Treatment of patients with hip and upper leg injuries in Institute for Emergency Medicine Novi Sad

INTODUCTION: Trauma is the highest financial burden for health system and the fourth leading cause of death. Hip and upper leg injuries are often the result of action by powerful forces in the region. These injuries disrupt movement and everyday functioning of a patient and represent big health and economical issue. Prehospital management of trauma patient comprise adequate treatment on the sciene and rapid transport of a patient to the nearest trauma centar. AIM: Aims of this study are to determine dynamics of patients with hip and femure injuries and significances in treatment of these patients in Institute for Emergency Medicine Novi Sad. MATERIALS AND METHODS: A retrospective study was undertaken for three months period (Jan 1st until Mar 31st 2015). Data were collected from official records (age, sex, body region, imobilization, therapy) and analyzed descriptively. Statistical significance was determined by using the x2 test. RESULTS: There were 662 trauma patients. There is significant number of patients wit hip and upper leg injuries (97 (14,7%)).68% of patients are more then 60 years old. 63,9% of them were women, and 36,1% were men. Injuries are mostly result of falls, contusions with intact skin. 39,13% of them were immobilized and 82,8% were transported to the hospital. CONCLUSION: Adecvate treatment of hip and upper leg trauma lower pain, improve functioning and prevent sirious complications. EMS doctors examine trauma patients and treat on the scene. According to evaluation, patients are transported to the hospital for the final treatment

Necessity of introducing the unique protocols for telephone assisted cardiopulmonary reanimation from the dispatch center

INTRODUCTION: Sudden cardiac arrest (SCA) is defined as a cessation of normal circulation of blood due to failure of the heart to contract effectively during the systole. Timely treatment of SCA improves chances for survival up to three times, until the discharge from a hospital. OBJECTIVE: Prove that there is a need to introduce a unified protocol for telephone-assisted cardiopulmonary reanimation (CPR) in dispatching centers. MATERIALS AND METHODS: Retrospective, observational research was conducted at the in the Institute for Emergency Medical Service Novi Sad (IEMSNS) in the period from 01 January 2008 to 31 December 2012. Data were collected from application forms indicators of quality of work of emergency medical services (EMS). All the data were calculated by using a statistic package Statistica 7th. RESULTS: During the five-year period, ambulance squads of IEMS Novi Sad had 183.882 patients on the field. CPR was initiated in 198 patients. Prehospital in 213 (25.33%) patients had established spontaneous circulation after CPR applied measures. In the last three years in 68.19% of cases of sudden cardiac arrest was an eyewitness to a layman, and survival in this group of patients was 19.30%. In the group of patients where the eyewitness was the team EMS survival was 36.78%. Activation time and reaction time were increasing trend from 2009 to 2011 that 2012 amounted to 1.32 minutes and 7.67 minutes. At the same time, the trend of successful prehospital CPR where the eyewitness was a layman he was dropped from 23.13% in 2010 to 18.95% in 2012. Trend of successful CPR where the team EMS witnessed was a significant increase, from 29.41% in 2010 to 40% in 2012. CONCLUSION: The increase in population in Novi Sad increasing calls for the dispatch center IEMSNS which results in an extension of the activation time. Greater traffic congestion led to the extension of reaction time. Better equipment and training team leads to a rise in the number of successful CPR when an eyewitness team EMS. At the same time it reduces the number of successful CPR which witnessed sudden cardiac arrest layman. Therefore, it is necessary to introduce a unique dispatching protocol for telephone assisted CPR to as many laymen eyewitnesses began CPR before the arrival of EMS teams