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Indications and Contraindications of Cardiopulmonary Resuscitation in Context of Establishing Death by a Paramedic
URBANOVÁ, Alena
Recently, the Czech Republic has seen more and more developing trends of increasing the number of paramedic assistance units, particularly in towns with a short time interval of getting to hospital, but often in peripheral areas as well. A problem occurs when the emergency condition of a patient must be treated right at the place and the paramedic assistance crew does not have the same authority as the medical emergency crew. Paramedic assistance units in the Region of South Bohemia can be named as an example. The paramedic does not have to start with cardiopulmonary resuscitation if certain signs of death are present and the injuries are incompatible with life. On the other hand, a doctor can pronounce death and not start cardiopulmonary resuscitation. This thesis titled ?Indications and Contraindications of Cardiopulmonary Resuscitation in the Context of Establishing Death by a Paramedic? aims to chart the procedures of paramedics in connection with starting or not starting cardiopulmonary resuscitation directly at the place when death is suspected. The qualitative research concentrates on paramedics of the South Bohemian Medical Emergency Service. The theoretical part introduces medical emergency services, a paramedic, cardiopulmonary resuscitation, death and the ethical issue of death as well as dying, with a large focus on medical law. The thesis established that some paramedics act in a completely opposite way than their competences allow them to do. Furthermore, a complete lack of knowledge regarding the medical law and legislation specifying the competences of paramedics occurred. Therefore I had to establish a hypothesis that paramedics do not always follow their competences in connection with starting or not starting cardiopulmonary resuscitation directly at the place. The thesis indicates that paramedics should be more educated in the area of medical law and well trained in respect of 2011 medical acts. At the same time I believe that paramedics should not only follow their intuition in emergency situations when a doctor is not present.
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Competence Paramedic in the Czech Republic
ČERNÝ, Jaroslav
Paramedics´ competencies in the Czech Republic is the name of the subject of this bachelor thesis. The thesis is targeted on mapping the knowledge of the competencies of paramedics and their satisfaction with the extent of activities performed under their competence. The theoretical part of this thesis systematically clarifies the relevant issue. I describe the Integrated Rescue System and the organization thereof on the grounds of the primary representation on which the health rescue service is based. As concerns such rescue service, the thesis is focused on the legislative development, specification and financing thereof. I also specify details of the individual types of rescue teams and describe paramedics with an emphasis on legal norms. The thesis also deals with obtaining and utilizing expertise and with specialist education. Paramedics´ competencies are broken down by several groups described in great detail. In the practical part, I used the method of quantitative research. The data collection method is an anonymous questionnaire. The research team consisted of paramedics working for the Health Rescue Service of the South Bohemian Region. The questionnaires were distributed to seven various rescue stations. The answered queries confirmed both hypotheses. The results show that paramedics know their professional competencies and, when performing their jobs, are satisfied with the extent of the activities performed under their competence. The thesis shows that paramedics´ competencies are not sufficiently well described in legal norms. As a result of such insufficiency, the situation of paramedics is uselessly complicated. In the thesis, I deal with the negative reverse issues and propose a document determined for paramedics to achieve a better legal position.
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Effect of acute stress on paramedic and subsequent crisis intervention.
JIŘIŠTA, Vladimír
This thesis deals with problems of psychological stress sustained by paramedics working in rescue service, as well as mapping the possibilities of the crisis intervention in case of excess stress events in the practice of these workers. The thesis is divided into two parts, theoretical and practical. The theoretical part of the thesis defines the basic terms relating to rescue services and paramedics, the stress, stress levels and subsequent psychosocial care, crisis intervention and its history. The practical part is focused on the level of mental stress found in paramedics in service, which was examined by the Meister questionnaire. In addition, the respondents were asked about the possible symptoms of acute stress. Another part of the questionnaire examined the awareness and possible experience of psychosocial assistance and crisis intervention among the paramedics of rescue services. The survey was conducted by questionnaire method in two regions of the CR, the Hradec Králové Region and the Moravian-Silesian Region.
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The Approach of Medical Rescue Service to Treatment of Clients from Different Cultures
TREŠLOVÁ, Zuzana
At the present time a varied ethnic population lives in the Czech Republic and foreigners are found in all medical institutions, from general practitioners to hospitals. This bachelor thesis briefly resumes the theory of multicultural nursing and the special characteristics of treating selected groups of foreigners. The aim of the thesis is both to map out the frequency of departures of the Medical Rescue Service of South Bohemia to patients/clients from different cultures, and to find out how the paramedics from the Medical Rescue Service of South Bohemia approach these patients/clients. The theoretical part contains characterization of rescue service, describes the profession of the paramedic and their competence. In the following part the thesis deals with multicultural health care. At first multicultural health care is described and the terms connected with this subject are explained. Then multicultural communication and its forms are discussed, the special characteristics of health care for foreign patients (in this particular case Romany, Vietnamese and Ukrainian inhabitants) are analysed. Finally the system of health care for foreign patients and the state of health of migrants in the Czech Republic are briefly mentioned. Part two, which is practical, is devoted to research, which used the quantitative method in the form of questionnaires. The findings suggest that the paramedics from the Medical Rescue Service of South Bohemia are well informed about the basic differences in distinct cultures, which means that the first hypothesis was confirmed. According to research paramedics are able to communicate adequately in English or German but at the same time they say that the language barrier is a frequent problem when treating a foreign client. However, this claim never exceded fifty per cent of the results, therefore I can neither confirm nor refute this hypothesis. Paramedics working for the medical rescue service do not need to know multicultural health care in depth. It is important to know at least one world language and, if possible, to have a car equipped with communication cards.
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Injuries of cyclists from the perspective of prehospital emergency care
KRBOVÁ, Petra
The popularity of everyday, both leisure and racing cycling, increases. The spectrum of accidents and injuries related to cycling extends with the increasing choice of bicycles for different types of cycling. Especially in summer months paramedics repeatedly provide prehospital emergency care to cyclists. A wide range of injuries require different intensity of treatment and care. The theoretical part is focused on a brief characteristics and descriptions of selected injuries, which are part of the research. The research was carried out by the quantitative form, by means of a questionnaire. It was distributed to paramedics in the South-Bohemian Region and in the Vysočina Region. The objective of the thesis was to assess and map the approach of paramedics to an injured cyclist, the correctness of provided care for selected injuries that are mentioned in the theoretical part from the perspective of prehospital emergency care and the evaluation of the need to pay more attention to this issue or to retain the current provided care and update only the new information and findings. The result of the research is the confirmation of all the research hypotheses. The questions testing knowledge of definitions of polytrauma and injuries were mostly answered correctly. The research questions focused on treatment and subsequent transport were also answered mostly correctly. Even though the research results were good and hypotheses were proved, it is necessary to bear in mind that cycling injuries are part of prehospital emergency care. Paramedics should be aware of current practices and continue with self-education.
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Attitude between paramedic and nurse in the prehospital urgent care and hospital urgent care
GRÜNN, Jan
The title of the bachelor?s thesis at hand is the Relationship between paramedics and general nurses during pre-hospital emergency care and hospital emergency care. The objective of the thesis was to find out how the general nurses and paramedics perceive the process of getting further education needed for work in the pre-hospital emergency care and hospital emergency care. The theoretical part deals with the current state of the Emergency Medical Service (EMS), its organisation, funding, and division. Next, the thesis provides characteristics of the professions of paramedic and general nurse, especially with regard to their educational background, how they get their qualifications, their competences, and with regard to legal relations these professions enter into. The practical part employed the method of quantitative research. Anonymous questionnaire was used as the method for collecting data. The target research group comprised of paramedics and general nurses that work at EMS Dispatch Centres of the Region of South Bohemia or at the Departments of Anaesthesiology and Resuscitation in the hospitals based in the Region of South Bohemia. This bachelor?s thesis introduces two hypotheses. The first one reads: ?University-educated paramedic needs more work experience for work at a Department of Anaesthesiology and Resuscitation than a general nurse with ARIC (Anaesthesiology, Resuscitation and Intensive Care) education.? The second one is as follows: ?General nurse education is more suitable for work in pre-hospital emergency care than that of paramedic.? At the beginning of writing this thesis, the competences of paramedics and general nurses were completely different. Due to the changes in laws and amendments to the law which defines these competences that came into effect in the meantime, the possibilities of getting further education have seen changes, too.
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The risk of transfer HIV in ambulance services
ALBRECHTOVÁ, Anežka
HIV and the infection of AIDS is a great threat for the inhabitants of the entire world, in particular for rescue services professionals and health workers who daily come into contact with blood and risk situations that require a rapid solution for the rescue of a human life. Their work is to treat the patient as quickly and safely as possible and not to endanger themselves or their surroundings. The objective of this work is to ascertain the awareness of this illness, and if health workers at rescue services are sufficiently protected against this diseases, so far untreatable. Through questionnaires I wanted to ascertain the level of knowledge and prevention from infection.
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The possibility of pain management in prehospital emergency care
GUIDA, Mario
I chose the topic Possibilities of pain management in pre-hospital emergency care for my bachelor thesis as pain belongs to the most frequent symptoms of patients in the care of the Emergency Medical Service. The goal was to map the possibilities of pain management in pre-hospital emergency care in South Bohemian Region. The second goal was to map the awareness of pain management in pre-hospital emergency care among South Bohemian medical rescuers. The theoretical part deals with the present situation of the Emergency Medical Service, education and competences of rescuers. In the next part I focused on various types of pain, assessment and subsequent treatment of pain. The last, theoretical part describes the caring process in pre-hospital emergency care for a patient in pain. The research was performed by means of quantitative method in the form of a questionnaire with semi open and closed questions. The questionnaires were distributed at Emergency Medical Service regional centres of South Bohemia. The results show that pain is sufficiently managed in pre-hospital care. Another fact was confirmed, that rescuers are familiar with the pain management possibilities and prefer pharmacological methods of pain management. We also found out that non pharmacological interventions were used less frequently than they could be. One of the hypotheses was refuted, two were confirmed. The quantitative research results show that there is still a relatively large reserve in using non pharmacological methods. Rescuers might use them more, particularly the quick emergency crews, or they might be applied in situations not requiring immediate pharmacological treatment. Educational seminars at the individual workplaces might improve the awareness of non pharmacological intervention techniques. A patient in pre hospital emergency care suffering from pain of various intensity should be given primary professional care from qualified rescuers.
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Monitoring of gas exchange as a part of technical equipment of Emergency Medical Service vehicles
KADLEC, Jan
The name of the bachelor degree thesis is "Monitoring of gas exchange as a part of technical equipment of Emergency Medical Service vehicles." The objective of my thesis was to map the knowledge of paramedici working for the Emergency Medical Service (EMS) of the South Bohemian region about the work with pulse oxymetr and kapnometr. The second objective was to identify or to compare possibilities of measurement of levels of cabroxyhemoglobine in blood. I would like my bachelor degree thesis to be used as a teaching material about pulse oxymetry, capnometry and cooxymetry for paramedics. The results of the research might serve as an impulse for the management of EMS of the South Bohemian region to make the user training for the devices more consistent, comprehensive and particularly uniform for all participants. One interesting finding was that the paramedics have a relatively good knowledge of the pulse cooxymetry which is in contrast with the fact that the method is not available for them to work with it.
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The Tasks of Paramedic at Gynaecological States in Pre-hospital Phase
ŠÍMA, Oldřich
This thesis is called The Tasks of Paramedic at Gynaecological States in Pre-hospital Phase. At the beginning of the chapter ``Present State{\crq}q the job of a paramedic and pre-hospital urgent care are briefly characterized. The information on anatomy and physiology of female reproductive organs, on examination procedures in pre-hospital phase with the focus on gynaecology and the survey of nosological units and syndromes are included. Also the last part of the chapter contains the characteristics of rape and abuse including recommended procedures for paramedics in pre-hospital phase. The objective of the thesis was to find out if a paramedic (during the action with gynaecological diagnosis) proceeds according to the recommended schemes, further, to find out theoretical knowledge of paramedics and to map particular practical experience of paramedics concerning gynaecology. For the research the quantitative method of data collection was used, while the data was gained by the questionnaire method addressed to paramedics of South Bohemian Region. The results have shown that paramedics have sufficient experience with gynaecological states in pre-hospital care including theoretical knowledge. Further, it also was found out that many paramedics are not willing to take a detailed gynaecological history from a patient and many of them are not willing to examine a patient. In this connection it proves the fact mentioned by Pokorný that gynaecological cases are considered specific private matter with increased claim to respect to shame and privacy by women, which often equals to very reserved history and data on present illness or injury. On the basis of these data I think the results contained in the thesis might be used to deepen practical skills of paramedics in the problems of gynaecological states, especially with respect to taking the history and clinical examination on conditions of pre-hospital care.
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