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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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Peculiarities of nursing care for a child under 6 years old with burns
KUČEROVÁ, Radka
Peculiarities of nursing care for a child under 6 years old with burns Current status This thesis deals with the peculiarities of nursing care for a child under 6 years old with burns. Children belong to one of the groups at risk of thermal injury. Treatment of burns is long and painful, because it involves surgical procedures, such as necrectomy, necrotomy and autotransplantation. After burns treatment scars are formed, which can harm a child physically and emotionally. Subsequent rehabilitation requires patience and consistency. The theoretical part is devoted to children burns. It deals with factors affecting the severity of the burn trauma. These factors include the mechanism of injury, location, extent, depth of injury and age of the individual. The work is further focused on the first aid for a burned area of a child and describes the necessary measures to safeguard children's condition. Treatment of burns is divided into conservative and surgical parts. Work aims and research questions To achieve the goals four research questions were created. Question 1: What are the peculiarities of nursing care for children with burns? Question 2: How a follow-up care with burns is done? Question 3: What are the main needs to be satisfied in terms of children with burns? Question 4: What are the problems in meeting higher needs of children with burns? Methodology of work In this work a research qualitative method was carried out, using semi-structured interviews and participant observation. Before undertaking the survey, the principal and head nurse were asked for permission to carry out the survey and they agreed. Interviews were conducted with six nurses who have experience with treating children with burns. The interviews were held separately with each nurse and were recorded in writing. For the purpose of the interview 29 key questions were made (see Appendix 3), and others were added during the interviews, depending on the answers of the nurses. Four nurses were observed at the intensive care unit department. Before the observation an observation sheet was compiled (see Appendix 6) and nurses were observed during their daily services. Results The research showed that the nursing care of children with burns has its own specifics. The selected nurses stated in the interviews that under nutrition having enough proteins and fluids is very important. Regarding the excretion the nurses indicated that when genitalia are burned, they introduce, as prescribed by a doctor, the permanent urinary catheter (hereinafter PUC). Other specifics has the pain treatment. All nurses reported that pain is checked regularly. Apart from analgesics they talked about alternative methods of pain treatment. Another area was sleeping. All nurses reported that they inquire sleep rituals from parents to put their children easier to sleep. Questions about the children needs, nurses had problems with accurate requirements listing. They were unable to identify needs. The results of the observation confirmed that nurses respect the principles of nursing care for a child with burns, as reported in the interviews. Nurses abided by aseptic approach and increased genital hygiene in terms of PUC Conclusion The survey revealed that nurses working at the burns clinic are fully qualified in the field of nursing care for burned children. Nurses know the specifics of nursing care, nutrition, excretion, hygiene, sleep and needs of children. They are aware that in terms of burns it is essential to follow aseptic approach, which means to use sterile disposable equipment and protective clothing. During the interviews with the nurses it was difficult to obtain information about the children needs and their satisfaction. From the interviews and observations emerged that nurses tried to satisfy the children needs as much as possible within the boun
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Issues connected with children's burn trauma
VOLOSHYN, Tetyana
Burns are common injuries among children. Healing development of deeper burns could be complicated and impaired functioning of the burned parts could have negative influence on patient's mental state. These severe children's injuries put stress on organism due to long-term hospitalisation. Injuries caused by heat energy directly by solar radiation, electricity, fire, by physical contact with heated object or surface or indirectly caused by heat radiation of a hot object or a flame are often caused by a lack of parent's care and these injury aftermaths follows the child through the rest of its life. This bachelor's thesis called "Issues connected with children's burn trauma" is purely theoretical and tries to summarise the overview of this area with focusing on modern approaches of caring for children from the beginning of the injury to the following treatment at home. There are a lot of possibilities of prevention of this severe injuries and the quality of health care is improving due to possibilities of modern medicine and nursing. Care about children's mental state and its family is very important. There are descriptions of situations causing lifethreatening burns in general terms. Clarifying the aetiology of particular injuries better manifests the importance of preventive programs and measures which may prevent the burns. There is a reference to anatomy and physiology of skin and its changes after burns in the first part of the work. There is a description of first aid kit content and short introduction into history of burns in the next part of this work. This work wouldn't be complete without these essential information. The aim of this bachelor's thesis is to map issues connected with children's burn trauma using available literature. It focuses on cause of appearance and risk factors, prevention and differentiation of burn trauma: singe, sunburn, heat stroke, skin corrosion, trauma caused by electricity, frostbites, sub-cooling. The next part focuses on overall treatment and nursing care in healthcare institutions and home environment. It was necessary to study a large amount of bibliographical publications coming from traumatology and paediatric experts in order to acquire awareness about status quo. This work uses methods of synthesis, proposal and demonstration for compiling this work. Using these methods helps with navigation in this issue and highlights the importance of preventive measures and flaws in home environment. There was an effort of conveying essential facts concerning this issue by gathering many relevant data. Acquired knowledge is divided into several part according to their importance and currency. This thesis should help with better understanding of problems concerning burn trauma in children step by step. Taking care of children suffering from burn trauma requires multidisciplinary approach. Not only them but also their relatives are supposed to be treated well. Unfortunately despite all these measures we can see injuries caused by negligence of parents, there is nothing left but hope that this is going to change. If only one person would benefit from this work by getting help this work would fulfil its purpose. Bachelor thesis could help those who wants to avoid thermal injury of children and use the procedures which improve their care.
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Evaluation factors severity of thermal injury in children in the pre-hospital care
JEŘÁBKOVÁ, Petra
Injuries in children have been undoubtedly a threat for all parents, healthcare professionals and the children themselves for many years, but the children often do not have the possibility to even realize this threat. Just in moment too fast, they enter the turmoil of prehospital care and become patients, victims of their own play or due to the lack of attention of others, or even victims of adults. Burns or the so called thermal injuries are very common mechanisms of injuries in children. In our diploma thesis, we decided to focus on thermal injuries from the viewpoint of those who are the first to come in contact with the patients, and who must evaluate the given trauma and initiate treatment based on the evaluation. In particular, this applies to the personnel of emergency medical services, and also to the graduates of the Faculty of Health and Social Studies, University of South Bohemia in České Budějovice (USB FHSS). These persons should also be the ones to be aware of how burn injuries are evaluated in children - given among others that many of them are often found in the position of healthcare personnel at children´s camps or nurse at offices of general practitioners for children and adolescents. The following hypothesis was formulated based on consultations with the professional public (MUDr. Robert Zajíček, Burn Medicine Department, University Hospital Královské Vinohrady): ?Education of healthcare personnel of emergency medical services and USB FHSS graduates is inadequate, being a potential source of errors in the provision of prehospital care?. Based on this hypothesis, objectives of the diploma thesis were set as follows: Objective 1: Determine the knowledge status and practical skills in respect of evaluating 6 essential burn factors amnog emergency medical service personnel and USB FHSS graduates. Objective 2: Develop an educational material on prehospital care in children with burns.
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KNOWLEDGE OF THE FIRST AID NEW PRINCIPALS AT HEALTH-SOCIAL WORKERS
KOKEŠOVÁ, Karolína
The bachelor thesis is divided into two parts. The first part describes providing of the first lay aid at cases which occur most frequently. Further there is characterized a health-social worker in this part. The second part of my bachelor thesis deals with a research conducted on several randomly chosen workplaces staffed by health-social workers or social workers. The research was carried out in regions of Liberec and South Bohemia. The first aim was to find out a level of knowledge of the first aid at the health-social workers and the second aim was to map a frequency and characteristic of the provided first aid. I collected data in a quantitative form, a method of an interview, a technique of questionnaires. The result of the research shows that the health-social workers a social workers know how to do the first aid, they are only not sufficiently oriented at questions concerning fainting and bleeding from the nose. Most workers ticked in the questionnaire that they would be interested in the first aid course.
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Nursing care of patients with burn trauma.
HAVELKOVÁ, Martina
Burn trauma is very stressing for patients physically due to the high level of pain, damage to the skin and risk of infection, and also from a psycho-social perspective. There are currently several facilities dedicated to burn therapy. These are staffed by quality personnel with a high level of experience, who increase the hopes of patients to achieve better living conditions. Therapy depends on the extent of the handicap as well as other factors affecting the individual. Extensive burns require treatment in specialized facilities, where the patient is subject to a demanding and long-term therapy. Such patients are subject to multiple surgical procedures in total anaesthesia. The burn trauma has many complications during the healing process. The physician together with the nurse care for the patient and play a crucial role in this process. The patient will is subject to a long-term rehabilitation and complicated reintegration into society. We carried out a quantitative examination by means of 65 questionnaires handed out to general nurses, of which 58 could be used. The objectives of the thesis were met. We defined five hypotheses: H1: Nurses observe the principles of care for patients with burn trauma. H2: Nurses are aware of the effectiveness of rehabilitation treatment when caring for clients with burn trauma. H3: It is easier for nurses to provide care to patients with burn trauma if the patient is lying on an air bed as opposed to a standard bed. H4: Nurses cooperate with a clinical psychologist when caring for a patient with burn trauma. H5: Nurses cooperate with a nutrition therapist when caring for a patient with burn trauma. All the hypotheses were confirmed except hypothesis H3, which was disconfirmed. The research examination showed that nurses adhere to the principles of hygienic care for patients with burn trauma, and that they are aware of the effectiveness of rehabilitation treatment in burn care. Care for patients on an air bed is not easier for nurses than on a standard bed. On the contrary, it is physically more demanding. It was further confirmed that nurses cooperate with a clinical psychologist as well as a nutrition therapist when caring for patients with burn trauma. The diploma thesis is elaborated in such a way so that it can be used to create and present a standard, which will help to improve care for patients with burn trauma.
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Burns as a Nursing Problem
KROPÍKOVÁ, Eva
The name of the bachelor work is "Burns as a Nursing Problem", which is divided into the theoretical and the practical part. The theoretical part of the work deals with the general description of skin and its functions, the causes of burns, its extent and depth, principles of the first aid, rehabilitation and medical treatment of burns, the infection connected with burns, nursing care, nursing problems, nursing procedures, the principles of barrier care, education and psychological issues.In the practical part of the work are compiled three objectives, which were determined in advance. The aim was to chart the procedures used by nurses while treating burnt surface. The second aim was to ascertain the problems nurses see during the care about the patients with burns. The third aim was to ascertain whether nurses educate patients with burns.In the practical part the method of quantitative survey was used for the data collection, which was realized by the research form of questionnaires, all of them were completely anonymous and were consisted of 34questions. The questionnaires were handed in the hospitals in South Bohemia. Pisek´s hospital plc, Prachatice´s hospital plc, Tabor´s hospital plc and Ceske Budejovice´s hopital plc participated in the research survey. The respondents were nurses working in the surgical wards. For the achievements of aids were created four hypotheses. H1: Nurses use modern methods with healing wounds of burns. H2: Nurses perceive like a nursing problem to communicate with patients who have burns. H3: Nurses see a problem with the observance of nursing barrier care when patients have burn trauma. H4: Nurses educate patiens with burns.
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The level of first aid knowledge of lay public
RYBÁČEK, Jan
The level of first aid knowledge of lay public is the topic I have chosen for my thesis. By the term first aid, a set of simple procedures is meant, that, if provided by a proper way and in time, significantly increase the chances of survival of an affected person. The thesis deals with the issue of whether general (lay) public is aware of first aid procedure, including the first aid procedures in selected life threatening states. In the practical part there are clearly processed research results that are consequently compared in the discussion with the results of other authors. The data for research were gathered in the following towns in South Bohemia ? České Budějovice, Český Krumlov, Prachatice, Třeboň and Vimperk. The research file was made up by randomly selected lay respondents in South Bohemia. To gather the research data, I applied quantitative research realized by the method of questioning and the technique of a questionnaire. On the grounds of the evaluation of the questionnaire the pre-set hypotheses were proved or disproved. The objective of the work was to find out what is the lay public knowledge of first aid and also to reveal, whether the level of knowledge increases proportionally with increasing education. The last objective was to evaluate, why some people are either afraid or do not want to provide first aid. The research results show that the lay public knowledge of first aid is not sufficient. However, it is evident that level of knowledge increases with increasing education. Further it was revealed that the main reason for not providing first aid is ignorance of first aid procedures. The results of the thesis might be used for first aid education providers or to inform general public and also it can serve as a basis for further research in this field.
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Temperature injures in pre-hospital emergency care
PAJURKOVÁ, Romana
The content of my bachelor thesis of the title Thermic injuries in pre-hospital urgent treatment is a brief summary of this issue theory with the performed research whose task is to confirm the knowledge of medical rescuers concerning the attitude to these injuries. The theoretical part deals with certain thermal shocks ? hypertermiae, burns, hypothermiae and frostbites. In each of these conditions a simple pathophysiology, its division, symptoms, possible risks, lay (non-expert) first aid and special pre-hospital urgent treatment are described. The technique of content analyses of expert monographies as well as magazines in the electronic form were used at work with literature. The practical part deals with the research and the intention to determine the level of rescuers´ knowledge concerning this issue from the point of view of pathophysiological thermic injuries and ways of their tratment in the pre-hospital urgent care. To verify the hypotheses, the method of quantitative research was used. Data acquisition was realized through the method of questioning in an anonymous questionnaire, distributed to regional centres of health rescue service in Moravian-Silesian region. Out of the total number of 100 distributed questionnaires, 82 returned, the rate of return thus equalled 82 %. The research outcomes are stated in this thesis in form of graphs with percentage results. The hypotheses which were set at the beginning of the reserach have been confirmed. Practical skils as well as theoretical knowledge of Moravian-Silesian region rescuers respond in a high rate to expert literary sources and attitudes. Of course, even incorrect answers have appeared, however their amount has not exceeded 50 % in any of the questions. Despite this, I would like to publicize my thesis content, for example, on the Internet pages with the intention of a brief and clear acquaintance with this issue so that it could serve as a kind of instruction in case of little ignorance. Even we, paramedical workers, are only humans and make mistakes at times. Therefore I think it is important to know where to find help in case we are not completely sure.
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The ability of perform first aid by students of the high schools of Zlin region
SURÁ, Kristýna
In recent years, the term ``first aid{\crqq} has become an integral part of our lives. Due to the increasingly rapid lifestyle, we are everyday witnessing traffic accidents or accidents that occur while doing extreme sports. These, together with the ever-worsening lifestyle, cause acute diseases. High school students, children from 15 up to 19, live an almost carefree life. They are often interested in sports and other forms of entertainment that may produce events requiring their help and provision of first aid. Therefore my thesis deals with the ability of high school students in the Zlín region to provide first unqualified aid. The survey was conducted at Uherský Brod high schools by means of a quantitative research questionnaire. The first objective was to ascertain the knowledge, skills, and quality of the performance in the area of first aid provision. The first hypothesis I had stipulated predicted insufficient knowledge of first aid. The survey showed 73% respondents were successful. Therefore, this hypothesis was invalidated. My next objective was to identify the level of the students{\crq} interest in first aid training in their free time. Students prefer the Czech Red Cross and joining the voluntary fire brigade or the Scout Movement. However, membership in such activities is rare. The second hypothesis was to verify students{\crq} interest in first aid training. The questionnaire shows that students are interested but only in school classes. The last objective was to analyze the content of first aid classes at high schools. All high schools deal with the topic as part of the schooling. At trade schools, this is carried out in the form of ``Safety at Work{\crqq} training. At secondary trade schools, students of the secondary nursing school are invited to train students in first aid. At secondary grammar schools the topic is taught the whole school year, as part of ``biology practical training{\crqq} classes. To achieve even better results I suggest not only further schooling in the theoretical knowledge but also practical training of approaching the injured person and the basic communication with the wounded. I recommend making the activities that offer first aid training more attractive by using e.g. adequate illustrative aids.
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