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Obstetric situations in prehospital emergency care and duties of a medical rescuer
KLEČATSKÁ, Lucie
The paper treats the subject of obstetric situations in pre-hospital emergency care and the tasks tackled by paramedics. Vital in such situations are the early recognition of symptoms; correct diagnostics; and a speedy transfer of the patient to a hospital. The paper concentrates primarily on delivery during the pre-hospital emergency care; on premature leak of the amniotic fluid; and on bleeding encountered in pregnant women in the second half of gestation and the related complications. The effort aimed particularly at mapping the frequency of emergency obstetric situations met during the pre-hospital emergency care in the Region of South Bohemia; at exploring the experience of paramedics; and at finding whether they were afraid of such situations and whether they were able to apply their theoretical background in practice. The defined objectives yielded four hypotheses: H 1: Emergency obstetric situations emerging during the transit are rare in the South Bohemian Region; H 2: Paramedics possess sufficient theoretical erudition to manage the emergency obstetric situations; H 3: Paramedics do not possess sufficient theoretical erudition to manage the emergency obstetric situations; and H 4: In providing emergency pre-hospital care paramedics try mainly to take the patient to hospital in good time. The research section of the paper relied on a quantitative survey conducted through a questionnaire distributed among paramedics in the Region of South Bohemia. Altogether 80 questionnaires were distributed, out of which 66 constituted the surveyed set. The results were processed and assembled into cake diagrams best depicting the percentage shares. All objectives have been accomplished. The first and fourth hypotheses proved false, while the second and third proved true.
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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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Children´s drowning from the perspective of pre-hospital emergency care
SEDLÁČEK, David
Drowning, especially in children, is a relatively frequent cause of death. Statistics speak clearly. Children´s drowning is the second most frequent cause of death of children in industrialized countries. Good knowledge of the issue of drowning in children, therefore, seems to be the best way how to at least partially minimize the unfavorable statistics. But it is necessary to be aware of the child drowning specificity due to the child age. And the nursing care specifics are the subject of the thesis. The main objective was to survey the knowledge of prevention and first aid for children in the context or drowning and near-drowning on the part of adult and child public and also in the Emergency Medical Rescue Service workers. The quantitative research method through anonymous questionnaires was chosen. The research sample representing the general public was composed of staff members and pupils and students of several primary and secondary schools in České Budějovice. The research was conducted with the Emergency Medical Rescue Service workers in the regional centers of the Emergency Medical Rescue Service of the South Bohemia region. The questionnaire addressed to the general public contained a set of 25 questions, the questionnaire for the Emergency Medical Rescue Service workers comprised a set of 20 questions. The research has confirmed that the general public knows the first aid basics, but does not have enough knowledge about prevention and first aid for child drowning and near-drowning. The outcomes have mainly proved unfamiliarity with principles of resuscitation for children. The research has also shown that in children in general the knowledge of prevention and first-aid provision for near-drowning or drowning only minimally depends on their age. According to the research results the Emergency Medical Rescue Service workers have adequate knowledge about prevention and first aid for drowning or near-drowning children. The obtained results suggest the need to increase training and education in issues relating to the near-drowning of children in the general public of all ages. In a limited range it would be useful to organize training on issues related to pre-hospital emergency care also for the Emergency Medical Rescue Service workers. The need of the knowledge of prevention and first aid for drowning or near-drowning is confirmed by the fact that even among the public, with which the research was conducted, several persons who had already met this problem were found.
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Acute myocardial infarction in pre-hospitalization urgent care - direct cooperation with a cardiology center
JONÁŠ, Jindřich
Acute myocardial infarction in pre-hospitalization urgent care {--} direct cooperation with a cardiology center The evaluation of urgency of the condition of a patient with cardiac disease symptoms, identified as chest pain or acute coronary syndrome, used to be in the pre-hospitalization urgent care always in the domain of the emergency service physician. However, with the progress of diagnostic techniques the working diagnosis can be also made by a trained paramedic, as long as he/she is unable to get a physician to the place of the intervention. A great advantage in this respect is the possibility of telemetric transmission of electrocardiographic records to the cardiology center where the curve is evaluated by a cardiologist and then the optimized method can be agreed with the specialist by phone so that the concerned patient can be transported into a hospital and given specialized treatment. The objective of the thesis was to analyze the working procedure of a paramedic with a patient who suffered an acute myocardial infarction and to evaluate specific features of communication and cooperation with the cardiology center by means of data transmission. The bachelor thesis is divided into two parts. The first part is theoretical and it describes the issues of pre-hospitalization urgent care of a patient with an acute myocardial infarction and the provision of the care. The second, practical part of the thesis, consists of a qualitative research. The employed technique for data collection was a structured interview. Based on an analysis of the acquired data we set the following hypotheses: Hypothesis 1: Paramedics are familiar with the procedure for pre-hospitalization urgent care of a patient with an acute myocardial infarction. Hypothesis 2: Teams sent to interventions with chest pain indication are primarily emergency medical service teams.
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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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