Publications by authors named "Marcin Podgórski"

5 Publications

  • Page 1 of 1

Analysis of out-of-hospital cardiac arrest in Poland in a 1-year period: data from the POL-OHCA registry.

Kardiol Pol 2020 05 19;78(5):404-411. Epub 2020 Mar 19.

Department of Emergency Medical Service, Medical University of Warsaw, Warsaw, Poland

Background: Out‑of‑hospital cardiac arrest (OHCA) is a severe medical condition. Prehospital care plays an essential role in patient survival.

Aims: First, the study aimed to evaluate cases of OHCA managed by cardiopulmonary resuscitation (CPR) attempts in Poland in 2018, including their frequency and patient outcomes in terms of survival until hospital admission or transport to the hospital by helicopter emergency medical service (HEMS). Second, the study was performed to identify the predictors of patient survival until hospital admission or transport by HEMS.

Methods: It was a case‑control study based on medical records. In 2018, 3 400 000 emergency visits were registered. Patients who were treated by emergency medical service (EMS) ambulance staff using defibrillation and / or administering at least 1 dose of 1 mg of epinephrine were considered to have OHCA managed by CPR attempts.

Results: A total of 26 783 CPR attempts were reported by EMS in Poland in 2018. The incidence of OHCA with CPR attempts in 2018 was 69.7 per 100 000 inhabitants and it varied from 58.9 per 100 000 to 84.5 per 100 000 inhabitants in 16 Polish provinces. The mean survival rate until hospital admission or transport by HEMS was 36.3% and it ranged from 34.5% to 38.3%. Patient survival until hospital admission or transport by HEMS was related to age, sex, emergency site, defibrillation during CPR, the first recorded rhythm, and procedures performed by the EMS personnel.

Conclusions: The rate of OHCA with CPR attempts was similar to that reported in other European countries. Patient survival until hospital admission or transport by HEMS was associated with many well‑‑known, identified nonmodifiable and modifiable factors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.33963/KP.15241DOI Listing
May 2020

Characteristics of aeromedical transport, both interhospital and directly from the scene of the incident, in patients with acute myocardial infarction or acute trauma between 2011-2016 in Poland: A case-control study.

Adv Clin Exp Med 2019 Nov;28(11):1495-1505

Department of Emergency Medical Services, Faculty of Health Science, Medical University of Warsaw, Poland.

Background: Patients with acute myocardial infarction (AMI) or acute trauma (AT) are transported by air to save time. Helicopter Emergency Medical Service (HEMS) provides both flights to and from the emergency scene, as well as interhospital transport (interHtransport).

Objectives: The objective of this study was to compare aeromedical transport and HEMS missions of AMI and AT patients regarding safety, medical procedures and the length of flights.

Material And Methods: This is a case-control study analyzing the medical history records of AMI and AT patients transported between hospitals and from the scene identified using ICD-10 codes. Research of customary data (age, sex and general health status measured with Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS)) was performed.

Results: There were 48,555 flights in the years 2011-2016, of which 7,645 (15.7%) were interhospital (19% AMI and 12% AT). Out of these, 40,910 (84.3%) HEMS missions were to patients on the scene (10% AMI and 13% AT). No fatalities were noted. The AMI GCS score was higher than in AT patients: 15.0 vs 14.0, respectively. The medical procedures during transport of AMI patients between hospitals and from the scene were the following: cardiopulmonary resuscitation (CPR): 6 vs 73 cases (p < 0.001); oxygen therapy: 41.1% vs 50.2%, respectively. The median distance was 59.4 km vs 52.1 km (p < 0.001), while median flight time was 45.0 min vs 38.0 min (p < 0.001), respectively. Regarding AT patients, the procedures performed (during interhospital and from the scene transport) were the following: CPR: 5 vs 244 cases (p < 0.001); intubation: 10.7% vs 17.3% (p < 0.001); sedation: 50.1% vs 24.3% (p < 0.001); oxygen therapy: 17.6% vs 36.6% (p < 0.001); spinal board: 17.1% vs 66% (p < 0.001); cervical collar: 15.9% vs 63.4% (p < 0.001), respectively. Interhospital transport and HEMS mission median flight distance was 135.9 km vs 56.3 km (p < 0.001), while median flight time was 66.0 min vs 45.0 min (p < 0.001), respectively.

Conclusions: Aeromedical transport is safe and very rarely requires resuscitation during the flight. The long distances of flights and time required can reflect the scarcity of trauma centers (TCs) compared to cardiovascular wards. The location of hemodynamic centers in Poland is optimal.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.17219/acem/109456DOI Listing
November 2019

Determinants of occupational burnout among employees of the Emergency Medical Services in Poland.

Ann Agric Environ Med 2019 Mar 3;26(1):114-119. Epub 2018 Sep 3.

Medical University, Warsaw, Poland.

Introduction: Occupational burnout is a multifaceted phenomenon and a problem often encountered among medical personnel. An example of such a group are workers of the Emergency Medical Services (EMS). The aim of the present study was to make an attempt to assess the level of job burnout among professionally active employees of the EMS and to compare the different occupational groups (paramedics, nurses of the system, doctors of the system) according to four analyzed factors.

Material And Methods: A cross-sectional study was performed using an on-line questionnaire. Four factors impacting the level of burnout were analyzed: 1) attitude to work; 2) workload; 3) contact with the patient; 4) attitude to stress). The minimum possible result on the scale is 36 points and the maximum - 252. Data were analysed by means of the Cronbach's alpha coefficient, the Spearman correlation, the Ramsey RESET test, the Chow test, VIF statistics.

Results: The average score for occupational burnout was 131.0 points (SD ± 31.47). The tool's reliability measured by means of Cronbach's alpha was 0.910). Both nurses and doctors obtained higher results throughout the scale (βstand.0.147 and 0.215). Significant differences were shown between the group working only in the Helicopter Emergency Medical Service (HEMS) teams and the other services (land EMS, emergency rooms, etc.) at the level of p < 0.000.

Conclusions: EMS employees encounter varying degrees of threat by occupational burnout. Doctors working in the system are shown to have the highest level of burnout, while paramedics the lowest. Among all the jobs analyzed, the lowest level of occupational burnout has been demonstrated by employees of HEMS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.26444/aaem/94294DOI Listing
March 2019

[An assessment of medical rescue actions performed by the students in the sixth year of medicine at the national medical universities in Lviv and ivano-frankivsk in an out-of-hospital cardiac arrest (ohca) patient. a simulation study].

Wiad Lek 2018;71(7):1200-1205

Klinika Medycyny Ratunkowej, Uniwersytet Medyczny W Białymstoku, Wojewódzkie Pogotowie Ratunkowe W Katowicach, Polska.

Objective: Introduction: Sudden cardiac arrest is a condition that requires the implementation of advanced emergency medical procedures. It constitutes a significant medical, economic and social issue. The aim: To assess the medical rescue actions performed by the students in the sixth year of medicine at the National Medical Universities in Lviv and Ivano-Frankivsk in an out-of-hospital cardiac arrest (OHCA) patient.

Patients And Methods: Material and methods: The research involved students in the sixth year of medicine at the National Medical Universities in Lviv and Ivano-Frankivsk. Participation was voluntary and all students were adult. Consequently, no written parental consent was required. The number of participating students amounted to 17 in Lviv and 16 in Ivano-Frankivsk. There were two stages of the study. The research was conducted in compliance with the 2015 guidelines formulated by the European Resuscitation Council. The adopted level of statistical significance was p<0.05.

Results: Results: The pre-test percent average amounted to 60.27% whereas the final test average values were 82.39% in the first stage and 77.96% in the second stage. Higher scores were reported in the case of Lviv students which especially refers to the final tests (p< 0.001). The most important element influencing the effectiveness of the procedures is chest compression (compression location, depth, frequency and relaxation). A higher chest compression effectiveness was reported in each subsequent stage of the research. A higher effectiveness rate was observed in students in Ivano-Frankivsk (p<0.028). The other element with a significant impact on the effectiveness of procedures is ventilation. A higher rate of successful ventilation (breath frequency, volume and strength) was noted in Ivano-Frankivsk, especially as far as the first stage after training was concerned (p<0.038).

Conclusion: Conclusion: The education of students of medicine in Ukraine is insufficient. The results of the effectiveness of resuscitation are not satisfactory and do not prepare future doctors to perform high quality resuscitation procedures.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2019

[The epidemiology of sudden cardiac arrest in prehospital care in the area of the silesian voivodeship].

Wiad Lek 2018;71(1 pt 2):193-200

Zakład Ratownictwa Medycznego, Warszawski Uniwersytet Medyczny, Warszawa, Polska.

Objective: Introduction: Sudden cardiac arrest (SCA) is a serious medical and social issue. The incidence of SCA varies depending on the location and the circumstances. The aim: A retrospective analysis of non-hospital SCA cases from an epidemiological perspective. The research involved the population monitored by the Voivodeship Rescue Service (VRS) in Katowice.

Patients And Methods: Material and methods The analysis covered dispatch order forms and emergency medical procedure forms of the VRS in Katowice in 2016 (n = 249 872). The retrospective analysis involved cases of non-hospital SCA in adults (n = 1603). Quantitative parameters have been presented as average values with standard deviation. Non-metric variables have been described by means of structure indicators. A comparative analysis was conducted by means of the Student's T-test for the quantitative variables and the Pearson's chisquared test for the non-metric variables. The statistical significance adopted for the purpose of all analyses was 0.05.

Results: Results: There were 1005 men (62.7%), 566 women (35.3%) and 32 cases (2.0%) where gender identification was not reported. Female individuals were generally older than male individuals (p = 0.000). Patients' average age was 65.7 years. The SCA attack rate was 59.37/100 000. SCA cases were usually reported in domestic conditions (71.1%, p = 0.000). In a majority of cases, the incident was witnessed by a third person (about 70.0% of cases, p= 0.000). Most of the SCA cases were reported in the first quarter of the year whereas the lowest number of cases was noticed in the third quarter (28.4 % vs 22.5 %). SCA was most frequent during the day. Restoration of spontaneous circulation was reported in 33.4% of the cases.

Conclusion: Conclusions: The incidence of SCA is occasional in the context of all analyzed emergency cases in the period under research. However, SCA cases are related with a high risk of failure. Acting according to the currently available knowledge will probably cause an increase of the restoration of spontaneous circulation (ROSC) rate.
View Article and Find Full Text PDF

Download full-text PDF

Source
August 2018