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Pain management with PCA usage in patients with thermal injuries
Kluková, Anna ; Bakalář, Bohumil (advisor) ; Zoubková, Renáta (referee)
Name and surname of the author: Bc. Anna Kluková Institution: Third Faculty of Medicine, Charles University Title: Pain management with PCA usage in patients with thermal injuries Supervisor: MUDr. Bohumil Bakalář Year of defense: 2023 Keywords: thermal injury, burned patient, patient-controlled analgesia, patient-controlled analgesia in thermally injured patients; opioid consumption This master's thesis focuses on the consumption of opioid quantities in thermally injured patients. The amount of morphine consumed by patients using patient-controlled analgesia (PCA) was compared with the amount of morphine routinely prescribed to patients as an i.v. infusion. The first group consisted of eight patients with a mean burn severity area (TBSA; %) of 32.71% who were able to actively participate in their pain management with PCA. The second group consisted of eight patients comparable by gender, age, and weight; their mean TBSA was 31.85%. There were no statistically significant differences between the groups. The Chorobopis software and the patient documentation archive helped to make the patients from both cohorts as similar as possible. At the time when patients from the first cohort used PCA, the amount of opioids consumed by them was monitored and recorded. The amount of opioids consumed by the...
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Emergency care of burned patients on the trauma scene and during transport - a prospective study
Benáková, Lada ; Bakalář, Bohumil (advisor) ; Sýkora, Roman (referee)
The aim of this thesis was to compare real prehospital care provided to adult burn patients to recommended procedures published in "Prehospital care for thermal injury" by the Czech Medical Society J. E. Purkyně, Society of Burn Medicine ČLS JEP, Society of Emergency Medicine and Disaster Medicine ČLS JEP in 2017. This thesis is divided into a theoretical part, which analyses the issue and defines the concepts, and a research survey, which was conducted at the Department of Burn Medicine, Královské Vinohrady University Hospital, Prague. The research took the form of data acquisition from the paramedic records and other admission documentation, and divided them into categories for subsequent comparison with the recommended procedures. The results of the research point to differences in the provision of urgent pre-hospital care in comparison to recommended procedures. The largest differences were noted in the estimation of the burn area and the amount of infusion administered. In contrast, the greatest agreement between the care provided and recommended has been demonstrated in the areas of determining the mechanism of injury and ensuring venous access. This thesis thus offers suggestions for a possible further extensive investigation in this medical field and for improvement of the existing care....
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Effect of illusory movements physiotherapy on vital and metabolic functions of patients with large burns
Jelínková, Pavla ; Bakalář, Bohumil (advisor) ; Jevič, Filip (referee) ; Smetana, Jiří (referee)
Name and surname of the author: Bc. Pavla Jelínková Institution: Third Faculty of Medicine, Charles University Title: Effect of illusory movements physiotherapy on vital and metabolic functions of patients with large burns Supervisor: MUDr. Bohumil Bakalář Year of defense: 2022 Keywords: large burns; illusory movements; proprioceptive neuromuscular facilitation; vital functions; catabolism; intensive care unit-acquired weakness The aim of this thesis was to determine how the usage of functional proprioceptive stimulation (so-called illusory movements) influenced vital and metabolic functions of patients with extensive burns. In the first part of the thesis we focus on defining the issues we encounter in patients with extensive trauma. Extensive damage not only affects metabolic and vital functions, but the extent of the skin injury changes prognosis of the injured person and the length of hospitalization. The longer patients are hospitalized in intensive care units, the more we encounter acquired muscle weakness. One of the ways to prevent this phenomenon is effective rehabilitation, which is quite challenging in burn patients. As an alternative, the usage of proprioceptive stimulation is offered. It creates illusions instead of real movements in the cerebral cortex. However, there has been no...
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Exposure to toxic concentrations of oxygen in ICU patients
Petránková, Eliška ; Bakalář, Bohumil (advisor) ; Jankovcová, Kateřina (referee) ; Hocková, Jana (referee)
Oxygen supplementation has been an important part of respiratory failure treatment in all fields of clinical medicine, especially on intensive care units (hereinafter referred to as ICU). Oxygen therapy is a life-saving measure but indiscriminate administration of oxygen can cause lung and nerve damage and consequently increase morbidity and mortality (1). In clinical practice we often encounter mechanically ventilated patients with high partial pressures of oxygen in arterial blood (5) which should direct our attention to possible consequences and have reliable data how is oxygen treatment managed. This thesis focuses on the exposure to toxic concentrations of oxygen on the resuscitation ward. The aim of this thesis is to determine whether patients are exposed to high concentrations of oxygen. Two other aims of this study are to find out how long are patients in a state of hyperoxemia and whether medical staff reacts to measured partial pressures of oxygen (hereinafter referred to as paO2) values in these patients by reducing oxygen fraction (hereinafter referred to as FiO2) on the ventilator. The research part of this thesis is a quantitative observational retrospective research. The inclusion criteria were hospital admission from 1st July to 1st October 2019, at least two paO2 values greater...
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