The purpose of this study was to examine the safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze using a swine model. The study was conducted on nine pigs weighing approximately 30 kg, which were randomly divided into three groups. Under deep anesthesia, the pigs underwent complete transverse cutting of the femoral artery in the groin region. Hemostatic dressings were left in the wound for 24 hours. The animals were euthanized 24 hours after dressing application. In each group, macroscopic and microscopic severe changes and shock symptoms were observed in the lungs, liver, kidneys and heart. Fibrino-gaseous embolic material was found in the pulmonary artery of each group and in the lung vessels of the animals from the ChitoGauze PRO and Celox Gauze groups. In conclusion, the long-term application of the evaluated hemostatic dressings has the risk of coagulopathy and reaching the progressive stage of shock. The residues from the hemostatic dressings can ingress into the systemic circulation, thereby increasing the risk of embolus formation. Because of these harmful effects, the evaluated hemostatic dressings are not appropriate for long-term use. Future studies are needed on the consequences of the long-term application of these hemostatic agents.

The presence of a well-developed collateral circulation in the area of the artery responsible for the infarction improves the prognosis of patients and leads to a smaller area of infarction. One of the factors influencing the formation of collateral circulation is hypoxia, which induces angiogenesis and arteriogenesis, which in turn cause the formation of new vessels. The aim of this study was to assess the effect of endurance training conducted under normobaric hypoxia in patients after myocardial infarction at the level of exercise tolerance and hemodynamic parameters of the left ventricle. Thirty-five patients aged 43–74 (60.48 ± 4.36) years who underwent angioplasty with stent implantation were examined. The program included 21 training units lasting about 90 min. A statistically significant improvement in exercise tolerance assessed with the cardiopulmonary exercise test (CPET) was observed: test duration (p < 0.001), distance covered (p < 0.001), HRmax (p = 0.039), maximal systolic blood pressure (SBPmax) (p = 0.044), peak minute ventilation (VE) (p = 0.004) and breathing frequency (BF) (p = 0.044). Favorable changes in left ventricular hemodynamic parameters were found for left ventricular end-diastolic dimension LVEDD (p = 0.002), left ventricular end-systolic dimension LVESD (p = 0.015), left ventricular ejection fraction (LVEF) (p = 0.021), lateral e’ (p < 0.001), septal e’ (p = 0.001), and E/A (p = 0.047). Endurance training conducted in hypoxic conditions has a positive effect on exercise tolerance and the hemodynamic indicators of the left ventricle.

BackgroundSerious injuries accompanied by severe bleeding are life-threatening. Post-traumatic hemorrhage involves the risk of developing coagulopathy. Hemostatic dressings are widely used to minimize bleeding. The application of procoagulants in control of hemorrhage may lead to thrombosis or disseminated intravascular coagulation. The aim of this study was to evaluate the effect of hemostatic dressing prototypes on the porcine coagulation system.ResultsFibrinogen and d-dimer concentrations were significantly higher in the experimental groups where hemostatic dressings were used in comparison with the control group. Considerable differences in antithrombin III activity and thrombin–antithrombin complex concentrations were also observed between groups.ConclusionsThe hemostatic dressing comprising modified seton impregnated with 18.0 g/m2 of procoagulant was most effective in preserving the physiological equilibrium between fibrinogenesis and fibrinolysis.

The objective of this study was to determine the response of hemostatic dressings. Coagulation and fibrinolytic systems, red blood cell parameters, platelet and leukocyte counts were evaluated after the application of hemostatic dressings: QuikClot, Chitoauze and Celox gauze. The experiment was performed on ten pigs.

(1) Objective: Paramedics as a profession are a pillar of the State Medical Rescue system. The basic difference between a specialist and a basic team is the composition of members. The aim of the study was to benchmark the effectiveness of performing advanced resuscitation procedures undertaken by two- and three-person basic emergency medical teams in adults under simulated conditions. (2) Design: The research was observational. 200 two- and three-people basic emergency medical teams were analyzed during advanced resuscitation procedures, ALS (Advanced Life Support) in adults under simulated conditions. (3) Method: The study was carried out among professionally active and certified paramedics. It lasted over two years. The study took place under simulated conditions using prepared scenarios. (4) Results: In total, 463 people took part in the study. The analysis of the survey results indicates that the efficiency of three-person teams is superior to the activities performed by two-person teams. Three-person teams were quicker to perform rescue actions than two-person teams. The two-person teams were much quicker to assess the condition of victims than the three-person teams. The three-person teams were more likely to check an open airway. The three-person teams were more efficient in assessing the heart rhythm and current condition of victims. It was demonstrated that three-person teams were more effective during electrotherapy. The analysis demonstrated that three-person teams were significantly faster and more efficient in chest compressions. Three-person teams were less likely to use emergency airway techniques than two-person teams. The results indicate that three-person teams administered the first dose of adrenaline significantly faster than two-person teams. For the “call for help”, the three-person teams were found to be more effective. (5) Conclusion: Paramedics in three-person teams work more effectively, make a proper assessment of heart rhythm and monitor when taking advanced actions. The quality of ventilation and BLS in both groups studied is insufficient. Numerous errors have been observed in two-person teams during pharmacotherapy.

Introduction: Accidents and emergencies in the workplace account for a significant proportion of emergency calls worldwide. The specificity of these events is often associated with hazards at a given workplace. Patients do not always require hospitalization; therefore, the characteristics of events can only be determined from the perspective of emergency medical services teams. The aim of the study was to analyze calls and the course of emergency ambulance interventions to patients at their workplace. Material and methods: The study was conducted based on a retrospective analysis of data contained in the medical records of the ambulance service from central Poland from 2015–2018. From all interventions (n = 155,993), 1601 calls to work were selected, and the urgency code, time of day and year, patients’ sex, general condition, as well as diagnoses according to the International Classification of Diseases—ICD-10 and the method of ending the call were considered. Results: The mean age of patients in the study group was 42.4 years (SD ± 13.5). The majority were men (n = 918; 57.3%). The number of calls increased in the autumn (n = 457; 28.5%) and in the morning (n = 609; 38.0%). The main reasons for the intervention were illnesses (ICD-10 group: R—‘symptoms’) and injuries (ICD-10 group: S, T—‘injuries’). Calls at workplaces most often ended with the patient being transported to the hospital (78.8%), and least often with his death (0.8%). Conclusions: The patient profile in the workplace indicates middle-aged men who fall ill in the fall, requiring transport to the hospital and further diagnostics.

IntroductionHypothermia may appear to be a benign condition, but it is an insidious and life-threatening dysfunction of the thermoregulatory system that occurs in all regions of the world, regardless of season. Hypothermia is caused by cooling when core body temperature decreases below 35°C. The information obtained during a patient interview is also helpful in establishing the causes of hypothermia. The pathophysiology of hypothermia has not been fully elucidated to date. It is rarely diagnosed, in particular in the temperate climate. Hypothermia poses a serious challenge for medical personnel, in particular medical rescue teams who arrive first at the scene.AimThe aim of this study was to present new information concerning hypothermia and the management of this condition.Material and methodsThis article reviews the available literature and statistical data relating to hypothermia, and it discusses various approaches to managing hypothermia, in particular in pre-hospital care.Results and discussionIn homeotherms, significant changes in body temperature affect the functioning of most organs and disrupt homeostasis. According to the European Resuscitation Council, hypothermia is one of the reversible causes of sudden cardiac arrest, which is why hypothermic patients should be adequately managed. Further research is also needed to expand our knowledge about hypothermia.ConclusionsHypothermia is an important cause of death particularly in the elderly, infants, and persons suffering from thermoregulatory disorders or diseases that influence thermogenesis. Therefore, education should be continued in this area and clinical studies should be conducted to deepen our understanding of this problem.

The effectiveness of three types of hemostatic dressings, QuikClot Gauze, ChitoGauze PRO and Celox Gauze, was evaluated in nine pigs. The results indicated a strong influence of all examined dressings on porcine femoral muscle tissue evaluated 24 hours after direct contact. A histopathological analysis revealed pathological changes in muscle tissue specimens collected from all the animals.