Psychological aspects of near-death experiences

Izložene su sve relevantne psihološke teorije kojima se pokušava definirati iskustvo kliničke smrti. Međutim, u proučavanju ovog fenomena psihologija je kao znanstvena disciplina više suočena s opovrgavanjem dogmatskog pogleda transcendentnih i parapsiholoških obilježja, a manje je orijentirana na fenomenologiju. Sve to upućuje na kompleksnost, jedinstvenost i zagonetnost tematike koju zasigurno nije moguće promatrati odvojeno od pristupa drugih znanstvenih disciplina. Zbog svega toga, u razumijevanju ovog konstrukta teško je zadržati poziciju strogog, neutralnog i kritički raspoloženog promatrača, bez upletanja spekulacija, zabluda i predrasuda. Stoga, sljedeći se retci mogu shvatiti kao prinos znanju i uspješnijem razumijevanju i mjerenju intrigantnog fenomena kliničke smrti. Također, u ovom je tekstu skriveno univerzalno pitanje o ljudskom životu: kako podnosimo kraj i je li doista moguće smrt prihvatiti kao pozitivni aspekt života Σ čemu nas uči iskustvo kliničke smrti.This article presents all the relevant psychological theories that attempt to define near-death experiences. However, in the study of this phenomenon, psychology as a scientific discipline is primarily faced with the refutation of dogmatic views of transcendental and psychic characteristics than oriented towards phenomenology. All of this points to the complexity, uniqueness and mystery of the themes that certainly cannot be considered separately from the approach of other scientific disciplines. For all these reasons, in the understanding of this construct it is difficult to hold the position of a strict, neutral and critical observer without the interference of speculation, misconceptions and prejudices. Therefore, this article can be seen as a contribution to knowledge and successful understanding of intriguing near-death phenomena. Additionally, this text addresses the universal question of human life: how we endure the end of life and if it is really possible to accept death as a positive aspect of life Σ the fact that the experience of near-death phenomena teaches us

Predictors of lower work ability among emergency medicine employees: the Croatian experience

ABSTRACT Background Worldwide research has indicated that emergency medicine employees and particularly ambulance personnel have symptoms related to traumatic events, and experience more chronic stressors in their work than workers in other health service settings. Unlike other countries which conducted similar studies, no specialty branch in emergency medicine exists in Croatia. Study objectives To identify possible predictors of low work ability, including occupational stress and quality of life, among emergency medicine employees. Methods A cross-sectional study was conducted from May 2010 till July 2010 in the Institute of Emergency Medicine in the City of Zagreb. Questionnaires were distributed to all employees with gathered total sample of 125 subjects (39 physicians, 38 medical nurses /technicians and 48 drivers). Data were collected using the socio-demographic questions, occupational stress assessment, work ability index (WAI) and WHO quality of life (WHOQOL-BREF) questionnaires. Results Emergency physicians were significantly more exposed to public criticism (p¼0.008) but drivers had more exposure to hazards at workplace (p¼0.001) regarding other employee groups. Binary logistic regression model showed two significant predictors of lower work ability (WAI score <37): lower physical WHO-BREF domain (OR¼0.78; 95% CI 0.68 to 0.89; p<0.001) and the professional and intellectual demands (OR¼1.09; 95% CI

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

ICT in institute of emergency medicine the city of Zagreb: Dispatching unit

Within the frame of information infrastructure permanent upgrading in the Institute for Emergency Medicine the City of Zagreb, in the year 2009, the new ICT system was put into operation. It is based on the new technological platform in accordance with world standard used in mission critical systems. The new information system comprises a several basic modules and the data entering the central operational system from all segments of working process can be used for various expert analysis and calculation of all provided services or final work reports. Dispatching center module is the backbone of the system and it consists of two parts: receiving and triage of calls and dispatching. The latest feature within the new information system is the ePCR (electronic Patient Care Record) system used in ambulance vehicles in the field, which provides all the relevant data on intervention and patient to be entered directly into computers in vehicles (toughbook) so the patient or hospital is given a printed listing of medical record instead of hand-written form as is used to be done. When finalized, all the data entered in the field and automatically sent to the central database is accessible for further usage. By putting the new system into operation, the possibility for connecting with other health institutions, as well as with Croatian Institute for Health Insurance, was opened. That also created a prerequisite for forming unique database in order to obtain high-quality, precise and faster exchange of data on each patient. University hospital 'Sv. Duh' is the first hospital in Zagreb, connected directly with teams of EMS in the field, by using application CareMonx eTriage. MD in emergency department can see prehospital patient report in emergency room before EMS arrival which provides adequate admission to hospital and more effective treatment of critically ill patient

To ventilate or not to ventilate during bystander CPR — A EuReCa TWO analysis

Background: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). Method: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. Results: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17–1.83). Conclusion: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both

To ventilate or not to ventilate during bystander CPR : a EuReCa TWO analysis

Background: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). Method: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. Results: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17–1.83). Conclusion: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both