|
|
A sudden cardiac arrest and use of capnometry in cardiopulmonary resuscitation
Pokorná, Milana ; Nečas, Emanuel (advisor) ; Málek, Jiří (referee) ; Bělohlávek, Jan (referee)
The study is focused on advanced life support (ALS) performed by rescue team physicians in an out-of-hospital setting. The first part of the study analyzes diagnostic possibilities and correctness of assumed aetiology of the sudden cardiac arrest during cardiopulmonary resuscitation (CPR) in the field. It introduces an original method of "Crosscheck Tables" and applies this method to 211 cases of CPR provided by physicians of the Emergency Care Service. The study demonstrates that significantly misleading conclusions can result from a global analysis of a set of cases. It stresses importance of diagnostic analyses applied to individual cases. The second part of the study concentrates on changes in PETCO2 level as related to the return of spontaneous circulation (ROSC - Return of Spontaneous Circulation) as opposed to the circulation fully dependent on chest compressions. The study demonstrates that in constantly ventilated patients undergoing CPR in an out-of-hospital setting, PETCO2 is significantly higher (about 10 mmHg) after ROSC than before ROSC. It demonstrates that a sudden increase in PETCO2 exceeding 10 mmHg is likely to indicate the moment of ROSC. The study also support a view that steadily low levels of PETCO2 values (<10 mmHg) indicate a low chance for a successful resuscitation outcome. Key...
|
|
|
The role of a paramedic in care of cardiac arrest patient in special circumstances
SAMCOVÁ, Markéta
The bachelor thesis is focused on the advanced life support during the cardiac arrest in special circumstances. The thesis is divided in two parts theoretical and research. In the theoretical part, the pre-hospital care is briefly defined and it covers also the anatomy and physiology of a heart. Described are selected heart rhythm disorders and a cardiac arrest. In more detail, the thesis describes the cardiac arrest in special circumstances. In this bachelor thesis, qualitative research was carried out covering medical rescue procedures in patient care with a cardiac arrest in special circumstances in pre-hospital emergency care. Subsequently, their procedure was compared with the current recommended procedures of the European Resuscitation Council for Resuscitation in 2015. The research found that the health rescuers who were questioned were sufficiently oriented in the issue of cardiac arrest in specific circumstances within pre-hospital emergency care. An exception is the advanced life support of a patient burriend by an avalanche. In this part, respondents did not have sufficient knowledge of the guidelines. In all other situations, questioned parademics would follow the suit with the current recommended procedures of the European Resuscitation Council in 2015. The thesis can be used as a study material for the paramedic students and as well as for the lay and professional community.
|
|
|
An over view of recommendations for an urgent resuscitation and their application in the field
STEHLÍK, Oldřich
The topic of this bachelor thesis are guidelines for resuscitation in field. The entire text is structured into two parts theoretical and empirical one. The emphasis is put mainly on the empirical part and related research. Theoretical part provides definition of resuscitation and specifies its roles and objectives. It includes the possible causes of cardiac arrest, the principles of initiating and ending resuscitation and presentation of factors increasing the probability of cardiac arrest recovery. The emphasis is given on the description of guidelines for basic and advanced life support of adults and children, which is based on "Guidelines for resuscitation 2015" published by European resuscitation council. Theoretical part is concluded with providing the description of resuscitation in specific setting (also known as in field). Empirical part consists of research which was conducted among EMS paramedics and laymen. The data were collected by quantitative research (method of anonymous questionnaires) were processed with the use of statistics and consequently evaluated. We have established two research aims. First aim of the thesis was to look into laymen knowledge of guidelines for resuscitation, second aim is to examine paramedics' knowledge of the specifics of resuscitation in the field. There were set up two groups of respondents, the laymen and the paramedics. We have created a questionnaire for each group. Collected data were presented in tables, statistically processed, evaluated and summarized. Even though, the laymen went through training in resuscitation, their knowledge of the resuscitation procedures were very poor. Most of them did not know when to initiate and stop cardiopulmonary resuscitation. They did not know how to resuscitate, neither. The respondents did not realize the differences between cardiopulmonary resuscitation of adults and of children. The problem of the first magnitude was that they did not know the right compressions/breaths ratio for cardiopulmonary resuscitation of adults. The correctness rate of laymen's answers reached only 43%. We have anticipated, that the knowledge of paramedics of cardiopulmonary resuscitation in pre-hospital care will be flawless. In other words, that the correctness rate of their answers will meet 100%. However, the presumption was too ambitious. The conducted research has shown that the paramedics' knowledge of cardiopulmonary resuscitation in the field is very good, but not perfect. The correctness rate of paramedics' answers reached only 83%. The question, which was focusing on the maximum length of time during which it is possible to suspend cardiopulmonary resuscitation, has appeared to be the most problematic one. It is possible to observe paradox situation in the case of question focusing on differences between cardiopulmonary resuscitation of adults and children, because the correctness rate of paramedics' answers was very low (65%). However, the correctness rate was much higher in the case of questions which were focusing on cardiopulmonary resuscitation of children and adults in detail. In conclusion, considering the laymen's poor knowledge of cardiopulmonary resuscitation it is advisable to reconsider the way of raising public awareness as well as to think of other possible ways and forms of training in cardiopulmonary resuscitation. The research has shown the imperfection of paramedics' knowledge of cardiopulmonary resuscitation in the pre-hospital care. Therefore, it would be highly beneficial to look into its possible reasons. The questions, which have arisen from the research of paramedics' knowledge of cardiopulmonary resuscitation in the field, unfortunately could not be answered within this thesis, therefore it would be suitable to deal with them in upcoming research.
|
|
|
Need of CPR (cardiopulmonary resuscitation) team in hospital
GRAUSAM, Tomáš
In the introduction of the theoretical part of the Bachelor's thesis, we learn about the history and development of life support and we explain the role of a resuscitation team (RT). The practical part focuses on mapping of the existence and activities of resuscitation teams in seven South Bohemian hospitals in case of a necessity for advanced life support (ALS) in sudden circulatory failures (SCF) that arise in a hospital. Data collection took place in the form of questionnaires based on a guided interview of the author with randomly chosen respondents, at previously determined workplaces with the highest probability of SCF. All questioning was anonymous and both respondents and hospitals were subsequently assigned code indications. The thesis should be beneficial for acquisition of information on current state of resuscitation teams in hospitals of the South Bohemian region and on provision of qualified resuscitation care according to valid rules updated by the European Resuscitation Council in October 2015. From the results of the research part, it is evident that resuscitation teams are active in all the South Bohemian hospitals. Their activities, personnel and technological equipment correspond to a standard and they are comparable in all the hospitals. Some shortcomings that may lead to not quite as optimal CPR results were found in the initial phases in first providers on standard inpatient wards.
|
|
|
A sudden cardiac arrest and use of capnometry in cardiopulmonary resuscitation
Pokorná, Milana ; Nečas, Emanuel (advisor) ; Málek, Jiří (referee) ; Bělohlávek, Jan (referee)
The study is focused on advanced life support (ALS) performed by rescue team physicians in an out-of-hospital setting. The first part of the study analyzes diagnostic possibilities and correctness of assumed aetiology of the sudden cardiac arrest during cardiopulmonary resuscitation (CPR) in the field. It introduces an original method of "Crosscheck Tables" and applies this method to 211 cases of CPR provided by physicians of the Emergency Care Service. The study demonstrates that significantly misleading conclusions can result from a global analysis of a set of cases. It stresses importance of diagnostic analyses applied to individual cases. The second part of the study concentrates on changes in PETCO2 level as related to the return of spontaneous circulation (ROSC - Return of Spontaneous Circulation) as opposed to the circulation fully dependent on chest compressions. The study demonstrates that in constantly ventilated patients undergoing CPR in an out-of-hospital setting, PETCO2 is significantly higher (about 10 mmHg) after ROSC than before ROSC. It demonstrates that a sudden increase in PETCO2 exceeding 10 mmHg is likely to indicate the moment of ROSC. The study also support a view that steadily low levels of PETCO2 values (<10 mmHg) indicate a low chance for a successful resuscitation outcome. Key...
|
guest ::
