Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland : a one-year retrospective study

Background: Out-of-hospital cardiac arrest (OHCA) is a common reason for calls for intervention by emergency medical teams (EMTs) in Poland. Regardless of the mechanism, OHCA is a state in which the chance of survival is dependent on rapid action from bystanders and responding health professionals in emergency medical services (EMS). We aimed to identify factors associated with return of spontaneous circulation (ROSC). Methods: The medical records of 2137 EMS responses to OHCA in the city of Wroclaw, Poland between July 2017 and June 2018 were analyzed. Results: The OHCA incidence rate for the year studied was 102 cases per 100,000 inhabitants. EMS were called to 2317 OHCA events of which 1167 (50.4%) did not have resuscitation attempted on EMS arrival. The difference between the number of successful and failed cardiopulmonary resuscitations (CPRs) was statistically significant (p < 0.001). Of 1150 patients in whom resuscitation was attempted, ROSC was achieved in 250 (27.8%). Rate of ROSC was significantly higher when CPR was initiated by bystanders (p < 0.001). Patients presenting with asystole or pulseless electrical activity (PEA) had a higher risk of CPR failure (86%) than those with ventricular fibrillation/ventricular tachycardia (VF/VT). Patients with VF/VT had a higher chance of ROSC (OR 2.68, 1.86–3.85) than those with asystole (p < 0.001). The chance of ROSC was 1.78 times higher when the event occurred in a public place (p < 0.001). Conclusions: The factors associated with ROSC were occurrence in a public place, CPR initiation by witnesses, and presence of a shockable rhythm. Gender, age, and the type of EMT did not influence ROSC. Low bystander CPR rates reinforce the need for further efforts to train the public in CPR

Missions of the Helicopter Emergency Medical Service in rural and urban areas in Poland - a comparative retrospective analysis

Introduction. Mortality due to various causes, despite continuous efforts to improve the quality of medical services, is a serious problem for modern healthcare systems. Ischaemic heart disease and stroke are the cause of over 15 million deaths annually, and are therefore known as the world’s number one killer. Objective. The aim of this study is to characterise the missions and the most common reasons for dispatching Helicopter Emergency Medical Service (HEMS) crews, with special emphasis on the differences between urban and rural areas. Materials and method. The study was conducted using a retrospective analysis of HEMS missions, including flights to accidents and diseases carried out by HEMS crews in Poland from January 2014 – December 2018. The final analysis included 35,213 cases of HEMS missions. Results. The study group consisted mainly of male patients (66.40%), aged 50–64 (22.06%), mean age of the entire analysed group – 47.71 (SD: 25.96). The main reason for HEMS missions were strokes (21.63%). Analysis of patients’ clinical status revealed that the clinical status of patients treated in rural areas was more severe, which was indicated by the Glasgow Coma Scale – GCS (12.03 vs 12.35) and the Revised Trauma Scale – RTS (10.14 vs 10.60) scores. When assessed by the National Advisory Committee for Aeronautics (NACA) score, body injuries and fatal diseases were observed more often in patients in rural areas (NACA 7 6.12% vs 3.46%) (p<0.05). Conclusions. Multi-organ injuries, head traumas, sudden cardiac arrest, traumatic brain injuries, collapse and epilepsy, were more frequent reasons for HEMS missions in rural areas than in urban areas

Population size and distribution of the capercaillie in Poland in the 21st century

The data on the distribution and number of the capercaillie Tetrao urogallus in Poland for the period from the end of the 20th century up to 2017−2018 is presented. The capercaillie is a sedentary forest grouse living in old mountain forests and within the boreal zone. Since more than a century, the decrease in the numbers of the species has been observed, interlinked with the extinction of isolated populations. Within the present borders of Poland, a 1925 questionnaire study noted 2200−2700 individuals. In the 1960s, the national population was estimated at 1700−2000 birds, living in five isolated populations. In 1985−1995, the population numbers of the capercaillie dropped to approx. 466−700 individuals in four regions, and in 2000 it was estimated at 470−570 birds. According to the results of the censuses performed in 2017−2018, the size of the capercaillie population risen to 523−631 individuals and 59−69 lekking grounds. Currently the capercaillie occurs in four isolated regions. These are the Western Carpathians (the Beskid Sądecki, Tatry, Gorce, Babia Góra, Beskid Żywiecki, and the Beskid Śląski ranges) where 284−326 individuals live and 35−41 leks are active. In the Solska and the Lasy Janowskie Forests (Lublin region), the population was estimated at 132−184 individuals and 12−13 lekking grounds. In the Augu− stów Forest (Podlasie region) 36−46 individuals and 5−7 leks were found. In the Bory Dolnośląskie Forest, where native capercaillies got extinct during the last decade, the reintroduction program resulted in the rebuilding of their 65−75 population (with 6−7 leks). The restitution of the species in the Piska Forest has begun. During the last 20 years, populations in the Carpathian national parks have been stable, although fluctuating in numbers. The increase in the number of individuals in the Augustów Forest as well as in the Sądecki and Beskid Śląski Mountains is an after−effect of the release of birds from breeding centers or translocations. In other strongholds, fluctuations or decreases have been recorded, including wisible in the Beskid Żywiecki Mountains