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Paediatric supraventricular tachycardia (SVT) is a common arrhythmia of great clinical significance. If not treated promptly, it can cause heart failure and cardiogenic shock. Depending on the patient's condition, SVT treatment involves vagal manoeuvres, pharmacological, or direct current cardioversion. The goal of acute SVT management is to immediately convert SVT to a normal sinus rhythm (NSR) and prevent its recurrence. Adenosine is recommended as the first-line treatment for stable SVT by the European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines, when vagal manoeuvres have proven ineffective. The ERC and AHA guidelines recommend the intravenous route of administration. The intraosseous (IO) administration technique is also possible, but still relatively unknown. The aim of this paper is to describe a 3.5-year-old child with SVT that was converted to NSR following IO administration of adenosine. Successful conversion was achieved after the second attempt with the adenosine dose. In the described case, there was no recurrence of SVT. [ABSTRACT FROM AUTHOR]

COVID-19 disease is characterised by a wide range of symptoms that in most cases resemble flu or cold. Early detection of infections, monitoring of patients' conditions, and identification of patients with worsening symptoms became crucial during the peak of pandemic. The aim of this study was to assess and compare the performance of common early warning scores at the time of admission to an emergency department in predicting in-hospital mortality in patients with COVID-19. The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to an emergency department between March 2020 and April 2022. The prognostic value of early warning scores in predicting in-hospital mortality was assessed using the receiver operating characteristic (ROC) curve. Patients' median age was 59 years, and 52.33% were male. Among all the EWS we assessed, REMS had the highest overall accuracy (AUC 0.84 (0.83–0.85)) and the highest NPV (97.4%). REMS was the most accurate scoring system, characterised by the highest discriminative power and negative predictive value compared to the other analysed scoring systems. Incorporating these tools into clinical practice in a hospital emergency department could provide more effective assessment of mortality and, consequently, avoid delayed medical assistance. [ABSTRACT FROM AUTHOR]

The effective management of diabetes is a complex issue and may be determined according to numerous patient-dependent and patient-independent factors. This study aimed to analyze the relationship between the place of residence and selected sociodemographic, psychological and diabetes-related parameters in people with type 1 diabetes (T1D). This study was conducted on 419 adults with T1D using nonprobability sampling. The following questionnaires were used: the Diabetes Dietary Guidelines Adherence Index, the Acceptance of Illness Scale, the Sense of Responsibility for Health Scale, the Diabetes Eating Problem Survey-Revised scale, the Eating Attitudes Test and questions on sociodemographic and diabetes-related parameters. People living in rural areas were characterized by a significantly lower age and level of education, a higher incidence of being overweight, a higher glycated hemoglobin concentration, a lower number of glucose measurements during the day and a higher level of acceptance of the disease compared to urban residents. The degree of adherence to dietary recommendations and the sense of responsibility for one's own health were significantly higher among urban residents. It is necessary to assess barriers to a proper diet and to increase the effectiveness in managing the disease in rural communities. Targeted actions promoting the health of type 1 diabetics need to be developed with particular emphasis on patients from rural areas. [ABSTRACT FROM AUTHOR]

Background. Arrhythmias in patients during medical transport remain a challenge for medical personnel. Helicopter emergency medical service (HEMS) crews, as the only medical rescue teams in Poland to conduct rescue flights, keep detailed documentation of monitoring vital functions over short time intervals during the flight. Aims. The aim of this study was to determine the characteristics of cardiac arrhythmia in pediatric patients (up to 12 years of age) transported by HEMS operatives, considering life-threatening rhythms and those that occur during out-of-hospital cardiac arrest (OHCA). Methods. The analysis of HEMS medical documentation covered 90345 missions carried out from 2011 to 2020. Among all activations, 820 cases of arrhythmias in pediatric patients up to 12 years of age were extracted. Results. Missions for males accounted for 60% of all activations (n = 492), while flights for females accounted for 40% (n = 328). A statistically significant relationship between the number of HEMS flights and the season was demonstrated (p = 0.015). During the study period, pediatric patients mostly experienced cardiac arrhythmias in the form of supraventricular tachycardia (sVT) (n = 504). Asystole (n = 178) and pulseless electrical activity (PEA) (n = 52) ranked second and third in terms of occurrence, respectively. A statistically significant relationship between the type of heart rhythm disorder and age was demonstrated (p < 0.05). Conclusions. Heart rhythm disorders most often affected children between 0 and 3 years of age. As the patient's age increased, the incidence of arrhythmias decreased. Among pediatric patients, supraventricular tachycardia proved to be the predominant arrhythmia during the study period. [ABSTRACT FROM AUTHOR]

Numerous complications of type 1 diabetes (T1D) may be prevented through suitable glycemic control. Glycated hemoglobin (HbA1c) may be one of the markers for the early detection of the metabolic imbalance characteristic of the disease. However, optimal control of diabetes is not achieved in a large group of patients. It was demonstrated that numerous factors (sociodemographic, psychological, and clinical) contributed to this condition. The aim of the study was to identify factors influencing the control of diabetes measured via glycated hemoglobin concentrations in people with T1D. Independent factors influencing better diabetes control measured via HbA1c in the study group included higher disease acceptance, higher nutritional adherence, lower BMI, and a lower risk of eating disorders. Describing the determinants will allow for the improvement of the system of care provided to people with T1D and for it to comprise important psychological variables related to self-care and acceptance of the disease. [ABSTRACT FROM AUTHOR]

Introduction and Objective. Childbirth is one of the most important events in a woman's life and is influenced by many factors. The aim of the research was to analyze the impact of the place of residence of women giving birth and the time of day on the course of natural birth. Materials and method. The study was conducted using the method of analysis of retrospective electronic documentation of patients who gave natural vaginal birth in the St. Zofia hospital in Warsaw, Poland. The analysis covered the period from 1 January 2015-31 December 2020; from 40,007 cases, 20,980 were qualified for final analysis. Analysis of the documentation allowed to obtain the following data: socio-demographic, lifestyle, obstetrics, course of delivery and the condition of the newborn. Analysis of the relationship between qualitative variables was performed using the Chi-square test, while the Mann-Whitney U test was used to compare two quantitative variables. Results. Women giving vaginal delivery from rural areas were younger (30.9 vs. 31.3), had primary education (2.4% vs. 1.7%) and secondary education (16.2% vs. 10.1%), were in a relationship (86.1% vs. 81.6%) and more often had a higher BMI at birth (27.8 vs. 27.0), compared to the patients living in cities (p<0.05). In addition, between 07:00-18:59., induction of labour (20.7% vs. 19.1%), epidural anesthesia (35.4% vs. 34.0%) and episiotomy were performed more often (29.1% vs. 27.8%) (p<0.05). Conclusions. Differences were shown in the course of vaginal delivery in relation to the place of residence of the women, and the time of day of the delivery. These factors should be considered in the planning of perinatal care. At the same time, it is necessary to conduct further research on the analyzed aspect in order to ensure the highest quality care. [ABSTRACT FROM AUTHOR]

Objectives: The article presents the results of selected pilot studies conducted in medical ambulances. Their aim was to determine the working conditions and identify troublesome factors accompanying the performance of basic medical procedures by rescue teams.Material and Methods: The study of working conditions was carried out in Mercedes-Benz ambulances, type S and P. Fifty-one paramedics of the Emergency Medical Rescue Service in Siedlce took part in the research. The questionnaire expert survey method and the direct observation method were used.Results: As a result of the applied research methods, knowledge was gained on the irregularities and difficulties that occur at the workplace of a paramedic, i.e., in an ambulance, including the lack of access to essential elements of medical equipment and their different location inside the vehicle, and the diversity of solutions for the spatial structure of ambulances, which all cause difficulties at work. Research has shown that paramedics take, on average, 33 min to familiarize themselves with the location of equipment in an ambulance other than the one in which they are usually on duty. There was no correlation between the lifeguard's length of service and the time necessary for getting acquainted with the equipment, which was studied using Pearson's correlation coefficient. In the study, rescuers also pointed to musculoskeletal ailments, mainly spinal pains resulting from taking forced positions during medical activities in an ambulance.Conclusions: The results obtained constitute the basis for the author's methodology of complex research aimed at defining the ergonomic recommendations necessary in the modification process of the operated medical fleet. The next step will be to formulate uniform guidelines for the construction of medical compartments of ambulances, the application of which will lead to the unification of their spatial structure regardless of the vehicle brand. Int J Occup Med Environ Health. 2020;33(1):91-105. [ABSTRACT FROM AUTHOR]

Introduction and objective. Vaginal bleeding during pregnancy is associated with risks to the health and life of the woman and/or the foetus. Moreover, it is usually unanticipated, which requires on-site care to be provided to the woman. Such care is handled by emergency medical services (EMS) teams until specialist obstetric care can be provided. The purpose of study was to analyze the characteristics of EMS team responses to calls regarding pregnant women with vaginal bleeding, considering the location of call: urban vs. rural area. Materials and method. The study was based on a retrospective analysis of 5,487 EMS team interventions due to vaginal bleeding in pregnant women in Poland. The data analyzed included the period January 2018-December 2019, obtained from the National Monitoring Centre of Emergency Medical Services. Results. The teams were more commonly dispatched to pregnant women in rural areas, who were more likely to be older and in the course of a second (27.52% vs. 26.88%) or subsequent pregnancy (34.00% vs. 27.49%), to have had one (28.22% vs. 26.75%) or more previous births (28.87% vs. 22.87%), and to have antepartum bleeding (23.91% vs. 20.36%) than those from urban areas. The mean time between receipt of the call and patient hand-over at the hospital by the EMS team was longer in rural areas (50.00 vs. 37.23 minutes). Conclusions. EMS teams responding to calls from rural areas regarding pregnant women with vaginal bleeding were most commonly dispatched in the summer, and the mean time between the receipt of the call and patient hand-over at the hospital was longer than in the calls from urban areas. Compared to patients calling from urban areas, those from rural areas were also more likely to be pregnant for the second or subsequent time, to have antepartum bleeding, and to have given birth before. [ABSTRACT FROM AUTHOR]

Introduction: Out-of-hospital cardiac arrest (OHCA) is a big medical problem. Material and methods: The aim of this study was to assess the occurrence of sitting position in victims of OHCA at the arrival of Emergency Medical Services (EMS) and examine whether maintaining a supine position until ambulance arrival impacts the return of spontaneous circulation (ROSC) and survival until hospital admission and discharge. The documentation of patients in the OHCA registry of part of Silesian Voivodeship 1-06.2018 was accessed and yielded 634 cases for analysis. Results: The sitting position was found in 41 (6.5%) patients. These patients were more frequently female: 46.3% vs 30.6%, and older: 74.0 (57.9-82.0) vs 67.7 (54.9-75.8) and less frequently received cardiopulmonary resuscitation (CPR) from bystanders: 7.3% vs 63.6%, while ROSC was found with similar frequency: 34.2% vs 34.1%, survival until hospital admission in ROSC subgroups was lower in those in a sitting position than in a lying position: 50% vs 75.5%. None patients who were found in the sitting position survived until hospital discharge, while 33 (6.1%) patients out of those found in the lying positions survived. The univariable analysis showed that the sitting position was associated with female sex, older age, previously implanted implantable cardioverter-defibrillator (ICD) before OHCA. The multivariable logistic revealed that the sitting position was independently associated with chest pain and the presence of ICD. Conclusions: Patients found in a sitting position at the arrival of EMS constituted 6.5% of patients with OHCA in whom resuscitation attempts were undertaken and were at higher risk of unfavorable outcomes. [ABSTRACT FROM AUTHOR]

The purpose of the study was to present the characteristics of Helicopter Emergency Medical Service (HEMS) and Emergency Medical Service (EMS) interventions concerning newborns in Poland. The study involved a retrospective analysis of missions by Polish Medical Air Rescue crews concerning newborns, carried out in Poland between January 2011 and December 2020. Polish Medical Air Rescue crews were most commonly dispatched to urban areas (86.83%), for patient transfer (59.67%), using an airplane (65.43%), between 7AMand 6:59 PM (93.14%), and in the summer (28.67%). Further management involved handing over the neonatal patient to a ground neonatal ambulance team. Most of the patients studied were male (58.02%), and the most common diagnosis requiring the HEMS or EMS intervention was a congenital heart defect (31.41%). The most common medical emergency procedure performed by Polish Medical Air Rescue crew members for the neonatal patients was intravenous cannulation (43.07%). The odds ratio for congenital malformations was higher in male newborns. The type of Polish Medical Air Rescue mission was associated with the location of the call, time of the call, ICD-10 diagnosis associated with the dispatch, selected clinical findings, most commonly performed medical emergency procedures, and mission duration and distance covered. [ABSTRACT FROM AUTHOR]

Background: Helicopter Emergency Medical Service (HEMS) conducts the evaluation of a patient's condition using NACA score before transporting the patient to hospital. The conditions inside the rescue helicopter limit or even make it impossible to conduct some medical procedures. An appropriate classification of the patient may lead to a lower possibility of occurrence of adverse events during the flight. The aim of the research was to evaluate the correlation of NACA score with the cardiac arrhythmia that may be life threatening.Methods: A retrospective observational study included a group of 47,131 patients, who were transported by HEMS services between 2012 and 2017. The research was conducted using the analysis of variance ANOVA running a post hoc test. In order to calculate the correlation of variables, Kruskal-Wallis and r-Pearson tests were carried out, interpreting the results according to J. Gilville's scale. The significance level was set at α = 0,05.Results: The average number of points using NACA score for the studied group was 4,06 (SD ± 1,38). Twelve heart rhythms were selected while evaluating correlations using NACA score. There was a significant relation between the ECG variable and NACA score (p = 0,003). There was a very strong correlation between NACA score and the following: VF/pVT (r-Pearson = 0,856; p = 0,006), PEA (r-Pearson = 0,810; p = 0,015) and Asystole (r-Pearson = 0,728; p = 0,026).Conclusions: NACA score allows to predict the risk of occurrence of ventricular arrhythmia of the myocardium as well as cardiac arrest. The possibility of occurrence of a life-threatening rhythm is significantly higher in patients classified as NACA IV or higher. [ABSTRACT FROM AUTHOR]

INTRODUCTION AND OBJECTIVE: Occupational stress-related factors among working municipal police officers in Poland have not been examined in the literature. The purpose of the paper was to evaluate the impact of selected work-related factors on occupational stress in active municipal police officers in Warsaw by using configural frequency analysis (CFA). MATERIALS AND METHODS: A cross-sectional study was conducted among 578 participants, which accounted for 55.1% of all municipal police officers in Warsaw. The majority of study participants were men (72%) (mean age 43 years old). Two groups of workplace-related stress factors were analysed in the study: physical conditions and organisational working conditions causing stress. The study was carried out using the PAPI method (Paper-and-Pencil Interviewing), based on a proprietary questionnaire developed for the study. CFA searches for templates and patterns in contingency tables. RESULTS: Municipal police officers who claimed that stress did not affect health, took advantage of psychological/psychiatric advice less often than those who thought so (1.7% vs 10.1%; χ2 = 20.152, df = 2, P = 0.000). Those who declared that they often experienced stress at work were also more prone to claiming that one or two factors affected their level of stress: physical abuse, contact with infectious materials, working at uncomfortable temperatures or working in a noisy environment. In the opinion of the study population, there were some factors which contributed to the occurrence of stress at work, and these factors included: working in a hurry, lack of necessary resources, devices and materials at work, the need to be available at all times and the unpredictability of the work. The municipal police officers from the study population combined two or three methods to cope with stress, such as watching TV, surfing the Internet and talking with their families. CONCLUSION: Due to the specificity of a municipal police officer's occupation, special attention should be paid to the occupational stress risk factors characteristic for this group of professionals, and measures should be taken to reduce the number of stressors. It is important to organise training events devoted to effective methods of coping with stress. There is need to carry out more in-depth studies of occupational stress among municipal police officers. [ABSTRACT FROM AUTHOR]

Introduction. Paramedics are at risk of occupational blood exposure, increased by the immediacy of provided treatment. However, the issue has not been acknowledged to date by any research in Europe. Methods. This research aimed at assessing occupational blood exposure among paramedics in Poland. Respondents represented 21 Polish medical institutions. Their participation was voluntary and anonymous. Paramedics were provided with a self-directed job-specific questionnaire adapted to Polish conditions from an original US version. Results. 118 paramedics participated in the study from institutions constituting the National Emergency Medical System in Poland; including ambulance crews, Helicopter Emergency Medical Services and emergency department employees. Occupational exposure was reported by 18.64% of respondents and the main route of exposure was needlestick events. Conclusions. There is a further need to improve education among paramedics concerning the threat of being infected with blood-borne pathogens through all existing routes. Our findings point to the problem as being hidden and considered a shameful issue. [ABSTRACT FROM AUTHOR]