Diagnosing chronic carbon monoxide poisoning can be a challenge for medical response teams. It is charaterised by unclear symptoms, which develop in a manner similar to many chronic cardiological or neurological diseases, and has consequences that can occur up to several months later. As a result, the character of such poisoning is often under¬estimated in daily practice. Multiple interventions and working under pressure does not always allow for a detailed analysis of many factors. It is therefore vital to develop solutions that allow for quick assessment of whether a patient has been exposed to carbon monoxide poisoning. Three-step analysis of the symptoms of poisoning is an ideal exam¬ple. This consists of a consultation on exposure to carbon monoxide poisoning, the presence of symptoms suggesting hypoxia due to poisoning, and determining the carboxyhaemoglobin index using equipment carried by the medical response team. Emergency procedures based on these three elements result in rapid identification of people suffering from carbon monoxide poisoning who require oxygen therapy, and the transportation of such people to specialised units for hyperbaric oxygen therapy. This system of analysis can also be used as part of a standard examination for assessing the exposure of a patient to carbon monoxide, both in hospital emergency departments and in medical response teams.

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Anaerobic bacterial infections are a broad group of conditions ranging from superficial skin infections to deeply embedded necrotic soft tissue infection. It has been observed that amongst all the microorganisms causing soft tissue infection, as many as 70% of anaerobic bacteria are unquestionably related to mortality in fulminant infections. Such infections are most commonly caused by an open wound that is insufficiently disinfected, or through the wound coming into contact with soil or human or animal faeces. This is particularly the case for wounds resulting from traffic accidents and injuries sustained in agriculture. In 80-95% of cases, the bacteria Clostridium perfringens is responsible for the appearance of gas gangrene manifested by sharp pain and crepitus in the wound area, as well as disseminated intravascular coagulation and septic shock. Due to time-consuming diagnosis and delays in obtaining the results of bacteriological tests, identifying the condition and commencing treatment relies mainly on a paramedic’s knowledge and experience. Improving the body of knowledge on soft tissue infection and awareness of the potential risks can affect the patient’s prognosis.

Cessation of emergency medical treatment on the basis of symptoms of clinical death and unclear indicators of death can result in numerous adverse phenomena. The currently available medical literature contains descriptions of cases of people with cardiac arrest in whom life function returned several minutes after emergency medical treatment was ceased. In the course of their work, paramedics must be aware of the existence of the auto-resuscitation phenomenon known as the Lazarus syndrome. Although the instance of the phenomenon remains exceptionally low, the possible consequences of an unrecognised case can be devastating. This can result in complaints of professional malpractice, negative reports in the media, as well as mental health issues among medical personnel and patients’ relatives. Medical response team procedures in the case of cessation of emergency medical treatment must contain elements that minimise the possibility of auto-resuscitation, also known as the Lazarus syndrome, from occurring.

Respiratory tract burns are among the most serious injuries. Complications include rapid swelling of the respiratory tract, which is the cause of high mortality rates. Such injuries require appropriate specialist treatment. The priority in emergency medical care is to ensure the airways remain unobstructed. If symptoms appear that suggest rapidly increasing swelling of the respiratory tract, intubation becomes essential to ensure the airways remain open. The aim of this article is to discuss the issue of the necessity to develop guidelines for emergency medical personnel attending patients with respiratory tract burns. Currently, according to the State Emergency Medical Care statute, paramedics may carry out intubation on patients suffering from sudden cardiac arrest. According to the Regulation of the Minister of Health of the 20th April 2016, the list of actions that a paramedic may freely undertake does not include intubation of patients with rapidly increasing swelling of the respiratory tract caused by burns. Taking into consideration the decrease in the number of specialist teams, recommendations should be developed as quickly as possible on indications for prompt intubation of patients with inhalation injuries. The scope of emergency medical treatment carried out independently by paramedics should also be expanded.