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Craniocerebral injuries in motorbikers
HEJNOVÁ, Anna
This thesis focuses on the craniocerebral injuries in motorcyclists. It is divided into a theoretical and practical part. In the theoretical part I have described the anatomy of the human skull and the brain. I have also described the mechanics of injuries on a one track vehicle and the most common types of craniocerebral injuries which are the focus of my thesis. The last chapter focuses on the immediate care necessary in patients that have suffered cranial trauma. The practical part of my paper contains excerpts of interviews conducted at random with members of the South Bohemian Emergency Medical Services. In this part of my thesis I focused on two goals. The first was to map out the knowledge of emergency workers which are not doctors regarding cranial cerebral injuries. The second was to find out their procedures in treating cranial trauma patients injured on motorcycles. This way I was able to map out the procedures used by non-medical emergency personnel when treating a motorcycle accident patient with craniocerebral injuries. To reach my conclusions I used a highly effective research method in which I questioned 10 informants in the form of a semistructured interview. The results of the interviews point to the fact that the non-medical emergency professionals have the theoretical knowledge of craniocerebral injuries and were able to name the particular symptoms and complications associated with them. However some of them were confused about some specifics. They were able to name the different types of these injuries. When it came to being able to name and identify the different types of helmets available most admitted that they weren't well informed. When it came to helmet removal the results were positive pointing to their awareness of the correct procedure. They also proved to be skilled in the placement of a neck brace/collar. When asked about therapy their answers were mostly chaotic.
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Prognostic significance of levels of brain specific biochemical markers in head injury patients
Homolková, Helena ; Choc, Milan (advisor) ; Náhlovský, Jiří (referee) ; Netuka, David (referee) ; Brichtová, Eva (referee)
OBJECTIVES: The S100B protein subgroup is a thermolabile acidic calcium-binding protein. S100B protein was first described in the central nervous system. Destruction of the nerve tissue results in S100B protein release from astrocytic glial cells and elevation of its levels in the cerebrospinal fluid. If the blood-brain barrier is also damaged, S100B gets into the systemic circulation and elevated blood levels of S100B are detected. Higher S100B serum levels in patients with head injury are predictive of possible development of secondary brain injury and the extent of permanent injury to the CNS. MATHERIAL AND METHODS: The authors present their results obtained in the group of 39 children aged 0 (newborns) to 17 years with isolated craniocerebral injury. RESULTS: Our group included 39 children aged 0-17 years. Excellent results (GOS - Glasgow outcome scale 4-5) were observed in 33 patients already at the time of transfer from our ICU to the neurological department. There was no death and the poor outcome group included only 6 children. Second GOS evaluation was performed 6 months later, when 36 children were in the GOS 4-5 group and only 3 children in the GOS 2-3 group. CONCLUSIONS: Due to high variability in S100B protein serum levels in children depending on age and gender, no correlation between...
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Monitoring of the nervous system of patients with craniocerebral injury - Nurse's role
VANIŠOVÁ, Štěpánka
This theoretical thesis focuses on monitoring of nervous system of patients with craniocerebral injury and the nurse´s role in the problem. Its aim was to provide a general and comprehensive overview of craniocerebral injury and also the monitoring options of nervous system of patients with this particular injury, and to map out the nurse´s role in monitoring of nervous system of patients with craniocerebral injury. In order to achieve the objectives, the method of review and data synthesis was employed. The sources for the thesis were sought out through professional foreign databases, internet browsers and with the help of catalogues and databases of libraries. It was drawn from professional literature, both domestic and foreign, in electronic and printed form. Owing to the development of technologies, new monitoring techniques of nervous system appear in clinical practice. Such techniques are somewhere considered standard, elsewhere they are only being introduced or there has been no experience with such techniques at all. The nurses working with patients with craniocerebral injury should have sufficient information on this problem. Unfortunately, literature dealing with this issue and intended for nurses is scarce in domestic sources. Thus the theses might at least partially serve as a study material both for nurses and students. In the thesis, patophysiology of craniocerebral disease is clarified as well as current most often applied methods of monitoring of nervous system of patients with craniocerebral injury, both abroad and in our country. In the next part of the thesis, the individual monitoring methods are supplemented by information used especially by the nurses working with patients with craniocerebral injury in Intensive Care Units.
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Management of patient with cranial trauma in prehospital care.
BAXA, Radim
The bachelor thesis is entitled: "Management of patient with cranial trauma in prehospital care". The teorethical part thoroughly deals with the characteristic of craniocerebral trauma and its management in prehospital emergency care. There is an overview of anatomy and physiology of head with an emphasis on perfusion and brain vascular supply. Further ways of origin, types, symptoms and assesment of the severity of craniocerebral injuries. Within the management of prehospital care, the teorethical part deals with the individual steps in examination and stabilising the patient and thr pointing to the target medical institution for final treatment. In the practical part there were set two objetives. The first objective was to map the issue of cranial trauma and the management of the patient with cranial trauma in prehospital care, based on expert literature. The second objective was to evaluate the practical procedure for six cases and how much it actually matches with the recomended procedure. A qualitative research approach was used to process the research part. The data was collected in form od cases reports, which were subsequently categorized into nine categories. According to the results, there was found that the paramedics are partly familiar and control the procedures for patient examination, its monitoring and the criteria for its targeting to the definitive health facility. The management problems may result into unequal use of fixation tools and inconsistency in the use of pharmacotherapy and volume therapy. The output of this bachelor thesis could serve as a basis for teaching paramedics dealing with craniocerebral injury and management in prehospital care. Furthermore, the work could be used to increase or supplement the awarness of paramedics when they meet a patient with trauma brain injury.
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Prehospital emergency care in neurotraumas
KADLEC, Josef
The Bachelor thesis is focused on the topic of Prehospital emergency care in neurotraumas, especially on the approach of paramedics and their knowledge about Prehospital emergency care in neurotraumas. Globally, for children and adults to 45 aged, neurotrauma could be placed in the highest position of death causes. This statistic testifies about the importance of the professional and early intervention in prehospital emergency care. In the thesis qualitative research was used and two purposes and questions were defined. The method used was a semi-structured interview with paramedics in Vysočina Region and South Bohemian Region. The first aim of the thesis was to chart knowledge and approaches of paramedics in Prehospital emergency care and the second aim was comparison of the previous aim in Regions mentioned above. From the outcome of my research results that paramedics are not qualified enough and they lack information about Prehospital emergency care. In interviews, information mentioned was incomplete and their approaches were inconclusive. However, it was detected that approaches used in both regions are nearly identical. In Vysočina Region, cooperation with workplaces of the follow-up hospital care is really difficult. This fact could be considered as a side result of the thesis. The workplaces mentioned are mainly traumacentres with neurosurgery workplace accessible 24 hours per day. To sum it up for the further use in practice, the educational system of paramedics is inadequate and improvement would be highly recommended.
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Prognostic significance of levels of brain specific biochemical markers in head injury patients
Homolková, Helena ; Choc, Milan (advisor) ; Náhlovský, Jiří (referee) ; Netuka, David (referee) ; Brichtová, Eva (referee)
OBJECTIVES: The S100B protein subgroup is a thermolabile acidic calcium-binding protein. S100B protein was first described in the central nervous system. Destruction of the nerve tissue results in S100B protein release from astrocytic glial cells and elevation of its levels in the cerebrospinal fluid. If the blood-brain barrier is also damaged, S100B gets into the systemic circulation and elevated blood levels of S100B are detected. Higher S100B serum levels in patients with head injury are predictive of possible development of secondary brain injury and the extent of permanent injury to the CNS. MATHERIAL AND METHODS: The authors present their results obtained in the group of 39 children aged 0 (newborns) to 17 years with isolated craniocerebral injury. RESULTS: Our group included 39 children aged 0-17 years. Excellent results (GOS - Glasgow outcome scale 4-5) were observed in 33 patients already at the time of transfer from our ICU to the neurological department. There was no death and the poor outcome group included only 6 children. Second GOS evaluation was performed 6 months later, when 36 children were in the GOS 4-5 group and only 3 children in the GOS 2-3 group. CONCLUSIONS: Due to high variability in S100B protein serum levels in children depending on age and gender, no correlation between...
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Approach of rescuer to craniocerebral injury
SCHWARTZ, Ondřej
In the theoretical part of my bachelor thesis I address the injury of neurokrania, anatomy, diagnosis, classification and possible complications of injuries, mainly in relation to paramedics and prehospital care. Marginally I also address paramedics themselves, particularly their responsibilities and competencies. In the practical part of my thesis I work with the results of my research for which the quantitave method was mainly used. Especially with the results of my questionnaire, which was directed to paramedics, students and other workers who are affected by the issue. The hypothesis was set: "A paramedic does not have sufficient knowledge and skills in an approach to craniocerebral injury." The research showed that respondents have knowledge, but not at a satisfactory level. And that they would appreciate the opportunity to extend or complement their knowledge, not only for themselves. The hypothesis was largely confirmed. This is why I decided, based on previously known information that I received while writing my thesis, to prepare a summary of information - an algorithm, that will serve those interested in the issue to expand and complement the information obtained so far.
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Nursing care for patients with craniocerebral trauma
PILNÁČKOVÁ, Jitka
The topic of this thesis is ?Nursing care for patients with craniocerebral trauma?. Three goals were set. We tried to find what the specifics of nursing care for patients with craniocerebral trauma are. We also examined whether nurses were aware of the specifics of nursing care for patients with craniocerebral trauma. The last goal was to find out whether nurses used basal stimulation in these patients. The research was based on a non-standardized interview. The interviews were performed with twelve nurses caring about these patients in the České Budějovice Hospital and the Faculty Hospital Královské Vinohrady. Three research questions were set. 1: What are the specifics of nursing care for patients with craniocerebral trauma? The research has shown that elevated head position, monitoring of GCS, pupil state and response, administering of bolus analgosedation doses in some nursing activities, ensuring detention administration and list of valuables are the specifics. We have also included CT examination, pre-operation preparation, care of invasive inputs, drains, operation wounds, careful handling with patients, constipation problems, care of a disturbed or aggressive patient and special approach to communication with these patients. 2: Are nurses aware of the specifics of nursing care for patients with craniocerebral trauma? We found that respondents knew the above mentioned specifics. However we found two drawbacks. The first one was in the unawareness of the possibility to increase ICP during defecation among the respondents, the other one was in communication with disturbed or aggressive patients. 3: Do nurses use basal stimulation in patients with craniocerebral trauma? The research has shown that the respondents do apply the concept of basal stimulation, but they only use some of the stimulation elements. This thesis may serve as study material for new nurses starting at the department, where they will care about these patients. The research results and the Standard nursing procedure of Basal stimulation elaborated by us will be offered to managers of both the hospitals where the interviews with nurses were performed.
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The Specifics of Nursing Care in Patients with Organic Psychosyndrome due to Craniocelebral Injury, Disorder.
GONDÁŠOVÁ, Jitka
Formerly used as a separate term, organic psychosyndrome has been currently included, according to the International Classification of Diseases, in the group of mental disorders arranged on the basis of the conclusive aetiology in the events of brain injuries, brain diseases and other brain damage leading to brain dysfunction. Organic psychosyndrome is a state of changed brain functioning resulting from an injury, cerebral apoplexy or brain tumour or from other causes. At that time the brain activity is changed, the cognitive functions are reduced, and the manner of experiencing along with the personality manifestations is changed with various intensities. Patients show overall restlessness and sometimes perception disorders. Organic psychosyndrome has a varied course and abates at various speeds. It never means a definite change of brain functioning. After the organic psychosyndrome abates, a cognitive deficit or a personality change caused by the brain injury may continue. Nursing care is very demanding for nurses both in physical and mental terms. The purpose of the quantitative research is to ascertain preparedness of nurses to communicate with patients with the organic psychosyndrome and to find out whether higher education influences provision of nursing care, whether nurses cooperate with the patients{\crq} families, and how nurses educate the families. The quantitative research was conducted in the form of questionnaires in selected wards of Nemocnice České Budějovice a.s. Pursued in March 2010, the research was aimed at respondents from the wards of traumatology, neurosurgery, neurology and psychiatry. 82 questionnaires were processed. Hypothesis 1 {--} Nurses do not have information concerning the specific communication with patients with organic psychosyndrome {--} has been disproved. The other hypotheses have been confirmed. A nurse with a higher education has more information about the form of nursing care of a patient with the psychosyndrome, educates the patient{\crq}s family continuously in the course of his/her hospitalization, involves the family members in the patient{\crq}s self-sufficiency training, educates the family mostly in the form of a dialog and has no printed education material at her disposal.
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