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Use of capnometry in emergency care
CIMICKÝ, Vít
The first half of the theoretical part of the work is focused on the physiology of respiration and the effect of carbon dioxide in the human body. The second half of the theoretical part focuses on defining the concept of capnometry, how it is measured and also on the states in which it is used. For specific conditions, it is described why it is used and what limitations it has. The practical part consists of the survey and the results that came from it. The survey was conducted through a semi-structured interview containing eleven questions. Six non-medical health professionals, who represent various positions at the Medical Rescue Service of the South Bohemian Region, joined the interview in April 2022. The aim of the research was to map the frequency and regularity of the use of capnometry in prehospital emergency care. The research answered all the researched questions. Objectively, the goal of the work was only partially fulfilled, based on a small amount of data obtained. However, these data are very similar and supported by recurring arguments. The analysis of the results showed a low frequency and a high rate of irregular use of capnometry in prehospital care. The main reason is the low and irregular occurrence of conditions requiring capnometry measurements.
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Invasive monitoring in intensive care
CUPER, Tomáš
Invasive monitoring is a repetitive, durative observation of physiological functions of a patient and functioning of apparatuses which serve as support of these functions. It is thus an active, repetitive and continuous process when both the patient and the medical apparatuses are regarded. The human factor is thus essential and vital. The reason for application of the invasive monitoring during an intensive hospital care is above all the ability to support physiological functions of a patient, at the same time, it serves to timely detect divergences in physiological values; it very often effectively helps in further decision-making of medical interventions, and clarifies the effectiveness of patient´s treatment. The theoretical part of this bachelor thesis deals with the issue of invasive monitoring in intensive hospital care. The beginning of the thesis provides an explanation what actually the invasive monitoring means, and clarifies and characterises intensive medicine and monitoring in general. The individual types of invasive monitoring are divided according to areas of basic living functions in cardiovascular, respiratory, and central nervous system. With every type of invasive monitoring comes an explanation and clarification of it, further, generally indicated and contraindicated statuses are provided, along with instruments and the way monitoring is applied. The theoretical part is concluded by a chapter that deals with general nursing care. The practical part focuses on mapping of the most often used types of invasive monitoring given critically ill patients in Anaesthesiology and Resuscitation wards, and Urgent Admittance wards in hospitals of the area of South Bohemia, and the region of Carlsbad, and mapping of knowledge of staff of Anaesthesiology and Resuscitation and Urgent Admittance in the particular regions given invasive monitoring. The research was implemented by a quantitative method using a printed standardised questionnaire. The amount of data was collected in March 2014. The target group of the research was a team of general nurses and paramedics, who work in Anaesthesiology and Resuscitation wards and Urgent Admittance wards. The anonymous questionnaire was handed out 100 exemplars for hospitals in South Bohemia, and 100 exemplars for hospitals in the region of Carlsbad. In South Bohemia, there were picked the hospitals in České Budějovice, Jindřichův Hradec, Písek, Prachatice, and Tábor, there. In the region of Carlsbad, there were picked the hospitals in Cheb, Carlsbad, and Sokolov, there, to fill in the questionnaire. There took part 141 respondents in the research. The total amount of responses out of 200 exemplars (100%) of the questionnaire thus reached 70, 5%. The questionnaire contained the total of 28 questions, out of which the opening 4 were stratification-like, question nr. 5 was closed, question nr. 6 were half-open and the remaining 22 questions were dealing with knowledge of respondents in the issue of invasive monitoring in intensive care. The results were progressed by the statistic programme SPSS into well arranged tables, and the set hypotheses were statistically evaluated with help of X2 square test. The goal of this bachelor thesis was to map the most often used types of invasive monitoring with critically ill patients in Anaesthesiology and Resuscitation wards, and Urgent Admittance wards in hospitals of South Bohemia, and in region of Carlsbad. This goal was fulfilled. The next goal was to map knowledge of invasive monitoring given staff of Anaesthesiology and Resuscitation wards, and Urgent Admittance wards in hospitals of South Bohemia, and in region of Carlsbad. This goal was fulfilled too. Statistically evaluated questionnaire proved that the workers have the knowledge in the area of treatment, hemodynamic values, as well as techniques in taking care of critically ill patients in Intensive Care wards.
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Ventilation support in prehospital care and during transport of the patient
PETROVIČ, Pavel
The topic of presented bachelor thesis is ventilation support in prehospital care and during transport of the patient. Consciousness, breathing and blood circulation belong among basic life functions. Thanks to ventilation support we are able to provide full or partial pulmonary ventilation. For this we use aids such as resuscitation masks meant for lay public or aids for trained paramedics like laryngeal masks, endotracheal tube and ventilator for artificial pulmonary ventilation. Prehospital care is not only about professional first aid, but about giving first aid by lay public as well. That is why aids for pulmonary ventilation are included in this thesis. This bachelor thesis had two aims; to map and compare knowledge of students attending the last year of high school in kiss of life and map experiences of paramedics with a laryngeal mask Supreme and capnometry. The research was implemented with mixed method research. Knowledge of students were found out by tests which were give in class "Z4" at Střední odborná škola veterinární, mechanizační a zahradnická a Jazyková škola s právem státní jazykové zkoušy and in class "4.B" Gymnázium Jírovcova. At Z4 class research took place on 14th March 2014. There were 25 students in this class, 4 men and 21 women. At class of 4.B students' knowledge was tested on 2nd April 2014 with presence of 26 students, 16 women and 10 men. At the beginning of test the anonymity of respondents was stressed, and then all respondents were acquainted with the character of my research and its aim. At the start of the test there were two statistic questions; if the respondent is either man or woman and whether the respondent has his/her driving license. There were 15 closed questions in the test and students were supposed to choose one right. After handing all the tests, the correct results were told to students. 51 tests altogether were given. Experiences of paramedic with the laryngeal mask and capnometry were found out in a form of five short dialogues in a week from 7th to 11th April 2014. The research group include paramedics of Zdravotnická záchranná služba Jihočeského kraje. Gained data from tests were evaluated, each question separately and then transformed in graphs which show the number of wrong and right answers. The aim of this thesis was to map and compare knowledge of students in the last year of their studies. Evaluated tests show us, that students of Z4 class have more knowledge about kiss of life or with cardiopulmonary resuscitation. In seven questions these students were more successful than their same-age colleagues from Gymnázium, who were better at three questions only. Experiences of paramedic with laryngeal masks Supreme are positive and if ensuring of air passages is needed, when a doctor is not present, they choose LMA Supreme. Paramedics agreed on that following ventilation via LMA Supreme is sufficient as long as we choose the right size. Paramedics ask for capnometer device in all cars EMS. Paramedics of the research group do not daily meet patients who would need or used at controlled ventilation. Students of the last year at high school have basic knowledge about kiss of life or about giving first aid. This knowledge is not 100% and teaching of giving first aid should be as a subject at high schools. Paramedics accept new aids and machines and use them during their practise. Thanks to this, first aid is becoming more beneficial for patients and for paramedics.
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