with people suffering from mental disorders.
{"title":"STIGMATIZATION OF MENTALLY ILL PEOPLE BY PARAMEDICS – PILOT STUDY","authors":"Paulina Pisaniak, Joanna Żołądź, Aleksander Tarczon, Dorota Ozga","doi":"10.36740/emems202101101","DOIUrl":"https://doi.org/10.36740/emems202101101","url":null,"abstract":"Aim: Stigmatization is about making a division – people are grouped into better and worse, people with mental disorders are very often perceived as different, which is why they are largely stigmatized. Mental illnesses are a growing problem among the society of developed countries, therefore, the problem of stigmatization of these people has also become noticeable, which may adversely affect their mental condition and the convalescence process. The aim of the study is to assess the degree of stigmatization of mentally ill people by paramedics.\u0000Material and methods: An original questionnaire was used to collect the data, distributed from February 15, 2020 to April 7, 2020. among paramedics working in various medical rescue units and in units cooperating with the National Medical Rescue system. We collected 91 respondents replied. The research was a pilot study.\u0000Results: Paramedics are a professional group that does not show any particular signs of stigmatization in relation to the mentally ill, but single responses were obtained, which may indicate a given respondent’s lack of understanding for the mentally ill.\u0000Conclusions: In order to prevent stigmatization of the mentally ill, it is very important to educate not only paramedics, but also representatives of other medical professions who have contact with people suffering from mental disorders.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132553325","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}
V. Boyko, Y. Avdosyev, A. Sochnieva, D. Yevtushenko, D. V. Minukhin
Aim: Evaluation of the effectiveness of percutaneous transhepatic cholangiography in the diagnostics of bile duct diseases complicated by obstructive jaundice. Material and methods: This article presents the experience of using percutaneous transhepatic cholangiography in 88 patients with benign and malignant common bile duct diseases complicated by obstructive jaundice. Results: Methods of direct contrasting of the biliary tract make it possible to visualize choledocholithiasis with 86.5% accuracy, with 84.1% common bile duct strictures, with 87.8% stricture of biliodigestive anastomosis and with 97.5% accuracy of cholangiocarcinomas. Conclusions: Direct antegrade bile duct enhancement should be used if ERCPG has low explanatory value. PTCG in case of “endoscopically complicated forms” of choledocholithiasis, CBD and BDA strictures and cholangiocarcinomas enhances all bile duct sections and helps assess the level and completeness of biliary blockade. Following PTCG, measures can be taken to achieve biliary decompression regardless of OJ genesis.
{"title":"PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY IN THE DIAGNOSTICS OF COMMON BILE DUCT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE*","authors":"V. Boyko, Y. Avdosyev, A. Sochnieva, D. Yevtushenko, D. V. Minukhin","doi":"10.36740/emems202102102","DOIUrl":"https://doi.org/10.36740/emems202102102","url":null,"abstract":"Aim: Evaluation of the effectiveness of percutaneous transhepatic cholangiography in the diagnostics of bile duct diseases complicated by obstructive jaundice.\u0000Material and methods: This article presents the experience of using percutaneous transhepatic cholangiography in 88 patients with benign and malignant common bile duct diseases complicated by obstructive jaundice.\u0000Results: Methods of direct contrasting of the biliary tract make it possible to visualize choledocholithiasis with 86.5% accuracy, with 84.1% common bile duct strictures, with 87.8% stricture of biliodigestive anastomosis and with 97.5% accuracy of cholangiocarcinomas.\u0000Conclusions: Direct antegrade bile duct enhancement should be used if ERCPG has low explanatory value. PTCG in case of “endoscopically complicated forms” of choledocholithiasis, CBD and BDA strictures and cholangiocarcinomas enhances all bile duct sections and helps assess the level and completeness of biliary blockade. Following PTCG, measures can be taken to achieve biliary decompression regardless of OJ genesis.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121260564","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}
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