Krzysztof Goniewicz

DNR declaration — emergency medical system nurses’ opinions

Advance directive and other declarations of will made by patients in a case of mental illness still raise ethical and legal issues. In Poland there is no legal regulation, neither research about code of conduct in situation of do not attempt resuscitation. There are also not enough studies regarding Healthcare workers’ opinion about DNAR declaration (Do Not Attempt Resuscitation). The study is aimed at finding out emergency medical system nurses opinion on the subject of enforcing do not attempt resuscitation in situation of circulatory and respiratory arrest. Methods: The research was conducted by means of the diagnostic survey method applying a self — constructed questionnaire. The study was carried out among 82 (100%) nurses, from September to December 2011. Obtained information were analyzed statistically, Chi-square of independence with assumed p ≤ 0.05. level of significance was used for statistical analysis. Results: The study of the respondents’ opinion shows that 67% Healthcare employees think that DNAR declaration should be obligatory in Poland. Contrary opinion has 7.3% of respondents. In their opinion the decision to refrain from resuscitating should be made by attending physician − 46.3% and medical board − 29.3%. Information enclosed within DNAR declaration, in most of respondents’ opinion − 59.5%, should be only passed on in written form. Conclusions: Majority of respondents agree that patients have a right to refrain from resuscitating as a self − determination act. Respondents concur the introduction of DNAR declaration in Polish Healthcare system. In respondents’ opinion that decision should be required in written form and an attending physician should decide about its implementation, what violates the existing rule. The execution of living will declaration raises ethical issues. Additionally, it also appears as public/social problem. The last stage of incurable disease is given as justifiable circumstances of DNAR.

PW 0208 Road traffic injuries in poland: magnitude and risk factors

The article presents the epidemiology of road crashes in Poland in the years 2004–2014. The research is based on the analysis of data contained in the reports of the Prevention and Analysis Office of Road Traffic Headquarters of Police; National Road Safety Program– GAMBIT 2005, National Road Safety Program 2013 to 2020; and Strategy for Efficient State in 2020, plus previous publications describing road safety in Poland. Our results suggest several thousand people are killed on Polish roads annually, and tens of thousands are injured. Road crashes represent the leading cause of death for Polish men up to 44 years of age. The most common causes of road crashes in Poland include failure to comply with the rules of the road traffic (mainly excessive speed, intoxication while engaged in traffic, and lack of respect for the rights of other road users, especially disregard for the rights of pedestrians and cyclists), and low driving skills. We also found drivers poorly assessed road situations, possessed a lack of adequate road infrastructure, and maintained many vehicles in poor condition. Drivers caused the majority of MVA in Poland in years 2004 to 2014. The most common underlying causes were inappropriate speed given the road traffic conditions and not respecting the right-of-way concerning other road users. Despite various measures that are being taken to improve safety on Polish roads, the number of the dead and wounded as a result of road crashes is still very high. It is necessary to continue multifaceted actions to improve safety on the roads in Poland.

Children road traffic injuries in Poland

Abstract Road traffic injuries are the leading cause of child mortality in Poland, resulting in more deaths than cancer or birth defects. We present the main problems of road safety and the nature of the causes and consequences of accidents among children based on the World Health Organization Report. Children injuries are one of the main problems in modern medicine requiring vigorous and preventive actions. Children of all ages should be intensively involved in the educational activities related to road safety. Raising awareness concerning the risks associated with children’s participation in traffic as well as the awareness of parents and carers can greatly reduce the number of accidents.

Analysis of the effectiveness concerning initiatives for pedestrians’ safety on roads: a questionnaire survey

Abstract Introduction. One of the most important issues and challenges of public safety policy in highly developed countries is the problem of ensuring road safety, along with dealing with health and material losses resulted from accidents. Unfortunately, Poland, in comparison to other EU countries, has one of the worst statistics regarding accidents and mortality ratios, therefore it is essential to undertake long-term actions aimed at improving road safety, as well as educating drivers and pedestrians. Aim. The purpose of this study is to analyse the problem and to investigate whether traffic safety campaigns are effective, and if they reach young audience. Material and methods. The research was conducted in the first quarter of 2018 among the students of Faculty of Health Sciences of the Medical University of Lublin. The study method applied was a diagnostic survey, and the tool was an original questionnaire. The participation was voluntary and anonymous. The obtained results were the subject of later statistical analysis. As many as 153 young respondents aged between 18 and 25 were tested, out of whom 73.68% were women and 26.32% were men. Results. Over half of the surveyed (56.3%) declared walking as the main form of participation in traffic, and 25.9% of the surveyed used public transport. The most numerous group of the examined (34.21%) thought that the Polish roads were rather unsafe. As the reasons for the low safety on the Polish roads the respondents identified: bad condition of the roads (69.1%), drivers’ recklessness (67.1%), and maladjustment of the driving style to weather conditions (60.5%). All respondents have encountered campaigns concerning road safety, however not too often (56.58% less than once a month). The surveyed encountered these social campaigns on TV (88.2%), on the Internet (54.6%), and on billboards (23.7%). Conclusion. Promotional campaigns concerning road safety have a greater impact on women. In the examined group, around 67% of women changed their behaviour as a result of the campaigns, and only 42.5% of men. Social campaign which was best remembered, and had the biggest influence on the respondents (50.3%) was „Say STOP to reckless driver you love”.

Analysis of the impact of harmful factors in the workplace on functioning of the respiratory system of firefighters

INTRODUCTION AND OBJECTIVE Firefighters are considered a healthy and fit group of individuals, well-prepared for taking action in disaster situations. While working, they suffer from exposure to certain toxic agents, especially combustion products generated when a fire takes place. Among them, the most frequent and the most toxic are: carbon monoxide, hydrogen cyanide, ammonia, and those resulting from PVC combustion - hydrochloride, phosgene and chloride. Additionally, fire-extinguisher powder can be inhaled and lead to certain lesion in the airways. The aim of study was to ascertain the influence of toxic agents present at the scene of fire on the lung tissue of firefighters, and also to study this on an animal model. MATERIAL AND METHODS The study group consisted of firefighters who had a minimum of 10 years service. After completing a questionnaire, their clinical status was ascertained based on a general examination, laboratory tests and lung function tests. RESULTS Questionnaire analysis showed a high percentage of pathological symptoms in the studied group. The incidence of the symptoms correlated with the duration of occupational exposure to toxic agents. Among other results, obstruction of flow in medium airways in about 30% of the studied individuals represented the most important finding. Experimental tests were next performed on male Wistar rats, aged 3 months. They were insufflated with the solution of powdered fire-extinguisher, after which morphology specimens of lung tissue were studied. Evidence for disseminated fibrosis was obtained, which supported the previous clinical findings in the firefighters. CONCLUSIONS The above shows correlation between occupational exposure and respiratory system involvement in firefighters. This justifies covering the group of firefighters with special medical care focused on prophilaxis, early detection and therapy of pulmonary diseases.

Meta-analysis of pain and stress in emergency department patients

Abstract Introduction. In Poland, among patients coming to hospital emergency departments (ED), one third require immediate surgical treatment. About one third are transferred to long-term intensive care. The remaining patients require a different type of care, e.g. consultation, healing wounds, observation in the emergency department. From there, they might either be referred to another hospital department or sent home after receiving outpatient help. Aim. The aim of this study was to determine the prevalence of pain and stress in patients treated in the emergency department with particular emphasis on the factors that determine their level. Material and methods. The study group consisted of 200 individuals treated in the emergency department of the Regional Hospital No. 2 in Rzeszów in 2013. The applied research method was a diagnostic survey that used a questionnaire as a research tool. The results were statistically analyzed using SPSS 20, whereas a statistically significant dependence was considered in those with level of significance p≤0.05. Results. Most respondents reported pain and feelings of stress while staying in the ED. Women and the unemployed were significantly less likely to report pain. Factors like gender, age, education level, and the coexistence of chronic diseases significantly affected the degree of stress among patients in the ED. Conclusion. Each patient treated at the emergency department should receive holistic care, so that the pain and stress of his injuries are reduced as soon as possible.

Road accidents in the early days of the automotive industry

Abstract The first recorded road fatality happened over 140 years ago. Since then, road accidents have become one of the main causes of concern in almost every country in the world. Nowadays, fatal motor vehicle crashes occur at an interval of 50 seconds and injuries happen every two seconds. According to the WHO, the world road death toll is nearly 1.3 million and 20-50 million of people have been badly injured in road accidents and usually require long and expensive treatment. This paper looks at the issue of road accidents in the earliest days of the automotive industry. The article looks at the first laws, which were introduced to improve road safety. Virtually every member of society is somewhat affected by road transport. All traffic participants are at risk of an accident to a certain degree which is why reducing this risk should become a priority.

First Aid education in the opinion of secondary school students

BackgroundThe European Resuscitation Council guidelines recommend First Aid education at all levels of schooling. Schools should prepare students for the challenges of the contemporary world, including First Aid assistance in cases of casualties and crisis response, to ensure their own safety as well as that of victims and witnesses. The present study aims to evaluate First Aid classes for secondary schools students and the correlation with acquired knowledge regarding conduct under conditions of an imminent threat to health or life.MethodsThe study included 500 people: secondary school students of second forms, second and third classes of technical colleges and university students of various faculties in the Lublin province. This paper uses a diagnostic survey and employs a specially developed questionnaire. Questions in the survey were constructed on the basis of the European Resuscitation Council Guidelines of 2010.ResultsMore than half its respondents (55.8%) assessed First Aid lessons as quite interesting. Statistical analysis showed that people who have assessed classes as having better quality were statistically more likely to know that everyone has the obligation to provide First Aid (p = 0.00001) and more likely to have given such assistance (p <0.00001). The study indicates that respondents assessing conducted classes in First Aid as interesting more often gave correct answers to questions about First Aid (p <0.05).ConclusionAfter analyzing the results of the study, it was shown that most students are satisfied with the First Aid classes at their school. Furthermore, the classes used phantoms and had a practical nature. Among students assessing First Aid classes as “well and very well” led, a greater level of knowledge regarding the recognition of cardiac arrest and performing resuscitation was ascertained. This suggests that such young people turn more often to rescue operations, taking into account both their own safety and that of the victim. It is desirable to continue further investigation into diversification of teaching methods, to increase both the number of hours devoted to teaching First Aid and to involve medical professionals in teaching these lessons.