Most cases of superior vena cava syndrome are easily diagnosed bya clinical examination alone, but several diagnostic tests and procedures can be helpful. When a patient presentswith a suspected diagnosis of superior vena cava syndrome, the first step is to obtain an imaging study that confirms the diagnosis and aids treatment decisions. Magnetic resonance imaging, contrast-enhanced CT scanning, radionuclide flow studies and traditional venography are all appropriate techniques. Still, the CT scan is the most readily available technology in most centers. The CT scan and magnetic resonance imaging also provide information on possible etiologies and can therefore direct the approach towards a tissue diagnosis.

Introduction: Burnout is a syndrome conceptualized as result of the chronic stress at the work place which was not successfully managed. The possible negative effects on the medical staff, the patients and the health institutions have generated interest and motivated the research to understand the possible causes, these effects also influence the burnout predictors. The medical services suppliers within the emergency department have had one of the greatest exhaution occurences even before the pandemic. Being in the first line in contact with the suspected patients or confirmed with COVID-19 infection intensifies this fact. Both the working factors (working hours, years of practice, number of treated patients, professional development activities) and the socio- demographic factors (age, sex, civil status, income, education) are associated with the exhaustion at the work place. Material and methods: I have studied a total of 120 participants, receiving 115 valid questionnaires, the answering ratio being 95,83%. This was a descriptive, multicentre, transversal study of the medical and the auxiliary staff within the department UPU-SMURD of the County Clinic Emergency Hospital “Sf. Ap. Andrei” Galați. The staff gave their consent and attended a combined interview which consisted of a pilot questionnaire and a demographic questionnaire. Results and discussions: The average score of exhaustion at the staff level was 3.25, a great percentage of the doctors within the ED (45.8%), (n=24) indicates an increased level of exhaustion, only 26.8% (n=80) of nurses show an increased level of exhaustion. The average score of the stress level shown by the staff is 3.1, 66.6% (n=24) among which the doctors with an increased stress level 9.1% (n=9) auxiliary staff, 23.8% (n=80) of nurses. Conclusions: The results show us a high exhaustion, stress and depression ratio at the emergency doctors in comparison with the other professional categories within the ED. A high level of professional satisfaction is accompanied by an increased level of stress and of self-esteem.

The aim of this study was to assess the delays that can potentially occur in the emergency transfer of patients with ST-elevation myocardial infarction (STEMI) to percutaneous coronary intervention (PCI) centers. We conducted a retrospective study using the medical reports pertaining to 97 patients who presented to the Emergency Department of the Emergency County Hospital of Galati during the year of 2018 with the diagnosis of STEMI and meeting eligibility criteria for PCI, thus warranting transfer to a hospital with PCI facilities. The pick-up time of patients diagnosed with acute myocardial infarction from the emergency department by the transfer crew is significantly shorter (p < 0.05) than those transferred by air, regardless of the PCI center to which the transfer was performed, Iasi or Bucharest, when compared to the time required to process the patients transferred by land to the same PCI centers. The results of the study shows that the helicopter use for transferring acute myocardial infarction patients to a PCI center must be considered, given the distance between non-PCI and PCI centers is over 200 km.

Introduction: Burnout syndrome is caused by a number of factors, including personal, organizational, and professional problems. Data from the literature reported a strong relationship between burnout syndrome and job satisfaction among emergency medical personnel. Material and Methods: We studied a sample of 80 nurses working in the Emergency Department of Emergency Clinical County Hospital “Sfântul Apostol Andrei” of Galati Romania. Participants signed an informed consent and then completed a socio-demographic questionnaire and the MBI-HSS (Maslach Burnout Inventory–Human Services Survey) questionnaire to assess the level of burnout and JSS (Job Satisfaction Survey) to assess the level of professional satisfaction. The aim of this study was to measure the levels of burnout and satisfaction among nurses in the Emergency Department as well as the relationship between these two variables and a group of selected socio-demographic characteristics. Results: This study found that 36.25% of nurses reported a high level of burnout. Additionally, emotional exhaustion is directly proportional to professional experience and age. Participants also reported a sense of ambivalence and satisfaction with the workplace, but were satisfied with the nature of their work. Conclusions: The results of this study suggest the relationship between variables and this could be used to implement psychoactive intervention strategies at both individual and organizational levels, which could lead to a decrease in burnout levels. Burnout is a predictor of job satisfaction for Emergency Department nurses. Personal achievement was relatively commensurate with the nature of the work. Additionally, the increase in burnout among nurses is directly proportional to the nature of the work.

Introduction Emergency department (ED) health care providers had one of the highest incidences of burnout just before the pandemic. Personality type influences the way we communicate and relate to others, as well as our reaction to stress. In evaluating the causes of burnout, we take into account several factors, the most important of which being the conditions of the professional environment, interpersonal relationships and personality traits. This study aims to identify and analyze the relationships between personality traits and burnout syndrome in medical staff in the Emergency Department. Material and Methods A descriptive, multicenter cross-sectional study project was used to collect data from 60 physicians and nurses from the Emergency Department of the County Emergency Clinical Hospital Galati. The tools used, distributed to participants to collect socio-demographic details, included the Eysenck Personality Inventory (EPI), and a pilot questionnaire. The questionnaire consisted of 11 questions, concerning exhaustion level, and focused on stress-generating elements and emotional management in the Emergency Department during the pandemic. Results A large percentage of doctors in ED (45.8%) (n = 24) indicated a high level of exhaustion, while only 30.6% (n = 36) of nurses indicated a high level of exhaustion. Physicians displayed a higher level of stress than nurses, with 66.6% (n = 24) of physicians indicating an increased level of stress, compared to only 36.1% (n = 36) of nurses. A large percentage of nurses indicated a high level of depression (36.1%), whereas only 25% of Emergency Department physicians indicated a high level of depression. Discussion The individuals with a melancholic and choleric temperament, as rated by the EPI, appeared more susceptible to developing burnout syndrome. The indication of instability or neuroticism appears to enhance the occurrence of burnout syndrome. There was also a correlation between extraversion and a high level of burnout, with extraverted individuals more easily reaching a high level of burnout. Conclusion The results indicate a greater occurrence of exhaustion and stress in Emergency Department physicians compared to nurses in the Emergency Department. From the results, we can propose that there is a relationship between the personality traits as measured by the EPI and the occurrence of burnout syndrome. These findings may help to understand the vulnerability of medical staff to burnout, and to pre-emptively support them to deal effectively with stressors in the work environment.

The traumatic phenomena in the lower extremities can lead to the amputations in more than 20% of the patients, especially when it is associated with the significant soft tissue loss or the severe wound contamination the blast events will require the amputation in 93% of cases. Case presentation:We present the case of a female patient, 8 -year and 7-month-old who was brought by the rescue crew members to the emergency room of the Children's Clinical Hospital "Sf. Ioan", Galati, on 12.12.2020. The patient arrived at the emergency care center as a victim of a road accident, as a passenger.Intraoperatively (12.12.2020 -13H.45): a complete section of the popliteal vascular-nerve bundle is revealed, which is why it is decided to amputate the lower limb segment from the proximal 1/3 of the calf. The fixation of the supracondylar fracture focus was performed with the 3 pins, achieving the bone stabilization. Conclusion:The particularity of this case consists of the difficulty to explain to a child that an adult's carelessness changed the course of her life and of the difficulty to support her morally to accept this situation.

Pediatric comas are particular situations of terrestrial or aerial medical intervention, requiring knowledge of specific protocols and prioritization and hierarchy of emergency interventions. The reactivity of the comatose child is modified according to multiple biological, physiological parameters and generating pathologies. The study aims to analyze the specific elements of aerial medical interventions with helicopter, HEMS (Helicopter Emergency Medical Service) at comatose child that influences the emergency path, but especially the medium and long term prognosis of these cases. The transfer of comatose children at Galati aeromedical base, both primary and secondary interventions, were studied. The study was a prospective randomized study involving pediatric comas transferred over a 4-year course (2014-2017) according to the criteria in force. A total of 24 children between the ages of 0-18 years were transferred, with primary and secondary interventions. In the study lot, the correlations between Glasgow scores and associated pathology, epidemiological characteristics, therapeutic elements, complications and case evolution were analyzed. A profile of the patient requiring emergency intervention for the comatose state was created, making it possible to predict the services they will need and to design the specialized interventions that will follow the transfer of these patients. Although still intensely disputed due to cost considerations, the air transfer of the comatose child facilitates a more prompt response of medical systems to manage this type of emergency and presents management particularities in pre-hospital. Based on this type of results, a strategy takes shape by which the Romanian emergency system aligns with the continuous improvement of life-saving interventions for children.

Introduction Emotional affectivity can be described under two general dimensions: positive affectivity and negative affectivity. It is often assessed by means of questionnaires completed retrospectively by the subjects. The most common scales used are PANAS, DES, and PANA-X. All these scales are based on the concept of two dimensions, negative and positive affective emotions, respectively. Both dimensions mentioned, positive and negative affectivity, can be associated with a bipolar dimensional entity called pleasant-unpleasant. Specifically, a high level of positive emotions and a low level of negative emotions are associated with pleasant/positive feelings (happiness, well-being, satisfaction, cheerfulness, etc.), while a low level of positive emotions and a high level of negative emotions are associated with negative feelings (sadness, anger, nervousness, depression, anxiety, etc.). Materials and Methods This study is an observational and cross-sectional study. The elements that led to the production of the final database were collected by means of a questionnaire, which included 43 items, 39 of which were specific questions found in the affective distress profile. The questionnaire was administered to 145 patients who had suffered polytrauma and were admitted to the Emergency Hospital of Galati in October 2022. The final centralizing tables included the characteristics of 145 patients, aged between 14 and 64 years. Results The aim of this study is to identify the level of emotional distress in patients who have suffered polytrauma, so the following scores were evaluated, obtained after the application of PDA: STD, ENF, END. The total distress score was obtained by summing all the negative items found in the PDA questionnaire. Conclusion Men show a high level of emotional distress compared to women. Polytrauma has a negative effect on patients’ emotional status, with a worrying prevalence of negative functional and dysfunctional emotions. The level of distress in polytrauma patients is high.