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Use of Mapleson C breathing system in pre-hospital care.
FILIP, Michal
The theoretical part describes the physiology of a human's respiratory tract. The next part focuses on the history of ventilation, non-invasive ventilation and its basic ventilation modes. Then it focuses on Mapleson´s systems, their advantages and disadvantages, then it focuses on Mapleson C, which is a priority for this work. Next is the instruction manual and in the last chapters we will discuss an acute situations in pre-hospital care, where Mapleson C can be used and important laws to clarify whether a paramedic can use this system or not. The practical part is processed by using a quantitative questionnaire which is completed by 38 paramedics and doctors in the South Bohemia region. The first goal of the work was to find out a knowledge about the safe use of this system. The second goal was to find out if the use of Mapleson C by a paramedic is correct with current legislation. The result of this thesis shows how high the level of information about Mapleson C system is. It shows its advantages, disadvantages and justifies why it is rarely used in practice. This work could serve as a protocol for the use of Mapleson C, which would be available to all paramedics.
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Non-invasive ventilation in patients with COPD
AUGUSTÍNOVÁ, Markéta
The thesis begins with a theoretical part containing a general description of artificial pulmonary ventilation, invasive pulmonary ventilation and a detailed description of non-invasive pulmonary ventilation and chronic obstructive pulmonary disease. This section also focuses on a detailed description of non-invasive pulmonary ventilation in patients with chronic obstructive pulmonary disease. The aim of this thesis is to find out the real usability and success of non-invasive pulmonary ventilation in patients with chronic obstructive pulmonary disease received in 2018 at the department of ARO in the Hospital Jindřichův Hradec. The data was obtained from the patient documentation for 2018 from the ARO department and subsequently entered in the tables. The research found that in 2018, 162 patients had undergone the selected department, of whom 63 patients suffered from chronic obstructive pulmonary disease. Noninvasive pulmonary ventilation was used in 75 patients. Of the total number of non-invasive pulmonary ventilation applications, 30 were used in patients with chronic obstructive pulmonary disease. The success of non-invasive pulmonary ventilation in chronic patients reached 90 %. The main benefit is the fact that the number of patients with chronic obstructive pulmonary disease is increasing and that indeed chronic obstructive pulmonary disease is aggravated in the winter months. Another benefit is the finding that the success and true utility of non-invasive pulmonary ventilation in patients with chronic obstructive pulmonary disease is very good.
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Specifies of nursing care for patiens with non-invazive ventilation.
TICHÁ, Věra
The use of the non-invasive ventilation of the lungs is connected with the positive pressure ventilation. When the endotracheal tube was developed, this method was put aside. Recently, its use has gone up again. It is indicated for the patients with acute respiratory insufficiency, cardiogenic pulmonary oedema. The non-invasive ventilation of the lungs does not require any sedation. In addition, there is no risk of intubation of the airways. The contraindication includes acute ischemic myocardium, a non-cooperating patient and inability to ensure the face seal. The research used qualitative and quantitative data collection methods. The qualitative research was done in the form of interviews and content analyses of data. The research sample composed of six patients from the intensive care units in the hospital Nemocnice Tábor, a.s. The research sample of the quantitative data collection was made up of nurses from four hospitals in the Czech Republic, who work at the intensive care units and at the anaesthesiology and resuscitation unit. In total, 100 questionnaires were distributed and 84 properly filled in questionnaires were returned. The questionnaire included 40 closed questions. Objective 1 was to find out whether the nurses know and use the standard of the nursing care for the patient with non-invasive ventilation of the lungs. Objective 2 was to map actual conditions of the nursing care for the patients with non-invasive ventilation of the lungs. Objective 3 was to map which problems the patients with non-invasive ventilation of the lungs have. The objectives of the work were fulfilled. This work has got one research question. Which problems do the patients with non-invasive ventilation of the lungs have? The research found out that the patients most often have problems with rubbing and soreness to their face, dry mouth and throat and problems with sleeping. Hypothesis 1 (the nurses know standards of the nursing care for patients with non-invasive ventilation of the lungs) was disproved. The standard is not established in any hospitals. Hypothesis 2 (the nurses use the standards of the nursing care for the patients with non-invasive ventilation of the lungs) was disproved. The output is the development of the standard called "The nurse assistance of the patients with non-invasive ventilation of the lungs". Hypothesis 3 (the way of the nursing care for the patients with non-invasive ventilation of the lungs is different in the selected hospitals) was disproved. The nursing care in the selected hospitals is provided at the same level. The nursing care for these patients is a very demanding task for a nurse. An important element of successful treatment is a good psychological preparation of the patient and almost continuous presence of the nurse at the patient´s bedside. We hope that some of the results of this research will draw attention to the problems of the nursing care for the patients with non-invasive ventilation of the lungs and will help to solve them. The developed standard could also become a part of the nursing care procedures in medical facilities. .
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