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Patients discomfort after surgery operation, possibilities of prevention
Schmidt, Matouš ; Málek, Jiří (advisor)
The patients in the postoperative period have a group of symptoms called "postoperative disease". It springs from global reaction of human organism to the surgical intervention, anesthesia and the disease that was the reason for the operation. The somatic symptoms of this "postoperative disease" can be palliated by many different methods. From the anesthesiological view it is mainly a pain and postoperative nausea and vomiting (PONV). For the pain management it is necessary to apply individual admission to treatment and exploitation of every available method to ensure maximal possible decrease of patient pain level. In the case of postoperative nausea and vomiting it is necessary to identify the patients with increased chance of PONV and use every possibility for prevention. This means mainly preoperative exhibition of antiemetics, prokinetics and the anesthesiological technique. This work includes questionnaire research achieved on 71 patients after surgical operation. From this study emergesthe fact that even if the patients evaluate the postoperative treatment as good, here is possibilities for more effective analgetic therapy, mainly using the combination of opioids with non-opioids analgetics. In the case of the postoperative nausea and vomiting it is important enhance of prevention for patients with...
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Anaesthesiology nursing care of the patient during the hip joint replacement surgery
Miketová, Štěpánka ; Zvoníčková, Marie (advisor) ; Málek, Jiří (referee)
Ke své bakalářské práci jsem si vybrala téma anesteziologická ošetřovatelská péče o pacienta v průběhu náhrady kyčelního kloubu. Jako anesteziologická sestra se s touto operací setkávám velice často a tímto způsobem jsem chtěla přiblížit práci anesteziologické sestry. Jelikož jsem se ještě nesetkala s uplatňováním ošetřovatelských modelů v práci anesteziologické sestry, pokusila jsem se touto formou jeden aplikovat. Ke své práci jsem proto použila ošetřovatelský model Virginie Henderson, který se dle mého názoru dá využít i v této oblasti.
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First aid skills and attitude to saving life among students of non-medical secondary schools
Štěchová, Jana ; Málek, Jiří (advisor) ; Klicperová, Zuzana (referee) ; Švarcová, Eva (referee)
The aim of my thesis is to answer the question whether students of non-medically oriented secondary schools are able to provide cardiopulmonary resuscitation. I also asked about their attitude to saving life. In the theoretical part, I focused on the history of first aid, defined terms and also described cardiopulmonary resuscitation procedures according to 2005 Guidelines. The practical part brings data obtained from questionnaire survey about willingness and ability of participants to provide cardiopulmonary resuscitation. I found that despite the majority of responders would want to help, much less can do so, probably because of insufficient teaching and practicing of first aid skills.
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Hemodynamics in the early stages of the critical illness and in the perioperative setting
Beneš, Jan ; Kasal, Eduard (advisor) ; Málek, Jiří (referee) ; Kroužecký, Aleš (referee) ; Adamus, Milan (referee)
Beneš J.: HEMODYNAMIKA V ČASNÉ FÁZI KRITICKÝCH STAVŮ A PERIOPERAČNÍ MEDICÍNĚ - Využití méně invazivních monitorovacích prostředků k cílené hemodynamické péči ABSTRACT Hemodynamic instability occurs very often in critically ill patients and during the perioperative period. Insufficiency in the preload, contractility and afterload contribute in major part to this phenomenon. Hemodynamic monitoring allows clinicians to recognize and to intervene early the underlying cause. Due to new technologies development in recent years it is possible to provide continuous monitoring of hemodynamic parameters with diminished invasivity. Hemodynamic optimization and goal directed therapy show treatment benefit in some groups of critically ill patients and mainly during the perioperative period. Aim of hemodynamic optimizations is to attain the best obtainable hemodynamic conditions with use of fluid loading and inotropic support. In many studies in recent years goal-directed therapy was associated with morbidity and mortality reduction. According to the results of our clinical research hemodynamic optimization using stroke volume variation and minimally invasive device based on the pressure wave analysis is feasible and show the same results as other works with more invasive devices. Key words Hemodynamic monitoring,...
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Optimization of Hemodynamics of Trauma Patients in Intensive Care Using Transesophageal Doppler Monitoring
Pradl, Richard ; Chytra, Ivan (advisor) ; Málek, Jiří (referee) ; Šrámek, Vladimír (referee)
Esophageal Doppler was confirmed as a useful non-invasive tool for management of fluid replacement in elective surgery. The aim of this study was to assess the effect of early optimization of intravascular volume using esophageal Doppler on blood lactate levels and organ dysfunction development in comparison with standard hemodynamic management in multiple-trauma patients. This was a randomized controlled trial. Multiple-trauma patients with blood loss of more than 2,000 ml admitted to the intensive care unit (1CU) were randomly assigned to the protocol group with esophageal Doppler monitoring and to the control group. Fluid resuscitation in the Doppler group was guided for the first 12 hours of ICU stay according to the protocol based on data obtained by esophageal Doppler, whereas control patients were managed conventionally. Blood lactate levels and organ dysfunction during ICU stay were evaluated. Eighty patients were randomly assigned to Doppler and 82 patients to control treatment. The Doppler group received more intravenous colloid during the first 12 hours of ICU stay (1,667±426 ml versus 682±322 ml; p < 0,0001), and blood lactate levels in the Doppler group were lower after 12 and 24 hours of treatment than in the control group (2,92±0,54 mmol/1 versus 3,23±0,54 mmol/1 [p = 0,0003] and 1,99±0,44...
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