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Preparedness of medical rescue service in South Bohemian coutry for solving emergency situacions
MAJSTR, Jiří
The frequency of emergency incidents and the expanding spectrum of all possible mass casualties require preventive and safety precautions and fast professional respond to their occurrence. Emergency prevailing medical complication requests from Medical Rescue Service providers a different attendance to intervention than is usually requested in their daily routine activities. Daily routines of Medical Rescue Service providers include medical treatments of one or two patients using urgent care medicine methods, which present a full medical treatment to a particular patient from the first contact to their handing over to other medical services providers. In emergencies with mass casualties? incidence, it is impossible to attend one particular patient at a time, but it is necessary to adjust priorities in medical attendance to patients in dispatch and as well to transfer all patients to other medical service provider facilities. Shall there be an emergency with mass casualties, there are few concomitant circumstances in their solving, and these are: lack of time for decision making and rescue works co-ordination, panic, delay in treatment and transport of patients to other medical facilities. Especially at the rescue work start of all integrated rescue system units, forces and equipments are insufficient, as for example lack of professional medical staff, rescuer and medical equipment including medicaments. The ration of rescue forces and medical equipment to a number of patients optimizes in following process, when a successful outcome is conditioned by the rescue work in the first thirty to sixty minutes. It is, thus, very important to paying attention to the organization and control of rescue works of all integrated rescue units right from the start. An intergrated rescue system is mentioned in theoretical part of the thesis. On the strenght of valid legislation, the provider of Medical Rescue Service is generally described, particularly focused on preparedness and solving of emergency incidents by the Medical Rescue Service of South Bohemia. Furthermore, the organisation trauma plan,the START asset classification of casualties with the follow-up method using identification and sorting cards (medical classification) are described. The theoretical part of thesis is closed up by an outlined exterior emergency plan of the nuclear power plant Temelin with focus on its trauma plan related to the Medical Rescue Service of South Bohemia activities solving emergency situation in the connection with an outflow of radioactive substance. The thesis was written on the ground of a qualitative research using the method of a semi-led interview of seven superintendant medical doctors of Medical Rescue Service from different areas in South Bohemia. The content of the research was an evaluation of possible development and potentional changes in preparing and also consequential activities of medical units at emergency situations with mass casulties. Research questionaire was focused on competence and funcion of medical dispatching centre, establishing work process of first paramedics attending at the place of an emergency situation, also co-operation of medical units with other units of an integrated rescue system and as well the tie-in system to other medical facilities. The aim of the research was establishing hypotheses in terms of Medical Rescue Service of South Bohemia preparadness to solution of emergency situations. Created hypotheses attached to a chapter ¨Discussion¨ may be verified, in the future, by a quantitative research. Other thesis aims are included in attachment part. It represents an interpretation of tactical and testing practise of Medical Rescue Service of South Bohemia from 2006 to 2012 and topics focused on emergency incidents and mapping incidence and solution of emergency incidents with mass casualties in South Bohemia region from 2003 to 2012.
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Suffering, dying and death in prehospital care
MAJSTR, Jiří
This thesis is topically focused on suffering, dying and death of a patient (patients) in fore hospital urgent care. It deals with above mentioned phenomena from the paramedic point of view. It refers to the impact of these events on paramedics, their perception of patients at sudden worsening of chronic disease, acute worsening of health state, immediate life threatening or death. The aim of the thesis is to map and interpret the attitude of addressed paramedics to given facts, which they normally encounter in their practice, and the evaluation of reflexive projection of above mentioned experiences into ethical attitude to the patients. The thesis is based on qualitative research. It uses the methods of controlled interview with ten chosen paramedics who have different period of professional practice. The dialogues are transcribed in the chapter called Results of Research. In the thesis the answers to particular questions are compared and the results of the research are the hypotheses which can be evaluated by means of quantitative research in the future.
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