No abstract

Introduction: Emergency medical systems, as the first line of management of infectious patients, were affected by the 2019 coronavirus acute respiratory disease (COVID-19) pandemic. The aim of the study was to analyze the impact of the COVID-19 pandemic on the Emergency Medical Service (EMS) with emphasis on response time. Material and methods: Retrospective analysis of dispatch card from EMS in Bydgoszcz between January 2018 and December 2020. The differences regarding the EMS response were analyzed between the pre-pandemic (2018-2019) and the pandemic (2020) period in three time-points: from call to Emergency Medical Team (EMT) departure (T1), from departure to arrival at the scene (T2), and from arrival to reaching the emergency department (T3). Results: There were 47783 EMT departures in 2018, 47113 in 2019 and 40835 in 2020. In 2020 mean (SD) monthly number of interventions was significantly lower [3403 (349) vs. 3954 (182), p < 0.001) compared to the 2018-2019 period. During the pandemic period the mean T1 [0.9 (1.49) vs. 0.63 (1.12) min, p < 0.001], T2 [9.91 (6.33) vs. 8.25 (5.07) min, p < 0.001], and T3 interval [40.45 (19.84) vs. 36.56 (14.63) min, p < 0.001] were prolonged in comparison to the pre-pandemic period. The differences in response time were the largest in October-December.Conclusions: During the first year of the pandemic, the number of EMT interventions decreased and the response time was prolonged compared to the pre-pandemic period. The largest differences were observed at the end of the year, which overlapped with the peak of the second wave of COVID-19 infections in Poland.

Introduction: The incidence of out-of-hospital cardiac arrests (OHCA) varies periodically. The aim of our study was to assess the temporal variability of OHCA occurrence in adult population of Bydgoszcz district.Material and methods: A retrospective analysis of 782 cases of OHCA, which occurred between January 1 st , 2018, and December 31 st , 2019, was performed. The temporal variability of OHCA occurrence was assessed during the day (within twenty-four 1-hour periods and four 6-hour time intervals), weeks, months, and seasons of the year. Results:The incidence of OHCA in the analyzed population was 84 per 100,000 inhabitants/year. The highest incidence of OHCA was observed between 08:00 and 08:59 and between 15:00 and 15:59.The lowest number of OHCA occurred at night (n = 84; 10.7%; p < 0.001). During the week, the lowest number of OHCA was noted on Saturday (12.4%) and the highest on Monday (16.5%), with no significant differences between days. The highest incidence of OHCA was observed in winter and the lowest in summer [225 (28.8%) vs. 171 (21.9%), p = 0.006]. December was the month with the highest number of OHCA cases, and July the lowest. Conclusions:The present analysis confirms that the occurrence of OHCA demonstrates circadian, monthly, and seasonal rhythm. The highest incidence of OHCA was in the morning and afternoon, and in winter, especially in December. The lowest occurrence of OHCA was at night and in the summer, particularly in July. There was a weekly pattern with the highest occurrence of OHCA on Mondays; however' no significant differences between weekdays were achieved.

The year 2021 with the SARS-CoV-2 virus was a difficult period both for the society and for the entire health care system in Poland. The lack of experience in the context of working with a rapidly spreading infectious disease that caused periodic exacerbations of the failure of the State Medical Rescue System forced the search for solutions to improve the operation of medical rescue teams. In many situations, the encountered problems have been successfully resolved, in others, unfortunately, we still see a real threat. Many hours of absences of the Medical Rescue Teams related to the long time of implementing non-standard calls, the need for disinfection, unexpectedly excluded personnel from being ready to be on duty are just one of the many factors that paralyzed the State Medical Rescue System. The problem of the pandemic will remain in the health care system much longer than originally expected, therefore locally developed solutions must be constantly evolved to meet the challenges that will put the National Medical Emergency System to the test many times.