QUALITATIVE STUDY ON THE RESILIENCE OF MEDICAL STAFF IN EMERGENCY UNITS IN THE COVID-19 PANDEMIC

Aim of the study This qualitative study explores the resilience of medical staff working in emergency units during the COVID-19 pandemic. Through in-depth interviews and thematic analysis, the research investigates how frontline healthcare workers coped with unprecedented challenges. Key themes identified include professional commitment, teamwork, and adaptability, which were crucial in navigating the crisis. Materials and methods: In order to assess the resilience of the medical staff in the COVID-19 pandemic between March 1, 2022 and March 31, 2021, a study was conducted in three emergency units in Romania: County Hospital of Emergency „Saint Spiridon” Iassy, Emergency University Hospital Bucharest and County Hospital of Emergency “Saint John the New” Suceava. Results: The study highlights the significant emotional and psychological toll on medical staff and underscores the importance of institutional support systems. Findings suggest that enhancing resilience through training, mental health resources, and robust communication channels is essential for future preparedness. Conclusions: This research provides valuable insights into the experiences of healthcare workers and emphasizes the need for sustained support to ensure the well-being and efficacy of medical personnel in emergency settings

STUDY REGARDING THE BEHAVIOUR OF CERTAIN DIRECT DIACRYLIC COMPOSITE RESINS TO ELECTROCHEMICAL CORROSION IN AFNOR ARTIFICIAL SALIVA

Currently the most frequently class of materials used in the dental office for the remake of coronary morphofunctionality is that of diacrylic-composite resins. This study aimed at highlighting the behaviour of certain direct diacrylic composite resins having a different polymerization type of matrix monomers to electrochemical corrosion in artificial saliva. The specimens made of Charisma, Charisma PPF-Heraeus-Kulzer were immersed in Afnor solution for a period of 40 days and analysed by electronic microscopy and EDS chemical analysis. The results of the study show that following the process of electrochemical corrosion on both materials under study, we may notice a decrease of the percentage of carbon, silica and zirconium simultaneously with the increase of the oxygen percentage and the formation of new sodium and chlorine-based chemical compound

Burnout Syndrome among Staff at an Emergency Department during the COVID-19 Pandemic

Objective: The aim of this current study was to identify the prevalence of burnout manifestation in a sample recruited from the emergency department of a hospital. Moreover, we aimed to assess the role of professional experience, age, and the professional category in shaping burnout manifestations. Results: The results showed that higher proportions of burnout symptoms were reported by resident physicians, nurses, and physicians whereas lower proportions were encountered in the orderly group. Moreover, the results revealed a significant difference between men and women in the nurse group concerning depersonalization; men presented higher levels of depersonalization compared with women. Concerning emotional exhaustion and depersonalization, multiple comparisons showed differences among the professional categories. Conclusions: The implications of these results for preventing burnout syndrome are discussed

Impact of Cardiopulmonary Resuscitation on Emergency Medical Staff—Romanian Perspective (IRESUS-EMS)

Background: Unnecessary resuscitation is defined as putting in a disproportionate amount of effort compared to the patients’ prognosis and chance of survival. The primary objective of this study was to determine the number of resuscitations perceived as unnecessary by emergency medical personnel and to correlate it with the characteristics of resuscitation team members, patient particularities and organizational factors related to the professional environment. Methods: This was a prospective cross-sectional study carried out in the emergency department of a university hospital, exploring the perception of the uselessness of cardiopulmonary resuscitation (CPR) through the completion of a questionnaire. Results: In total, 70.37% of respondents are often involved in CPR attempts in which the efforts made are disproportionate compared to the patients’ expected prognosis, in terms of survival or quality of life. The presence of a non-shockable rhythm increased, by two times, the chances of medical staff finding it unnecessary to initiate CPR. Conclusions: The current study was the first in Romania to investigate the perception of unnecessary CPR, based on the recollection of the last resuscitation performed by the emergency medical staff. The objective criteria related to the patient were the most important predictors for assessing the adequacy of the decision to initiate CPR

Skin Lesions with Loss of Tissue and Cutaneous-Onset Sepsis: The Skin Infection–Sepsis Relationship

Infectious and inflammatory dermatoses featuring skin lesions with loss of tissue expose skin layers to microbial invasions, disrupt the normal skin microbiome, and potentially lead to sepsis. However, literature data on the incidence of cutaneous-onset sepsis are scarce. This retrospective observational study assessed hospital admissions for primary skin lesions without bacterial infections and sepsis during 2020–2022 in the largest emergency hospital in NE Romania. Of 509 patients, 441 had infected lesions, 78 had sepsis caused by venous ulcers from microbial eczema cellulitis, superinfected bullous dermatoses, erysipelas, and erythroderma. Cultured samples revealed S. aureus, P. aeruginosa, and E. coli; and K. pneumoniae and S. β-hemolytic associated with sepsis, even if this was rarer. Clinical manifestations included ulcerations, erosions, fissures, excoriations, bullae, vesicles, pruritus, tumefaction, edema, fever, chills, pain, adenopathy, and mildly altered mental status. Underlying chronic heart failure, atrial fibrillation, anemia, and type-1 diabetes mellitus were comorbidities associated with infection and sepsis. Significant associations and risk factors, including their combined effects, are discussed to draw attention to the need for further research and adequate management to prevent sepsis in adult patients of any age presenting with infected skin lesions (especially cellulitis) and comorbidities (especially type 1 diabetes mellitus and anemia)

The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study

Background Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients’ ED management and short-term outcomes. Methods This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Results Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p  30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11–5.81, p = 0.027). Conclusion Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality

Get with the guidelines: management of chronic obstructive pulmonary disease in emergency departments in Europe and Australasia is sub‐optimal

International audienc