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Background Lidocaine, a widely used local anaesthetic, also serves as an adjuvant in pain management. However, its use in children is off-label. This study aimed to determine if intravenous lidocaine alleviates the haemodynamic, metabolic, and hormonal responses to intubation and laparoscopic surgery in children. Methods A single-centre, parallel, double-masked, randomised, placebo-controlled trial. 132 patients, aged 18 months to 18 years, with no contraindications to lidocaine administration and qualified for laparoscopic appendectomy were enrolled. The intervention studied was a lidocaine bolus of 1.5 mg⋅kg − 1 over 5 min given before induction of anaesthesia, followed by intraoperative lidocaine infusion at 1.5 mg⋅kg − 1 ⋅h − 1 intraoperatively. Patients in the control group were administered a placebo. Mean arterial pressure, glucose, cortisol, lidocaine blood levels, lidocaine-related side effects, and intraoperative opioid requirements were analysed. Results 132 participants completed the trial. The number of patients who experienced an excessive cardiovascular response to induction of anaesthesia or intubation was 23 (37%) in the control group and 21 (34%) in the lidocaine group ( p  = 0.707). No statistically significant difference was found between the control and lidocaine groups in the hormonal and metabolic responses, as well as intraoperative fentanyl requirements. Serum lidocaine levels remained below the toxic threshold in all patients. Conclusions Although the studied intervention appears to be safe, with no clinical side effects observed and serum lidocaine levels remaining below the toxic threshold, its intraoperative administration is not recommended, as it does not demonstrate any significant benefit during the anaesthesia period when compared to placebo. Trial registration number NCT05238506. The date of first registration: 14/02/2022.

It has become a standard measure in recent years to utilise evidence-based practice, which is associated with a greater need to implement and use advanced, reliable methods of summarising the achievements of various scientific disciplines, including such highly specialised approaches as personalised medicine. The aim of this paper was to discuss the current state of knowledge related to improvements in “nursing” involving management of delirium in intensive care units during the SARS-CoV-2 pandemic. This narrative review summarises the current knowledge concerning the challenges associated with assessment of delirium in patients with COVID-19 by ICU nurses, and the role and tasks in the personalised approach to patients with COVID-19.

Background: Opioids remain the most effective component of systemic analgesia and are considered safe and beneficial when administered at the lowest effective dose. Nevertheless, their potential adverse effects may diminish the quality of the postoperative period or, in some cases, lead to life-threatening complications. This analysis examines whether the mandatory implementation of a standardised protocol offers opioid-sparing potential. Methods: In this single-centre retrospective cohort study, intraoperative opioid consumption during laparoscopic appendectomy was compared between patients anaesthetised according to a standardised protocol (n1 = 132) and those managed at clinicians’ discretion in line with good medical practice (n2 = 212). Length of hospital stay and use of intraoperative non-opioid analgesics were also assessed. Results: The total fentanyl dose administered during anaesthesia was significantly lower in the standardised protocol cohort compared to the cohort without a protocol: 3.13 μg·kg−1 (IQR: 2.98–4.08) vs. 5.19 μg·kg−1 (IQR: 3.89–6.67), p < 0.001. In the protocol cohort, the percentage of patients who received acetaminophen and metamizole was significantly higher—increasing by 57% and 23%, respectively (p < 0.001). No significant inter-cohort difference was observed in terms of length of hospital stay. Conclusions: The use of a mandatory anaesthetic protocol based on a multimodal approach had an opioid-sparing effect in children undergoing laparoscopic appendectomy. This retrospective analysis was approved by the Ethics Committee of the Medical University of Warsaw (identifier: AKBE/118/2025; date of acceptance: 12 May 2025), and the primary trial was registered in the U.S. National Library of Medicine Clinical Trials Registry (registration number: NCT05238506; date of first registration: 14 February 2022).

Introduction. The nursing profession in Poland is subject to continuous transformations, but it should follow the directions based on the common framework for the development of specialist nursing, drawn up by international specialist nurses associations in Europe. A change in the nursing education system in Poland has provided an opportunity for progress based on consistent framework.Summary. Nurse education organised in a system of first cycle and second cycle university courses was a milestone towards improving the status of the nursing profession. The improved position of Polish nurses paved the way for further advancements in this profession and in the related scientific research, which in the past was rarely conducted by Polish nurses; today more and more research teams are launched and operate both at universities and in nurses’ scientific associations.

Introduction. Research demonstrates that nursing documentation is a condition for the continuity of patient care and for their safety. The objective of the article is to present the existing knowledge on anaesthesiology nursing documentation and to specify its essential elements.Material and methods. A literature review was performed with a systematic literature search. The content of the included studies was analysed in terms of its content and relevance. The materials was gathered through electronic database search.Results. It was found that the key elements of the documentation-related practice of anaesthesiology nurses were as follows: the record-keeping tool should be adjusted to the clinical practice, the documentation for nurses should take into consideration the patient safety aspect and protect nurses from legal consequences; also, the documentation should comply with the current legal regulations and be regularly updated.Conclusions. Anaesthesiology nurses who keep their documentation contribute to improving the safety of patients and themselves. With observations and taking notes on all performed interventions, it is possible to prevent errors and track changes in the patient’s condition reflected in their medical record.

Objectives The study aimed to assess sleep disturbances in patients subjected to home quarantine due to suspected SARS-CoV-2 infection. The study used a mixed methods design study as a research methodology. Methods A semi-structured interview and the scale for Insomnia Severity Index (ISI) were used to achieve the aim of the study. The survey was conducted from 16 to 20 April 2020 and 1 to 2 September 2020 in Poland, at the during of SARS-CoV-2 epidemic in this country. The data were coded and cross-processed. The (COREQ) checklist was followed. Results Interviews with patients and a thorough analysis of recordings revealed commonly used phrases in the following categories: “anxiety”, “Am I going crazy?”, “Sleep problems”. 10 out of 11 respondents reported sleep disorders of varying severity according to the Insomnia Severity Index scale. Patients presented a fear related to the return to society and normal functioning after quarantine. Additionally, some study participants voiced concerns related to their mental health; some cases of hallucinations were reported. Conclusions Further global population studies should be conducted to analyse this phenomenon. Acute Stress Disorder should be understood as a threat to life and health of an isolated society in quarantine. Further research in this area should be promoted and the need for global guidelines for the entire population should be developed.

Cílem této studie je prověření a další rozvoj \"Kontrolního seznamu pro anesteziologické sestry\" (CLNA). Pro tento účel byla použita kvalitativně-kvantitativní studie. První fáze studie se zúčastnilo technikou focus group 13 zdravotních sester s dlouhodobými pracovními zkušenostmi v oblasti anesteziologie a intenzivní péče. Tyto zdravotní sestry vyvinuly kontrolní seznam pro anesteziologické sestry. Posléze se tato skupina sester pokusila tento kontrolní seznam prověřit a standardizovat. Kontrolní seznam umožnil sběr informací o zákrocích provedených anesteziologickými sestrami. Tyto zákroky byly rozděleny do šesti skupin. Během druhé fáze testování bylo prověřeno celkem 130 kontrolních seznamů. Kontrolní seznam CLNA zvyšuje bezpečnost jak zdravotních sester, tak pacientů; pomáhá udržovat bezpečné pracovní prostředí, určit, kdo zodpovídá za bezpečné pracovní podmínky a zvýšit pocit zodpovědnosti mezi anesteziologickými sestrami. Tento kontrolní seznam také pomáhá sbírat a zaznamenávat informace o příčinách negativních událostí v anesteziologickém ošetřovatelství, aby následně mohly být příslušné postupy upraveny. Podle \"Pracovní skupiny polské asociace anesteziologických sester a zdravotních sester v oboru intenzivní péče\" by měl být v budoucnu kontrolní seznam CLNA povinnou součástí pacientovy interní zdravotní dokumentace.

Background: Aortic dissection (AoD) is a life-threatening medical emergency characterized by the separation of the layers of the aortic wall. The typical clinical presentation of AoD includes intense thoracic pain in the anterior chest or interscapular region, often described as migratory and tearing in nature. However, in rare cases, AoD can present without classic signs but with neurological symptoms, including seizures. Case Presentation: A 60-year-old patient experienced a sudden loss of consciousness followed by a tonic–clonic seizure and subsequently developed right-sided weakness. He had a medical history of hypertension and smoking. Although the symptoms quickly resolved, the brain imaging revealed signs of an acute ischemic stroke located in the left hemisphere. The seizures resumed, blood D-dimer levels were found to be highly elevated, and subsequent thoracic and abdominal computed tomography angiography revealed the presence of AoD, which originated at the proximal part of the ascending aorta. The patient received symptomatic treatment to alleviate his symptoms and prevent complications and was quickly transferred for surgical intervention, resulting in a favorable outcome. Conclusions: This case demonstrates that a tonic–clonic seizure can be the first clinical manifestation of AoD. Such atypical symptoms highlight the diverse and misleading nature of AoD presentations, underscoring the challenges in the diagnostic process. This emphasizes the need for increased clinical vigilance when treating a patient experiencing their first seizure episode.

To indicate predictors of witnessed hypothermic cardiac arrest. We conducted a retrospective analysis of 182 patients with severe accidental hypothermia (i.e., with core body temperature of ≤28 °C) who presented with preserved spontaneous circulation at first contact with medical services. We divided the study population into two groups: patients who suffered hypothermic cardiac arrest (HCA) at any time between encounter with medical service and restoration of normothermia, and those who did not sustain HCA. The analyzed outcome was the occurrence of cardiac arrest prior to achieving normothermia. Hemodynamic and biochemical parameters were analyzed with regard to their association with the outcome. Fifty-two (29%) patients suffered HCA. In a univariable analysis, four variables were significantly associated with the outcome, namely heart rate (p < 0.001), systolic blood pressure (p = 0.03), ventricular arrhythmia (p = 0.001), and arterial oxygen partial pressure (p = 0.002). In the multivariable logistic regression the best model predicting HCA included heart rate, PaO2, and Base Excess (AUROC = 0.78). In prehospital settings, when blood gas analysis is not available, other multivariable model including heart rate and occurrence of ventricular arrhythmia (AUROC = 0.74) can be used. In this study population, threshold values of heart rate of 43/min, temperature-corrected PaO2 of 72 mmHg, and uncorrected PaO2 of 109 mmHg, presented satisfactory sensitivity and specificity for HCA prediction. In patients with severe accidental hypothermia, the occurrence of HCA is associated with a lower heart rate, hypoxemia, ventricular arrhythmia, lower BE, and lower blood pressure. These parameters can be helpful in the early selection of high-risk patients and their allocation to extracorporeal rewarming facilities.