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Management of patient with critical thorax injury in prehospital care.
HARUDA, Stanislav
This bachelor thesis is mainly focused on critikal thorax injury in prehospital care. This thesis had two goals. First was theoreticly described critical thorax injury and the second goal was compare five cases from praxis with the theoretical part of this work. On the beginig of this work was discribed anatomy of thorax and phyziology of respiratory system. Next is discribed an introduction to critacal thorax injury, how they usually arise and how to provide a better prognosis for the patient. In the next chapter we are dealing with primary and secondary survay as well as the basic device examination of the patient. The following chapter is the critical chest injury itself, which is presented according to scholarly sources as life-threatening chest injury. This chapter describe symptoms, their pathophysiology and the appropriate therapy. This chapter includes these serious injuries: tension pneumothorax, massive hemotorax, open pneumothorax, flail chest with pulmonary contusion and cardiac tamponade. In other chapter are mentioned life saving skills including: needle thoracentesis, chest tube insertion and pericardiocentesis. There is also brief talk about analgesia, and the last chapter of the theoretical section is about immediate transport. In the empirical part, was used a qualitative analysis in five cases from praxis. These analysed cases were classified into categories, and then in the discussion were compared with the theoretical part of the thesis. The result of this work is that there is a correct final solution to all five critical chest injuries in pre-hospital care, but in some cases we experience incomplete examinations and there are certain differences in the treatment of these critical injuries than the scholarly sources mentioned.
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Evaluation quality of the treatment of the most common injuries in medical first aid.
LEVKO, Marina
The theoretical part of this bachelor thesis deals with the medical first aid service (emergency) and its current status in the Czech Republic with a focus on the South Bohemian region. I also describe the difference between the ambulance and the emergency because patients often mislead those two terms. The theoretical part focuses too on the trauma issue. Children and teenagers are the most endangered by suffering a trauma. That is why I describe the problematic of children in premedical care. The objective of the thesis was to find out the number of the most common children traumas on the three departments of the medical first aid service in the South Bohemian region and evaluate the quality of treatment. I was trying to meet the goals through a data collection from the three departments of the emergency service in the South Bohemian region from 2013 to 2014. The research was conducted through qualitative and quantitative data analysis. Based on the available documentation on emergency, I was retrospectively finding out the number of all patients treated on the emergency. From this data I subsequently learned the numbers of treated children with a trauma in years 2013 and 2014. All the data learned are worked out into charts to make them more transparent. The qualitative form of the research was done by the method of casuistry analysis. By analysing the casuistries I was also finding out what were the most common children traumas treated on the emergency, its diagnosis and the process of the treatment of each of the children patients in years 2013 and 2014. Two research questions were stated for this thesis. What are the most common traumas which are treated on emergencies and what is the way to treat such traumas and whether it corresponds with lege artis. For better orientation, the data learned about the most frequent children traumas treated on the emergency are put into graphs. After the evaluation of results I found out that the most common children traumas on all three departments of the emergency in years 2013 and 2014 were: injury caused by a sharp object then fall or a blunt impact to an object and burns of I. and II. degree burns. Those results matches with the results presented in other works dealing with the most frequent children traumas. The casuistry analysis implies that all the three departments of the emergency treat the most common types of a light injury the same way, in comparison with the reference literature in all the cases the procedure of treatment was correct. In cases when the trauma was not possible to be solved on the emergency, because of need of a laboratory or projecting medical examination which are not available on emergency, the ambulance was called to a patient, or the patient was redirected to another specialised department to be provided with safe and lege artis diagnosis. While evaluating the quality of the treatment I also focused on the evaluation of the medical documentation which is, on the emergency, represented by the book of daily records. On the emergency 1 and 2 I have met a serious failure with managing this book. Those failures were recorded only within the casuistries dealing with the treatment of adults. When evaluating the quality of treatment of children patients I have not met any wrong or partly filled documentation. To make the transparency better and have the unified form it would be adequate to keep the books in an electronic way at all three emergencies. This is where we are confronted by financial background of the emergency services. In the Czech republic there have not been institutionalized the form of the emergency, its function neither the network of emergencies, have not been specified by any law yet. If the function, provision, availability and the financial background of the emergency is united it would have a positive impact even to patients who this service is meant for.
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Burn-out syndrome in thepre-hospital and hospital care forparamedicalpersonnel
ŠAŠKOVÁ, Jana
The "burn out "syndrom is the state of a physical, emotional and psychical exhaustion. There is a relatively big danger of the "burn out"syndrom emergence by the paramedics and that is why there should be given a big stress to its prevention. The aim of this bachelor´s work was to find out if there is a bigger "burn out" syndrom by the paramedics than by hospital paramedics. The next aim was to find out the influence of the practice´ lenght and of the workfalling in to the psychical point of view to the paramedics. It was used the investigation of quantity through the standartised quostionnaire to find out the "burn out" level. We created a quostionnaire that contained 11 questions to find out if the paramedics have the prevention against the "burn out" syndrom. The standartised questonnaire MBI was evaluated in the area of the South Bohemian region through the charts and graphs. It was found that the hospital paramedics are more inclinating to the "burn out" syndrom than the ambulance service paramedics. Followingly the investigation, there is a bigger risk of "burn out" syndrom by paramedics with the longer practice. The most of the paramedics try to prevent the "burn out" syndrom but the prevention didn´t appear to be efficient in comparison to the number of "burn out" paramedics.
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Intraoseal approach - an alternative to peripheral venous entry
TUROŇ, Jiří
The intraoseal approach is an alternative method how to ensure bloodstream in cases when it is difficult or impossible to use venous entry. It is used mostly in children, but it is possible to apply it to adults too. This bachelor?s thesis called ?Intraoseal approach - an alternative to peripheral venous entry? deals with theory of using intraoseal approach in conditions of pre-hospital urgent care. The practical part of this thesis surveys the frequency of using intraoseal implant and screens the knowledge of rescuers working in Salvage and rescue service of Moravian-Silesian district. The method of quantitative research was used to validate the hypothesis. Obtained data were collected by method of anonymous questionaires. These questionaires were distributed to Salvage and rescue service of Moravian-Silesian district, to resorts of Ostrava, Opava, Havířov, Karviná, Krnov, Třinec and Frýdek ? Místek in the concrete. The results of this work showed practical and theoretical knowledge of paramedics of Moravian-Silesian district. Their orientation in the problematics of using alternative venous entry in conditions of pre-hospital urgent care is mostly correct even if there was few wrong answers. Nevertheless the results of research were excellent. These are hypotheses defined ? H1: Paramedics know the process of using intraoseal approach, and H2: The intraoseal approach is used less than venous cannulation in life endangering cases. Both of these hypotheses were verified. The frequency of using this entry is not so high, but I believe it becomes more common with increasing knowledge of rescuers, especially in cases of immediate threat of life with impossibility of using peripheral venous entry.
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Cooperation of the Mountain Rescue Service of the Czech Republic, Šumava region, with basic units of the integrated rescue system
HLAVÁČEK, Jan
The topic I selected for my bachelor degree thesis is a not-very-well-mapped area of cooperation between basic units of the Integrated Rescue System and the Mountain Rescue Service, Šumava region. I have described the content of works performed by the Mountain Rescue Service and their points of contact with the Emergency Medical Service, Police of the Czech Republic and Fire Rescue Service of the Pilsen and South Bohemian region, in connection with rescue of persons and their health. In my thesis I have attempted to describe situations typical for cooperation between the units, as well as the quality of cooperation, mutual interconnection between the organizations and potential possibilities to expand the cooperation in order to ensure safe movement and stay of persons in the mountain region of Šumava. The qualitative research used a method of semi-structured interview with members of the individual above-mentioned organizations. The research has shown that the cooperation functions at a very good level, it develops continually and that it is indispensable in the conditions existing in one of the country´s biggest mountain regions. One particular measure that could ensure further improvement is the development of a legislative document accurately defining competences of mountain rescuers.
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