Organization of trauma centres in Poland

The organization of the medical emergency system in Poland assumes assistance to persons in danger of life and health at various stages, starting with the onset of their first symptoms. The witnesses of the event who undertake rescue operations — begin first aid and inform the emergency medical team — play a key role. The management of the trauma patient by staff requires knowledge of the patient’s assessment, as well as the ability to qualify the patient to the trauma centre according to criteria and age group, as there are two types of trauma centres: for adults and for people under 18 years of age, called a traumatic centre for children

Selected aspects of extending professional qualifications as perceived by medical rescue workers

Wstęp. Ratownicy medyczni z racji specyfiki wykonywanego zawodu winni posiadać aktualną wiedzę z zakresu medycyny ratunkowej oraz umieć ją wykorzystać wobec pacjenta znajdującego się w stanie nagłego zagrożenia życia. Cel pracy. Celem pracy była próba określenia wiedzy oraz zainteresowania ratowników medycznych problemem doskonalenia zawodowego, w tym wytypowanie zarówno czynników motywacyjnych do podejmowania doskonalenia zawodowego, jak też przeszkód. Materiał i metody. W badaniach ankietowych uczestniczyło 158 ratowników medycznych. Wyniki. 68% ankietowanych posiada wiedzę na temat długości okresu edukacyjnego rozliczeniowego, zaś 48% osób wie ile w trakcie tego okresu należy uzyskać punktów edukacyjnych. Dla 48% osób, kurs doskonalący to optymalna forma doskonalenia zawodowego, 81% wskazuje na istnienie przeszkód w podnoszeniu kwalifikacji, za główną uznano brak oddelegowania z pracy na taki kurs. Dla 82,2% badanych głównym motywatorem dokształcania jest wzrost satysfakcji z pracy. Wnioski. W badanym materiale ratownicy medyczni nie posiadają dostatecznej wiedzy z zakresu warunków doskonalenia zawodowego ratownika medycznego. Preferowaną formą doskonalenia zawodowe-go są kursy doskonalące, zaś głównym źródłem wiedzy o doskonaleniu jest internet. Największym motywatorem do doskonalenia zawodowego jest wzrost satysfakcji z pracy, zaś największym demotywatorem brak wzrostu wynagrodzenia.Introduction. Medical rescue workers should, due to the character of their profession, possess updated knowledge on rescue medicine and know how to put it into use in the cases of patients whose lives are in jeopardy. The purpose of the paper. The purpose of the study was to attempt to define the necessary knowledge and to interest medical rescue workers in the matter of professional development, including pointing out both motivational factors for self-improvement and obstacle on its way. The material and methods. The survey research included 158 medical rescue workers. The results. 68% of the interviewees had knowledge of the duration of education clearing period, whereas 48% of the responders knew how many education one is obliged to get during that period. For 48% of the participants a professional course is an optimal form of training. 81% of responders indicated the existence of some obstacles to professional development – the predominant one was a failure to assign a worker for such a course on the part of the employer. For 82,2% of the interviewees, the main motivation to extend their qualifications was an improvement in the workrelated contentment level. Conclusions. The medical rescue workers in the material under investigation had insufficient knowledge on the conditions of professional education. The preferred form of professional development were training courses, whereas the main source of knowledge on the development concerned was the Internet. The most significant motivational factor was an increase in the satisfaction with work, whereas the most common factor responsible for decreasing motivation was related to the lack of pay rise

Emergency medicine point of view on epidemiology of diabetes and diabetes-related complications

Despite centuries of research and clinical work, the diagnosis of diabetes was still treated as a quick death sentence at the beginning of the 20th century. Unfortunately, the number of patients with diabetes is increasing every year. Type 2 diabetes is increasingly common among young people: children and adolescents. The article discusses the type of diabetes and the importance of rapid diagnosis and management. Type 1 diabetes, type 2 diabetes, latent autoimmune diabetes in adults, monogenic diabetes, gestational diabetes was analyzed. Life threatening conditions resulting from complications of diabetes including diabetic ketoacidosis, hyperglycemic hyperosmolar state, hypoglycemia, lactic acidosis was discussed, and the first-line emergency treatment were analyzed. The life-threatening complications of diabetes and rescue procedures in these conditions were discussed in detail. Conclusion. Due to the frequency of life-threatening complications, diabetes is a heavy burden on the medical staff. Adequate diagnosis and implementation of appropriate treatment significantly improve the patient's condition

BEPS 13: CBCR – raport według krajów

W celu wyeliminowania nieuczciwej konkurencji podatkowej polegającej na unikaniu opodatkowania i przenoszeniu zysków, OECD i UE zalecają podjęcie skutecznych przedsięwzięć, które zostały zebrane w pakiet 15 działań, jakie państwa członkowskie powinny wdrożyć do swoich porządków prawnych. Jednym z priorytetów stało się promowanie automatycznej wymiany informacji i raportowania (BEPS 13) jako narzędzia zapewniającego przejrzystość działań oraz przyszłego europejskiego i międzynarodowego standardu w sprawach podatkowych. Ponieważ grupy przedsiębiorstw wielonarodowych mają możliwość przenoszenia dochodów pomiędzy podmiotami powiązanymi usytuowanymi w różnych jurysdykcjach podatkowych, organy podatkowe poszczególnych państw członkowskich potrzebują wyczerpujących i rzetelnych danych, które umożliwią im identyfikację krajów, w których powstaje dochód, oraz identyfikację krajów, w których dochód ten jest zgłaszany do opodatkowania oraz ustalenie, ile wynosi podatek zapłacony w poszczególnym kraju. Większa przejrzystość pomiędzy państwami powinna spowodować, że grupy przedsiębiorstw wielonarodowych zaprzestaną dotychczasowych praktyk i zaczną płacić podatki w kraju, w którym osiągają zyski

History of the State Medical Rescue Service in Poland

The State Medical Rescue Service in Poland dates back to 1891, when the first ambulance service was established in Cracow. Over 129 years, the system has been fully transformed, starting with medical staff,through numbers, equipment, and modern information and communication systems for emergency callsand assistance during interventions, and medical records. Emergency medical services in Poland had theirbreakthrough when the current Act of 8 September 2006 on the National Medical Rescue Service was introduced, which is the foundation for the modern organisation of medical rescue and emergency medicine inPoland. According to the Ministry of Health, the total number of Emergency Medical Services Teams operatingin 2019 was 1585, including those operating on a seasonal basis

Targeted temperature management: State of the Art

One of the indicated elements of post-resuscitation care is therapeutic hypothermia or temperature treatment management. the survivability of out-of-hospital cardiac arrest (OHCA) till admission to hospital is only 23%. Efficient thermoregulatory mechanisms are the basis for maintaining optimal body temperature. Therapeutic hypothermia shows normalizing effect on metabolic processes disturbed in ischaemic conditions, including improving metabolism and maintaining glucose balance in the brain, lowering the concentration of lactates, limiting the secretion of free radicals in damaged neurons, lowering the production of pro-inflammatory cytokines, stabilizes the blood-brain barrier and reduces endothelial dysfunction preventing ischaemic damage to tissues and organs. Hypothermia has a wide multidirectional effect on the human body, which can be useful in patients. Most available scientific studies show the efficacy and benefits of hypothermia in patients with out-of-hospital sudden cardiac arrest, including especially with ventricular fibrillation. The delay in the initiation of therapeutic hypothermia and reaching target temperature significantly increased the odds of a poor neurological outcome. Current American Heart Association (AHA) and European Resuscitation Council (ERC) resuscitation guidelines recommend that targeted temperature management should be implemented in all adult coma patients with return of spontaneous circulation (ROCS) after sudden cardiac arrest. The target temperature should be between 32°C and 36°C and then maintained for at least 24 hours. In patients with coma after TTM, fever should be actively prevented. For patients with out-of-hospital cardiac arrest, it is not recommended to routinely cool patients in prehospital conditions with a rapid intravenous infusion of cold fluids after ROSC

Application of interventional ultrasound in emergency medicine conditions

ULTRASONOGRAPHY is a modern diagnostic tool both in intensive care and emergency medicine. Small, portable and simple ultrasound devices have been introduced due to technological advances. The image quality, size, and weight of portable ultrasound devices are improving. Prehospital point-of-care ultrasonog- raphy may have an impact on the decision making in prioritizing initial treatment. First aid at the scene of the accident and transporting the patient to the hospital is a key element, which in the case of appropriate diagnostics allows you to fight life-threatening injuries. The intention of using ultrasound protocols is to shorten and simplify the ultrasound examination allowing to eliminate or find complications of an injury as soon as possible. The protocols used include elements of ultrasonography and echocardiography of the lung tissue, abdominal cavity, pelvis, large vessels or the eyeball. The intention of the authors of the article was to present to the reader the basic ultrasound protocols applicable to patients in emergency situations.