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Specific tasks of Emergency Medical Dispatch centre when dealing with mass casualty.
VODEHNALOVÁ, Ivana
The goal of this thesis was to analyze processes of the Emergency Medical Dispatch Center of the Emergency Medical Service of the Pilsen Region (ZOS ZZS Pk) when dealing with a mass casualty incident. The theoretical part of the thesis provides basic information relevant to the Pilsen Region, the Emergency Medical Service of the Pilsen Region, basic information on operations and general work processes of an emergency medical dispatch center during a normal work regime, and specific activities performed when dealing with a mass casualty incident. The research part of this thesis analyses activities and processes of an emergency medical dispatch center as described in the Mutual Mission Types Manual for Integrated Rescue System forces while at a mutual incident - Activities of Integrated Rescue System Forces at a Mass Casualty Incident (STČ 09/IZS). Further on the thesis evaluates activities of the ZOS ZZS Pk taken while dealing with two mass casualty incidents. These were a bus accident nearby Rokycany town in 2013 and a two trains collision nearby Horažďovice town in 2015. In order to make the analysis of readiness of the ZOS ZZS Pk to deal with mass casualty incidents more complex, SWOT analysis was added to the results. Based on the results of the STČ 09/IZS-manual analysis and of the SWOT analysis, suggestions for new manuals were made, that should make all the actions taken by employees of the ZOS ZZS Pk while dealing with a mass casualty incident more efficient and more effective. The goal of this thesis: to analyze activities of the ZOS ZZS Pk while dealing with a mass casualty incident, and to create suggestions of which inadequacies to remove and how to make operations of the ZOS ZZS Pk more efficient and more effective when dealing with mass casualty incidents; has therefore been fulfilled. The main outcome of the thesis are the final recommendations for making operations of the ZOS ZZS Pk more efficient and more effective when dealing with a mass casualty incident.
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Dispatch life support
VÁŇOVÁ, Petra
Dispatcher of medical operation center casts an important and significant role in the chain of survival for emergency resuscitation. Within a short time must quickly and accurately provide information from the caller, delegate a professional help to the place of an incident. Timely launch telephone-assisted resuscitation, which this thesis is about. The first goal was set to chart providing phone-assisted cardiopulmonary resuscitation dispatchers at the regional operational center of emergency medical services. Analyze the process by which the dispatchers manage and provide instructions for conducting cardiopulmonary resuscitation, whether these guidelines actually manage and provide proper instruction to all rescuers. The second goal was to explore the motivational factors MUDr. Ondřej Fraňěk, the author of a publication "The manual of medical dispatcher in operations center " who was deeply engaged in telephone-assisted resuscitation. This goal should be focused on the analysis of the story of the author and the origin of interest to the issue. The research was conducted by qualitative method of data processing. To the research part of the thesis I used to analyze six audio recordings of emergency calls from the archives of the Regional medical operation center of South Bohemia, where dispatchers recognized by the affected persons malfunction of vital signs and started the phone-assisted resuscitation. The recordings were transcribed into electronic form and analyzed. I also realized interviews with MUDr. Franěk, with MUDr. Kratochvil, head doctor of Air Rescue Service of South Bohemia and Mrs. Hornychová, deputy head of the paramedical staff of the Regional Medical Operations Centre South Region. The results of the analysis showed that most of the dispatchers is not progressing adequately in providing telephone-assisted emergency resuscitation. The second objective was not achieved because it has not been possible to obtain the data needed to evaluate the objectives. Dispatchers, after reading my thesis, you can think over this issue. Work can be an incentive for self-improvement and improvement of the results. Prospective students of paramedical staff in health service can help as a source of information.
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A communication of a rescue worker with the selected groups of patients
VÍTKOVÁ, Michaela
The key topic of this bachelor thesis is an option to call via a distress call, which would be suitable preferably for speech-disabled or deaf people. During my training at the operation center of the South Bohemian Emergency Medical Service, I have observed on more than one occasion that callers are under a lot of stress, even though most of them possess the ability to hear and speak. However, deaf, hard of hearing or speech impaired callers might seem to be in a lot more difficult position. In the theoretical part, the definition of the call center as a whole is carried out, including its tasks and functions. A division of distress calls is included, kinds of dispatch groups and an indication of dispatches. The complex capture of issue of speech-disabled people follows definition of basic terms, division and means of their communication. The similar structure can be found in the next chapter, dealing with deaf or hard of hearing people. In the thesis, there are mentioned rules of communication with both groups of disabilities. This is one of the basic pillars of succesful communication with them. Practical part is formed with a qualitative research of half-structured dialogues. 7 randomly chosen operators of Pilsen district and 7 of Budweis district participated in the research. The aim is to monitor possible procedures of communication with the people with speech or hearing disability and an overview of possible solutions to these complicated distress calls. The research shows, that a phone call is not the only way how to reach a distress line. It has also been proven that although both operational centers are ready for a possibility of accepting other forms of distress calls than classic phonecalls, both speech disabled and hearing disabled people hardly ever use them. The results of all calls are only tentative and they are dependant on the experience gained by a particular operator. The purpose of this work is to use it as an option for further study material for the work of a distress call center operator, which is included in the curriculum plan of paramedics.
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Dispatcher-assisted cardiopulmonary resuscitation
Pajkrtová, Veronika ; Hladká, Petra (advisor) ; Klokočková, Šárka (referee)
The main task of providing dispatcher-assisted first aid is to guide bystanders to giving the first aid to the victiim directly in the situation where the incident happened according to the possibilities and conditions. It's one of the basic roles of medical dispatch centre and each dispatcher working on dispatch centre has to manage this role. These basic instructions should be provide in many different situations. One of this situation is pre-hospital cardiac arrest. When the dispatcher detects cardiac arrest during the emergency call, he/she should start providing dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) immediately. It means telephone assistance and guidance of bystander to perform cardiopulmonary resuscitation on the place of incident. The main aim of the research is to find out, whether the dispatchers are able to detect cardiac arrest in time and respond to it appropriately. It means iniciate the bystander to begin cardiopulmonary resuscitation, motivate him/her, instruct him/her correctly and easily, calm the situation and guide the bystander till the ambulance arrives. There are aslo set three sectional goals. Their task is to apprise with the work of the medical dispatch centre, with the dispatcher's job description and with dispatcher-assisted cardiopulmonary...
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Protecting the Health Operations Centre of Emergency Medical Services Pilsen Region as a Critical Infrastructure Element
HRDLIČKA, Pavel
The aim of the bachelor thesis is to assess the conservation status of the critical infrastructure element, in this case medical operations centre of the Emergency Medical Service of the Pilsner region. Firstly, the work deals with situations of the imminent danger of the building on the basis of emergency or crisis situations, which are based on the risk analysis. This risk analysis is a part of the Emergency Plan of the Pilsen Region, which has been prepared by the Fire Brigade of the Pilsner region. On the basis of local investigations there are evaluated some current measures in the context of already existing documents, namely the processed crises preparedness plan. These most probable "classic risks" are then further elaborated including evacuation as a typical measure for some of them. In the next section this Bachelor thesis has focused on the "new threats", mainly on a violation of a cyber security, with an assessment of the current state of backup systems and their own security, storage and the backup of the electronic data. Analyzing the current hardware and software of the operating medical centres and related infrastructure network, there are identified configurations of some individual elements, their relationships and especially their security. Some remedial measures are suggested in case of the unsatisfactory situation. The benefit of this work is the inclusion of results of the investigation related to cyber security in the current crisis preparedness plan, which has not included this issue yet. The results and conclusions of this bachelor thesis are therefore used to improve crisis preparedness of Emergency Medical Services of Pilsen region in terms of the protection of the critical infrastructure element.
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One instead of six: does the centralization of Emergency Medical Dispatch affect the quality of care?
Bradna, Jan ; Vrzáček, Petr (advisor) ; Franěk, Ondřej (referee)
This thesis engages in its theoretical part description of the process of pursuance and assurance of quality in emergency medical dispatch centre. There is also a comprehensive description of key quality parameters used in this environment in this part. The content of the empiric section is an organizational case study, which aim was to evaluate an extensive organizational change in emergency medical dispatch centre of the Emergency Medical Service of the Central Bohemian region and its impacts on the quality of care. The first phase of centralization of emergency medical dispatch centres in the Central Bohemian region went through during the first half of 2011. Four local emergency medical dispatch centres were gradually brought together into one entity. The aim of the research was to evaluate impacts of the organizational change on key quality parameters. The observational retrospective study consists of two groups of data, collected from identical area during two equivalent periods. Group A contains data from the period of six months before and group B contains data from the period of six months after the centralization. Key quality indicators were compared in both groups: response time; call processing times; safety of classification and indication of calls; use of dispatch life support and...
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The role of the medical operations center, a provider of emergency medical services
JIRKŮ, Tomáš
Bachelor's thesis deals with the medical operating center and its activities. A lot of people have no idea what a medical operating centre actually is. My knowledge about it was also scarce before the beginning of my studies. Therefore I would like to outline the problems, tasks and also the demanding character of the work of operators. That is why this thesis is aimed at examining the tasks of the medical operating centre. Everybody probably knows the term medical rescue service and imagines immediately a yellow vehicle with reflective strips and blue lights. Hardly anybody realizes, however, that the medical rescue service needs the medical operating centre to be functional. It may be also called a control centre. This centre is an inseparable part of the medical service and also of the integrated rescue system. Specialized medical workers, called operators or controllers, are employed here. These workers, among others, receive continuously emergency calls, evaluate them and pass them on to exit groups, and, last but not least, assist the caller with giving first aid. All these problems are the subject of the theoretical part of the thesis. Two research issues were determined for the purpose of the research part of the thesis. The first one deals with all tasks ordered by legislation being used by the operating centre and the second research issue is aimed at the problems of urgent basic life support assisted by phone, namely if this basic life support assisted by phone is utilized always when unconsciousness is indicated. These issues were dealt with by means of the qualitative research method consisting in the secondary data analysis. The research set constituted the regional operating centre of the South Moravian Region. Specifically, documentation of emergency medical services was used operator record and audio record of emergency call. This documentation is a part of each emergency call. By means of the secondary analysis the data from 20 emergency calls were obtained. Emergency calls were chosen by simple random choice. The sample of these 20 emergency calls was chosen from the period of the year 2014. Because of protection of personal data no names are given in the thesis, only the initials. For the same reason no actual addresses are used in the research. In the discussion there are given all tasks ordered by legislation and recommended procedures from professional sources. This information is subsequently compared with the obtained data. The results in the case of the first research issue indicated that some tasks ordered by legislation are not used too often. Some tasks within the framework of the small sample being examined are not used at all and, on the contrary, they are used in the receiving of each emergency call. The tasks that were not used at all were three altogether. The results in the case of the second research issue demonstrated that indication of unconsciousness is not always necessarily the reason for using urgent basic life support assisted by phone. It is important that also other aspects are taken into account, not only consciousness of the patient. Of ten emergency calls concerning unconsciousness being examined this urgent basic life support assisted by phone was used in five of them. It was found out that utilization of the medical operations center tasks is individual in each emergency call. From the point of view of the total activity of the centre it could be declared, however, that the centre uses most of the tasks ordered by legislation. This bachelor's thesis can be used as a material extending the knowledge of both non-professional public and medical personnel concerning the activities of medical operating centre. It can be a stepping stone for further research concerning medical operations center.
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Cooperation of the Trauma Centre of the Hospital České Budějovice and Medical Operation Center of the Emergency Medical Service of the South Bohemian Region in the Event of Mass-Casualty Incident
URBANOVÁ, Alena
In 2011 and 2012, dramatic changes were made to the health care reform in the Czech Republic. As a consequence, almost the complete legislation related to traumatological planning was changed. This reform primarily introduced two new types of operating divisions; a department of emergency preparedness, as for the emergency medical service providers, and a contact point, from the aspect of emergency inpatient care providers. Emergency preparedness primarily processes a concept of the traumatological plan for the emergency medical service and introduces potential changes. The contact point, as a department of the emergency inpatient care with continuous operation, receives calls from the emergency medical service, especially in the event of emergencies and crisis situations. The given Master's Diploma Thesis entitled "Cooperation of the Trauma Centre of the Hospital České Budějovice and Medical Operation Center of the Emergency Medical Service of the South Bohemian Region in the Event of Mass-Casualty Incident" develops a key issue of the interconnection of traumatological plans established by health service providers within the South Bohemian Region and the level of their cooperation. Then the work analyses three mass-casualty incidents which happened in the past within the area and the level of involvement and cooperation of the aforementioned departments, i.e. the Hospital's trauma centre and Medical Operation Centre upon the Medical Emergency Centre of the Region of South Bohemia. The Diploma Thesis proceeds from the qualitative research which is divided into two parts. The first one defines the V1 research question specifying the role of the Traumatological Plan of the South Bohemian health care during the cooperation with the trauma centre under the Hospital České Budějovice and medical operation centre of the Medical Emergency Service of the South Bohemian Region in the event of a mass-casualty incident. By using a comparative method, which assessed the three traumatological plans, the level of cooperation did not exceed more than 20 % owing to the fact that the Traumatological Plan of the South Bohemian health care is out-dated. As a consequence, the answer to the V1 research question was following: The role of the Traumatological Plan of the South Bohemian health care with the cooperation of the trauma centre under the Hospital České Budějovice and Medical operation centre of the Medical Emergency Service of the South Bohemian Region in the event of a mass-casualty incident is insignificant. The second part develops the V2 research question: whether the failure in communication between the aforementioned trauma centre and medical operation centre could have any impact on the injured in the event of a mass-casualty incident. The qualitative research with the use of a method of analysis implemented during the previous mass-casualty incidents and interviews with four operators working for the medical operation centre and four doctors working at the accident, emergency and plastic surgery department provided the second answer to the V2 research question: Failure in communication between the two aforementioned departments could have a significant impact on the injured in the event of a mass-casualty incident. In the end, the thesis refers to the dramatic difference between the ideal traumatological planning and the current situation pointing out the Traumatological Plan of the South Bohemian healthcare which has not been updated for three and a half years since the reform. The given work also describes the issue of the ideal solution to the establishment of contact points in hospitals and compares it with the current situation at the Hospital České Budějovice where the contact point was established only in order to comply with the legislation, i.e. the contact point is based in the operating centre of medical transport.
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Problems of Indications Rides Emergency Medical Services
DVOŘÁK, Jiří
The bachelor thesis deals with the issues addressed at the dispatching center of the emergency medical service. The indication of actions by emergency medical service has been a topical issue in the debate on provision of pre-hospitalization emergency care. In 2012 the dispatching center for the South Bohemian region was centralized in České Budějovice. The center managing the operations has acquired a more comprehensive overview of positions and activities of all emergency medical crews. This has also changed the approach to crew deployment coordination. The dispatcher now coordinates crews in action in the entire region, being the only person responsible for the correct procedure. The most important aid used by the dispatcher is a list of indications which describes various situations and procedures to deal with them. However, the list includes only situations when the action by the emergency medical service is required. The list of indications is issued by the provider of the emergency medical service based on the Act No 374/2011 Coll., on emergency medical services, and the Decree 240/2012 Coll., implementing the act. The research was conducted at the emergency medical dispatching center in České Budějovice. A qualitative method of research was selected as the most appropriate. The respondents were employees of the emergency medical dispatching center who are in charge of coordination. A part of the respondents performed both the function of emergency calls receiving and the function of operative management of crews. Semi-structured interviews with 15 questions were conducted with the respondents. The questions focused both on receiving of emergency calls and operative management of crews and they concerned primarily the urgency levels N3 and N4. A substantial part of the interview concerned the list of indications and confrontation of formalized and intuitive procedures in decision.-making by the operators. During the interviews the respondents were asked additional questions to ensure maximum accuracy of the answers. Tables or diagrams were used for several questions to obtain some quantitative results in order to determine prevailing opinions or facts among the operators. It should be noted that the data are approximate and have low validity due to the low number of the respondents. The surveyed group consisted nine of operators of both genders, different ages and different lengths of experience in the health sector. The research has shown that the operators use alternative options in ca. 10% of cases. They are very well familiar with the issues of indication of actions by the emergency medical service. Differences in decision-making result from a greater or smaller willingness to be exposed to risks of forensic consequences. The issue of indication of actions by the emergency medical service keeps developing. The general efforts head towards maximum formalization of the procedures to relieve the operators from their legal liability. The thesis maps procedures used in the emergency medical dispatching center and it may be used as a study material for medical workers who need more information about the issue.
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Air Rescue Service and its coordination with the ground based rescue personnel
NOVOTNÁ, Pavla
The Air Rescue Service is now an integral part of the Emergency Medical Service in the Czech Republic. At present the number of primary interventions in which the two components have to cooperate has been increasing. As most cases are serious, life-threatening events, it is crucial for the two components to create a collaborative unit. Therefore it is necessary to ensure an excellent level of communication and cooperation between them. This can be achieved only if both partners know, employ and respect certain rules of the partner´s cooperation. In the theoretical part the thesis deals with history and activities of the Air Rescue Service and its cooperation with the ground based component. The objective of my thesis was to survey and evaluate the level of communication and cooperation between the Air Rescue Service crews, the ground based components of the Emergency Medical Service and the Emergency Command Centre. Quantitative research was conducted through the use of questionnaires. The questionnaires were distributed to selected Emergency Medical Service and Air Rescue Service centers in the South Bohemian region and the Vysočina region. The questionnaires were addressed only to paramedics. The outcomes of the research prove that paramedics consider the communication level and the level of cooperation between the ground based components, the Air Rescue Service and the Emergency Command Centre to be adequate. It was also found that if an error occurs in communication, in the majority of cases human failure is responsible. I hope the findings of my thesis can help paramedics get an overview of this topic, or supplement their knowledge of this issue
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