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Compartment syndrome in pre-hospital urgent care
BENEŠOVÁ, Lucie
This bachelor thesis focuses on conditions associated with compartment syndrome development in prehospital care. Pressure increase in a closed anatomical space is characteristic for this condition, leading to circulation and neural sensitivity affection in the specified area. In the prehospital care, we may meet with the compartment syndrome in fractures, burns, allergic reactions, traumas caused by an accident, electrotraumas; further in crush syndrome, traffic accidents, craniocerebral injuries and other conditions associated with swelling. This thesis focuses on burns, fractures, electrotraumas, intra-abdominal hypertension and conditions caused by snake bite. Inconsiderate or inadequate manipulation with affected patient may worsen his/her condition and lead to deterioration of his/her health condition or even fatal consequences. The aim of this thesis was to map the theoretical and practical knowledge of non-medical health care professionals working in prehospital care, in treatment of conditions able to delay compartment syndrome development or even to accelerate it. Data collection for the research was performed using questionnaires and semistandardised interviews. Questionnaires were filled by 20 randomly chosen respondents. 12 respondents were interviewed. Correct answers evaluation is listed in the tables in the practical part of this thesis. Interviews transcript is a part of the practical part as well, with colour coded correct and incorrect information provided by the interviewed medical rescuers. A sample test and list of posed questions with sub-questions are included in the attachment. Both parts of the research were performed with medical rescuers and general medicine nurses working at medical rescue services of southbohemian region and the region of Vysočina. The research found that the term of compartment syndrome is well known by medical rescuers and general nurses working at medical rescue services. However, they are not aware of its association with prehospital care. In some cases, the answers of the responders differed significantly, as for treatment of acute conditions associated with this problem, from the recommended procedures according to the literature. Furthermore, the research analysed the type and amount of used fluids in pre-hospital care. This question showed interesting findings as well. Lastly, the research analysed the options of acute fasciotomy in circular neck burns in prehospital care. The respondents interpreted this procedure as life-saving, as this condition is life-threatening for patients and quick transport without releasing incisions is very risky. It is a procedure that should be known to medical rescuers, at least at the theoretical level, and considered life-saving, even if they do not have sufficient competences to perform it. Respondents showed interest and effort for deepening of their knowledge about this procedure during the research. This situation may be improved by additional training in traumatology, surgery and intensive care not only in medical rescuers working in medical rescue services, but in students of these specialisations as well. This thesis could be a base for deeper investigation of this topic, currently insufficiently known; furthermore, for increasing specialised knowledge of medical rescuers in treatment of oedematous conditions and increasing of health care quality in prehospital acute care.
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