[The TISS-28 scoring system for assessment of cardiac surgical postoperative intensive care]. / Zastosowanie skali TISS-28 w intensywnej opiece pooperacyjnej w kardiochirurgii.

BACKGROUND: The TISS-28 scoring system, commonly used in Poland in general intensive care, relies mostly on nursing activities in individual patient care. It is not known, however, whether this system can also be useful in specialised intensive care. The aim of this study was to assess the usefulness of the TISS-28 scoring system in cardiac surgical intensive care. METHODS: Clinical records of three hundred and fifty-nine consecutive patients, treated in a cardiac surgical intensive care unit, were retrospectively analyzed. The records were analyzed overall, and in subgroups according to various ranges of operative risk according to the EuroSCORE (a scoring system commonly used in the preoperative assessment of cardiac surgical patients). The TISS-28 scores for each individual day of treatment were calculated. Additionally, individual real costs of treatment were calculated for each patient. RESULTS: One hundred and four patients (28.9%) were preoperatively allocated to the EuroSCORE low-risk group, 158 (44.0%) to the medium-risk group, and 97 (27.1%) to the high-risk group. The overall mean TISS-28 score was high (39.2+/-7.6). Patients in the high-risk group had the highest TISS-28 scores. Overall costs of treatment, calculated for individual patients, were closely correlated to the TISS-28 scores (r=0.76, p<0.0001). CONCLUSIONS: The TISS-28 scoring system may be useful in prediction of treatment costs and in planning of nursing staff allocation in a specialized cardiac surgical intensive care.

[Radiographic assessment of accuracy of tracheal tube placement in children]. / Ocena prawidlowego polozenia rurki dotchawiczej u dzieci na podstawie radiogramu klatki piersiowej.

BACKGROUND: Accidental migration of endotracheal tubes has been recognized by the European Resuscitation Council (ERC) as an important morbidity factor in ventilated children. Several equations have been proposed for prediction of the ideal position of the endotracheal tube, but none of them was found to be ideal. METHODS: We have retrospectively assessed the positions of endotracheal tubes in 108 intubated children. Infants were nasally intubated and oral intubation was used in older children. We compared the measured distances with theoretical lengths, obtained from various equations. RESULTS: We found that if the tube was placed according to the Lau equation (age/2+13 mm) or the ALS group equation (age/2+12 mm), the estimation was correct in 83% (Lau equation) and in 94.7% (ALS recommendations). CONCLUSION: Since results depended very much on the age and route of intubation, we suggest that extended studies may be recommended.

[Parents' and caregivers' theoretical and practical knowledge of first aid in case of accidents and minor injuries in children]. / Wiedza oraz umiejetnosci rodziców i opiekunów w zakresie udzielania pierwszej pomocy dzieciom ulegajacym wypadkom.

Accidents and injuries cause most serious health problems in pediatric group of patients in Poland. We asked a group of 93 parents and tutors (11 men and 82 women) to complete a questionnaire containing 20 questions. It referred to their knowledge on first aid treatment. We have analyzed the answers using statistical methods and couched our conclusions. 1. The results of the enquiry show a great extent of self-satisfaction in the questioned group of parents. Most of them (64.5%) think they know first aid rules, although only 35 people (37.6%) were ever trained in this field. Parents declare they known, how to deal with such conditions as bums, slight contusions and injuries, fractures, torsions, choking and high temperature. 2. Most parents (71%) have already treated minor injuries and dealt with minor accidents which took place while they took care of a child. Most common health problems were: high temperature--23.9%, slight contusions--22.4%, minor injuries--16.1%, hemorrhage--8.8%, scalding--8.3%, choking--7.3%. Accidents occur mainly during playground activities or cycling (63%) and at home (17%). 3. When an accident involving children occurs, 29.2% of parents call for medical help, 63.8% of them do it only if very serious injuries occur and 9% always try to treat a child themselves. In our enquiry most parents knew the names of popular analgesic and antipyretic drugs. They also knew how to deal with a slight burn or scald. 4. In questioned adults' opinion health care professionals do not give enough first aid information to the society. In our examined group, 58.1% of parents try to read and learn themselves. This shows the need for training people who take care of children in first aid treatment. As the best places for such training enquired parents pointed schools, kindergartens, pediatric and obstetric clinics.