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Crush syndrome from the perspective of the paramedic
TARAS, Ivan
The topic of the bachelor thesis is Crush syndrome from the perspective of the paramedic. In the theoretical part of the work, readers can learn what the crush syndrome is, when and in what situations it arises, what processes take place in the affected person's body, how it then manifests itself and what is its therapy. In the practical part, one goal was chosen. To map the level of awareness of non-medical medical staff about the issue of crush syndrome. A qualitative method of data collection in the form of semi-structured interviews was used to process the research set, where there were 7 main questions, on the basis of which the interviews were further developed. The research sample consisted of 12 respondents. 6 paramedics performing their service in pre-hospital emergency care and 6 members of nursing staff performing their profession in an acute care inpatient facility. The output of the bachelor's thesis is an overview that shows the awareness of the respondents about the issue of crush syndrome. It draws attention to minor shortcomings in both theoretical and practical knowledge of the issue. The work could serve as a basis for a better understanding of crush syndrome in the training of paramedics.
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Nursing care of patients with the compartment syndrome
KRČMOVÁ, Tereza
The bachelor thesis "Nursing Care of a Patient with Compartment Syndrome" surveys the specialities of a nursing care about a patient with this syndrome. As the care of such a patient is highly specific, a nurse is supposed to have enough information about this issue. The theoretical part deals especially with preventive precautions, syndromes, diagnostics, treatment, perioperative period, complications and furthermore also a care after releasing a patient for home care. The empiric part is based on a qualitative survey construct. A data collection is based on half-structured interviews. The aim of the thesis was: 1. To find out specialities of the care of a patient with this diagnosis. 2. To reveal possible complications concerning a patient with a developing compartment syndrome. From the results of a survey research emerged that despite small faults, the questioned nurses provide the patients with a high quality nursing. It was found out that the nurses highly appreciate preventive precautions with which they try to prevent a compartment syndrome development. According to obtained information, the nurses contact a doctor immediately in case of alarming symptoms. The doctor deals with the diagnostic and following treatment measures. It was detected that the provided care is varied because a nurse takes care of a patient both before and after the operation. Furthermore, it was revealed that a care of a patient after fasciotomy does not differ substantially from a common care provided by nurses for other patients.
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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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Crush syndrom in prehospital care
JENDŘEJASOVÁ, Tereza
The issue of the Crush syndrome in pre-hospital care is not a topic into which new findings are often brought by science workers. All the currently known and available knowledge about the Crush syndrome has not changed for decades. In part this is caused by the difficulty in pre-hospital emergency care to determine whether the condition signifies the Crush syndrome or also a hypovolemic shock resulting in kidney damage. In the Czech Republic there are neither big earthquakes, fortunately nor major landslides, and yet from time to time such an event occurs. That is why today it is more and more desirable that paramedics should be theoretically well prepared for such interventions. The purpose of this study was to survey and compare theoretical knowledge of paramedics working at the Emergency Medical Service of the South Bohemian and the Central Bohemian regions, including the ability to utilize this knowledge in practice. In the study quantitative and qualitative research was used. The quantitative part of the research mapped, using anonymous structured questionnaires, the theoretical knowledge of paramedics working at the Emergency Medical Service of the South Bohemian and the Central Bohemian regions in terms of the Crush syndrome issue. The results of the quantitative research have proved very good knowledge of the Crush syndrome issue in both regions and thus the hypothesis has been verified. The qualitative part of the research identified, through structured interviews with three respondents from the Central Bohemian region and three respondents from the South Bohemian region, the practical connection of theoretical knowledge directly in the field in a client with developing Crush syndrome. The knowledge was assessed as sufficient to provide quality pre-hospital emergency care. The results of this study have shown that paramedics in the South Bohemian as well as the Central Bohemian regions are well familiar with the theory for providing high-quality pre-hospital care for clients with developing Crush syndrome.
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Kompartment syndrome with injuries to the legs and issues from the perspective of patient care
BÁRTOVÁ, Marcela
A complex of clinical symptoms occurring as a consequence of pressure increase in enclosed anatomic space is called the compartment syndrome. We must pay great attention to this diagnostics as local ischemia occurs and sometimes fasciotomy is indicated during compartment syndrome development. This means difficult and log treatment for the affected patients. The aim of the thesis was to find out whether patients are informed on the possibility of surgical solution of compartment syndrome, what information they have on subsequent care of fasciotomy, and to what extent patients fear of possible leg amputation in the instance of compartment syndrome diagnosis. The last aim was to find out to what extent patients fear of consequent functionality limitation of the leg. Interviews were conducted with four patients hospitalized at the traumatology ward of České Budějovice Hospital and with three nurses working at the same ward. The method of non-standardized interview was used in the research. The research has shown that patients are provided with information on the method of surgical solution of compartment syndrome, however sometimes with delay, namely in a situation when a patient learnt the information after the surgery. The patients focused on their injured limbs, the nurses perceive the care of fasciotomy as a complex and inform a patient on all nursing care procedures applicable to the particular patient. The research has also confirmed the fears the patients have of possible amputation of their limbs as well as of subsequent limited functionality of the limb. This influences patient?s mentality, which is very important for the due course of treatment. This thesis outlines the importance of timely provision of information on possible complications and subsequent solution of these complications to the patients. Its lack might increase patient?s overall anxiety of his/her health condition, in our case about an injured limb. The research results will be probably published in journals and lectures may be given at educational events on this topic. A brochure Compartment Syndrome and its Treatment will be issued for patients.
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Problems of treating of sicks with the compartment syndrom on crus injuries
WICHTOVÁ, Zdeňka
Compartment syndrome is a syndrome of clinical signs that arise due to the increased blood pressure within a confined space. For some time, this pressure increase is balanced by the flexibility of fascia. But when the mechanism becomes exhausted, the development of ischemia occurs and the compartment syndrome turns up. The treatment is aimed at saving the extremity and the patient. The role of a nurse is to closely observe the patient´s overall condition and clinical symptoms of the compartment syndrome, to carry out auxiliary examinations, to assist in taking the intrafascial pressure in the affected part of the body and to take part in the demanding treatment of the complication. A nurse is in a constant contact with the patient, provides him/her with education and support and notifies the doctor of all alterations in the patient´s condition. The objective of the thesis was to learn if nurses are informed enough on the causation of the compartment syndrome on the crus injury. The other objective was to find out if nurses are familiar with the specifics of the care for patients with the compartment syndrome on the crus injury. Three hypotheses were stated: H I: Nurses have knowledge of causes of the compartment syndrome on the crus injury. This hypothesis was confirmed. H II: Nurses are not able to recognize the onset of the compartment syndrome on the crus injury on due time. This hypothesis was rejected. H III: Nurses have knowledge of specifics of the nursing care in patients with the compartment syndrome on the crus injury. The research was conducted by the quantitative method. The data necessary to achieve the objectives were gathered by the questionnaire method. The research was anonymous and it was voluntary to fill in the questionnaires. The research was conducted in the České Budějovice hospital in the Orthopaedic unit and in the Department of Accident and Plastic Surgery. The findings of the research may be useful to medical staff members in practice or in workshops.
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