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  • Author: Mariusz Goniewicz x
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Meta-analysis of pain and stress in emergency department patients

Abstract

Introduction. In Poland, among patients coming to hospital emergency departments (ED), one third require immediate surgical treatment. About one third are transferred to long-term intensive care. The remaining patients require a different type of care, e.g. consultation, healing wounds, observation in the emergency department. From there, they might either be referred to another hospital department or sent home after receiving outpatient help.

Aim. The aim of this study was to determine the prevalence of pain and stress in patients treated in the emergency department with particular emphasis on the factors that determine their level.

Material and methods. The study group consisted of 200 individuals treated in the emergency department of the Regional Hospital No. 2 in Rzeszów in 2013. The applied research method was a diagnostic survey that used a questionnaire as a research tool. The results were statistically analyzed using SPSS 20, whereas a statistically significant dependence was considered in those with level of significance p≤0.05.

Results. Most respondents reported pain and feelings of stress while staying in the ED. Women and the unemployed were significantly less likely to report pain. Factors like gender, age, education level, and the coexistence of chronic diseases significantly affected the degree of stress among patients in the ED.

Conclusion. Each patient treated at the emergency department should receive holistic care, so that the pain and stress of his injuries are reduced as soon as possible.

Open access
Road accidents in the early days of the automotive industry

Abstract

The first recorded road fatality happened over 140 years ago. Since then, road accidents have become one of the main causes of concern in almost every country in the world. Nowadays, fatal motor vehicle crashes occur at an interval of 50 seconds and injuries happen every two seconds. According to the WHO, the world road death toll is nearly 1.3 million and 20-50 million of people have been badly injured in road accidents and usually require long and expensive treatment. This paper looks at the issue of road accidents in the earliest days of the automotive industry. The article looks at the first laws, which were introduced to improve road safety. Virtually every member of society is somewhat affected by road transport. All traffic participants are at risk of an accident to a certain degree which is why reducing this risk should become a priority.

Open access
Children road traffic injuries in Poland

Abstract

Road traffic injuries are the leading cause of child mortality in Poland, resulting in more deaths than cancer or birth defects. We present the main problems of road safety and the nature of the causes and consequences of accidents among children based on the World Health Organization Report. Children injuries are one of the main problems in modern medicine requiring vigorous and preventive actions. Children of all ages should be intensively involved in the educational activities related to road safety. Raising awareness concerning the risks associated with children’s participation in traffic as well as the awareness of parents and carers can greatly reduce the number of accidents.

Open access
The role and responsibilities of the raramedic in the State Medical Rescue System

Abstract

The profession of paramedic is a recent profession functioning in Poland since 1992. Over those 27 years the training, the role and responsibilities given to paramedics have undergone many changes. Initially, paramedics were trained in two-year colleges (post-secondary schools) and were not qualified to administer medical emergency treatment (medical rescue procedures) at the place of accidents. At present, they are educated at universities and are qualified to apply emergency medical treatment by themselves, inter alia to ensure the safe transport of the injured person in a life-threatening emergency, provide mental support to the injured, and carry out health education and promotion. Moreover, they are the core personnel of the State Medical Rescue System (PRM).

The goal of the study was to present the history of the establishment of paramedical profession and its current role and responsibilities in the PRM.

Open access
Analysis of the effectiveness concerning initiatives for pedestrians’ safety on roads: a questionnaire survey

Abstract

Introduction. One of the most important issues and challenges of public safety policy in highly developed countries is the problem of ensuring road safety, along with dealing with health and material losses resulted from accidents. Unfortunately, Poland, in comparison to other EU countries, has one of the worst statistics regarding accidents and mortality ratios, therefore it is essential to undertake long-term actions aimed at improving road safety, as well as educating drivers and pedestrians.

Aim. The purpose of this study is to analyse the problem and to investigate whether traffic safety campaigns are effective, and if they reach young audience.

Material and methods. The research was conducted in the first quarter of 2018 among the students of Faculty of Health Sciences of the Medical University of Lublin. The study method applied was a diagnostic survey, and the tool was an original questionnaire. The participation was voluntary and anonymous. The obtained results were the subject of later statistical analysis. As many as 153 young respondents aged between 18 and 25 were tested, out of whom 73.68% were women and 26.32% were men.

Results. Over half of the surveyed (56.3%) declared walking as the main form of participation in traffic, and 25.9% of the surveyed used public transport. The most numerous group of the examined (34.21%) thought that the Polish roads were rather unsafe. As the reasons for the low safety on the Polish roads the respondents identified: bad condition of the roads (69.1%), drivers’ recklessness (67.1%), and maladjustment of the driving style to weather conditions (60.5%). All respondents have encountered campaigns concerning road safety, however not too often (56.58% less than once a month). The surveyed encountered these social campaigns on TV (88.2%), on the Internet (54.6%), and on billboards (23.7%).

Conclusion. Promotional campaigns concerning road safety have a greater impact on women. In the examined group, around 67% of women changed their behaviour as a result of the campaigns, and only 42.5% of men. Social campaign which was best remembered, and had the biggest influence on the respondents (50.3%) was „Say STOP to reckless driver you love”.

Open access
Comparison of two treatment methods of congenital clubfoot in the orthopaedists’ opinion

Abstract

Introduction. Clubfoot is the second most common birth defect of the lower limb. In Europe (including Poland) it concerns about 1-2 in 1000 newborns. What is characteristic for a clubfoot, is change in the foot shape and its impairment with preserving anatomical structures.

Aim. The aim of this work is to gather opinions of orthopedic physicians on the effectiveness of the two methods used to treat congenital clubfoot: the Turco method and the Ponseti method.

Material and methods. The research method used in the work was a diagnostic survey and research technique was the author’s questionnaire designed to gather opinions of orthopedic surgeons on the two methods of clubfoot treatment. The questionnaires were collected in the Orthopaedic Clinics in Lublin and Rzeszów, as well as during the specialization courses for orthopaedic surgeons in Lublin.

Results. The most important advantages of the Ponseti method according to respondents are high clinical effectiveness (average 4.48) and short duration of hospitalization (average 4.31). While the most important disadvantages of the method is length of rehabilitation (average 2.85) and convalescence (average 2.36). Top assets of the Turco method in turn, according to respondents, are high clinical efficiency (average 2.92) and certainty of the patient’s recovery (2.74). In turn, the downsides of the Turco method according to the respondents are high invasiveness (average 4.11) and length of convalescence (average 3.87).

Conclusion. The Ponseti method is the surveyed doctors’ preferred method of congenital clubfoot treatment.

Open access
Return of spontaneous circulation and heart rhythm during the first analysis of the heart electrical activity

Abstract

Introduction. Return of spontaneous circulation (ROSC) of a patient with cardiac arrest is the main goal of carrying out cardiopulmonary resuscitation.

Aim. Evaluation of frequency of return of spontaneous circulation depending on the heart rhythms in the first moment of heart electrical activity.

Material and methods. Analysis of 105 cases of sudden cardiac arrest in out-of-hospital conditions on the premises of Brzozow Emergency Medical Service from September 2016 to the end of February 2018. The data was collected from intervention medical cards and medical rescue procedure cards. Statistical analysis was carried out using STATISTICA software. Statistical significance was assumed to be p<0.05.

Results. Sudden cardiac arrest in the analysed group applied to 62.9% of men. Return of spontaneous circulation was achieved only in 16 out of 105 cases (15.2%) of sudden cardiac arrest. The analysis has indicated that ROSC was successful among 66.67% of patients, who during the first analysis of the rhythm, represented cardiac arrest in VF/pVT, what constituted 75% of all ROSC cases in the analysed group. Comparison between ROSC and rhythm during the first evaluation of the rhythm showed statistical significance (p=0.00). Statistical significance was also shown in the relationship between ROSC and the average age of the patient (p=0.0155).

Conclusions. Sudden cardiac arrest, when diagnosed in the first analysis of the rhythm VF/pVT, has bigger chances for return of spontaneous circulation than it has in other rhythms.

Open access
Frequency of hospitalization in patients diagnosed with congenital talipes equinovarus (CTEV)

Abstract

Introduction. Congenital talipes equinovarus (CTEV), also called clubfoot is the second after congenital dysplasia of the hip (CDH) most frequently occurring congenital limb defect. In Europe the deformity affects 1-2 newborns in 1000 live births.

Aim. The aim of the study was to determine frequency of the deformity among other reasons for hospitalization, as well as depicting the profile of patients treated for clubfoot.

Material and methods. Study method was the analysis of medical documentation from two Orthopaedic Wards of Prof. Antoni Gębala Children’s Hospital of Lublin. Medical records of patients treated for congenital talipes equinovarus (IDC 10-Q66.0) between 2008 and 2013 were the study material.

Results. Results of the study show that in the analyzed period of time 310 children were hospitalized for clubfoot in hospotal. 39.35% (n=122) of the total number of patients were girls and 60.65% (n=188) were boys. The average age of patients was 3.69 years, (Me=1.09 years). Average age of girls was 4.17 (Me=1.35 years) and boys 3.89 (Me=0.83 years). The most numerous group consisted of infants up to 1 year (n=154; 49.68%).

Conclusions. Clubfoot affects boys twice as often as girls. Moreover, in the examined hospital the average length of stay for patients with clubfoot has decreased. The research reveals that the average hospitalization length in children with congenital talipes equinovarus is systematically decreasing. The study shows that the number of patients being admitted to the Children’s Orthopedics Institute of the Hospital is increasing while the number of patients with clubfoot remains on the same level.

Open access
Public awareness about the use of automatic external defibrillator (AED) in giving first aid

Abstract

Introduction. Chances for survival of a patient who has suffered from sudden cardiac arrest (SCA) depend on a number of factors. One of the most important however, is the time within which the patient is provided with actions to restore normal heart function. In the Guidelines for Resuscitation 2015, The European Resuscitation Council states that defibrillation done within 3-5 minutes since a patient with SCA lost his/her consciousness can increase the survival rate up to 50-70%. However, such a short time of providing help is only achievable through the implementation of universal defibrillation programs and the automatic external defibrillator (AED) devices densely distributed in public places. By contrast, every minute of delay in defibrillation reduces the probability of survival by approximately 10-12% until the hospital discharge.

Aim. The purpose of the research was to elicit the opinions of adult respondents on first aid and the use of automatic external defibrillator (AED).

Material and methods. The research method used in this paper was a diagnostic survey, the technique was a web-based questionnaire, and a research tool was the authors’ own questionnaire survey. The survey was active between April 8, 2016 and May 20, 2016. During this time, 116 opinions were collected.

Results. As many as 77% of respondents declared that they had attended a first aid course, but 21% of them stated that they no longer remembered the knowledge acquired. The number of 63% of respondents did not know what an automatic external defibrillator is. Only 27% of respondents knew that AEDs are public devices, and only 47% believed that using an AED would not worsen the health of the victim.

Conclusions. The availability of AEDs and knowledge of their use are insufficient. Low social awareness and irrational fear of using an AED (fear of deterioration of the victim’s health) support the need for continuing education in this area.

Open access
Safety of intramuscular injections in medical rescue

Abstract

Injection is the delivery of medication into the tissues. It is the administration of medication by means of a needle (cannula) into the body tissues, cavities or blood vessels. An injection is one of aseptic procedures, i.e. those that require the use of sterile equipment, sterile medication, and treatment in compliance with the principles of asepsis. Failure to observe these rules as well as those that have to be followed in connection with the delivery of medication regardless of the route of administration may result in many complications. The administration of medications by paramedics is one of their competencies defined in the Regulation of Health Minister of 20 April 2016 on the medical emergency treatment and health services other than medical emergency treatment that can be provided by a paramedic. A paramedic can himself administer 47 drugs specified in the foregoing Regulation, and he can also administer other drugs as ordered by a doctor. The article describes the principles of safe intramuscular injection as one of the methods of administering medication in emergency medicine.

Open access