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Gąsior M, Tajstra M, Cieśla D, Hrapkowicz T, Nadolny K, Wita K, Smolka G, Milewski K, Wojakowski W, Mizia-Stec K, Kalarus Z, Trzeciak P. Management of patients with myocardial infarction complicated by cardiogenic shock: Data from comprehensive all-comers administrative database covering a population of 4.4 million. Kardiol Pol 2024:VM/OJS/J/99071. [PMID: 38493458 DOI: 10.33963/v.phj.99071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Mateusz Tajstra
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.
| | - Daniel Cieśla
- Department of Science and New Technologies, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Tomasz Hrapkowicz
- Department of Cardiac Surgery, Transplantology, Vascular and Endovascular Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Faculty of Medicine, Silesian Academy in Katowice, Katowice, Poland
| | - Krystian Wita
- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Smolka
- Department of Cardiology, Faculty of Health Science, Medical University of Silesia, Katowice, Poland; Upper-Silesian Medical Centre, Katowice, Poland
| | - Krzysztof Milewski
- Cardiology and Cardiac Surgery Center in Bielsko-Biala, American Heart of Poland
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Mizia-Stec
- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Upper Silesia Medical Centre, Katowice, Poland
| | - Zbigniew Kalarus
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Silesian Center for Heart Diseases in Zabrze, Zabrze, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
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Jaskiewicz F, Timler W, Panasiuk J, Starosta K, Cierniak M, Kozlowski R, Borzuchowska M, Nadolny K, Timler D. Willingness and Barriers to Undertaking Cardiopulmonary Resuscitation Reported by Medical Students after the SARS-CoV-2 Pandemic-Single-Center Study. J Clin Med 2024; 13:438. [PMID: 38256572 PMCID: PMC10816474 DOI: 10.3390/jcm13020438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/28/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Most of the studies in the field of willingness and barriers to resuscitation (CPR) were conducted before the SARS-CoV-2 pandemic. The aim of the study was to assess the number and types of barriers to CPR among medical students after the pandemic ended. This study was based on a survey. The data was collected from 12 April 2022 to 25 May 2022. A total of 509 complete questionnaires were obtained. The number of barriers depending on the time elapsed from the last CPR course did not differ significantly (Me = 4 [IQR 2-6] vs. Me = 5 [IQR 3-7]; p = 0.054, respectively). The number of all barriers reported by respondents differed significantly and was higher in those reporting fear of coronavirus (Me = 4 [IQR 2-6] vs. Me = 7 [IQR 4-9]; p < 0.001, respectively). A total of 12 out of all 23 barriers were significantly more frequent in this group of respondents. Barriers to CPR are still common among medical students, even despite a high rate of CPR training. The pandemic significantly affected both the number and frequency of barriers. The group of strangers and children, as potential cardiac arrest victims, deserve special attention. Efforts should be made to minimize the potentially modifiable barriers.
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Affiliation(s)
- Filip Jaskiewicz
- Emergency Medicine and Disaster Medicine Department, Medical University of Lodz, 90-419 Lodz, Poland; (J.P.); (K.S.); (M.C.); (D.T.)
| | - Wojciech Timler
- Department of Family Medicine, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Jakub Panasiuk
- Emergency Medicine and Disaster Medicine Department, Medical University of Lodz, 90-419 Lodz, Poland; (J.P.); (K.S.); (M.C.); (D.T.)
| | - Katarzyna Starosta
- Emergency Medicine and Disaster Medicine Department, Medical University of Lodz, 90-419 Lodz, Poland; (J.P.); (K.S.); (M.C.); (D.T.)
| | - Marcin Cierniak
- Emergency Medicine and Disaster Medicine Department, Medical University of Lodz, 90-419 Lodz, Poland; (J.P.); (K.S.); (M.C.); (D.T.)
| | - Remigiusz Kozlowski
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland; (R.K.); (M.B.)
| | - Monika Borzuchowska
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland; (R.K.); (M.B.)
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Faculty of Medicine, Silesian Academy in Katowice, 40-555 Katowice, Poland;
| | - Dariusz Timler
- Emergency Medicine and Disaster Medicine Department, Medical University of Lodz, 90-419 Lodz, Poland; (J.P.); (K.S.); (M.C.); (D.T.)
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Trzeciak P, Stępińska J, Gil R, Hawranek M, Nadolny K, Tycińska A, Bartuś S, Gierlotka M, Kałużna-Oleksy M, Zymliński R, Grygier M, Wojakowski W, Gąsior M. Management of myocardial infarction complicated by cardiogenic shock: Expert opinion of the Association of Intensive Cardiac Care and Association of Cardiovascular Interventions of the Polish Society of Cardiology. Kardiol Pol 2023; 81:1312-1324. [PMID: 37823758 DOI: 10.33963/v.kp.97817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/13/2023]
Abstract
Despite significant advances in interventional cardiology and mechanical circulatory support (MCS) techniques, outcomes for patients with myocardial infarction (MI) complicated by cardiogenic shock (CS) remain suboptimal. This expert consensus aims to provide information on the current management of patients with MI complicated by CS in Poland and to propose solutions, including systemic ones, for all stages of care. The document uses data from the Polish PL-ACS Registry of Acute Coronary Syndromes, which includes records of more than 820 000 hospital admissions. We describe the role of medical rescue teams, highlighting the necessity to expand their range of competencies at the level of prehospital care. We emphasize the importance of treating the underlying cause of CS and direct patient transfer to centers capable of performing percutaneous coronary interventions. We present current recommendations of scientific societies on MCS use. We underline the role of the Cardiac Shock Team in the management of patients with MI complicated by CS. Such teams should comprise an interventional cardiologist, a cardiothoracic surgeon, and an intensive care physician. Patients should be transferred to highly specialized CS centers, following the example of so-called Cardiac Shock Care Centers described in some other countries. We propose criteria for the operation of such centers Other important aspects discussed in the document include the role of rehabilitation, multidisciplinary care, and long-term follow-up of treatment outcomes. The document was developed in cooperation with experts from different scientific societies in Poland, which illustrates the importance of interdisciplinary care in this patient population.
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Affiliation(s)
- Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.
| | - Janina Stępińska
- Department of Medical Communication, School of Public Health, Centre of Postgraduate Medical Education, Warszawa, Poland
| | - Robert Gil
- Department of Cardiology, Ministry of Interior and Administration National Medical Institute, Warszawa, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Faculty of Medicine, Silesian Academy in Katowice, Katowice, Poland
- Regional Ambulance Service in Sosnowiec, Sosnowiec, Poland
| | - Agnieszka Tycińska
- Department of Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Marta Kałużna-Oleksy
- 1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Robert Zymliński
- Institute of Cardiac Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Marek Grygier
- 1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia in Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
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Pawłuszewicz P, Wojciak PA, Łukaszewicz A, Chilmonczyk J, Ładny JR, Nadolny K, Razak Hady H. Assessment of Lipid Balance Parameters after Laparoscopic Sleeve Gastrectomy in 1-Year Observation. J Clin Med 2023; 12:4079. [PMID: 37373773 DOI: 10.3390/jcm12124079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction: Currently, the increase in the percentage of obese people observed along with the development of civilization, reaching the level of a global pandemic, has forced a search for methods of effective and permanent obesity treatment. Obesity is a multifactorial disease; it coexists with many disease entities and requires multidisciplinary treatment. Obesity leads to metabolic changes in the form of metabolic syndromes, which include, among others, atherogenic dyslipidemia. The proven relationship between dyslipidemia and cardiovascular risk enforces the need to effectively improve the lipid profile of obese patients. Laparoscopic sleeve gastrectomy is a method of surgical treatment of morbid obesity which improves bariatric and metabolic parameters. The aim of the study was to assess the effectiveness of laparoscopic sleeve gastrectomy (LSG) at improving lipid profile parameters upon a 1-year follow up. Material and Methods: Bariatric parameters of 196 patients who underwent laparoscopic sleeve gastrectomy as well as the lipid profile of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), non-NDL, and triglycerides (TG) in a 1-year observation were analyzed. Results: Improvements in bariatric parameters were observed in patients after LSG. Total cholesterol, low-density lipoprotein (LDL), triglycerides and non-HDL level decreases were observed along with an increase in high-density lipoprotein (HDL) cholesterol levels. Conclusions: Sleeve gastrectomy is an effective method of treating obesity and improving the lipid profile in obese patients.
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Affiliation(s)
- Patrycja Pawłuszewicz
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | | | - Aleksander Łukaszewicz
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Jan Chilmonczyk
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Jerzy Robert Ładny
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
- Department of Emergency Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Klaudiusz Nadolny
- Faculty of Medicine, Katowice School of Technology, 40-555 Katowice, Poland
| | - Hady Razak Hady
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
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Wańha W, Kołodziejczak M, Kowalewski M, Januszek R, Kuźma Ł, Jaguszewski M, Tomaniak M, Darocha S, Kupczyńska K, Dobrowolski P, Tymińska A, Ciepłucha A, Sokolska J, Kapłon-Cieślicka A, Kułach A, Wybraniec M, Roleder T, Tajstra M, Nadolny K, Darocha T, Sierakowska K, Pawłowski T, Gierlotka M, Leskiak M, Wita K, Gil R, Trzeciak P. Out-of-hospital cardiac arrest: Do we have to perform coronary angiography? Cardiol J 2023:VM/OJS/J/92653. [PMID: 37183538 DOI: 10.5603/cj.a2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 05/16/2023] Open
Abstract
Out-of-hospital cardiac arrest (OHCA) remains a leading cause of global mortality, while survivors are burdened with long-term neurological and cardiovascular complications. OHCA management at the hospital level remains challenging, due to heterogeneity of OHCA presentation, the critical status of OHCA patients reaching the return of spontaneous circulation (ROSC), and the demands of post ROSC treatment. The validity and optimal timing for coronary angiography is one important, yet not fully defined, component of OHCA management. Guidelines state clear recommendations for coronary angiography in OHCA patients with shockable rhythms, cardiogenic shock, or in patients with ST-segment elevation observed in electrocardiography after ROSC. However, there is no established consensus on the angiographic management in other clinical settings. While coronary angiography may accelerate the diagnostic and therapeutic process (provided OHCA was a consequence of coronary artery disease), it might come at the cost of impaired post-resuscitation care quality due to postponing of intensive care management. The aim of the current statement paper is to discuss clinical strategies for the management of OHCA including the stratification to invasive procedures and the rationale behind the risk-benefit ratio of coronary angiography, especially with patients in critical condition.
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Affiliation(s)
- Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.
- "Club 30", Polish Cardiac Society, Poland.
| | - Michalina Kołodziejczak
- Department of Anesthesiology and Intensive Care, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Mariusz Kowalewski
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Center of Postgraduate Medical Education, Warsaw, Poland
- Thoracic Research Center, Innovative Medical Forum, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Rafał Januszek
- Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, Poland
| | - Miłosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Mariusz Tomaniak
- First Department of Cardiology, Medical University of Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Szymon Darocha
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Center of Postgraduate Medical Education Fryderyk Chopin Hospital in European Health Center Otwock, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Karolina Kupczyńska
- Chair and Department of Cardiology, Medical University of Lodz, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Piotr Dobrowolski
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Agata Tymińska
- First Department of Cardiology, Medical University of Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Aleksandra Ciepłucha
- First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Justyna Sokolska
- Department of Cardiovascular Imaging, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Agnieszka Kapłon-Cieślicka
- First Department of Cardiology, Medical University of Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Andrzej Kułach
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Maciej Wybraniec
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Tomasz Roleder
- Department of Cardiology, Regional Specialist Hospital in Wroclaw, Poland
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Mateusz Tajstra
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Klaudiusz Nadolny
- Faculty of Medicine, Katowice School of Technology, Katowice, Poland
- Department of Health Sciences, WSB University, Dabrowa Gornicza, Poland
| | - Tomasz Darocha
- Department of Anesthesiology and Intensive Therapy, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Sierakowska
- Department of Anesthesiology and Intensive Care, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Tomasz Pawłowski
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland
| | - Maciej Leskiak
- First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Krystian Wita
- First Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Robert Gil
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Przemysław Trzeciak
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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6
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Kubica J, Gajda R, Nadolny K. Mild therapeutic hypothermia or targeted temperature management for cardiac arrest survivors? Cardiol J 2022; 29:1053-1054. [PMID: 36342034 PMCID: PMC9788740 DOI: 10.5603/cj.a2022.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/29/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jacek Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | | | - Klaudiusz Nadolny
- Faculty of Medicine, Katowice School of Technology, Katowice, Poland
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7
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Bujak K, Nadolny K, Trzeciak P, Gałązkowski R, Ładny JR, Gąsior M. Does the presence of physician-staffed emergency medical services improve the prognosis in out-of-hospital cardiac arrest? A propensity score matching analysis. Kardiol Pol 2022; 80:685-692. [PMID: 35445741 DOI: 10.33963/kp.a2022.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Substantial differences in survival after out-of-hospital cardiac arrest (OHCA) have been observed between countries. These might be attributed to the organization of emergency medical service (EMS) systems, including prehospital physician involvement. However, limited data exist on the physician's role in improving survival after OHCA. AIMS To compare prehospital and in-hospital outcomes of OHCA patients attended by physician-staffed EMS vs. paramedic-staffed EMS units. METHODS Among all patients enrolled in the regional, prospective registry of OHCA in southern Poland, we excluded those aged <18 years, with unwitnessed or EMS-witnessed cardiac arrest, without attempted cardiopulmonary resuscitation (CPR), attended by more than one EMS, or with traumatic cardiac arrest. The groups were matched 1:1 using propensity scores for baseline characteristic variables that might influence physician-staffed EMS dispatch. RESULTS A total of 812 OHCA cases were included in the current analysis. Among them, 351 patients were attended by physician-staffed EMS. There were no differences in baseline characteristics in the propensity-score matched cohort consisting of 351 pairs. The return of spontaneous circulation (ROSC) was more often achieved in the physician-staffed EMS group (42.7% vs. 33.3%; P = 0.01). The prehospital survival rate was also higher in this group (34.1% vs. 19.2%; P <0.01). However, there were no significant differences in survival rate to discharge between cases treated by physician-staffed and paramedic-staffed EMS (9.7% vs. 7.0%; P = 0.22). CONCLUSIONS OHCA patients attended by physician-staffed EMS were more likely to have ROSC and survive till hospital admission. However, better prehospital outcomes might not translate into improved in-hospital prognosis in these patients.
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Affiliation(s)
- Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Klaudiusz Nadolny
- Faculty of Medicine, Katowice School of Technology, Katowice, Poland.,Departament of Health Sciences, WSB University, Dąbrowa Górnicza, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Robert Gałązkowski
- Department of Emergency Medical Service, Medical University of Warsaw, Warszawa, Poland
| | - Jerzy Robert Ładny
- Department of Emergency Medicine, Medical University of Bialystok, Białystok, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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8
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Kubica J, Adamski P, Ładny JR, Kaźmierczak J, Fabiszak T, Filipiak KJ, Gajda R, Gąsior M, Gąsior Z, Gil R, Gorący J, Grajek S, Gromadziński L, Gruchała M, Grześk G, Hoffman P, Jaguszewski MJ, Janion M, Jankowski P, Kalarus Z, Kasprzak JD, Kleinrok A, Kochman W, Kubica A, Kuliczkowski W, Legutko J, Lesiak M, Nadolny K, Navarese EP, Niezgoda P, Ostrowska M, Paciorek P, Siller-Matula J, Szarpak Ł, Timler D, Witkowski A, Wojakowski W, Wysokiński A, Zielińska M. Pre-hospital treatment of patients with acute coronary syndrome: Recommendations for medical emergency teams. Expert position update 2022. Cardiol J 2022; 29:540-552. [PMID: 35514089 PMCID: PMC9273237 DOI: 10.5603/cj.a2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/31/2022] [Accepted: 04/24/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Piotr Adamski
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - Jerzy R Ładny
- Department of Emergency Medicine Medical University of Bialystok, Poland
| | | | - Tomasz Fabiszak
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Krzysztof J Filipiak
- Institute of Clinical Medicine, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | | | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Zbigniew Gąsior
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Robert Gil
- Mossakowski Medical Research Institute, Polish Academy of Science, Warsaw, Poland
| | - Jarosław Gorący
- Independent Laboratory of Invasive Cardiology, Pomeranian Medical University, Szczecin, Poland.,Department of Cardiology, Pomeranian Medical University, Szczecin, Poland
| | - Stefan Grajek
- Ist Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Marcin Gruchała
- Ist Department of Cardiology, Medical University of Gdańsk, Poland
| | - Grzegorz Grześk
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Nicolaus Copernicus University, Toruń, Poland
| | - Piotr Hoffman
- Department of Congenital Heart Defects, National Institute of Cardiology, Warszawa, Poland
| | | | - Marianna Janion
- Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Epidemiology and Health Promotion, School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Zbigniew Kalarus
- 2nd Chair and Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jarosław D Kasprzak
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
| | - Andrzej Kleinrok
- University of Information Technology and Management in Rzeszów, Poland
| | - Wacław Kochman
- The National Institute of Cardiology, Department of Cardiology, Bielanski Hospital, Warsaw, Poland
| | - Aldona Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital in Krakow, Poland
| | - Maciej Lesiak
- Ist Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Eliano P Navarese
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Piotr Niezgoda
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | | | - Jolanta Siller-Matula
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland.,Department of Cardiology, Medical University of Vienna, Austria
| | - Łukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.,Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
| | - Dariusz Timler
- Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, Lodz, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Marzenna Zielińska
- Department of Invasive Cardiology, Medical University of Lodz, Lodz, Poland
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9
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Umińska JM, Ratajczak J, Pstrągowski K, Buszko K, Nadolny K, Fabiszak T, Steblovnik K, Noč M, Kubica J. The impact of mild therapeutic hypothermia on platelet reactivity in comatose survivors of cardiac arrest with acute myocardial infarction treated with ticagrelor. Cardiol J 2022:VM/OJS/J/85033. [PMID: 35514087 DOI: 10.5603/cj.a2022.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/31/2021] [Accepted: 02/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of the study was to assess the antiplatelet effect of ticagrelor in patients with myocardial infarction (MI) after out-of-hospital cardiac arrest (OHCA) treated with percutaneous coronary intervention (PCI) and mild therapeutic hypothermia (MTH) vs. MI patients without OHCA treated with PCI. METHODS The study was designed and performed as a phase IV, single-center, investigator-initiated, prospective, observational study assessing the early pharmacodynamic effect (within first 24 h) of a ticagrelor loading dose (180 mg) in both groups of patients (MTH group vs. MI group). For assessment of ticagrelor pharmacodynamics Multiple Electrode Aggregometry (MEA) was applied. RESULTS Compared with the MTH group, platelet inhibition was persistently stronger in the MI group over the entire observation period (up to 24 h), with the highest difference at 4 hours after loading with ticagrelor (25.8 ± 26.4 vs. 75.8 ± 40.9 U, p = 0.002). As a consequence, there was a higher prevalence of high platelet reactivity in the MTH group, with the most explicit difference at 6 hours after the loading dose of ticagrelor (78% vs. 7%, p < 0.001). CONCLUSIONS In comparison with patients treated with primary PCI for uncomplicated MI, the antiplatelet effect of ticagrelor in patients with MI complicated with OHCA, undergoing MTH and primary PCI, is attenuated and delayed.
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Affiliation(s)
- Julia M Umińska
- Department of Geriatrics, Nicolaus Copernicus University, Torun, Poland.
| | - Jakub Ratajczak
- Department of Cardiology, Nicolaus Copernicus University, Torun, Poland
| | | | - Katarzyna Buszko
- Department of Theoretical Foundations of Biomedical Science and Medical Informatics, Nicolaus Copernicus University, Torun, Poland
| | - Klaudiusz Nadolny
- Faculty of Medicine, University of Technology, Katowice, Poland
- Department of Emergency Medical Service, Strategic Planning University of Dabrowa Gornicza, Poland
| | - Tomasz Fabiszak
- Department of Cardiology, Nicolaus Copernicus University, Torun, Poland
| | - Klemen Steblovnik
- Center for Intensive Internal Medicine, University Medical Center, Ljubljana, Slovenia
| | - Marko Noč
- Center for Intensive Internal Medicine, University Medical Center, Ljubljana, Slovenia
| | - Jacek Kubica
- Department of Cardiology, Nicolaus Copernicus University, Torun, Poland
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10
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Szarpak L, Peacock FW, Rafique Z, Ladny JR, Nadolny K, Malysz M, Dabrowski M, Chirico F, Smereka J. Comparison of Vie Scope® and Macintosh laryngoscopes for intubation during resuscitation by paramedics wearing personal protective equipment. Am J Emerg Med 2022; 53:122-126. [PMID: 35016094 PMCID: PMC8731221 DOI: 10.1016/j.ajem.2021.12.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/28/2021] [Accepted: 12/28/2021] [Indexed: 12/12/2022] Open
Abstract
Background Endotracheal intubation (ETI) is still the gold standard of airway management, but in cases of sudden cardiac arrest in patients with suspected SARS-CoV-2 infection, ETI is associated with risks for both the patient and the medical personnel. We hypothesized that the Vie Scope® is more useful for endotracheal intubation of suspected or confirmed COVID-19 cardiac arrest patients than the conventional laryngoscope with Macintosh blade when operators are wearing personal protective equipment (PPE). Methods Study was designed as a prospective, multicenter, randomized clinical trial performed by Emergency Medical Services in Poland. Patients with suspected or confirmed COVID-19 diagnosis who needed cardiopulmonary resuscitation in prehospital setting were included. Patients under 18 years old or with criteria predictive of impossible intubation under direct laryngoscopy, were excluded. Patients were randomly allocated 1:1 to Vie Scope® versus direct laryngoscopy with a Macintosh blade. Study groups were compared on success of intubation attempts, time to intubation, glottis visualization and number of optimization maneuvers. Results We enrolled 90 out-of-hospital cardiac arrest (OHCA) patients, aged 43–92 years. Compared to the VieScope® laryngoscope, use of the Macintosh laryngoscope required longer times for tracheal intubation with an estimated mean difference of −48 s (95%CI confidence interval [CI], −60.23, −35.77; p < 0.001). Moreover VieScope® improved first attempt success rate, 93.3% vs. 51.1% respectively (odds ratio [OR] = 13.39; 95%CI: 3.62, 49.58; p < 0.001). Conclusions The use of the Vie Scope® laryngoscope in OHCA patients improved the first attempt success rate, and reduced intubation time compared to Macintosh laryngoscope in paramedics wearing PPE for against aerosol generating procedures. Trial registration: ClinicalTrials registration number NCT04365608
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Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland; Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland; Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland; Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jerzy R Ladny
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland; Department Emergency Medicine, University Medicine of Białystok, Bialystok, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland
| | - Marek Malysz
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland; Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Marek Dabrowski
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland; Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
| | - Francesco Chirico
- Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy; Health Service Department, Italian State Police, Ministry of the Interior, Milan, Italy
| | - Jacek Smereka
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland; Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
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11
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Niezgoda P, Barańska M, Adamski P, Pietrzykowski Ł, Marszałł MP, Wojakowski W, Kuliczkowski W, Gorog D, Jilma B, Nadolny K, Navarese EP, Kubica A, Kubica J. Influence of METHoxyflurane on ANtiplatelet Effect of ticagrelor in patients with unstable angina pectoris: Rationale and a protocol of a randomized clinical METHANE-SIRIO 4 study. Cardiol J 2021; 29:324-328. [PMID: 34642919 PMCID: PMC9007486 DOI: 10.5603/cj.a2021.0126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/11/2021] [Accepted: 08/22/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Piotr Niezgoda
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - Malwina Barańska
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Piotr Adamski
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Łukasz Pietrzykowski
- Collegium Medicum, Nicolaus Copernicus University, Department of Health Promotion
| | | | | | | | - Diana Gorog
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Bernd Jilma
- Medical University of Vienna, Dept. of Clinical Pharmacology, Vienna, Austria
| | - Klaudiusz Nadolny
- Medical University of Białystok, Białystok, Poland.,Higher School of Strategic Planning, Dąbrowa Górnicza, Poland
| | | | - Aldona Kubica
- Collegium Medicum, Nicolaus Copernicus University, Department of Health Promotion
| | - Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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12
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Obremska M, Pazgan-Simon M, Budrewicz K, Bilaszewski L, Wizowska J, Jagielski D, Jankowska-Polanska B, Nadolny K, Madowicz J, Zuwala-Jagiello J, Zysko D, Banasiak W, Simon K. Simple demographic characteristics and laboratory findings on admission may predict in-hospital mortality in patients with SARS-CoV-2 infection: development and validation of the covid-19 score. BMC Infect Dis 2021; 21:945. [PMID: 34521357 PMCID: PMC8438286 DOI: 10.1186/s12879-021-06645-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes a major health burden worldwide due to high mortality rates and hospital bed shortages. SARS-CoV-2 infection is associated with several laboratory abnormalities. We aimed to develop and validate a risk score based on simple demographic and laboratory data that could be used on admission in patients with SARS-CoV-2 infection to predict in-hospital mortality. Methods Three cohorts of patients from different hospitals were studied consecutively (developing, validation, and prospective cohorts). The following demographic and laboratory data were obtained from medical records: sex, age, hemoglobin, mean corpuscular volume (MCV), platelets, leukocytes, sodium, potassium, creatinine, and C-reactive protein (CRP). For each variable, classification and regression tree analysis were used to establish the cut-off point(s) associated with in-hospital mortality outcome based on data from developing cohort and before they were used for analysis in the validation and prospective cohort. The covid-19 score was calculated as a sum of cut-off points associated with mortality outcome. Results The developing, validation, and prospective cohorts included 129, 239, and 497 patients, respectively (median age, 71, 67, and 70 years, respectively). The following cut of points associated with in-hospital mortality: age > 56 years, male sex, hemoglobin < 10.55 g/dL, MCV > 92.9 fL, leukocyte count > 9.635 or < 2.64 103/µL, platelet count, < 81.49 or > 315.5 103/µL, CRP > 51.14 mg/dL, creatinine > 1.115 mg/dL, sodium < 134.7 or > 145.4 mEq/L, and potassium < 3.65 or > 6.255 mEq/L. The AUC of the covid-19 score for predicting in-hospital mortality was 0.89 (0.84–0.95), 0.850 (0.75–0.88), and 0.773 (0.731–0.816) in the developing, validation, and prospective cohorts, respectively (P < 0.001The mortality of the prospective cohort stratified on the basis of the covid-19 score was as follows: 0–2 points,4.2%; 3 points, 15%; 4 points, 29%; 5 points, 38.2%; 6 and more points, 60%. Conclusion The covid-19 score based on simple demographic and laboratory parameters may become an easy-to-use, widely accessible, and objective tool for predicting mortality in hospitalized patients with SARS-CoV-2 infection.
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Affiliation(s)
- Marta Obremska
- Department of Preclinical Research, Wroclaw Medical University, Wroclaw, Poland
| | - Monika Pazgan-Simon
- Ist Department of Infectious Diseases Regional Specialistic Hospital, Wroclaw, Poland
| | - Katarzyna Budrewicz
- Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland.
| | - Lukasz Bilaszewski
- Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Joanna Wizowska
- Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland
| | | | | | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland.,Faculty of Medicine, Katowice School of Technology, Katowice, Poland
| | - Jarosław Madowicz
- Provincial Specialist Hospital, Tychy, Poland.,Department of Health Sciences, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland
| | | | - Dorota Zysko
- Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland
| | | | - Krzysztof Simon
- Ist Department of Infectious Diseases Regional Specialistic Hospital, Wroclaw, Poland.,Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Wroclaw, Poland
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13
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Diemieszczyk I, Woźniewska P, Gołaszewski P, Drygalski K, Nadolny K, Ładny JR, Razak Hady H. Does weight loss after laparoscopic sleeve gastrectomy contribute to reduction in blood pressure? Pol Arch Intern Med 2021; 131:693-700. [PMID: 34075736 DOI: 10.20452/pamw.16023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Obesity‑related hypertension is a life threatening medical condition that significantly increases the risk of cardiovascular diseases and premature mortality. Effective treatment of obesity may be achieved by laparoscopic sleeve gastrectomy (LSG). This surgical method contributes not only to sustained weight loss but also to normalization of blood pressure. OBJECTIVES To evaluate the effect of weight loss after LSG on partial or full control of blood pressure. PATIENTS AND METHODS A retrospective analysis of medical and clinical data of 305 patients who had undergone LSG was performed. The bariatric effect of LSG was assessed by calculating percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and percentage of excess BMI loss (%EBMIL). Blood pressure status after surgery was categorized as partial or full hypertension resolution. RESULTS A total of 143 patients (46.9%) were diagnosed with hypertension preoperatively with median (IQR) hypertension duration of 7.52 (1.88-13.16) years. Hypertensive patients were older (49 vs 38.5 years) and had higher prevalence of coexisting diseases (type 2 diabetes, dyslipidemia, and obstructive sleep apnea) than patients with normal blood pressure. During 1‑year follow up, 90 patients (63%) used lower doses of antihypertensive medications and 33 patients (23%) discontinued the therapy. Twelve months after the surgery, median (IQR) %TWL in the control group was 32.5% (28.1%-37.7%), while in the hypertensive group, 29.1% (25.9%-33.6%) (P <0.001); %EWL was 62.9% (53%-74.6%) and 54.8% (47.4%-68.2%), respectively (P = 0.001), and %EBMIL 73.9% (59.5%-91.2%) and 63% (55%-80.5%), respectively (P = 0.002). CONCLUSIONS Laparoscopic sleeve gastrectomy is an effective method for the treatment of obesity‑ related hypertension. However, weight loss induced by LSG does not affect the blood pressure status after the surgery.
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Affiliation(s)
- Inna Diemieszczyk
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, Białystok, Poland
| | - Paulina Woźniewska
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, Białystok, Poland.
| | - Piotr Gołaszewski
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, Białystok, Poland
| | - Krzysztof Drygalski
- Clinical Research Center, Medical University of Bialystok, Białystok, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning, University of Dabrowa Gornicza, Dąbrowa Górnicza, Poland
| | - Jerzy R Ładny
- Department of Emergency Medicine, Medical University of Bialystok, Białystok, Poland
| | - Hady Razak Hady
- 1st Department of General and Endocrine Surgery, Medical University of Bialystok, Białystok, Poland
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14
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Kubica A, Kosobucka A, Niezgoda P, Adamski P, Buszko K, Lesiak M, Wojakowski W, Gasior M, Gorący J, Kleinrok A, Nadolny K, Navarese E, Kubica J. ANalgesic Efficacy and safety of MOrphiNe versus methoxyflurane in patients with acute myocardial infarction: the rationale and design of the ANEMON-SIRIO 3 study: a multicentre, open-label, phase II, randomised clinical trial. BMJ Open 2021; 11:e043330. [PMID: 33649058 PMCID: PMC8098993 DOI: 10.1136/bmjopen-2020-043330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The unfavourable influence of morphine on the pharmacokinetics of ticagrelor resulting in weaker and retarded antiplatelet effect in patients with acute coronary syndrome (ACS) has been previously shown. Replacing morphine with methoxyflurane, a potent, non-opioid analgesic agent, that does not weaken or delay the effect of antiplatelet agents may improve the clinical efficacy of treatment of patients with ACS. METHODS The ANEMON-SIRIO 3 study was designed as a multicentre, open-label, phase II, randomised clinical trial aimed to test the analgesic efficacy and safety of methoxyflurane in patients with ACS. The study population will comprise patients with ST-elevation myocardial infarction or non-ST-elevation ACS admitted to the study centres with typical chest pain requiring analgesic treatment. Before percutaneous coronary intervention (PCI) for the patients with index ACS will be randomly assigned in 1:1 ratio to receive methoxyflurane administered by inhalation, or to obtain morphine administered intravenously. Analgesic treatment will be followed by 300 mg loading dose of aspirin and 180 mg loading dose of ticagrelor. Patients will be assessed with regard to pain intensity according to the Numeric Pain Rating Scale at baseline, 3 min after study drug administration and immediately after PCI. Moreover, patients will be actively monitored with regard to the occurrence of side effects of evaluated therapies, as well as adverse events that may be related to insufficient platelet inhibition (no-reflow phenomenon assessed immediately after PCI, administration of GPIIb/IIIa inhibitors during PCI, acute stent thrombosis). ETHICS AND DISSEMINATION The study will be conducted in six Polish clinical centres from the beginning of in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. TRIAL REGISTRATION DETAILS ClinicalTrials.gov, NCT04476173.
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Affiliation(s)
- Aldona Kubica
- Departament of Health Promotion, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Agata Kosobucka
- Departament of Health Promotion, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Piotr Niezgoda
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Piotr Adamski
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Katarzyna Buszko
- Department of Theoretical Foundations of Biomedical Science and Medical Informatics, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Maciej Lesiak
- The 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gasior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Jarosław Gorący
- Department of Cardiology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Andrzej Kleinrok
- Department of Cardiology, Pope John Paul II Reginal Hospital, Zamosc, Poland
- Medical Department, University of Information Technology and Management, Rzeszow, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medicine and Disasters, Medical University of Bialystok, Bialystok, Poland
- Department of Emergency Medical Service, Higher School of Strategic Planning, Dąbrowa Górnicza, Poland
| | - Eliano Navarese
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Jacek Kubica
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
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15
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Nadolny K, Wierzbik-Strońska M, Ładny JR, Grabarek BO, Warmusz O, Boroń D, Ostenda A. Emergency Medical Teams Interventions due to Cardiovascular Diseases in 2018: Polish Regional Observational Study. Medicina (B Aires) 2021; 57:medicina57020139. [PMID: 33557380 PMCID: PMC7915856 DOI: 10.3390/medicina57020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022] Open
Abstract
Background and objectives: The goal of this work was to assess the interventions for cardiovascular causes (ICD-10: I) and analyze the time between the request for intervention and the arrival of the Medical Emergency Team realized by the Voivodeship Rescue Service in Katowice in the period between 1 January 2018 to 31 December 2018. Materials and Methods: Analysis of the characteristics of the interventions was completed based on the information contained on the dispatch order cards and medical emergency services. Statistical analysis was done using the Chi-square test (p < 0.05). Results: Out of 211,548 cases, 26,672 were associated with cardiovascular diseases. It can be observed that the large majority of interventions took place in urban areas (89.98%; 23,998 cases), whereas only 11.02% took place in rural areas (2674 cases). The most common cause for medical interventions being made by the Medical Emergency Team was primary hypertension—11,649 cases. The average arrival time to urban areas was 9 min and 12 s ± 3 min and 54 s, whereas for rural areas it was 11 min and 57 s ± 4 min and 32 s (p < 0.05). Conclusions: It can be observed that the Medical Emergency System in Katowice operates accordingly with the intentions of the legislator. The obtained data also indicates that there is a high societal awareness of the residents about the purpose of the Medical Emergency Team.
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Affiliation(s)
- Klaudiusz Nadolny
- Faculty of Medicine, University of Technology in Katowice, 40-555 Katowice, Poland; (K.N.); (O.W.); (A.O.)
- Department of Emergency Medical Service, Strategic Planning University of Dabrowa Gornicza, 40-555 Dąbrowa Górnicza, Poland
| | - Magdalena Wierzbik-Strońska
- Faculty of Medicine, University of Technology in Katowice, 40-555 Katowice, Poland; (K.N.); (O.W.); (A.O.)
- Correspondence:
| | - Jerzy R. Ładny
- Department of Emergency Medcine, Medical University of Bialystok, 15-295 Białystok, Poland;
| | - Beniamin O. Grabarek
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine, University of Technology in Katowice, 41-800 Zabrze, Poland; (B.O.G.); (D.B.)
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland
| | - Oliwia Warmusz
- Faculty of Medicine, University of Technology in Katowice, 40-555 Katowice, Poland; (K.N.); (O.W.); (A.O.)
| | - Dariusz Boroń
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine, University of Technology in Katowice, 41-800 Zabrze, Poland; (B.O.G.); (D.B.)
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland
| | - Aleksander Ostenda
- Faculty of Medicine, University of Technology in Katowice, 40-555 Katowice, Poland; (K.N.); (O.W.); (A.O.)
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16
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Nadolny K, Bujak K, Obremska M, Zysko D, Sterlinski M, Szarpak L, Kubica J, Ladny JR, Gasior M. Glasgow Coma Scale score of more than four on admission predicts in-hospital survival in patients after out-of-hospital cardiac arrest. Am J Emerg Med 2021; 42:90-94. [PMID: 33497899 DOI: 10.1016/j.ajem.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 10/22/2022] Open
Abstract
AIM The aim of the study was to assess the usefulness of the Glasgow Coma Scale (GCS) score assessed by EMS team in predicting survival to hospital discharge in patients after out-of-hospital cardiac arrest (OHCA). METHODS Silesian Registry of OHCA (SIL-OHCA) is a prospective, population-based regional registry of OHCAs. All cases of OHCAs between the 1st of January 2018 and the 31st of December 2018 were included. Data were collected by EMS using a paper-based, Utstein-style form. OHCA patients aged ≥18 years, with CPR attempted or continued by EMS, who survived to hospital admission, were included in the current analysis. Patients who did not achieve return of spontaneous circulation (ROSC) in the field, with missing data on GCS after ROSC or survival status at discharge were excluded from the study. RESULTS Two hundred eighteen patients with OHCA, who achieved ROSC, were included in the present analysis. ROC analysis revealed GCS = 4 as a cut-off value in predicting survival to discharge (AUC 0.735; 95%CI 0.655-0.816; p < 0.001). Variables significantly associated with in-hospital survival were young age, short response time, witnessed event, previous myocardial infarction, chest pain before OHCA, initial shockable rhythm, coronary angiography, and GCS > 4. On the other hand, epinephrine administration, intubation, the need for dispatching two ambulances, and/or a physician-staffed ambulance were associated with a worse prognosis. Multivariable logistic regression analysis revealed GCS > 4 as an independent predictor of in-hospital survival after OHCA (OR of 6.4; 95% CI 2.0-20.3; p < 0.0001). Other independent predictors of survival were the lack of epinephrine administration, previous myocardial infarction, coronary angiography, and the patient's age. CONCLUSION The survival to hospital discharge after OHCA could be predicted by the GCS score on hospital admission.
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Affiliation(s)
- Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland; Faculty of Medicine, Katowice School of Technology, Katowice, Poland.
| | - Kamil Bujak
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marta Obremska
- Department of Preclinical Research, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Zysko
- Department of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Maciej Sterlinski
- 1st Department of Heart Arrhythmia National Institute of Cardiology, Warsaw, Poland
| | | | - Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Jerzy Robert Ladny
- Department Emergency Medicine, University Medicine of Białystok, Bialystok, Poland
| | - Mariusz Gasior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Nadolny K, Zyśko D, Ładny JR, Gałązkowski R. Why epinephrine should not always be used in pediatric cardiac arrest? Authors' reply. Kardiol Pol 2021; 79:221-222. [PMID: 33463991 DOI: 10.33963/kp.15755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Trela M, Szarpak Ł, Filipiak KJ, Meyer-Szary J, Gilis-Malinowska N, Nadolny K, Gąsecka A, Szarpak A, Smereka J, Jaguszewski MJ. Why epinephrine should not always be used in pediatric cardiac arrest? Kardiol Pol 2021; 79:220-221. [PMID: 33463990 DOI: 10.33963/kp.15754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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19
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Drozd A, Smereka J, Filipiak KJ, Jaguszewski M, Ładny JR, Bielski K, Nadolny K, Ruetzler K, Szarpak Ł. Intraosseous versus intravenous access while wearing personal protective equipment: a meta-analysis in the era of COVID-19. Kardiol Pol 2021; 79:277-286. [PMID: 33415967 DOI: 10.33963/kp.15741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Obtaining vascular access is one of the key procedures performed in patients in emergency settings. AIMS The study was conducted as a meta‑analysis and a systematic review and aimed to address the following question: which intravascular access method should be used in patients with COVID‑19 when wearing full personal protective equipment (PPE)? METHODS We performed a systematic search of PubMed, EMBASE, and CENTRAL databases for randomized controlled trials that compared intravascular access methods used by operators wearing full level C PPE. We evaluated procedure duration and the success rate of intraosseous and peripheral intravenous accesses. RESULTS Eight randomized controlled trials were included in quantitative synthesis. The use of PPE during intravascular access procedures had an impact on procedure duration in the case of intraosseous access (mean difference [MD], 11.69; 95% CI, 6.47-16.92; P <0.001), as well as reduced the success rate of intraosseous access by 0.8% and intravenous access by 10.1%. Under PPE conditions, intraosseous access, compared with peripheral intravenous access, offered a shorter procedure time (MD, -41.43; 95% CI, -62.36 to -24.47; P <0.001). CONCLUSION This comprehensive meta‑analysis suggested that the use of PPE significantly extends the duration of intravascular procedures. However, under PPE conditions, operators were able to obtain intraosseous access in a shorter time and with a higher success rate than in the case of intravenous access.
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20
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Obremska M, Madziarska K, Zyśko D, Ładny JR, Gałązkowski R, Gąsior M, Nadolny K. Out-of-hospital cardiac arrest in dialysis patients. Int Urol Nephrol 2020; 53:563-569. [PMID: 33337538 PMCID: PMC7907018 DOI: 10.1007/s11255-020-02694-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/27/2020] [Indexed: 11/04/2022]
Abstract
Purpose The aim of the study was to assess whether a history of dialysis is related to cardiopulmonary resuscitation (CPR) attempts and survival to hospital admission in patients with out-of-hospital cardiac arrest (OHCA). Methods The databases of the POL-OHCA registry and of emergency medical calls in the Command Support System of the State of Emergency Medicine (CSS) were searched to identify patients with OHCA and a history of dialysis. A total of 264 dialysis patient with OHCA were found: 126 were dead on arrival of emergency medical services (EMS), and 138 had OHCA with CPR attempts. Data from the POL-OHCA registry for patients with CPR attempts, including age, sex, place of residence, first recorded rhythm, defibrillation during CPR, and priority dispatch codes, were collected and compared between patients with and without dialysis. Results CPR attempts by EMS were undertaken in 138 dialyzed patients (52.3%). The analysis of POL-OHCA data revealed no differences in age, sex, place of residence, first recorded rhythm, and priority dispatch codes between patients with and without dialysis. Defibrillation was less frequent in dialysis patients (P = 0.04). A stepwise logistic regression analysis revealed no association between survival to hospital admission and a history of hemodialysis (odds ratio = 1.12; 95% CI 0.74–1.70, P = 0.60). Conclusions A history of dialysis in patients with OHCA does not affect the rate of CPR attempts by EMS or a short-term outcome in comparison with patients without dialysis. Defibrillation during CPR is less common in patients on dialysis than in those without.
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Affiliation(s)
- Marta Obremska
- Department of Preclinical Research, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Madziarska
- Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska St. 213, 50-556, Wroclaw, Poland.
| | - Dorota Zyśko
- Department of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy R Ładny
- Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Robert Gałązkowski
- Department of Emergency Medical Service, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Gąsior
- Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland.,Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland.,Faculty of Medicine, Katowice School of Technology, Katowice, Poland
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21
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Ludwin K, Safiejko K, Smereka J, Nadolny K, Cyran M, Yakubtsevich R, Jaguszewski MJ, Filipiak KJ, Szarpak L, Rodríguez-Núñez A. Systematic review and meta-analysis appraising efficacy and safety of adrenaline for adult cardiopulmonary resuscitation. Cardiol J 2020; 28:279-292. [PMID: 33140398 DOI: 10.5603/cj.a2020.0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is a beneficial effect of adrenaline during adult cardiopulmonary resuscitation (CPR) from cardiac arrest but there is also uncertainty about its safety and effectiveness. The aim of this study was to evaluate the use of adrenaline versus non-adrenaline CPR. METHODS PubMed, ScienceDirect, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Google Scholar databases were searched from their inception up to 1st July 2020. Two reviewers independently assessed eligibility and risk of bias, with conflicts resolved by a third reviewer. Risk ratio (RR) or mean difference of groups were calculated using fixed or random-effect models. RESULTS Nineteen trials were identified. The use of adrenaline during CPR was associated with a significantly higher percentage of return of spontaneous circulation (ROSC) compared to non-adrenaline treatment (20.9% vs. 5.9%; RR = 1.87; 95% confidence interval [CI] 1.37-2.55; p < 0.001). The use of adrenaline in CPR was associated with ROSC at 19.4% and for non-adrenaline treatment - 4.3% (RR = 3.23; 95% CI 1.89-5.53; p < 0.001). Survival to discharge (or 30-day survival) when using adrenaline was 6.8% compared to non-adrenaline treatment (5.5%; RR = 0.99; 95% CI 0.76-1.30; p = 0.97). However, the use of adrenaline was associated with a worse neurological outcome (1.6% vs. 2.2%; RR = 0.57; 95% CI 0.42-0.78; p < 0.001). CONCLUSIONS This review suggests that resuscitation with adrenaline is associated with the ROSC and survival to hospital discharge, but no higher effectiveness was observed at discharge with favorable neurological outcome. The analysis showed higher effectiveness of ROSC and survival to hospital discharge in non-shockable rhythms. But more multicenter randomized controlled trials are needed in the future.
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Affiliation(s)
- Kobi Ludwin
- Polish Society of Disaster Medicine, Warsaw, Poland
| | | | - Jacek Smereka
- Polish Society of Disaster Medicine, Warsaw, Poland.,Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland.,Faculty of Medicine, Katowice School of Technology, Katowice, Poland
| | - Maciej Cyran
- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland
| | - Ruslan Yakubtsevich
- Department of Anesthesiology and Intensive Care Grodno State Medical University, Grodno, Belarus
| | | | - Krzysztof J Filipiak
- First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Lukasz Szarpak
- Bialystok Oncology Center, Bialystok, Poland. .,Polish Society of Disaster Medicine, Warsaw, Poland. .,Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland.
| | - Antonio Rodríguez-Núñez
- Pediatric Intensive Care Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
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22
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Borkowska MJ, Smereka J, Safiejko K, Nadolny K, Maslanka M, Filipiak KJ, Jaguszewski MJ, Szarpak L. Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study. Cardiol J 2020; 28:15-22. [PMID: 33140396 DOI: 10.5603/cj.a2020.0135] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/02/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a challenge for medical personnel, especially in the current COVID-19 pandemic, where medical personnel should perform resuscitation wearing full personal protective equipment. This study aims were to assess the characteristics and outcomes of adults who suffered an OHCA in the COVID-19 pandemic treated by emergency medical service (EMS) teams. METHODS All EMS-attended OHCA adults over than 18 years in the Polish EMS registry were analyzed. The retrospective EMS database was conducted. EMS interventions performed between March 1, and April 30, 2020 were retrospectively screened. RESULTS In the study period EMS operated 527 times for OHCA cases. The average age of patients with OHCA was 67.8 years. Statistically significantly more frequently men were involved (64.3%). 298 (56.6%) of all OHCA patients had resuscitation attempted by EMS providers. Among resuscitated patients, 73.8% were cardiac etiology. 9.4% of patients had return of spontaneous circulation, 27.2% of patients were admitted to hospital with ongoing chest compression. In the case of 63.4% cardiopulmonary resuscitation was ineffective and death was determined. CONCLUSIONS The present study found that OHCA incidence rate in the Masovian population (central region of Poland) in March-April 2020 period was 12.2/100,000 adult inhabitants. Return of spontaneous circulation in EMS was observed only in 9.4% of resuscitated patients. The presence of shockable rhythms was associated with better prognosis. The prehospital mortality, even though it was high, did not differ from those reported by other studies.
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Affiliation(s)
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | | | - Klaudiusz Nadolny
- Faculty of Medicine, Katowice School of Technology, Katowice, Poland.,Department of Emergency Medical Service, Strategic Planning University of Dabrowa Gornicza, Dabrowa Gornicza, Poland
| | - Maciej Maslanka
- Polish Society of Disaster Medicine, Warsaw, Poland.,Maria Skłodowska-Curie Medical Academy in Warsaw, Poland
| | - Krzysztof J Filipiak
- First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Lukasz Szarpak
- Białystok Oncology Center, Białystok, Poland. .,Polish Society of Disaster Medicine, Warsaw, Poland.
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23
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Ludwin K, Smereka J, Nadolny K, Ładny JR, Szarpak A, Fajfer Z, Jaguszewski M, Filipiak KJ, Szarpak Ł. Effect of amiodarone and lidocaine on shock-refractory cardiac arrest: a systematic review and meta-analysis. Kardiol Pol 2020; 78:999-1007. [DOI: 10.33963/kp.15483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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24
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Kubica J, Adamski P, Niezgoda P, Alexopoulos D, Badarienė J, Budaj A, Buszko K, Dudek D, Fabiszak T, Gąsior M, Gil R, Gorog DA, Grajek S, Gurbel PA, Gruchała M, Jaguszewski MJ, James S, Jeong YH, Jilma B, Kasprzak JD, Kleinrok A, Kubica A, Kuliczkowski W, Legutko J, Lesiak M, Siller-Matula JM, Nadolny K, Pstrągowski K, Di Somma S, Specchia G, Stępińska J, Tantry US, Tycińska A, Verdoia M, Wojakowski W, Navarese EP. Prolonged antithrombotic therapy in patients after acute coronary syndrome: A critical appraisal of current European Society of Cardiology guidelines. Cardiol J 2020; 27:661-676. [PMID: 33073857 DOI: 10.5603/cj.a2020.0132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/12/2020] [Indexed: 01/23/2023] Open
Abstract
The increased risk of non-cardiovascular death in patients receiving clopidogrel or prasugrel in comparison with the placebo group in the Dual Antiplatelet Therapy (DAPT) trial in contrast to the decreased risk of cardiovascular death and all-cause death seen in patients treated with low-dose ticagrelor in the EU label population of the PEGASUS-TIMI 54 trial, resulted in inclusion in the 2020 ESC NSTE-ACS guidelines the recommendation for use of clopidogrel or prasugrel only if the patient is not eligible for treatment with ticagrelor. The prevalence of the primary outcome composed of cardiovascular death, stroke, or myocardial infarction was lower in the low-dose rivaroxaban and acetylsalicylic acid (ASA) group than in the ASA-alone group in the COMPASS trial. Moreover, all-cause mortality and cardiovascular mortality rates were lower in the rivaroxaban-plus-ASA group. Comparison of the PEGASUS-TIMI 54 and COMPASS trial patient characteristics clearly shows that each of these treatment strategies should be addressed at different groups of patients. A greater benefit in post-acute coronary syndrome (ACS) patients with a high risk of ischemic events and without high bleeding risk may be expected with ASA and ticagrelor 60 mg b.i.d. when the therapy is continued without interruption or with short interruption only after ACS. On the other hand, ASA and rivaroxaban 2.5 mg b.i.d. seems to be a better option when indications for dual antithrombotic therapy (DATT) appear after a longer time from ACS (more than 2 years) and/or from cessation of DAPT (more than 1 year) and in patients with multiple vascular bed atherosclerosis. Thus, both options of DATTs complement each other rather than compete, as can be presumed from the recommendations. However, a direct comparison between these strategies should be tested in future clinical trials.
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Affiliation(s)
- Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, Ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.
| | - Piotr Adamski
- Collegium Medicum, Nicolaus Copernicus University, Ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Piotr Niezgoda
- Collegium Medicum, Nicolaus Copernicus University, Ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Dimitrios Alexopoulos
- National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Jolita Badarienė
- Clinic of Cardiac and Vascular diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Andrzej Budaj
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | | | - Dariusz Dudek
- Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.,Maria Cecilia Hospital, GVM Care&Research, Cotignola (RA), Ravenna, Italy
| | - Tomasz Fabiszak
- Collegium Medicum, Nicolaus Copernicus University, Ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Mariusz Gąsior
- IIIrd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Robert Gil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Hospital of the Internal Affairs and Administration Ministry, Warsaw, Poland
| | - Diana A Gorog
- Postgraduate Medicine, University of Hertfordshire, United Kingdom and Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Stefan Grajek
- Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Paul A Gurbel
- Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Marcin Gruchała
- 1st Department of Cardiology, Medical University of Gdańsk, Poland
| | | | - Stefan James
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala, Sweden
| | - Young-Hoon Jeong
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - Jarosław D Kasprzak
- 1st Department and Chair of Cardiology, Medical University of Lodz Bieganski Hospital, Lodz Poland
| | - Andrzej Kleinrok
- University of Information Technology and Management in Rzeszow, Poland.,Department of Cardiology The Pope John Paul II Hospital in Zamosc, Poland
| | - Aldona Kubica
- Department of Health Promotion, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital in Krakow, Poland
| | - Maciej Lesiak
- Postgraduate Medicine, University of Hertfordshire, United Kingdom and Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Jolanta M Siller-Matula
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland.,Department of Cardiology, Medical University of Vienna, Austria
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Strategic Planning University of Dabrowa Gornicza, Dabrowa Gornicza, Poland.,Faculty of Medicine, Katowice School of Technology, Katowice, Katowice, Poland
| | - Krzysztof Pstrągowski
- Collegium Medicum, Nicolaus Copernicus University, Ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Salvatore Di Somma
- Department of Medical-Surgery Sciences and Translational Medicine, University La Sapienza, Rome, Italy
| | | | - Janina Stępińska
- Department of Intensive Cardiac Therapy, National Institute of Cardiology, Warsaw, Poland
| | - Udaya S Tantry
- Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | | | - Monica Verdoia
- Division of Cardiology, Ospedale degli Infermi ASL Biella, Università del Piemonte Orientale, Italy
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Eliano P Navarese
- Collegium Medicum, Nicolaus Copernicus University, Ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
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25
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Małysz M, Smereka J, Jaguszewski M, Dąbrowski M, Nadolny K, Ruetzler K, Ładny JR, Sterliński M, Filipiak KJ, Szarpak Ł. An optimal chest compression technique using personal protective equipment during resuscitation in the COVID-19 pandemic: a randomized crossover simulation study. Kardiol Pol 2020; 78:1254-1261. [PMID: 33047942 DOI: 10.33963/kp.15643] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation with the use of personal protective equipment (PPE) for aerosol generating procedures (AGP) in patients with suspected or confirmed coronavirus disease 2019 (COVID‑19) remains challenging. AIMS The aim of this study was to compare 3 chest compression (CC) methods used by paramedics wearing PPE. METHODS The single‑blinded, multicenter, randomized, crossover simulation study involved 67 paramedics wearing PPE AGP. They performed 2‑minute continuous CCs in an adult with suspected or confirmed COVID‑19 in 3 scenarios: 1) manual CCs; 2) CCs with the TrueCPR feedback device; 3) CCs with the LUCAS 3 mechanical CC device. RESULTS The depth of CC was more frequently correct when using LUCAS 3 compared with TrueCPR and manual CC (median [IQR] 51 [50-55] mm vs 47 [43-52] mm vs 43 [38-46] mm; P = 0.005). This was also true for the CC rate (median [IQR]102 [100-102] compressions per minute [CPM] vs 105 [98-1114] CPM vs 116 [112-129] CPM; P = 0.027) and chest recoil (median [IQR]100% [98%-100%] vs 83% [60%-92%] vs 39% [25%-50%]; P = 0.001). A detailed analysis of 2‑minute resuscitation with manual CCs showed a decrease in compression depth and full chest recoil after 1 minute of CCs. CONCLUSION We demonstrated that during simulated resuscitation with the use of PPE AGP in patients with suspected or confirmed COVID‑19, CC with LUCAS 3 compared with manual CCs as well as the TrueCPR essentially increased the CC quality. In the case of manual CCs by paramedics dressed in PPE AGP, it is advisable to change the person performing resuscitation every minute.
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Nadolny K, Ładny JR, Zyśko D, Gałązkowski R, Gąsior M, Kraska W. Interventions of emergency medical teams in Poland during the SARS-CoV-2 pandemic. Kardiol Pol 2020; 79:72-75. [PMID: 33021351 DOI: 10.33963/kp.15632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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27
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Nadolny K, Zyśko D, Ładny JR, Gałązkowski R. Data from the polish POL-OHCA register on OHCA in annual observation. Resuscitation 2020. [DOI: 10.1016/j.resuscitation.2020.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Barycka K, Torlinski T, Filipiak KJ, Jaguszewski M, Nadolny K, Szarpak L. Risk of self-contamination among healthcare workers in the COVID-19 pandemic. Am J Emerg Med 2020; 46:751-752. [PMID: 33008700 PMCID: PMC7521207 DOI: 10.1016/j.ajem.2020.09.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/24/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Katarzyna Barycka
- Department of Veterinary Hygiene, Kielce Regional Veterinary Inspectorate, Kielce, Poland; Polish Society of Disaster Medicine, Warsaw, Poland
| | - Tomasz Torlinski
- Department of Anaesthetics and Intensive Care Medicine, University Hospitals Birmingham NHS FT, Birmingham, United Kingdom
| | | | - Milosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland
| | - Lukasz Szarpak
- Polish Society of Disaster Medicine, Warsaw, Poland; Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
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29
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Gąsior M, Gierlotka M, Tycińska A, Wojtaszczyk A, Skrzypek M, Nadolny K, Ładny JR, Dobrzycki S, Hausner A, Wita K, Wojakowski W, Hawranek M. Effects of the coronavirus disease 2019 pandemic on the number of hospitalizations for myocardial infarction: regional differences. Population analysis of 7 million people. Kardiol Pol 2020; 78:1039-1042. [PMID: 32820878 DOI: 10.33963/kp.15559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases,Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Agnieszka Tycińska
- Department of Cardiology, Medical University of Białystok, Faculty of Medicine, Białystok, Poland
| | - Adam Wojtaszczyk
- 3rd Department of Cardiology, Silesian Center for Heart Diseases,Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Michał Skrzypek
- Department of Science, Training and New Medical Technologies, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Strategic Planning University of Dąbrowa Górnicza, Dąbrowa Górnicza, Poland; Faculty of Medicine, Katowice School of Technology, Katowice, Poland
| | - Jerzy Robert Ładny
- Department of Emergency Medicine, University Medical of Białystok, Białystok, Poland
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University in Białystok, Białystok, Poland
| | - Andrzej Hausner
- Opole Voivodeship Branch of the National Health Fund, Opole, Poland
| | - Krystian Wita
- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases,Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, Silesian Center for Heart Diseases,Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze, Poland.
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Nadolny K, Zyśko D, Obremska M, Wierzbik-Strońska M, Ładny JR, Podgórski M, Gałązkowski R. Analysis of out-of-hospital cardiac arrest in Poland in a 1-year period: data from the POL-OHCA registry. Kardiol Pol 2020; 78:404-411. [DOI: 10.33963/kp.15241] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Szarpak L, Ruetzler K, Dabrowski M, Nadolny K, Ladny JR, Smereka J, Jaguszewski M, Filipiak KJ. Dilemmas in resuscitation of COVID-19 patients based on current evidence. Cardiol J 2020; 27:327-328. [PMID: 32419130 DOI: 10.5603/cj.a2020.0066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Lazarski University, Warsaw, Poland. .,Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Kurt Ruetzler
- Departments of Outcomes Research and General Anesthesia, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Marek Dabrowski
- Chair and Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland, Dabrowa Gornicza, Poland
| | - Jerzy R Ladny
- Clinic of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland; Polish Society of Disaster Medicine, Warsaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | - Milosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof J Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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Nadolny K, Ładny JR, Gałązkowski R, Gąsior M, Kubica J, Zyśko D, Kaźmierczak J, Ponikowski P. Medical emergency team interventions in patients with ST-segment elevation myocardial infarction in Poland in 2018. Kardiol Pol 2020; 78:292-299. [DOI: 10.33963/kp.15222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Wierzbik-Strońska M, Nadolny K, Grabarek BO, Boroń D. CHARACTERISTICS OF THE INTERVENTION OF EMERGENCY MEDICAL TEAMS IN THE SOUTHERN PART OF POLAND IN 12-MONTH OBSERVATION. Wiad Lek 2020; 73:1632-1636. [PMID: 33055324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The aim: The aim of this study was to characterize the general characteristics of the completed interventions by the Voivodeship Rescue Service of Katowice in the time period from 1st January 2018 to 31 December 2018. PATIENTS AND METHODS Material and methods: Analysis of the characteristics of the trips was done based on the information contained in the dispatch order cards and medical emergency services cards. In the statistical analysis the Chi-Square (p<0.05) test was utilized. RESULTS Results: The total number of interventions was 211,548 cases. It is also worth observing, that the general number of interventions out of town amounted to 20,344 interventions, whereas, in town, there were 191,204 interventions. It can be observed that the most common decision made by the Emergency Medical Team was the decision to directly transported and received by the emergency department (126,553 cases; p<0.05). The definite most common reason for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (ICD-10 code : R; p<0.05). CONCLUSION Conclusion: The largest number of interventions completed by the Voivodeship Rescue Service in Katowice in 2018 was due to injuries and poisonings, symptoms, diseases features and incorrect results of diagnostic tests, and in third place were cardiovascular diseases.
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Affiliation(s)
| | - Klaudiusz Nadolny
- FACULTY OF MEDICINE,, UNIVERSITY OF TECHNOLOGY IN KATOWICE, KATOWICE, POLAND; DEPARTMENT OF EMERGENCY MEDICAL SERVICE, STRATEGIC PLANNING UNIVERSITY OF DABROWA GORNICZA, DABROWA GORNICZA, POLAND
| | - Beniamin Oskar Grabarek
- DEPARTMENT OF HISTOLOGY, CYTOPHYSIOLOGY AND EMBRYOLOGY, FACULTY OF MEDICINE, UNIVERSITY OF TECHNOLOGY IN KATOWICE, ZABRZE, POLAND
| | - Dariusz Boroń
- DEPARTMENT OF HISTOLOGY, CYTOPHYSIOLOGY AND EMBRYOLOGY, FACULTY OF MEDICINE, UNIVERSITY OF TECHNOLOGY IN KATOWICE, ZABRZE, POLAND; DEPARTMENT OF GYNECOLOGY AND OBSTETRICS WITH GYNECOLOGIC ONCOLOGY, LUDWIK RYDYGIER MEMORIAL SPECIALIZED HOSPITAL, CRACOW, POLAND
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Kucap M, Nadolny K, Ładny JR, Zyśko D, Gałązkowski R, Gąsior M, Kraska W. RETROSPECTIVE ANALYSIS OF INTERVENTIONS PERFORMED BY EMERGENCY MEDICAL TEAMS IN POLAND BEFORE AND DURING THE SARS COV-2 PANDEMIC. Wiad Lek 2020; 73:1659-1662. [PMID: 33055329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Introduction: The SARS-CoV-2 virus was recognized in December 2019 in China. From that moment it has quickly spread around the whole world. It causes COVID-19 disease manifested by breathlessness, coughing and high temperature. The COVID-19 pandemic has become a great challenge for humanity. The aim: To analyze interventions of emergency medical teams during the SAR-CoV-2 pandemic, and to compare obtained data with the same periods in 2018-2019. PATIENTS AND METHODS Material and methods: The study retrospectively analyzed interventions of emergency medical teams in the period from 15.03 to 15.05 in 2018 - 2020. 1,479,530 interventions of emergency medical teams were included in the study. The number of interventions, reasons for calls, and diagnoses made by heads of the emergency medical teams during the SARS-CoV-2 pandemic were compared to the same period in 2018-2019. RESULTS Results: Authors observed the decline in the number of interventions performed by emergency medical teams during the pandemic in relation to earlier years by approximately 25%. The big decline concerned interventions that were the reason for calls to public places, such as "traffic accident" and "collapse". In the case of diagnoses made by the head of the emergency medical team, the diagnoses regarding stroke or sudden cardiac arrest remained at the similar level. Others showed a marked decline. CONCLUSION Conclusions: Reduced social activity contributed to a reduced number of interventions by emergency medical teams in public places. The societal fear of the unknown also contributed to the decrease in the number of interventions performed by emergency medical teams. People began to avoid contact with other people.
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Affiliation(s)
- Michał Kucap
- DEPARTMENT OF EMERGENCY MEDICAL SERVICE, STRATEGIC PLANNING UNIVERSITY OF DABROWA GORNICZA, DABROWA GORNICZA, POLAND; FACULTY OF MEDICINE, KATOWICE SCHOOL OF TECHNOLOGY, KATOWICE, POLAND
| | - Klaudiusz Nadolny
- DEPARTMENT OF EMERGENCY MEDICAL SERVICE, STRATEGIC PLANNING UNIVERSITY OF DABROWA GORNICZA, DABROWA GORNICZA, POLAND; FACULTY OF MEDICINE, KATOWICE SCHOOL OF TECHNOLOGY, KATOWICE, POLAND
| | - Jerzy R Ładny
- DEPARTMENT OF EMERGENCY MEDICINE, MEDICAL UNIVERSITY OF BIALYSTOK, BIALYSTOK, POLAND
| | - Dorota Zyśko
- DEPARTMENT OF EMERGENCY MEDICINE, WROCLAW MEDICAL UNIVERSITY, WROCLAW, POLAND
| | - Robert Gałązkowski
- DEPARTMENT OF EMERGENCY MEDICAL SERVICE, MEDICAL UNIVERSITY OF WARSAW, WARSAW, POLAND
| | - Mariusz Gąsior
- 3RD DEPARTMENT OF CARDIOLOGY, SILESIAN CENTER FOR HEART DISEASES, FACULTY OF MEDICAL SCIENCES IN ZABRZE, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
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Sowa K, Łobaczuk-Sitnik A, Piszczatowski B, Duchnowska E, Kosztyła-Hojna B, Nadolny K, Ładny JR, Zdrojkowski M. Specifics and diagnostic procedure in reflux-related dysphonia. Wiad Lek 2020; 73:814-817. [PMID: 32731723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Voice is a work tool for many professional groups. Currently, cases of dysphonia of multiple origin consist a growing issue. Voice disorders may result from disturbed voice production process, congenital defects, post-traumatic conditions, chronic diseases or hormonal disorders. Chronic diseases causing voice disorders include laryngopharyngeal reflux disease and esophageal reflux disease.The chronic character of reflux causes the formation of numerous morphological changes of the larynx, including: hyperemia of the mucosa limited to arytenoid and intraarytenoid area, edema of the vocal folds, edema of the larynx mucosa. These changes contribute to voice disorders. Among the pathological changes of voice organ etiologically associated with reflux, the following disease units may be distinguished: reflux laryngitis, subglottic edema, contact ulceration, larynx granuloma, larynx and pharynx cancer. Many of disorders in the upper respiratory tract are etiologically related to reflux, e.g. dysphonia, grunting, coughing and dyspnoea.
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Affiliation(s)
- Klaudia Sowa
- Department of Clinical Phonoaudiology and Speech Therapy, Medical University of Bialystok, Bialystok, Poland
| | - Anna Łobaczuk-Sitnik
- Department of Clinical Phonoaudiology and Speech Therapy, Medical University of Bialystok, Bialystok, Poland
| | | | - Emilia Duchnowska
- Department of Clinical Phonoaudiology and Speech Therapy, Medical University of Bialystok, Bialystok, Poland
| | - Bożena Kosztyła-Hojna
- Department of Clinical Phonoaudiology and Speech Therapy, Medical University of Bialystok, Bialystok, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland, Department of Emergency Medical Service, Strategic Planning University of Dabrowa Gornicza, Dabrowa Gornicza, Poland
| | - Jerzy Robert Ładny
- Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Maciej Zdrojkowski
- Department of Clinical Phonoaudiology and Speech Therapy, Medical University Of Bialystok, Bialystok, Poland
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Nadolny K. An analysis of activities and medical rescue actions in patients with OHCA in the system of emergency medical services in Silesia region (Poland). Resuscitation 2019. [DOI: 10.1016/j.resuscitation.2019.06.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Borowicz A, Nadolny K, Bujak K, Cieśla D, Gąsior M, Hudzik B. Paramedic versus physician-staffed ambulances and prehospital delays in the management of patients with ST-segment elevation myocardial infarction. Cardiol J 2019; 28:110-117. [PMID: 31313273 DOI: 10.5603/cj.a2019.0072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/03/2019] [Accepted: 06/23/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Time delays to reperfusion therapy in ST-segment elevation myocardial infarction (STEMI) still remain a considerable drawback in many healthcare systems. Emergency medical service (EMS) has a critical role in the early management of STEMI. Under investigation herein, was whether the use of physician-staffed ambulances leads to shorter pre-hospital delays in STEMI patients. METHODS This was an observational and retrospective study, using data from the registry of the Silesian regional EMS system in Katowice, Poland and the Polish Registry on Acute Coronary Syndromes (PL-ACS) for a study period of January 1, 2013 to December 31, 2016. The study population (n = 717) was divided into two groups: group 1 (n = 546 patients) - physician-staffed ambulances and group 2 (n = 171 patients) - paramedic-staffed ambulances. RESULTS Responses during the day and night shifts were similar. Paramedic-led ambulances more often transmitted 12-lead electrocardiogram (ECG) to the percutaneous coronary intervention centers. All EMS time intervals were similar in both groups. The type of EMS dispatched to patients (physicianstaffed vs. paramedic/nurse-only staffed ambulance) was adjusted for ECG transmission, sex had no impact on in-hospital mortality (odds ratio [OR] 1.41; 95% confidence interval [CI] 0.79-1.95; p = 0.4). However, service time exceeding 42 min was an independent predictor of in-hospital mortality (OR 4.19; 95% CI 1.27-13.89; p = 0.019). In-hospital mortality rate was higher in the two upper quartiles of service time in the entire study population. CONCLUSIONS These findings suggest that both physician-led and paramedic-led ambulances meet the criteria set out by the Polish and European authorities. All EMS time intervals are similar regardless of the type of EMS unit dispatched. A physician being present on board did not have a prognostic impact on outcomes.
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Affiliation(s)
- Artur Borowicz
- Voivodeship Rescue Service in Katowice, Katowice, Poland
| | - Klaudiusz Nadolny
- Voivodeship Rescue Service in Katowice, Katowice, Poland.,Department of Emergency Medicine, Medical University of Bialystok, Bialystok.,University of Strategic Planning in Dabrowa Gornicza, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Sil
| | - Daniel Cieśla
- Department of Science, Biostatistics and New Technologies, Silesian Center for Heart Disease, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Sil
| | - Bartosz Hudzik
- 3rd Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Sil. .,Department of Cardiovascular Disease Prevention, School of Public Health in Bytom, Medical University of Silesia.
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Jagielski D, Zyśko D, Nadolny K, Wizowska J, Biel B, Banasiak W, Ponikowski P. Prognostic importance of serum troponin concentration in patients with an implanted cardioverter‑defibrillator admitted to the emergency department due to electric shock. Kardiol Pol 2019; 77:618-623. [PMID: 31066727 DOI: 10.33963/kp.14810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND High-energy implantable cardioverter-defibrillator (ICD) therapy may increase serum troponin (cTnI) concentration. Aims: We aimed to assess an impact of cTnI concentration after ICD high-energy therapy on mortality. METHODS A total of 150 patients aged 64.2 +/- 12.8 years admitted to the Emergency Departments (EDs) due to at least one electrical shock during the last 24 hours with measured serum cTnI concentration at admission were included. Age, gender, comorbidities, shocks' numbers, therapy appropriateness, serum creatinine concentration, and left ventricular ejection fraction were noted for the retrospective analysis. Survival was obtained using the personal identification numbers (PESEL), on November 2018 until death or a period of three years had elapsed (1057 days). RESULTS cTnI concentration was increased in 92 (61.3%) patients. The mortality rate was related to age - HR: 1.04, 95% CI: 1.01-1.08, p = 0.026; increased cTnI concentration - HR: 2.88, 95% CI: 1.30-6.37, p = 0.009; diabetes - HR: 2.19, 95% CI: 1.09-4.39, p = 0.027; ischemic heart disease - HR: 2.96, 95% CI: 1.11-7.87, p = 0.030, serum creatinine concentration - HR: 2.17, 95% CI: 1.18-4.00, p = 0.013; LVEF (HR 0.95, 95% CI: 0.91-0.99, p = 0.009), and previous or current CABG or PCI (HR: 0.38, 95% CI: 0.15-0.96, p = 0.040 and HR: 0.29, 95% CI: 0.13-0.65, p = 0.003, respectively). CONCLUSIONS Increased mortality rate in patients with ICD shocks is multifactorial. Increased cTnI concentration at ED admission, but not the number of ICD shocks, is an independent marker of higher long-term mortality.
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Affiliation(s)
- Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Dorota Zyśko
- Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medicine, Medical University of Bialystok, Wrocław, Poland
| | - Joanna Wizowska
- Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Bartosz Biel
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Piotr Ponikowski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland,Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
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Nadolny K, Ładny JR, Ślęzak D, Komza M, Gałązkowski R. [Analysis of medical rescue operations performed by medical rescue teams from all over poland in patients with burn wounds]. Wiad Lek 2019; 72:26-30. [PMID: 30796857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Introduction: A burn is a superficial or deep tissue damage caused by the action of: heat (high temperature), chemicals, electric current, solar rays and ionizing radiation. The aim: To analyze the trips of emergency medical teams in the period from November 1, 2017 to April 30, 2018 to patients diagnosed with burns throughout the country. PATIENTS AND METHODS Materials and methods: The analysis covers the whole of Poland, all medical rescue teams. The obtained data comes from the System of Supporting the State Medical Rescue System. The analysis includes the characteristics of the population studied and the medicines used. The study included those that ended with the diagnosis of burns (T-20 to T-32). Taking into account the above criteria, 547 cases were obtained. RESULTS Results: In 321 cases, there were women and 226 cases of men (58.68% vs 41.32%, p<0.001). More often, it referred to patients over 18 (317 cases vs. 193 below 18 years of age, p<0.001) in 37 cases no data. Most events were recorded in the Masovian and Silesian voivodships (12.97% and 11.33%) and the least in Podlasin (2.92%). In 20.47% of cases, pain treatment was applied, of which in the group of adults in 25.23% vs. 1658% in children, p<0.001. CONCLUSION Conclusions: The above results of medical emergency teams' activities indicate insufficient pharmacological treatment, which requires rapid improvement.
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Affiliation(s)
- Klaudiusz Nadolny
- Klinika Medycyny Ratunkowej, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Białymstoku, Białystok, Polska, Katedra Ratownictwa Medycznego, Wydział Medyczno-Społeczny, Wyższa Szkoła Planowania Strategicznego w Dąbrowie Górniczej, Dąbrowa Górnicza, Polska
| | - Jerzy Robert Ładny
- Klinika Medycyny Ratunkowej, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Białymstoku, Białystok, Polska
| | - Daniel Ślęzak
- Pracownia Ratownictwa Medycznego, Katedra i Klinika Medycyny Ratunkowej, Wydział Nauk o Zdrowiu, Gdański Uniwersytet Medyczny, Gdańsk, Polska
| | - Mateusz Komza
- Krajowe Centrum Monitorowania Ratownictwa Medycznego, Warszawa, Polska, Lotnicze Pogotowie Ratunkowe, Warszawa, Polska
| | - Robert Gałązkowski
- Lotnicze Pogotowie Ratunkowe, Warszawa, Polska, Zakład Ratownictwa Medycznego, Wydział Nauk o Zdrowiu, Warszawski Uniwersytet Medyczny, Warszawa, Polska
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Jagielski D, Zyśko D, Nadolny K, Wizowska J, Biel B, Banasiak W, Ponikowski P. Predictors of inappropriate shocks from implantable cardioverter-defibrillators. Wiad Lek 2019; 72:1243-1246. [PMID: 31398149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Introduction: Inappropriate shocks in patients with an implantable cardioverter-defibrillator (ICD) are associated with significant psychological and physical consequences and increased long-term mortality. The aim: To assess predictors associated with inappropriate high-energy discharges of implantable cardioverter-defibrillators. PATIENTS AND METHODS Material and Methods: Retrospective data analysis of 150 patients aged 64.2±12.8 years (84.7% male) admitted to the Hospital Emergency Department due to at least one cardioverter-defibrillator discharge was performed. All of the discharges were inappropriate in the group of 33 patients, and in the group of 117 patients at least one discharge was appropriate. The following data: age, gender, concomitant diseases, type of ICD implantation (primary vs. secondary prevention), type of discharge, number of discharges, serum potassium, and sodium concentration were collected. RESULTS Results: Patients with only inappropriate discharges were younger, significantly more often had chronic atrial fibrillation, a significantly higher number of discharges, and ischaemic cardiomyopathy. Logistic regression analysis revealed that the occurrence of only inappropriate discharges was related to the number of discharges over three, the age of patients below 60 years, the serum sodium concentration between 135 mEq/L and 142 mEq/L, and the primary type of prevention of sudden cardiac death. CONCLUSION Conclusions: 1. Predictors of inappropriate discharges include: age, serum sodium concentration, and primary type of indications for cardioverter-defibrillator implantation. 2. Further research is necessary to determine the influence of disturbances in the sodium economy on the occurrence of appropriate and inappropriate interventions of implantable cardioverter-defibrillators.
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Affiliation(s)
- Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Dorota Zyśko
- Department and Clinic Of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medicine, Białystok Medical University, Bialystok, Poland, University of Strategic Planning in Dabrowa Górcznia, Poland
| | - Joanna Wizowska
- Department and Clinic Of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Biel
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Piotr Ponikowski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
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Nadolny K, Bujak K, Kucap M, Trzeciak P, Hudzik B, Borowicz A, Gąsior M. The Silesian Registry of Out-of-Hospital Cardiac Arrest: Study design and results of a three-month pilot study. Cardiol J 2018; 27:566-574. [PMID: 30444257 DOI: 10.5603/cj.a2018.0140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/08/2018] [Accepted: 10/11/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite the introduction of the concept known as "Chain of Survival" has significantly increased survival rates in patients with out-of-hospital cardiac arrest (OHCA), short-term mortality in this group of patients is still very high. Epidemiological data on OHCA in Poland are limited. The aim of this study was to create a prospective registry on OHCA covering a population of 2.7 million inhabitants of Upper Silesia in Poland. Presented herein is the study design and results of a 3-month pilot study. METHODS The Silesian Registry of Out-of-Hospital Cardiac Arrest (SIL-OHCA) is a prospective, population-based registry of OHCA, of minimum duration which was planned for 12 months; from January 1st, 2018 to December 31st, 2018. The first 3 months of the study constituted the pilot phase. The inclusion criterion is the occurrence of OHCA in the course of activity of the Voivodeship Rescue Service in Katowice, Poland. RESULTS During the 3-month pilot phase of the study there were 390 cases of OHCA in which cardiopulmonary resuscitation was undertaken. Estimated frequency of OHCA in the population analyzed was 57 per 100,000 population per year. Shockable rhythm was present in 25.8% of cases. Return of spontaneous circulation was achieved in 35.1% of the whole cohort. 28.7% of patients were admitted to the hospital, including 2.8% of patients, who were admitted during an ongoing cardiopulmonary resuscitation. CONCLUSIONS Prehospital survival of patients with OHCA in Poland is still unsatisfactory. It is believed that data collected in SIL-OHCA registry will allow identification factors, which require improvement in order to reduce short- and long-term mortality of patients with OHCA.
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Affiliation(s)
- Klaudiusz Nadolny
- Voivodeship Rescue Service, Katowice, Poland.,Department of Emergency Medicine, Medical University of Białystok, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.
| | - Michał Kucap
- Voivodeship Rescue Service, Katowice, Poland.,Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health, Medical University of Gdańsk, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Bartosz Hudzik
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.,Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia in Katowice, Poland
| | | | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
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Nadolny K, Szarpak L, Gotlib J, Panczyk M, Sterlinski M, Ladny JR, Smereka J, Galazkowski R. An analysis of the relationship between the applied medical rescue actions and the return of spontaneous circulation in adults with out-of-hospital sudden cardiac arrest. Medicine (Baltimore) 2018; 97:e11607. [PMID: 30045296 PMCID: PMC6078650 DOI: 10.1097/md.0000000000011607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022] Open
Abstract
Sudden cardiac arrest (SCA) is a significant medical and social issue, the main cause of death in Europe and the United States.The aim of the research was to evaluate the effectiveness of emergency medical procedures applied by emergency medical teams in prehospital care in the context of return of spontaneous circulation (ROSC).The case-control study was based on the medical documentation of the Rescue Service in Katowice (responsible for monitoring 2.7 million inhabitants of the region) referring to 2016. The research involved exclusively adults (ie, individuals older than 18 years) with out-of-hospital cardiac arrest (OHCA). After considering the above inclusion criteria, there were 1603 dispatch order forms (0.64% of all dispatch orders) involved in further research.On the basis of the emergency medical procedure forms, the actions of emergency medical teams were verified as medical procedures (endotracheal intubation, the use of suction pumps, defibrillation, the use of alternatives providing airway patency and ROSC was determined.The analysis covered 1603 cases of OHCA. SCA turned out more frequent in men than in women (P = .000). Most often, SCA occurred in domestic conditions during the day and was witnessed by a third person. In 59.9% of the cases, actions were taken by witnesses, which increased the probability of ROSC. Patients were usually intubated (51.4%). Respirators were used less frequently (20.2%). Ventricular fibrillation (VF) was reported only in 22.0% of the cases. The ROSC rate was higher in the group of patients with diagnosed VF than in those with nonshockable rhythms (VF, 55.43% vs asystole, 24.05%; P = .000).Successful resuscitation depends on the quality of emergency medical procedures performed at the place of incident. The highest probability of ROSC is related with defibrillation (in the cases of VF or ventricular tachycardia with no pulse), intubation, the application of a respirator, and performing mechanical ventilation, as well as with a shorter time from dispatch to arrival.
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Affiliation(s)
- Klaudiusz Nadolny
- Department of Emergency Medicine and Disasters, Medical University of Bialystok, Bialystok
| | - Lukasz Szarpak
- Department of Emergency Medicine, Lazarski University, Warsaw
| | - Joanna Gotlib
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw
| | - Mariusz Panczyk
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw
| | - Maciej Sterlinski
- Department of Arrhythmia, The Cardinal Stefan Wyszynski Institute of Cardiology
| | - Jerzy Robert Ladny
- Department of Emergency Medicine and Disasters, Medical University of Bialystok, Bialystok
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Robert Galazkowski
- Department of Emergency Medical Service, Medical University of Warsaw, Warsaw, Poland
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Andrzejewska K, Snarska K, Chorąży M, Brola W, Szwedziński P, Nadolny K, Ładny J, Kulikowski G. Occurrence of sleep disorders among nursing staff. Med Og Nauk Zdr 2018. [DOI: 10.26444/monz/89532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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44
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Kaminska H, Wieczorek W, Dabrowski M, Nadolny K, Smereka J. Knowledge and attitudes of paramedics toward the usage of capnography as a ventilation monitoring tool during resuscitation. Am J Emerg Med 2018; 36:1116-1117. [DOI: 10.1016/j.ajem.2017.10.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022] Open
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45
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Iskrzycki L, Smereka J, Rodriguez-Nunez A, Barcala Furelos R, Abelarias Gomez C, Kaminska H, Wieczorek W, Szarpak L, Nadolny K, Galazkowski R, Ruetzler K, Ladny JR. The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation. Kardiol Pol 2018; 76:574-579. [PMID: 29297195 DOI: 10.5603/kp.a2017.0255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Drowning is a common issue at many pools and beaches, and in seas all over the world. Lifeguards often act as bystanders, and therefore adequate training in high-quality cardiopulmonary resuscitation (CPR) and use of adequate equip-ment by lifeguards is essential. AIM The aim of this study was to evaluate the impact of the recently introduced CPRMeter (Laerdal, Stavanger, Norway) on quality of CPR, if used by moderately experienced CPR providers. In particular, we tested the hypothesis that using the CPRMeter improves quality of chest compression by lifeguards compared to standard non-feedback CPR. METHODS The study was designed as prospective, randomised, cross-over manikin trial. Fifty lifeguards of the Volunteer Water Rescue Service (WOPR), a Polish nationwide association specialised in water rescue, participated in this study. Participants were randomly assigned 1:1 to one of two groups: a feedback group and a non-feedback group. Participants swim a distance of 25 m in the pool, and then they were asked to haul a manikin for the second 25 m, simulating rescuing a drowning victim. Once participants finished the second 25-m distance, participants were asked to initiate 2-min basic life support according to the randomisation. RESULTS The median quality of CPR score for the 2-min CPR session without feedback was 69 (33-77) compared to 84 (55-93) in the feedback group (p < 0.001). Compression score, mean depth, rate of adequate chest compressions/min, and overall mean rate during the CPR session improved significantly in the feedback group, compared to the non-feedback group. CONCLUSIONS Using the visual real-time feedback device significantly improved quality of CPR in our relatively unexperienced CPR providers. Better quality of bystander CPR is essential for clinical outcomes, and therefore feedback devices should be considered. Further clinical studies are needed to assess the effect of real-time visual devices, especially in bystander-CPR.
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Affiliation(s)
| | | | | | | | | | | | | | - Lukasz Szarpak
- Department of Emergency Medicine, Medical University of Warsaw, Lindleya 4, 02-005 Warsaw, Poland; Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland, Szpitalna 37, 15-295 Bialystok, Poland.
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Pogorzelczyk K, Synoweć J, Robakowska M, Ślęzak D, Holajn P, Robakowski P, Żuratyński P, Nadolny K. Pharmaceutical markets regulation overview of the selected European Union countries. Wiad Lek 2018; 71:1404-1408. [PMID: 30448818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Introduction: Pharmacy markets, operating in the European Union are regulated by national laws. In many of them, the main restrictions concern the process of creating a new pharmacy - institutions. They are basic criteria for entities that can carry out this form of business, as well as demographic and geographic factors regulating the possible location of a new pharmacy. In Poland, the Act of from the 7th of April 2017 has changed the pharmaceutical law and introduced new legal restrictions so far unknown on the Polish market. The aim: To analyze the main changes in the Polish legal requirements focused on opening process of new pharmacies and review of regulations on European markets. PATIENTS AND METHODS Materials and Methods: The materials used in the study were concentrating on legal acts regulating the pharmacy markets of the European Community countries, as well as EU directives issued by the European Union Parliament. The analysis of the Polish market took place on the basis of the adopted amendment to the Pharmaceutical Law in the Act from April 7th 2017 (Journal of Laws 2017, No. 0, item 1015). CONCLUSION Conclusions: The amendment to the Pharmaceutical Law, brings the Polish pharmaceutical market standard to European conditions. The introduction of the restrictions on the pharmaceutical market in Polish will contribute to the fulfillment of the obligation to guarantee permanent and equal access to benefits for all citizens.
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Affiliation(s)
- Katarzyna Pogorzelczyk
- Department Of Emergency, Medicine Faculty Of Health, Medical University Of Gdańsk, Gdansk, Polska
| | | | - Marlena Robakowska
- Department Of Public Health & Social Medicine,Medicine Faculty Of Health, Medical University Of Gdańsk, Gdansk, Polska
| | - Daniel Ślęzak
- Department Of Emergency, Medicine Faculty Of Health, Medical University Of Gdańsk, Gdansk, Polska
| | - Piotr Holajn
- Department Of Emergency, Medicine Faculty Of Health, Medical University Of Gdańsk, Gdansk, Polska
| | | | - Przemysław Żuratyński
- Department Of Emergency, Medicine Faculty Of Health, Medical University Of Gdańsk, Gdansk, Polska
| | - Klaudiusz Nadolny
- Department Of Emergency, Medicine Faculty Of Health, Medical University Of Białystok, Bialystok, Polska
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Besh O, Besh D, Sorkopud O, Kondratiuk M, Slaba O, Zhakun I, Strilchuk L, Ładny JR, Rafałowicz B, Szarpak Ł, Gałązkowski R, Nadolny K. ASIT as the component of bronchial asthma's therapy can improve the adherence to the treatment. Wiad Lek 2018; 71:849-854. [PMID: 30099422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim: To compare the treatment adherence of patients with Bronchial Asthma (BA) receiving basic treatment and its combination with allergen-specific immunotherapy. PATIENTS AND METHODS Materials and methods: The study included 104 patients aged from 18 to 50 with BA. All patients were divided into two groups. The main group (MG) consisted of 51 patients receiving basic medical treatment and ASIT. 38 of them received subcutaneous ASIT and 13 patients received sublingual ASIT. The comparative group (CG) consisted of 53 patients who received only basic therapy. The patients' observation duration was for a year. RESULTS Results: All patients were done the computer spirometry with a bronchodilation test, determination of the total IgE level, questionnaires (quality of life, control of asthma, adherence to treatment). Also the major and minor component of allergy house dust mites and specific IgG4 were determined in patients of main groups. After 12 months of observation in both groups the spirometry rates improved (the main group result was 16.9%, the control group - was 12.8%). The indicators of asthma's control also increased (MG by 28%, in CG - 21%, (p <0,05)). After individual conversations and training the patients improved and adherence to the treatment too. In the beginning of our research the mean level in MG was 3.2 ± 0.3 points, in - CG-3.3 ± 0.2 points (p> 0.05), after 12 months it increased to 6.3 ± 0.2 points in MG vs 5. 8 ± 0.1 points in CG (p <0.05). CONCLUSION Conclusion: Patients' combining basic therapy with SIT had significantly better results of the overall BA's controllability compared to the patients' receiving only basic therapy.
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Affiliation(s)
- Olesia Besh
- Danylo Halytskiy Lviv National Medical University, Lviv, Ukraine
| | - Dmytro Besh
- Danylo Halytskiy Lviv National Medical University, Lviv, Ukraine
| | - Olena Sorkopud
- Danylo Halytskiy Lviv National Medical University, Lviv, Ukraine
| | - Marta Kondratiuk
- Danylo Halytskiy Lviv National Medical University, Lviv, Ukraine
| | - Oksana Slaba
- Danylo Halytskiy Lviv National Medical University, Lviv, Ukraine
| | - Irina Zhakun
- Danylo Halytskiy Lviv National Medical University, Lviv, Ukraine
| | - Larysa Strilchuk
- Danylo Halytskiy Lviv National Medical University, Lviv, Ukraine
| | - Jerzy Robert Ładny
- Clinic Of Emergency Medicine, University Of Bialystok, Bialystok, Poland
| | - Barbara Rafałowicz
- Department Of Dental Propaedeutics And Prophylaxis, Medical University Of Warsaw, Warsaw, Poland
| | | | - Robert Gałązkowski
- Department Of Emergency Medical Service, Medical University Of Warsaw, Warsaw, Poland
| | - Klaudiusz Nadolny
- Clinic Of Emergency Medicine, University Of Bialystok, Bialystok, Poland
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Nadolny K, Gotlib J, Panczyk M, Ładny JR, Białczak Z, Podgórski M, Makar O, Izhytska N, Gałązkowski R. [The epidemiology of sudden cardiac arrest in prehospital care in the area of the silesian voivodeship]. Wiad Lek 2018; 71:193-200. [PMID: 29602932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Introduction: Sudden cardiac arrest (SCA) is a serious medical and social issue. The incidence of SCA varies depending on the location and the circumstances. The aim: A retrospective analysis of non-hospital SCA cases from an epidemiological perspective. The research involved the population monitored by the Voivodeship Rescue Service (VRS) in Katowice. PATIENTS AND METHODS Material and methods The analysis covered dispatch order forms and emergency medical procedure forms of the VRS in Katowice in 2016 (n = 249 872). The retrospective analysis involved cases of non-hospital SCA in adults (n = 1603). Quantitative parameters have been presented as average values with standard deviation. Non-metric variables have been described by means of structure indicators. A comparative analysis was conducted by means of the Student's T-test for the quantitative variables and the Pearson's chisquared test for the non-metric variables. The statistical significance adopted for the purpose of all analyses was 0.05. RESULTS Results: There were 1005 men (62.7%), 566 women (35.3%) and 32 cases (2.0%) where gender identification was not reported. Female individuals were generally older than male individuals (p = 0.000). Patients' average age was 65.7 years. The SCA attack rate was 59.37/100 000. SCA cases were usually reported in domestic conditions (71.1%, p = 0.000). In a majority of cases, the incident was witnessed by a third person (about 70.0% of cases, p= 0.000). Most of the SCA cases were reported in the first quarter of the year whereas the lowest number of cases was noticed in the third quarter (28.4 % vs 22.5 %). SCA was most frequent during the day. Restoration of spontaneous circulation was reported in 33.4% of the cases. CONCLUSION Conclusions: The incidence of SCA is occasional in the context of all analyzed emergency cases in the period under research. However, SCA cases are related with a high risk of failure. Acting according to the currently available knowledge will probably cause an increase of the restoration of spontaneous circulation (ROSC) rate.
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Affiliation(s)
- Klaudiusz Nadolny
- Zakład Medycyny Ratunkowej I Katastrof, Uniwersytet Medyczny W Białymstoku, Białystok, Polska, Wojewódzkie Pogotowie Ratunkowe W Katowicach, Katowice, Polska
| | - Joanna Gotlib
- Zakład Dydaktyki I Efektów Kształcenia, Wydział Nauk O Zdrowiu, Warszawski Uniwersytet Medyczny Warszawa, Polska
| | - Mariusz Panczyk
- Zakład Dydaktyki I Efektów Kształcenia, Wydział Nauk O Zdrowiu, Warszawski Uniwersytet Medyczny Warszawa, Polska
| | - Jerzy Robert Ładny
- Zakład Medycyny Ratunkowej I Katastrof, Uniwersytet Medyczny W Białymstoku, Białystok, Polska
| | - Zbigniew Białczak
- Samodzielny Publiczny Zespół Zakładów Opieki Zdrowotnej W Żurominie, Żuromin, Polska
| | - Marcin Podgórski
- Zakład Ratownictwa Medycznego, Uniwersytet Przyrodniczo-Humanistyczny W Siedlcach
| | - Oksana Makar
- Lwowski Narodowy Uniwersytet Medyczny Im. Danyla Galyckogo, Lwów, Ukraina
| | - Nataliya Izhytska
- Lwowski Narodowy Uniwersytet Medyczny Im. Danyla Galyckogo, Lwów, Ukraina
| | - Robert Gałązkowski
- Zakład Ratownictwa Medycznego, Warszawski Uniwersytet Medyczny, Warszawa, Polska
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Celiński D, Mitura K, Szpakowski L, Pilip S, Nadolny K, Gałązkowski R. [Sudden cardiac arrests in years 2013-2016 within operation area of siedlce emergency ambulance service]. Wiad Lek 2018; 71:1729-1737. [PMID: 30737931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Introduction: SCA is an unexpected, and potentially of reversible effect, in which occurs a cessation of hemodynamically heart beat as a pump, and cessation of cardiovascular circulation. PATIENTS AND METHODS Materials and methods: Our analysis is based on 1032 SCA occurrences where cardiopulmonary resuscitation have been applied. The analysis covers operating region of Siedlce Emergency Medical Services in years 2013-2016. The study is of retrospective nature. The analysis has been based on all cases of cardiac arrests. Successful rate of medical assistance at patients with SCA have been assessed. RESULTS Results: CPR have been applied 1032 times, out of which 45,3& of cases have resulted in spontaneous recovery of circulation, and in 54,7& such action have failed. however the efficiency of CPR applied K-2 call-outs was higher (p=0.016). It was noted that there was significantly higher (p = 0,010) number of interventions due to SCA with males (n = 744) than females (n = 288). Also, there was higher successful rate for SCA treatment with females than males. It was proven that the number of SCA have grown in line with an age, however successful rate of SCA treatment have been comparable among all age groups (p = 0,553). Most numerous group of patients with SCA have been 75 year old and above (n = 281). It was noted that significant factor in SCA and CPR successful treatment was the time of the day (p = 0,021). There was more SCA as well as successful CPRs before afternoon and afternoon in comparison with evening and night time. The time of arrival for Ambulance crews for patients with spontaneous was significantly shorter (p = 0,000) in comparison with patients who have failed to recover (on average 7,3± 5,96 vs. 9,8± 6,42 min). In rhythm to defibrilation or PEA, ROSC took place significantly more often than at patients with asystole (p = 0,000). CONCLUSION Conclusions: A successful resuscitation depends on the quality of emergency medical procedures performed at the place of incident. The highest probability of ROSC is related with defibrillation, intubation, the application of a respirator and performing mechanical ventilation, as well as shorter time from dispatch to arrival.
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Affiliation(s)
- Daniel Celiński
- Zakład Ratownictwa Medycznego, Warszawski Uniwersytet Medyczny, Warszawa, Polska, SP ZOZ "RM Meditrans" Stacja Pogotowia Ratunkowego i Transportu Sanitarnego w Siedlcach, Siedlce, Polska
| | - Krzysztof Mitura
- SP ZOZ "RM Meditrans" Stacja Pogotowia Ratunkowego i Transportu Sanitarnego w Siedlcach, Siedlce, Polska
| | - Leszek Szpakowski
- SP ZOZ "RM Meditrans" Stacja Pogotowia Ratunkowego i Transportu Sanitarnego w Siedlcach, Siedlce, Polska
| | - Sławomir Pilip
- Zakład Ratownictwa Medycznego, Warszawski Uniwersytet Medyczny, Warszawa, Polska, SP ZOZ "RM Meditrans" Stacja Pogotowia Ratunkowego i Transportu Sanitarnego w Siedlcach, Siedlce, Polska
| | - Klaudiusz Nadolny
- Klinika Medycyny Ratunkowej, Uniwersytet Medyczny W Białymstoku, Białystok, Polska, Wyższa Szkoła Planowania Strategicznego w Dąbrowie Górniczej, Dąbrowa Górnicza, Polska
| | - Robert Gałązkowski
- Zakład Ratownictwa Medycznego, Warszawski Uniwersytet Medyczny, Warszawa, Polska
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Żuratyński P, Ślęzak D, Robakowska M, Tyrańska-Fobke A, Krzyżanowski K, Nadolny K, Jałtuszewska S, Mędrzycka-Dąbrowska W. [The role of medical segregation during mass events and its use on the example of rescue operations after a construction disaster on the premises of the international katowice fair]. Wiad Lek 2018; 71:1815-1822. [PMID: 30737946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The rules related to the conduct of emergency and medical services during the occurrence of a mass event are described in the Act on State Emergency Medical Services of 8 September 2006 and the notice issued by the Ministry of Health. The biggest disaster in Poland was the event of 2006 at the International Katowice Fair located on the border between Katowice and Chorzów. The tragedy covered a hall with an area of about 1 ha, in which there were about 700 people. It is worth noting that the described event was the first test of such scale for the first in Poland Voivodship Center for the Coordination of Medical Rescue. This was also the main reason for work on the shape of the Rescue Act. Contemporary segregation techniques date back to Napoleonic times. In the eighties of the twentieth, the Simple Triage and Rapid Treatment (START) segregation system was developed, which is widely used in the original version or modified in many countries, including Poland. Other systems of segregation include the Triage SIEVE system (popular in Australia and Great Britain), Triage SORT and the STM System. Providing medical help must be based on the principles of rational and logical scale of damage, determination of the number of people injured in an accident, as well as on the basis of ethical standards. Effectiveness of segregation determines the detection of the deterioration of the injured person's condition and allows him to be moved to a higher segregation group to get help faster. The basic assumption of medical segregation, however, is to select persons who are in immediate danger of life from those who are injured.
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Affiliation(s)
- Przemysław Żuratyński
- Katedra i Klinika Medycyny Ratunkowej, Pracownia Ratownictwa Medycznego, Wydział Nauk o Zdrowiu z Oddziałem Pielęgniarstwa i Instytutem Medycyny Morskiej i Tropikalnej, Gdański Uniwersytet Medyczny, Gdańsk, Polska
| | - Daniel Ślęzak
- Katedra i Klinika Medycyny Ratunkowej, Pracownia Ratownictwa Medycznego, Wydział Nauk o Zdrowiu z Oddziałem Pielęgniarstwa i Instytutem Medycyny Morskiej i Tropikalnej, Gdański Uniwersytet Medyczny, Gdańsk, Polska
| | - Marlena Robakowska
- Zakład Zdrowia Publicznego i Medycyny Społecznej, Wydział Nauk o Zdrowiu z Oddziałem Pielęgniarstwa i Instytutem Medycyny Morskiej I Tropikalnej, Gdański Uniwersytet Medyczny, Gdańsk, Polska
| | - Anna Tyrańska-Fobke
- Katedra i Klinika Medycyny Ratunkowej, Pracownia Ratownictwa Medycznego, Wydział Nauk o Zdrowiu z Oddziałem Pielęgniarstwa i Instytutem Medycyny Morskiej i Tropikalnej, Gdański Uniwersytet Medyczny, Gdańsk, Polska
| | - Kamil Krzyżanowski
- Katedra i Klinika Medycyny Ratunkowej, Pracownia Ratownictwa Medycznego, Wydział Nauk o Zdrowiu z Oddziałem Pielęgniarstwa i Instytutem Medycyny Morskiej i Tropikalnej, Gdański Uniwersytet Medyczny, Gdańsk, Polska
| | - Klaudiusz Nadolny
- Wydział Społeczno-Medyczny Wyższa Szkoła Planowania Strategicznego w Dąbrowie Górniczej, Dąbrowa Górnicza, Polska
| | - Sylwia Jałtuszewska
- Zakład Ratownictwa Medycznego, Katedra Fizjoterapii i Ratownictwa Medycznego, Akademia Pomorska W Słupsku, Słupsk, Polska
| | - Wioletta Mędrzycka-Dąbrowska
- Zakład Pielęgniarstwa Anestezjologicznego i Intensywnej Opieki, Wydział Nauk o Zdrowiu, Gdański Uniwersytet Medyczny, Gdańsk, Polska
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