|
|
Basic clinical examination of the client by the medical rescuer in the pre-hospital urgent care in the South-Bohemian Region
VIKTORA, Martin
The issue of the clinical examination is the topic being more a part of physician work from the historical point of view. This state changes under the influence of the development of manning the crews in the rescue service. This bachelor thesis called Basic clinical examination of the client by the medical rescuer in the pre-hospital urgent care in the South-Bohemian Region summarizes the basic examinations which should be theoretically known as well as practically used by each medical rescuer. The target of the thesis was to find out the knowledge of the present medical rescuers working in the Medical Rescue Service of the South-Bohemian Region and if they observe the procedures of clinical examination. The contents of the theoretical part is the characteristics of rescue service, its last development and trend, also the young specialization of ?medical rescuer? is described, i.e. the possibilities of study, powers and contents of work. In the next part, the thesis treats the clinical examination. At first the contents of clinical examination is described, the access to it and its importance is explained, than the individual parts of the examination are analyzed. In the theoretical part, it is possible to find the information about anamnesis, methods of physical examination of all the body parts and organs. At the end, also the basic appliance method is mentioned, contributing to the clinical examination in the pre-hospital care as well as the good attitude to the patient, who is an important part also in this topic. If follows from the results of the quantitative examination that there are big differences between various degrees of the education. The graduates of secondary medical schools, of the study (after GCE) of anesthesiology-resuscitation care and intensive care and of higher professional schools have a lower knowledge in this field than their colleagues with the university education. In total the rescuers do not observe the procedures of the clinical examination more often. Both hypotheses were confirmed. It follows from the thesis that it is necessary to try to close the gap. During the studies, the clinical examination should be more accentuated, we should not reconcile with the present state. Also after the study of the branch, the topic should be repeated at the workplaces by means of theoretical lectures and practical seminars. In future, the medical rescuer will have to substitute also the physician in clinical examination, but he/she is not prepared for this up to now.
|
|
|
The possibility of pain management in prehospital emergency care
GUIDA, Mario
I chose the topic Possibilities of pain management in pre-hospital emergency care for my bachelor thesis as pain belongs to the most frequent symptoms of patients in the care of the Emergency Medical Service. The goal was to map the possibilities of pain management in pre-hospital emergency care in South Bohemian Region. The second goal was to map the awareness of pain management in pre-hospital emergency care among South Bohemian medical rescuers. The theoretical part deals with the present situation of the Emergency Medical Service, education and competences of rescuers. In the next part I focused on various types of pain, assessment and subsequent treatment of pain. The last, theoretical part describes the caring process in pre-hospital emergency care for a patient in pain. The research was performed by means of quantitative method in the form of a questionnaire with semi open and closed questions. The questionnaires were distributed at Emergency Medical Service regional centres of South Bohemia. The results show that pain is sufficiently managed in pre-hospital care. Another fact was confirmed, that rescuers are familiar with the pain management possibilities and prefer pharmacological methods of pain management. We also found out that non pharmacological interventions were used less frequently than they could be. One of the hypotheses was refuted, two were confirmed. The quantitative research results show that there is still a relatively large reserve in using non pharmacological methods. Rescuers might use them more, particularly the quick emergency crews, or they might be applied in situations not requiring immediate pharmacological treatment. Educational seminars at the individual workplaces might improve the awareness of non pharmacological intervention techniques. A patient in pre hospital emergency care suffering from pain of various intensity should be given primary professional care from qualified rescuers.
|
|
|
The Problem of Distal Cannulation by Medical Rescuer in Pre-Hospitalization Care
BRATRÁNEK, Pavel
At present, an absolute necessity for health workers is knowledge of the way how to access the bloodstream both in an area of the pre-hospital care and in an area of the health care. The bloodstream is an ideal choice in cases when times plays a major role in the onset of a drug. In my bachelor thesis I focused on issues regarding an assurance of the peripheral bloodstream by a medical rescue worker in the pre-hospital emergency care. I concentrated on the assurance of an intravenous access and at present more and more discussed intraosseous entry. Nowadays, when a lot of medical rescue workers yearn for raising their competences, it is necessary to think if they really know and apply these basic skills while assuring the peripheral bloodstream. An aim of the thesis was to determine if medical rescue workers have an appropriate theoretic preparation and if they know principles of the assurance of the peripheral bloodstream, if they follow these procedures in practice and if there are any differences in the issues of the assurance of the peripheral bloodstream at chosen regional centres of Medical Rescue Service of the South Bohemian Region given by a different driving distance to a hospital facility. A quantitative research was selected as a method applied. An anonymous questionnaire was used as a technique of the data collection. It was distributed to medical rescue workers operating at Medical Rescue Service of the South Bohemian Region. The results of the research showed that medical rescue workers did not have very deep knowledge in case of the intravenous entry but on the contrary they had good knowledge of the intraosseous access. It was also proved that medical rescue workers did not follow prescribed procedures during the intravenous cannulation and not all of them used safety devices. Another result of the research is a fact that medical rescue workers have theoretic knowledge of the intraosseous cannulation but they do not have enough practical experience with it. The last of the most important results of the research was the finding that medical rescue workers in České Budějovice cannulate with a lower frequency than medical rescue workers from other regional centres where there are not so noticeable differences. On the grounds of the data obtained I think that the results of the research included in the bachelor thesis could be used to deepen theoretical knowledge of medical rescue workers in the area of cannulation issues of the peripheral bloodstream.
|
|
|
Treatment of burn trauma in prehospital emergency care
HASMANOVÁ, Ilona
The number of serious thermal injuries keeps increasing. Their treatment requires fast, first-class professional, well-organized service, with an adequate material and personnel provision, capable of dealing with even a sudden occurrence of a high number of afflicted persons in one location. The treatment of such injuries requires an interdisciplinary team of cooperating professionals, including the care provided in specialized facilities. I have selected the topic of treatment of trauma caused by burns because it is highly relevant for everybody as it may afflict each person at any time. Treatment of burns in field conditions is far from easy and it has its specifics. The specific features consist in somatic aspects of nursing activities but also in mental aspects. The objective of the thesis was to summarize theoretical information about treatment of burns in the conditions of pre-hospital care and to map the knowledge and skills of paramedics working for the Emergency Medical Service. The thesis consists of two parts: theoretical and practical. The theoretical part explains the term of pre-hospital immediate care and identifies the scope of its application and the providers of such care. The burns are presented and clearly classified based on many aspects and the thesis describes their incidence and, last but not least, also the prevention. The thesis also deals with specific features of nursing care in the conditions of pre-hospital immediate care from the viewpoint of nurses and subsequently also with the field treatment of trauma caused by burns. The practical part used quantitative research, method of inquiring with a questionnaire. The results indicate that paramedics are completely familiar with the procedures to treat trauma caused by burns, that that the cooperation between the Emergency Medical Service and specialized burns centers is sufficient and that the method of intraosseous infusion to children is not sufficiently used. This means that all of the three hypotheses have been confirmed. The results of the research suggest that more attention should be paid to treatment of burns not only in classroom but mainly in a practical part of the training. It is because burns may result in life-long consequences and their treatment in pre-hospital immediate care shall be therefore of the highest professional quality.
|
|
|
Temperature injures in pre-hospital emergency care
PAJURKOVÁ, Romana
The content of my bachelor thesis of the title Thermic injuries in pre-hospital urgent treatment is a brief summary of this issue theory with the performed research whose task is to confirm the knowledge of medical rescuers concerning the attitude to these injuries. The theoretical part deals with certain thermal shocks ? hypertermiae, burns, hypothermiae and frostbites. In each of these conditions a simple pathophysiology, its division, symptoms, possible risks, lay (non-expert) first aid and special pre-hospital urgent treatment are described. The technique of content analyses of expert monographies as well as magazines in the electronic form were used at work with literature. The practical part deals with the research and the intention to determine the level of rescuers´ knowledge concerning this issue from the point of view of pathophysiological thermic injuries and ways of their tratment in the pre-hospital urgent care. To verify the hypotheses, the method of quantitative research was used. Data acquisition was realized through the method of questioning in an anonymous questionnaire, distributed to regional centres of health rescue service in Moravian-Silesian region. Out of the total number of 100 distributed questionnaires, 82 returned, the rate of return thus equalled 82 %. The research outcomes are stated in this thesis in form of graphs with percentage results. The hypotheses which were set at the beginning of the reserach have been confirmed. Practical skils as well as theoretical knowledge of Moravian-Silesian region rescuers respond in a high rate to expert literary sources and attitudes. Of course, even incorrect answers have appeared, however their amount has not exceeded 50 % in any of the questions. Despite this, I would like to publicize my thesis content, for example, on the Internet pages with the intention of a brief and clear acquaintance with this issue so that it could serve as a kind of instruction in case of little ignorance. Even we, paramedical workers, are only humans and make mistakes at times. Therefore I think it is important to know where to find help in case we are not completely sure.
|
|
|
The organization of emergency medical treatment with intention to the medicine of disasters and mass catastrophes
CHALOUPEK, Milan
The medicine of disasters and mass catastrophes is an interdisciplinary medical specialism exploiting scientific discoveries made and lessons taught by experience in the other branches of medicine while attending to emergencies and carrying out rescue, demolition and sanitation operations. Practices already applied to handle mass catastrophes are being analyzed in case the humankind has to face similar events in the future. Related to the analyses are requirements for organizing urgent care. To illustrate the types of cooperation; to exemplify organization of the urgent care on specific cases; to compare the ways of cooperation between health-care facilities and the constituent elements of the Integrated Rescue System (IRS); and to cope with large-scale disasters, the mass catastrophes occurring in the Czech Republic have been treated to an analysis. Evaluated in the relevant cases was the level of security that the Czech Republic can rely on in case of emergencies - catastrophes and major disasters. Comparison was made between what was done by large health-care facilities and what was taken care of by the Integrated Rescue System, with special focus on the triage of the victims. As follows from analyses of different mass disasters, the medical care provided to save lives is satisfactory, and the urgent care is organized properly. The information on organizing urgent care oriented towards the medicine of disasters and mass catastrophes has been extracted from a variety of sources and through inquiring competent professionals.
|
|
|
Obstetric situations in prehospital emergency care and duties of a medical rescuer
KLEČATSKÁ, Lucie
The paper treats the subject of obstetric situations in pre-hospital emergency care and the tasks tackled by paramedics. Vital in such situations are the early recognition of symptoms; correct diagnostics; and a speedy transfer of the patient to a hospital. The paper concentrates primarily on delivery during the pre-hospital emergency care; on premature leak of the amniotic fluid; and on bleeding encountered in pregnant women in the second half of gestation and the related complications. The effort aimed particularly at mapping the frequency of emergency obstetric situations met during the pre-hospital emergency care in the Region of South Bohemia; at exploring the experience of paramedics; and at finding whether they were afraid of such situations and whether they were able to apply their theoretical background in practice. The defined objectives yielded four hypotheses: H 1: Emergency obstetric situations emerging during the transit are rare in the South Bohemian Region; H 2: Paramedics possess sufficient theoretical erudition to manage the emergency obstetric situations; H 3: Paramedics do not possess sufficient theoretical erudition to manage the emergency obstetric situations; and H 4: In providing emergency pre-hospital care paramedics try mainly to take the patient to hospital in good time. The research section of the paper relied on a quantitative survey conducted through a questionnaire distributed among paramedics in the Region of South Bohemia. Altogether 80 questionnaires were distributed, out of which 66 constituted the surveyed set. The results were processed and assembled into cake diagrams best depicting the percentage shares. All objectives have been accomplished. The first and fourth hypotheses proved false, while the second and third proved true.
|
|
|
The Tasks of Paramedic at Gynaecological States in Pre-hospital Phase
ŠÍMA, Oldřich
This thesis is called The Tasks of Paramedic at Gynaecological States in Pre-hospital Phase. At the beginning of the chapter ``Present State{\crq}q the job of a paramedic and pre-hospital urgent care are briefly characterized. The information on anatomy and physiology of female reproductive organs, on examination procedures in pre-hospital phase with the focus on gynaecology and the survey of nosological units and syndromes are included. Also the last part of the chapter contains the characteristics of rape and abuse including recommended procedures for paramedics in pre-hospital phase. The objective of the thesis was to find out if a paramedic (during the action with gynaecological diagnosis) proceeds according to the recommended schemes, further, to find out theoretical knowledge of paramedics and to map particular practical experience of paramedics concerning gynaecology. For the research the quantitative method of data collection was used, while the data was gained by the questionnaire method addressed to paramedics of South Bohemian Region. The results have shown that paramedics have sufficient experience with gynaecological states in pre-hospital care including theoretical knowledge. Further, it also was found out that many paramedics are not willing to take a detailed gynaecological history from a patient and many of them are not willing to examine a patient. In this connection it proves the fact mentioned by Pokorný that gynaecological cases are considered specific private matter with increased claim to respect to shame and privacy by women, which often equals to very reserved history and data on present illness or injury. On the basis of these data I think the results contained in the thesis might be used to deepen practical skills of paramedics in the problems of gynaecological states, especially with respect to taking the history and clinical examination on conditions of pre-hospital care.
|
|
|
Children´s drowning from the perspective of pre-hospital emergency care
SEDLÁČEK, David
Drowning, especially in children, is a relatively frequent cause of death. Statistics speak clearly. Children´s drowning is the second most frequent cause of death of children in industrialized countries. Good knowledge of the issue of drowning in children, therefore, seems to be the best way how to at least partially minimize the unfavorable statistics. But it is necessary to be aware of the child drowning specificity due to the child age. And the nursing care specifics are the subject of the thesis. The main objective was to survey the knowledge of prevention and first aid for children in the context or drowning and near-drowning on the part of adult and child public and also in the Emergency Medical Rescue Service workers. The quantitative research method through anonymous questionnaires was chosen. The research sample representing the general public was composed of staff members and pupils and students of several primary and secondary schools in České Budějovice. The research was conducted with the Emergency Medical Rescue Service workers in the regional centers of the Emergency Medical Rescue Service of the South Bohemia region. The questionnaire addressed to the general public contained a set of 25 questions, the questionnaire for the Emergency Medical Rescue Service workers comprised a set of 20 questions. The research has confirmed that the general public knows the first aid basics, but does not have enough knowledge about prevention and first aid for child drowning and near-drowning. The outcomes have mainly proved unfamiliarity with principles of resuscitation for children. The research has also shown that in children in general the knowledge of prevention and first-aid provision for near-drowning or drowning only minimally depends on their age. According to the research results the Emergency Medical Rescue Service workers have adequate knowledge about prevention and first aid for drowning or near-drowning children. The obtained results suggest the need to increase training and education in issues relating to the near-drowning of children in the general public of all ages. In a limited range it would be useful to organize training on issues related to pre-hospital emergency care also for the Emergency Medical Rescue Service workers. The need of the knowledge of prevention and first aid for drowning or near-drowning is confirmed by the fact that even among the public, with which the research was conducted, several persons who had already met this problem were found.
|
|
|
Acute myocardial infarction in pre-hospitalization urgent care - direct cooperation with a cardiology center
JONÁŠ, Jindřich
Acute myocardial infarction in pre-hospitalization urgent care {--} direct cooperation with a cardiology center The evaluation of urgency of the condition of a patient with cardiac disease symptoms, identified as chest pain or acute coronary syndrome, used to be in the pre-hospitalization urgent care always in the domain of the emergency service physician. However, with the progress of diagnostic techniques the working diagnosis can be also made by a trained paramedic, as long as he/she is unable to get a physician to the place of the intervention. A great advantage in this respect is the possibility of telemetric transmission of electrocardiographic records to the cardiology center where the curve is evaluated by a cardiologist and then the optimized method can be agreed with the specialist by phone so that the concerned patient can be transported into a hospital and given specialized treatment. The objective of the thesis was to analyze the working procedure of a paramedic with a patient who suffered an acute myocardial infarction and to evaluate specific features of communication and cooperation with the cardiology center by means of data transmission. The bachelor thesis is divided into two parts. The first part is theoretical and it describes the issues of pre-hospitalization urgent care of a patient with an acute myocardial infarction and the provision of the care. The second, practical part of the thesis, consists of a qualitative research. The employed technique for data collection was a structured interview. Based on an analysis of the acquired data we set the following hypotheses: Hypothesis 1: Paramedics are familiar with the procedure for pre-hospitalization urgent care of a patient with an acute myocardial infarction. Hypothesis 2: Teams sent to interventions with chest pain indication are primarily emergency medical service teams.
|
guest ::
