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Tytuł:
Knowledge of CPR and first aid for children among pedagogy students
Autorzy:
Sholokhova, Daryna
Michalak, Monika
Wejnarski, Arkadiusz
Powiązania:
https://bibliotekanauki.pl/articles/29432046.pdf
Data publikacji:
2023-12
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
First aid
educator
child
CPR
knowledge
skills
Opis:
INTRODUCTION: At home, the parents take care of the child's safety, but when the child is in school or kindergarten, it is the educator that takes care of the child. The awareness of dangers the child is exposed to at every moment of his or her activity during the day obliges educators to have up-to-date knowledge of first aid. The marked differences in anatomy, physiology and mechanisms of life-threatening conditions make the principles of first aid differ from those of an adult. First aid courses organised for both educators and pedagogy students should focus on highlighting these differences and learning how to deal with individuals of all ages. The aim of the study is to assess the level of knowledge and practical skills among pedagogy students and to identify aspects requiring adjustments to the curriculum of future teachers. MATERIALS AND METHODS: The study was conducted in 2022 at the Institute of Pedagogy at the University of Siedlce, Poland. Sixty-three pedagogy students participated in it. For the purpose of the study, a survey questionnaire covering the principles of first aid for children and a practical task evaluation sheet were created. Practical skills were assessed using the Resusci Junior QCPR simulator and a 0-15 point rating scale. RESULTS: The study included as many as 63 students of early childhood and pre-school pedagogy. The mean score achieved on the theory test was M=11.49 out of a possible 14 points (SD±1.24). The highest number of correct answers were given by students for the following questions: actions performed when assessing the child's breathing (n=63; 100%) and placing the child in the safe position (n=61; 96.8%). In contrast, the fewest correct answers were related to the rate of chest compressions (n=27; 42.9%). In the practical task, as many as 15 child CPR activities were considered. The average points scored by students on the practical task was M=6.73 out of a possible 15 points (SD±2.73). The average quality of compressions performed was M=28.59% (SD±30.41), breaths M=17.7% (SD±17.70) and chest compression depth was M=20.29% (SD±27.98). CONCLUSIONS: The level of theoretical knowledge and practical skills of pedagogy students is clearly insufficient to provide effective first aid to children. Significant differences were observed among students taking first aid classes onsite versus remotely. Having theoretical knowledge does not translate into practical skills. It seems that it is necessary to modify the curriculum for training future educators in first aid for children.
Źródło:
Critical Care Innovations; 2023, 6, 4; 23-33
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Social reactions to emergencies and illnesses: identifying the validity of EMS calls
Autorzy:
Bakalarski, Paweł
Jędral, Klaudia
Przychodzeń, Bartosz
Leszczyński, Piotr
Powiązania:
https://bibliotekanauki.pl/articles/29432044.pdf
Data publikacji:
2023-12
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Healthcare
emergency medical service
healthcare
calls
Opis:
INTRODUCTION: Poland’s healthcare systems is based on insurance and universal and equal access. The first component of the system is primary healthcare. At night and on holidays, the medical help can be obtained by means of After Hours Medical Services. Private paid visits can also be arranged. In emergencies, and cases of risk to health or life, emergency medical team can be called at 112 or 999, or a patient can go to the hospital emergency department (ED) on their own. There are also pharmacies where selected over-the-counter medicines can be bought. MATERIALS AND METHODS: The study was conducted in the first quarter of 2023 using a proprietary questionnaire with 5 sociodemographic questions and 20 case descriptions for which the participants indicated the type of medical help which they would use. The expert panel prepared a set of cases (accidents and illnesses), taking into account patient’s age and gender, time of day and working days and holidays when the incident occurred. The group of participants was selected using the snowball sampling method. The results were subjected to statistical analysis using nonparametric tests, the Spearman’s rho test and the Wilcoxon test. The used significance level was p<0.05. RESULTS: The study comprised 233 participants (166 females and 66 males). The mean age was 25 years (SD ± 9.50). A significant correlation was showed between the decision made and the gender in case of stroke occurring on a weekday (p=0.042); stroke symptoms on a holiday (p=0.024); head injury in a child (p=0,024); chest pain in an adult (p=0.009), and also the place of residence in case of an infection in a child (p=0.008). The decision was also influenced by education in case of chest pain in an adult (p=0.048); stroke (p=0.046) and sudden weakness (p=0.009). Also performing a medical profession correlated with the decision in case of arterial hypertension (p=0.028) and chest pain (p=0.010) in adults. The type of day (working/holiday) and the time of day were also analysed, revealing statistical differences depending on the type and time of day for infection in a child (p<0.000 in each comparison); working day and holiday for abdominal pain (p=0.000), stroke (p=0.023), diarrhea (p<0.000) and weakness (p<0.000), and also depending on the time of day in arterial hypertension (p<0.000); however, no differences were found in case of chest pain depending on the time of day(p=0.073). CONCLUSIONS: Emergency medical teams are called both in urgent cases, such as stroke or chest pain, and also in cases that do not require an immediate responses, such as diarrhea or weakness. Solutions need to be sought which would provide information what healthcare system units should be used in specific situations. The EMTs are called more often during the day on weekdays than at night or on holidays. The ambulance service responds most often in emergency cases such as convulsions, stroke or chest pain, but a significant number of calls is related to cases of weakness or arterial hypertension where the medical help should be sought in other healthcare units.
Źródło:
Critical Care Innovations; 2023, 6, 4; 48-57
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Extreme hypernatremia in a critically ill patient with feeding-jejunostomy: a case report
Autorzy:
Kumar, Amarjeet
Singh, Kunal
Kumari, Poonam
Dara, Haasith
Sagdeo, Gayatri
Powiązania:
https://bibliotekanauki.pl/articles/29432055.pdf
Data publikacji:
2023
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Hypernatremia
jejunostomy
critically ill
Opis:
Hypernatremia is a frequent and potentially life-threatening condition in hospitalized patients. It is a disorder of water metabolism and is usually defined as a plasma sodium concentration above 145 mEq/L. The treatment of severe cases of hypernatremia might be challenging in patient with feeding jejunostomy. The average person’s GI tract secretes and reabsorbs around 7 L of gastrointestinal fluid (including 3-5 L originating above the pylorus alone). These 7 L of gastrointestinal fluid will significantly dilute whatever we consume or infuse. However, this dilution of enteral feed may be bypassed in by feeding jejunostomy. There are very few cases reported on extreme hypernatremia. We present a case of severe hypernatremia in patient with feeding-jejunostomy, managed successfully with the recommended correction.
Źródło:
Critical Care Innovations; 2023, 6, 1; 36-40
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Student paramedic exposure to workplace violence: a scoping review
Autorzy:
Belk, Stephanie
Armstrong, James
Ilczak, Tomasz
Webster, Carl A.
Sumera, Kacper
Powiązania:
https://bibliotekanauki.pl/articles/29432035.pdf
Data publikacji:
2024-03-31
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Workplace violence
student
paramedic
healthcare professionals
prehospital
Opis:
INTRODUCTION: Workplace violence (WPV) against healthcare professionals (HCPs), including student paramedics, is a global concern, with reported incidents ranging from physical to psychological abuse. The prehospital environment, characterised by its high-risk nature, presents unique challenges for student paramedics during clinical placements. To explore the extent and nature of WPV experienced by student paramedics during clinical placements, assess the impact of WPV on their training and psychological well-being, and identify existing support mechanisms and training provisions. MATERIALS AND METHODS: Included were research or review articles specifically exploring WPV experienced by student paramedics during clinical placements. Exclusions were applied to articles not focusing on student paramedics, those not in English, and publications outside the specified time frame. A comprehensive search strategy was used across the databases CINAHL, Medline, EMBASE, EMCARE, and PubMed, supplemented by grey literature searches via Google Scholar and citation searching. Data extraction was facilitated through a synthesis matrix and themes were identified and analysed. RESULTS: From 417 records identified, six articles were included, all conducted in Australia, revealing themes such as the risk and effects of WPV, lack of reporting, the role of the practice educator (PEds), and preparedness for WPV. Freedom of Information (FoI) requests to English Ambulance Services highlighted inconsistencies in recording WPV incidents and variability in support provided to student paramedics. CONCLUSIONS: WPV significantly impacts student paramedics' educational experience and psychological health. There is a crucial need for improved education on WPV, standardised reporting mechanisms, and enhanced support systems. Collaborative efforts between ambulance services and higher educational institutions (HEIs) are essential to address these challenges and ensure a safer learning environment for student paramedics.
Źródło:
Critical Care Innovations; 2024, 7, 1; 34-48
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Lactate / albumin ratio as prognostic tool for risk stratification in septic patients admitted to ICU
Autorzy:
Mourya, Vasant
Gupta, Rakesh
Yadav, Amlendu
Yadav, Rupesh
Powiązania:
https://bibliotekanauki.pl/articles/29432047.pdf
Data publikacji:
2023-12
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Albumin
lactate
mortality
sepsis
Opis:
INTRODUCTION: Sepsis stands as the primary cause behind intensive care unit (ICU) admissions. The most critical parameters in sepsis management have been shown to be early recognition. Management delays have been associated with increased mortality and morbidity The aim of this study is to study the lactate/albumin (L/A) ratio as prognostic tool for risk stratification in septic patients admitted to ICU. MATERIALS AND METHODS: This prospective observational study was conducted with100 patients. Admitted in ICU with sepsis and septic shock were studied. Serum lactate/albumin ratio was calculated at the time of admission. Apache 2 and SOFA score was calculated at admission. All patients received initial treatment according standard protocol. All patients were followed up till discharge. An adverse outcome in terms of in hospital mortality, length of ICU stays and inotropic support was used in this study. RESULTS: Lactate/albumin ratio >1.5(AUC 0.89) correctly predicted in-hospital mortality among 27% patients with sensitivity and specificity of 90% and 78.6% respectively (p value =0.001). Lactate/albumin ratio <1.50 (AUC 0.73) correctly predicted length of ICU stays <72 hours among 17% patients with sensitivity and specificity of 85% and 58.8% respectively (p value =0.001). Lactate/albumin ratio >1.50 (AUC 0.91) correctly predicted requiring inotropic support among 36% patients with sensitivity and specificity of 83.7% and 89.5% respectively (p value =0.001). CONCLUSIONS: We concluded that lactate/albumin ratio was a stronger parameter than lactate, albumin, APACHE score and SOFA alone in predicting mortality, length of ICU stay and requiring noradrenaline inotropic support among sepsis patients in the ICU.
Źródło:
Critical Care Innovations; 2023, 6, 4; 11-22
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Acute naphthalene toxicity following ingestion of mothballs and ethyl alcohol: a case report
Autorzy:
Roshan, Nikesh Kumar
Vishwas, Kirti
Kumar, Neeraj
Powiązania:
https://bibliotekanauki.pl/articles/29432052.pdf
Data publikacji:
2023
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Naphthalene balls
mothballs
ethyl alcohol
toxicity
intensive care unit
Opis:
Naphthalene poisoning is an uncommon poisoning due to its pungent smell, taste, insolubility in water, and poor absorption from the gut following exposure to naphthalene-containing compounds such as mothballs. Paradichlorobenzene has been reported to dissolve more quickly in alcohol. Within a period of 48-96 hours following naphthalene mothball exposure patient presents with acute onset of non-bloody bilious vomiting, dark brown urine and watery diarrhoea. We present a diagnostic and therapeutic challenge while treating a 27 years old male admitted to the intensive care unit with features of acute naphthalene-toxicity, methemoglobinemia and acute kidney injury following accidental ingestion of mothballs and ethyl alcohol. His vital signs at the time of intensive care unit admission included fever, tachycardia, and hypotension, and his laboratory workup demonstrates hyperbilirubinemia with indirect predominance, hemolytic anaemia, methemoglobinemia, and renal dysfunction. Treatment options include supportive care, red cell transfusion, ascorbic acid, methylene blue, and N-acetylcysteine. The importance of obtaining a careful history and clinical findings is of paramount importance, especially in making the right diagnosis and a successful outcome largely depends on it.
Źródło:
Critical Care Innovations; 2023, 6, 1; 29-35
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
White blood cells count and its populations in patients with acute coronary syndromes and co-morbidities
Autorzy:
Vakaliuk, Igor
Alghzawi, Iyad
Powiązania:
https://bibliotekanauki.pl/articles/29432078.pdf
Data publikacji:
2021-06
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Acute coronary syndrome
white blood cells
hypertension
diabetes mellitus
Opis:
INTRODUCTION: Acute coronary syndromes (ACS) and sudden death cause most ischemic heart disease (IHD)- related deaths, which represent 1.8 million deaths per year, with similar numbers of men and women dying from coronary artery disease (CAD). It’s known that inflammation plays crucial role in atherosclerotic plaque formation and its destabilization. The purpose of this study is to evaluate of white blood cells count in its subpopulation in patients with ACS and modifiable cardiovascular risk factors – arterial hypertension and 2 type Diabetes Mellitus (DM). MATERIAL AND METHODS: In this observational cohort trial we observed of 184 patients with ACS. All patients were randomized into four groups: 1st group - 42 patients with ACS without arterial hypertension (AH) or DM; 2nd group – 56 patients with ACS and previous AH; 3rd group – 42 patients with ACS and 2 type DM; and 4th group – 44 patients with ACS and AH and DM. We studied of leukocytes count and their subpopulations in blood. RESULTS: The mean white blood cells count was significant higher in patients with ASC, compared with control group: 8.23 [6.50; 9.40] vs 5.49 [5.20; 5.70] (p<0.001). Similarly, ACS caused increase of leukocytes subpopulation count in blood. The significant higher count of white blood cells was observed in patients with ACS and co-morbidities: 2 type DM and its association with AH. In patients with ACS and previous AH we observed significant lower neutrophils count (p<0.05), but increased quantity of lymphocytes, compared with patients with ACS without co-morbidities (p<0.001). DM and its association with AH was characterized of neutrophils, lymphocytes and monocytes counts growth. CONCLUSIONS:ACS is characterized of raised white blood cells count and its population, especially in cases of association with 2 type Diabetes Mellitus.
Źródło:
Critical Care Innovations; 2021, 4, 2; 1-7
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Distribution of papers on COVID-19 in the field of anesthesiology in individual countries and journals
Autorzy:
Ayvat, Pinar
Powiązania:
https://bibliotekanauki.pl/articles/29432076.pdf
Data publikacji:
2021-06
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
COVID-19
anesthesia
citation impact
international co-authorship
bibliometric analysis
Opis:
INTRODUCTION: The are many published papers on COVID-19 in the field of anesthesia recently. However, there isn’t any study that indicates what kind of issues countries and journals are focusing on this particular subject. The aim of this paper is to determine the countries and journals that contribute the most to the literature on COVID-19 in the field of anesthesia and also to examine the features that make the difference in the total cited count numbers of related papers. MATERIAL AND METHODS: The search engine of the Web of Science was used for the selection of papers. The search yielded 359 published materials in total. However, 78 (61 Articles, 17 Reviews) of them did not have keywords. Therefore, they were excluded from the analysis. The remaining 196 articles plus 84 reviews, in total 280 papers were examined. In order to examine the differences between published materials in terms of total cited count numbers, independent samples t-tests and one-way Anova test were performed with SPSS. In order to explore the topical differences, the keywords according to country of the first author, and the journal were mapped. KNIME and FactoMiner software were used for the analysis. RESULTS: Results indicated that international papers were cited more compared to domestic papers; multi-centered national papers were cited more compared to single-centered national papers. The largest percentage (34.64%) of the overall publications originated from Anglo-American countries (USA=13.93%; England=12.14%; Canada=6.07%; Australia=2.50%). The keyword mapping showed that COVID-19, SARS-CoV-2, Pandemic, Anesthesia, Airway, Acute Respiratory Distress Syndrome, Critical Care, Intensive Care, Personal Protective Equipment, Infection, Mortality, and Mechanical Ventilation were the main keywords of these published materials. CONCLUSIONS:This paper not only showed the features of papers that are cited more but also showed the ranking of countries that contribute the most to the literature and reflected the hot topics about COVID-19 in the field of anesthesia. Extensive studies about COVID-19 have already begun, and the number of studies keep increasing. Therefore, this study could provide hints for authors who would like their papers to be cited more as well as useful information for further research.
Źródło:
Critical Care Innovations; 2021, 4, 2; 8-22
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Tracheostomy in intensive care unit in a patient with COVID-19
Autorzy:
Wyrzykowska, Dorota
Kisielewski, Krystian
Sawicka, Małgorzata
Mitura, Kryspin
Powiązania:
https://bibliotekanauki.pl/articles/29432108.pdf
Data publikacji:
2020
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
SARS-CoV-2 coronavirus
COVID-19 pandemics
respiratory failure
tracheostomy
aerosolization
Opis:
INTRODUCTION: For many months now, the entire world experiences effects of the COVID-19 pandemic, and current data indicate that this condition will continue even longer. About 5% of patients who become infected with the SARSCoV-2 coronavirus may develop a critical form of severe respiratory failure, due to which they will undergo intubation and mechanical ventilation. Prolonged mechanical ventilation will be an indication for an open tracheostomy, burdened with an increased production of aerosol containing virus particles and an increased risk of transmitting the highly contagious pathogen to medical personnel. In this situation, surgical departments with a limited number of operating theaters may be dedicated only to COVID-19 patients. Their use for other procedures will be significantly reduced or even impossible to prevent transmission of infections and exposure to other people. Taking into account the well-being of patients and staff and limiting the transmission of the virus to other departments, other safe solutions are being sought to perform a tracheostomy. An alternative procedure may be to perform a tracheostomy directly at the bedside (point-of-care) of a patient hospitalized in an intensive care unit (ICU). PURPOSE: The purpose of the study is to present an effective performance of safe, open tracheostomy in the ICU. METHODS: The bedside tracheotomy as an alternative to the procedure performed in the setting of an operating theater has been presented. A case study was based on the analysis of the procedure performed in a 42-year-old patient who was installed an open tracheotomy tube on the twenty-ninth day of intubation. CONCLUSIONS: In order to limit the transmission of the SARS-CoV-2 coronavirus outside the intensive care unit, it is recommended to perform a tracheotomy in ICU, in patients requiring mechanical ventilation, as the method is effective and safe.
Źródło:
Critical Care Innovations; 2020, 3, 4; 21-29
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The impact of firefighter fatigue on the quality of chest compressions during resuscitation
Autorzy:
Gryz, Paulina
Kowalski, Jakub
Leszczyński, Piotr K.
Miftadinow, Martyna
Szubińska, Katarzyna
Powiązania:
https://bibliotekanauki.pl/articles/29432048.pdf
Data publikacji:
2023-12
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
chest compressions
firefighter
fatigue
quality
Resuscitation
Opis:
INTRODUCTION: The effectiveness of cardiopulmonary resuscitation depends primarily on the actions taken at the scene. Firefighters are often the first ones to help the injured. The quality of their rescue efforts in such case determines the subsequent prognosis for the patient. Nevertheless, the tasks of firefighters also involve activities associated with a lot of physical activity, which can cause them to lose strength faster during CPR. The aim of the study was to assess the impact of fatigue on the quality of CPR performed by firefighters. MATERIALS AND METHODS: The study group consisted of 100 firefighters of volunteer firefighting units in the Siedlce poviat in Poland. The study was divided into three stages: I - performing chest compressions in a timed regime, II - subjecting the study group to uniform physical activity, III - reassessing the quality of chest compressions. The effectiveness of CPR was analyzed using a computer system and a professional training model. To analyze the variables, the normality of the distribution was determined using the Shapiro-Wilk test, and then the non-parametric test for uncorrelated variables Mann-Whitney U was used. Correlations were tested using the r-Pearson test at p<0.05 significance. RESULTS: The study group consisted of 93 men and 7 women, with a mean age of M=30.84 (SD ± 10.95). The respondents mostly had secondary education (42%) and vocational education (24%), with the majority (54%) declaring their marital status as single. Firefighters with varying ranks, including commanders, chiefs and presidents, participated in the study. The overall quality of chest compressions was lower each time after physical activity, at each analyzed minute of stage I and stage III (minute 1: 84.56% vs. 81.68%, p=0.281; minute 2: 81.13% vs. 80,25%, p=0,558; minute 3: 81.91% vs. 77.78%; p=0.243). A significantly higher quality of chest compressions was observed among men compared to women, both before fatigue (p=0.019) and after physical activity (p=0.053). Participants in the >53 age group had the best resuscitation scores in both during fatigue (90.78%) and before physical activity (90.83%). There was no significant correlation with rank or function of firefighters. Among the parameters of chest compressions evaluated in the third minute, the greatest effect of fatigue was shown in the aspect of the compression rate (59.42% vs. 49.20%) and depth (71.61% vs. 67.86%). CONCLUSIONS: Physical fatigue of firefighters results in moderate decrease in the effectiveness of chest compressions, especially in terms of the rate and depth of compressions. The overall quality of chest compressions is significantly higher in men than in women both before and after physical activity. The experience of firefighters can translate into the quality of resuscitation, regardless of their age.
Źródło:
Critical Care Innovations; 2023, 6, 4; 1-10
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Polish State Fire Service (SFS) response to out-of-hospital cardiac arrest (OHCA): a retrospective study
Autorzy:
Glinka, Marcin
Dudziński, Łukasz
Glinka, Paulina
Powiązania:
https://bibliotekanauki.pl/articles/29432089.pdf
Data publikacji:
2021-03
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Sudden cardiac arrest
OHCA
state fire service
medical incidents
Opis:
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death in developed countries, which is a leading public health problem. Saving endangered human life is a priority task for emergency services around the world. The aim of study was to analysis of OHCA cases for which the Fire Rescue Units (FRU) teams were ordered in situations that meet the criteria of the isolated emergency medical incidents (IEMI). MATERIAL AND METHODS: The study included a retrospective analysis of calls by Polish FRU to local medical threats over a period of 5 years. The data come from the Decision Support System for Fire Service. Quantitative data were described using classical measures: arithmetic means (M), standard deviations (SD), median (Me) and interquartile ranges (IQR). RESULTS: The total number of OHCA cases included was 94. The mean time between receipt of the IEMI call and arrival on scene was 6 minutes and 22 seconds (IQR = 4). ROSC occurred in 21 patients, which is 22.34% of all cases. An Automated External Defibrillator (AED) was used in 64 cases (68.09%). The analyzed victims were mostly men (76.59%). The mean age of the victims was 63.06 years (Me = 62 years). CONCLUSIONS:The results of the research are in line with global trends and show the role of early cardiopulmonary resuscitation. Sending FRU to OHCA in the case of non-availability of the EMT in the initial phase of the intervention is justified.
Źródło:
Critical Care Innovations; 2021, 4, 1; 21-29
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Anaesthetic management of a pregnant women taking sildenafil for intra uterine growth retardation undergoing caesarean section: a case report
Autorzy:
Kumar, Sandeep
Nayak, Sudhansu Sekhar
Yadav, Usha
Yadav, Rupesh
Powiązania:
https://bibliotekanauki.pl/articles/29432032.pdf
Data publikacji:
2024-03-31
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Caesarean section
hypotension
sildenafil
anaesthesia
Opis:
The role of Sildenafil was found in the potential weight gain of the foetus in pregnant women with intrauterine growth retardation (IUGR). Sildenafil acted by inhibiting phosphodiesterase type 5 (PDE5), which was an important enzyme responsible for the degradation of Cyclic guanosine monophosphate (cGMP), resulting in prolongation of action of cGMP and therefore prolonged smooth muscle relaxation and vasodilation of smooth muscle. The mechanism behind the beneficial effect on IUGR was its vasodilator action and, hence, an increase in uteroplacental circulation. But the main issue during anaesthesia was fear of severe hypotension, ocular side effects, and bleeding due to the effect of sildenafil. which was expected in pregnant women taking Sildenafil for intrauterine growth retardation undergoing caesarean section. Severe hypotension was due to augmentation of hypotensive effect of sildenafil and regional anaesthesia. A 29-year-old female, previously healthy, non-smoking, at 33 weeks’ period of gestation presented with complaints of headache and pedal edema in third trimester and was diagnosed with gestational hypertension. On the 28th day of admission, she had episodes of elevated blood pressure. The patient was considered for emergency caesarean section after taking high-risk consent. Techniques for cesarean sections include the single shot spinal technique, epidural catheter technique, or the combined spinal-epidural technique (CSE). While spinal anaesthesia offers a simpler approach with a faster and more reliable onset of surgical anaesthesia, it may be associated with abrupt hemodynamic changes. On the contrary, epidural anaesthesia allows for a gradual onset of sympathectomy, titrated dosing, and postoperative analgesia. In this case, the decision was made to opt for epidural anaesthesia over spinal approach was made to allow for careful drug titration and enhance hemodynamic stability. We conclude that graded epidural epidural anaesthesia played an important role in the prevention of hypotension that was expected in pregnant women taking Sildenafil for intrauterine growth retardation undergoing caesarean section.
Źródło:
Critical Care Innovations; 2024, 7, 1; 49-53
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Association of glycosylated hemoglobin with mortality of patients in intensive care unit: a prospective observation study
Autorzy:
Kumar, Damera Seshi
Wasnik, Seema Balkrishna
Yadav, Amlendu
Yadav, Rupesh
Powiązania:
https://bibliotekanauki.pl/articles/29432036.pdf
Data publikacji:
2024-03-31
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Glycated hemoglobin
intensive care unit
mortality
Opis:
INTRODUCTION: Glycated hemoglobin (HbA1c) is the most commonly used clinical test to estimate mean blood glucose during the past 2 to 3 months. In addition to diagnostic purposes, the HbA1c level also predicts diabetes complications. The aim of this study was to determine the association of glycosylated hemoglobin with mortality in intensive care unit (ICU). MATERIALS AND METHODS: A prospective observational study was conducted in the ICU with a total of 281 patients. These patients were classified into two groups based on their HbA1c levels: one group with HbA1c level < 6.5 % and another group with HbA1c level ≥ 6.5%. The following data were collected during the study period. Clinical details and scores such as the APACHE II score (Acute Physiology and Chronic Health Assessment) and daily SOFA (Sequential Organ Failure Assessment) scores for the period of stay in the ICU. ICU morbidities as the need for mechanical ventilation, the use of inotropes / vasopressors, the length of stay in the ICU, and the requirement of renal replacement therapy (RRT). The outcome measures were ICU mortality and 28-day mortality. RESULTS: Of 281 patients admitted to the ICU for more than 48 hours, 157 patients (55.9%) had HbA1c levels < 6.5%, with the remaining 124 (44.1%) had levels ≥ 6.5%. ICU mortality was present in 107 (38.07%) cases. ICU mortality was higher in patients in the HbA1c ≥ 6.5% group compared to the HbA1c < 6.5% group. This was statistically significant (p-value <0.001). Mortality at 28 days was observed in 125 (44.48%) cases. Patients with an HbA1c value ≥ 6.5%, there was a higher mortality at 28 days compared to patients with an HbA1c value < 6.5%. This was found to be statistically significant (p-value <0.001). CONCLUSIONS: The study showed that glycated hemoglobin levels (HbA1c) levels ≥ 6.5% had a significantly higher mortality rate compared to the patient in the HbA1c level < 6.5%.
Źródło:
Critical Care Innovations; 2024, 7, 1; 24-33
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Medical interventions of the Fire Service during the COVID-19 pandemic in Poland
Autorzy:
Dudziński, Łukasz
Glinka, Marcin
Glinka, Paulina
Powiązania:
https://bibliotekanauki.pl/articles/29432073.pdf
Data publikacji:
2021-06
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Pandemic
COVID-19
State Fire Service
isolated events of medical emergency
medical interventions
Opis:
INTRODUCTION: The rescue services which take interventions in the scene of accidents include the Fire Service officers. The tasks of the Fire Service carried out to serve the society include the cooperation with units of the Emergency Medical Services and performance of medical operations. The spreading of the COVID-19 pandemic led to many changes in daily public and private life, in the functioning of institutions, public offices, the healthcare system and the uniformed services. MATERIAL AND METHODS: The study included a retrospective analysis of departures of Polish fire-fighting units (FFU) for isolated events of medical emergency (IEMEs) in a two-year period: from March 2019 to the end of February 2021 (one year before the pandemic and one year during the pandemic in Poland). The data come from the EWID event recording programme and the Decision-Making Support System of the State Fire Service. The quantitative data were prepared depending on the distribution of the variable: the mean and the standard deviation (if the distribution was normal) and the median and the interquartile range (if the distribution was not normal). RESULTS: The studied period included 5272 events meeting the criteria for inclusion in the analysis. An increase by over 56% was seen in IEMEs in the pandemic year compared to the previous year. The dynamics of the IEME increase are identical to the waves of the pandemic occurring in Poland. A statistically significant correlation (p<0.001, R=0.93) was demonstrated between the number of coronavirus infections and the number of IEMEs in the pandemic period. CONCLUSIONS:The studied period included 5272 events meeting the criteria for inclusion in the analysis. An increase by over 56% was seen in IEMEs in the pandemic year compared to the previous year. The dynamics of the IEME increase are identical to the waves of the pandemic occurring in Poland. A statistically significant correlation (p<0.001, R=0.93) was demonstrated between the number of coronavirus infections and the number of IEMEs in the pandemic period.
Źródło:
Critical Care Innovations; 2021, 4, 2; 23-31
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Course of hospitalization of patients referred on an emergency basis due to bleeding into the gastrointestinal tract
Autorzy:
Bojanowski, Adrian
Mitura, Kryspin
Kisielewski, Krystian
Leszczyński, Piotr K.
Powiązania:
https://bibliotekanauki.pl/articles/29432093.pdf
Data publikacji:
2021-03
Wydawca:
Towarzystwo Pomocy Doraźnej
Tematy:
Gastrointestinal bleeding
hospital
blood count
admittance
Opis:
INTRODUCTION: Bleeding into the gastrointestinal tract in the prehospital setting is often a cause of a life-threatening condition. The vast majority of cases (80%) involve bleeding from the upper gastrointestinal tract and the mortality reaches even 14% of cases. It is then necessary to quickly diagnose and direct the patient for hospitalisation as the most effective treatment in the endoscopic therapy. The study aimed to analyse the profile of the patient referred to a hospital by a primary healthcare physician with suspicion and/or diagnosis of bleeding from the gastrointestinal tract. MATERIAL AND METHODS: The authors attempted to assess the initial laboratory results of critical parameters (RBC, HGB, HCT and PLT) of patients admitted on an emergency basis in 2017-2020 to the municipal hospital in Siedlce, Poland. The total number of patients with bleeding symptoms referred by a primary healthcare physician was 843. The inclusion procedure included patients referred on an emergency basis only (n=56). The statistical analysis was conducted by means of the Shapiro–Wilk test of normal distribution, Spearman's rho correlation and Chi-Square Tests of Independence. All results were regarded as significant at p < 0.05. RESULTS: The study included 32 males and 24 females referred in 60.71% of cases with the ICD-10 diagnosis of K92.2. The mean age of the patients was 65.02 years (SD±14.69). The mean hospitalisation time was 5.11 days (SD±12.14), both in males and females. The average blood test results in males were as follows: RBC: 3.28 106/μL; HGB: 9.26 g/dL; HCT: 27.94%; PLT: 229.13 103/μL, while in females: RBC: 3.26 106/μL; HGB: 9.76 g/dL; HCT: 29.12%; PLT: 240.33 103/μL. Therapy with packed red blood cells was significantly dependent on the level of RBC (p=0.000), HGB (p=0.001) and HCT (p=0.000). However, it was not dependent on PLT (p=0.141). A similar tendency was shown in the correlation of plasma therapy with critical values of selected laboratory tests (RBC: p=0,000; HGB: p=0.021; HCT: p=0.005; PLT: p=0.116). CONCLUSIONS:The hospitalisation of patients from the study group concerned mostly to older males, whose laboratory test results were usually much below the normal limits. Patients referred to hospital on an emergency basis usually warrant therapy related to deep anaemia. Despite a high survival rate, educational programmes aiming at early diagnosis of symptoms and implementation of diagnostics for bleeding from the gastrointestinal tract are to be considered.
WSTĘP: Krwawienia do przewodu pokarmowego w warunkach przedszpitalnych niejednokrotnie są przyczyną wystąpienia stanu zagrożenia życia. Zdecydowana większość przypadków (80%) dotyczy krwawienia z górnego odcinka przewodu pokarmowego, a śmiertelność wynosi wówczas nawet do 14% przypadków. Niezbędne jest wówczas szybkie rozpoznanie i skierowanie pacjenta na hospitalizację, gdyż najskuteczniejszym leczeniem jest terapia endoskopowa. Celem badania była analiza profilu pacjenta skierowanego do szpitala przez lekarza pierwszego kontaktu z podejrzeniem i/lub rozpoznaniem krwawienia z przewodu pokarmowego. MATERIAŁ I METODY: Autorzy podjęli próbę oceny wyjściowych wyników laboratoryjnych parametrów krytycznych (RBC, HGB, HCT, PLT) pacjentów przyjętych w trybie pilnym w latach 2017-2020 do szpitala miejskiego w Siedlcach, Polska. Łączna liczba chorych skierowanych przez lekarza pierwszego kontaktu z objawami krwawienia wynosiła 843. Procedura włączenia uwzględniała pacjentów skierowanych jedynie w trybie pilnym (n=56). Do opracowania statystycznego wykorzystano test normalności rozkładu zmiennych Shapiro-Wilka, korelację rho-Spearmana oraz testy niezależności Chi kwadrat. Wszystkie wyniki uznano za istotne przy p < 0,05. WYNIKI: Badaniem objęto 32 mężczyzn oraz 24 kobiety, kierowanych w 60,71% przypadkach z rozpoznaniem ICD-10: K92.2. Średnia wieku chorych wynosiła 65,02 lat (SD±14,69). Średnia długość hospitalizacji zarówno u kobiet jak i u mężczyzn wyniosła 5,11 dnia (SD±12,14). Wyniki krwi mężczyzn wynosiły średnio dla RBC: 3,28 106/µl; HGB: 9,26 g/dl; HCT: 27,94%; PLT: 229,13 103/µl, zaś u kobiet RBC: 3,26 106/µl; HGB: 9,76 g/dl; HCT: 29,12%; PLT: 240,33 103/µl. Terapia koncentratami krwinek czerwonych była istotnie zależna od wartości RBC (p=0,000), HGB (p=0,001) i HCT (p=0,000). Nie była jednak zależna od PLT (p=0,141). Podobną tendencję wykazała korelacja terapii osoczem z krytycznymi wartościami wybranych badań laboratoryjnych (RBC: p=0,000; HGB: p=0,021; HCT: p=0,005; PLT: p=0,116). WNIOSKI: Hospitalizacja pacjentów z grupy badanej dotyczyła przeważnie osób starszych płci męskiej, u których wyniki badań laboratoryjnych były zazwyczaj znacznie poniżej dolnej granic norm. Pacjenci kierowani do szpitala w trybie pilnym wymagają zazwyczaj terapii związanej z głęboką niedokrwistością. Pomimo wysokiego współczynnika przeżywalności należy rozważyć wdrożenie programów edukacyjnych mających na celu wcześniejsze rozpoznawanie objawów i wdrożenie diagnostyki w kierunku krwawienia z przewodu pokarmowego.
Źródło:
Critical Care Innovations; 2021, 4, 1; 11-20
2545-2533
Pojawia się w:
Critical Care Innovations
Dostawca treści:
Biblioteka Nauki
Artykuł
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