Impact of COVID-19 Pandemic on Health and Life Emergencies Resulting from Illness Cases and Injuries-A Preliminary Study.

Background: Despite organised efforts, the COVID-19 pandemic had a significant impact on the health status of the population and health services including the emergency medical system. The objective of the study was to investigate, based on the Emergency Medical Teams' (EMT) interventions, the impact of the COVID-19 pandemic on health and life emergencies resulting from illness cases and injuries of Polish females and males. Material and Methods: The data under analysis concern EMT interventions carried out in central and eastern Poland from 1 January 2017 to 31 December 2022 (n = 226,038). The study used descriptive statistics, the Mann-Whitney U Test, and the Chi-square test. Results: A significant increase was observed in the proportion of EMT interventions (p < 0.001) to patients with illness cases (80.30% vs. 83.17%) and a decrease in interventions to patients with injuries (19.70% vs. 16.83%) during the pandemic as compared to the pre-pandemic period. As for illness cases, the patients' ages during both periods were similar (Me = 66.00 vs. 66.00, p = 0.071). On the other hand, during the pandemic, injuries mainly affected elderly patients as compared to the pre-pandemic period (Me = 50.00 vs. 47.00, p < 0.001). The increase in the proportion of EMT interventions to patients with illness cases and the decrease in patients with injuries during the pandemic, as compared to the pre-pandemic period, concerned the area of intervention, patient's sex, and age. During the pandemic period, a significantly lower proportion of patients transported to the hospital (p < 0.001) and an increase in the proportion of patients left at the place of call (p < 0.001) were noted. Conclusions: The restrictions aimed at preventing the spread of the SARS-CoV-2 virus contributed to a reduced number of injuries without, however, reducing the number of illness cases. During the pandemic, the elderly were affected by injuries. The study indicates the need for further in-depth analyses to prepare the pre-hospital care system in Poland for the occurrence of other or similar emergencies.

ICD-10 Classification in the Practice of Emergency Medical Teams: New Insights.

The role of the emergency medical system is to provide assistance to every person in a state in the event of a sudden threat to health and life. Emergency medical teams (EMTs) are an important element of this system, making diagnoses based on the International Classification of Diseases (ICD-10). The study was aimed at analysing the causes of EMT intervention based on groups of diagnoses codified according to the ICD-10. The analysis was based on data from 116,278 EMT interventions in central-eastern Poland in 2017-2019. The research showed that EMT most often made diagnoses based on groups of ICD-10 codes: R00-R99-Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (39.11%); S00-T98-Injury, poisoning, and certain other consequences of external causes (18.23%); and I00-I99-Diseases of the circulatory system (15.57%). The analysis of the obtained results showed statistically significant differences (p < 0.0001) regarding the area of intervention (urban, rural), sex, age of the patient, and the method of completion of the activities by EMTs in relation to the group of ICD-10 diagnoses for the diagnosis. The conducted study showed the actual reasons for EMT calls. The use of the ICD-10 classification has practical application in EMTs, as it enables the identification of a disease or health problem.

[(Un)ergonomic working conditions for a paramedic in a medical ambulance]. / (Nie)ergonomiczne warunki pracy ratownika w ambulansie medycznym.

BACKGROUND: The work of a paramedic, is characterised by a high risk of injury. Ergonomic, psychological, and biomechanical factors are considered risk factors in the profession of emergency medical technicians. Ensuring ergonomic working conditions for emergency medical technicians is a priority and requires a thorough assessment both in the design process and during the operation of the ambulance, to provide a diagnosis of the current state and present necessary recommendations for modernization. Identifying stressors will enable the design of an ergonomic interior for the ambulance, ensuring comfort and reliability for members of the emergency medical team, thereby reducing the risk of injuries. MATERIAL AND METHODS: The authors of this article developed a comprehensive methodology for assessing the nuisances occurring during the paramedic's work, which required specialised preliminary research. The research included the measurement and analysis of the paramedic's movement kinematics during typical medical procedures, both at a standstill and while driving the ambulance. For the analysis of motion kinematics, a non-invasive method called myoMotion was employed, and the study was conducted in a Mercedes ambulance. RESULTS: This article contains preliminary results on the evaluation of movement kinematics. These demonstrated the necessity for the paramedic to adopt forced positions when performing medical procedures. The ranges of movement of the individual body parts of the paramedic deviated from accepted norms, resulting in musculoskeletal overload. CONCLUSIONS: The acquired knowledge forms the basis for a detailed analysis of tasks performed within each procedure from the perspective of the spatial structure of the ambulance, the arrangement of equipment and medical supplies, their accessibility during work, and the organization of work within the ambulance. Additional identification of musculoskeletal system stress, its sources, and the formulation of modification recommendations for the ambulance interior will enable ensuring the comfort and reliability of the work for emergency medical teams, thereby reducing the risk of injuries in the workplace. Med Pr Work Health Saf. 2024;75(1):31-44.

Characteristics of Emergencies in the Workplace from the Perspective of the Emergency Medical Services: A 4-Year Case-Control Study.

INTRODUCTION: Accidents and emergencies in the workplace account for a significant proportion of emergency calls worldwide. The specificity of these events is often associated with hazards at a given workplace. Patients do not always require hospitalization; therefore, the characteristics of events can only be determined from the perspective of emergency medical services teams. The aim of the study was to analyze calls and the course of emergency ambulance interventions to patients at their workplace. MATERIAL AND METHODS: The study was conducted based on a retrospective analysis of data contained in the medical records of the ambulance service from central Poland from 2015-2018. From all interventions (n = 155,993), 1601 calls to work were selected, and the urgency code, time of day and year, patients' sex, general condition, as well as diagnoses according to the International Classification of Diseases-ICD-10 and the method of ending the call were considered. RESULTS: The mean age of patients in the study group was 42.4 years (SD ± 13.5). The majority were men (n = 918; 57.3%). The number of calls increased in the autumn (n = 457; 28.5%) and in the morning (n = 609; 38.0%). The main reasons for the intervention were illnesses (ICD-10 group: R-'symptoms') and injuries (ICD-10 group: S, T-'injuries'). Calls at workplaces most often ended with the patient being transported to the hospital (78.8%), and least often with his death (0.8%). CONCLUSIONS: The patient profile in the workplace indicates middle-aged men who fall ill in the fall, requiring transport to the hospital and further diagnostics.

[Sudden cardiac arrests in years 2013-2016 within operation area of siedlce emergency ambulance service].

OBJECTIVE: Introduction: SCA is an unexpected, and potentially of reversible effect, in which occurs a cessation of hemodynamically heart beat as a pump, and cessation of cardiovascular circulation. PATIENTS AND METHODS: Materials and methods: Our analysis is based on 1032 SCA occurrences where cardiopulmonary resuscitation have been applied. The analysis covers operating region of Siedlce Emergency Medical Services in years 2013-2016. The study is of retrospective nature. The analysis has been based on all cases of cardiac arrests. Successful rate of medical assistance at patients with SCA have been assessed. RESULTS: Results: CPR have been applied 1032 times, out of which 45,3& of cases have resulted in spontaneous recovery of circulation, and in 54,7& such action have failed. however the efficiency of CPR applied K-2 call-outs was higher (p=0.016). It was noted that there was significantly higher (p = 0,010) number of interventions due to SCA with males (n = 744) than females (n = 288). Also, there was higher successful rate for SCA treatment with females than males. It was proven that the number of SCA have grown in line with an age, however successful rate of SCA treatment have been comparable among all age groups (p = 0,553). Most numerous group of patients with SCA have been 75 year old and above (n = 281). It was noted that significant factor in SCA and CPR successful treatment was the time of the day (p = 0,021). There was more SCA as well as successful CPRs before afternoon and afternoon in comparison with evening and night time. The time of arrival for Ambulance crews for patients with spontaneous was significantly shorter (p = 0,000) in comparison with patients who have failed to recover (on average 7,3± 5,96 vs. 9,8± 6,42 min). In rhythm to defibrilation or PEA, ROSC took place significantly more often than at patients with asystole (p = 0,000). CONCLUSION: Conclusions: A 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, intubation, the application of a respirator and performing mechanical ventilation, as well as shorter time from dispatch to arrival.