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Bronchial asthma in the practice of paramedic
ŠEBEST, Jakub
Astma bronchiale is a lifelong chronic respiratory illness which affects all the age categories of population. The aim of this final work is to obtain knowledge and to analyse paramedics´ approaches used during a diagnosis and providing prehospital urgent care to patients affected by this illness.The bachelor´s work is divided into a theoretical and a research part. The theoretical part deals with the anatomy of the respiratory system, process of breathing, diagnosis and treatment in prehospital urgent care.The research of this work was realized by using recorded interview with paramedics. The aim of this research is to show the reader more viewpoints to this issue and to outline the experience of paramedics with treatment of this illness. This research demostrates that paramedics get in contact with the asthma bronchiale several times in a month, they are familiar with this illness and they know methods of its treatment. The result of the work shows how difficult the diagnostics of this illness is. Differential diagnostics also points to broad-spectrum of illnesses. Eventually, we can also enroll a wrong feedback between emergency service and medical facility. Results of this work in the theoretical part help the reader to get objective information about this matters, diagnostics and treatment of this illness in prehospital urgent care. The main contribution of this work should also be the view to the methods, approaches and experiences of paramedics during the treatment of the asthma bronchiale in prehospital urgent care. The output of the bachelor´s work is a brief manual for paramedics showing how to proceed during diagnostics and treatment of the asthma bronchiale.
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Pulmonary embolism in the practice of paramedic
KAHOUNOVÁ, Šárka
The bachelor thesis discusses the issue of states of dyspnoea, specifically pulmonary embolism from the perspective of a paramedic working in the area of pre-hospital emergency care. In the theoretical part, a brief characteristic of pre-hospital emergency care is given, the paramedic branch is briefly defined and further on, the basic anatomy and the physiology of the circulatory and respiratory systems is given. Dyspnoea is defined from a general perspective, its causes, diagnosis and risk factors are mentioned. Diagnostically and therapeutically, the thesis is focused on specific characteristics of dyspnoea within pulmonary embolism, including the main causes of their origin. The research part of the thesis was implemented based on semi-structured, anonymously processed interviews. The research file was made of randomly chosen paramedics of the Ambulance in South Bohemia and Central Bohemia. The analysis of the obtained data was focused on the awareness of the paramedics themselves concerning the given issue of dyspnoea, including the presentation of their perspective on the implementation of professional preparation in the dyspnoea issue from their employer´s side. Further on, the procedures of differential diagnosis and pulmonary embolism treatment in pre-hospital emergency care were evaluated. The implemented research has found out that the paramedics from South Bohemia are not sufficiently educated in the issue of dyspnoea, including pulmonary embolism. The paramedics from Central Bohemia are, compared to that, educated by the relevant educational and training centre, educated enough concerning states of dyspnoea. Based on the findings, the thesis results might be presented to the educational and training centre of the South-Bohemian and Central-Bohemian Ambulances to perhaps consider the future aiming of educational and training programmes concerning dyspnoea issues, including the specific aiming at the awareness about pulmonary embolism diagnosis and therapy.
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Evolving needs of patients with chronic obstructive pulmonary disease
KAŠPAROVÁ, Iveta
Nowadays chronic obstructive pulmonary disease (COPD) is considered to be a global and all society problems. COPD interferes in all aspects of patient´s life. It implicates limitations to physical aspect which is the cause of psychological and social effects. The disease changes the present way of patient´s life, the patients have to change their lifestyle, adapt themselves and learn new habits which can also mean changes of their needs during the COPD. The thesis deals with the problems of COPD patient´s needs. The thesis is divided into two main parts. The theoretical part focuses on characteristic of the disease, classification and hierarchy of human needs, the effects of COPD on biological, psychological, social and spiritual needs and next on the nursing care for patients with COPD. The practical part of the thesis includes the processing and next the evaluation of the dates obtained during the research. The aim of the thesis was to findout how the patient's needs differ in particular stadium of the disease. To get the aim there were determined six research questions:1) What is the knowledge level of COPD patients? 2) How different are their needs in particular stadium of the disease? 3) Which needs predominate in individual stadium of the disease? 4) Which activities can COPD patients do? 5) Which limitations and problems do COPD patients have? 6) Which needs does a COPD patient have in the field of home oxygen therapy? The method of qualitative research was used for the research. The technique of non-standardized interview was used for the data gathering. The research complex was formed by 15 COPD patients from the first to the third stadium of the disease. There were five patients in each chosen stadium. The evidence of the individual patients were divided according to their specific stadium into particular categories: knowledge of the disease, respiration, sleep, lifestyle, profession, check-ups. The research shows that the need changes did not directly depend on the level of the disease stadium, but mainly on the patient´s facing up to the disease, their total state of health and based on their individual needs. The firstand second stadium patients gave as the most common need to have their medicines permanently at their disposal, next the bigger need of sleep and rest and last but not least the need of being more independent. The progress of needs in the third stadium was different according to using of home oxygen the therapy or not. The patients who use home oxygen therapy coincided that the therapy helped them to improve their life. Now the main need is to increase their independence in household activities and to besurrounded by their family. Some COPD patients have demonstrable common symptom of depression which consequently influences physiological needs such as sleep, rest, independence and also their total self-realization. The need changes significantly affected the field of life habits, regime,lifestyle and leisure time activities. First of all there has been the absence of cigarettes and alcohol among their life habits and regime. There have been some limitations such as fishing, riding a bike, mushroomingin leisure time activities. The lifestyle was affected the changes in family and work life. The patients often suffer from dyspnoea, which subsequently limits walking, household activities, self-service,for example: shopping, meal preparing, dressing or doing personal hygiene. Despite various limitations the patients do various activities like walking dogs, strolling, reading books, watching TV, visiting clubs and other interesting culture events. The research results pointed to insufficient level of knowledge of the COPD patients. Due to the low level of the patients´ knowledge of the disease an information material with basic information about the disease was prepared.
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Differential diagnosis of dyspnoea in the prehospital emergency care
JENÍČEK, Petr
The bachelor work is devoted to the topic of differential diagnostics of dyspnoea in prehospital emergency care. The issue of dyspnoea is still very relevant because of number of diseases causing it. The theoretical part of this bachelor work contains basic information about terms of dyspnoea, differential diagnostics and examination methods with regard to the dyspnoea. The most often incidence of dyspnoea is generally associated with cardiac and pulmonic diseases. There are also described additional diseases caused by other reasons, i.e. the carbon monoxide intoxication, anemia or hyperventilation, which are often occurred in prehospital emergency care and therefore could be difficult to distinguish from the pulmonic dyspnoea. In particular for paramedics, distinguishing the cardiac or pulmonic dyspnoea from the dyspnoea caused by other reason could be difficult. The examination methods in prehospital emergency care currently available for paramedics are very limited, which can make the fieldwork diagnostic of dyspnoea more difficult. The research was realized by the standardized half-structured interviews with the paramedics working at Emergency service of South Bohemian region. The surveyed group was composed of 14 respondents from all regional centers of Emergency service of South Bohemian region. Selected respondents were at all age categories varying in the length of the praxis at the emergency service, educational background and also in the composition of ambulance crew. The respondents answered 20 prepared questions regarding the knowledge and experience with dyspnoea. The research was aimed to the knowledge of paramedics in the field of differential diagnostics of dyspnoea in prehospital care and also to the difficulty of determination of working diagnosis based on examination methods available for paramedics in prehospital emergency care. Results of the research were summed up into the tables and consequent results are included in the discussion. The first goal of the research was to monitor the knowledge of paramedical staff about differential diagnostics of dyspnoea in prehospital emergency care. The second goal is aimed to monitoring the difficulty of working diagnosis assessment of dyspnoea associated with possibilities of diagnostics in prehospital emergency care. Two experimental questions were elected for research. The first question is dealing with the enough knowledge of paramedics for correct differential diagnosis of dyspnoea in patients in prehospital emergency care. The second experimental question is addressed to the dyspnoea, diagnostics possibility in prehospital emergency care for paramedics and whether it is complicated symptom for working diagnosis assessment. Based on interviews results, the insufficient knowledge of paramedics in most cases of dyspnoea are evident. Paramedics with university degree are more educated in this field. The big lack of knowledge related to dyspnoea lies also in the education of paramedics in the Emergency service of South Bohemian region. Respondents also mentioned the absence of primarily focused course on dyspnoea. The theme is obviously discussed during the course of Emergency service of South Bohemian region only in connection with another theme. Therefore, the big lack of necessary information is obvious. Regarding the insufficient education of paramedics the problem of wrong dyspnoea diagnostics in prehospital emergency care could be closely related. Commonly, paramedics treat cardiac and pulmonic dyspnoea. However, research results emphasize the problems with working diagnosis assessment, necessary for subsequent treatment and targeting the patient. Concerning the gravity of some diseases causing dyspnoea, the incorrect diagnostics could be fatal for patient.
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Specifics of nursing care for clients with chronic obstructive pulmonary disease.
DVOŘÁKOVÁ, Romana
The chronic obstructive pulmonary disease is characterized by the restriction of air flow in the bronchi. It is a combination of two diseases: chronic bronchitis and pulmonary emphysema. Because the symptoms of both diseases blend, the joint name ?chronic obstructive pulmonary disease? is used. It is a neutrophil inflammation that causes irreversible changes. The most common cause of the disease is smoking tobacco products.The aim of this bachelor?s work is to determine the specifics of nursing and refer to the specific needs of patients. If nurses should provide high-quality care, they must be aware of these specifics when treating patients with this particular disease. The role of the nurses in this area is very important as they must approach patients individually. The nurses provide specific nursing care and educate patients. The theoretical part of the work focuses on the characteristics of the disease, its causes, treatment or prevention and nursing activities performed by nurses. The practical part of the work was processed in the form of qualitative research by means of a semi-structured interview. The research sample was represented by patients from pulmonary hospitals and pulmonary departments of hospitals in the Plzeň region and the Central Bohemian region. In total, eight respondents participated in the research. According to interviews, case reports were executed based on which categorized tables were executed with the most interesting data.It arises from the results that the chronic obstructive pulmonary disease brings various problems, and a patient and nurse must be able to solve them and be aware of them. Further, it is obvious that informedness of patients, and the wider public, could be more detailed because this disease stands on the first place in the list of civilization diseases and there are increasingly more patients with this disease. Thus, a brochure was executed based on the results with the aim to provide information about chronic obstructive pulmonary disease.This information brochure can be used for study purposes or for patients with this disease.
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