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Introduction: The aim of the study was to assess the knowledge of the procedure for clearing the respiratory tract and updated qualified first aid (QFA) 1a and 2a procedures by firefighters serving in State Fire Service (SFS) rescue and firefighting units, and their knowledge of the transmission of the SARS-CoV-2 virus. Material and methods: The cross-sectional study covered 19 408 firefighters (officers serving in SFS rescue and firefighting units from all over Poland). The study was conducted using the diagnostic survey method, the Computer Assisted Web Interview (CAWI) technique consisting of a set of particulars regarding a specific officer and the appropriate medical part of the survey. Results: In the group of 19,408 respondents, 99.31% were men (n = 19,275), while women accounted for 0.69% (n = 133; p < 0.001). The age of the respondents was in the range of 18-66 years, and the average age was 35.88 ± 7.14 years. The length of service was 11.95 ± 6.44 years. The knowledge of procedures 1a and 2a declared by the respondents [OR = 1.51 (95% CI: 1.22-1.86), x2 = 14.76], the ability to operate a suction unit [OR = 1.73 (95% CI: 1.44-2.08, x2 = 34.58)], the frequency of airway clearance training (p < < 0.001, x2 = 61.74). Only 15% of respondents used a suction unit on an injured person during operations. Conclusions: The knowledge of firefighters in the subject matter covered by the analysis is diverse, some firefighters have additional experience and practice from working in health care units. Professional development in the field of QFA supplemented with procedures 1a and 2a may translate into a lower risk of infection associated with airway clearing in the era of the pandemic. There is a visible need for constant training of SFS officers in terms of medical activities to maintain the knowledge of firefighters at a high initial level. [ABSTRACT FROM AUTHOR]

INTRODUCTION: State Fire Service (SFS) officers are increasingly frequently carrying out medical rescue activities (MRA), especially in the scope of qualified first aid (QFA), providing assistance to people harmed in fires and other local threats. Due to the accepted medical procedures, possessed medical equipment and a high number of officers with medical background, SFS units are the second service, right after NEMS, in terms of the volume of provided medical support in different events, particularly fires (F) and local threats (LT). MATERIAL AND METHODS: The paper used the statistical data regarding performance of QFA tasks by SFS officers from the Decision-Making Support System of the State Fire Service (DMSSFS), made available by the Operations Planning Office (OPO) in the Headquarters of the State Fire Service (HSFS). The analyzed material covered the period of 2010 -- 2021 and the area of the capital city of Warsaw. Using the method of choropleth maps to present the administrative units of the city, the most overloaded places in terms of emergency activities were presented where QFA intervention was required. RESULTS: The number of events recorded by SFS in Warsaw in the analyzed period was 150,209 (without false alarms -- FA), during which QFA activities were performed 9,911 times. The average percentage number of such activities in relation to all events (fires and local threats) was 6.60% and a slow, yet systematic, growth of such events in consecutive years. The highest magnitude of QFA activities -- and so the very high level (>201 points) was seen in the district of Śródmieście and the high level(121-200 points)in the following districts: Mokotów, Wola, PragaPółnoc, PragaPołudnie, Targówek. In particular, considering individual estates, these were: ŚródmieściePołudniowe (293), StaryMokotów (150), Mirów (139), Brudno (122), Zacisze (179), Grochów (155) and SaskaKępa (145). CONCLUSIONS: Assessment of the usefulness of mapping medical interventionsand the analyzed spatial data Confirm that the KDE method is characterized by a more precise fitting of the fragments of the MIS estates to the scale of magnitude of the investigated event -- QFA activities performed by SFS firefighters. Therefore, using the analytical techniques of GIS is a good tool for planning and interventional support for the SFS activities and it additionally shows phenomena not visible when the data are presented in a table. [ABSTRACT FROM AUTHOR]

Introduction: Analysis of the medical education of State Fire Service (SFS) officers in terms of the possibility to perform medical emergency procedures at the advanced level in connection with an update of the Rules of Medical Rescue Organisation in National Emergency and Fire System (NEFS). Material and methods: An analysis was conducted of the nationwide staff-related data on the medical education of SFS officers, both in the day-based and shift-based system. The analysis also covered additional qualifications for the pursuit of the profession of a physician, nurse and medical emergency worker among the firefighters/medical emergency workers in Poland, satisfaction of the obligation of professional training and additional employment in healthcare facilities. Results: 2220 officers with medical education work in the organisational units of SFS. Nearly 40% of the officers with medical education in SFS additionally work in healthcare units and more than a half pursues the statutory professional training. To ensure one medical emergency worker per professional shift on the ready, every SFS EFU should have ca. 5.6 full-time positions for medical emergency workers -- this is a coefficient including absences of leave, sickness absences and other variables. Therefore, the above calculations indicate that to ensure one medical emergency worker per professional shift in one SFS EFU (E = 5.6), ca. 2817 officers with medical education should be employed. With the current staff level (SRM = 2220), ca. 597 officers should be employed to fill the demand (Mrt) if the advanced level is to be achieved Conclusions: The medical rescue in SFS as one of the disciplines of medicine requires continual development in terms of solutions for the system, equipment and first of all the staff. A higher number of medical emergency workers in SFS may have a positive effect on the quality of the medical procedures carried out during isolated emergency medical incidents. The organisational units of SFS in most voivodeships in Poland face a shortage of medical emergency workers on duty, which has a negative effect on the possibility to perform Medical Rescue Procedures at the advanced level. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The rescue services which take interventions in the scene of accidents include the Fire Service officers. The tasks of the Fire Service carried out to serve the society include the cooperation with units of the Emergency Medical Services and performance of medical operations. The spreading of the COVID-19 pandemic led to many changes in daily public and private life, in the functioning of institutions, public offices, the healthcare system and the uniformed services. MATERIAL AND METHODS: The study included a retrospective analysis of departures of Polish fire-fighting units (FFU) for isolated events of medical emergency (IEMEs) in a two-year period: from March 2019 to the end of February 2021 (one year before the pandemic and one year during the pandemic in Poland). The data come from the EWID event recording programme and the Decision-Making Support System of the State Fire Service. The quantitative data were prepared depending on the distribution of the variable: the mean and the standard deviation (if the distribution was normal) and the median and the interquartile range (if the distribution was not normal). RESULTS: The studied period included 5272 events meeting the criteria for inclusion in the analysis. An increase by over 56% was seen in IEMEs in the pandemic year compared to the previous year. The dynamics of the IEME increase are identical to the waves of the pandemic occurring in Poland. A statistically significant correlation (p<0.001, R=0.93) was demonstrated between the number of coronavirus infections and the number of IEMEs in the pandemic period. CONCLUSIONS: The studied period included 5272 events meeting the criteria for inclusion in the analysis. An increase by over 56% was seen in IEMEs in the pandemic year compared to the previous year. The dynamics of the IEME increase are identical to the waves of the pandemic occurring in Poland. A statistically significant correlation (p<0.001, R=0.93) was demonstrated between the number of coronavirus infections and the number of IEMEs in the pandemic period. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death in developed countries, which is a leading public health problem. Saving endangered human life is a priority task for emergency services around the world. The aim of study was to analysis of OHCA cases for which the Fire Rescue Units (FRU) teams were ordered in situations that meet the criteria of the isolated emergency medical incidents (IEMI). MATERIAL AND METHODS: The study included a retrospective analysis of calls by Polish FRU to local medical threats over a period of 5 years. The data come from the Decision Support System for Fire Service. Quantitative data were described using classical measures: arithmetic means (M), standard deviations (SD), median (Me) and interquartile ranges (IQR). RESULTS: The total number of OHCA cases included was 94. The mean time between receipt of the IEMI call and arrival on scene was 6 minutes and 22 seconds (IQR = 4). ROSC occurred in 21 patients, which is 22.34% of all cases. An Automated External Defibrillator (AED) was used in 64 cases (68.09%). The analyzed victims were mostly men (76.59%). The mean age of the victims was 63.06 years (Me = 62 years). CONCLUSIONS: The results of the research are in line with global trends and show the role of early cardiopulmonary resuscitation. Sending FRU to OHCA in the case of non-availability of the EMT in the initial phase of the intervention is justified. [ABSTRACT FROM AUTHOR]

Background. Air-conducted and skull-tap cervical vestibular evoked myogenic potentials (AC-cVEMP and Tap-cVEMP) have been shown to be very promising tools in clinical practice. They are noninvasive, easy to obtain and - importantly - they require little time and the cost of the instruments is low. Objectives. The aim of this study was to evaluate the usefulness of the combined use of AC- and Tap-cVEMPs as a diagnostic tool for advanced assessment of vestibular schwannoma in determining tumor origin, and to investigate whether the results are helpful for a surgeon as an additional source of information about the tumor before surgery. Material and methods. AC- and Tap-cVEMPs were acquired (with EMG-based biofeedback) from the sternocleidomastoid muscles (SCM) of 30 vestibular schwannoma patients just before surgery. The results were compared to the surgical information about nerve bundle involvement in the tumor and the size of the tumor obtained from magnetic resonance imaging (MRI). Results. On the tumor side, abnormal corrected amplitude asymmetry ratios were detected in 73.33% of the patients, abnormalities in P1-latencies in 70% of the patients, and both in 90% of the patients. The cervical vestibular evoked myogenic potential (cVEMP) results indicated the affected nerve division to be the inferior in 23.33% of the patients, the superior in 20% of the patients, and both in 46.67% of the patients. No cVEMP abnormalities were found in 10% of cases. The combined results of both AC- and Tap-cVEMP were significantly compatible with the surgical information about the tumor origin. The number of abnormalities was significantly correlated with the tumor size. Conclusions. The information provided by the combined application of AC- and Tap-cVEMPs might be useful for a surgeon in presurgical planning, providing more detailed information about the tumor and the affected nerve division in the internal auditory canal. It is not a diagnostic replacement for MRI in vestibular schwannoma patients; however, in our opinion, AC- and Tap-cVEMPs may serve as additional sources of information about the tumor before the surgery. [ABSTRACT FROM AUTHOR]

Background. Sudden cardiac arrest (SCA) is a leading cause of premature death. The most common cause of SCA is ventricular fibrillation and many lives can be saved with early defibrillation. An automatic external defibrillator (AED) is a device that analyses the cardiac rhythm and generates an electric shock. Thus far, the public access defibrillation program (PAD) has not been implemented in Warsaw. Aim. To investigate the accessibility of automatic defibrillators in the capital city of Warsaw with particular regard to the number and spatial distribution of the AED devices. Material and methods. AED devices have been identified, visualized and localized using QGIS geographic information systems. The locations were confirmed via visual inspection, telephone and/or email with the use of electronic questionnaire. Data obtained in this study helped to establish an AED database, which contains the geographic coordinates of the attributes. Results. In Warsaw, 582 AED devices are deployed in 463 locations. Distribution of defibrillators is uneven, with the largest number of AEDs in the Mokotów (n = 98) and Śródmieście districts (n = 84), and the smallest in Wesoła (n = 3) and Rembertów (n = 3). The critical radius (Rcr) from a hypothetical cardiac arrest site to the nearest AED was calculated to be ~333 m. It follows that in order to fully cover the Warsaw spatial grid with AED devices, public space should contain approximately 1551 devices (3.0/km²). Conclusions. In Warsaw, the number of AEDs is insufficient and their spatial distribution is greatly uneven. While planning the deployment of AEDs one should take into account not only the critical radius Rcr, but also other criteria of optimal location, including the number of inhabitants within a given area, strategic places on the basis of population density, and incidence rate of sudden cardiac arrest. Our data show that there is an urgent need to develop and implement PAD programs in Warsaw and other large metropolitan areas in Poland. [ABSTRACT FROM AUTHOR]

Aim: The objective was to retrospectively analyze the benefits of cochlear implantation in deafened elderly (>65 years old). Method: Data from 30 elderly patients with a unilateral cochlear implant were included and analyzed. Audiometric threshold and speech data in aided and unaided conditions were examined at pre- and postimplant intervals at 3, 6, and 12 months after activation of the sound processor and compared. Results: All patients demonstrated hearing benefits after implant and over time with results ranging from very good, good, to limited performance in a few cases. The mean postimplantation follow-up time was 2.74 years (minimum 1 year). Our study cohort demonstrates that cochlear implantation is a successful treatment method for improving speech perception in the auditory alone or auditory-visual mode for the majority of elderly patients. No correlations were observed between postimplant outcomes and age, or preimplant hearing thresholds and speech audiometry. Conclusion: Age is not a determining or limiting factor for post-CI outcome performance in deafened elderly patients. Counselling should consider the patient as a whole and include explanation of the risk for a minority of elderly patients who may demonstrate poor outcomes after implant, despite presenting as good candidates before implantation. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: To assess the benefits of cochlear implantation in the elderly. Patients and methods: A retrospective analysis of 31 postlingually deafened elderly (⩾60 years of age) with unilateral cochlear implants was conducted. Audiological testing included preoperative and postoperative pure-tone audiometry and a monosyllabic word recognition test presented from recorded material in free field. Speech perception tests included Ling's six sound test (sound detection, discrimination, and identification), syllable discrimination, and monosyllabic and multisyllabic word recognition (open set) without lip-reading. Everyday life benefits from cochlear implantation were also evaluated. Results: The mean age at the time of cochlear implantation was 72.4 years old. The mean post-implantation follow-up time was 2.34 years. All patients significantly improved their audiological and speech understanding performances. The preoperative mean pure-tone average threshold for 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz was 110.17 dB HL. Before cochlear implantation, all patients scored 0% on the monosyllabic word recognition test in free field at 70 dB SPL intensity level. The postoperative pure-tone average was 37.14 dB HL (the best mean threshold was 17.50 dB HL, the worst was 58.75 dB HL). After the surgery, mean monosyllabic word recognition reached 47.25%. Speech perception tests showed statistically significant improvement in speech recognition. Conclusion: The results of this study showed that cochlear implantation is indeed a successful treatment for improving speech recognition and offers a great help in everyday life to deafened elderly patients. Therefore, they can be good candidates for cochlear implantation and their age alone should not be a relevant or excluding factor when choosing candidates for cochlear implantation. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate acoustically evoked cervical and ocular vestibular miogenic potentials (AC cVEMP and oVEMP) findings in patients diagnosed with Susac's syndrome (SS). Material and methods: Two patients with SS were tested. The stimuli (500 Hz frequency tone bursts) were presented unilaterally one ear at a time. 'The resulting VEMP waveforms were analyzed for the response presence, latency and amplitude in the time domain. Results: Patient#1, responses on both sides showed latencies within normal limits for both c- and oVEMP; small amplitudes for cVEMP. Patient#2, only cVEMPs were present; latencies within normative values, amplitudes low and asymmetric between sides. Conclusions: The combined application of AC cVEMP and oVEMP may provide additional and useful information about affected vestibular system and be of help in treatment and rehabilitation planning in patients with Susacs syndrome. [ABSTRACT FROM AUTHOR]