المؤلفون: Podsiadło, Paweł, Darocha, Tomasz, Kosiński, Sylweriusz, Sanak, Tomasz, Gałązkowski, Robert

المصدر: BMC Emergency Medicine, Vol 19, Iss 1, Pp 1-5 (2019)
BMC Emergency Medicine

مصطلحات موضوعية: Emergency Medical Services, Accidental hypothermia, Thermometers, Ambulances, lcsh:Special situations and conditions, Body temperature measurement, Hypothermia, Core temperature, Body Temperature, Diagnose hypothermia, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Medicine, Humans, 030212 general & internal medicine, Emergency medical system, Thermometer, business.industry, lcsh:RC952-1245, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Survey research, lcsh:RC86-88.9, medicine.disease, Cross-Sectional Studies, Emergency Medicine, Ear thermometers, Christian ministry, Medical emergency, Poland, business, Research Article

الوصف: Background Some crucial decisions in treatment of hypothermic patients are closely linked to core body temperature. They concern modification of resuscitation algorithms and choosing the target hospital. Under- as well as over-estimation of a patient’s temperature may limit his chances for survival. Only thermometers designed for core temperature measurement can serve as a guide in such decision making. The aim of the study was to assess whether ambulance teams are equipped properly to measure core temperature. Methods A survey study was conducted in collaboration with the Health Ministry in April 2018. Questionnaires regarding the model, number, and year of production of thermometers were sent to each pre-hospital unit of the National Emergency Medical System in Poland. Results A total of 1523 ground ambulances are equipped with 1582 thermometers. 53.57% are infrared-based ear thermometers, 23.02% are infrared-based surface thermometers, and 20.13% are conventional medical thermometers. Only 3.28% of devices are able to measure core body temperature. Most of analyzed thermometers (91.4%) are not allowed to operate in ambient temperature below 10 °C. Conclusions There are only 3.28% of ground ambulances that are able to follow precisely international guidelines regarding a patient’s core body temperature. A light, reliable thermometer designed to measure core temperature in pre-hospital conditions is needed.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8355505cb32a1037b8de265f217b6c9eTest
https://ruj.uj.edu.pl/xmlui/handle/item/128813Test

المؤلفون: Kosiński, Sylweriusz, Darocha, Tomasz, Jarosz, Anna, Zeliaś, Aleksander, Ziętkiewicz, Mirosław, Podsiadło, Paweł, Sanak, Tomasz, Sałapa, Kinga, Piątek, Jacek, Konstanty-Kalandyk, Janusz, Gałązkowski, Robert, Krawczyk, Paweł, Krzych, Łukasz, Drwiła, Rafał

المصدر: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 25, Iss 1, Pp 1-7 (2017)

مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Hemodynamics, Hypothermia, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Extracorporeal, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Extracorporeal membrane oxygenation, Humans, Rewarming, Original Research, Aged, Aged, 80 and over, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Shock, lcsh:RC86-88.9, Middle Aged, Prognosis, Surgery, Heart Arrest, Critical care, Blood pressure, Shock (circulatory), Anesthesia, Accidents, Emergency Medicine, Arterial blood, Female, medicine.symptom, business, Case series

الوصف: Background Recently, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become the rewarming treatment of choice in hypothermic cardiac arrest. The detailed indications for extracorporeal rewarming in non-arrested, severely hypothermic patients with circulatory instability have not been established yet. The primary purpose of the study was a preliminary analysis of all aspects of the treatment process, as well as initial identification of mortality risk factors within the group of severely hypothermic patients, treated with arteriovenous extracorporeal membrane oxygenation (VA-ECMO). The secondary aim of the study was to evaluate efficacy of VA-ECMO in initial 6-h period of treatment Methods From July 2013 to June 2016, thirty one hypothermic patients were accepted for extracorporeal rewarming at Severe Accidental Hypothermia Center, Cracow. Thirteen patients were identified with circulatory instability and were enrolled in the study. The evaluation took into account patients’ condition on admission, the course of therapy, and changes in laboratory and hemodynamic parameters. Results Nine out of 13 analyzed patients survived (69%). Patients who died were older, had lower both systolic and diastolic pressure, and had increased creatinine an potassium levels on admission. In surviving patients, arterial blood gases parameters (pH, BE, HCO3) and lactates would normalize more quickly. Their potassium level was lower on admission as well. The values of the core temperature on admission were comparable. Although normothermia was achieved in 92% of patients, none of them had been weaned-off VA-ECMO in the first 6 h of treatment. Discussion and Conclusions In our preliminary study more pronounced markers of cardiocirculatory instability and organ hypoperfusion were observed in non-survivors. Future studies on indications to extracorporeal rewarming in severely hypothermic, non-arrested patients should focus on the extent of hemodynamic disturbances. Short term (

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e07d4b81e8cc1f7177d3f364500aacebTest
http://europepmc.org/articles/PMC5414327Test

المؤلفون: Podsiadło, Paweł, Darocha, Tomasz, Kosiński, Sylweriusz, Jarosz, Anna, Ziętkiewicz, Mirosław, Sanak, Tomasz, Gałązkowski, Robert, Piątek, Jacek, Konstanty-Kalandyk, Janusz, Drwiła, Rafał

المصدر: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

مصطلحات موضوعية: Male, Decision Making, Collateral Circulation, Hypothermia, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Capnography, medicine, Humans, Esophagus, Original Research, Retrospective Studies, medicine.diagnostic_test, business.industry, Hemodynamics, 030208 emergency & critical care medicine, Middle Aged, Respiration, Artificial, medicine.anatomical_structure, Shock (circulatory), Anesthesia, Pulmonary ventilation, Circulatory system, Breathing, Emergency Medicine, Arterial blood, Female, Poland, medicine.symptom, business, Accidental hypothermia, Case series

الوصف: Background Severe accidental hypothermia can cause circulatory disturbances ranging from cardiac arrhythmias through circulatory shock to cardiac arrest. Severity of shock, pulmonary hypoperfusion and ventilation-perfusion mismatch are reflected by a discrepancy between measurements of CO2 levels in end-tidal air (EtCO2) and partial CO2 pressure in arterial blood (PaCO2). This disparity can pose a problem in the choice of an optimal ventilation strategy for accidental hypothermia victims, particularly in the prehospital period. We hypothesized that in severely hypothermic patients capnometry should not be used as a reliable guide to choose optimal ventilatory parameters. Methods We undertook a pilot, observational case-series study, in which we included all consecutive patients admitted to the Severe Hypothermia Treatment Centre in Cracow, Poland for VA-ECMO in stage III hypothermia and with signs of circulatory shock. We performed serial measurements of arterial blood gases and EtCO2, core temperature, and calculated a PaCO2/EtCO2 quotient. Results The study population consisted of 13 consecutive patients (ten males, three females, median 60 years old). The core temperature measured in esophagus was 20.7–29.0 °C, median 25.7 °C. In extreme cases we have observed a Pa-EtCO2 gradient of 35–36 mmHg. Median PaCO2/EtCO2 quotient was 2.15. Discussion and Conclusion Severe hypothermia seems to present an example of extremely large Pa-EtCO2 gradient. EtCO2 monitoring does not seem to be a reliable guide to ventilation parameters in severe hypothermia.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a4ba5e2eae04eb2b525acacef3ca94abTest
https://ruj.uj.edu.pl/xmlui/handle/item/110639Test

المؤلفون: Darocha, Tomasz, Majkowski, Jacek, Sanak, Tomasz, Podsiadło, Paweł, Kosiński, Sylweriusz, Sałapa, Kinga, Mazur, Piotr, Ziętkiewicz, Mirosław, Gałązkowski, Robert, Krzych, Łukasz, Drwiła, Rafał

المصدر: Journal of Clinical Monitoring and Computing

مصطلحات موضوعية: medicine.medical_specialty, Tympanic Membrane, Accidental hypothermia, Computer science, Thermometers, Headset, Point-of-Care Systems, Equipment, Health Informatics, Hypothermia, Core temperature, Critical Care and Intensive Care Medicine, Temperature measurement, Body Temperature, Catheterization, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Original Research, Monitoring, Physiologic, Thermometer, Measurement, Adapter (computing), Vital Signs, Reproducibility of Results, 030208 emergency & critical care medicine, Signal Processing, Computer-Assisted, Equipment Design, Surgery, Catheter, Concordance correlation coefficient, Anesthesiology and Pain Medicine, Smartphone, Biomedical engineering

الوصف: Fast and accurate measurement of core body temperature is crucial for accidental hypothermia treatment. We have developed a novel light and small adapter to the headset jack of a mobile phone based on Android. It has been applied to measure temperature and set up automatic notifications (e.g. Global Positioning System coordinates to emergency services dispatcher, ECMO coordinator). Its validity was confirmed in comparison with Vital Signs Monitor Spacelabs Healthcare Elance 93300 as a reference method, in a series of 260 measurements in the temperature range of 10–42 °C. Measurement repeatability was verified in a battery of 600 measurements (i.e. 100 readings at three points of 10, 25, 42 °C for both esophageal and tympanic catheters). Inter-method difference of ≤0.5 °C was found for 98.5% for esophageal catheter and 100% for tympanic catheter measurements, with concordance correlation coefficient of 0.99 for both. The readings were almost completely repeatable with water bath measurements (difference of ≤0.5 °C in 10 °C: 100% for both catheters; in 25 °C: 99% for esophageal catheter and 100% tympanic catheter; in 42 °C: 100% for both catheters). This lightweight adapter attached to smartphone and standard disposable probes is a promising tool to be applied on-site for temperature measurement in patients at risk of hypothermia.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b1086628c720af1315b0ea13372f752fTest
https://ruj.uj.edu.pl/xmlui/handle/item/124026Test

المؤلفون: Kosiński, Sylweriusz, Darocha, Tomasz, Jarosz, Anna, Czerw, Aleksandra, Podsiadło, Paweł, Sanak, Tomasz, Gałązkowski, Robert, Piątek, Jacek, Konstanty-Kalandyk, Janusz, Ziętkiewicz, Mirosław, Kusza, Krzysztof, Krzych, Łukasz, Drwiła, Rafał

المصدر: Anaesthesiology intensive therapy. 49(2)

مصطلحات موضوعية: oksygenacja membranowa, Adult, Resuscitation, finansowanie, Accidental hypothermia, Hypothermia, 030204 cardiovascular system & hematology, Core temperature, Critical Care and Intensive Care Medicine, Severity of Illness Index, law.invention, severe hypothermia, 03 medical and health sciences, 0302 clinical medicine, Extracorporeal Membrane Oxygenation, law, medicine, Effective treatment, Economic analysis, Humans, membrane oxygenation, Rewarming, health care economics and organizations, business.industry, funding, 030208 emergency & critical care medicine, General Medicine, Health Care Costs, National health service, medicine.disease, Intensive care unit, Heart Arrest, hipotermia głęboka, Intensive Care Units, Anesthesiology and Pain Medicine, Treatment Outcome, Current medication, Medical emergency, Poland, business

الوصف: BACKGROUND: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland. METHODS: We carried out the economic analysis of 31 hypothermic adults in stage III-IV (Swiss Staging) treated with VA ECMO. Twenty-nine individuals were further managed in the Intensive Care Unit. The actual treatment costs were evaluated based on current medication, equipment, and dressing pricing. The costs incurred by the John Paul II Hospital were then collated with the National Health Service (NHS) funding, assessed based on current financial contract. RESULTS: In most of the cases, the actual treatment cost was greater than the funding received by around 10000 PLN per patient. The positive financial balance was achieved in only 4 (14%) individuals; other 25 cases (86%) showed a financial loss. CONCLUSION: Performed analysis clearly shows that hospitals undertaking ECR may experience financial loss due to implementation of effective treatment recommended by international guidelines. Thanks to new NHS funding policy since January 2017 such loss can be avoided, what shall encourage hospitals to perform this expensive, yet effective method of treatment.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dfa9b3bd7963aebea897f2a030cc3448Test
https://pubmed.ncbi.nlm.nih.gov/28643322Test