Introduction: Trauma scoring systems in prehospital settings are supposed to ensure the most appropriate in-hospital treatment of the injured. Aim of the study: To determine the sensitivity and specificity of the CRAMS scale (circulation, respiration, abdomen, motor and speech), RTS score (revised trauma score), MGAP (mechanism, Glasgow Coma Scale, age, arterial pressure) and GAP (Glasgow Coma Scale, age, arterial pressure) scoring systems in prehospital settings in order to evaluate trauma severity and to predict the outcome. Materials and Methods: A prospective, observational study was conducted. For every trauma patient, a questionnaire was initially filled in by a prehospital doctor and these data were subsequently collected by the hospital. Results: The study included 307 trauma patients with an average age of 51.7 ± 20.9. Based on the ISS (injury severity score), severe trauma was diagnosed in 50 (16.3%) patients. MGAP had the best sensitivity/specificity ratio when the obtained values indicated severe trauma. The sensitivity and specificity were 93.4 and 62.0%, respectively, for an MGAP value of 22. MGAP and GAP were strongly correlated with each other and were statistically significant in predicting the outcome of treatment (OR 2.23; 95% Cl 1.06–4.70; p = 0.035). With a rise of one in the MGAP score value, the probability of survival increases 2.2 times. Conclusion: MGAP and GAP, in prehospital settings, had higher sensitivity and specificity when identifying patients with a severe trauma and predicting an unfavorable outcome than other scoring systems.

The relationship between coronavirus disease 2019 (COVID-19) and myocardial injury was established at the onset of the COVID-19 pandemic. An increase in the incidence of out-of-hospital cardiac arrest was also observed. This case report aims to point to the prothrombotic and proinflammatory nature of coronavirus infection, leading to simultaneous coronary vessel thrombosis and subsequently to out-of-hospital cardiac arrest. During the COVID-19 pandemic, a 46-year-old male patient with no comorbidities suffered out-of-hospital cardiac arrest (OHCA) with ventricular fibrillation as the first recorded rhythm. The applied cardiopulmonary resuscitation (CPR) measures initiated by bystanders and continued by emergency medical service (EMS) resulted in the return of spontaneous circulation. The stabilized patient was transferred to the tertiary university center. Electrocardiogram (ECG) revealed “lambda-like” ST-segment elevation in DI and aVL leads, necessitating an immediate coronary angiography, which demonstrated simultaneous occlusion of the left anterior descending (LAD) and right coronary artery (RCA). Primary percutaneous coronary intervention (PCI) with the implantation of one drug-eluting stent (DES) in LAD and two DES in RCA was done. Due to the presence of cardiogenic shock (SCAI C), an intra-aortic balloon pump (IABP) was implanted during the procedure, and due to the comatose state and shockable cardiac arrest, targeted temperature management was initiated. The baseline chest X-ray revealed bilateral interstitial infiltrates, followed by increased proinflammatory markers and a positive polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) demasking underlying COVID-19-related pneumonia. Within the following 48 h, the patient was hemodynamically stable, which enabled weaning from IABP and vasopressor discontinuation. However, due to the worsening of COVID-19 pneumonia, prolonged mechanical ventilation, together with antibiotics and other supportive measures, was needed. The applied therapy resulted in clinical improvement, and the patient was extubated and finally discharged on Day 26, with no neurological sequelae and with mildly reduced left ventricle ejection fraction.

Background/Objectives: Pain is the most frequently reported symptom in over 90% of patients presenting with traumatic injuries, and three-quarters of patients are discharged from emergency departments experiencing moderate to severe pain. The objective of this study was to compare the frequency of analgesic administration between patients with chest pain presumed to be of cardiac origin and those with suspected bone fractures as well as to assess whether significant differences exist between these two groups. Methods: A retrospective, observational study was conducted. Patients were categorized into two groups: Group 1—patients with angina pectoris, acute myocardial infarction, or non-specific chest pain; and Group 2—patients with a preliminary diagnosis of bone fracture made by the attending physician at the scene. Results: A total of 1189 patients were included in this study, with 503 (42.3%) in Group 1 and 686 (57.7%) in Group 2 (χ² = 28.166; p < 0.001). Analgesic administration was significantly more frequent among patients in Group 1 than in Group 2 (χ² = 23.187; p < 0.001). Within Group 1, the highest rate of analgesic use was recorded in patients diagnosed with acute myocardial infarction. In Group 2, analgesics were administered to 36.4% of patients with suspected trunk bone fractures, while only 7.1% of patients with suspected cranial fractures received analgesic therapy. Pain intensity scores were not available for either group. Conclusions: The administration of analgesic treatment was significantly more common among patients presenting with chest pain of presumed cardiac origin than among those with suspected bone fractures, including fractures involving multiple body regions.

The first edition of ABC Journal of the Emergency Medicine was published in September 2001. A decision was made on the Emergency Medicine Conference in the town of Aranđelovac, Serbia, to establish a scientific journal covering the wide range of topics in this specialty of medicine, especially paying attention to the prehospital setting. Medical emergencies are very common in everyday life. It is assumed that, with the advance in medicine and genetic therapies, traumatism and emergency cases will remain the greatest challenge in our century. From our point of view, it can be said that 21st century will be the emergency medicine century. Unfortunately, the historical moment we are witnessing demands additional engagement in finding the possibilities for even more prompt management of the critically ill. Therefore, it is our great ambition to introduce improvements in the emergency medicine. Publishing a scientific journal was one of the ways to achieve our goals. It is a medium for open discussion of relevant topics of emergencies, traumatism, scientific findings and personal experiences by emergency medicine specialists and doctors from other branches. The journal has been published three times a year for twenty-three years. We decided to make a list of all articles published in ABC Journal of the Emergency Medicine in the period between 2001 and 2024 so that our young colleagues could find interesting case reports and articles analyzing the emergency medicine practice.

INTRODUCTION: The most common cardiovascular complications during COVID-19 disease are pulmonary thromboembolism. AIM: The importance of early recognition of pulmonary embolism and initiation of adequate therapeutic procedures in prehospital conditions in a patient with confirmed coronavirus infection has been shown. Methodology: Case report based on medical records. CASE REPORT: The ambulance team intervened in a coronavirus-positive patient due to sudden problems in the form of dyspnea and cyanosis in the neck area. During the examination, the patient is conscious, oriented, has difficulty pronouncing words, has pale and sweaty facial skin, cyanosis of the chest, neck and fingers without peripheral oedema, he is dyspnoic with shallow breaths, SpO2 51%, tachycardia (pulse 135/min.), and is normotensive (TA: 120/60 mm Hg). According to clinical condition of the patient, it is suspected that it is a pulmonary embolism. The patient was placed on non-invasive mechanical ventilation in CPAP mode (PEEP 5, FiO2, 100% O2), accompanied by the opening of a venous line and the administration of a Heparin 5000 i.j. intravenous bolus. The oxygen flow was 15 L/min during the ambulance transport. The patient was continuously monitored for ECG, blood pressure, pulse, and SpO2. He was urgently transferred to the Covid Hospital in Mišeluk to the Intensive Care Unit, where a pulmonary embolism was confirmed and therapy was continued. On the fifth day of hospitalisation, a fatal outcome occurs. CONCLUSION: The anamnestic data on COVID-19 disease and the typical clinical picture facilitated the diagnosis of pulmonary embolism in prehospital conditions.

Background/Objectives: This study aimed to evaluate the incidence and outcomes of emergency medical service (EMS)-treated out-of-hospital cardiac arrest (OHCA) and to determine whether predictors of outcomes differed across the pre-pandemic, pandemic, and post-pandemic periods. Methods: A retrospective observational study was conducted over a six-year period and included 1150 patients with EMS-treated OHCA. Patients were categorized into three groups according to the study period. Results: The incidence of EMS-treated OHCA differed significantly across the three study periods (χ² = 15.184, p = 0.001), with the highest number of cases observed during the pandemic. The rate of return of spontaneous circulation (ROSC) also varied significantly between periods (p = 0.035). Although the highest overall mortality was observed during the pandemic period (97.5%), differences in overall mortality across the study periods did not reach statistical significance (p = 0.079). Variables independently associated with ROSC were EMS response time, initial cardiac rhythm, and the administration of adrenaline and atropine. Age and initial cardiac rhythm were independently associated with mortality. No significant interactions were observed between study period and the identified predictors of ROSC or mortality. Conclusions: The COVID-19 pandemic was associated with a significant increase in EMS-treated OHCA incidence and poorer patient outcomes, including lower ROSC and survival rates. Although outcomes improved in the post-pandemic period, multivariable analysis demonstrated that the pandemic period itself was not independently associated with ROSC or mortality after adjustment for relevant clinical factors. Instead, outcome differences were primarily explained by established clinical predictors, including patient age, initial cardiac rhythm, EMS response time, and resuscitation-related factors. Prospective studies incorporating more detailed data on patient characteristics, the quality of resuscitation, and organizational characteristics of the healthcare system may enable more accurate outcome modeling.