The aim of the study was to conduct a comparative analysis of three forms of knowledge transfer online, taking into account the long-term knowledge growth rate and the satisfaction of students surveyed in respect to distance learning. The cohort of participants for this survey were students of the first degree, studying in the Emergency Medical Services. The authors created three e-learning courses in basic and advanced resuscitation procedures. The level of course participants’ satisfaction was analysed, as well as the knowledge growth rate measured three times: 7, 30 and 90 days, respectively, after finishing the course. The level of satisfaction in all the groups surveyed was comparable. The growth rate for knowledge was the highest in group C in the second and third survey, respectively (30 and 90 days after the end of the course), and a significant difference in favour of course C was demonstrated one month after finishing classes.

The incidence of hypothermia is difficult to evaluate, and the data concerning the morbidity and mortality rates do not seem to fully represent the problem. The aim of the study was to estimate the actual prevalence of accidental hypothermia in Poland, as well as the methods of diagnosis and management procedures used in emergency rooms (ERs). A specially designed questionnaire, consisting of 14 questions, was mailed to all the 223 emergency rooms (ER) in Poland. The questions concerned the incidence, methods of diagnosis and risk factors, as well as the rewarming methods used and available measurement instruments. The analysis involved data from 42 ERs providing emergency healthcare for the population of 5 305 000. The prevalence of accidental hypothermia may have been 5.05 cases per 100.000 residents per year. Among the 268 cases listed 25% were diagnosed with codes T68, T69 or X31, and in 75% hypothermia was neither included nor assigned a code in the final diagnosis. The most frequent cause of hypothermia was exposure to cold air alongside ethanol abuse (68%). Peripheral temperature was measured in 57%, core temperature measurement was taken in 29% of the patients. Peripheral temperature was measured most often at the axilla, while core temperature measurement was predominantly taken rectally. Mild hypothermia was diagnosed in 75.5% of the patients, moderate (32-28°C) in 16.5%, while severe hypothermia (less than 28°C) in 8% of the cases. Cardiopulmonary resuscitation was carried out in 7.5% of the patients. The treatment involved mainly warmed intravenous fluids (83.5%) and active external rewarming measures (70%). In no case was extracorporeal rewarming put to use. The actual incidence of accidental hypothermia in Polish emergency departments may exceed up to four times the official data. Core temperature is taken only in one third of the patients, the treatment of hypothermic patients is rarely conducted in intensive care wards and extracorporeal rewarming techniques are not used. It may be expected that personnel education and the development of management procedures will brighten the prognosis and increase the survival rate in accidental hypothermia.

Hypothermic patients may be rewarmed using passive or active techniques. In case of severe accidental hypothermia (temperature<28°C) and stage III/IV according to the Swiss Staging System, standard methods might not be effective and aggressive treatment is needed. Extracorporeal membrane oxygenation (ECMO) has proved to be both effective and safe in such cases. The Department of Anesthesiology and Intensive Care, John Paul II Hospital, Cracow, Poland, established the Severe Accidental Hypothermia Center, which provides 24 h on-call to consult and accept patients who need ECMO implantation for profound hypothermia rewarming. Our center is so far the only one in Poland and can accept patients from south-east Poland. Most importantly, it collaborates with all prehospital medical services, namely, with 115 Ambulances, Polish Medical Air Rescue, Mountain Rescue Services, and all 28 Emergency Departments in the area. Severe Accidental Hypothermia Center is a solution for advanced treatment of patients with accidental hypothermia requiring ECMO implantation.

Introduction: Occupational burnout is a multifaceted phenomenon and a problem often encountered among medical personnel. An example of such a group are workers of the Emergency Medical Services (EMS). The aim of the present study was to make an attempt to assess the level of job burnout among...

The prognosis in hypothermic cardiac arrest is frequently good despite prolonged period of hypoperfusion and cardiopulmonary resuscitation. Apart from protective effect of hypothermia itself established protocols of treatment and novel rewarming techniques may influence on outcome. The purpose of the study was to assess the outcome of patients with hypothermic circulatory arrest treated by means of arterio-venous extracorporeal membrane oxygenation (ECMO) according to locally elaborated protocol in Severe Accidental Hypothermia Center in Cracow, Poland. Prospective observational case-series study – all patients with confirmed hypothermic cardiac arrest consulted with hypothermia coordinator were accepted for extracorporeal rewarming, unless contraindications for ECMO were observed (active bleeding). The study population consisted of 10 patients (7 male, median age 48.5 years). The core temperature measured esophageally was 16.9–28.4 °C, median 22 °C. On admission 5 patients presented with asystole and 5 with ventricular fibrillation. Duration of circulatory arrest before ECMO implantation was 107 to 345 min (median 156 min). The duration of ECMO support was 1.5 to 91 h (median 22 h). Cardiorespiratory stability and full neurologic recovery was achieved in 7 patients. The duration of mechanical ventilation was 88–437 h (median 177 h) and the length of stay in the ICU was 8–26 days (median 15 days). All survivors had mildly impaired (1 patient, LVEF 40 %) or preserved (6 patients, LVEF 55–65 %) left ventricular systolic function at the time of discharge from ICU. The cause of death of non-survivors (three patients) was acute myocarditis, massive retroperitoneal bleeding, and massive gastrointestinal bleeding. Our data confirm the high survival rate (70 %) and excellent neurologic outcome in hypothermic cardiac arrest. The following key elements seem to impact the final prognosis: the appropriate coordination of the rescue operation, immediate high-quality CPR (preferably using mechanical chest compression system) and application of ECMO for rewarming and cardiorespiratory support.

INTRODUCTION AND OBJECTIVE: Occupational stress-related factors among working municipal police officers in Poland have not been examined in the literature. The purpose of the paper was to evaluate the impact of selected work-related factors on occupa