Analysis of specialist medical rescue team interventions in Sokołów county in 2016

INTRODUCTION: One of the main aims of the Polish Emergency Medical Services (EMS) is to rescue and protect human health and life. The aim of the study is to analyze specialist medical rescue team (S MRT) interventions in the county of Sokołów in 2016. METHODS: A retrospective analysis of 1361 ambulance call reports from the period January 1st to December 31st 2016 of rescue activities performed during interventions by S MRTs in Sokołów county. RESULTS: The mean time of arrival of S MRTs to the patient was 9.42 ± 7.5 min (max time is 49 min, min time is 1 minute). Average departure time was 51.8 ± 23.5 min (max 218 min, min 23.5 min). The highest incidence of S MRTs operations was observed in July (n = 134, 10%) and lowest in February (n = 95, 7%). CONCLUSIONS: Emergency Medical System reaction time for patients in our region does not differ from other data available in the literature

Evaluation of ventilation quality conducted by firefighters during simulated cardiopulmonary resuscitation

INTRODUCTION: High-quality ventilation in unconscious victims is a priority action for first responders at the scene. Firefighters often arrive first at the scene, providing medical assistance at the level of qualified first aid (QFA). This research aimed to evaluate the quality of ventilation using supraglottic methods with and without visual feedback and self-inflating bags during simulated cardiopulmonary resuscitation (CPR) performed by members of the State Fire Service (SFS). MATERIAL AND METHODS: A cross-sectional study was conducted in organizational units of the State Fire Service (SFS) in the Lubelskie and Warmińsko-Mazurskie voivodeships (24-hour duty officers). 112 firefighters aged 26–48 years (Mean 33.1; SD 6.7), with service duration of 1-20 years (Mean 7.3; SD 4.7) participated in the study. The study involved a 2-minute supraglottic ventilation (self-expanding bag + I-gel mask, size 4: 50–90 kg). Subsequently, 2-minute ventilation was conducted with the effectiveness visible on the monitor in real-time. The following ventilation variables were recorded: frequency (per minute), the volume of each inhalation (mL), and the ratio of correct to incorrect single inhalations (%). RESULTS: It was shown that in stage 1, firefighters more often (P < 0.001) performed ventilation at an excessively high frequency (max rate = 14 ± 4) compared to stage 2 (max rate = 11 ± 1). A statistically significant influence of the possibility of assessment and correction of rescue actions in real-time on the correct frequency (% correct – rate = 52.3 ± 30.1 vs 91.4 ± 12.1; P < 0.001) and ventilation volume (% correct — V = 40.6 ± 28.2 vs 85.3 ± 15.0; P < 0.001) was demonstrated. No statistically significant impact of service duration and age on evaluating parameters in stages 1 and 2 was shown. CONCLUSIONS: Software assistance and the possibility of real-time feedback significantly improve the quality of ventilation conducted by firefighters using SAD. More training using elements of medical simulation with visual feedback should be introduced so that firefighters improve ventilation quality under realistic conditions. Consideration should be given to including tools for assessing CPR quality in CPR rescue kits, especially in units that, according to statistics, handle a larger number of EMS interventions

EMPATHY AND BURNOUT SYNDROME IN THE PRACTICE OF EMERGENCY SERVICES — PILOT STUDY

  INTRODUCTION: The burnout syndrome is a result of stress on the work situation and most often concerns pro­fessions requiring emotional and direct contact with another human being. The level of empathy is closely related to the phenomenon of occupational burnout. The aim of the study was to determine the impact of socio-demo­graphic factors of emergency services employees on the level of empathy. METHOD: In the period January–March 2018, a survey was conducted using a questionnaire — Emphatic Sensi­tiveness Scale (ESC) and an anonymous author’s questionnaire containing questions regarding sex, age, length of employment, occupation, marital status and number of hours worked per month. The survey was addressed to 81 employees of emergency services: paramedics (n = 17) and firefighters (n = 23). The control group consisted of 16 nurses and 25 people performing non–medical professions. RESULTS: The average number of hours worked per month by the respondents was 189 ± 49. There were 50 fe­males (62%) and 31 males (38%). The questionnaire showed statistically significant differences in perspective taking domain between the control group composed of people working in non-medical professions (25.6 ± 4.3) and emergency services professionals: firefighter (28.7 ± 3.6) vs. paramedic (29.9 ± 3.5) vs. nurse (31.2 ± 3.0), p < 0.001. It has been shown a statistically significant effect of sex on personal distress domain: male (21.4 ± 4.2) vs. female (24.3 ± 4.7), p = 0.005. CONCLUSIONS: In conclusion, our data indicates that: (1) Nurses were characterised by the highest level of empathy amongst the surveyed professional groups; (2) Females were characterised by a higher level of personal distress; (3) Variables such as sex, age, and length of employment did not affect the level of empathy

The Borderland Foundation: a living experiment in cross-cultural relations

This is the archive of a lecture given by Krzysztof Czyzewski, Chairman, Borderland Foundation, Sejny, Poland

Czynniki wpływające na wysokiej jakości uciski klatki piersiowej w czasie symulowanej resuscytacji krążeniowo-oddechowej na podstawie wytycznych Amerykańskiego Towarzystwa Kardiologicznego 2015

   Background and aim: Recent American Heart Association guidelines from 2010 and 2015 stressed the importance of high-quality chest compression and defined standards for compression rate, depth, recoil, and maximal acceptable time for interruptions. High-quality cardiopulmonary resuscitation (CPR) is the “cornerstone” of a system of care that can optimise outcomes beyond the return of spontaneous circulation. Methods: One hundred medical students were enrolled to the study. Study participants, after attending a Basic Life Support Course according to American Heart Association 2015 guidelines, performed 2-min CPR on a Resusci Anne® QCPR Mani­kin. The following data were collected: age, sex, and health status. The study made use of a Tanita MC-980 MA for body composition analysis. Results: Mean height of participants was 170.2 ± 8.3 cm, and mean weight was 65 ± 11.8 kg. Mean body mass index was 22.1 ± 2.7, and mean fat-free mass (FFM) was 50.1 ± 10.5 kg. The mean fat mass (FAT%) was 22.9 ± 7.6. Basal metabolic rate, FFM, trunk muscle mass, left arm muscle mass, and right arm muscle mass were positively correlated with compression depth (all p for trend &lt; 0.05). Mean compression depth was 49.7 ± 8.4 (for female 48.7 ± 7.9 mm, for male 42.4 ± 9.5 mm; p = 0.144). Compression rate for males and females was the same, at 114 ×/min (p = 0.769). Conclusions: In our study, basal metabolic rate, FFM, trunk muscle mass, and left and right arm muscle mass were positively correlated with compression depth. Moreover, an arm muscle mass rise of 1 kg caused a rise of compression depth param­eter of 7.3 mm, while when chest compression was performed by females, a fall of compression depth of 3.3 mm was seen.Wstęp i cel: Aktualne wytyczne Amerykańskiego Towarzystwa Kardiologicznego z 2010 i 2015 roku podkreślają znaczenie uciśnięć klatki piersiowej oraz definiują właściwą częstość uciśnięć klatki piersiowej, głębokość uciśnięć, czas relaksacji oraz maksymalne dopuszczalny czas przerw w uciśnięciach. Wysokiej jakości resuscytacja krążeniowo-oddechowa jest kluczowym elementem kształcenia w zakresie udzielania pierwszej pomocy, może pozwolić tym samym na lepsze wyniki przeżywalności i powrotu spontanicznego krążenia. Metody: Do badania zakwalifikowano 100 studentów. Uczestnicy badania zostali przeszkoleniu z zakresu podstawowych czynności resuscytacyjnych zgodnie z protokołem BLS z 2015 roku (Basic Life Support) Amerykańskiego Towarzystwa Kardiologicznego. Podczas badania wykonali 2-minutowy scenariusz BLS przy użyciu fantomu Resusci Anne® QCPR Manikin. Podczas badania zebrano dane antropometryczne uczestników (wiek, płeć) oraz dotyczące stanu zdrowia. Do pomiaru składu masy ciała użyto analizatora Tanita MC-980 MA. Wyniki: Średni wzrost uczestników wynosił 170.2 ± 8.3 cm, średnia masa ciała 65 ± 11.8 kg. Średni wskaźnik masy ciała (BMI) wynosił 22.1 ± 2.7, a średnia beztłuszczowa masa ciała (fat free mass [FFM]) — 50.1 ± 10.5 kg. Średni procent tkanki tłuszczowej FAT% (fat mass) wynosił 22.9 [SD ± 7.6]. BMR, FFM, masa mięśniowa tułowia, masa mięśniowa lewego I prawego ramienia dodatnio korelowała z głębokością uciśnięć klatki piersiowej (dla wszystkich p < 0,05). Średnia głębokość uciśnięć klatki piersiowej [mm] wynosiła 49.7 ± 8.4 (dla kobiet 48.7 ± 7.9, dla mężczyzn 42.4 ± 9.5; p = 0.144). Częstość uciśnięć klatki piersiowej w obu grupach była porównywalna 114 x/min (p = 0.769). Wnioski: W przedstawionym badaniu podstawowa przemiana materii, beztłuszczowa masa ciała, masa mięśniowa tułowia, masa mięśniowa lewego i prawego ramienia dodatnio korelowały z głębokością uciśnięć klatki piersiowej. Ponadto wzrost masy mięśniowej ramienia o 1 kg powodował wzrost parametrów głębokości uciśnięć o 7,3 mm, uciśnięcia klatki piersiowej wykonywane przez kobiety powodowały spadek głębokości uciśnięć o 3,3 mm

Identification of a Novel LRRK2 Mutation Linked to Autosomal Dominant Parkinsonism: Evidence of a Common Founder across European Populations

Autosomal dominant parkinsonism has been attributed to pathogenic amino acid substitutions in leucine-rich repeat kinase 2 (LRRK2). By sequencing multiplex families consistent with a PARK8 assignment, we identified a novel heterozygous LRRK2 mutation. A referral sample of 248 affected probands from families with autosomal dominant parkinsonism was subsequently assessed; 7 (2.8%) were found to carry a heterozygous LRRK2 6055G→A transition (G2019S). These seven patients originate from the United States, Norway, Ireland, and Poland. In samples of patients with idiopathic Parkinson disease (PD) from the same populations, further screening identified six more patients with LRRK2 G2019S; no mutations were found in matched control individuals. Subsequently, 42 family members of the 13 probands were examined; 22 have an LRRK2 G2019S substitution, 7 with a diagnosis of PD. Of note, all patients share an ancestral haplotype indicative of a common founder, and, within families, LRRK2 G2019S segregates with disease (multipoint LOD score 2.41). Penetrance is age dependent, increasing from 17% at age 50 years to 85% at age 70 years. In summary, our study demonstrates that LRRK2 G2019S accounts for parkinsonism in several families within Europe and North America. Our work highlights the fact that a proportion of clinically typical, late-onset PD cases have a genetic basis