Patryk Rzońca

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.

Should the family witness cardiopulmonary resuscitation? Perceptions of health professionals in Poland

1Department of Emergency Medicine, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland 2Chair and Department of Family Medicine, First Faculty of Medicine, Medical University of Lublin, Lublin, Poland 3Division of Teaching and Outcomes of Education, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland 4Department of Emergency Medical Services, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland 5Polish Medical Air Rescue, Poland

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”.

Fall as a cause of hospitalization in the Emergency Department in a population of people over 65 years of age

Introduction. Falls are included among the geriatric giants, as their consequences in older people are major in terms of nursing, medical, social and economic problems. In the case of elders they can lead to fractures and, consequently, even to death. Materials and method. The study retrospectively analysed the medical records of 455 cases of injuries resulting from falls among patients over 65 years of age. Data was gathered in the Emergency Department (ER) of the Independent Public Clinical Hospital No. 1 in Lublin, Poland. The analysis included patients who visited the ER during the period 01.05.2009–30.04.2010. Results. Elderly patients hospitalized in the ER within the given period accounted for 8.10% of all patients. Most of patients over 65 years of age were admitted in December due to falls; slightly fewer cases were recorded in March and April. Mondays and Saturdays were the days of the week with the highest number of reports of elderly patients. Analysis of the collected data incorporating further treatment showed that the great majority of injured patients did not require hospitalization and were discharged home. In the analyzed population of older people, damage to upper and lower limbs dominated, followed by injuries to the head, chest and abdomen. Conclusion. Falls are a major cause of reduced quality of life, disability and death in older people. There are important factors in limb fractures (90%-100%). Preventing falls is a difficult and underestimated problem. There is a need of implementing preventative measures in the case of falls in elderly patients.