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Oxygen therapy in newborns of nursing perspective
KADLEČKOVÁ, Zuzana
The thesis concerns the treatment of newborns with oxygen from the nursing perspective. Work has part of theoretical and of research. In the theoretical part I focus on the latest European Resuscitation Council best practices in the administration of oxygen as well as longer-term oxygen according to best practices of the Czech neonatology in inpatient Department. First, particular attention devoted to the reconstruction of the fetoplacental circulation of the newborn with subsequent changes in his lung and blood circulation after birth, because it is an integral part of the knowledge in the treatment of oxygen. The next section is devoted to the principles of the first treatment of the newborn, in particular with regard to the assessment of the postnatal adaptation and the decision to open the oxygen therapy by nurse or midwife assistant. The following are mentioned in the work at the same time valid recommendations for the resuscitation of the newborn, again with an emphasis on the question of the use of oxygen. In the next chapter is summarized the most common neonatal pathology, which requires oxygenotherapy. The following chapter covers ways to feed oxygen to newborns as early in the process of adaptation, so when a stay in the neonatal intensive care unit. There are described the proper techniques of monitoring and summarises the complications of treatment with oxygen in its inadequate application. Research section includes the identification of the knowledge of the nursing staff in the treatment of oxygen for newborns and then system in the education of nursing staff in matters of oxygen therapy. For research were established two objectives. The first objective is to map the knowledge of nursing staff in the principles of application of oxygen for newborns in the neonatal intensive care and resuscitation and in the birthing room. And the aim of the second was to determine what form is tutored by the nursing staff in the area of oxygen for newborns. On the basis of these objectives have been laid down 3 research questions. The first question is: What are the main differences between knowledge and best practice version of the nursing staff in the application of oxygen for a newborn? The second question is: Is the education of nursing staff in the resuscitation of the emphasis is on the practical implementation and on the systematic recurrence? And the third question is: How does the education staff in the principles of oxygen therapy beyond resuscitation? For research inquiries, he was elected qualitative research. For data collection have been used individual interviews with 5 children's nurses, who work in a specialized neonatologickém work in the field of neonatal intensive care units and in the field of bithings rooms of the Hospital Department in České Budějovice a.s. The Interviews were subsequently rewritten into a Bachelor's thesis and at the conclusion of the results of a detailed table was created, where results are presented. Of the investigation can be concluded that nursing staff have sufficient knowledges in the field of oxygen therapy in newborns and nursing and best practices in the application of oxygen. As regards education, which relates to the resuscitation of newborns is done regularly, once a year in the Department The results of the work could be used to identify deficiencies in training in the field of application of oxygen in resuscitation with the aim of directing the education of personnel in this area.
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Ethical aspects of decisions made about resuscitation of patients in the terminal phase of illness in prehospital care
UHER, Lukáš
One of the three contraindications to initiation of cardiopulmonary resuscitation is a condition where the patient is in the terminal stage of the disease. (Bydžovský, 2008) The patient's terminal condition of incurable disease must be diagnosed by a doctor, not a paramedic or other health professional. (Sláma, 2009) The paramedic can (...) initiate and perform cardiopulmonary resuscitation. (Decree 55/2011 Coll., §17, letter. B) In an atmosphere where over-optimistic presentation of resuscitation protocol outcomes is growing, many people believe that it is the only orrect procedure for circulatory arrest regardless of life stage or terminal conditions. This increases the pressure put on the rescuers and doctors in pre-hospital emergency care by loved ones and family members of victims of sudden circulatory arrest. A paramedic and a doctor may respond the fear of legal challenges for failure to provide heroic care by actually begining resuscitation on patients with end-stage disease, but with less emphasis on the frequency and depth of compression of the sternum against their knowledge and beliefs. This phenomenon is called "hollywood resuscitation." (Sláma, 2009) The purpose of this thesis is to outline the ethical issues of resuscitation on patients in the terminal phase of illness as perceived by emergency workers. The research question that I deal with is, ?How do emergency medical rescue service staff access the decision to resuscitate terminally ill patients with particular regard to the expectations of family members?? The introduction introduces the reader with the nature of the paramedic profession, the importance of resuscitation and my relationship to the topic. In the theoretical part I define terms such as emergency medical service, resuscitation and its indications and contraindications, medical law and terminal condition. To get the results I used qualitative research that I realized at Emergency Medical Service South Moravian Region. I asked ten basic questions. The research group consists of two male doctors, four female doctors and seven paramedics. The interviews show that the notion of hollywood resuscitation is not known, but resuscitation at the interface of ethics and justice is experienced by all. Four paramedics rate their actions as unethical, this leaves them with the feeling of disapointment in themselves and their profession. They feel forced into this bind by the legislation. For the other three paramedics ethics at the place of the event were either do not percieve or they transfered esponsibility to the doctor by calling him. All of these doctors were fully qualified and most of them have not launched the resuscitation against their ethical beliefs. Some doctors avoid the issue by speaking with sensitivity to the family, others by solving the patient's current difficulties and they get the general information about him later. To improve this situation by contributing quality education to families in the facility where the patient is monitored for his primary diagnosis. Another solution could be specific document outlining end of life choices as desired by the patient or card on which ?Do Not Resuscitate? direction is clearly given. According to these specific documents pre-event direction is given that will direct amendment the standard procedure for emergency medical services. The rescue workers will feel greater legal certainty. This final designation document solution will increase paramedic´s competences.
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The role of a medical rescuer during cardiopulmocerebral resuscitation in the ambulance crew of emergency rescue help,emergency medical help and randez vous system
HOKROVÁ, Iveta
The thesis surveys the performance of a rescue worker by cardiopulmonary resuscitation in a rescue team (squad) of emergency care. This care is provided by several kinds of squads ? by ALS (Advanced life support vehicles) ? large ambulance vehicles comprising a paramedic and a driver/rescue person), by RRV (Rapid response vehicles) ambulance carrying a physician, and also by the rendezvous system, where a physician works together with an ALS crew in situations when a patient's life or health is in serious danger. The theoretical part of the thesis deals with education and competences and powers of a medical rescue worker. Anatomic-physiological information on the heart, the respiratory system and the central nervous system follow. At the same time, the personnel of the medical rescue are explained and the emergency medical stations (bases) in Southern Bohemia are mentioned. Further on, the procedure during basic and extended cardiopulmonary resuscitation and the handling of external defibrillator are described. Then, the practical part follows. Its objective is to survey the competences of a rescue worker in the above mentioned emergency squads and the procedure by the cardiopulmonary resuscitation. The survey had the form of a questionnaire and 100 rescue workers from Southern Bohemia responded to 13 questions related to the cardiopulmonary resuscitation. The gathered results brought the answer to the third hypothesis. The geographical dislocation of emergency medical service stations of Southern Bohemia and the table of the stations of Emergency Medical Services of Southern Bohemia ? types of emergency rescue squads and their composition according to the type are enclosed in the appendix.
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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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Level of knowledge of midwives and pediatric nurses for oxygen therapy in neonates and infants
JIRÁKOVÁ, Nikol
Abstract The theoretical part of the thesis focuses on oxygen therapy of mature and premature newborns, particularly as a part of resuscitation. The thesis summarizes general findings about postpartum adaptation of individual groups of newborns and about immediate care provided in the delivery room. The theoretical part also deals with a nursing care of newborns and young babies requiring ventilation support in the hospital neonatology ward. The practical part surveyed both theoretical knowledge and practical skills of pediatric nurses and midwives. The survey used quantitative inquiry and observation. Anonymous questionnaires were distributed to midwives and pediatric nurses working at the gynecology-obstetrics and neonatology wards in the hospitals in České Budějovice (Nemocnice České Budějovice, a. s.) and in Benešov (Nemocnice Rudolfa a Stefanie Benešov, a.s.) The observation was conducted during my practice at the neonatology ward in the hospital in České Budějovice. The thesis had one formulated objective and two related hypotheses. The objective was to determine the level of knowledge of midwives and pediatric nurses about the principles of treatment of newborns and young babies with oxygen. The objective has been met. Hypothesis 1: ?I believe that the level of knowledge of midwives and pediatric nurses about the oxygen treatment of newborns and young babies is sufficient? has been confirmed. Hypothesis 2: ?The nursing team in the delivery room is familiar with the current recommendations for application of oxygen during resuscitation of newborns in the delivery room? has been confirmed. This bachelor degree thesis may serve to future students of midwife profession as a study material and source of information. Moreover, the thesis might be used as an educational material for midwives and pediatric nurses working in delivery rooms and at neonatology in-patient wards.
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Pectoris angina as a symptom of acute myocardial infarction in urgent care
ŠVORC, Jaroslav
This dissertation deals with the topic of stenocardia as the symptom of an acute myocardial infarction in prehospital emergency care. The goal of my work is to map the time lag from the first symptoms of an acute myocardial infarction to giving an urgent non-hospital first aid. The introductory part summarizes basic terms of anatomy and physiology of the considered system. The theoretical part of my work includes an ischemic disease and the most frequent risk factors which patients bear. The theoretical part is mainly dedicated to an acute myocardial infarction, i.e. its origin, symptoms, diagnostics, and treatment. The final part deals with issues concerning education of a patient from a medical rescuer's point of view. My work also involves a research part including the file of patients with diagnosed acute myocardial infarction. I nave got the data using retrospective analysis of the outgoing cards of the patients of the Medical Rescue Service Team of Ústí Region, with diagnoses of an acute myocardial infarction. The data has been processed into a table from which other graphs and tables in research part result. It observes the time lag from the first symptoms of an acute myocardial infarction to calling for help and giving an urgent non-hospital first aid. I also follow the main symptoms of an acute myocardial infarction (pain, propagation of pain). The research part results into conclusion, that the majority of patients calls for Medical Rescue Service Team within 3 hours after appearing the first symptoms of stenocardia. The patients mainly call for help within 1 hour after the first problems appear in this 3 hours interval.
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Need of a resuscitation standard in inpatient medical facilities
DLOUHÁ, Hana
The diploma paper presents a brief overview of the development of resuscitation in the world and current recommendations for resuscitation by the European Resuscitation Council. Also included is a description of basic diagnosis of a sudden cardiac arrest, providing vital functions, including the use of alternative materials and the problems of resuscitation in hospitals. Providing effective resuscitation is reflected in the quality of care provided, which is much emphasized nowadays, especially for the accreditation of medical facilities and the creation of standards for nursing care. The objective of this paper is to determine and compare the extent of knowledge of nurses in the inpatient departments of emergency cardiopulmonary resuscitation at two hospitals, one of which uses a standard resuscitation. Another objective is to create a resuscitation standard for nurses at inpatient departments, submit it to involved nurses for assessment and to determine to what extent the created resuscitation standard contributes to the work of nurses who have not used it yet. The first research question is: How do nurses view the newly created standard? The second research question is: Will nurses appreciate the contribution of the created standard? A given hypothesis implies a greater knowledge of nurses who use the resuscitation standard, than nurses who do not use it. The first phase used a quantitative survey using the questionnaire technique; skills and knowledge of nurses were mapped at two medical facilities, one of which uses a resuscitation standard valid for the entire facility. The questionnaire included 34 items, 21 questions dealt with the knowledge of nurses surveyed, and 13 questions mapped demographic data, work organization and the respondents{\crq} workplace experiences with resuscitation. Based on the results of the quantitative survey, the hypothesis has been confirmed. The results also unveil weaknesses in the training of medical personnel at both hospitals and the surveyed nurses{\crq} knowledge. In the second phase of the survey, nurses who did not have a resuscitation standard were presented with the resuscitation standard version for assessment. The assessment of the standard was carried out with qualitative survey using semi-standardized interviews with senior nurses at nursing stations. These nurses assessed the presented resuscitation standard positively; they welcome its presence and see its benefits in improving nursing 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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Professional drivers and first aid
KŘÍŽOVÁ, Radmila
The thesis called ``Professional drivers and first aid`` is concerned with professional drivers´ knowledge of providing first aid and their further education in this field. Based on the statistics a car accident occurs every three minutes and a man dies in car accidents every eight minutes. To save men´s lives the first minutes are the most important. Professional drivers are regularly trained in traffic regulations but health care preparation is not usually included or it is only a side issue. A quantitative research was accomplished and the objectives and hypotheses were stated. The data were collected through an anonymous questionnaire containing 29 questions. The questionnaires were distributed to professional drivers in the districts of Jihlava and Znojmo. The research set consisted of 112 respondents with the prevalance of lorry drivers. The research proved that the drivers know emergency call numbers. They know how to provide first aid but they are not informed of new methods, especially in resuscitation. Most drivers admit that a regular training of first aid should be included in professional trainings and the education in this field is unsufficient. The research indicated that professional drivers need more training of first aid as well as other people.
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First aid´s Knowledge of Emergency Units
MORAVCOVÁ, Marta
Increasing number of life and health threatening emergency events causes significant financial and environmental damage. With their large range and destructiveness these events compel an effective communication of the available rescue capacities. This increase was the crucial moment for commencement of a development of such system which would join all the necessary establishments predetermined for dealing with a specific emergency situation and concurrently which would become an effective tool for its handling. Such system nowadays is the Joint Rescue Service. The basic establishments within the Joint Rescue Service are the Fire Brigade of the Czech Republic, the Medical Rescue Service and Police of the Czech Republic. Mutual collaboration during actions is co-ordinated and requires permanent co-operation, especially when securing personal safety of rescue groups of the Fire Brigade and Police. It is beneficial when members of these establishments are educated in the area of first aid application as also during the actions lives of these people are often threatened and only the immediate first aid in place may be the crucial prognostic factor. The objective of my Bachelor Thesis was to map the knowledge of first aid application at the basic emergency establishments within the Joint Rescue (Police of the Czech Republic and the Fire Brigade of the Czech Republic). The research group consisted of members of police and fire brigade of the South Bohemian Region. Data collection was in form of a questionnaire provided to be filled in. I distributed the questionnaires personally as I wanted to discuss the relevant topic with the police and fire brigade members and to know their opinion. The research proved that both the members of the Fire Brigade and Police of the Czech Republic are very well prepared in terms of the theory of first aid application to an injured person. The established system of education of policemen and fire brigade men rescuing people in need of first aid is probably functional and provides policemen and fire brigade men with enough information on fist aid basics. Although policemen have less practical experience it does not mean that they would not be able to apply first aid to an injured person. Both rescue services are well prepared for helping an injured person.
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