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Management of pre-hospital care in patients with refractory ventricular fibrillation.
 ZEMAN, Denis
Ventricular fibrillation is a life-threatening arrhythmia that manifests as rapid and irregular contraction of the heart chambers. If not treated immediately, it can lead to circulatory arrest and death of the patient. Treatment of ventricular fibrillation consists of immediate cardiopulmonary resuscitation and defibrillation, which restores normal heart rhythm with an electrical shock. However, some patients may be refractory, that is, resistant to repeated defibrillation bursts. The first aim of my bachelor's thesis was to find out what awareness paramedics have of the options for managing refractory ventricular fibrillation. The second aim was to find out what methods paramedics use for refractory ventricular fibrillation in practice. The research investigation was carried out by means of semi-structured interviews with paramedics working at the South Bohemia Region ambulance service. The results show that paramedics are sufficiently familiar with the treatment options for refractory ventricular fibrillation. A negative finding was that not every rescuer was able to mention all the options for changing electrode positions and the correct pharmacological management. Another negative finding was that rescuers could not agree on the number of times that ventricular fibrillation is refractory. On the contrary, the investigated method of double sequential external defibrillation was found to be very successful and thus more beneficial than conventional methods in the treatment of refractory ventricular fibrillation. The results of the bachelor thesis may offer a way for paramedics to approach refractory ventricular fibrillation. This bachelor thesis may improve the management of refractory ventricular fibrillation, which should be approached differently than classical ventricular fibrillation.
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