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Gynecological and obstetric interventions in the emergency medical service in Poland during the COVID-19 pandemic: a pilot study.

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Dudziński Ł., Glinka M., Zalewski R., Panczyk M.

Critical Care Innovations

2022

vol. 5

issue 1

38-48

INTRODUCTION: : Functioning of the EMS during one year pre-pandemic compared to one year pandemic outbreak was analysed in relation to specific intervention groups alongside each other. Our observations focused on women requiring implementation of medical procedures and treatment by gynecology and obstetrics departments with the initial participation of EMS. Cases of both pregnant women and those with reproductive system diseases were analysed. MATERIAL AND METHODS: The study included a retrospective analysis of EMS interventions from the Łuków region in the two-year period from March 2019 to the end of February 2021 (one year before the epidemic - period I, and the year of the epidemic in Poland - period II). The material consisted of departure order flowsheet and the ambulance flowsheet records. RESULTS: In the 2-year period, there were 101 events that met the criteria for inclusion in the analysis, respectively 58 - period I and 43 - period II. In both periods, cases related to the commencement of the patient's labor outside the hospital ward are analyzed more often. The percentage share of interventions in the period before and during the pandemic for subsequent months of the year showed no significant correlations (χ2 = 14.886; p = 0.188). CONCLUSIONS: The COVID-19 pandemic did not significantly affect the number of EMS interventions related to gynecological and obstetric events in the area covered by the analysis. The mean duration of EMS interventions to gynecological and obstetric conditions slightly increased during the epidemic period.

WSTĘP: Analizie poddano funkcjonowanie jednostek PRM w początkowym okresie epidemii wobec konkretnej grupy interwencji. Obserwacje ogniskowały wokół kobiet wymagających wdrożenia procedur medycznych i leczenia przez oddziały ginekologiczno-położnicze przy udziale jednostek PRM. Analizowano przypadki zarówno kobiet w ciąży, jak i kobiet z chorobami układu rozrodczego. MATERIAŁ I METODY: Badanie obejmowało retrospektywną analizę wyjazdów ZRM powiatu łukowskiego (północna część woj. lubelskiego) w dwuletnim okresie od marca 2019 do końcalutego 2021(rok przed epidemią – okres I, oraz rok trwania epidemii w Polsce- okres II).Materiał stanowiły Karty Zlecenia Wyjazdu i Karty Medycznych Czynności Ratunkowych ZRM. WYNIKI: W 2-letnim okresie wystąpiło 101 zdarzeń spełniających kryteria włączenia do analizy, odpowiednio 58 – okres I i43 – okres II. W obu okresach częściej przedmiotem analizy przypadki związane z rozpoczęciem akcji porodowej pacjentki poza oddziałem szpitalnym. WNIOSKI: Pandemia COVID–19 nie wpłynęła w znaczący sposób na liczbę interwencji ZRM związanych ze zdarzeniami ginekologiczno- położniczymi w rejonie objętym analizą. Średni czas realizacji interwencji ZRM do stanów ginekologiczno-położniczych nieznacznie zwiększył się w okresie epidemii.

Characteristics of emergency medical service (EMS) calls to mentally disabled residents of a social welfare home

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Zdzieborska P., Sholokhova D., Zalewski R.

Critical Care Innovations

2023

vol. 6

issue 3

1-12

INTRODUCTION: The problem of disability in the modern world affects a significant number of people of different ages. Mental disability is a disorder characterised by limitations in a person's intellectual functioning, social, and adaptive behavior, appearing before the age of 18. According to a report published in 2022, there were 897 social welfare homes in Poland, of which there were up to 16,412 residents with disabilities. Interventions in emergency medical services for mentally disabled patients require an interdisciplinary approach. The purpose of the study is to attempt to outline the profile of a patient with mental disabilities from the perspective of the emergency medical services (EMS) team, as well as to indicate the characteristics of calls to social welfare homes. MATERIAL AND METHODS: A retrospective analysis included 125 patients who were treated by emergency services at the "Pomocna Dłoń" Social Welfare Home (SWH) in Wirów (central Poland). Data on the time of call, urgency code, type of team dispatched, and reason for call were analysed. The following data were extracted from all information about patients: age, gender, medical rescue procedures performed, supply of sedatives to patients, diagnosis, and destination of patient transport. In the statistical analysis, the significance threshold was established at p<0.05. RESULTS: During the period under study, the emergency services performed a total of 125 interventions. The highest number of interventions took place in the afternoon and evening (49.6%). 59.2% of the trips were made to men (n=74) and 40.8% to women (n=51). The mean age of the patients was 62.6 (SD ± 17.91) years. The most common reason for calling EMS was shortness of breath (n=16; 12.8%), while the most common diagnosis was cystostomy dysfunction (n=15; 12%). The final destination of transport for most patients was the hospital outpatient department (52.8%), the second place was the emergency department - ED (23.2%), and the third place was the psychiatric department (11.2%). 12.8% of the patients were helped at the scene, without having to be transported to hospital. CONCLUSIONS: A mentally disabled patient in a nursing home to whom EMS is called is usually a middle-aged man. The number of interventions increases in the evenings. The most common reason for emergency medical services calls is shortness of breath, which is not confirmed by on-scene examination. Every tenth patient did not require transport to the hospital, raising doubts as to the validity of calling an emergency medical team. Human resources and organizational solutions should be considered to improve the quality of medical care and the supply of emergency medicines in social welfare homes, without the need for emergency services.

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2 Critical Care Innovations

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1 Panczyk M.

1 Sholokhova D.

1 Zdzieborska P.

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Gynecological and obstetric interventions in the emergency medical service in Poland during the COVID-19 pandemic: a pilot study.

Characteristics of emergency medical service (EMS) calls to mentally disabled residents of a social welfare home