Aim: The present paper attempts to find the risk factors for hypotension suffered by patients in the postoperative period taking into account the following aspects: gender, type of anaesthesia, ASA score, type of surgery, and time after surgery when it is likely to be at its lowest. Material and methods: The main method used in the study was to analyze the medical records regarding patient data in the perioperative period. Patients had their mean arterial pressure (MAP) measured and documented in the Intensive Care Chart. Information on the type of surgery and choice of anesthesia was obtained from the Anaesthesia Records. Eighty patients participated in the study. Results: There was no clear correlation between the gender of the patients and the decrease in blood pressure. Hypotonia occurred in the 8th hour after surgery in both men and women in the study group. It was observed that in subjects under 80 years of age, hypotonia occurs mainly in the 8th hour after the procedure, while in older subjects – after 12 hours following surgery. The type of procedure affects the occurrence of hypotonia. In patients undergoing general and epidural anaesthesia, the highest decreases in mean arterial pressure values were observed 8 hours after surgery compared to other methods of anaesthesia. The ASA classification proved useful in predicting the incidence of hypotonia; in Class 4 patients, it was pronounced and persisted for 12 hours after surgery. Conclusions: It cannot be conclusively stated which factors most influence the occurrence of hypotension in patients after surgery.
{"title":"ANALYSIS OF THE CAUSES OF HYPOTENSION IN RECOVERY ROOM SURGICAL PATIENTS","authors":"Robert Hadzik, Marta Pietrzak, D. Kosson","doi":"10.36740/emems202203105","DOIUrl":"https://doi.org/10.36740/emems202203105","url":null,"abstract":"Aim: The present paper attempts to find the risk factors for hypotension suffered by patients in the postoperative period taking into account the following aspects: gender, type of anaesthesia, ASA score, type of surgery, and time after surgery when it is likely to be at its lowest. \u0000Material and methods: The main method used in the study was to analyze the medical records regarding patient data in the perioperative period. Patients had their mean arterial pressure (MAP) measured and documented in the Intensive Care Chart. Information on the type of surgery and choice of anesthesia was obtained from the Anaesthesia Records. Eighty patients participated in the study. \u0000Results: There was no clear correlation between the gender of the patients and the decrease in blood pressure. Hypotonia occurred in the 8th hour after surgery in both men and women in the study group. It was observed that in subjects under 80 years of age, hypotonia occurs mainly in the 8th hour after the procedure, while in older subjects – after 12 hours following surgery. The type of procedure affects the occurrence of hypotonia. In patients undergoing general and epidural anaesthesia, the highest decreases in mean arterial pressure values were observed 8 hours after surgery compared to other methods of anaesthesia. The ASA classification proved useful in predicting the incidence of hypotonia; in Class 4 patients, it was pronounced and persisted for 12 hours after surgery. \u0000Conclusions: It cannot be conclusively stated which factors most influence the occurrence of hypotension in patients after surgery.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"57 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":"130083439","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}
In recent years, there has been an increase in the incidence of dental injuries among children and adolescents, which is associated with a change in lifestyle activity, practicing various sports during which there is frequent damage to various parts of the body. At the same time, there is a growing need to know the procedures for proper conduct in providing first aid for dental injuries by people caring for children and adolescents, i.e. teachers, trainers but also medical personnel (doctors, paramedics, school nurses). One of the most serious injuries affecting permanent teeth is the complete knockout of the tooth. Failure to perform immediate tooth replantation within 30 minutes (insertion of the tooth into the socket) may result in premature tooth loss. The International Association of Dental Traumatology (IADT) has devel¬oped guidelines for dealing with dental injuries, in which it recognizes that in the event of tooth extraction, the most important factor for a good prognosis is to perform immediate replantation, and if this is impossible, transport the tooth in an appropriate way and send the patient to the dentist as soon as possible. This article describes the procedure for performing immediate replantation in the case of complete knockout of a permanent tooth and presents a clinical case in which the key to the success of treatment was to perform this procedure by the patient immediately after the injury, after a telephone con¬versation with her mother, who a few days earlier watched a film about such an injury and while remaining calm, ordered her daughter to insert the tooth into the socket. This case demonstrates the need for the necessary broad social education in this area.
{"title":"COMPLETE KNOCKOUT OF A PERMANENT TOOTH – INTERDISCIPLINARY PROBLEM OR HOW TO HELP SO THAT IT DOES NOT HARM – CASE STUDY","authors":"Anna Goszczycka, J. Głogowska-Szeląg","doi":"10.36740/emems202301109","DOIUrl":"https://doi.org/10.36740/emems202301109","url":null,"abstract":"In recent years, there has been an increase in the incidence of dental injuries among children and adolescents, which is associated with a change in lifestyle activity, practicing various sports during which there is frequent damage to various parts of the body. \u0000At the same time, there is a growing need to know the procedures for proper conduct in providing first aid for dental injuries by people caring for children and adolescents, i.e. teachers, trainers but also medical personnel (doctors, paramedics, school nurses). \u0000One of the most serious injuries affecting permanent teeth is the complete knockout of the tooth. Failure to perform immediate tooth replantation within 30 minutes (insertion of the tooth into the socket) may result in premature tooth loss. The International Association of Dental Traumatology (IADT) has devel¬oped guidelines for dealing with dental injuries, in which it recognizes that in the event of tooth extraction, the most important factor for a good prognosis is to perform immediate replantation, and if this is impossible, transport the tooth in an appropriate way and send the patient to the dentist as soon as possible. This article describes the procedure for performing immediate replantation in the case of complete knockout of a permanent tooth and presents a clinical case in which the key to the success of treatment was to perform this procedure by the patient immediately after the injury, after a telephone con¬versation with her mother, who a few days earlier watched a film about such an injury and while remaining calm, ordered her daughter to insert the tooth into the socket. This case demonstrates the need for the necessary broad social education in this area.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"150 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":"134409545","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 assess endothelial dysfunction in patients with liver cirrhosis. Material and methods: The study involved 95 patients with alcoholic liver cirrhosis. The data were subjected to analysis of variance involving the calculation of arithmetic mean value and variance (М±m), estimating the values validity according to Student’s t-test and measuring Pearson correlation coefficient for binary variables. Results: The brachial artery diameter was 0.4±0.02 mm narrower, with its blood velocity flow being 25.8±3.4 cm/s slower in the mean, in the patients with liver cirrhosis with signs of hepatic encephalopathy as compared to the control group. The maximum EDV values were recorded in the patients in Group I (7.5±1.9 %), while Group III patients displayed the lowest EDV value (5.6±1.9 %). The LC patients were found to exhibit a significant increase in the concentration of ET-1 up to 1.14±0.07 fmol/ml as opposed to 0.34±0.05 fmol/ml in the control group (р<0.01), an increase in the level of VWF by 139.4±24,8 % as compared to the control group (р<0.01) and D-dimer by a factor of 6.8. Conclusions: The patients with liver cirrhosis were found to have endothelial damage, namely the dysfunction of the vasoregulating activity of vascular wall against the background of portal hypertension. Changes in the vasoactive BAS values are indicative of the damage to the vascular endothelium in LC patients with signs of HE. A steady and gradual increase or decrease in the levels of ЕТ-1, VWF, АТ ІІІ, and D-dimer may suggest the progressive character of ED in the LC patients.
{"title":"ENDOTHELIUM DYSFUNCTION IN PATIENTS WITH LIVER CIRRHOSIS","authors":"O. Balazh","doi":"10.36740/emems202202105","DOIUrl":"https://doi.org/10.36740/emems202202105","url":null,"abstract":"Aim: To assess endothelial dysfunction in patients with liver cirrhosis. \u0000Material and methods: The study involved 95 patients with alcoholic liver cirrhosis. The data were subjected to analysis of variance involving the calculation of arithmetic mean value and variance (М±m), estimating the values validity according to Student’s t-test and measuring Pearson correlation coefficient for binary variables. \u0000Results: The brachial artery diameter was 0.4±0.02 mm narrower, with its blood velocity flow being 25.8±3.4 cm/s slower in the mean, in the patients with liver cirrhosis with signs of hepatic encephalopathy as compared to the control group. The maximum EDV values were recorded in the patients in Group I (7.5±1.9 %), while Group III patients displayed the lowest EDV value (5.6±1.9 %). The LC patients were found to exhibit a significant increase in the concentration of ET-1 up to 1.14±0.07 fmol/ml as opposed to 0.34±0.05 fmol/ml in the control group (р<0.01), an increase in the level of VWF by 139.4±24,8 % as compared to the control group (р<0.01) and D-dimer by a factor of 6.8. \u0000Conclusions: The patients with liver cirrhosis were found to have endothelial damage, namely the dysfunction of the vasoregulating activity of vascular wall against the background of portal hypertension. Changes in the vasoactive BAS values are indicative of the damage to the vascular endothelium in LC patients with signs of HE. A steady and gradual increase or decrease in the levels of ЕТ-1, VWF, АТ ІІІ, and D-dimer may suggest the progressive character of ED in the LC patients.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"34 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":"115551635","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}
W. Roczniak, M. Wojtanowska, M. Mikoś, R. Antoniewicz, P. Roczniak, Magdalena Babuśka-Roczniak
{"title":"Abdominal pain as life-threatening condition – case study","authors":"W. Roczniak, M. Wojtanowska, M. Mikoś, R. Antoniewicz, P. Roczniak, Magdalena Babuśka-Roczniak","doi":"10.36740/emems201901105","DOIUrl":"https://doi.org/10.36740/emems201901105","url":null,"abstract":"","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"49 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":"115782606","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 determine the approaches to form stress tolerance of the individual in quarantine conditions and justify the means of providing remote psychological assistance. Material and methods: The research methods were chosen taking into account the set goal, and are also caused by the need for a comprehensive study of the means of providing psychological assistance to persons who are (were) in stressful conditions (analysis, prediction, comparative method, generalization method, etc.). Results: The problem of overcoming stress involves the study of the patterns of formation and implementation of the processes of preventive and operational protection of the body and psyche from stressful influences; development and manifestation of various strategies (methods) and styles of behavior in these conditions; personal determination of the processes of counteraction; the role of functional resources in the formation of methods of countering stress. Dur¬ing remote psychological counseling of people in a crisis situation, it is useful to use directive interaction techniques. The use of valid psychotherapeutic methods provides for the preservation and restoration of the resource state of the consulted person. Conclusions: Rehabilitation measures (the use of advisory methods; changing the strategies and behaviors of a per¬son; using self-regulation techniques, etc.) are aimed at reducing the risks of developing stressful phenomena and their impact on a person during quarantine. The tools of professional psychological assistance should focus primarily on improving communicative openness, stress tolerance, social confidence, etc.
{"title":"Means of providing remote psychological assistance in the conditions of quarantine","authors":"I. Okhrimenko, Nina V. Lyhun, O. Rivchachenko","doi":"10.36740/emems202201102","DOIUrl":"https://doi.org/10.36740/emems202201102","url":null,"abstract":"Aim: To determine the approaches to form stress tolerance of the individual in quarantine conditions and justify the means of providing remote psychological assistance. \u0000Material and methods: The research methods were chosen taking into account the set goal, and are also caused by the need for a comprehensive study of the means of providing psychological assistance to persons who are (were) in stressful conditions (analysis, prediction, comparative method, generalization method, etc.). \u0000Results: The problem of overcoming stress involves the study of the patterns of formation and implementation of the processes of preventive and operational protection of the body and psyche from stressful influences; development and manifestation of various strategies (methods) and styles of behavior in these conditions; personal determination of the processes of counteraction; the role of functional resources in the formation of methods of countering stress. Dur¬ing remote psychological counseling of people in a crisis situation, it is useful to use directive interaction techniques. The use of valid psychotherapeutic methods provides for the preservation and restoration of the resource state of the consulted person. \u0000Conclusions: Rehabilitation measures (the use of advisory methods; changing the strategies and behaviors of a per¬son; using self-regulation techniques, etc.) are aimed at reducing the risks of developing stressful phenomena and their impact on a person during quarantine. The tools of professional psychological assistance should focus primarily on improving communicative openness, stress tolerance, social confidence, etc.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"31 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":"116933914","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. I. Lyakhovsky, O. H. Krasnov, R.B. Lisenko, T. V. Gorodova-Andreeva, Oleksandr M. Liulka, N. O. Lyakhova, O. Krasnova
Aim: Improving emergency surgical care for patients with diabetic foot syndrome. Materials and methods: We conducted treatment of 268 patients with diabetic foot syndrome (DFS). The first group (136 patients) consisted of patients admitted to the hospital in 2012-2016, organ-preserving operations were performed according to the methods developed in the clinic (126 patients).The second group (132 patients) consisted of patients admitted in 2017-2021. Results: In the main group, surgical treatment was determined by the form of DFS. There were in the neuropathic form: stage I – surgical treatment of the focus, and stage II – plastic closure of the wound. There were in neuroischemic form (60 patients): stage I – correction of ischemia; stage II – surgical treat¬ment of the focus; stage III – plastic closure of the wound. In 10 (7.3%) patients of the main group amputations were performed at the level of the shin and the thigh. In the control group, in 19 (14.4%) patients, amputation was performed at the level of the thigh. Conclusions: Organ-preserving treatment of DFS should be carried out in accordance with the form of DFS with determination of tissue viability. Among the factors influencing the rate of healing, the shape of the wound, its size and localization are important.
{"title":"CURRENT ASPECTS OF URGENT SURGICAL ASSISTANCE IN PATIENTS WITH DIABETIC FOOT SYNDROME","authors":"V. I. Lyakhovsky, O. H. Krasnov, R.B. Lisenko, T. V. Gorodova-Andreeva, Oleksandr M. Liulka, N. O. Lyakhova, O. Krasnova","doi":"10.36740/emems202301103","DOIUrl":"https://doi.org/10.36740/emems202301103","url":null,"abstract":"Aim: Improving emergency surgical care for patients with diabetic foot syndrome. \u0000Materials and methods: We conducted treatment of 268 patients with diabetic foot syndrome (DFS). The first group (136 patients) consisted of patients admitted to the hospital in 2012-2016, organ-preserving operations were performed according to the methods developed in the clinic (126 patients).The second group (132 patients) consisted of patients admitted in 2017-2021. \u0000Results: In the main group, surgical treatment was determined by the form of DFS. There were in the neuropathic form: stage I – surgical treatment of the focus, and stage II – plastic closure of the wound. There were in neuroischemic form (60 patients): stage I – correction of ischemia; stage II – surgical treat¬ment of the focus; stage III – plastic closure of the wound. In 10 (7.3%) patients of the main group amputations were performed at the level of the shin and the thigh. In the control group, in 19 (14.4%) patients, amputation was performed at the level of the thigh. \u0000Conclusions: Organ-preserving treatment of DFS should be carried out in accordance with the form of DFS with determination of tissue viability. Among the factors influencing the rate of healing, the shape of the wound, its size and localization are important.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"37 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":"130800238","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":"Legal regulations and medical error of a medical dispatcher","authors":"D. Zawadzki, J. Sikora, Anna Rej-Kietla","doi":"10.36740/emems201903104","DOIUrl":"https://doi.org/10.36740/emems201903104","url":null,"abstract":"","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":"125373550","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}
Robert Kijanka, P. Białoń, Marek Kawecki, M. Szlagor, Michał Dudek, R. Bobiński
Diagnosing chronic carbon monoxide poisoning can be a challenge for medical response teams. It is charaterised by unclear symptoms, which develop in a manner similar to many chronic cardiological or neurological diseases, and has consequences that can occur up to several months later. As a result, the character of such poisoning is often under¬estimated in daily practice. Multiple interventions and working under pressure does not always allow for a detailed analysis of many factors. It is therefore vital to develop solutions that allow for quick assessment of whether a patient has been exposed to carbon monoxide poisoning. Three-step analysis of the symptoms of poisoning is an ideal exam¬ple. This consists of a consultation on exposure to carbon monoxide poisoning, the presence of symptoms suggesting hypoxia due to poisoning, and determining the carboxyhaemoglobin index using equipment carried by the medical response team. Emergency procedures based on these three elements result in rapid identification of people suffering from carbon monoxide poisoning who require oxygen therapy, and the transportation of such people to specialised units for hyperbaric oxygen therapy. This system of analysis can also be used as part of a standard examination for assessing the exposure of a patient to carbon monoxide, both in hospital emergency departments and in medical response teams.
{"title":"Three-step analysis of symptoms of carbon monoxide poisoning in pre-hospital medical response teams","authors":"Robert Kijanka, P. Białoń, Marek Kawecki, M. Szlagor, Michał Dudek, R. Bobiński","doi":"10.36740/emems202201108","DOIUrl":"https://doi.org/10.36740/emems202201108","url":null,"abstract":"Diagnosing chronic carbon monoxide poisoning can be a challenge for medical response teams. It is charaterised by unclear symptoms, which develop in a manner similar to many chronic cardiological or neurological diseases, and has consequences that can occur up to several months later. As a result, the character of such poisoning is often under¬estimated in daily practice. Multiple interventions and working under pressure does not always allow for a detailed analysis of many factors. It is therefore vital to develop solutions that allow for quick assessment of whether a patient has been exposed to carbon monoxide poisoning. Three-step analysis of the symptoms of poisoning is an ideal exam¬ple. This consists of a consultation on exposure to carbon monoxide poisoning, the presence of symptoms suggesting hypoxia due to poisoning, and determining the carboxyhaemoglobin index using equipment carried by the medical response team. Emergency procedures based on these three elements result in rapid identification of people suffering from carbon monoxide poisoning who require oxygen therapy, and the transportation of such people to specialised units for hyperbaric oxygen therapy. This system of analysis can also be used as part of a standard examination for assessing the exposure of a patient to carbon monoxide, both in hospital emergency departments and in medical response teams.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"66 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":"121536950","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}
The aim of the study was to present skin diseases that occur during the Sars-CoV-2 pandemic, especially among healthcare workers. Literature data on skin symptoms associated with COVID-19, frequently reported, e.g. by healthcare workers in the last months of the pandemic. Properly built, healthy, undamaged skin is our protection. It is extremely important for our health during the COVID-19 pandemic, and especially for people working in the health service. There is an increasing number of reports of irritating dermatitis among healthcare workers due to the increased need to wear personal protective equipment and more frequent hand washing than before the pandemic. Overzealous use of disinfectants and frequent hand washing can lead to disturbances in the functioning of the skin barrier, which in turn can lead to diseases such as hand eczema. This systematic review focuses on all skin problems related to COVID-19, including primary and secondary COVID-related cutaneous presentations. Skin diseases caused by Sars-CoV-2 virus should be monitored.
{"title":"SKIN DISEASES CAUSED BY THE SARS-COV-2 VIRUS AND THEIR INCREASE DURING THE USE OF PERSONAL PROTECTIVE EQUIPMENT","authors":"J. Olszewska, A. Charuta, J. Ładny, K. Nadolny","doi":"10.36740/emems202104110","DOIUrl":"https://doi.org/10.36740/emems202104110","url":null,"abstract":"The aim of the study was to present skin diseases that occur during the Sars-CoV-2 pandemic, especially among healthcare workers. Literature data on skin symptoms associated with COVID-19, frequently reported, e.g. by healthcare workers in the last months of the pandemic. Properly built, healthy, undamaged skin is our protection. It is extremely important for our health during the COVID-19 pandemic, and especially for people working in the health service. There is an increasing number of reports of irritating dermatitis among healthcare workers due to the increased need to wear personal protective equipment and more frequent hand washing than before the pandemic. Overzealous use of disinfectants and frequent hand washing can lead to disturbances in the functioning of the skin barrier, which in turn can lead to diseases such as hand eczema. This systematic review focuses on all skin problems related to COVID-19, including primary and secondary COVID-related cutaneous presentations. Skin diseases caused by Sars-CoV-2 virus should be monitored.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"6 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":"121109888","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}
D. Zyśko, G. Chourasia, G. Gogolewski, P. Skoczyński, R. Zymliński, J. Wizowska, K. Nadolny
Aim: To determine the presence and the importance of a difference in end tidal carbon dioxide between lateral decubitus positions for pulmonary embolism prediction. Material and methods: There were 32 patients aged 65.7±14.4 (16M, 16F) with pulmonary embolism and 15 patients aged 56.7±20.3 (10M, 5F) with excluded pulmonary embolism Capnography was performed in supine, left and right lateral decubitus position. The absolute value of the difference in end tidal carbon dioxide concentration between left and right decubitus position was called the delta index. Demographics and clinical data were collected. Results: The delta index was significantly higher in patients with pulmonary embolism vs those with excluded pulmonary embolism: 4 (3-5.5) mmHg vs 1 (1-2) mmHg p<0.001. Area under curve for the delta index was 0.92; 95% CI 0.83-1.0 p 3 mmHg to predict PE the sensitivity and specificity was 66% and 100%, respectively. Conclusions: The patients with pulmonary embolism had increased variability of end tidal carbon dioxide concentration while changing their position.
目的:确定侧卧位之间终潮二氧化碳的差异对肺栓塞预测的存在和重要性。材料与方法:32例年龄为65.7±14.4 (16M, 16F)的肺栓塞患者和15例年龄为56.7±20.3 (10M, 5F)的排除肺栓塞患者分别采用仰卧位、左右侧卧位进行肺栓塞造影。左右卧位末潮二氧化碳浓度差值的绝对值称为δ指数。收集了人口统计学和临床数据。结果:肺栓塞患者的delta指数明显高于非肺栓塞患者:4 (3-5.5)mmHg vs 1 (1-2) mmHg p<0.001。δ指数曲线下面积为0.92;95% CI 0.83-1.0 p3mmhg预测PE的敏感性和特异性分别为66%和100%。结论:肺栓塞患者体位改变，终潮二氧化碳浓度变异性增加。
{"title":"THE DELTA INDEX – THE DIFFERENCE BETWEEN END TIDALCARBON DIOXIDE CONCENTRATION IN RIGHTAND LEFT LATERAL DECUBITUS POSITION– COULD PREDICT PULMONARY EMBOLISM –PRELIMINARY RESULTS","authors":"D. Zyśko, G. Chourasia, G. Gogolewski, P. Skoczyński, R. Zymliński, J. Wizowska, K. Nadolny","doi":"10.36740/emems202202101","DOIUrl":"https://doi.org/10.36740/emems202202101","url":null,"abstract":"Aim: To determine the presence and the importance of a difference in end tidal carbon dioxide between lateral decubitus positions for pulmonary embolism prediction. \u0000Material and methods: There were 32 patients aged 65.7±14.4 (16M, 16F) with pulmonary embolism and 15 patients aged 56.7±20.3 (10M, 5F) with excluded pulmonary embolism Capnography was performed in supine, left and right lateral decubitus position. The absolute value of the difference in end tidal carbon dioxide concentration between left and right decubitus position was called the delta index. Demographics and clinical data were collected. \u0000Results: The delta index was significantly higher in patients with pulmonary embolism vs those with excluded pulmonary embolism: 4 (3-5.5) mmHg vs 1 (1-2) mmHg p<0.001. Area under curve for the delta index was 0.92; 95% CI 0.83-1.0 p 3 mmHg to predict PE the sensitivity and specificity was 66% and 100%, respectively. \u0000Conclusions: The patients with pulmonary embolism had increased variability of end tidal carbon dioxide concentration while changing their position.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"115 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":"122437009","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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