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Analgosedation of a child patient in pre-hospital emergency care and children's urgent care
MRÁZ, Štěpán
This bachelor's thesis is focused on the topic of analgosedation of an infant patient in pre-hospital emergency care and children's urgent care. It comprises two parts, the theoretical and the practical one. The theoretical part includes some information about pre-hospital and urgent emergency cares. Furthermore it is mainly focused on specifics of infant patients, analgosedation and last but not least on resuscitation of adults and children. For the practical part of this thesis was chosen one aim. It was to find out how urgent wards are ready to face intake of infant patients. Due to this target came out two investigative questions. The first one:"What facilities can be found in hospitals, which are ready for intake of infant patient?" The second question: "Are hospital workers prepared for infant patients within the framework of PNP and urgent care?" The research was carried by a quantitative method of gathering data through the half structuralized dialogues covering 12 questions. The research sample contained 6 paramedics of an emergency ambulance and 6 hospital employees from an urgent ward. The data obtained by this research are divided into 11 categories. After summarization of all information and data I found out that there is a high standard of facilities covering pre-hospital and hospital care, therefore an infant patient can be provided with a necessary help. Within the investigation was also proved the following fact. Hospital employees are well trained in issues of infant patient. Nevertheless they agreed that there are not so many practical training based on children emergency care organised, therefore they would really welcome them to be able to improve their practical skills in connection of this specific field.
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Craniocerebral injuries in motorbikers
HEJNOVÁ, Anna
This thesis focuses on the craniocerebral injuries in motorcyclists. It is divided into a theoretical and practical part. In the theoretical part I have described the anatomy of the human skull and the brain. I have also described the mechanics of injuries on a one track vehicle and the most common types of craniocerebral injuries which are the focus of my thesis. The last chapter focuses on the immediate care necessary in patients that have suffered cranial trauma. The practical part of my paper contains excerpts of interviews conducted at random with members of the South Bohemian Emergency Medical Services. In this part of my thesis I focused on two goals. The first was to map out the knowledge of emergency workers which are not doctors regarding cranial cerebral injuries. The second was to find out their procedures in treating cranial trauma patients injured on motorcycles. This way I was able to map out the procedures used by non-medical emergency personnel when treating a motorcycle accident patient with craniocerebral injuries. To reach my conclusions I used a highly effective research method in which I questioned 10 informants in the form of a semistructured interview. The results of the interviews point to the fact that the non-medical emergency professionals have the theoretical knowledge of craniocerebral injuries and were able to name the particular symptoms and complications associated with them. However some of them were confused about some specifics. They were able to name the different types of these injuries. When it came to being able to name and identify the different types of helmets available most admitted that they weren't well informed. When it came to helmet removal the results were positive pointing to their awareness of the correct procedure. They also proved to be skilled in the placement of a neck brace/collar. When asked about therapy their answers were mostly chaotic.
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Use of Mapleson C breathing system in pre-hospital care.
FILIP, Michal
The theoretical part describes the physiology of a human's respiratory tract. The next part focuses on the history of ventilation, non-invasive ventilation and its basic ventilation modes. Then it focuses on Mapleson´s systems, their advantages and disadvantages, then it focuses on Mapleson C, which is a priority for this work. Next is the instruction manual and in the last chapters we will discuss an acute situations in pre-hospital care, where Mapleson C can be used and important laws to clarify whether a paramedic can use this system or not. The practical part is processed by using a quantitative questionnaire which is completed by 38 paramedics and doctors in the South Bohemia region. The first goal of the work was to find out a knowledge about the safe use of this system. The second goal was to find out if the use of Mapleson C by a paramedic is correct with current legislation. The result of this thesis shows how high the level of information about Mapleson C system is. It shows its advantages, disadvantages and justifies why it is rarely used in practice. This work could serve as a protocol for the use of Mapleson C, which would be available to all paramedics.
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An algorithm of the pre-hospital and the acute hospital care during an ethylene glycol intoxication.
MILOTA, Jiří
Ethylene glycol intoxication is a serious life threatening condition, that may appear to be a serious risk in connection with the easy availability of preparations containing this substance. The work titled An algorithm of the pre-hospital and the acute hospital care during an ethylene glycol intoxication provides information on this issue and summarizes appropriate treatment in pre hospital and acute hospital care, which should lead to increased treatment efficiency and reduced health consequences. The most common source of ethylene glycol in the household is anti freeze mixtures for vehicles, the most often accidental ingested liquid. The toxic nature of ethylene glycol is a decomposition into acidic metabolites and formation of calcium crystals causing necrosis and organ failure. A typical immage of ethylenglycol intoxication is a consciousness depresion, total acidosis, acute renal failure, and an increased anion gap. Appropriate therapy should be initiate by first aid, followed by professional pre hospital and hospital care. There should be made a gastric decontamination in first houre of ingestion. Vital functions must be provided, but the key method is using of antidotes (alcohol dehydrogenase inhibitors ethanol or fomepizol). In case of indikation causal treatment also includes elimination methods, most often intermittent hemodialysis and cofactor application. Symptomatic treatment is based on acid base homeostasis and specific biochemical levels balance. The thesis was made by form of review and synthesis using large number of science sourc es dealing with the current issue of EG intoxication. The main purpose of work is comparing of Czech and global authors to illustrate different possibilities of treatmet and create educational material for students of health care disciplines or medical professionals looking for quick and simply way to solve acute emergency or crate an idea of adequate care.
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Chest injuries in prehospital emergency care
SOUČEK, Jan
Chest injuries are one of the very common injuries that often endanger the patient's life. Therefore, it is important to quickly determine the severity of the injury, to define further procedures, such as medication, and to ensure the most careful and fastest transport to the hospital. It is therefore important that health rescuers have the best knowledge, practical skills and awareness of possible complications, which can significantly influence the course of the injury and the state of health of the patient. Aim of this bachelor´s thesis is to map knowledge of paramedics about chest injuries in Pre-hospital Emergency Medicine (PHME) and compare rescuer´s procedures in care of patients with chest injury. Research questions are following: How different is the knowledge of medical procedures for chest injuries? What is the difference in medical procedures in chest injuries? Empirical part of the thesis is based on the qualitative survey. Semi-structured interviews with opened questions were arranged with paramedics of region Vysočina and South Bohemia. Based on the results of this work, it can be said that health rescuers have good knowledge in their field. Moderate shortcomings include uncertainty in competencies, and slight deficiencies in theoretical knowledge and awareness of the possibilities of using aids in the Ambulance car. These deficiencies may be a reflection of unified equipment, the different competencies of rescuers, and the possibilities and responsibilities to further educate and improve on the topic.
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Management of patient with critical thorax injury in prehospital care.
HARUDA, Stanislav
This bachelor thesis is mainly focused on critikal thorax injury in prehospital care. This thesis had two goals. First was theoreticly described critical thorax injury and the second goal was compare five cases from praxis with the theoretical part of this work. On the beginig of this work was discribed anatomy of thorax and phyziology of respiratory system. Next is discribed an introduction to critacal thorax injury, how they usually arise and how to provide a better prognosis for the patient. In the next chapter we are dealing with primary and secondary survay as well as the basic device examination of the patient. The following chapter is the critical chest injury itself, which is presented according to scholarly sources as life-threatening chest injury. This chapter describe symptoms, their pathophysiology and the appropriate therapy. This chapter includes these serious injuries: tension pneumothorax, massive hemotorax, open pneumothorax, flail chest with pulmonary contusion and cardiac tamponade. In other chapter are mentioned life saving skills including: needle thoracentesis, chest tube insertion and pericardiocentesis. There is also brief talk about analgesia, and the last chapter of the theoretical section is about immediate transport. In the empirical part, was used a qualitative analysis in five cases from praxis. These analysed cases were classified into categories, and then in the discussion were compared with the theoretical part of the thesis. The result of this work is that there is a correct final solution to all five critical chest injuries in pre-hospital care, but in some cases we experience incomplete examinations and there are certain differences in the treatment of these critical injuries than the scholarly sources mentioned.
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Evaluation quality of the treatment of the most common injuries in medical first aid.
LEVKO, Marina
The theoretical part of this bachelor thesis deals with the medical first aid service (emergency) and its current status in the Czech Republic with a focus on the South Bohemian region. I also describe the difference between the ambulance and the emergency because patients often mislead those two terms. The theoretical part focuses too on the trauma issue. Children and teenagers are the most endangered by suffering a trauma. That is why I describe the problematic of children in premedical care. The objective of the thesis was to find out the number of the most common children traumas on the three departments of the medical first aid service in the South Bohemian region and evaluate the quality of treatment. I was trying to meet the goals through a data collection from the three departments of the emergency service in the South Bohemian region from 2013 to 2014. The research was conducted through qualitative and quantitative data analysis. Based on the available documentation on emergency, I was retrospectively finding out the number of all patients treated on the emergency. From this data I subsequently learned the numbers of treated children with a trauma in years 2013 and 2014. All the data learned are worked out into charts to make them more transparent. The qualitative form of the research was done by the method of casuistry analysis. By analysing the casuistries I was also finding out what were the most common children traumas treated on the emergency, its diagnosis and the process of the treatment of each of the children patients in years 2013 and 2014. Two research questions were stated for this thesis. What are the most common traumas which are treated on emergencies and what is the way to treat such traumas and whether it corresponds with lege artis. For better orientation, the data learned about the most frequent children traumas treated on the emergency are put into graphs. After the evaluation of results I found out that the most common children traumas on all three departments of the emergency in years 2013 and 2014 were: injury caused by a sharp object then fall or a blunt impact to an object and burns of I. and II. degree burns. Those results matches with the results presented in other works dealing with the most frequent children traumas. The casuistry analysis implies that all the three departments of the emergency treat the most common types of a light injury the same way, in comparison with the reference literature in all the cases the procedure of treatment was correct. In cases when the trauma was not possible to be solved on the emergency, because of need of a laboratory or projecting medical examination which are not available on emergency, the ambulance was called to a patient, or the patient was redirected to another specialised department to be provided with safe and lege artis diagnosis. While evaluating the quality of the treatment I also focused on the evaluation of the medical documentation which is, on the emergency, represented by the book of daily records. On the emergency 1 and 2 I have met a serious failure with managing this book. Those failures were recorded only within the casuistries dealing with the treatment of adults. When evaluating the quality of treatment of children patients I have not met any wrong or partly filled documentation. To make the transparency better and have the unified form it would be adequate to keep the books in an electronic way at all three emergencies. This is where we are confronted by financial background of the emergency services. In the Czech republic there have not been institutionalized the form of the emergency, its function neither the network of emergencies, have not been specified by any law yet. If the function, provision, availability and the financial background of the emergency is united it would have a positive impact even to patients who this service is meant for.
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Burn-out syndrome in thepre-hospital and hospital care forparamedicalpersonnel
ŠAŠKOVÁ, Jana
The "burn out "syndrom is the state of a physical, emotional and psychical exhaustion. There is a relatively big danger of the "burn out"syndrom emergence by the paramedics and that is why there should be given a big stress to its prevention. The aim of this bachelor´s work was to find out if there is a bigger "burn out" syndrom by the paramedics than by hospital paramedics. The next aim was to find out the influence of the practice´ lenght and of the workfalling in to the psychical point of view to the paramedics. It was used the investigation of quantity through the standartised quostionnaire to find out the "burn out" level. We created a quostionnaire that contained 11 questions to find out if the paramedics have the prevention against the "burn out" syndrom. The standartised questonnaire MBI was evaluated in the area of the South Bohemian region through the charts and graphs. It was found that the hospital paramedics are more inclinating to the "burn out" syndrom than the ambulance service paramedics. Followingly the investigation, there is a bigger risk of "burn out" syndrom by paramedics with the longer practice. The most of the paramedics try to prevent the "burn out" syndrom but the prevention didn´t appear to be efficient in comparison to the number of "burn out" paramedics.
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Intraoseal approach - an alternative to peripheral venous entry
TUROŇ, Jiří
The intraoseal approach is an alternative method how to ensure bloodstream in cases when it is difficult or impossible to use venous entry. It is used mostly in children, but it is possible to apply it to adults too. This bachelor?s thesis called ?Intraoseal approach - an alternative to peripheral venous entry? deals with theory of using intraoseal approach in conditions of pre-hospital urgent care. The practical part of this thesis surveys the frequency of using intraoseal implant and screens the knowledge of rescuers working in Salvage and rescue service of Moravian-Silesian district. The method of quantitative research was used to validate the hypothesis. Obtained data were collected by method of anonymous questionaires. These questionaires were distributed to Salvage and rescue service of Moravian-Silesian district, to resorts of Ostrava, Opava, Havířov, Karviná, Krnov, Třinec and Frýdek ? Místek in the concrete. The results of this work showed practical and theoretical knowledge of paramedics of Moravian-Silesian district. Their orientation in the problematics of using alternative venous entry in conditions of pre-hospital urgent care is mostly correct even if there was few wrong answers. Nevertheless the results of research were excellent. These are hypotheses defined ? H1: Paramedics know the process of using intraoseal approach, and H2: The intraoseal approach is used less than venous cannulation in life endangering cases. Both of these hypotheses were verified. The frequency of using this entry is not so high, but I believe it becomes more common with increasing knowledge of rescuers, especially in cases of immediate threat of life with impossibility of using peripheral venous entry.
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Cooperation of the Mountain Rescue Service of the Czech Republic, Šumava region, with basic units of the integrated rescue system
HLAVÁČEK, Jan
The topic I selected for my bachelor degree thesis is a not-very-well-mapped area of cooperation between basic units of the Integrated Rescue System and the Mountain Rescue Service, Šumava region. I have described the content of works performed by the Mountain Rescue Service and their points of contact with the Emergency Medical Service, Police of the Czech Republic and Fire Rescue Service of the Pilsen and South Bohemian region, in connection with rescue of persons and their health. In my thesis I have attempted to describe situations typical for cooperation between the units, as well as the quality of cooperation, mutual interconnection between the organizations and potential possibilities to expand the cooperation in order to ensure safe movement and stay of persons in the mountain region of Šumava. The qualitative research used a method of semi-structured interview with members of the individual above-mentioned organizations. The research has shown that the cooperation functions at a very good level, it develops continually and that it is indispensable in the conditions existing in one of the country´s biggest mountain regions. One particular measure that could ensure further improvement is the development of a legislative document accurately defining competences of mountain rescuers.
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