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Possibilities of artificial pulmonary ventilation in urgent care and anesteziological resuscitation department
BINTEROVÁ, Jana
The aim was to explore the possibilities of mechanical ventilation in prehospital emergency care and Anesthesiology and Intensive Care qualitative research method. The first part of the research was focused on finding out how the use, including the most frequently used modes of ventilation, and frequency of artificial ventilation. Research has found that in pre-hospital care are used methods of invasive and noninvasive ventilation and ventilatory modes most widely used in prehospital care are IPPV, CPAP and SIMV. In the second part of the research focuses on the possibility of mechanical ventilation on Anesthesiology-Intensive Care and neužívanějších detection schemes. They are IPPV, BIPAP, SIMV, APRV, PS and CPAP. The last part of the research deals mainly comparing the possibilities of mechanical ventilation at the base emergency medical services of the Liberec Region and South Region. I ran into very different views on the importance of mechanical ventilation in prehospital emergency care, but the result is the possibility of artificial ventilation in different regions does not differ much.
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The view on the Krnov Hospital X Ray Department's Preparedness to Handle an Increased Number of Casualties at Emergency Management
PODEŠVOVÁ, Jitka
Exercising their profession, nursing staff in health facilities may commit a fatal mistake in tense moments in terms of time. An illustrious example may be the admission of a higher number of casualties after an emergency event. So that to prevent these negative consequences, emphasis is put on the readiness of the entire health system from the headquarters to individual care providers. Special attention is also paid to trauma planning, because especially in complex cases greater demands are developed on the functioning and rapid succession of individual operations of medical care, along with observing all approved medical principles, of course. To verify the readiness and to reveal any shortcomings and reserves tactical exercises are held. The Krnov hospital also participated in that kind of training with activating the trauma plan. Another workplace involved was also the radio-diagnostic department. A simulated bus accident was to reveal whether the individual workplaces could provide adequate examinations and treatment. The thesis is divided into several parts. In the introductory section it is explained in brief how the health system is organized. To understand the text, it was necessary to define the necessary terminology and to mention the binding, legal legislation for emergency management authorities at all levels that affect the operations and carry out supervision on medical institutions. Gradually, the theoretical part presents trauma plans, sorting out casualties in the place of an emergency event, and specific exercises in the Krnov hospital that were announced and carried out in the early afternoon, when the hospital was fully filled with staff members. In the research part the analysis of a real accident that occurred in a late evening about a year later is made. Time demandingness of individual examinations is evaluated. Factual results are compared with the data obtained from simulated exercises. In the final part I tried to assess the quality and topicality of the trauma plan elaborated by our facility as well as the internal trauma plan of the RDG department and to propose possible changes and improvements.
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Paramedics' awareness of blood-borne infections
DALIHODOVÁ, Andrea
My bachelor's thesis focuses on identifying paramedics' awareness of blood-borne infections. The issue of infections transmitted by blood is very extensive and complicated. Much emphasis is placed on prevention by health care employees who are threatened by infections of this kind in their day-to-day practice. For the sake of structure, the thesis is divided into two main parts. The theoretical portion presents a comprehensive overview of blood-borne diseases paramedics are exposed to while performing their work. It also explains terms such as paramedic and the importance of first aid service. The practical portion contains the actual survey and the evaluation of results. This section of the thesis uses quantitative research method via questionnaires. Data was obtained through questioning using anonymous questionnaires. The surveyed group included 90 paramedics. The aim of the work was to identify paramedics' awareness of blood-borne infections, find out what kind of personal protective equipment, if any, they use, and whether applicable regulations are being complied with. Based on the results obtained from the survey, I have concluded that paramedics are not sufficiently aware of blood-borne diseases. I also found out that 33% of the respondents violate applicable legislation by improper handling used by paramedics to the fullest possible extent. The most important aspects, I believe, are compliance with sanitary and epidemic regulations, vaccination, the availability of quality protective equipment and training as part of general prevention measures. In my opinion, more attention should be paid to providing health care workers with quality post-graduate education, the prevention of blood-borne infections, compliance with applicable regulations and the use of personal protective equipment.
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Competencies of Professional Rescuer in Emergency Medical Service Rescue Squads
ŠUSTA, Jan
The topic of my bachelor degree work is ``Competences of a paramedic in an ambulance crew``. One of the objectives of the work was to discover opinions of doctors and paramedics regarding the competences of a paramedic in an ambulance crew. The other objective was to map out the situation in individual stations of emergency services in South Bohemia. In the theoretical portion of the work I focused on various aspects of the medical emergency services such as their origin, characteristics and activities. Further on I described the job of a paramedic as regards the education, activities and legal responsibilities related to this job. In the practical portion of the work I chose the method of quantitative research. To gather data I used a questionnaire and a knowledge test. The inquired group comprised doctors and paramedics working in ambulance stations of the South-Bohemian medical emergency service. With regards to the objective of the work I determined three hypotheses. The first hypothesis assumed that ``Most paramedics consider their competences insufficient because of their education``. The second hypothesis assumed that ``Most doctors consider paramedics´ competences sufficient. `` The third hypothesis said that ``Most paramedics have sufficient professional knowledge about the scope of their competences``. The research confirmed two of the hypotheses. The one mentioned as second was not confirmed. Even though paramedics´ competences have been very topical among specialist in this field lately, no legislative changes that would extend the current competences have been adopted yet.
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The knowledge of work with a traumatological plan by workers of the medical rescue service
SCHLINDENBUCHOVÁ, Eliška
I have chosen the topic ``Knowledge of Work with a Traumatological Plan by Workers of the Medical Rescue Service{\crqq} due to topicality its content. Nowadays so called extraordinary events are still more frequent. The most frequent ones in the Czech Republic are floods, windstorms and traffic accidents, both on railways and roads. Also danger of terrorist attacks is still more frequent, not only in the world, but also in our territory. The extraordinary event is practically always connected with higher number of wounded people. Therefore it is necessary for us to be better prepared for these situations (events), especially as far as providing timely and effective pre-hospital immediate care is concerned, i.e. providing expert medical first aid in the spot of the extraordinary event. For these reasons the traumatological plan of the medical rescue service has been developed, which is updated twice a year in compliance with the latest pieces of knowledge. The objective of my thesis was to map knowledge of work with the traumatological plan in pre-hospital immediate care at workers of the Medical Rescue Service of the South Bohemian Region. There have been established two hypotheses for research. The hypothesis 1, i.e. that workers of the Medical Rescue Service of the South Bohemian Region have theoretical knowledge of the traumatological plan, have been confirmed by the total share of 71 % of all correct responses provided by all respondents. In my opinion this number is in the low limit of capacity in order to confirm this hypothesis. However I consider this value sufficient for confirmation of theoretical knowledge of the traumatological plan, and consequently also of the hypothesis 1. The hypothesis 2, i.e. that workers of the Medical Rescue Service of the South Bohemian Region can use theoretical knowledge of the traumatological plan in practice, has not been confirmed based on the 52% share of respondent, who during their work in the medical rescue service participated in practical exercises in the framework of the traumatological plan. However I do not consider the share of 52 % as sufficient for confirmation of the hypothesis 2. This results in disproving of hypothesis 2. This bachelor thesis could be used as a study material for students in medical specializations in higher educational institutions and colleges.
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The urgent care of the clients suffering from the acute heart stroke provided by the medical rescue service
KALÁŠKOVÁ, Dana
The pre-hospital emergency care for clients with acute myocardial infarction within the medical rescue service The pre-hospital emergency care for clients with acute myocardial infarction within the medical rescue service is the topic that I selected intentionally. On one side, I was guided by my own still fresh experience with my father and on the other side I was guided evenby the fact that interventions of the rescue service at patients with chest pains are still the most frequent indications. This is a really up-to-date subject due to contemporary life style and style of living of most of our inhabitants. The term acute coronary syndrome means all the statuses patho-physiologically connected with an instable plate and related thrombosis in the coronary artery. The main symptoms include chest pains or their equivalent in resting state. The bachelor thesis was processed on the basis of quantity method, using the technique of questionnaires. The research set included employees of the Medical Rescue Service of the South Bohemian Region. The first aim of the work was to make a chart of their opinions regarding use of automatic external defibrillators (AED). The results of the research investigation indicated that the employees of the Medical Rescue Service of the South Bohemian Region are well aware of recommended procedures in pre-hospital care for clients with acute myocardial infarction, which successfully confirmed the first hypothesis. Unfortunately, even the second hypothesis was successfully verified,as the automatic external defibrillators still do not belong to natural part of public locations equipment and that is why their use in practice is minimal. Based on results of this work that will be published in a specialised magazine rescue and Urgent Medicine, I would like to appeal to managing employees of medical rescue services to strengthen promotion of automatic external defibrillators and also to the Ministry of Health to more quickly extend the current stage of AED within legal rules of the Czech Republic, which do not still deal with attitude towards defibrillation, which does not solve the difference between manual and automatic defibrillation.
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Frequency and causes of injuries of children in pre-hospital emergency care
MINAŘÍKOVÁ, Petra
Injuries represent the greatest danger for children and the most frequent cause of their death. A certain dangerous situation precedes every injury and as such it can always be prevented. Emergency rescue teams provide professional urgent pre-hospital care. Based on theoretical knowledge and practical experience of a member of a rescue team providing pre-hospital urgent care, two research objectives were determined. Objective no. 1 was to map out the number of children{\crq}s injuries in the regional centre of České Budějovice between 2004-2008. Objective no. 2 was to analyze the situations in which children of various ages get injured. Three hypotheses were determined. Hypothesis no. 1 ``Children living in towns get injured more frequently than children in villages``, was not confirmed. Hypothesis no. 2 ``Children up to 6 years of age most frequently suffer injuries when they are at home and their parents are not cautious enough``, was confirmed. The last determined hypothesis ``Children between 6 {--} 18 years of age get injured during active sports and traffic accidents most frequently``, was confirmed. It is more efficient to invest in preventative activities that reduce the number and seriousness of injuries in children. If we take measures to prevent injuries, the number of fatalities will go down.
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Education in pre - hospital acute care
AUGUSTA, Martin
This Graduation Paper covers the subject of education provided to patients as a part of their urgent pre-hospitalization care. Since the education has become an integral component of health care, the paramedical members of rescue teams have to deliver it before the care itself is provided. The theoretic section of the Paper deals with pedagogics as the basic discipline of education; with the education of patients going through the urgent pre-hospitalization care; and with the autodiagnostics and self-reflection of the paramedical rescuers, which are essential conditions of their improvement in the art of providing education. As an important part of the theoretical section comes communication, first and foremost communication as a means used to create a relation of mutual trust between the patient and the paramedical rescuer, but also communication with patients having specific needs such as those hard of hearing, patients with partial sight or similar disabilities. The final part of the theoretical section treats the issues of ethics as encountered in the urgent pre-hospitalization care. The practical section of the Paper presents the results of a quantitative survey encompassing two research sets. The first set consisted of paramedical rescuers based in Emergency Centers in the towns of Tábor and České Budějovice; the second set comprised patients treated by the Paramedical Rescue Service staff operating from the above-specified Centers. The survey, carried out as a quantitative survey, relied on questionnaires containing 13 questions for the paramedical rescuers and 12 so-called closed questions (with predefined optional answers) for the patients. The questions were asked so as to reveal whether the paramedical rescuers educated the patients undergoing the urgent pre-hospitalization care, and whether the rescuers' educational performance depended on their own level of education completed. The survey concluded that the university educated paramedical rescuers achieved much better educational performance than those having completed vocational high-school or general high-school education.
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Clearing the airway by an emergency care provider in the prehospital emergency care
NOVOTNÁ, Magdalena
Clearing an obstructed airway to facilitate breathing is a critical element of airway management. It is the emergency care provider who administers first aid and he/she has to master the technique of opening the airway as well as the aspiration prevention. The right airway management may avert the life-threatening condition of an injured person. The thesis is focused on the possibilities of clearing the airway by the emergency care provider in the Central Bohemian region. Techniques of opening and clearing the airway both without or with aids, which are at the emergency care provider´s disposal in prehospital care, are mentioned. The research set was formed by emergency care providers in transit first-aid stations providing emergency care in the Central Bohemian region. The research was conducted by the quantitative method. To collect data, the questionnaire method was used. I handed out 100 questionnaires in transit first-aid stations in the Central Bohemian region. The research was anonymous. The rate of return was 76%, it means I was given back 76 anonymously filled in questionnaires. The objective of the research was to survey possibilities of clearing the airway by the emergency care provider in the Central Bohemian region {--} and the objective was accomplished. The hypothesis I {--} on the part of an emergency care provider the most effective way how to clear the airway is endotracheal intubation {--} was confirmed {--} as well as the hypothesis II - emergency care providers do not use the {\clqq}LMA- Fastrach`` to clear the airways.The conclusions of the thesis may be used in making up standardized methods and techniques of clearing the airway in the prehospital emergency care. They may also be used for further education of university students of nursing and medical care.
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Crisis management and planning in the sphere of health medical service
MLEJNEK, Miroslav
This bachelor{\crq}s work is concerned with the principles of crisis management and planning in the area of health service. A special attention is paid to the Rescue Service as the crucial link of the Integrated Rescue System. The theoretical part of the work provides a kind of simplified summary of information from the area of the theory of crisis management and planning. Subsequently, the basic principles of crisis management in health service are defined. The core part of this work deals with specific conditions of the Plzeň Region, unveils the basic features of the crisis plan of this region, as well as analyses the traumatological plan of the Plzeň Region and verifies its effectiveness. The work ends with the assessment of the standard of crisis management in the territory of the Plzeň Region.
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