Experience of the Polish Medical Air Rescue Service During the First Year of the COVID-19 Pandemic and Measures Taken to Protect Patients, Medical Staff, and Air Crew from SARS-CoV-2 Infection.

BACKGROUND The emergence of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and the sudden inflow of patients with severe COVID-19 (coronavirus disease 2019) symptoms increased demand for hospital and pre-hospital care, the latter being provided by emergency medical teams. The Polish Medical Air Rescue Services include the Helicopter Emergency Medical Service (HEMS) and the airplane-based Emergency Medical Service (EMS). This study aimed to present the experience of the Polish Medical Air Rescue Service during the first year of the COVID-19 pandemic and measures taken to protect patients, medical staff, and air crew from SARS-CoV-2 infection. MATERIAL AND METHODS We conducted a retrospective analysis of missions completed by the Polish Medical Air Rescue crews with respect to confirmed SARS-CoV-2 cases. We analyzed data from the medical records of the Polish Medical Air Rescue Service, which included flights to accidents and emergencies, and air patient transport missions, where medical assistance was provided to patients with confirmed SARS-CoV-2 infection in the first year of the pandemic in Poland. RESULTS Among the COVID-19 patients, the most common comorbidity was acute respiratory failure (41.58%). Emergency missions more often concerned older patients with sudden cardiac arrest, dyspnea, upper respiratory tract infection, stroke, and acute coronary syndromes. CONCLUSIONS During the first year of the COVID-19 pandemic in Poland, the Polish Medical Air Rescue Service implemented procedures to protect patients, medical staff, and air crew from SARS-CoV-2 infection. This study highlights the importance of using single-patient isolation units for patient transport between hospitals and for emergency hospital admissions when the SARS-CoV-2 status of the patients were unknown.

Retrospective Study to Identify Risk Factors for Severe Disease and Mortality Using the Modified Early Warning Score in 5127 Patients with COVID-19 Admitted to an Emergency Department in Poland Between March 2020 and April 2021.

BACKGROUND COVID-19, a disease caused by SARS-CoV-2, has posed a threat to global public health. This retrospective study of 5127 patients with COVID-19 admitted to an Emergency Department in Poland between March 2020 and April 2021 aimed to identify risk factors for severe disease and mortality using the modified early warning score (MEWS). MATERIAL AND METHODS The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to the Emergency Department between March 2020 and April 2021. A total of 5127 cases were included in the final analysis. Identifying the group of high-risk patients with COVID-19 was determined based on the MEWS score. RESULTS Most of the patients studied were male (53.38%). The in-hospital mortality rate among the patients was 21.53%. The factors associated with the risk of in-hospital mortality from COVID-19 were age (>60 years, hazard ratio [HR]=2.27, P<0.001), comorbidities (cancer, HR=1.39, P=0.005; heart failure, HR=1.31, P=0.009; renal failure, HR=1.37, P=0.004), higher MEWS score (MEWS ≥5, HR=1.43, P<0.001), higher percentage of lung parenchyma affected (>50%, HR=2.10, P=0.001), and higher respiratory rate (>24 breaths per min, HR=2.10, P<0.001). CONCLUSIONS This study produced real-world data of risk factors for mortality from COVID-19 and the use of the MEWS for a faster identification of patients with COVID-19 requiring more intensive medical care.

Burns in practice of helicopter emergency medical service in Poland. Retrospective analysis.

OBJECTIVE: Introduction: Burns are a huge problem for public health and a challenge for healthcare systems all around the world. They are responsible for 180.000 deaths worldwide each year. In order to ensure high quality treatment and rehabilitation of these patients burn centres are established in many countries. Another vital factor influencing the prognosis of patients with burns is quick transport that in many countries, including Poland is carried out by Helicopter Emergency Medical Service (HEMS). The aim: To describe the operations carried out by HEMS with particular stress put on the target medical facility. PATIENTS AND METHODS: Materials and methods: The research was conducted with the method of retrospective analysis of operations performed by HEMS crews. All missions from January 2011 to December 2018 were included in the study and 2534 cases were qualified for the final analysis. RESULTS: Results: The study group was predominantly male (72.72%) aged 18 years old and less (36.65%). Nearly two thirds of the patients were transported to hospitals with a burn ward (61.88%). Opioid analgesics as well as crystalloids were the most commonly administered drugs (respectively 68.55% and 64.76%). Statistical analysis showed that HEMS arrival time (20.77 minutes vs 18.60 minutes) and duration of the transport to designated hospital (40.11 minutes vs 19.66 minutes) were significantly higher in the cases of deciding to transport the patient to the hospital with the burns department (p<0.001). CONCLUSION: Conclusions: Presented results showed that HEMS crews are more often assigned to help ground-based Medical Rescue Teams in case of patients who required treatment in burn centres. Moreover, the time and distance to the hospital with burn ward was significantly longer compared to other healthcare facilities. This confirms that the assigning of HEMS crews for the patients with severe burns was reasonable.