Occupational injury rates in personnel of emergency medical services

[i][/i][b]Introduction and objectives. [/b]The system of emergency medical services (EMS) in Poland was established in 2006. The risk of occupational injuries to EMS personnel is very high, irrespective of the country where they operate, as they face many hazards in their everyday work. The aim of this study is to describe the type, incidence and consequences of occupational accidents among the personnel of the National Emergency Medical Services in Poland (NEMS – land and air ambulance crews) in 2008–2012. [b]Material and methods:[/b] The study reviewed all occupational accidents among the EMS personnel reported to the National Labour Inspectorate in 2008–2012. [b]Results[/b]: In the period reported, the number of accidents decreased from 32 in 2008 to just 6 in 2012. Traffic accidents predominated and most of the victims were male paramedics under 30 years of age. The most common injuries included multiple organ injuries and injuries of the cervical spine, chest and trunk. [b]Conclusions:[/b] The growing professional experience of the EMS personnel has a beneficial effect on occupational injury rates as they tend to decrease with longer employment. Occupational accidents are definitely more common among ambulance crews than in the personnel of other organizational units of the National Emergency Medical Services

Accidental hypothermia in Poland : estimation of prevalence, diagnostic methods and treatment

BACKGROUND: The incidence of hypothermia is difficult to evaluate, and the data concerning the morbidity and mortality rates do not seem to fully represent the problem. The aim of the study was to estimate the actual prevalence of accidental hypothermia in Poland, as well as the methods of diagnosis and management procedures used in emergency rooms (ERs). METHODS: A specially designed questionnaire, consisting of 14 questions, was mailed to all the 223 emergency rooms (ER) in Poland. The questions concerned the incidence, methods of diagnosis and risk factors, as well as the rewarming methods used and available measurement instruments. RESULTS: The analysis involved data from 42 ERs providing emergency healthcare for the population of 5 305 000. The prevalence of accidental hypothermia may have been 5.05 cases per 100.000 residents per year. Among the 268 cases listed 25% were diagnosed with codes T68, T69 or X31, and in 75% hypothermia was neither included nor assigned a code in the final diagnosis. The most frequent cause of hypothermia was exposure to cold air alongside ethanol abuse (68%). Peripheral temperature was measured in 57%, core temperature measurement was taken in 29% of the patients. Peripheral temperature was measured most often at the axilla, while core temperature measurement was predominantly taken rectally. Mild hypothermia was diagnosed in 75.5% of the patients, moderate (32-28°C) in 16.5%, while severe hypothermia (less than 28°C) in 8% of the cases. Cardiopulmonary resuscitation was carried out in 7.5% of the patients. The treatment involved mainly warmed intravenous fluids (83.5%) and active external rewarming measures (70%). In no case was extracorporeal rewarming put to use. CONCLUSIONS: The actual incidence of accidental hypothermia in Polish emergency departments may exceed up to four times the official data. Core temperature is taken only in one third of the patients, the treatment of hypothermic patients is rarely conducted in intensive care wards and extracorporeal rewarming techniques are not used. It may be expected that personnel education and the development of management procedures will brighten the prognosis and increase the survival rate in accidental hypothermia

Reasons for medical rescue team interventions in the northwest part of masovian voivodeship

Introduction: Civilisation development and huge technological progress influence the life and functioning of every human being. They facilitate functioning in the modern world but are also associated with increased incidence of trauma and morbidity, which are a challenge for modern health care systems. One of the main elements of health care is Emergency Medical Services System, whose aim is to save people who are in the state of sudden health hazard. Aim: The aim of this paper was to analyse the reasons for medical rescue team interventions in the northwest part of Masovian voivodeship within the period of four years (2013-2016). Materials and method: The analysis showed that the most common reason for medical rescue team intervention in the studied region and time period was cardiovascular diseases. Results: Men and people aged 75-89 were the main beneficiaries of medical services provided by medical rescue teams. Cardiovascular diseases were more often diagnosed in women and people aged 75-89, while injuries were mainly diagnosed in men and people aged 45-59. Conclusion: The gender and age of the patient, year, day of the week, the place of the call, team type and the urgency code of the call were important factors influencing the reasons for the intervention of MRTs in the analysed region and period

Analysis of Web-based learning methods in emergency medicine : randomized controlled trial

Introduction: In medical education, Web-based learning is increasingly used as a complement to practical classes. The objective of the study was to perform a comparative analysis of three different forms of e-learning course on emergency medicine in terms of an indicator of knowledge growth and students’ satisfaction.Material and methods: For the purpose of the study, we developed and im-plemented a tool in the form of an online course: A – non-animated presen-tation, B – video, C – interactive video. The participants were undergraduate students of emergency medicine and nursing (n = 106). A pre-test and a post-test were carried out, and the resulting data were analyzed using parametric tests (t-test, ANOVA, post-hoc). Final questionnaires assessing six parameters of satisfaction were also evaluated.Results: A significant increase in knowledge in the experimental group which used an interactive video was observed (p = 0.04). Moreover, the number of replays of learning material was the highest in group C (2.09 ±2.48). The level of post-course satisfaction turned out to be comparable in all three groups (p = 0.62).Conclusions: The study allowed the interactive course to be identified as the most effective method of distance learning among selected ones. Due to the limitations of the study, we conclude that there is a need for further studies on the effectiveness of e-learning in emergency medicin

The strategy of training staff for a new type of helicopter as an element of raising the security level of flight operations

In 2008, the Polish Medical Air Rescue started replacing its fleet with modern EC135 machines. To ensure the maximum possible safety of the missions performed both in the period of implementing the change and later on, the management prepared a strategy of training its crews to use the new type of helicopter. The analysis of incidents that occurred during 2006–2009 showed that both the human and the technical factors must be carefully considered. Moreover, a risk analysis was conducted to reduce the risk both during general crew training and in the course of particular flight operations. A four-stage strategy of training pilots and crew members was worked out by weighing up all the risks. The analysis of data from 2010 to 2013 confirmed that the risk connected with flying and with all the activities involved in direct support aircraft operations is under control and lowered to an acceptable level