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Darocha T, Kosinski S, Serednicki W, Derkowski T, Podsiadlo P, Szpor J, Sanak T, Galazkowski R. Prehospital emergency thoracotomy performed by helicopter emergency medical service team: A case report. ULUS TRAVMA ACIL CER 2019; 25:303-306. [PMID: 31135944 DOI: 10.5505/tjtes.2018.50284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Emergency thoracotomy can be a life-saving procedure in critically injured patients who present with chest injuries. Currently, the indications for an on-the-scene thoracotomy are penetrating trauma of the chest or upper abdomen with cardiac arrest that has occurred in the presence of an emergency team or within 10 minutes prior to their arrival. The indications for an emergency thoracotomy in blunt chest trauma are less clearly defined. In the present case, a helicopter emergency medical service (HEMS) team performed an emergency thoracotomy at the scene. To the best of our knowledge, it is the first description of such a procedure in Poland. A 41-year-old male was crushed in a tractor accident. Though all available measures were taken, a sudden cardiac arrest occurred. The HEMS team performed an emergency thoracotomy at the scene as an integral part of prehospital cardiopulmonary arrest management. The patient survived, and was later discharged from the hospital in good physical condition. No neurological deficit was identified (cerebral performance category 1). The patient returned to his previous activities with no complications or deficits. The presence of a fully trained crew allows for the performance of a potentially critical on-the-scene emergency thoracotomy. In a well-selected group of patients with blunt thoracic injury, a prehospital emergency thoracotomy may be a significant and life-saving procedure.
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Affiliation(s)
- Tomasz Darocha
- Department of Anesthesiology and Intensive Care, Medical University of Silesia, Medykow 14, Katowice, Poland
| | - Sylweriusz Kosinski
- Department of Anesthesiology and Intensive Care, Pulmonary Hospital, Gladkie 1, Zakopane, Poland
| | - Wojciech Serednicki
- Department of Anesthesiology and Intensive Care, Trauma Center, University Hospital, Kopernika 36, Krakow, Poland
| | | | | | - Jan Szpor
- Department of Anesthesiology and Intensive Care, Trauma Center, University Hospital, Kopernika 36, Krakow, Poland
| | - Tomasz Sanak
- Department of Disaster Medicine and Emergency Care, Jagiellonian University Medical College, Krakow, Poland
| | - Robert Galazkowski
- Department of Emergency Medical Services, Medical University of Warsaw, Zwirki i Wigury 61, Warsaw, Poland
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Nadolny K, Szarpak L, Gotlib J, Panczyk M, Sterlinski M, Ladny JR, Smereka J, Galazkowski R. An analysis of the relationship between the applied medical rescue actions and the return of spontaneous circulation in adults with out-of-hospital sudden cardiac arrest. Medicine (Baltimore) 2018; 97:e11607. [PMID: 30045296 PMCID: PMC6078650 DOI: 10.1097/md.0000000000011607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022] Open
Abstract
Sudden cardiac arrest (SCA) is a significant medical and social issue, the main cause of death in Europe and the United States.The aim of the research was to evaluate the effectiveness of emergency medical procedures applied by emergency medical teams in prehospital care in the context of return of spontaneous circulation (ROSC).The case-control study was based on the medical documentation of the Rescue Service in Katowice (responsible for monitoring 2.7 million inhabitants of the region) referring to 2016. The research involved exclusively adults (ie, individuals older than 18 years) with out-of-hospital cardiac arrest (OHCA). After considering the above inclusion criteria, there were 1603 dispatch order forms (0.64% of all dispatch orders) involved in further research.On the basis of the emergency medical procedure forms, the actions of emergency medical teams were verified as medical procedures (endotracheal intubation, the use of suction pumps, defibrillation, the use of alternatives providing airway patency and ROSC was determined.The analysis covered 1603 cases of OHCA. SCA turned out more frequent in men than in women (P = .000). Most often, SCA occurred in domestic conditions during the day and was witnessed by a third person. In 59.9% of the cases, actions were taken by witnesses, which increased the probability of ROSC. Patients were usually intubated (51.4%). Respirators were used less frequently (20.2%). Ventricular fibrillation (VF) was reported only in 22.0% of the cases. The ROSC rate was higher in the group of patients with diagnosed VF than in those with nonshockable rhythms (VF, 55.43% vs asystole, 24.05%; P = .000).Successful resuscitation depends on the quality of emergency medical procedures performed at the place of incident. The highest probability of ROSC is related with defibrillation (in the cases of VF or ventricular tachycardia with no pulse), intubation, the application of a respirator, and performing mechanical ventilation, as well as with a shorter time from dispatch to arrival.
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Affiliation(s)
- Klaudiusz Nadolny
- Department of Emergency Medicine and Disasters, Medical University of Bialystok, Bialystok
| | - Lukasz Szarpak
- Department of Emergency Medicine, Lazarski University, Warsaw
| | - Joanna Gotlib
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw
| | - Mariusz Panczyk
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw
| | - Maciej Sterlinski
- Department of Arrhythmia, The Cardinal Stefan Wyszynski Institute of Cardiology
| | - Jerzy Robert Ladny
- Department of Emergency Medicine and Disasters, Medical University of Bialystok, Bialystok
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Robert Galazkowski
- Department of Emergency Medical Service, Medical University of Warsaw, Warsaw, Poland
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Iskrzycki L, Smereka J, Rodriguez-Nunez A, Barcala Furelos R, Abelarias Gomez C, Kaminska H, Wieczorek W, Szarpak L, Nadolny K, Galazkowski R, Ruetzler K, Ladny JR. The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation. Kardiol Pol 2018; 76:574-579. [PMID: 29297195 DOI: 10.5603/kp.a2017.0255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Drowning is a common issue at many pools and beaches, and in seas all over the world. Lifeguards often act as bystanders, and therefore adequate training in high-quality cardiopulmonary resuscitation (CPR) and use of adequate equip-ment by lifeguards is essential. AIM The aim of this study was to evaluate the impact of the recently introduced CPRMeter (Laerdal, Stavanger, Norway) on quality of CPR, if used by moderately experienced CPR providers. In particular, we tested the hypothesis that using the CPRMeter improves quality of chest compression by lifeguards compared to standard non-feedback CPR. METHODS The study was designed as prospective, randomised, cross-over manikin trial. Fifty lifeguards of the Volunteer Water Rescue Service (WOPR), a Polish nationwide association specialised in water rescue, participated in this study. Participants were randomly assigned 1:1 to one of two groups: a feedback group and a non-feedback group. Participants swim a distance of 25 m in the pool, and then they were asked to haul a manikin for the second 25 m, simulating rescuing a drowning victim. Once participants finished the second 25-m distance, participants were asked to initiate 2-min basic life support according to the randomisation. RESULTS The median quality of CPR score for the 2-min CPR session without feedback was 69 (33-77) compared to 84 (55-93) in the feedback group (p < 0.001). Compression score, mean depth, rate of adequate chest compressions/min, and overall mean rate during the CPR session improved significantly in the feedback group, compared to the non-feedback group. CONCLUSIONS Using the visual real-time feedback device significantly improved quality of CPR in our relatively unexperienced CPR providers. Better quality of bystander CPR is essential for clinical outcomes, and therefore feedback devices should be considered. Further clinical studies are needed to assess the effect of real-time visual devices, especially in bystander-CPR.
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Affiliation(s)
| | | | | | | | | | | | | | - Lukasz Szarpak
- Department of Emergency Medicine, Medical University of Warsaw, Lindleya 4, 02-005 Warsaw, Poland; Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland, Szpitalna 37, 15-295 Bialystok, Poland.
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Wieczorek W, Smereka J, Ladny JR, Kaminska H, Galazkowski R, Szarpak L. The impact of a CPRezy™ feedback device on the quality of chest compressions performed by nurses. Am J Emerg Med 2017; 36:1318-1319. [PMID: 29196113 DOI: 10.1016/j.ajem.2017.11.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/19/2017] [Accepted: 11/27/2017] [Indexed: 11/15/2022] Open
Affiliation(s)
- Wojciech Wieczorek
- Department of Anaesthesiology, Intensive Care and Emergency Medicine in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy R Ladny
- Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland
| | - Halla Kaminska
- Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland
| | - Robert Galazkowski
- Department of Emergency Medical Service, Medical University of Warsaw, Warsaw, Poland
| | - Lukasz Szarpak
- Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland; Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
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Galazkowski R, Celinski D, Szarpak L. Analysis of interventions of polish helicopter emergency medical service in pediatric patients due to poisoning. Am J Emerg Med 2017; 35:1019-1020. [DOI: 10.1016/j.ajem.2017.03.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 11/16/2022] Open
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Darocha T, Kosinski S, Ziętkiewicz M, Jarosz A, Galazkowski R, Piątek J, Konstany-Kalandyk J, Sanak T, Zeliaś A, Drwila R. Create a Chain of Survival: Extracorporeal Life Support Treatment of Severe Hypothermia Victims. Artif Organs 2016; 40:812-3. [PMID: 27530670 DOI: 10.1111/aor.12743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/11/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Tomasz Darocha
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Sylweriusz Kosinski
- Department of Anesthesiology and Intensive Care, Pulmonary Hospital, Zakopane, Poland Tatra Mountain Rescue Service, Zakopane, Poland
| | - Mirosław Ziętkiewicz
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Anna Jarosz
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Robert Galazkowski
- Department of Emergency Medical Services, Medical University of Warsaw, Polish Medical Air Rescue, Warsaw, Poland
| | - Jacek Piątek
- Department of Cardiovascular Surgery and Transplantology, Collegium Medicum, Jagiellonian University, the John Paul II Hospital, Cracow, Poland
| | - Janusz Konstany-Kalandyk
- Department of Cardiovascular Surgery and Transplantology, Collegium Medicum, Jagiellonian University, the John Paul II Hospital, Cracow, Poland
| | - Tomasz Sanak
- Department of Disaster Medicine and Emergency Care, Medical College of Jagiellonian University, Cracow, Poland
| | - Aleksander Zeliaś
- Clinic of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
| | - Rafal Drwila
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
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Kosinski S, Darocha T, Jarosz A, Migiel L, Zelias A, Marcinkowski W, Filip G, Galazkowski R, Drwila R. The longest persisting ventricular fibrillation with an excellent outcome - 6h 45min cardiac arrest. Resuscitation 2016; 105:e21-2. [PMID: 27283064 DOI: 10.1016/j.resuscitation.2016.05.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Sylweriusz Kosinski
- Tatra Mountain Rescue Service, Zakopane, Poland; Department of Anesthesiology and Intensive Care, Pulmonary Hospital, Zakopane, Poland.
| | - Tomasz Darocha
- Severe Accidental Hypothermia Center, Department of Anesthesiology and Intensive Care, The John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland; Polish Medical Air Rescue, Warsaw, Poland.
| | - Anna Jarosz
- Severe Accidental Hypothermia Center, Department of Anesthesiology and Intensive Care, The John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland.
| | | | | | - Winicjusz Marcinkowski
- Severe Accidental Hypothermia Center, Department of Anesthesiology and Intensive Care, The John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland.
| | - Grzegorz Filip
- Department of Cardiovascular Surgery and Transplantology, Collegium Medicum, Jagiellonian University, the John Paul II Hospital, Cracow, Poland.
| | - Robert Galazkowski
- Polish Medical Air Rescue, Warsaw, Poland; Department of Emergency Medical Services, Medical University of Warsaw, Poland.
| | - Rafal Drwila
- Severe Accidental Hypothermia Center, Department of Anesthesiology and Intensive Care, The John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland.
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Batycka-Stachnik D, Piwoda A, Darocha T, Spiewak M, Kosinski S, Jarosz A, Hymczak H, Sanak T, Galazkowski R, Piatek J, Konstanty-Kalandyk J, Drwila R. Problems and challenges in the early period of rehabilitating patients with severe hypothermia treated using ecmo support. Wiad Lek 2016; 69:489-494. [PMID: 28478412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited. DESIGN Retrospective analysis Setting: Severe Accidental Hypothermia Center ( medical intensive care unit of a university hospital) Patients or participants: Nineteen patients who were qualified for ECMO in Severe Accidental Hypothermia Center Intervention: At least three times a day rehabilitation session (physiotherapeutic procedures adequate to patient problems) and interventions in case of emergency. Physiotherapy staff in the Center has regular work hours and night duties, so can provide round-the clock rehabilitation treatment adjusted to the dynamically changing clinical picture of the patient. METHODS AND RESULTS We analyzed the group of patients who were treated in our center from July 2013 to March 2015. The degree of functional complications increased with the duration and extent of hypothermia and time of conducting extracorporeal therapy. The frequent problems were: respiratory failure due to sputum retention (25%) or sternum fracture due to resuscitation (25%), lower and upper extremity muscle weakening (75%), peroneal nerve palsy (25%). In the first period of hospitalization all of patients have generalised edema. As a result of the treatment and rehabilitation, full stabilization of the cardiovascular - respiratory system and full recovery of neurological functions was achieved in 14 persons (73.68%). CONCLUSION early and round-the clock physiotherapy treatment adequate to appearing patient's syndromes seems crucial for his physical and mental recovery after severe accidental hypothermia treated by ECMO support. In order to attain therapeutic success, it is indispensable to work in experienced, multidisciplinary team.
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Affiliation(s)
- Dominika Batycka-Stachnik
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland; Academy of Physical Education, Cracow, Poland
| | - Agnieszka Piwoda
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Tomasz Darocha
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland, e-mail:
| | - Malgorzata Spiewak
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Sylweriusz Kosinski
- Department of Anesthesiology and Intensive Care, Pulmonary Hospital, Zakopane , Poland; Tatra Mountain Rescue Service, Zakopane, Poland
| | - Anna Jarosz
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Hubert Hymczak
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Tomasz Sanak
- Department of Disaster Medicine and Emergency Care, Medical College of Jagiellonian University, Krakow, Poland; Department of Combat Medicine, Military Institute in Warsaw
| | - Robert Galazkowski
- Department of Emergency Medical Services, Medical University of Warsaw, Polish Medical Air Rescue, Warsaw, Poland
| | - Jacek Piatek
- Department of Cardiovascular Surgery and Transplantology, The John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Janusz Konstanty-Kalandyk
- Department of Cardiovascular Surgery and Transplantology, The John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Rafal Drwila
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
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Batycka-Stachnik D, Piwoda A, Darocha T, Spiewak M, Kosinski S, Jarosz A, Hymczak H, Sanak T, Galazkowski R, Piatek J, Konstanty-Kalandyk J, Drwila R. Problems and challenges in the early period of rehabilitating patients with severe hypothermia treated using ecmo support. Wiad Lek 2016; 69:489-494. [PMID: 27717931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited. DESIGN Retrospective analysis Setting: Severe Accidental Hypothermia Center ( medical intensive care unit of a university hospital) Patients or participants: Nineteen patients who were qualified for ECMO in Severe Accidental Hypothermia Center Intervention: At least three times a day rehabilitation session (physiotherapeutic procedures adequate to patient problems) and interventions in case of emergency. Physiotherapy staff in the Center has regular work hours and night duties, so can provide round-the clock rehabilitation treatment adjusted to the dynamically changing clinical picture of the patient. METHODS AND RESULTS We analyzed the group of patients who were treated in our center from July 2013 to March 2015. The degree of functional complications increased with the duration and extent of hypothermia and time of conducting extracorporeal therapy. The frequent problems were: respiratory failure due to sputum retention (25%) or sternum fracture due to resuscitation (25%), lower and upper extremity muscle weakening (75%), peroneal nerve palsy (25%). In the first period of hospitalization all of patients have generalised edema. As a result of the treatment and rehabilitation, full stabilization of the cardiovascular - respiratory system and full recovery of neurological functions was achieved in 14 persons (73.68%). CONCLUSION early and round-the clock physiotherapy treatment adequate to appearing patient's syndromes seems crucial for his physical and mental recovery after severe accidental hypothermia treated by ECMO support. In order to attain therapeutic success, it is indispensable to work in experienced, multidisciplinary team.
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Affiliation(s)
- Dominika Batycka-Stachnik
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland; Academy of Physical Education, Cracow, Poland
| | - Agnieszka Piwoda
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Tomasz Darocha
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland, e-mail:
| | - Malgorzata Spiewak
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Sylweriusz Kosinski
- Department of Anesthesiology and Intensive Care, Pulmonary Hospital, Zakopane , Poland; Tatra Mountain Rescue Service, Zakopane, Poland
| | - Anna Jarosz
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Hubert Hymczak
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Tomasz Sanak
- Department of Disaster Medicine and Emergency Care, Medical College of Jagiellonian University, Krakow, Poland; Department of Combat Medicine, Military Institute in Warsaw
| | - Robert Galazkowski
- Department of Emergency Medical Services, Medical University of Warsaw, Polish Medical Air Rescue, Warsaw, Poland
| | - Jacek Piatek
- Department of Cardiovascular Surgery and Transplantology, The John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Janusz Konstanty-Kalandyk
- Department of Cardiovascular Surgery and Transplantology, The John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
| | - Rafal Drwila
- Department of Anesthesiology and Intensive Care, the John Paul II Hospital, Medical College of Jagiellonian University, Cracow, Poland
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Darocha T, Kosinski S, Moskwa M, Jarosz A, Sobczyk D, Galazkowski R, Slowik M, Drwila R. The Role of Hypothermia Coordinator: A Case of Hypothermic Cardiac Arrest Treated with ECMO. High Alt Med Biol 2015; 16:352-5. [PMID: 26301723 PMCID: PMC4685480 DOI: 10.1089/ham.2015.0055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Darocha, Tomasz, Sylweriusz Kosinski, Maciej Moskwa, Anna Jarosz, Dorota Sobczyk, Robert Galazkowski, Marcin Slowik, and Rafal Drwila. The role of hypothermia coordinator: A case of hypothermic cardiac arrest treated with ECMO. High Alt Biol Med 16:352-355, 2015.—We present a description of emergency medical rescue procedures in a patient suffering from severe hypothermia who was found in the Babia Gora mountain range (Poland). After diagnosing the symptoms of II/III stage hypothermia according to the Swiss Staging System, the Mountain Rescue Service notified the coordinator from the Severe Accidental Hypothermia Center (CLHG) Coordinator in Krakow and then kept in constant touch with him. In accordance with the protocol for managing such situations, the coordinator started the procedure for patients in severe hypothermia with the option of extracorporeal warming and secured access to a device for continuous mechanical chest compression. After reaching the hospital, extracorporeal warming with ECMO support in the arteriovenuous configuration was started. The total duration of circulatory arrest was 150 minutes. The rescue procedures were supervised by the coordinator, who was on 24-hour duty and was reached by means of an alarm phone. The task of the coordinator is to consult the management of hypothermia cases, use his knowledge and experience to help in the diagnosis and treatment. and if the need arises refer the patient for ECMO at CLHG. Good coordination, planning, predicting possible problems, and acting in accordance with the agreed procedures in the scheme, make it possible to shorten the time of reaching the destination hospital and implement effective treatment.
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Affiliation(s)
- Tomasz Darocha
- 1 Department of Anesthesiology and Intensive Care, John Paul II Hospital, Medical College of Jagiellonian University , Cracow, Poland .,2 Polish Medical Air Rescue , Warsaw, Poland
| | - Sylweriusz Kosinski
- 3 Department of Anesthesiology and Intensive Care, Pulmonary Hospital , and Tatra Mountain Rescue Service, Zakopane, Poland
| | - Maciej Moskwa
- 4 Polish Mountain Rescue , Beskidy Group, Szczyrk, Poland
| | - Anna Jarosz
- 1 Department of Anesthesiology and Intensive Care, John Paul II Hospital, Medical College of Jagiellonian University , Cracow, Poland
| | - Dorota Sobczyk
- 5 Department of Admission and Emergency, John Paul II Hospital, Medical College of Jagiellonian University , Cracow, Poland
| | - Robert Galazkowski
- 2 Polish Medical Air Rescue , Warsaw, Poland .,6 Department of Emergency Medical Services, Medical University of Warsaw , Warsaw, Poland
| | - Marcin Slowik
- 7 Dispatch Center , Emergency Services Cracow, Cracow, Poland
| | - Rafal Drwila
- 1 Department of Anesthesiology and Intensive Care, John Paul II Hospital, Medical College of Jagiellonian University , Cracow, Poland
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Timler D, Galazkowski R, Bogusiak K, Kasielska-Trojan A. [Helicopter emergency medical services for patients with cerebral stroke]. Emergencias 2015; 27:193-196. [PMID: 29077314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this cross-sectional study was to analyze transport by helicopter emergency medical services (HEMS) in cases of ischemic cerebral stroke in Poland in 2011 and 2012. We assessed the role of the HEMS in reducing prehospital times and analyzed changes in patients' status during transport. MATERIAL AND METHODS Retrospective study of all missions flown by the Polish HEMS to attend stroke patients over the 2-year period. The following data were collected for each mission and patient: time from activation of the HEMS until arrival at the scene, time spent at the scene; and scores on the National Advisory Committee for Aeronautics scale, the Revised Trauma Scale (ETR), and the Glasgow Coma Scale (ECG) at the scene and on transfer of the patient to the hospital or ambulance. RESULTS A total of 1191 patients were analyzed. The mean (SD) ETR and ECG scores on the scene were 11.1 (1.36) and 11.8 (3.39), respectively. After HEMS transport the means were 11.0 (1.5) and 11.7 (3.5). In-flight transport did not affect the patient's condition, but more time spent at the scene was associated with significantly lower scores on the scales. CONCLUSION Helicopter transport of these patients is safe and ensures their transfer to the nearest hospital or ambulance within the treatment time window. Time spent on care at the scene of the emergency should probably be as short as possible.
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Affiliation(s)
- Dariusz Timler
- Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, Polonia
| | | | | | - Anna Kasielska-Trojan
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Polonia
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