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In their daily work, a primary care physician often meets patients with indications to issue a prescription for epinephrine for self-supply. However, they should not settle for writing a prescription, but also carry out full instructions as to the indications as well as the method of injection. The instruction should be carried out by a doctor or a nurse and be adapted to the specific medication that the patient will purchase. Attention should be paid not only to the patient, but also to all persons in the patient’s environment who may be forced to administrate epinephrine. The article discusses the mechanism of action of epinephrine, indications for its prescription and applicable contraindications. Attention was paid to the correct dosage of the drug, in particular – the need to prescribe at least two doses of the drug to the patient, so that the patient had at least two pieces of the medicine with him. Potential risks for the patient in the case of improper use are presented, for example a wrong route of administration. Differences between pre-filled syringes and auto-injectors are described. The preparations available on the Polish drug market (Adrenaline WZF and EpiPen) are presented. The work describes in detail how to use these devices, which allows a doctor or a nurse to prepare for the training of the use of a pre-filled syringe or an auto-injector. Attention is drawn to the application of training devices in order to instruct the use of the EpiPen.

Consequences of using psychoactive substances are always negative. They cause not only physical and mental dependence, but also huge damage in the body in case of poisoning. The toxicity of these substances varies and depends on the type of chemical compound. The effects can be difficult to predict and often can pose a direct threat to life and health. The objective of this study was to analyse the causes and consequences of poisoning with psychoactive substances among patients hospitalized in the Emergency Department of Stefan Kardynał Wyszyński Province Specialist Hospital in Lublin within the period of one year (01.01.2016 - 31.12.2016). Our own study results showed that men and people living in urban areas were the patients most frequently admitted to the Emergency Department due to poisoning. Alcohol was the most common psychoactive substance used by the patients in the study group. Poisoning with anti-epileptic, sedative-hypnotic and psychotropic medications predominated among women, whereas alcohol and narcotics and psychodysleptic medications were the most frequent cause of poisoning among men.

Introduction: Civilisation development and huge technological progress influence the life and functioning of every human being. They facilitate functioning in the modern world but are also associated with increased incidence of trauma and morbidity, which are a challenge for modern health care systems. One of the main elements of health care is Emergency Medical Services System, whose aim is to save people who are in the state of sudden health hazard. Aim: The aim of this paper was to analyse the reasons for medical rescue team interventions in the northwest part of Masovian voivodeship within the period of four years (2013-2016). Materials and method: The analysis showed that the most common reason for medical rescue team intervention in the studied region and time period was cardiovascular diseases. Results: Men and people aged 75-89 were the main beneficiaries of medical services provided by medical rescue teams. Cardiovascular diseases were more often diagnosed in women and people aged 75-89, while injuries were mainly diagnosed in men and people aged 45-59. Conclusion: The gender and age of the patient, year, day of the week, the place of the call, team type and the urgency code of the call were important factors influencing the reasons for the intervention of MRTs in the analysed region and period.

Methemoglobin is an oxidized form of hemoglobin that is not capable of carrying oxygen. Exposure to exogenous oxidizing agents can cause severe methemoglobinemia and subsequent hypoxia. This article presents the rare case of a 23-year old patient with methemoglobinemia of 54.2% of total hemoglobin, induced by workplace exposure to 1,4-diaminobenzene and diphenylamine. Following the hyperbaric oxygen therapy the patient was discharged in good general condition and referred to a district hospital for observation. Med Pr 2018;69(3):345–350

Consequences of using psychoactive substances are always negative. They cause not only physical and mental dependence, but also huge damage in the body in case of poisoning. The toxicity of these substances varies and depends on the type of chemical compound. The effects can be difficult to predict and often can pose a direct threat to life and health. The objective of this study was to analyse the causes and consequences of poisoning with psychoactive substances among patients hospitalized in the Emergency Department of Stefan Kardynał Wyszyński Province Specialist Hospital in Lublin within the period of one year (01.01.2016 - 31.12.2016). Our own study results showed that men and people living in urban areas were the patients most frequently admitted to the Emergency Department due to poisoning. Alcohol was the most common psychoactive substance used by the patients in the study group. Poisoning with anti-epileptic, sedative-hypnotic and psychotropic medications predominated among women, whereas alcohol and narcotics and psychodysleptic medications were the most frequent cause of poisoning among men.

Background: Due to the specifics of their work and to being exposed to a wide range of hazards, firefighters working for the State Fire Service (SFS) face the risk of work-related accidents more often than members of other occupational groups. The aim of this paper is to analyze the occurrence and consequences of accidents in the work environment of the SFS officers in Poland between the years 2008–2013. Material and Methods: The material analyzed is based on aggregate data collected by the Headquarters of the State Fire Service. Figures regarding accidents in the period between 1 January 2008 and 31 December 2013 show that 8518 workrelated accidents occurred in that period and 8635 people were injured. Results: The data shows that neither the number of accidents nor their frequency indicator underwent any significant fluctuations over the 6 years under consideration. The group that is most exposed to accidents on duty in the profession includes active firefighters serving in rescue and fire extinguishment divisions. According to the data, the greatest number of trauma incidents in the SFS between the years 2008–2013 occurred during sporting activities. The predominant cause of these was inappropriate behavior or the lack of proper care. The most frequent injuries sustained during the accidents were broken or fractured bones and sprained joints. Conclusions: Accidents on duty occur significantly more often when firefighters are at their stations, during sporting classes, exercises or maneuvers, than in the course of actual rescue operations. The firefighters of the State Fire Services are insufficiently prepared for their sporting activities. Med Pr 2016;67(1):1–9

Introduction: Civilisation development and huge technological progress influence the life and functioning of every human being. They facilitate functioning in the modern world but are also associated with increased incidence of trauma and morbidity, which are a challenge for modern health care systems. One of the main elements of health care is Emergency Medical Services System, whose aim is to save people who are in the state of sudden health hazard. Aim: The aim of this paper was to analyse the reasons for medical rescue team interventions in the northwest part of Masovian voivodeship within the period of four years (2013-2016). Materials and method: The analysis showed that the most common reason for medical rescue team intervention in the studied region and time period was cardiovascular diseases. Results: Men and people aged 75-89 were the main beneficiaries of medical services provided by medical rescue teams. Cardiovascular diseases were more often diagnosed in women and people aged 75-89, while injuries were mainly diagnosed in men and people aged 45-59. Conclusion: The gender and age of the patient, year, day of the week, the place of the call, team type and the urgency code of the call were important factors influencing the reasons for the intervention of MRTs in the analysed region and period.

Mikos Marcin, Juszczyk Grzegorz, Czerw Aleksandra, Gałązkowski Robert. Nowy model kształcenia ratowników medycznych w Polsce w świetle aktualnych regulacji prawnych = The new model of education of medical rescuers in Poland in light of current regulations. Journal of Education, Health and Sport. 2015;5(12):110-117. ISSN 2391-8306. DOIhttp://dx.doi.org/10.5281/zenodo.35190 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2812%29%3A110-117 http://pbn.nauka.gov.pl/works/678366 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.11.2015. Revised 25.11.2015. Accepted: 10.12.2015. Nowy model kształcenia ratowników medycznych w Polsce w świetle aktualnych regulacji prawnych The new model of education of medical rescuers in Poland in light of current regulations Marcin Mikos1, Grzegorz Juszczyk2, Aleksandra Czerw2, Robert Gałązkowski3 (1) Polskie Towarzystwo Prawa Medycznego (2) Zakład Zdrowia Publicznego, Warszawski Uniwersytet Medyczny (3) Zakład Ratownictwa Medycznego, Warszawski Uniwersytet Medyczny Słowa kluczowe: kształcenie, ratownik medyczny. Keywords: education, medical rescuer. Streszczenie W przepisach prawach zaszły w ostatnim czasie zmiany, które całkowicie zmieniają model kształcenia ratowników medycznych w Polsce. Do głównych zmian należą wymóg realizacji co najmniej 2455 godzin kształcenia na studiach pierwszego stopnia i konieczność uzyskania co najmniej 80 punktów ECTS, konieczność odbycia 6 miesięcznej praktyki zawodowej, a także obowiązek pozytywnego złożenia Państwowego Egzaminu z Ratownictwa Medycznego. Brak jest przeszkód prawnych do odbywania przez ratowników medycznych studiów drugiego stopnia i uzyskiwania tytułu zawodowego magistra. Abstract The provisions of the laws have been recently revised in a way that substantially change the model of training of paramedics in Poland. The major changes include: the requirement to implement at least 2455 hours of education at the undergraduate level and the need to obtain at least 80 ECTS credits, the necessity of the 6-month professional apprentice, and positive pass of the National Medical Emergency Exam. Therefore there are legal obstacles to open second degree studies for paramedics, allowing them obtaining a master's degree.

Background: Due to the growing use of various types of industrial and agricultural machinery, occupational accidents are among the most serious ones and quite frequently result in the permanent posttraumatic disability of the injured person. In Poland, a replantation service has been operating since 2010. Each day, one out of six centres provides emergency replantation service accepting amputation calls from across the country. Patients qualified for replantation often need to be transported from places located even several hundred kilometres from the target hospital. Material and Methods: The analysis covered 174 Helicopter Emergency Medical Service (HEMS) missions and 112 interhospital transports. The data were obtained as a result of a retrospective analysis of the air and medical documentation of 23 460 missions carried out by the Polish Medical Air Rescue (Samodzielny Publiczny Zakład Opieki Zdrowotnej Lotnicze Pogotowie Ratunkowe – SP ZOZ LPR) aircrafts in the years 2011–2013. Results: In the period under study, the Polish Medical Air Rescue helicopters dressed 135 patients with upper extremity amputations at the scene and transported them to hospitals as part of HEMS missions. At the same time, SP ZOZ LPR aircrafts made 102 interhospital transports. Ninety patients were qualified for treatment in replantation service centres. The average air transport time was 76 min, while the total transport time was 172.3 min. With transport exceeding 300 km, the average time advantage over the ground transport was approximately 1.5 h. Conclusions: In justified cases, the use of helicopters and airplanes is an optimal method of transporting patients with the major trauma to upper extremities. Med. Pr. 2014;65(6):765–776

In 2013 a fire broke out in the Nursing Home (NH) in the Henryszew village 5 km away from the district hospital in Żyrardów. At the time of the incident 52 residents and 16 staff members were present in the building. Due to a large number of casualties, the occurrence was classified as a potentially mass casualty incident (MCI). Troops of the State Fire Brigade, Paramedic Rescue Squads, choppers of the Helicopter Emergency Medical Service, the Police, and the NH staff took part in the rescue operation. The priority was given to the evacuation of the NH residents carried out by the NH staff and firefighters, extinguishing the fire, as well as to primary and secondary survey triage. Due to the pre-accident health state of the victims, the latter posed a considerable difficulty. A decisive role was played by the need to conduct non-invasive measurements of carboxyhemoglobin in all the casualties, which then made it possible to adequately diagnose the patients and implement proper procedures. The rescue operation was correctly followed although it proved to be a serious logistical and technical undertaking for the participating emergency services. The residents were not found to be suffering from carbon monoxide poisoning, therefore 46 of the residents safely returned to the building. The fact that all the Paramedic Rescue Squads were equipped with medical triage sets and were able to conduct non-invasive measurements of carboxyhemoglobin made it possible to introduce effective procedures in the cases of suspected carbon monoxide poisoning and abandon costly and complicated organisational procedures when they proved to be unnecessary. Med Pr 2014;65(2):289–295

Mikos Marcin, Juszczyk Grzegorz, Czerw Aleksandra, Gałązkowski Robert. Nowy model kształcenia ratowników medycznych w Polsce w świetle aktualnych regulacji prawnych = The new model of education of medical rescuers in Poland in light of current regulations. Journal of Education, Health and Sport. 2015;5(12):110-117. ISSN 2391-8306. DOIhttp://dx.doi.org/10.5281/zenodo.35190 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2812%29%3A110-117 http://pbn.nauka.gov.pl/works/678366 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.11.2015. Revised 25.11.2015. Accepted: 10.12.2015. Nowy model kształcenia ratowników medycznych w Polsce w świetle aktualnych regulacji prawnych The new model of education of medical rescuers in Poland in light of current regulations Marcin Mikos1, Grzegorz Juszczyk2, Aleksandra Czerw2, Robert Gałązkowski3 (1) Polskie Towarzystwo Prawa Medycznego (2) Zakład Zdrowia Publicznego, Warszawski Uniwersytet Medyczny (3) Zakład Ratownictwa Medycznego, Warszawski Uniwersytet Medyczny Słowa kluczowe: kształcenie, ratownik medyczny. Keywords: education, medical rescuer. Streszczenie W przepisach prawach zaszły w ostatnim czasie zmiany, które całkowicie zmieniają model kształcenia ratowników medycznych w Polsce. Do głównych zmian należą wymóg realizacji co najmniej 2455 godzin kształcenia na studiach pierwszego stopnia i konieczność uzyskania co najmniej 80 punktów ECTS, konieczność odbycia 6 miesięcznej praktyki zawodowej, a także obowiązek pozytywnego złożenia Państwowego Egzaminu z Ratownictwa Medycznego. Brak jest przeszkód prawnych do odbywania przez ratowników medycznych studiów drugiego stopnia i uzyskiwania tytułu zawodowego magistra. Abstract The provisions of the laws have been recently revised in a way that substantially change the model of training of paramedics in Poland. The major changes include: the requirement to implement at least 2455 hours of education at the undergraduate level and the need to obtain at least 80 ECTS credits, the necessity of the 6-month professional apprentice, and positive pass of the National Medical Emergency Exam. Therefore there are legal obstacles to open second degree studies for paramedics, allowing them obtaining a master's degree.