Aim: The aim of the study was to determine the clinical characteristics and long term survival in patients with SARS-CoV-2 infection presenting with AMS. Material and methods: Retrospective analysis of the medical records was performed. The patients were divided into a group 1 with AMS and a group 2 without AMS. Demographics, the presence of concomitant diseases, systolic and diastolic blood pressure, heart rate and peripheral oxygen saturation (SpO2) were compared between the group that presented with AMS and the group that did not present with AMS. Survival analysis was performed with multiple regression models. The study was approved by Bioethical Commission. Results: The study group consisted of 174 patients aged 65±14 years. There were 88 (51%) women and 86 (49%) men. AMS at hospital admission was recognized in 14 (8%) patients. The patients with AMS were significantly older. Follow-up data were available for 163 patients. The median follow-up time was 467 (20-484) days. The 30 day mortality was 24% and the long term mortality was 30%. Conclusions: AMS occurs in about 8% of patients with COVID-19 admitted to the hospital. AMS is an independent from age, gender, and low oxygen saturation risk factor for long term mortality in patients with COVID-19 disease. Quarantine have the importance of early diagnosis of SARS-CoV-2 infection and patient monitoring in preventing deaths. The long term mortality in comparison to 30-day mortality doubled in patients with AMS and only slightly increased in patients without AMS.
The term ataxia includes impaired coordination and balance, and a lack of muscle control over intended movements. The most common signs and symptoms of cerebellar ataxia are ataxic gait (shaky, broad-based), movement disorders resulting from lack of proper muscular coordination, dysmetria, movement decomposition, intention tremor, and dysdiadachokinesia (disorder of alternating movements). Clinical symptoms vary depending on the damaged element: cerebellar hemisphere, cerebellar vermis, damage to the deep sensory pathways or damage to the cerebellar-frontal tracts and frontal centers. The most common causes of acute ataxia in children are drug overdoses, poisoning, and post-infectious cerebellitis. It is worth remembering that many causes of ataxia are metabolic and immunological. There are acute ataxias, intermittent and recurrent ataxias, chronic progressive and non-progressive ataxias. It should be remembered that each child with acute ataxia requires diagnosis and hospitalization. It is necessary to conduct a detailed interview regarding the time and circumstances of the onset of ataxia, accompanying symptoms, continuously and temporarily taken medications, possible previous episodes of these the symptoms themselves and the current state of health.
Aim: Paramedics carry out their work duties in a shift system. Shift work is related to a multitude of health complications, disrupting their biological habits and natural rhythm, impeding their private life and negatively affecting nutrition and the quality of sleep. The aim of the study was the evaluation of the effect of shift work on the nutrition habits of paramedics. Material and methods: The study was carried out in the period between in 2019 using diagnostic survey methodology among a group of 238 paramedics from mobile Emergency Response Teams of the Mazovian voivodeship. The mean age of the participants was 39.03±9.27 years for males and 31.93±7.76 years for females. In order to examine the differences between the groups, the χ2 test was used with an established statistical significance level of p <0.05. Results: Among the paramedics, the mean value of BMI was at a level of 24.99±3.36.56.30% (n = 134) of the participants indicated exhibiting improper nutrition habits. As the research found, the reasons for the improper nutrition habits in this occupational group are primarily shift work (151; 63.44%) and hurry (87; 36.54%). Conclusions: In order to minimize the possible health consequences related to the nutrition habits of paramedics, it seems essential to incorporate issues concerning the rules of proper nutrition in the health education process, as well as continuously monitoring their condition as part of occupational medicine practice.
Aim: The aim of this paper is an attempt to analyse the determinants of effective cardiopulmonary resuscitation (CPR) performed by medical personnel over a five-year span. Material and methods: An original research questionnaire was used to collect and process data for the purposes of this retrospective observational study. The research sample consisted of 167 patients aged between 16 and 102 who had in-hospital sudden cardiac arrest (SCA) and underwent cardiopulmonary resuscitation (CPR). Results: The most common causes of SCA in the study group of patients were cardiovascular diseases, and the mechanism of asystole was responsible for half of the recorded sudden cardiac arrests. While performing CPR, chest compressions were the most frequently applied procedure, whereas defibrillation or the Esmarch (jaw-thrust) maneuver were used less often. The effectiveness of resuscitation in almost a half of the cases was unsatisfactory, whereas the average time of performing resuscitation was 27,83 minutes. Pronouncement of death was made with regard to patients on whom resuscitation was performed for the longest time. On the other hand, among patients who were resuscitated for less than 20 minutes, breathing, blood circulation and con¬sciousness were restored, or only breathing and circulation were restored. Conclusions: The main cause of sudden cardiac arrest in the study period were non-shockable heart rhythms, whereas the restoration of spontaneous cir¬culation and breathing was achieved in the cases when resuscitation was performed for less than 20 minutes. The survival rate after successful resuscitation is comparable to the results obtained in other hospitals in Poland and Europe, as well as statistical data from scientific publications.
Aim: The COVID-19 pandemic is still a real threat to global public health. Medical personnel face new, previously unencountered challenges, and their feel¬ing of physical and psychological safety is under threat. The aim of the paper is to examine the differences in the feeling of safety among emergency medical personnel during the COVID-19 pandemic in selected European countries. Material and methods: The study group consisted of 1984 people working in the emergency medical services in seven countries. The research tool was a proprietary internet questionnaire, which prior to commencement of the research was validated using the Mc-Donald test, achieving a result of > 0.7, which underlines a satisfactory level of reliability. In the statistical analysis, a significance level of p = 0.05 was adopted. Analysis of the quantitative variables, presented by division into groups, was conducted using the non-parametric Mann-Whitney and Kruskal-Wallis tests. The choice of tests was conducted on the basis of the distribution of variables, verified by the Shapiro-Wilk test. Results: During the COVID-19 pandemic, the feeling of safety among employees of the emergency medical services and the feeling of danger to health and life as a result of infection with the SARS-CoV-2 virus was varied and depended on the job position. Principles for observing the sanitary regulations and the level of fear of infection are at a similar level and depend on place of work. Conclusions: Those most at risk from a lack of safety are emergency medical response teams.
