Sudden cardiac arrest accompanied by severe accidental hypothermia - modifications of the standard cardiopulmonary resuscitation procedure

Severe accidental hypothermia is associated with a high mortality rate. This is related to the fact that assessment and treatment may be difficult: the severity of determining the presence of pulse and breathing, the significant sensitivity of the patient to a change in body position, difficulty in the instrumental protection of airways, ease of ventricular fibrillation occurrence and many other risks. A well-prepared medical team, coordinated actions based on current medical guidelines and recommendations, give a chance to save patients even after a few hours of cardiopulmonary resuscitation. Despite the availability of advanced devices for heating and supporting cardiovascular function in patients with cardiac arrest with coexisting hypothermia, basic activities such as isolation and protection against heat loss are critical important rescue tasks necessary for effective treatment of the patient. In connection with the above, this article summarizes current information about sudden cardiac arrest with coexisting hypothermia. The following aspects were discussed: definition, epidemiology, diagnosis and assessment of hypothermia severity and modifications of standard resuscitation algorithm in the case of coexisting hypothermia

Anaphylaxis: the current state of knowledge

Anaphylaxis is a severe, life threatening, generalised or systemic hypersensitivity reaction. In the last decade there has been a significant increase in the frequency of anaphylactic reactions in all age groups and all regions of the world. It is estimated that about 0.3% of the European population experience anaphylaxis at some point in their lives. In connection with the above, this article summarizes current information about anaphylaxis. The following aspects were discussed: definition, epidemiology of disease, pathomechanism, triggers, signs and symptoms, clinical criteria for the diagnosis, treatment and preventive activities

Abdominal injuries caused by a horse kick - rescue procedure

Kicking by the horse can cause very serious injuries to the victim. The groups of people particularly vulnerable to such an injury are: veterinarians, farmers, sport riders and stables. The aim of this article is to present the proceedings with the victim, who was kicked by a horse with special attention to abdominal injuries. Injuries caused as a result of horse kick are paradoxically quite frequent. Early call for help, precise gathering of the interview according to the SAMPLE algorithm and patient’s observation in the direction of shock symptoms may later help the ambulance crew and emergency medicine physician in treatment and in faster, targeted diagnostics in the emergency department

Kolodziej's subsolution theorem for unbounded pseudoconvex domains

In this paper we generalize Kolodziej's subsolution theorem to bounded and unbounded pseudoconvex domains, and in that way we are able to solve complex Monge-Ampère equations on general pseudoconvex domains. We then give a negative answer to a question of Cegrell and Kolodziej by constructing a compactly supported Radon measure $\mu$ that vanishes on all pluripolar sets in $C^n$ such that $\lambda(C^n)=(2\pi)^n$, and for which there is no function $u$ in $\mathcal L_+$ such that $(dd^cu)^n=\mu$. We end this paper by solving a Monge_Amp±re type equation. Furthermore, we prove uniqueness and stability of the solution

On the complex Monge-Ampère operator in unbounded domains

In this note we give sufficient conditions on a measure \mu, defined on a unbounded strictly hyperconvex domain in $\mathbb{C}^{n}$, to be the Monge-Ampère measure of some plurisubharmonic function. These generalize recent results by Lê et al

Supraglottic devices as alternative equipment to airway management in state of sudden cardiac arrest

Czyż Rafał, Zawłodzki Mateusz, Czyż Izabela. Supraglottic devices as alternative equipment to airway management in state of sudden cardiac arrest. Journal of Education, Health and Sport. 2017;7(8):202-208. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.845753 http://ojs.ukw.edu.pl/index.php/johs/article/view/4712 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.08.2017. Revised: 02.08.2017. Accepted: 20.08.2017. Przyrządy nadgłośniowe jako alternatywny sprzęt do udrożnienia dróg oddechowych pacjenta w stanie nagłego zatrzymania krążenia. Supraglottic devices as alternative equipment to airway management in state of sudden cardiac arrest. Rafał Czyż1, Mateusz Zawłodzki1, Izabela Czyż2 1) Katedra Medycyny Ratunkowej Uniwersytetu Medycznego im. Piastów Śląskich we Wrocławiu 2) Uniwersytet Medyczny im. Piastów Śląskich we Wrocławiu STRESZCZENIE Skuteczne zabezpieczenie drożności dróg oddechowych pacjenta w sytuacji nagłego zatrzymania krążenia jest priorytetowym działaniem zespołu ratowniczego na miejscu zdarzenia. Za złoty standard nadal uważana jest intubacja dotchawicza, której wykonanie wymaga dużego doświadczenia i treningu. W związku z tym przyrządy nadgłośniowe, jako alternatywne urządzenia do udrażniania dróg oddechowych odgrywają istotną rolę, szczególnie w medycynie ratunkowej. Celem niniejszego artykułu jest przedstawienie wybranych alternatywnych metod udrażniania dróg oddechowych pacjenta w stanie zatrzymania krążenia ze szczególnym uwzględnieniem maski krtaniowej, urządzenia I-gel oraz rurki krtaniowej. Wszystkie urządzenia nadgłośniowe charakteryzują się łatwością założenia nawet dla osób bez doświadczenia w ich stosowaniu. Dodatkowo czas potrzeby do udrożnienia dróg oddechowych z ich wykorzystaniem jest niejednokrotnie krótszy niż w przypadku tradycyjnej intubacji dotchawiczej. Zasadniczą wadą tych urządzeń jest fakt, iż nie zapewniają całkowitego bezpieczeństwa przed aspiracją treści pokarmowej. Obecna literatura pokazuje, że nadgłośniowe urządzenia do udrażniania dróg oddechowych stanowią idealną alternatywą dla intubacji dotchawiczej. Słowa kluczowe: udrażnianie dróg oddechowych, przyrządy nadgłośniowe, resuscytacja ABSTRACT Effective airway management of patient in sudden cardiac arrest is a priority of rescue team on the accident spot. Endotracheal intubation which requires great experience and training is still regarded as the gold standard. Therefore supraglottic airway devices, as alternative devices for airways management are matter greatly role especially in emergency medicine. The aim of this study was to present chosen alternative methods of airway management to patient in sudden cardiac arrest with particular reference to laryngeal mask, I-gel and laryngeal tube. All of supraglottic devices are characterized by easiness in applying without experience in use them. Additionally time need to airway management in use of them is many times shorter than with traditional endotracheal intubation. Fundamental defect in these devices is a fact that they don’t provide total safety before aspiration for chime. Current literature shows us that supraglottic airway devices are perfect alternative to endotracheal intubation. Key words: airway management, supraglottic airway devices, resuscitatio

Intraosseous access as a modern method of fast ensuring the access to the cardiovascular system in conditions of emergency medicine

Providing of intravenous access to the injured person is one of the most necessary medical activities executed by medical staff in emergency situation. Many times traditional method of intravenous access is impossible or it could disadvantageously extend time to drug injecting. In such a situations very helpful could be use of available ready to use sets of intraosseous devices.  Purpose of this work is to sum up the actual knowledge about intraosseous access, actual recommendations of world organizations and to present indications, contraindications and possible complications in using of intraosseous access.Numerous research studies show that intraosseous devices are safe and easy to use and achieved results of the effectiveness comparable with the central line. Researchers proved that applying intraosseous devices was connected with earlier injecting of the pharmaceutical drugs to the patient.Current literature shows us that intraosseous access is perfect alternative method to traditional intravenous access

Knowledge and skills toward capnometry and capnography among Emergency Medical Service providers

Capnometry is an increasingly used element of patient monitoring in emergency medicine, also in pre-hospital area. The increasing availability of compact devices for measuring the end-expiratory concentration of carbon dioxide (EtCO2) offers great opportunities to improve the quality of treatments, as well as giving rescuers feedback on the effectiveness of life-saving procedures. However, the capnometer is just another device and without the proper substantive preparation of the person who uses it, its usefulness will be negligible. Aim of this study, is to assess paramedics knowledge about capnometry and capnography. The study group consisted of 102 paramedics who are actively working in ambulance service, aged 30.5 ± 5.7 years including 7% of women and 93% of men. Results were collected with the author’s questionnaire. Most of participants (91%) confirmed that in their ambulance was available device to measure end-expiratory carbon dioxide (EtCO2). The most commonly available device was capnometry (72%), followed by the capnography (19%). Moreover, the analysis shows that the rescuers who declared participation in the training of monitoring and analysis end-expiratory value of carbon dioxide concentration in the last 12 months obtained significantly higher correct answers than the staff who did not have such training (6.5 ± 2.0 vs. 5.4 ± 1.7). However, only 35% of participants took part in such training in last year. Study shown a lack of knowledge and experience in use of devices to measure end-expiratory carbon dioxide concentration (EtCO2) by Emergency Medical Service providers

Paramedics knowledge about providing paediatric advanced medical resuscitation procedures

Child in emergency state requires treating in the fast and precise way. It is possible only in the situation when medical staff is having up-to-date knowledge and the ability in providing aid to such a patient's.The aim of this study was to evaluate the knowledge level about providing paediatric advanced medical resuscitation procedures by paramedics working in National Emergency Medicine System.In examination took part 186 paramedics working in emergency ambulance services and in hospital emergency departments. Average age of the group amounted to 29.1 ± 5.4 of years. The anonymous and author's questionnaire form made up of 22 questions concerning socjodemographic data, as well as specialist medical knowledge.The average test result of knowledge level about paediatric advanced medical resuscitation procedures from entire group amounted 8.9 ± 2.9 points. Paramedics from ambulance services achieved the better average outcome than emergency departments rescuers (8.9 ± 3.0 vs 8.8 ± 2.8). Only 44% examined rescuers participated in child resuscitation course. Paramedics most often assessed their knowledge in the examined scope on the average level (55%). Less than ¾ of rescuers knows formula being used to convert the child age into approximate body weight. Alarming is a fact that only 76% examined is able to give right dose of adrenaline for child with weight of 10 kg. 66% of paramedics would carry out defibrillation to child with weight of 18 kg with correct energy.Knowledge in the scope of advanced medical resuscitation procedures to the paediatric patient by paramedics is insufficient. It is essential to increase amount of children resuscitation trainings amongst medical staff