Introduction-Achieving the optimal survival rate for sudden cardiac arrest in mountains is challenging. The odds of surviving are influenced mainly by distance, response time, and organization of the emergency medical system. The aim of this study was to analyze the epidemiology and outcomes of patients with out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation was performed in the Polish Tatra Mountains.Methods-This was a retrospective analysis of data on sudden cardiac arrest collected from the database of the Tatra Mountain Rescue Service and local emergency medical system from 2001 to 2021.Results-A total of 74 cases of sudden cardiac arrest were recorded. The mortality rate was 88% (65/74). Return of spontaneous circulation was achieved in 22 (30%) patients. A group of survivors was characterized by more frequent use of an automated external defibrillator (AED) (56% vs 14%, P=0.011), a shorter interval between cardiac arrest and emergency team arrival (12 vs 20 min, P=0.005), and a shorter time to initiation of advanced life support (ALS) (12 vs 22 min, P=0.004). All survivors had a shockable initial rhythm. The majority of survivors (8/9, 89%) had a good or moderate neurological outcome.Conclusions-This study confirms poor survival rate after sudden cardiac arrest in the mountain area. The use of AED, shockable initial rhythm, and shorter time interval to emergency team arrival and ALS initiation are associated with better outcomes.

Background: Despite its potential advantages, ultrasound-guided cannulation of the axillary vein in the infraclavicular area is still rarely used as an alternative to other techniques. There are few large series demonstrating the safety and feasibility of this approach. Methods: Retrospective analysis of data on patients undergoing ultrasound-guided, long-axis, in-plane infraclavicular axillary vein cannulation for the incidence of complications and the failure rate from two secondary-care hospitals. Results: The analysis included 710 successful attempts of axillary vein long-axis, in-plane, US-guided cannulation, and 24 (3.3%) failed attempts. We recorded a 96.7% success rate with an overall incidence of complications of 13%, mainly malposition (8.1%). There was one case of pneumothorax (0.14%), five cases of arterial puncture (0.7%), and two cases of brachial plexus injury. Conclusions: The US-guided axillary central venous cannulation (CVC) access technique can be undertaken successfully in patients, even in challenging circumstances. Taken together with existing work on the utility and safety of this technique, we suggest that it should be adopted more widely in clinical practice.

The pandemic caused by SARS-CoV-2, ongoing for more than two years, has dominated public and scientific debates on an unprecedented scale. Thanks to the intense efforts of researchers, the risk factors for severe COVID-19 have been identified, including diabetes, obesity, cardiovascular diseases, and others [1]. Moreover, some treatment options, e.g., systemic glucocorticosteroids, tocilizumab, and baricitinib, have been confirmed to be effective in reducing mortality [2][3][4]. Nevertheless, mortality among critically ill people with COVID-19 remains high.The dominant manifestation of SARS-CoV-2 infection is pneumonia, which often leads to acute respiratory failure requiring treatment in the hos-