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The evacuation plan of the health care ward block in the mode of general evacuation {--} the analysis of the principle of the evacuation plan of the inhabitants and their application to a health care ward block.
SKÁCELOVÁ, Lada
Population evacuation plan is one of the plans of specific operations, which are covered within the region's emergency plan according to Decree No. 328/2001 Coll.Evacuation belongs among the basic methods of population protection, being a summary of principles and organisation measures to ensure moving the persons, animals and material assets from the area endangered by an extraordinary event to other area. In the case of an extraordinary event endangering larger territorial unit, not only the populated agglomerations and industrial facilities may be included in the area evacuation, but also the inpatient healthcare facilities, where the situation difficulty is amplified by the patients depending on care by medical personnel and provision of healthcare services. Presently, there is no clear legal standard imposing an obligation on organisations to elaborate a complete evacuation plan. This issue is covered only partially in the sphere of legislation concerning fire protection. Nevertheless within the region's emergency plan elaborated for solution of extraordinary events requiring declaration of the third level (in the case of endangering more than 100 and less than 1,000 persons) and special level of alarm (when more than 1,000, a part of a municipality or enterprise grounds are endangered), all organisations with more than 100 persons should have the evacuation plans prepared. In the case of inpatient healthcare facilities, elaboration of evacuation plans is absolutely inevitable. The theoretical part of the dissertation describes the general principles and methods of performing the population evacuation. Attention was paid also to professional coverage, evacuation authorities and organisations and their structure according to the scope of the taken measures. In the chapter called "Application of the evacuation plan to inpatient healthcare facilities", the general principles and procedures concerning evacuation were applied to the inpatient healthcare facilities. In the practical part of the dissertation, an analysis of preparedness of the inpatient healthcare facilities for possible area evacuation to all-nation extent was made and the hitherto experience of the personnel of the inpatient healthcare facilities with any type of evacuation and their preparedness for possible complete evacuation were examined. Such examinations were made by questionnaire surveys. The collected data have been processed by statistical methods. The evaluation of results is presented in the "Results" chapter. On the basis of the acquired knowledge, a proposal of evacuation plan was drafted for the inpatient healthcare facilities. At the end of the dissertation, the procedures are suggested that may help manage perfectly the potential complete evacuation. Expected utilisation of the dissertation results was directed to definition of the optimum procedures and measures leading to successful management of evacuation of an inpatient health care facility. The dissertation conclusions may be used not only as the document for creating evacuation plans for other health care facilities, but they may contribute to considerable extent to elaboration of uniform evacuation preparation methodology within the emergency preparedness of the healthcare services.
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Monitoring the personnel radiation load in percutaneous interventions
SKÁCELOVÁ, Lada
The discovery of ionising radiation at the turn of the nineteenth and twentieth centuries was a landmark for medicine: the methods based on the principle and effects of ionising radiation are used even in the present medicine to a considerable extent. As early as in the very beginnings, adverse affects of ionising radiation were observed, and from this early period the first references to the need of radiation protection date. The fields of medicine dealing with the application of ionising radiation, whether in the diagnosis or in the therapy of diseases, went through an extensive development in their over hundred-year history. It was in the technical sphere in particular where the most important progress was accomplished, thanks to the ever more advanced instrumentation put on the market, meeting the strict criteria of radiation protection. On the one hand, a large group of diagnostic and therapeutic procedures was replaced by new methods (based on ultrasound and magnetic resonance) that are not based on ionising radiation, and thus the patient or the attending personnel are not exposed to the harmful effects of the radiation. On the other hand, the interventional radiology has attained an unprecedented expansion. With the development of new interventional methods and procedures, the number and duration of interventions has been growing. The radiation load to which the intervening personnel are exposed has thus been rising despite the state-of-the-art instrumentation. The theoretical part of the dissertation describes the origin and types of the ionising radiation, its properties and interactions with the environment; a proportional part has been devoted to the biological effects of the radiation. The prime attention has been concentrated on radiation protection, its objectives, principles and methods of radiation protection. An overview of the current legislation and list of requirements on the radiation monitoring has been elaborated. In the chapter on personal dosimetry, the fundamental relations and quantities used in the radiation dosimetry have been described, as well as the types of personal dosimeters and protective equipment. In the practical part, the radiation load of the personnel attending percutaneous interventions in the department of interventional radiology of the Clinic of Radiology of the Teaching Hospital Olomouc was measured. Personal electronic radiation dosimeters Rados, type RAD 60S, were used. All the data obtained were processed using statistical methods, and, on the basis of the results thus obtained, the effectiveness of protection was determined, and the importance of the observation of the principles of radiation hygiene was evaluated. The presumed use of the results of this work in practice is in the optimisation of procedures and measures leading to the maximum possible reduction of the radiation load in percutaneous interventions, and to the education and guidance of personnel towards consequential compliance with all principles of the radiation hygiene.
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