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Management of difficult intubation in the prehospital emergency care
SKLENKOVÁ, Hana
The thesis deals with the management of difficult intubation in pre-hospital emergency care. In the context of a difficult intubation it tries to solve the issue of difficult airways management when dealing in such arduous situations. Within the interim legislation a paramedic is not qualified to perform the actual endotracheal intubation, by ordinance No. 55/2011 statue book which determines activities of medical staff and other professionals. Except in extreme emergency situations. (29) Despite of this, he is expected to know all the procedures and master these functions mainly in emergency situations when he must assist a doctor. The aim of this work was to set out the possibilities of solving difficult intubation in pre-hospital emergency care with a focus on competence of a paramedic. But during the research process I reached the view that, taking into consideration the interim legislation and the attitude of paramedics to this issue, it will be more suitable to map out the experience and knowledge of paramedics related to the management of a difficult intubation and airways management. In the theoretical part I tried to approach the issue of difficult intubation and with that, of course, airways management. The part of the procedure of solving difficult intubation, which it is not in the competence of paramedic, is also the use of alternative tools that every paramedic should manage. The research was carried using a qualitative method in the form of a structured interview. The interview was conducted with paramedics who were randomly selected in various regional centers of the Emergency Medical Services in South Region. The research group consisted of thirteen respondents of different gender, age and length of service. Respondents were asked 11 questions, which surveyed the attitudes of paramedics to the issue of difficult airways management. The questions concerned the experience of these states, their options and also verified general knowledge of whether paramedics are theoretically prepared to tackle difficult intubation and difficult airways management in pre-hospital emergency care. When processing data from the research I concluded that the approach to the issue of paramedics' difficult airways management is not as responsible as it should. Although paramedics met with difficulty in ensuring the airway, it was usually the doctors who solved these states. In the majority opinion, the paramedics agreed that for the time being using the laryngeal mask is sufficient or, if need be, they call the doctor. But if the doctor was not available, it is not certain whether they would be able to handle the situation themselves, because their theoretical knowledge is not always sufficient. As a positive outcome of my research was finding that most of the paramedics did not object to further practical and theoretical training in this direction and that there are some individuals who are privately educated in this area.The thesis can be beneficial for students in the paramedic field and also specialized healthcare professionals to bring together information on airway management. Part of the thesis is also a DVD-ROM complete with video attachments.
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