MILITARY PHARMACY AND MEDICINE

© Military Pharmacy and Medicine • 2012 • 4 • 94 – 96Question 12. In the twelfth question we askedrespondents about the meaning of the term „saturation.”Only 30% of them were able to identifysaturation as blood oxygen concentration. Asmuch as 70% of subjects gave wrong answers.A detailed distribution of answers given byrespondents is depicted in Figure 4.Figure 5: .Answers provided by respondents to question 12.Question 13. This question also referred to assessmentof saturation level. Among the providedanswers („carbon monoxide poisoning,” “cyanidepoisoning,” „hyperthermia”) respondents wereto choose the state, in which saturation measurementwould be unreliable. Only 25% gave a correctanswer, while 75 people responded incorrectly.DiscussionOxygen, an element necessary for human existence,is also used as a drug [4, 5, 6]. Just like inany other case of drug administration, supplementationof oxygen should be given accordingto indications and with careful dosing. For thatpurpose firefighter rescue teams, who are oftenthe ones to administer first aid to victims beforearrival of medical emergency services, undergofirst aid training. First aid course, which lasts66 hours (involving 25 hours of theory and 41hours of practical training), includes issuesrelated to supplementation of oxygen therapy tocasualties [3].Unfortunately, there are no reports in the literatureon the problem of knowledge regardingprinciples of oxygen therapy amongfirefighter rescue teams. Therefore, it is not possibleto compare our results to those obtained byother authors.The level of self-confidence among firefightersfrom the studied group was high and amountedOriginal articleto 4.32 points. There was a great disparitybetween their self-evaluated knowledge and testresults, as evidenced by a 61% rate of incorrectanswers given by respondents. At this point, itis safe to say that members of firefighter rescueteams overstate their knowledge of oxygen therapyadministration.At the scene of rescue operation firefighterrescue teams may administer oxygen therapyto the patient according to first aid procedures.Oxygen therapy may be divided intopassive and active types [7]. In passive therapyoxygen is inhaled due to patient’s preservedventilatory function, while in case of activeoxygen therapy forced ventilation (replacementbreathing) is used [7, 8]. In our material,only 46% of respondents knew the differencebetween methods of passive and active oxygentherapy, as demonstrated by indicating patientventilation via nasal cannulas as an element ofpassive oxygen therapy.Symptoms of hypoxia include: skin cyanosis (ifdeoxygenated hemoglobin concentration fallsbelow 5 g/l) [4, 8]. Moreover, we may observeexcessive respiratory muscle work, which is asign of dyspnea. In case of central nervous systemhypoxia patient may be restless or aggravated.Severe hypoxia may be associated withloss of consciousness. The simplest, non-invasivemethod of evaluating the level of blood oxygensaturation at the site of rescue operation is pulseoximetry. Only 30% of respondents in our studygroup possessed the knowledge that saturation isa measure of oxygen content in arterial blood.Despite pulse oximetry being a routinely usedmethod of saturation measurement, in some situationsthis measurement may be unreliable (erroneous).An example of such situation is carbonmonoxide poisoning. As carbon monoxide hasalmost 250-fold greater affinity to hemoglobinthan oxygen, bonds created as a result of couplingof hemoglobin with carbon monoxide and carboxyhemoglobinformation are extremely strong.It leads to tissue hypoxia. In the above situation,pulse oximeter may show normal values despitethe true level of arterial blood oxygenation beingsignificantly lower. Carbon monoxide poisoningis dangerous, as the most susceptible organs suchas the cardiovascular system and central nervoussystem are damaged first. In severe carbon94 http://military.isl-journals.com