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Perception of hospitalization of polytraumatised ICU patients and its evolution in time
Haramijová, Eva ; Mareš, Jiří (advisor) ; Gigalová, Veronika (referee)
Author: Eva Haramijová Institution: Charles University in Prague Faculty of Medicine in Hradec Králové Department of Social Medicine Department of Nursing Title: Perception of hospitalization of polytraumatised ICU patients and its evolution in time Supervisor: Prof. PhDr. Jiří Mareš, CSc. Number of pages: 132 Number of attachments: 6 Year of defense: 2016 Keywords: polytrauma, pacient's perceptions, aspects of hospitalization, ICU Bachelor's thesis is a summary of basic knowledge in the field of general traumatology and specifics of polytraumatized patient's care. It describes the system of patient's care based on ATLS principles, care management, complications and psychosocial aspects. Empiric part concentrates on description of qualitative research performed in two phases by the method of half structured interviews with five patients to describe perception changes in time. Mainly, the goal was to clarify negatively percepted phenomenons of ICU hospitalization: restrictions, sleep and rest, staff behaviour and psychological dealing with the situation. Additional questions referred to the worst experience, positives of hospitalization and potential live changes due to injury. The research was performed in intensive care unit of surgical clinic of university hospital in Hradec Kralove. The result...
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Pathophysiological aspects of critically ill patients and its influencing with hormonal and nutritional support.
Kafková, Anežka ; Hronek, Miloslav (advisor) ; Kovařík, Miroslav (referee)
The state of critically ill patients suffering from polytrauma or sepsis is characterised by pathophysiologic processes, which cause significant changes in an organism on both a local and a systematic level. A stressful situation elicits an acute inflammatory response. This response is primarily meant to be a defence mechanism; however, this mechanism might become harmful to a certain degree. Hormones, cytokines and growth factors are included among the main control mechanisms activated during inflammatory response. A metabolic response to a stressful situation is characterized by an increased turnover of proteins, lipids, and glucose. Clinical consequences may develop as a result of these metabolic responses and include inflammation, anorexia, immobility, increased vascular permeability (which results in edema), vasodilation, tachycardia, and increased cardiac output. There are some key factors which have a negative contribution on an inflammatory response. Those factors may include malnutrition, pre-existing inflammatory activity, severe infection, obesity, ageing, genotype, and finally gender-gene effects, which may also play a role. The development of significant hormonal changes can be typified for critically ill patients. Such changes are particularly connected to catecholamines, thyroid...
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Case study of physiotherapy treatment of a patient with polytrauma.
Hons, Ondřej ; Novotná, Irena (advisor) ; Křížková, Štěpánka (referee)
Title: Case study of physiotherapy treatment of a patient with polytrauma. Summary: The general part of the bachelor thesis deals with the topic of polytrauma. For a better understanding of this issue here will be briefly and chronologically described how to care for the affected patient with polytrauma. The possible damage to the tissue and its healing. I focused mainly on the bone tissue and its complication with emphasis on bone fractures. I deal in detail the anatomy of the bone tissue, its function, blood supply, and especially the very fractures, its healing and rebuilding. I also deal with the disturbances of bone healing and other possible complications associated with this issue. Finally i discuss general physiotherapy procedures and its usage in the diagnosis. In the practical part of the thesis there will be described case study of the patient treated for polytrauma. The case study contains kinesiological analysis, therapeutic units and evaluation of their effect. Keywords: polytrauma, bone tissue, bone fracture, bone healing, physiotherapeutic methods, therapy
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The issue of treating patient with polytrauma
DVOŘÁKOVÁ, Barbora
Polytrauma is an injury of one or more organic systems or body areas the mutual combination and extent of which may lead to direct death threat. Polytrauma stands on the first step of the mortality ladder particularly among those of 1 45 years of age. Not only timely emergency care, but also professional quality of the care play important role here. Treatment of a patient with polytrauma requires quality performance of physically and psychically demanding work The aim of the thesis was 1: To find out whether nurses at an ARD, an ICU and a standard department have knowledge of nursing care of a patient with polytrauma. 2: To find out the specifics of nursing care of a patient with polytrauma at an ARD, an ICU and a standard department. 3: To find out the differences in nursing care of a patient with polytrauma at an ARD, an ICU and a standard department. Research questions: 1. Where do ARD nurses see the biggest problems of nursing care of a patient with polytrauma? 2. Where do ICU nurses see the biggest problems of nursing care of a patient with polytrauma? 3. Where do nurses from a standard department see the biggest problems of nursing care of a patient with polytrauma? 4. How do ARD nurses care of a patient with polytrauma? 5: How do ICU nurses care of a patient with polytrauma? 6: How do nurses from a standard department care of a patient with polytrauma? 7: What opportunities for education in nursing care of a patient with polytrauma do ARD nurses have? 8: What opportunities for education in nursing care of a patient with polytrauma do ICU nurses have? 9: What opportunities for education in nursing care of a patient with polytrauma do nurses from a standard department have? Qualitative research was applied to preparation of the thesis. Non-structured interview and involved observation were the data collection methods. The research was performed at an anaesthesia and resuscitation department, at an intensive care unit and at a standard traumatology department. The research was anonymous. The research has shown that ARD and ICU nurses as well as those at the standard department are aware of treatment of patients with polytrauma. We observed that they cared about patients' needs and all activities they perform comply with nursing care standards. They are aware of complications that might occur in a polytraumatized patient. We have also found that mainly the difference in communication with a patient belongs to the specifics of the above mentioned departments. The results also show that the care provided at the ARD and the ICU is acute, while the standard department mostly provides subsequent care. We found that the biggest difference in treatment of patients with polytrauma at the above departments is in communication with a patient. Communication is at the minimum at ARD, where work with monitors prevails. Nurses of the ICU and the standard department cope with different problems. These are lack of space and electronic equipment at the ICU. The care of a patient with polytrauma who is not self-sufficient and requires permanent care and attention of a nurse is physically and psychically demanding at a standard department. It is not sufficient according to the nurses. The problem is in their opinion in high number of patients, lack of beds, extensive attention to some patients and last but not least the growing administration conducted by nurses. This brings the problems in nurse-patient communication at a standard department. The nurses are aware of the fact that effective communication has positive impact on patient recovery as it moderates pain and confusion and helps against anxiety and stress, helps relieve pain, reduce complications and accelerate convalescence. It would be interesting to prepare a seminar for the ARD, ICU and standard department healthcare staff to improve nursing care of a patient with polytrauma in relation to that.
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Traffic accidents on department of forensic medicine – cases from practice
Ďatko, Miroslav ; Zelený, Michal ; Sedlák, Jaroslav
The authors present two cases from the recent practice. In the first case report the authors describe a conflict of an aggressive driver, which occurred after stopping vehicles, one of the drivers was injured and his vehicle was damaged. The second case study concerns the unusual fatal traffic accident, during which a cyclist collide with delivery van. The cyclist was killed at the end of traffic accident due to the fact that the delivery van flipped on the side and fell on the body of the cyclist.
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Physiotherapy methods for fractures of the femur after moto-accidents
VOHRALÍKOVÁ, Kristýna
This thesis is entitled Physiotherapy in fractures of the femur after moto-accidents and examines the feasibility of using different physiotherapeutic techniques for this type of diagnosis. The work consists of theoretical and practical part. The theoretical part is a summary of knowledge about the anatomy of the femur, kinesiology of the hip and knee joints and there are outlined physiotherapeutic methods that can be used to influence femur fractures incurred after moto-accidents in the patient's immobile phase and later in the period after the immobilization. In the practical part, which was drawn up in the form of qualitative research, is then prepared a case report of a patient with the given diagnosis, input and output kinesiology analysis, itemized individual therapeutic unit and at the end of practical part described the evaluation of the effect of therapy. The aim of this work is to monitor the physiotherapeutic methods and techniques used in the treatment of patients with fracture of the femur and also to explain the problems of these injuries and their subsequent complications in treatment. The methods used have produced positive results such as significant improvement of the patient's health, particularly his joint movement in all directions, muscle strength, posture and walking stereotype. The work may be useful in practice for healthcare workers in the trauma department at the hospital or outpatient clinics, where they carry out subsequent rehabilitation of these patients. Furthermore, due to the seasonal type of injury can take advantage of the work and health professions students who meet with these patients passing the summer practice.
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Activity of the radiographer at the emergency department.
PIŠTĚKOVÁ, Martina
A patient with urgent condition which threatens his life or health requires special approach of a radiology assistant to executed diagnostic performances. In this bachelor thesis, I describe procedures in case of these conditions. Because the given topic is quite extensive, I preferred a detailed description of the most serious conditions. I chose the topic because of its timeliness. The number of patients with urgent condition has an upward character for sure because of accelerated life pace and related traumas as well as diseases of civilization. My work describes three researches. The first one finds out the share of different investigations in the radiodiagnostic department as regards patients with urgent condition per one year in one hospital. The second one is related to the refresher courses of radiology assistants in relation to patients with urgent condition. The third one investigates algorithms of investigations in the radiodiagnostic department in different medical facilities. The bachelor thesis is divided into a theoretical and practical part. The theoretical part explains the term "urgent condition" and basic description of the approach to a patient in the given situation. I mention brief principles of cardiopulmonary resuscitation. I analyse individual modalities used in the radiodiagnostic department. Other subchapters are focused on the description of concrete conditions and sequence of investigations. The practical part begins with the chapter called "Targets, Hypothesis". It is concentrated on the description of the main role of my work which is discovery of radiology assistants´ approach to patients with urgent condition and the situation in education of radiology assistants in the Czech Republic. Some parts compare the condition with the situation in other countries of the European Union. The chapter called "Discussion" is devoted to the general evaluation of researches. It mentions also the important role of radiology assistants when treating patients with urgent condition. The "Conclusion" evaluates meeting of targets of this thesis and outlines possible solutions.
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Injuries caused by an animal in the pre-hospital emergency care and subsequent outpatient care
VOTRUBOVÁ, Kateřina
The topic of this bachelor thesis is the various types of injuries from animals in prehosptial emergency care and their subsequent treatment in outpatient clinics. The theoretical section includes the summary of possible predicaments, which various animals cause. It discusses anaphylactic reaction to insect stings and furthermore the poisoning by snake venom, which in the Czech Republic primarily concerns the common viper (otherwise known as the common adder). The next chapter deals with the illnesses caused by cats, specifically cat scratch disease (lymphadenopathy) and toxoplasmosis with acute childbirth. The acute condition caused by dog bites and rabies belong to the next section of the thesis. In the conclusion a brief summary of injuries is mentioned, which are a threat during the handling of domestic animals, where the thesis focuses on the polytraumatized patient, fractures and cranio-cerebral injuries. The practical section was carried out on two qualitative levels in the Central Bohemian Region in connection with the Region of the Capital City, Prague and the Southern Bohemian Region. The first of these was the verification of knowledge of paramedics about injuries caused by animals through a knowledge test, comprising of ten questions. These questionnaires were always filled in my presence. In total 40 knowledge tests were distributed, of which 38 were returned completed. The return rate was thus 95%. The second section determined the differences in outpatient care in the individual regions. It was carried out through managed interviews with outpatient medical doctors from the surgical and internal medicine departments, a traumatologist, general practitioner and paediatrician. In total, eight medical doctors were approached. Furthermore an identical questionnaire was given to all these medical doctors. The research was carried out from November 2013 to April 2014. The aim of this thesis is to ascertain the knowledge about these injuries of paramedics in the Central Bohemian Region in connection with Region of the Capital City, Prague and the Southern Bohemian Region and compare them. Furthermore, it intends to find the difference in outpatient care of patients in the same territorial units injured in this way. Three research questions were asked, specifically to the mid-level health services personnel, whether paramedics have the correct knowledge about this issue and whether their knowledge varied in the regions. Regarding the second aim, the question asked was whether outpatient care of injured patients varied in the relevant regions.
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The role of radio-diagnostic department in investigation of polytraumas
MRÁČKOVÁ, Petra
Theme of this bachelor theses is the role of radio-diagnostic department in investigation of polytraumas. The theoretical part of the thesis deals with the characteristics of multiple traumas and trauma care that is provided in a specialized departments for the facility of multiple trauma, in traumacentres. Obligatory conditions that the traumacenters must meet to be granted the status of traumacanter are in this thesis mentioned. Another part of the theoretical part is focused to diagnostic imaging methods, specifically mentioned examination by X-ray, computer tomography, magnetic resonance, ultrasound and angiography examination. The aim of the thesis is to analyze the number of patients with polytrauma and see what radiodiagnostic examinations for these patients was performed in the hospital České Budějovice, a.s. The hypotheses of this bachelor thesis are formulated as follows: Number of patients with polytrauma is growing. Most were done CT examinations during investigation of polytrauma. The practical part provides information of the number of polytrauma, the division of patients by gender, age rating in three designated groups and radiodiagnostic tests that these patients was performed in a hospital České Budějovice, a.s. in 2011-2013. Data collection was performed at the radiology department at the hospital in České Budějovice from the electronic patient database. In the chapter "Results" was acquired data processed in graphs. These graphs are described in the next section "Discussion". They were completed by my own beliefs, thoughts and opinions. The results mentioned in the practical part of the thesis show that the objective has been achieved. From the polytrauma database implies that the first set hypothesis the number of patients with polytrauma is growing, wasn´t confirmed because in 2013 it was registered less patients with polytrauma than in 2011 and 2012. On the other hand, the investigation revealed that the second set hypothesis, assuming that in multiple injuries examination was used computer tomography mostly was confirmed. Computed tomography was used during examination of all patients with polytrauma registered in Hospital České Budějovice, a.s. in the mentioned period. In the chapter "Conclusion" the results are summarized. The purpose of this thesis was to prepare clear text dealing with the use of radiodiagnostic imaging methods in the examination of patients with polytrauma. Results of this work can serve as a statistical material of radiodiagnostic examination of multiple traumas to the radiology department at the hospital in České Budějovice. The theoretical part of the thesis can be used as teaching or informational materials for professionals.
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