CPR using the lifeline ARM mechanical chest compression device: a randomized, crossover, manikin trial.

INTRODUCTION: European Resuscitation Council as well as American Heart Association guidelines for cardiopulmonary resuscitation (CPR) stress the importance of uninterrupted and effective chest compressions (CCs). Manual CPR decreases in quality of CCs over time because of fatigue which impacts outcome. We report the first study with the Lifeline ARM automated CC device for providing uninterrupted CCs. METHODS: Seventy-eight paramedics participated in this randomized, crossover, manikin trial. We compared the fraction of effective CCs between manual CPR and automated CPR using the ARM. RESULTS: Using the ARM during resuscitation resulted in a higher percentage of effective CCs (100/min [interquartile range, 99-100]) compared with manual CCs (43/min [interquartile range, 39-46]; P<.001). The number of effective CCs decreased less over time with the ARM (P<.001), more often reached the required depth of 5 cm (97% vs 63%, P<.001), and more often reached the recommended CC rate (P<.001). The median tidal volume was higher and hands-off time was lower when using the ARM. CONCLUSION: Mechanical CCs in our study adhere more closely to current guidelines than manual CCs. The Lifeline ARM provides more effective CCs, more ventilation time and minute volume, less hands-off time, and less decrease in effective CCs over time compared with manual Basic Life Support and might therefore impact outcome.

Contribution of volume overload to the arterial stiffness of hemodialysis patients.

Arterial stiffness is evaluated with the measurement of pulse wave velocity (PWV), while overhydration (OH) and nutritional status are evaluated with bioimpedance spectroscopy (BIS). In this study, we investigated the effect of a single dialysis session on arterial stiffness, hydration status, and laboratory parameters. The observational, cross-sectional, cohort study included 71 HD patients with mean age 64 ± 16 yrs. A Complior device was used to perform PWV measurements. The patients were examined immediately before and 15 min after a mid-week hemodialysis session. Body fluids and nutritional status were studied using a Body Composition Monitor (BCM), Fresenius Medical Care. Clinical and laboratory data were also analyzed. Multivariate regression analysis of PWV before HD showed that an OH increase of 1 L relate to a PWV parameter rise before HD of 0.523 m/s. Multivariate regression analysis of PWV after HD showed that a rise of central SBP after HD of 10 mmHg relate to a PWV increase after HD of 0.707 m/s. Our data indicate that hydration status and blood pressure may be major determinants of PWV in HD patients.

Airtraq Laryngoscope Versus the Conventional Macintosh Laryngoscope During Pediatric Intubation Performed by Nurses: A Randomized Crossover Manikin Study With Three Airway Scenarios.

OBJECTIVES: We hypothesized that the Airtraq laryngoscope (Airtraq LLC, Bonita Springs, Fla) is beneficial for intubation of pediatric manikins while performing cardiopulmonary resuscitation (CPR). In the present study, we evaluated the effectiveness of the Macintosh (MAC) laryngoscope (HEINE Optotechnik, Munich, Germany) and Airtraq in 3 simulated CPR scenarios. METHODS: A randomized crossover simulation trial was designed. Eighty-three nurses intubated the trachea of a PediaSIM CPR training manikin (FCAE HealthCare, Sarasota, Fla) using the MAC and Airtraq in a normal airway scenario, normal airway with chest compression scenario, and difficult airway with chest compression scenario. The participants were directed to perform a maximum of 3 attempts in each scenario. The success rate, time to intubation, Cormack & Lehane grade, dental compression, and the ease of intubation were measured. RESULTS: All participants performed successful intubation with the Airtraq in all 3 scenarios. In all scenarios, the success rate was significantly higher and the time to intubation was significantly shorter with the Airtraq than with the MAC. Glottic visualization using the Cormack-Lehane scale was also better when using Airtraq in all scenarios. CONCLUSIONS: In this manikin study, we found that the Airtraq can be used successfully for the intubation of pediatric manikins with normal and difficult airways by medical staff without previous experience in pediatric intubation. Moreover, intubation can be achieved without interrupting chest compression. The use of the Airtraq compared with the MAC led to faster time to intubation. Nevertheless, we recommend that the performance of the Airtraq and the MAC during CPR should be further evaluated in a clinical setting.

A comparison of the McGrath-MAC and Macintosh laryngoscopes for child tracheal intubation during resuscitation by paramedics. A randomized, crossover, manikin study.

INTRODUCTION: Prehospital tracheal intubation by paramedics during cardiopulmonary resuscitation (CPR) in children is challenging. The potential role of new intubation devices during CPR is unclear. Our objective was to assess the impact of CPR (with and without chest compressions [CCs]) on the success and time to intubation (TTI) with the Macintosh laryngoscope vs the McGrath video laryngoscope on a pediatric manikin. METHODS: This was an open, prospective, randomized, crossover, manikin trial involving 95 paramedics who performed intubations in a PediaSIM pediatric high-fidelity manikin with Macintosh and McGrath laryngoscopes, with and without concomitant mechanical CCs. Primary outcome was the TTI, and secondary outcome was success of the attempt. Participants rated their best glottic view, the severity of the potential dental trauma, and subjective opinion about the difficulty of the procedure. RESULTS: The median TTI with the Macintosh in the scenario with uninterrupted CC was 33 (interquartile range [IQR], 24-36) seconds, which is significantly longer than TTI in the scenario with interrupted CC (23 [IQR, 20-29] seconds, P < .001). Time to intubation using the McGrath was similar in both scenarios: 20 (IQR, 17-23) seconds vs 19.5 (IQR, 17-22) seconds (P = .083). A statistically significant difference between McGrath and Macintosh was noticed in TTI both in scenario with (P < .001) and without CC (P = .017). CONCLUSIONS: McGrath video laryngoscope helps paramedics to intubate a pediatric manikin in a CPR scenario in less time and with fewer attempts than with the classical Macintosh, both in case of ongoing or stopped CC. McGrath use in actual patients could improve CPR quality by paramedics.

Ability of paramedics to perform endotracheal intubation during continuous chest compressions: a randomized cadaver study comparing Pentax AWS and Macintosh laryngoscopes.

OBJECTIVE: The aim of the trial was to compare the time parameters for intubation with the use of the Macintosh (MAC) laryngoscope and Pentax AWS-S100 videolaryngoscope (AWS; Pentax Corporation, Tokyo, Japan) with and without chest compression (CC) by paramedics during simulated cardiopulmonary resuscitation in a cadaver model. METHODS: This was a randomized crossover cadaver trial. Thirty-five paramedics with no experience in videolaryngoscopy participated in the study. They performed intubation in two emergency scenarios: scenario A, normal airway without CC; scenario B, normal airway with continuous CC. RESULTS: The median time to first ventilation with the use of the AWS and the MAC was similar in scenario A: 25 (IQR, 22-27) seconds vs. 24 (IQR, 22.5-26) seconds (P=.072). A statistically significant difference in TTFV between AWS and MAC was noticed in scenario B (P=.011). In scenario A, the first endotracheal intubation (ETI) attempt success rate was achieved in 97.1% with AWS compared with 94.3% with MAC (P=.43). In scenario B, the success rate after the first ETI attempt with the use of the different intubation methods varied and amounted to 88.6% vs. 77.1% for AWS and MAC, respectively (P=.002). CONCLUSIONS: The Pentax AWS offered a superior glottic view as compared with the MAC laryngoscope, which was associated with a higher intubation rate and a shorter intubation time during an uninterrupted CC scenario. However, in the scenario without CC, the results for AWS and MAC were comparable.

Randomized trial of the chest compressions effectiveness comparing 3 feedback CPR devices and standard basic life support by nurses.

BACKGROUND: Out-of-hospital cardiac arrest is a leading cause of mortality and serious neurological morbidity in Europe. We aim to investigate the effect of 3 cardiopulmonary resuscitation (CPR) feedback devices on effectiveness of chest compression during CPR. METHODS: This was prospective, randomized, crossover, controlled trial. Following a brief didactic session, 140 volunteer nurses inexperienced with feedback CPR devices attempted chest compression on a manikin using 3 CPR feedback devices (TrueCPR, CPR-Ezy, and iCPR) and standard basic life support (BLS) without feedback. RESULTS: Comparison of standard BLS, TrueCPR, CPR-Ezy, and iCPR showed differences in the effectiveness of chest compression (compressions with correct pressure point, correct depth, and sufficient decompression), which are, respectively, 37.5%, 85.6%, 39.5%, and 33.4%; compression depth (44.6 vs 54.5 vs 45.6 vs 39.6 mm); and compression rate (129.4 vs 110.2 vs 101.5 vs 103.5 min(-1)). CONCLUSIONS: During the simulated resuscitation scenario, only TrueCPR significantly affected the increased effectiveness compression compared with standard BLS, CPR-Ezy, and iCPR. Further studies are required to confirm the results in clinical practice.

Comparison of the TruView PCD video laryngoscope and macintosh laryngoscope for pediatric tracheal intubation by novice paramedics: a randomized crossover simulation trial.

UNLABELLED: The aim of the present study was to evaluate whether the TruView video laryngoscope (TruView) facilitates pediatric endotracheal intubation (ETI) more quickly and safely than conventional Macintosh laryngoscope (MAC) in three manikin-based airway scenarios. This was a randomized crossover manikin study including 120 novice paramedics. The participants performed tracheal intubations using both TruView and MAC on a pediatric manikin in a control scenario (A), chest compression scenario (B), and chest compression cervical stabilization scenario (C). The sequence of scenarios was randomized. The primary outcome was time to intubation. Secondary outcomes were overall success rates, incidence of dental trauma, and ease of intubation. All intubation attempts were assessed by a trained assistant. The overall success rate was significantly higher with the TruView compared than the MAC in scenario B (100 vs. 81.7 %; p = 0.011) and scenario C (100 vs. 68.3 %; p < 0.001). The intubation time was significantly lower with the TruView than the MAC (18.5 vs. 24.3 s, p = 0.017, for scenario A; 21.6 vs. 25.7 s, p = 0.023, for scenario B; and 28.9 vs. 45.4 s, p < 0.001, for scenario C). Glottic view quality was better with TruView than the MAC in all scenarios, p < 0.001. CONCLUSIONS: The TruView offers better intubation conditions than the MAC on a pediatric manikin in the control scenario, chest compression scenario, and chest compression scenario with cervical stabilization scenario. The TruView may be used to elevate the epiglottis for orotracheal intubation. Further clinical studies are necessary to confirm these initial positive findings. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT02289872. WHAT IS KNOWN: •Prehospital pediatric intubation using a standard laryngoscope is varied and ranges from 63.4 to 82 %. What is New: •This is the first study showing efficiency of pediatric endotracheal intubation using the TruView PCD by paramedics in tree simulation scenarios. •TruView PCD offers better pediatric intubation conditions than the Macintosh laryngoscope.

Comparison of Coopdech®, CoPilot®, Intubrite®, and Macintosh laryngoscopes for tracheal intubation during pediatric cardiopulmonary resuscitation: a randomized, controlled crossover simulation trial.

UNLABELLED: The aim of the study was to compare the intubation times and success rates of various laryngoscopes during resuscitation in pediatric emergency intubation with uninterrupted chest compression on a standardized pediatric manikin model. This was a randomized crossover study with 107 paramedic participants. We compared times to successful intubation, intubation success rates, and glottic visibility using a Cormack-Lehane grade for Macintosh, Intubrite®, Coopdech®, and Copilot® laryngoscopes. One hundred seven paramedics (mean age 31.2 ± 7.5 years) routinely involved in the management of prehospital care participated in this study. Intubation success rates (overall effectiveness), which was the primary study endpoint, were highest for the Coopdech® and CoPilot® devices (100 %) and were lowest for Intubrite® (89.7 %, p < 0.001) and Macintosh (80.4 %, p < 0.001). The secondary study endpoint, time to first effective ventilation, was achieved fastest when using the Coopdech® laryngoscope (21.6 ± 6.2 s) and was significantly slower with all other devices (Intubrite® 25.4 ± 10.5 s, p = 0.006; CoPilot® 25.6 ± 7.4 s, p = 0.007; Macintosh 29.4 ± 8.2 s, p < 0.001). CONCLUSION: We conclude that in child simulations managed by paramedics, the Coopdech® and Copilot® video laryngoscopes performed better than the standard Macintosh or Intubrite® laryngoscopes for endotracheal intubation during child chest compression.

Comparison of the Pentax, Truview, GlideScope, and the Miller laryngoscope for child intubation during resuscitation.

BACKGROUND: The study was designed to compare the effectiveness of 3 video laryngoscopes with the Miller laryngoscope during pediatric resuscitation. MATERIAL AND METHODS: This was a randomized crossover study involving 87 paramedics and 54 nurses. The primary end point of the study was the success rate of blind tracheal intubation, whereas the secondary end point was defined as the time from insertion of a device to the first manual ventilation of the manikin's lungs. RESULTS: The median time to intubation using the Pentax, Truview, GlideScope, and Miller varied with the times being 20.6 (interquartile range [IQR], 18-27) vs 20.1 (IQR, 18-23.3) vs 30.2 (IQR, 29.6-35) vs 41.3 (IQR, 33-45.2) seconds, respectively. The overall success ratios of intubation for the devices were 100% vs 100% vs 100% vs 79.4%. CONCLUSIONS: We concluded that, in a pediatric manikin scenario, the video laryngoscopes are safe devices and can be used for pediatric intubation during uninterrupted chest compressions. Further clinical studies are necessary to confirm these initial positive findings.

Pentax Airway Scope AWS-S200 video laryngoscope for child tracheal intubation in a manikin study with 3 airway scenarios.

BACKGROUND: Endotracheal intubation is considered a criterion standard for securing the airway during cardiopulmonary resuscitation, yet it requires a very skillful operator. The aim of the study was to investigate whether paramedic staff can successfully use the Pentax Airway Scope AWS-S200 video laryngoscope (AWS) for intubating with 3 simulated airway scenarios. METHODS: It was a randomized nonblinded crossover simulation trial. Fifty-four paramedics performed intubation using an AWS in a manikin, with 3 airway scenarios: scenario A, normal airway; scenario B, normal airway with chest compression (CC); and scenario C, difficult airway with CC. RESULTS: Median intubation times for the AWS during scenarios A, B, and C were 20 seconds (interquartile range [IQR], 19-23 seconds), 22 seconds (IQR, 20-25 seconds), and 26 seconds (IQR, 23-29 seconds), respectively, and the respective overall success rates of intubation were 100%, 100%, and 94.4%. CONCLUSION: In this manikin study, paramedics could successfully intubate using the AWS, regardless of CCs being interrupted or not, even when a patient's airway was difficult.

Comparison of intubation through the McGrath MAC, GlideScope, AirTraq, and Miller Laryngoscope by paramedics during child CPR: a randomized crossover manikin trial.

BACKGROUD: Advanced airway management and endotracheal intubation (ETI) during cardiopulmonary resuscitation (CPR) is more difficult than, for example, during anesthesia. However, new devices such as video laryngoscopes should help in such circumstances. The aim of this study was to compare the performance of 4 intubation devices in pediatric manikin-simulated CPR. METHODS: One hundred two paramedics participated in this study. None had prior experience in video laryngoscopy. After a standardized audiovisual lecture lasting 45 minutes, the paramedics participated in a practical demonstration using the advanced pediatric patient simulator PediaSIM CPR (FCAE HealthCare, Sarasota, FL), which was designed to be an accurate representation of a 6-year-old child. Cardiopulmonary resuscitation was performed using LUCAS-2 (Physio-Contro, Redmond, WA). Afterward, paramedics were instructed to perform ETI using 4 intubation devices (MacGrathMAC, GlideScope, AirTraq, and Miller Laryngoscope Blade [Miller]) in a randomized sequence. The primary outcome was the success rate of tracheal intubation. The secondary outcome was the time to intubation. RESULTS: The mean time to intubation was 30.7 ± 15.3, 28.6 ± 15.9, 24.1 ± 5.0, and 39.3 ± 14.7 seconds (McGrath, GlideScope, AirTraq, and Miller, respectively); and the success ratio of intubation for the devices was 100% vs 100% vs 100% vs 77.5%, respectively. CONCLUSIONS: Child ETI performed by paramedics during uninterrupted chest compression often has a low success rate. In contrast, McGrath, GlideScope, and AirTraq intubation devices are fast, safe, and easy to use. Within the limitations of a manikin study, this study suggests that inexperienced medical staff might benefit from using video laryngoscopy devices for child emergency airway management.

Comparison of infant intubation through the TruView EVO2, TruView PCD, and Miller laryngoscope by paramedics during simulated infant cardiopulmonary resuscitation: A randomized crossover manikin study.

INTRODUCTION: The aim of the study was to compare the efficacy of the TruView EVO2, TruView PCD, and Miller laryngoscopes for tracheal intubation during cardiopulmonary resuscitation with and without chest compressions (CCs) by paramedics in an infant manikin model. METHODS: This was an open, prospective, randomized, simulated trial. After a brief didactic session, 78 volunteer paramedics attempted to intubate a manikin using TruView EVO2, TruView PCD, and Miller laryngoscopes during resuscitation with and without CC scenarios. Primary end point was intubation success rate and secondary was time to intubation with each device. Glottic view using a Cormack-Lehane grade in using each device was also assessed. RESULTS: In scenario with uninterrupted CCs, the median time to intubation using the TruView EVO2, TruView PCD, and Miller varied with the times being 25.3 seconds (interquartile range [IQR], 23-30.5 seconds) vs 20.2 seconds (IQR, 18-23 seconds) vs 24.4 seconds (IQR, 21-28 seconds), respectively. The overall success rate of intubation during CC for the devices were 94.9% vs 100% vs 92.1%. During intubation without CC, median time to intubation varied and amounted to 24.9 seconds (IQR, 21-29.6 seconds) for TruView EVO2, 18.3 seconds (IQR, 16-21.3 seconds) for TruView PCD, and 19.4 seconds (IQR, 17-23.3 seconds) for Miller laryngoscope. The overall success rate of intubation without CC for all devices was 100%. CONCLUSIONS: For infant tracheal intubation with TruView PCD, when used by paramedics, the malleable TruView PCD showed shorter intubation time and higher overall success rate in a simulated CC scenario than TruView EVO2 or Miller laryngoscopes. Further clinical studies are necessary to confirm these initial positive findings.

A randomized comparison of the Laryngoscope with Fiber Optic Reusable Flexible Tip English Macintosh blade to the conventional Macintosh laryngoscope for intubation in simulated easy and difficult child airway with chest compression scenarios.

INTRODUCTION: We hypothesized that the Laryngoscope with Fiber Optic Reusable Flexible Tip English Macintosh blade (TMAC) is beneficial for the intubation of child manikins while performing cardiopulmonary resuscitation (CPR). In the present study, we evaluated the effectiveness of the conventional Macintosh laryngoscope (MAC) and TMAC in 3 simulated CPR scenarios. METHODS: A randomized crossover simulation trial was designed. One hundred seven paramedics intubated the trachea of a PediaSIM CPR training manikin (FCAE HealthCare, Sarasota, FL) using the MAC and TMAC in a normal airway scenario (scenario A), normal airway with chest compression scenario (scenario B), and difficult airway with chest compression scenario (scenario C). The participants were directed to make a maximum of 3 attempts in each scenario. The success rate, time required for intubation, Cormack-Lehane grade, dental compression, and the ease of intubation were measured. RESULTS: The median time of intubation with MAC and TMAC in scenario A was 19.6 (interquartile range [IQR], 18-23) vs 19 (IQR, 16.2-21.8); in scenario B, 29.5 (IQR, 25-31) vs 26 (IQR, 23.5-29) seconds; and in scenario C, 38 (IQR, 32.5-45) vs 29 (IQR, 25-31) seconds, respectively. The overall efficacy for each of the scenarios was as follows: in scenario A, it was 100% vs 100%; in scenario B, it was 79.4% vs 100% (P = .007); and in scenario C, it was 68.2% vs 90.7% (P < .001), respectively. CONCLUSIONS: The TMAC seems to be a superior intubating device compared with the conventional MAC when used in simulated normal and difficult child airway with chest compression scenarios. Future studies should explore the efficacy of TMAC in pediatric clinical emergency settings.

Video rigid flexing laryngoscope (RIFL) vs Miller laryngoscope for tracheal intubation during pediatric resuscitation by paramedics: a simulation study.

OBJECTIVES: Endotracheal intubation (ETI) is an essential resuscitation procedure in children. Video laryngoscopes have been developed to avoid intubation failures in a variety of scenarios, including cardiopulmonary resuscitation. We hypothesized that the video laryngoscope RIFL (AI Medical Devices, Inc, Williamston, MI) offers advantages in the ETI of a pediatric manikin while performing chest compressions (CCs). METHODS: Randomized nonblinded crossover simulation trial conducted among 132 paramedics with no prior experience with RIFL. Each participant performed intubations with Miller (MIL; Mercury Medical, Clearwater, FL) laryngoscope and RIFL in a PediaSIM CPR training manikin (FCAE HealthCare, Sarasota, FL) in 3 airway scenarios: (a) normal airway at rest (without concomitant CC), (b) normal airway with mechanically controlled CC, and (c) difficult airway with concomitant CC. The primary outcome was the time to intubation, and secondary one was the success of the intubation attempt. RESULTS: In the manikin at rest with normal airway, nearly all participants performed successful ETI both with MIL and RIFL, with similar intubation times. However, in the other scenarios (normal and difficult airway with uninterrupted CC), the results with RIFL were significantly better than with MIL (P < .05) for all the analyzed variables (success of first attempt, overall success rate, time to intubation, Cormac-Lehane grade, dental compression, and easy of intubation scores). CONCLUSIONS: In simulated child arrest scenarios with normal/difficult airway conditions and with concomitant mechanical CC, paramedics performed better with the RIFL video laryngoscope than with the standard MIL.

Child endotracheal intubation with a Clarus Levitan fiberoptic stylet vs Macintosh laryngoscope during resuscitation performed by paramedics: a randomized crossover manikin trial.

INTRODUCTION: The main cause of cardiac arrest in pediatric patients is respiratory failure. OBJECTIVE: To test the ability of paramedics to intubate the trachea of a child by means of the standard Macintosh [MAC] laryngoscope vs the Clarus Leviatan fiberoptic stylet (FPS) during 3-airway scenarios. METHODS: This was a randomized crossover manikin study involving 89 paramedics. The participants performed tracheal intubations using the MAC laryngoscope and the Clarus Leviatan FPS in 3 pediatric airway scenarios: scenario A, normal airway without chest compression (CC); scenario B, normal airway with CC; and scenario C, difficult airway with CC. RESULTS: A total of 89 paramedics participated in this study. In scenario A, the FPS maintained a better success rate at first attempt (97.8% vs 88.9%; P=.73) and time required to intubate (17 [interquartile range, 15-21) seconds vs 18 [interquartile range, 16-22] seconds; P=.67) when compared with MAC. In scenarios B and C, the results with FPS were significantly better than those with MAC (P<.05) for all analyzed variables. CONCLUSIONS: This study suggested that the FPS could be used as an option for airway management even for paramedics with little experience. Future studies should explore the efficacy of FPS in pediatric clinical emergency settings.

Simulated endotracheal intubation of a patient with cervical spine immobilization during resuscitation: a randomized comparison of the Pentax AWS, the Airtraq, and the McCoy Laryngoscopes.

BACKGROUND: Tracheal intubation during cardiopulmonary resuscitation is a high-risk procedure. The aim of this study was to compare efficacy of intubation with the Pentax AWS, Airtraq, and McCoy laryngoscopes in patients with cervical spine immobilization during resuscitation in a randomized, controlled simulation trial. METHODS: We compared times to intubation, success rate, Cormack and Lehane grading, and ease of intubation when using Pentax AWS, Airtraq, and McCoy in randomized order. RESULTS: Sixty-seven paramedics were trained in the use of the Pentax AWS, Airtraq, and McCoy laryngoscopes with a METIman Prehospital manikin. Participants performed tracheal intubation in patients with cervical spine immobilization during resuscitation scenario. We measured success rates, times for tracheal intubation, the glottic view, and ease of intubation. RESULTS: The primary study end point, overall success rate, was highest when using Pentax AWS (94.0%) and was lower in Airtraq (86.6%; P = .017) and in McCoy (85.1%; P = .019). Time to first effective ventilation was achieved significantly shorter when using Pentax AWS (25.4 ± 6.7 seconds) than Airtraq (35.6 ± 5.1 seconds; P < .001) or McCoy (38.5 ± 10.3 seconds; P < .001). The quality of glottic view and ease of use were best with Pentax AWS. CONCLUSIONS: The Pentax AWS videolaryngoscope provided a better view of the vocal cords, less insertion time, and higher success rate of the endotracheal intubation compared with the Airtraq or McCoy laryngoscopes in adults with simulated cervical spine immobilization during resuscitation.

Emergency services response to eCall System alerts: Observations from 2016-2022 in the National Fire and Rescue System.

OBJECTIVE: Analysis of interventions by fire protection units in road traffic incidents alerted by the eCall system between 2016 and 2022. MATERIALS AND METHODS: Data from the State Fire Service Decision Support System (SFS DSS), provided by the Operational Planning Office, were used. Events from January 1, 2016, 00:00 to December 31, 2022, 23:59 were analyzed. Quantitative data were described using mean (Mean) and standard deviation (SD). Correlations and differences at a significance level of p < 0.05 were considered statistically significant. The analysis is anonymous for both victims and officers involved in the interventions. RESULTS: Between 2016 and 2022, firefighters were alerted by the e-call system 896 times. The shortest average intervention time was 47 ± 37 min and was recorded in 2021. In the comparative analysis of intervention time and factors conditioning the use of the eCall system, it was shown that this time was significantly statistically dependent on the number of cars involved in the incident (p < 0.001), the number of injured persons (p < 0.001), the type of intervention (p < 0.001),), and the occurrence of fuel leakage (p < 0.001). CONCLUSIONS: ECall is a relevant system for reporting accidents and collisions on the road. While it proves reliable in road incidents, a significantly high number of false alarms initiated from eCall requires system refinement to avoid accidental alarms and user education about the possibility of unintentionally sending an alarm signal. The authors predict that as the number of vehicles with the eCall system introduced to the roads increases, so will the number of notifications from this system. Data from the analysis of false reports suggest that mechanics and electricians in facilities performing repairs and maintenance of vehicles with the eCall system may lack the necessary knowledge of the need to deactivate the system before starting work. The number of injured people had no impact on the intervention time, which may prove that the rescue services were properly prepared.

Long-term Development of Fibrosarcoma in the Practice of Emergency Medical Teams: a Case Report.

Fibrosarcoma is a relatively rapidly growing, poorly delineated spindle cell tumour. It has generally good prognosis and rarely metastasizes. Soft tissue sarcomas account for less than 1% of all malignancies in adults. High rates of sarcomas are, for example, seen in patients with tuberous sclerosis complex. This paper presents the case of a patient with knee joint destruction caused by a fibrosarcoma, on account of which an emergency medical team was summoned several times. We present data from three medical rescue team interventions to a patient with a tumour in the left lower leg. The data was obtained from the documentation generated during the interventions: dispatch order record (DOR) and medical emergency treatment report (METR). The patient had a history of the following chronic diseases (ICD-10): E11.8, I50.9, I10, and M15. Two interventions involved patient transportation to a hospital, whereas the third intervention was completed in the patient's home. The fibrosarcoma caused only slight pain. Frequent bleeding from an open cancerous wound was the main problem in this patient. Difficulty in wound healing could have been related to complications of diabetes mellitus and the patients advanced age.

Geriatric patient in the practice of emergency medical teams - observation in 2020-2022.

Purpose: Analysis of interventions of medical rescue teams for geriatric patients in a three-year period, taking into account the causes, circumstances, medical management, pharmacology. Materials and methods: The study included a 3-year retrospective analysis of the trips of medical rescue teams in the northern part of the Lubelskie Voivodeship in the period from January 1, 2020 to December 31, 2022. The data comes from medical documentation. Interventions caused by a health risk in a patient in the 90+ age group were qualified as events. 897 EMT interventions were qualified (2020-327, 2021-269, 2022-301) constituting 4.29% of all interventions carried out in the operational area. In addition, a quantitative analysis of a comparative group of patients aged 80-89 was performed. Results: It was shown that the time of rescue activities was the longest for injuries and the shortest for mental disorders (60 ± 31 vs. 43 ± 21 min). It was shown that specialist EMT teams (S) were statistically significantly more often called for cardiology disorders (63%). It was shown that pharmacological agents were used statistically significantly more often in respiratory disorders (83%) compared to neurology disorders (47%, p < 0.001). It was also shown that patients whose call was caused by neurology disorders were statistically more often transported to the emergency department (N = 76, 76%, p < 0.001). Conclusion: The causes of calls regarding disorders of the circulatory and respiratory systems most often require the implementation of pharmacology during EMT interventions, mainly short-term and symptomatic drugs. Interventions to rural areas dominate in the presented analysis in each year of the analysis and in each group of reasons for calls, which may be associated with more difficult access to a primary care physician. Most EMT interventions concern exacerbation of chronic diseases. Transport to the hospital was necessary mainly due to neurological and traumatic calls.