Praca Oryginalna Original Article

Transkrypt

Praca Oryginalna Original Article
Praca Oryginalna
Zdr Publ 2010;120(1):29-32
Original Article
!"#$%&'()*"+&$,-"*1, BEATA RYBOJAD2, IWONA JAWORSKA3, RENATA KORECKA1,
ANNA AFTYKA1
Analiza przyczyn hospitalizacji
na Oddziale Intensywnej
Terapii Wojewódzkiego Szpitala
Specjalistycznego w Lublinie
2/+1*)*+34+
Analysis of the causes
of hospitalization in the Intensive
Care Unit of the Regional Specialist
Hospital in Lublin
<=12/$)2
512678 9""#$%&%3$ $'()'*+,')- ().%/$$ *5 !""#$%&+
/.!,%"#!') /.#)# %')*()#-!:!2;, $ 2.!3%"#58) 8<!.+8<
#'%-"1-58+8< *$= , *(%'$) #%2.!6)'$% 6+8$% # .;6'+8< /.#+8#+'>
9+'+: ?%"%@ ?+&% %'%:$#% /.#+8#+' <!*/$(%:$#%8-$
/%8-)'(;, '% 9""#$%:) A'()'*+,')- B).%/$$>
;$2+/4$!%4%:+2"0$8 C /.%8+ #%*(!*!,%'! 3)(!"= %'%:$#+
"!413)'(%8-$ 3)"+8#')-0 '% /!(.#)?+ '$'$)-*#)- /.%8+
*(,!.#!'! '%.#="#$) ?%"%,8#) 4,)*($!'%.$1*# %'4$)(+>
D%"%'$% #!*(%&+ /.#)/.!,%"#!') '% ().)'$) 9""#$%&1
A'()'*+,')- B).%/$$ $ E')*()#-!:!2$$ C!-),;"#4$)2!
F#/$(%:% F/)8-%:$*(+8#')2! $3> F()G%'% H%."+'%&%
C+*#+@*4$)2! , I1?:$'$)0 , !4.)*$) !" /%J"#$).'$4% KLLM
"! /%J"#$).'$4% KLLN .!41> 92;&)3 %'%:$#$) /!""%'! OKM
/%8-)'(;,0 # ?%"%@ ,+4:18#!'! KM # /!,!"1 '$)/)&')"!413)'(%8-$ 3)"+8#')->
5.34&4% 4% #34"1&48 P%-8#=Q8$)- 8#%* /!?+(1 /%8-)'(;,
'% 9""#$%:) A'()'*+,')- B).%/$$ ,+'!*$& !" ORN"'$>S&;,')
/.#+8#+'+ <!*/$(%:$#%8-$ '% (+3 !""#$%:) (!T '$),+"!:'!QU
!"")8<!,%0 *(%' /! '%2&+3 #%(.#+3%'$1 4.56)'$% !.%#
1.%#+ ,$):!'%.#5"!,)> F(,$)."#!'! $*(!(') .;6'$8)
/!3$="#+ ,$)4$)3 /%8-)'(% % /.#+8#+'5 <!*/$(%:$#%8-$
T !V%.+ ,+/%"4;, 4!31'$4%8+-'+8< (! !*!?+ , ,$)41
!4!&! WK :%(%> F(%.*$ /%8-)'8$ #) Q.)"'$5 ,$)41 MW :%(% (!
!*!?+ /.#)'$)*$!') # $'')2! !""#$%&1> H!?$)(+ '%-8#=Q8$)?+&+ <!*/$(%:$#!,%') '% 9AB # /!,!"1 /.#)'$)*$)'$% #
$'')2! !""#$%&10 3=68#+J'$ #%Q .;,'$) 8#=*(! '% *41()4
/.#)'$)*$)'$% # $'')2! !""#$%&1 -%4 $ # /!,!"1 ,+/%"41
4!31'$4%8+-')2!>
>32/"0()24"38 Intensive Care units are departments
3%'%2)" ?+ %')*(<)*$!:!2$*(* ,<$8< %"3$( /%($)'(* $' :$G)R
(<.)%()'$'2 *$(1%($!'* "1) (! 7%.$!1* .)%*!'*>
?@+% $4: !G (<$* *(1"+ ,%* (! %'%:+#) (<) 8%1*)*
!G <!*/$(%:$#%($!' !G /%($)'(* $' A'()'*$7) X%.) Y'$(*>
Z%().$%: %'" 3)(<!"*> B<) 3)(<!" 1*)" $' (<) .)*)%.8<
,%* (<) %'%:+*$* !G 3)"$8%: .)8!."*0 %'" (<) .)*)%.8< (!!: ,%*
% [1)*($!''%$.) *1.7)+ ")7):!/)" G!. (<) /1./!*) !G (<$* *(1"+>
?@+% /+1+$/)@ ,%* 8%..$)" !1( %( (<) \)/%.(3)'(
!G E')*(<)*$!:!2+ %'" A'()'*$7) X%.) Y'$( !G (<) X%."$'%:
Stefan Wyszynski Regional Hospital in Lublin from October
KLLM (! 98(!?). KLLN> B<) *(1"+ $'8:1")" OKM /%($)'(* !1(
!G ,<!3 KM *1?-)8(* ,).) )]8:1")" ?)8%1*) !G $'8!3/:)()
3)"$8%: .)8!."*>
9"3)'(14"38 B<) <!*/$(%:$#%($!' %( (<) $'()'*$7) 8%.) 1'$(
.%'2)" G.!3 ORN "%+*> B<) 3%$' 8%1*)* !G <!*/$(%:$#%($!'
$' (<$* ")/%.(3)'( %.)T .)*/$.%(!.+ G%$:1.)0 (<) *(%() %G().
% *1"")' 8%."$%8 %..)*( %'" 31:($R!.2%' $'-1.$)*> F$2'$V8%'(
"$GG).)'8)* ,).) G!1'" ?)(,))' /%($)'(*^ %2) %'" (<) 8%1*)
!G <!*/$(%:$#%($!'T (<) 8%*1%:($)* !G (.%GV8 %88$")'(* ,).)
/)!/:) 8$.8% WK +)%.* !:"> 9:"). /%($)'(* ,$(< %' %7).%2) %2)
!G MW ,).) 3!*(:+ /)!/:) (.%'*G)..)" G.!3 !(<). ")/%.(3)'(*>
B<) ,!3)' ,).) 3!*( !G()' <!*/$(%:$#)" %( AXY %G(). ?)$'2
transferred from other departments and the men also as
a result of a transfer from other departments and because of
(.%GV8 %88$")'(*>
!"#$%&'()*"#+, !""#$%& $'()'*+,')- ().%/$$0 1.%#+0 '%2&)
#%(.#+3%'$) 4.56)'$%
-+.#"/01,% $'()'*$7) 8%.) 1'$(0 $'-1.$)*0 *1"")' 8%."$%8
arrest
1
Independent Laboratory of Medicine of Disasters, Medical University of Lublin
Children’s University Hospital, Lublin,
3
Stefan Cardinal Wyszynski Regional Hospital in Lublin
2
WL
>A?BCDE9?>CA%
B<) <$*(!.+ !G $'()'*$7) 8%.) 1'$(* 2!)* ?%84 (! (<) O_`L*
!G KL(< 8)'(1.+> \1.$'2 (<) !1(?.)%4 !G a)$')RZ)"$'%
disease epidemics, the team of anesthesiologists in Denmark
!.2%'$#)" % 1'$( ,<).) /.!:!'2)" %.($V8$%: .)*/$.%($!' ,%*
1*)" bOc>
B<) V.*( $'()'*$7) 8%.) 1'$(* $' d!:%'" ,).) 8.)%()"
$' %8%")3$8 8)'().* R $' O_ML $' I!"#0 $' O_MO $' d!#'%' %'"
$' H%(!,$8) $' O_MW> B<) )]/).$)'8) 2%$')" (<)' $* *($:: 1/R
(!R"%() e %:*! %( 3!").' $'()'*$7) 8%.) 1'$(*>
EG(). $'$($%: "!1?(* %* (! (<) '%3) f$'()'*$7) 8%.) 1'$(*0
$'()'*$7) *1/).7$*$!' 1'$(*0 ghi 1'$(*0 *<!84 (.!!/*0 )(8>j0 (<)
'%3) !G $'()'*$7) 8%.) 1'$( ,%* %"!/()" $' %88!."%'8) ,$(< (<)
$'*(.18($!'* !G (<) Z$'$*(). !G a)%:(< %'" C):G%.) fZ$'$*(.+
!G a)%:(<j $' O_kW bKc>
B<) ?%*$8 $'()'*$7) 8%.) 1'$(* %.) 3%'%2)" ?+ %')*(<)*$!R
:!2$*(* %'" %"3$( /%($)'(* $' :$G)R(<.)%()'$'2 8!'"$($!'* "1)
(! 7%.$!1* .)%*!'*> A' %""$($!'0 G!. 3%'+ +)%.*0 ")/%.(3)'(*
targeted for treatment of selected medical conditions have
?))' !.2%'$#)">
Currently, the legal basis for the establishment
and functioning of departments of anaesthesiology and
$'()'*$7) 8%.) $* (<) h)21:%($!' !G O__k !G (<) Z$'$*(.+ !G
Health and Regulation of the Ministry of Health of June 22,
KLL`> B<) '13?). !G ?)"* $' $'()'*$7) 8%.) 1'$(* *<!1:"
8!'*($(1() Kl R`l !G (<) '13?). !G <!*/$(%: ?)"* bWc>
CFGH9?>IH%
B<) !?-)8($7) !G (<$* *(1"+ ,%* (! %'%:+#) (<) 8%1*)*
!G <!*/$(%:$#%($!' !G /%($)'(* $' $'()'*$7) 8%.) 1'$(*>
;<?HB><J %<AD%;H?KCD %
B<) *(1"+ 1*)" % 3)(<!" !G 3)"$8%: .)8!."* %'%:+*$*0
%'" % [1)*($!''%$.) ,%* ")7):!/)" %* % .)*)%.8< (!!:>
B<) .)*)%.8< ,%* 8!'"18()" %( (<) \)/%.(3)'( !GE')*(<)*$!R
logy and Intensive Care Unit of the Cardinal Stefan Wyszynski
h)2$!'%: a!*/$(%: $' I1?:$' G.!3 98(!?). KLLM (! 98(!?).
KLLN> B<).) ,).) OKM /%($)'(* 8!7).)" ?+ (<) *(1"+ %'"
KM /%($)'(* ,).) )]8:1")" ?)8%1*) !G $'8!3/:)() 3)"$8%:
.)8!."*>
BH EJ? %
B<) %'%:+#)" 2.!1/ 8!3/.$*)" OLL /).*!'*> E3!'2
(<) .)*/!'")'(*0 WWl ,).) ,!3)' %'" (,!G!:" 3!.) 3)' R
MNl> B<) %7).%2) %2) ,%* `M>M +)%.* fOk R _k +)%.*j0 MM>N
G!. ,!3)' fKL R _k +)%.*j %'" G!. 3)' `O>N +)%.* fOk R kL
+)%.*j>
B<) .)*$")'(* !G (<) 8$(+ %88!1'()" G!. MKl !G /%($)'(*0
,<$:) Wkl ,).) (<) $'<%?$(%'(* !G .1.%: %.)%*> E:3!*( <%:G
!G (<) .)*/!'")'(* R mNl *(%+)" $' (<) 1'$( G!. :)** (<%' N
"%+*0 KWl G.!3 k (! Om "%+*0 Oml R G.!3 O` (! KO0 %'" G!.
3!.) (<%' KO "%+* R OMl>
B<) 3!*( 8!33!' 8%1*)* !G <!*/$(%:$#%($!' ,).)T
.)*/$.%(!.+ G%$:1.) R W_l !G 8%*)*0 % *1"")' 8%."$%8 %..)*( R
KLl0 31:($R!.2%' $'-1.+ R ONl0 8%."$%8 $'*1GV8$)'8+ R Kl>
t". d1?: KLOLpOKLfOj
B<) *!R8%::)" n!(<).^ .)%*!'* %88!1'()" G!. KKl !G (<)
<!*/$(%:$#)" /)!/:)0 %3!'2 ,<$8< ,).)T *(%(1* )/$:)/($81*0
hemorrhagic shock, methanol poisoning, septic shock, acute
renal failure, suicide attempt, cracked abdominal aortic
%')1.+*30 % *(%() !G 8!'71:*$!'0 8.%'$!R8).)?.%: (.%13%>
B<) %'%:+*$* *<!,)" *$2'$V8%'( *(%($*($8%: "$GG).)'8)*
?)(,))' 3)' %'" ,!3)' %* .)2%."* (<) 8%1*) !G
<!*/$(%:$#%($!' f/ o L>L`0 K o N>_Oj> E3!'2 ,!3)'0 (<)
3!*( G.)[1)'( 8%1*)* !G <!*/$(%:$#%($!' ,).) 8%."$%8 G%$:1.)
%'" .)*/$.%(!.+ G%$:1.) f`m>``lj0 *1"")' 8%."$%8 %..)*(
fKO>KOlj %'" 31:($R!.2%' (.%13% fW>LWlj> E3!'2 3)'0 (<)
3!*( 8!33!' 8%1*) ,%* .)*/$.%(!.+ G%$:1.) fmOlj0 G!::!,)"
?+ 31:($R!.2%' (.%13% fKW>kklj %'" !(<). 8%1*)* fKKlj
fB%?:) O j>
B<) %'%:+*$* *<!,)" % <$2<:+ *(%($*($8%::+ *$2'$V8%'(
.):%($!'*<$/ ?)(,))' (<) 8%1*)* !G <!*/$(%:$#%($!' %'" (<)
/%($)'(^* %2)> \1) (! .)*/$.%(!.+ %'" 8$.81:%(!.+ G%$:1.)0 (<).)
,).) <!*/$(%:$#)" (<) !:")*( /)!/:) f%7).%2) %2) e MM>`O
+)%.*jp "1) (! % *1"")' 8%."$%8 %..)*( R/)!/:) !7). `L +)%.*
!:"0 %'" "1) (! 31:($R!.2%' $'-1.$)* e (<) +!1'2)*( /%($)'(*
f3)%' %2) WK>W`lj f/ qLLL>LLO0 K o OM>kKj fB%?:) Kj>
Y/ (! MLl !G (<) /%($)'(* *(%+)" $' (<) $'()'*$7) 8%.)
1'$( %G(). ?)$'2 (.%'*G)..)" G.!3 %'!(<). 1'$(0 ,<$:) ONl
R ?)8%1*) !G % (.%GV8 %88$")'(0 KKl "1) (! )7)'(* %( <!3)
%'" Ol "1) (! %' %88$")'( %( ,!.4> B<) *(1"$)* 8!'V.3)"
*(%($*($8%::+ *$2'$V8%'( "$GG).)'8)* ?)(,))' 3)' %'" ,!3)'
%* .)2%."* (<) 8%1*) !G <!*/$(%:$#%($!' f/ o L>LW0 K o M>kKj>
C!3)' ,).) 2)').%::+ %"3$(()" ?)8%1*) !G (<) (.%'*G).
G.!3 %'!(<). 1'$( fM_>Nlj0 .%(<). (<%' ?)8%1*) !G (<) )7)'(
%( <!3) fKN>KNlj !. % (.%GV8 %88$")'( fW>LWlj> D+ 8!'(.%*(0
3)' ,).) *$2'$V8%'(:+ 3!.) G.)[1)'( (<%' ,!3)' 7$8($3* !G
(.%GV8 %88$")'(* fKW>kklj fB%?:) Wj>
B<) %'%:+*$* 8!'V.3* % <$2<:+ *(%($*($8%::+ *$2'$V8%'(
.):%($!'*<$/ ?)(,))' (<) 4$'" !G )7)'( %'" %2) f/ q L>LLLLLO0
Ko KK>OLj> d%($)'(* ,<! ,).) $'7!:7)" $' (.%GV8 %88$")'(*
,).) +!1'2 R (<) %7).%2) %2) ,%* WK>Km +)%.*0 ,<$:) (<)
8!'*)[1)'8)* !G ,!.4 .):%()" )7)'(* 8!'8).')" /).*!'*
%2)" !' %7).%2) `N>W_ +)%.*>
B<) *(%($*($8%: %'%:+*$* *<!,)" '! *$2'$V8%'( .):%($!'
?)(,))' (<) )/$8.$*$* %'" (<) 8%1*) !G <!*/$(%:$#%($!'
f/ o L>KL0 Ko m>k_j> d%($)'(* ,<! ,).) 7$8($3* !G (.%GV8
%88$")'(* fNM>mNlj ,).) 3!*(:+r1*1%::+ (.%'*G)..)" (!
!(<). 1'$(*0 ,<$:) (<) !(<). /%($)'(* fKW>`Wlj <%" "$)"> B<)
/%($)'(* %"3$(()" G.!3 !(<). ")/%.(3)'(* ,).) (.%'*G)..)"
%2%$' (! !(<). ")/%.(3)'(* f`Llj0 mk>WWl !G (<) /%($)'(* "$"
'!( *1.7$7)0 %'" O>MNl ,).) "$*8<%.2)" <!3) fB%?:) mj>
D> 9E
>CA%
B<) :%.2)*( '13?). !G *1"")' 8%."$%8 %..)*(* %'" ")%(<*
!881.* $' /%($)'(* ,$(< 8%."$!7%*81:%. "$*)%*) ,<! ,).)
'!( /.)7$!1*:+ "$%2'!*)"> s.)[1)'(:+0 (<) V.*( *+3/(!3 !G
% <)%.( "$*)%*) $* % G%(%: 3+!8%."$%: $'G%.8($!'> E *3%::).
number of deaths due to cardiovascular causes concerns
+!1'2). /)!/:) ,$(< '! <)%.( "$*)%*)* .)/!.()" )%.:$).>
Epidemiological studies can help identify people at higher
risk of heart diseases in terms of the critical complications
(<%( 1*1%::+ (<.)%()' :$G)> B<)*) G%8(!.* 3%+ $'8:1")0
%3!'2 !(<).*T (<) %2$'2 /.!8)**0 2)')($8 8%1*)*0 *3!4$'20
male gender, stress, certain diseases, such as diabetes,
<+/).:$/$"%)3$%0 <+/).()'*$!' bmc>
31
t". d1?: KLOLpOKLfOj
?<FJH%L8%9$(1+%"M%@"1742$'41$24"3%#42@%/+N$/0%2"%1+O8
(00+3%)4/)('$2"/.%
$//+12
94/)('$2"/.%M$4'(/+
+O
;('24"/N$3%43P(/.
C2@+/
?"2$'
A%%%%%%%%%%%%%QRS
A%%%%%%%%%%%%QRS
A%%%%%%%%%%%%%%QRS
A%%%%%%%%%%%QRS
A%%%%%%%%%%QRS
Women
Ok
f`m>`j
N
fKO>Kj
O
fW>Wj
N
fKO>Lj
WW
fOLLj
Men
KW
fWm>Wj
OW
fO_>mj
OM
fKW>kj
O`
fKK>`j
MN
fOLLj
B!(%:
mO
fmO>Lj
KL
fKL>Lj
ON
fON>Lj
KK
fKK>Lj
OLL
fOLLj
2
/oL>L`
oN>_O
?<FJH%U8%9$(1+1%"M%@"1742$'41$24"3%#42@%/+N$/0%2"%$N+8
<N+
9$(1+%"M%@"1742$'41$24"3
;+$3
;438
;$O8
2$30$/0%0+T4$24"3
h)*/$.%(!.+r8$.81:%(!.+ $'*1GV8$)'8+
MM>`O
Ok>LL
_k>LL
ON>LL
Sudden circulatory arrest
`N>O`
O_>LL
kL>LL
OM>_O
Z1:($!.2%' $'-1.+
WK>W`
KL>LL
`k>LL
OK>_N
2
/qL>LLLLLOp
o OM>kK
?<FJH%X8%9$(1+1%"M%@"1742$'41$24"3%#42@%/+N$/0%2"%1+O8
?/$MV)%$))40+32
<))40+32%$2%@":+W#"/&
<0:4114"3%M/":%"2@+/%
0+7$/2:+321
?"2$'
A%%%%%%%%%%%%%%%%%%QRS
A%%%%%%%%%%%%%%%%%%QRS
A%%%%%%%%%%%%%%%%%QRS
A%%%%%%%%%%%%%%%%QRS
Women
O
fW>LWj
_
fKN>KNj
KW
fM_>NLj
WW
fOLLj
Men
OM
fKW>kkj
Om
fKL>_Lj
WN
f``>KKj
MN
fOLLj
B!(%:
ON
fON>LLj
KW
fKW>LLj
ML
fML>LLj
OLL
fOLLj
+O
/o L>LWp
2
oM>kK
?<FJH%Y8%H74)/4141%"M%7$24+321%#42@%/+N$/0%2"%2@+%2.7+%"M%+T+328
D41)@$/N+
?/$31M+/%2"%B"2@+/%
0+7$/2:+321
D+$2@
?"2$'
A%%%%%%%%%%%%%%%%%%%QRS
A%%%%%%%%%%%%%%%%%QRS
A%%%%%%%%%%%%%%%%QRS
A%%%%%%%%%%%%%%%%QRS
9$(1+%"M%@"1742$'41$24"3
B.%GV8 %88$")'(
L
L>LL
OW
NM>mN
m
KW>`W
ON
OLL
E88$")'( %( <!3)r,!.4
O
m>W`
OO
mN>kW
OO
mN>kW
KW
OLL
E"3$**$!' G.!3 !(<).
departments
O
O>MN
WL
`L>LL
K_
mk>WW
ML
OLL
B!(%:
K
K>LL
`m
`m>LL
mm
mm>LL
OLL
OLL
/oL>WL
2
om>k_
32
E *$2'$V8%'( '13?). !G 8%."$%8 %..)*(* $* "1) (! ?!(<
(.%GV8 %88$")'( $'-1.$)* %'" $'-1.$)* $' (<) ,!.4/:%8) !. %(
<!3)> a!3) $'-1.$)* 8!'*($(1() % <$2< /).8)'(%2) !G *).$!1*
complications, including circulatory arrest, this also concerns
8<$:".)'>
Other causes of sudden cardiac arrest due to circulatory
*+*()3 "$*!.").* %.)T $*8<)3$8 <)%.( "$*)%*)0 %..<+(<3$%*0
acute and chronic cardiac failure, advanced valvular defects,
hypovolemic and cardiogenic shock, pulmonary oedema,
3%-!. 7%*81:%. $'-1.$)* %'" /!*(R(.%13%($8 %')1.+*3
f"$**)8($'2 %')1.+*3 !G (<) %!.(%j>
Most common causes of a sudden cardiac arrest related
(! (<) .)*/$.%(!.+ *+*()3 %.)T %$.,%+ !?*(.18($!'0 8<)*(
(.%13%0 /')13!(<!.%]0 /%.)'8<+3%: %'" !?*(.18($7) :1'2
"$*)%*) %'" (<) *(%() !G ?.!'8<$%: %*(<3%> B<) 3!*( 8!33!'
causes of circulatory arrest on the part of the central nervous
*+*()3 %.)T *(.!4) ,$(< $'(.%8.%'$%: <)3!..<%2)0 /!$*!'$'2
f!/$!$"*0 *)"%($7)*0 /!$*!'*j0 $'G)8($!'* f8).)?.!*/$'%:
3)'$'2$($* ,$(< *)7).) 3)(%?!:$8 %8$"!*$* /)')(.%($!'* %'"
<+/).7)'($:%($!' %'" ?.%$' (13!.*j>
B<) 3%$' 8%1*) !G <!*/$(%:$#%($!' $' (<) $'()'*$7) 8%.)
1'$( ,).)T .)*/$.%(!.+ G%$:1.) fW_lj0 % *1"")' 8%."$%8 %..)*(
fKLlj %'" 31:($R!.2%' $'-1.$)* fONljp KKl !G (<) /%($)'(*
,).) %"3$(()" (! (<) 1'$( "1) (! !(<). .)%*!'* f*(%(1*
)/$:)/($81*0 <)3!..<%2$8 *<!840 %81() .)'%: G%$:1.)j>
A'-1.$)* %.) 8%::)" (<) :%.2)*( )/$")3$8* !G (<) (,)'($)(<
8)'(1.+> E3).$8%' *!1.8)* f>>>j $'"$8%() (<%( 7%.$!1* $'-1.$)*
%GG)8( ML 3$::$!' E3).$8%'* %''1%::+0 WL 3$::$!' !G (<)3
.)[1$.) 3)"$8%: %**$*(%'8) e !G ,<$8< OKl %.) <!*/$(%:
%"3$**$!'*p WLL (<!1*%'" b/)!/:)c .)3%$' /).3%')'(:+ 1'V(
G!. ,!.4 %'" O`L (<!1*%'" "$)>
A' d!:%'"0 (<) 3!.(%:$(+ .%() %88!1'(* G!. (!(%: !G WL
(<!1*%'" % +)%. e (<$* $* ?+ <%:G 3!.) (<%' $' u1.!/) %'"
P!.(< E3).$8% e $>)>0 kL /). "%+> E88!."$'2 (! (<) :$().%(1.)0
(<) 3!*( 8!33!' 8%1*) !G $'-1.+ f%//.!]$3%():+ `Llj %.)
*!R8%::)" !."$'%.+ <!.$#!'(%: G%::*> B.%GV8 %88$")'(* (%4) (<)
*)8!'" /:%8)> B<)+ 8!'*($(1() 1/ (! NLlRN`l !G %:: 3!*(
*)7).) 8%*)*0 $'8:1"$'2 31:($/:) %'" 31:($R!.2%' $'-1.$)* %'"
(<).)G!.) (<)+ %.) :$G)R(<.)%()'$'2 $'-1.$)* b`RNc>
C<)' %'%:+#$'2 /!*(R(.%13%($8 3!.(%:$(+0 W /).$!"* 8%'
?) "$*($'21$*<)" ,<)' ")%(< !881.*> F!3) /%($)'(* "$)
$33)"$%():+ R ,$(<$' 3$'1()* %G(). (<) %88$")'(0 1*1%::+
before the arrival of the emergency medical team, and
(<) 8%1*) !G ")%(< %.) *)7).) 8.%'$!R8).)?.%: $'-1.$)* %'"
massive haemorrhage as a result of heart and large blood
7)**):* $'-1.+> A' d!:%'" 3!.) (<%' <%:G !G *18< G%(%:$($)*
!881.> E G1.(<). OLl RO`l !G /)!/:) "$) "1.$'2 (<) *!R8%::)"
n2!:")' <!1.^> a).) (<) 8%1*) $* !G()' <)3!..<%2) %'" :)**
!G()' e 8).)?.%: $'-1.$)*> B<) .)*( !G (<) 7$8($3* "$) "%+* %'"
,))4* %G(). (<) %88$")'( ?)8%1*) !G 8!3/:$8%($!'*0 $>)> .)'%:
G%$:1.)0 .)*/$.%(!.+ G%$:1.)0 $'G)8($!' f*)/*$*j %'" 31:($R!.2%'
G%$:1.) bk0 _0 OLc>
B<) 8%..$)" !1( %'%:+*$* *<!,* (<%( $( $* 3%$':+ +!1'2
/)!/:) ,<! ,).) 7$8($3* !G (.%GV8 %88$")'(*0 (<) %7).%2)
%2) ,%* WK>m +)%.*0 ,<$:) (<!*) (.%'*G)..)" G.!3 !(<). 1'$(*
(! (<) $'()'*$7) 8%.) 1'$( ,).) 8<%.%8().$#)" ?+ !:"). 3)%'
%2) R MW>KW +)%.* !:">
t". d1?: KLOLpOKLfOj
F$2'$V8%'( "$GG).)'8)* ,).) %:*! G!1'" $' (<) 8%1*)
!G <!*/$(%:$#%($!' %3!'2 3)' %'" ,!3)'> C!3)' 1*1%::+
,).) (.%'*G)..)" (! (<) $'()'*$7) 8%.) 1'$( G.!3 !(<). <!*/$(%:
1'$(*p (<).) ,%* % *$3$:%. 8%*) ,$(< 3)'0 ?1( 3!.) !G()' (<%'
,!3)' (<)+ ,).) %"3$(()" %G(). (.%GV8 %88$")'(*> E3!'2 (<)
.)*/!'")'(*0 !':+ Kl !G (<) /%($)'(* ,).) "$*8<%.2)" <!3)0
?1( $' 1/ (! mml !G (<) /%($)'(* % G%(%: !1(8!3) ,%* .)/!.()">
9CA9JE >CA%
O> Z!*( G.)[1)'(:+ (<) /%($)'(*^ <!*/$(%:$#%($!' $' (<)
$'()'*$7) 8%.) 1'$( .%'2)" G.!3 ORN"%+*>
K> B<) 3%$' 8%1*)* !G <!*/$(%:$#%($!' $' (<$* 1'$( %.)T
respiratory failure, the state after a sudden cardiac arrest
%'" 31:($R!.2%' $'-1.$)*>
W> F$2'$V8%'( "$GG).)'8)* ,).) G!1'" ?)(,))' /%($)'(^*
%2) %'" 8%1*) !G <!*/$(%:$#%($!'T (<) 7$8($3* !G (.%GV8
%88$")'(* ,).) /)!/:) %2)" 8$.8% WK +)%.* !G %2)> 9:").
/%($)'(* ,$(< (<)rR %7).%2) %2) !G MW +)%.* !:" %.) (<)
/)!/:) ,<! ,).) (.%'*G)..)" G.!3 !(<). ")/%.(3)'(*>
m> B<) ,!3)' ,).) 3!*( !G()' <!*/$(%:$#)" $' AXY %G().
?)$'2 (.%'*G)..)" G.!3 !(<). <!*/$(%: 1'$(*0 ,<).)%*
(<) 3)' ,).) (.%'*G)..)" G.!3 !(<). 1'$(* %'" %:*! "1)
(! (.%GV8 %88$")'(*
BHZHBHA9H ,
O> C!&!,$84% I0 \+4 \> f)"$(!.*j E')*()#-!:!2$% $ $'()'*+,'% !/$)4%> H:$'$4%
$ /$):=2'$%.*(,!> C%.*#%,%T dtCIp KLLN>
K> H%3$@*4$ D0 \#$%4 E> d!*(=/!,%'$) , *(%'%8< #%2.!6)'$% 6+8$%>
C%.*#%,%T dtCIp KLLN>
W> C$"!3*4%RX#)4%-*4% B> f)"$(!.*j A'().'$*(+8#'% ().%/$% $ !/$)4%
/$):=2'$%.*4%> C%.*#%,%T dtCIp O__O>
m> t%,%"#4$ E> Z)"+8+'% .%(1'4!,% $ 4%(%*(.!G> C%.*#%,%T dtCIp KLLM>
`> D.!'2): I0 \1"% H> f)"$(!.*j Z'!2$) $ ,$):!'%.#5"!,) !?.%6)'$% 8$%&%>
C%.*#%,%T dtCIp KLLO>
M> H;#4% Z> F(%'+ #%2.!6)'$% 6+8$%> H.%4;,T C+"%,'$8(,! Yvp KLLO>
N> H!4!( s> 9*(.) *(%'+ #%2.!6)'$% 6+8$% , 8<!.!?%8< ,),'=(.#'+8<>
C%.*#%,%T dtCIp KLLW>
k> D.!'2): I> f)"$(!.j t&!(% 2!"#$'% 8#%* 6+8$%0 8#%* Q3$).8$> H.%4;,T
C+"%,'$8(,! Z)"+8#')p KLLN>
_> h+?$84$ v> A'()'*+,'% ().%/$% "!.!*&+8<> S"%@*4T P9wYF 9hDAFp
O___>
OL> v%41?%*#4! v0 h+Q E> f)"$(!.*j h%(!,'$8(,! 3)"+8#') , d!:*8)>
H.%4;,T t".!,$) $ t%.#5"#%'$)p KLLK>
>3M"/:$)P+%"%<(2"/$)@
\. <%?> '> 3)"> !"# $%&'()*"+&$,-"* e />!>4$).!,'$40 F%3!"#$):'%
d.%8!,'$% Z)"+8+'+ H%(%*(.!G0 Y'$,).*+()( Z)"+8#'+ , I1?:$'$)p
:)4> 3)"> BEATA RYBOJAD e *(%.*#+ %*+*()'(0 H:$'$8#'+ 9""#$%& E')*()#-!:!2$$
$ A'()'*+,')- B).%/$$0 \#$)8$=8+ F#/$(%: H:$'$8#'+ , I1?:$'$)0 32. IWONA
JAWORSKA, mgr ANNA AFTYKA e "!4(!.%'(0 :)4> 3)"> REANATA KORECKA e
,+4&%"!,8%0 F%3!"#$):'% d.%8!,'$% Z)"+8+'+ H%(%*(.!G0 Y'$,).*+()(
Z)"+8#'+ , I1?:$'$)
<0/+1%0"%&"/+17"30+3)P4
F%3!"#$):'% d.%8!,'$% Z)"+8+'+ H%(%*(.!G
Y'$,).*+()( Z)"+8#'+ , I1?:$'$)
1:> X<!"J4$ M0 KLRL_W I1?:$'