Loss of Consciousness and Prolonged Convulsions Due to Amanita Pantherina Intoxication.

Loss of consciousness ranks among very common causes for emergency medical service actions and is common occurrence in the emergency department. Its differential diagnosis is very broad and includes many possible causes, not in the least an intoxication. The same applies to convulsive states. Clinical course of mushroom poisoning varies depending on the particular fungal species, with some of the species causing loss of consciousness. One typical representative of such species is panther cap (Amanita pantherina). This case report introduces panther cap poisoning, initially presenting in given patient as coma and protracted generalized convulsions. Complex treatment led to withdrawal of neurologic symptoms, circulatory and metabolic stabilisation and subsequent discharge without signs of permanent organ damage.

Cerebral Performance Category score in patients after out-of-hospital cardiac arrest.

OBJECTIVE: Reporting epidemiological data on prehospital cardiac arrest in the Pilsen Region in 2022. Expression of cardiopulmonary resuscitation success using the Cerebral Performance Category (CPC) score. MATERIALS AND METHODS: The study looked at the survival rate of out-of-hospital sudden cardiac arrest in all patients in whom emergency medical services performed cardiopulmonary resuscitation (CPR). The study covered the period from 1 January 2022 to 31 December 2022. Both electronic and paper medical records were used to obtain data. All cases were evaluated according to Utstein-style guidelines. RESULTS: During the studied period, emergency response teams in the Pilsen Region carried out CPR in 499 cases. The incidence of prehospital CPR was 88.43 cases per 100,000 population. A total of 146 patients (29.26%) were referred to the hospital with spontaneous circulation, and results indicating survival with a good neurological outcome of CPC 1 or 2 were recorded in 48 cases (9.62%). The first monitored rhythm was shockable in 119 cases (23.85%). In this subgroup, ROSC was achieved in 71 cases (59.66%) and 61 of them (51.26%) were referred to hospital. In this study subgroup, a total of 36 patients (30.25%) achieved a good neurological outcome with a CPC score of 1 or 2. CONCLUSION: The study presented epidemiological data on OHCA and prehospital CPR in the Pilsen region in 2022. The data obtained shows a survival rate with good neurological outcome in 9.62% of cases.

Clinical picture, diagnostics and treatment of bacterial meningitis.

Bacterial meningitis is a serious infectious disease of the cerebral meninges, which occurs worldwide and threatens the lives of people of all ages. The largest number of cases in developed countries is caused by the gram-positive bacterium Streptococcus pneumoniae. Other more common agents are Neisseria meningitidis serotype B and Listeria monocytogenes. Fever is the most commonly reported symptom in paediatric patients, occurring in up to 93% of cases. Further, it is possible to observe headache, vomiting and positive meningeal phenomena. The most common symptoms in adults are fever, headache, positive meningeal symptoms and impaired consciousness. Examination of cerebrospinal fluid is essential for the diagnosis of bacterial meningitis. The basis of treatment is the earliest possible administration of antibiotics, initially empirically and then purposefully according to the results. Corticosteroids, traditionally dexamethasone, are also used in therapy.

Out-of-hospital cardiac arrest in the Pilsen Region in 2018.

AIMS: To acquire epidemiological data on pre-hospital cardiac arrest incidents occurring in the Pilsen Region of the Czech Republic in 2018, and the results of subsequent cardiopulmonary resuscitation Methods. A prospective observational study of the survival rate of out-of-hospital cardiac arrest (OHCA) in patients undergoing CPR carried out by emergency medical service personnel. The observed time period was from January 1st, 2018 until December 31st, 2018. The data were acquired from patients' records in paper and electronic forms. RESULTS: In the monitored period 707 patients with signs of cardiac arrest were recorded in the Pilsen Region with an incidence rate of 128.9 per 100,000 inhabitants. Emergency medical units performed CPR in 484 cases. The incidence rate of pre-hospital CPR was 88.2 cases per 100,000 inhabitants. Spontaneous blood circulation was temporarily or permanently restored in 276 patients (57.0%), 203 (41.9%) patients were transferred to a hospital, and there were 61 (12.6%) cases of survival with Cerebral Performance Category (CPC) score of 1 or 2. The first monitored rhythm was a shockable in 134 (27.7%) cases. In this sub-group ROSC was achieved in 94 (70.1%) cases and 58 (43.3%) of those were subsequently transferred to a hospital. A good CPC result was achieved in 41 (30.6%) patients of this sub group. CONCLUSION: The study has provided valuable epidemiological data on OHCA and prehospital CPR in the area of the Pilsen Region in 2018. The collected data, compared to international results, show a higher survival rate with good neurological score in 12.6% of cases.