Medical Rescue Teams Research Articles

Analysis of the use of nitroglycerin in pre-hospital procedure by medical rescue teams in patients with acute coronary syndrome (ACS STEMI), with particular regard to a closed right coronary artery

Introduction: Currently, cardiological societies and associations do not recommend the use of nitroglycerin in patients with acute coronary syndrome ST-elevation myocardial infarction (ACS STEMI). However, an analysis of medical rescue practice shows that this medicine is still being used. The aim of this study is to conduct a correlation analysis of the use of nitroglycerin by medical rescue teams (MRT) in patients with ACS STEMI and its impact on selected biochemical parameters. Materials and methods: The study group consisted of 312 patients. Data for these patients over a period of 8 years (2009–2017) was analysed. A retrospective study of the dispatch orders for MRT, including primary transport was conducted. Results: Coronary angiography revealed a closed right coronary artery (RCA) in 312 patients. In 210 patients, the MRT administered nitroglycerin during pre-hospital procedure, where RCA closure was confirmed in a coronary angiography. After administering nitroglycerin and discovering an RCA occlusion, more favourable results of biochemical parameters and statistical differences between the groups in Killip class were shown (p = 0.022). Lower values of Troponin I and creatine kinase–myocardial band (CK-MB) max. parameters as well as higher cardiac ejection fraction (left ventricular ejection fraction – LVEF) were observed after administering nitroglycerin (no statistical significance). Conclusions: It was not clearly demonstrated that the use or non-use of nitroglycerin at the pre-hospital stage (1–2 doses of the drug) negatively affected the patient’s condition. At the same time, it was shown that the use of nitroglycerin at the pre-hospital stage, and the lack of nitroglycerin administration at hospital resulted in lower, selected biochemical parameters, and that theuse of nitroglycerin had a significant impact on the Killip class.

The Regulation on Emergencies in Workplaces: Applicability in a University Hospital

Introduction: Hospitals provide healthcare services to society during and after emergencies. Therefore, the hospitals should be well-prepared for emergencies and have easy applicable, and efficient emergency plans. We aimed to investigate the applicability of emergency regulations in a university hospital. Methods: It is a descriptive study in which the current emergency plan of a university hospital is compared with the regulations and legislation in effect in Turkey. The number of teams and officials included in the teams in the current legislative emergency plan are identified and compared to the available emergency teams in a hospital for the present study. Results: The present study identified the potential emergencies in accordance with the “Regulation on Emergencies in Workplaces” and the conditions in the particular region and hospital. 16 teams were identified for these emergencies and the number of officials in each team was confirmed. In the current staff of the hospital, there were 12 teams. Additionally, three teams were identified in the current hospital team that was not stated in the regulation. Although stipulated in the regulations, chemical, biological, radiological, and nuclear teams, and national medical rescue teams were not available in the hospital. Therefore, these teams and the number of officials in each team were determined. Discussion: Due to the geopolitical location of Turkey, the high disaster risk in the region, and the history of disasters, all hospitals should have applicable and constantly updated emergency plans. The number of teams in emergency plans and the number of officials in these teams should be arranged under current legislation, size of the hospitals, risk analyses, and functionality. With this study, we determined the emergency teams and the number of staff in the hospital.

Atrial fibrillation as a frequent reason for calls by Emergency Medical Teams

Introduction. Atrial fibrillation is the most common supraventricular arrhythmia which is also a frequent cause of calls by Emergency Medical Services Teams.The purpose of the work was presentation of the conduct of the Medical Rescue Teams in about patients with atrial fibrillation. Research methodology. The study included an 86-year-old woman who was called by the Medical Rescue Team due to increasing weakness accompanied by chest pain and dyspnoea. At the patient after a thorough medical history and physical examination, the first episode of atrial fibrillation was found. An individual case study method was used. The study was conducted on the basis of a medical rescue cardthose. Conclusions.There is no one size fits all regimen for the management of patients with atrial fibrillation. There are algorithms that facilitate the implementation of appropriate treatment. The rescue operation must always be tailored to the individualthe patient's health status and modified as necessary. Thanks to this procedure, paramedics minimize the chances of making a mistake and improve the patient's health.

ASSESSMENT OF INTERVENTIONS COMPLETED BY THE VOIVODESHIP RESCUE SERVICE IN KATOWICE IN THE SILESIAN VOIVODESHIP IN 2018 DUE TO INJURIES

Aim: To assess the trips made by Emergency Medical Teams due to injuries (ICD-10 code: S) completed by Voivodeship Medical Rescue Teams in Katowice in 2018. Material and methods: Analysis of the characteristics of the trips was done based on information contained on “Emergency ambulance travel cards”. Statistical analysis was carried out using the t-Student, ANOVA variance as well as the Tukey post-hoc tests (p<0.05). Results: The whole number of trips made by the Emergency Medical Teams in the Silesian Voivodeship totalled 211,896, of which due to the reported injury, the total number of trips was 202,946 cases (183,827 calls were in town – 91%; 19,119 calls were out of town – 9%; p<0.05). The most common cause for calls were due to head injuries (S03 – dislocation, sprain and strain of joints and ligaments of the head as well as S04 – cranial nerve injuries). Statistically significant differences in the number of trips depending on cause identification (p<0.05) were determined, as well as in comparison to the number of cases identified as S03 and S04 between the in town and out of town territory (p<0.05). The median arrival time to an in town site was 7 minutes and 42 second, whereas in out of town sites it was 13 minutes and 19 seconds. Conclusion: The characteristics of the trips made by Emergency Medical Teams depends on the time, and what is affected by organizational changes in the emergency medical system.

Pain as a determinant of outgoing dispatch to events for Basic and Specialist Medical Rescue Teams on the example of the city of one of the selected provinces in Poland

Pain is perceived by patients as a multi-stage component of feelings and ailments that have accompanied the individual since the dawn of time. Diagnostics of pain is a problem that is subject to constant analysis in order to eliminate the symptoms that repeatedly constitute the basis for qualifying them to take medical actions to relieve pain and ensure full psycho-physical comfort. Pain is repeatedly a component of the ongoing pathological process in the body.

Complaints against Medical Rescue Teams and their members submitted to District and Regional Courts within the area of District Court in Kielce and Katowice in the years 2014-2019

Today's medical rescue in pre-hospital care is a series of ongoing legal and administrative changes and regulations, increasing the scope of competence of medical rescuers working in - basic Medical Rescue Teams. The decreasing number of specialist Emergency Medical Teams, in the continuous process of system changes, makes paramedics face even greater responsibility in terms of performing medical rescue operations and possible errors that hang over paramedics in their everyday work. Demanding patients and their families, the growing number of many private insurance claim law firms dealing with the medical cases is another piece of the puzzle that today sets a bruising path in the search for property benefits and compensation in the form of lawsuits brought to Medical Rescue Teams and their members.

A Readiness of Areas and Space Planning in Houses Supporting Emergency Services for Fall Injuries in The Elderly

The global population structure is currently stepping into an aging society. In the change of the world population structure, critical care of older adults from fall injuries at home is a major public health issue since the falls can lead to disability or death. By reviewing the architectural design research, most studies focus on the design approaches aiming to reduce the risk of fall accidents occurred among the elderly. However, no study has investigated the correlation of architectural design in supporting the medical care of seniors after slip and fall accidents. Therefore, this research aims to evaluate area and space planning of typical three single houses supporting emergency medical care for falling accidents amongst the elderly. The study firstly investigates the activities and the area required for the medical operation by interviewing medical specialists and rescue teams from two hospitals and two related agencies. Then, the activities and area requirements are mapped with the room layout of three typical single houses located in the Bangkok neighborhood areas. It is found that the designed layout and room area of all studied houses inadequately supports for emergency situations, which has only two available areas from a total of thirteen areas. The details of the space availability and obstacles for emergency medical care are discussed and proposed for improving the space planning and layout of the house for future work.

Two-stage multi-sided matching dispatching models based on improved BPR function with probabilistic linguistic term sets

Disaster has great destructiveness and a wide influence on urban and rural construction, and more than one place is affected by disaster. Thus, it needs to take multiple disaster points into account. In view of different rescue missions, both medical rescue teams and search rescue teams also need to be dispatched. That is the multi-sided matching among medical rescue teams, search rescue teams and disaster points. Firstly, we describe the matching process, including the related symbols used in the process, and define a concept called multi-sided matching. Then, we aim to solve two problems: determining the competency degree of rescuers and calculating the time reliability of rescue teams arriving at disaster points. For the first one, we invite experts to evaluate pending rescue teams in terms of professional ability and collaboration ability using probabilistic linguistic term sets (PLTSs) because PLTSs not only keep original linguistic information but also give distributed expressions. For the second one, we determine the arriving time and calculating the time reliability by using the improved Bureau of Public Road (BPR) function. After that, we construct the two-stage multi-sided matching programming models based on the improved BPR function and PLTSs. Finally, a case study is used to demonstrate the proposed matching process, some comparative analyses and discussions are also conducted to validate the proposed models.

Proceedings of an emergency medical team (paramedics) with a patient in anaphylaxis

Introduction: Anaphylactic shock is an acute allergic body reaction to allergens. This condition threatens the patient's life and health. Anaphylaxis can be caused by intolerance to many nutrients, medications or hymenoptera stings.Aim of the manuscript: The aim of the manuscript was to determine the pattern of proceedings of emergency medical teams with patients in anaphylactic shock.Material and methods: The individual case method of a patient stung by a Hymenoptera insect, for whom a medical rescue team was dispatched, was used. The research material was obtained thanks to the analysis of medical rescue operations and dispatch orders.Results: The analysis of medical records of the injured person depicted an appropriate algorithm of proceedings with a patient in anaphylactic shock. In anaphylaxis, it is important to gather information as soon as possible, make an accurate and prompt diagnosis, and provide immediate pharmacotherapy. In this case, the first-line drug is Adrenaline, which prevents the release of histamine and reverses the effects of shock. Further treatment requires oxygen, fluids and second-line pharmacotherapy. Conclusions: The emergency medical team followed the applicable algorithms and current knowledge. It implemented appropriate medical rescue operations, thanks to which the condition of the injured was stabilized. The first step is to stop the exposure to the allergen.

Role of Anesthesia Nurses in the Treatment and Management of Patients With COVID-19

As the backbone for the treatment of patients with coronavirus disease 2019 (COVID-19), nurses have been playing key roles in cabin hospitals, isolation wards, and intensive care units for critical cases. Anesthesia nurses have their own professional specialties, such as airway management, the use and maintenance of life support equipment, including ventilators, and the use of high-flow oxygen equipment. With rich experience in emergency responses and nursing, anesthesia nurses, along with emergency nurses and critical care nurses, play important roles during the treatment of patients with COVID-19. In our hospital, 27 of 34 anesthesia nurses participated in the front-line fight against COVID-19 and did an excellent job. Anesthesia care by nurses is relatively new in China, and the role of anesthesia nurses during a disaster response has not been fully appreciated. Given their specialty, anesthesia nurses have played important roles in the treatment of patients with COVID-19. We hope that authorities will consider including anesthesia nurses in national disaster response medical rescue teams.

Teletransmission as a useful method in the conduct of Medical Rescue Teams

Introduction: Emergency medical services, during their activities, must diagnose conditions directly threatening the patient’s life and health, implement appropriate procedures, secure the patient, and transport them to a place where they can be given more appropriate assistance in the shortest possible time. Performing teletransmission significantly reduces the time to provide the patient with proper, life-saving assistance. In this study the authors undertook an analysis of teletransmissions carried out by the teams of EMS. These data are to be used to assess the MRT activities depending on the hospital to which the patient was transferred. Material and methods: The information was obtained based on the analysis of MRT exit cards working in the area of the Sokolowski powiat and the city of Sokolow Podlaski. The author analysed 3804 travel cards of the MRT 04-51, 04-52, 04-54 teams in Sokolow Podlaski and Kosow Lacki in 2018, distinguished 147 cards during which the teams performed teletransmission to the Haemodynamics Centre in Siedlce. Then the exit cards were analysed according to the patient’s age, and then the time elapsed from departure to arrival at the place of call and from arrival to the moment of transferring the patient to the hospital, broken down by urgency code of departure: code 1 (C1) and code 2 (C2). P < 0.05 was adopted as the significance level. Results: The average age of teletransmitted patients was 69.8 ± 17 years, and the average age without teletransmission was 65.8 ± 23.6 years (p = 0.042). The time elapsed from reaching the patient to the time of transfer in the hospital for patients who were teletransmitted was 49.1 ± 16.1 minutes, and for patients who were not it was 39 ± 22.2 minutes (p < 0.001). The average time to reach the patient in the code 1 was 10.9 ± 7.4 minutes, and in the code 2 it was 14.5 ± 17.9 min (p < 0.001). It was shown that the patient’s age did not affect the time of departure and arrival at the place of call (r = 0.075), nor the time of transferring the patient to the hospital (r = 0.027). Conclusions: 1. The results obtained show the need to perform the teletransmission procedure as soon as possible and to apply appropriate treatment by MRT. This can significantly reduce the time to balloon a clogged vessel or attach a stent. 2. Performing teletransmission extends the time of patient transfer in hospital by nearly 10 minutes 3. Considering the place of patient transfer in ER or ED, both the age of the patients, times from the MRT departure to arrival at the call site, and the time from arrival at the place of call to transfer in hospital turned out to be statistically significant.

Roles of the public-facility-turned temporary hospital in prevention and control of coronavirus disease 2019 in Wuhan, China and clinical experience in the hospital

Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, the public-facility-turned temporary hospital (PFTH) has played an important role in preventing the spread of the epidemic. Wuchang PFTH is the first one to put into clinical practice and the last one suspended in Wuhan. The National Emergency Medical Rescue Team of the Second Xiangya Hospital of Central South University, together with other 13 medical teams (841 medical staff in total), have fulfilled the task for the treatment of non-severe COVID-19 patients, without any medical staff infected. The first author of the article was the only pediatrician working in the Wuchang PFTH. The author describes and summarizes the features/functions, management/operations, and advantages/challenges of the PFTH, in order to provide reference for medical institutions and relevant departments to deal with public health emergencies.

Supporting the battle against COVID-19 in E'zhou, Hubei Province: the experience of Guizhou medical team

To suppress the rapid spread of coronavirus disease 2019 (COVID-19) in Hubei province, a medical rescue team consisting of 860 members was sent to E'zhou, one of the hard-hit cities in east Hubei. A total of 414 of the team members, whose core members were from Guizhou Medical University and its Affiliated Hospital, took over the full operation of Leishan hospital of E'zhou, a makeshift hospital built for treating COVID-19 patients. Under the instructions by the E'zhou Medical Team Front Command, the staff made quick responses to the surging number of patients with COVID-19 and rapidly formulated treatment plans based on the local conditions. The medical team efficiently carried out the operations and successfully completed the rescue mission. Herein the authors, as members of Guizhou Medical Team supporting COVID-19 containment in E'zhou, analyze and summarize the experiences of Guizhou Medical Team with the organization, implementation and logistic support of medical rescue operations, which may provide reference for future rescue missions in a similar scenario.

Risk Management of COVID-19 by Universities in China

The rapid spread of new coronaviruses throughout China and the world in 2019–2020 has had a great impact on China’s economic and social development. As the backbone of Chinese society, Chinese universities have made significant contributions to emergency risk management. Such contributions have been made primarily in the following areas: alumni resource collection, medical rescue and emergency management, mental health maintenance, control of staff mobility, and innovation in online education models. Through the support of these methods, Chinese universities have played a positive role in the prevention and control of the epidemic situation. However, they also face the problems of alumni’s economic development difficulties, the risk of deadly infection to medical rescue teams and health workers, infection of teachers and students, and the unsatisfactory application of information technology in resolving the crisis. In response to these risks and emergency problems, we propose some corresponding solutions for public dissemination, including issues related to medical security, emergency research, professional assistance, positive communication, and hierarchical information-based teaching.

SEVERE METHEMOGLOBINEMIA WITH UNKNOWN CAUSE – CASE REPORT

The aim: Methemoglobina is an oxidized form of hemoglobin, which normally doesn`t exceed 1%. It is stated that the amount of methemoglobin over 70% is fatal. The etiology vary, it might for instance be idiopathic, congenital or caused by toxic compounds. Material and methods: We analyzed the case of patient who had exceeded the fatal level of methemoglobin in a blood. Case report: Medical Air Rescue Team was dispatched to an 80-year-old patient who suddenly lost consciousness at home. Methemoglobin level was measured using Cobas b221 system and amounted to 75%. Given the patient’s advanced age, congenital causes of methemoglobinemia, such as deficiency of cytochrome-b5 reductase or nicotinamide adenine dinucleotide reductase (NADPH-MHb reductase) were excluded a priori. It seems that the only reason for the observed methemoglobinemia in the case of the examined patient was the acquired methemoglobinemia. The patient was treated with methylene blue with good results, her state improved soon. Despite a detailed interview, it was impossible to establish the etiological factor of methemoglobinemia. None of the household members exhibited clinical symptoms of poisoning with methemoglobinogenic substance. Although the methemoglobin level was potentially deadly, the patients survived. Conclusion: It should be stressed that it is not always possible to determine the etiological factor of the discussed disorders. Knowledge of the clinical picture of poisoning, as well as of the changes characteristic for poisoning and observable in laboratory, is extremely important, especially when it is not possible to determine the etiological factor of poisoning.

Status of occupational protection in the COVID-19 Fangcang Shelter Hospital in Wuhan, China

ABSTRACT Staff and employees “Zero infection” has been achieved during the whole medical activities in the COVID-19 Fangcang Shelter Hospital in Wuhan, China. This study analyses the personnel and environmental protection status of the East–West Lake Fangcang Shelter Hospital. The HCWs were mostly composed of national medical rescue teams, from different provinces in China. Before the COVID-19 outbreak, 82.64% of the HCWs had already known the proper procedure of wearing masks and other personal protective equipment (PPE). For the total of 634 participants entering the inpatient areas, 99.8% of them took occupational protection trainings via various methods. By carefully training and supervision, most of them were competent to work in the inpatient areas six hours/d, three-four times/week. Besides, 7.8% experienced different types of occupational exposure, which mainly caused by the damage of PPE. Once exposed, the HCWs would disinfect skin or mucous in time. No SARS-CoV-2 RNA was detected in 48 air and environmental samples after regular disinfection and cleaning. To conclude, the bundle including intensive training, strengthened personal protection, strict environmental disinfection and timely remedial measures for occupational exposure had ensured the safety of the East–West Lake Fangcang Shelter Hospital.

Emergency healthcare providers perception of workplace dangers in the polish Emergency Medical Service: a multi-centre survey study

INTRODUCTION: There are many risk factors that account for hazards in paramedics’ and ambulance nurses’ profession. Driving a vehicle, having contact with patients, making difficult medical decisions, doing night shifts and working in a stressful environment, all of those features negatively affect their health. The aim of the study was to evaluate paramedics’ and ambulance nurses attitude towards personal safety, to assess their subjective feeling of danger, as well as identify types of hazards they experience. MATERIAL AND METHODS: The study was carried out via a diagnostic survey method, an anonymous questionnaire. Among 572 responders there were nurses and paramedics, who work in non-physician medical rescue teams in Poland. RESULTS: Most of the surveyed medics (40.5%) have rated the level of danger of their occupation to 4 on a scale from 1 to 5, with the greatest hazard being posed by patients under the influence of designer drugs. As many as 43% of medics have had back-related problems and 41% have suffered injuries at work. Notwithstanding, a majority of respondents have admitted that if they could plan their career again, they would choose the same profession. CONCLUSIONS: Prehospital healthcare providers have generally rated their work as dangerous. More attention should be paid to teach first responders how to deal with aggression and how to handle stress. Efforts should be made to increase paramedics’ and nurses’ awareness about health problems related to shift work.

State Medical Emergency System in Poland

The first ambulance service in Poland was established in 1891 in Cracow. Many tips and assistance concerning the creation of the ambulance were provided by the organisers of the first ambulance in Europe (the Vienna ambulance in 1883). Since January 2007, the Act of 8 September 2006 on the National Medical Rescue Service has been a binding legal act. The aim of the Act is to introduce the functioning of the emergency medical system, both through a high level of health services based on the standards of Western countries and providing the required solutions in the area of emergency notification. The State Medical Rescue System was established to provide assistance to any person in need who is in a state of health emergency. The owner of the PRM system unit must ensure the readiness of people, resources and organizational units. The units of the PRM system providing services only in case of an emergency are: medical rescue teams, including airborne medical rescue teams and hospital emergency departments.

Sign Board Monitoring and Vehicle Accident Detection System Using IoT

Abstarct: The Rapid growth of technology and infrastructure has made our lives easier. The advent of technology has also increased the traffic hazards and the road accidents take place frequently which causes huge loss of life and property because of the poor emergency facilities. Our project will provide an optimum solution to this draw back. According to this project when a vehicle meets with an accident immediately Vibration sensor will detect the signal or if a car rolls over, and vibration sensor will detects the signal and sends it to RASPBERRY PI controller. Alcohol detection, eye blink is performed by the RASPBERRY PI Microcontroller sends, it alert mail through the IOT to the parents or a rescue team. So the person can immediately then after conforming the location necessary action will be taken. If the person meets with a small accident or if there is no serious threat to anyone’s life, then the alert message can be terminated by the driver by a switch provided in order to avoid wasting the valuable time of the medical rescue team. This paper is useful in detecting the accident precisely by means of both vibration sensor and Alcohol detection, eye blink sensor.. As there is a scope for improvement and as a future implementation we can add a wireless webcam for capturing the images which will help in providing driver’s assistance.

The specificity of work at the Emergency Medical Services and the psychological support of medical rescuers

Abstract Introduction: Professional work is an extremely important aspect of the life of an adult. Probably we all want to be satisfied with this, and not just financially. It can be a source of positive experiences, but also a huge negative burden. It often generates and provides us with many adverse reactions, strains or stresses. The aim of the study was to determine the current status of psychological support to Medical Rescue Teams, and the opinions of medical rescuers on the need for psychological help in their work. Materials and methods: A questionnaire was addressed to medical rescuers across the country; 115 respondents participated in the study. It was conducted in April 2016. A statistical analysis of results was performed using the statistical package PQStat ver. 1.6. Analyses of dependences were carried out with χ2 tests. Significance was considered at p &lt; 0.05, and highly significant was taken at p &lt; 0.01. Results: Almost 90% of respondents had never taken part in a psychological workshop. About 80% of medical rescuers had never participated in training courses on the techniques of relieving tension. In the workplaces of 98 (85.2%) of the medical rescuers, there had never been any group meetings held in which stress was relieved via conversation. Sometimes such meetings were held in the workplaces of 17 (14.8%) of the medical rescuers. More than the half of respondents, 72 (62.6%) people, believe that such meetings are definitely needed and could be effective. Conclusions: 1. The current level of psychological support for Medical Rescue Teams is negligible. Only in a few workplaces it is offered to the medical rescuers. The majority of the study group were not provided access to a psychologist. 2. Medical rescuers believe that the profession requires working with a psychologist, and this cooperation should be ensured by the employer. 3. In 85.2% of cases there were no conversational meetings after difficult actions, with analysis and relieving of emotional tensions. If such meetings were held, almost 90% of respondents would participate. 4. The current ways of reducing stress for medical rescuers are not always safe for their health and can lead to addictions. A possible cause is non-attendance by the majority in workshops on the techniques of relieving tension and psychological training.