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Analgosedation of a child patient in pre-hospital emergency care and children's urgent care
MRÁZ, Štěpán
This bachelor's thesis is focused on the topic of analgosedation of an infant patient in pre-hospital emergency care and children's urgent care. It comprises two parts, the theoretical and the practical one. The theoretical part includes some information about pre-hospital and urgent emergency cares. Furthermore it is mainly focused on specifics of infant patients, analgosedation and last but not least on resuscitation of adults and children. For the practical part of this thesis was chosen one aim. It was to find out how urgent wards are ready to face intake of infant patients. Due to this target came out two investigative questions. The first one:"What facilities can be found in hospitals, which are ready for intake of infant patient?" The second question: "Are hospital workers prepared for infant patients within the framework of PNP and urgent care?" The research was carried by a quantitative method of gathering data through the half structuralized dialogues covering 12 questions. The research sample contained 6 paramedics of an emergency ambulance and 6 hospital employees from an urgent ward. The data obtained by this research are divided into 11 categories. After summarization of all information and data I found out that there is a high standard of facilities covering pre-hospital and hospital care, therefore an infant patient can be provided with a necessary help. Within the investigation was also proved the following fact. Hospital employees are well trained in issues of infant patient. Nevertheless they agreed that there are not so many practical training based on children emergency care organised, therefore they would really welcome them to be able to improve their practical skills in connection of this specific field.
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Polymorphism of drug metabolizing enzymes as a potential target of prevention of serious treatment complications in neonates and infants
Hronová, Karolína ; Slanař, Ondřej (advisor) ; Paluch, Zoltán (referee) ; Hladík, Michal (referee)
Univerzita Karlova 1. lékařská fakulta Studijní program: Biomedicína Studijní obor: Preventivní medicína MUDr. Karolína Hronová Polymorfismus genů účastnících se v metabolismu léčiv jako potenciální cíl prevence závažných komplikací léčby u novorozenců a dětí Polymorphism of drug metabolizing enzymes as a potential target of prevention of serious treatment complications in neonates and infants Disertační práce- ABSTRAKT V ANGLICKÉM JAZYCE Školitel: prof. MUDr. Ondřej Slanař, Ph.D. Konzultant: MUDr. Pavla Pokorná, PhD. Praha, 2018 Abstract Background and aims: The safety of analgosedative drugs includes drug interactions, adverse effects, withdrawal syndrome and drug dependence are factors that significantly affect morbidity and mortality. Its prevention is critical for quality improvement of care in paediatric patients. The aim of the thesis was to evaluate the prediction of efficacy and safety of analgosedative drugs sufentanil, midazolam, tramadol and valproic acid in neonates and children based on the occurrence of selected pharmacogenetic biomarkers. The incidence of drug interactions of phenobarbital with other analgosedative drugs has also been evaluated. Methodology: The thesis is based on two studies conducted on Intensive and Resuscitation Care Unit of the Clinic of Paediatric and Adolescent...
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Assessment methods for measuring the depth of analgosedation in patients in intensive and resuscitation care and their practical application
Machačová, Jana ; Jaroměřský, Dušan (advisor) ; Kulířová, Veronika (referee)
Introduction: Prevention and treatment of pain or discomfort is an integral part of modern intensive care. Insufficient or, conversely, excessively deep sedation and analgesia are associated with a number of risks, such as prolonged hospitalization. For this reason, the use of scoring systems to monitor agitation and pain is currently recommended. Objectives and methodology: The aim of the work was to obtain data on the use of scoring systems to assess the pain and depth of sedation in intensive and resuscitation care workplaces in the Czech Republic and to evaluate the satisfaction of nurses with their use. The research was carried out using a quantitative method in the form of a semi-structured questionnaire of my own creation. The research sample consisted of station nurses and head nurses from anesthesiology and resuscitation departments and intensive care units. Results: The research survey involved 62 workplaces of intensive and resuscitation care in the Czech Republic. The existence of a sedation protocol was reported by 26 workplaces (42 %), the use of standardized scales to assess the depth of sedation was reported by 46 workplaces (74 %). Pain in ventilated patients is evaluated in all 62 workplaces (100 %). The most frequently used scale for assessing the depth of sedation is RSS, which...
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Polymorphism of drug metabolizing enzymes as a potential target of prevention of serious treatment complications in neonates and infants
Hronová, Karolína ; Slanař, Ondřej (advisor) ; Paluch, Zoltán (referee) ; Hladík, Michal (referee)
Univerzita Karlova 1. lékařská fakulta Studijní program: Biomedicína Studijní obor: Preventivní medicína MUDr. Karolína Hronová Polymorfismus genů účastnících se v metabolismu léčiv jako potenciální cíl prevence závažných komplikací léčby u novorozenců a dětí Polymorphism of drug metabolizing enzymes as a potential target of prevention of serious treatment complications in neonates and infants Disertační práce- ABSTRAKT V ANGLICKÉM JAZYCE Školitel: prof. MUDr. Ondřej Slanař, Ph.D. Konzultant: MUDr. Pavla Pokorná, PhD. Praha, 2018 Abstract Background and aims: The safety of analgosedative drugs includes drug interactions, adverse effects, withdrawal syndrome and drug dependence are factors that significantly affect morbidity and mortality. Its prevention is critical for quality improvement of care in paediatric patients. The aim of the thesis was to evaluate the prediction of efficacy and safety of analgosedative drugs sufentanil, midazolam, tramadol and valproic acid in neonates and children based on the occurrence of selected pharmacogenetic biomarkers. The incidence of drug interactions of phenobarbital with other analgosedative drugs has also been evaluated. Methodology: The thesis is based on two studies conducted on Intensive and Resuscitation Care Unit of the Clinic of Paediatric and Adolescent...
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Nursing patient care during analgosedation in an in-patient ward
VANČUROVÁ, Jana
The aim and research questions: The aim of the work was to find out the specifics of the nursing care of the patient in analgosedation. The eight research questions were created to respond to the aim: What are the specifics of the nursing care for a patient in the field of basic life fiction monitoring? What are the specifics of the nursing care for a patient in hygiene? What are the specifics of the nursing care for a patient in the area of skin care? What are the specifics of the nursing care for a patient in the area of emptying? What are the specifics of the nursing care for a patient in the area of nutrition? What are the specifics of the nursing care for a patient in the field of respiratory care? What are the specifics of the nursing care for a patient in the field of vascular access care? What are the specifics of the nursing care for a patient in the field of pain management? Methodology and research file: The qualitative research method was used for the research part of the thesis. The data collection technique was a semi-structured interview with nurses and health rescuers at the Anesthesiology-Resuscitation Department. The interview data were then processed using an open pencil and paper encoding. Results: According to the research, care staff focus on monitoring life functions, patient assessment, hygienic care, rehabilitation, nutrition, emptying and care for inputs and defects. Conclusion: The paper provides an overview of drugs used in analgosedation and nursing care in patients in analgesic surgery in the Anesthesiology-Resuscitation Department.
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The use of sedative and analgesic in children's injuries in prehospital emergency care
TOMANOVÁ, Markéta
The theme of this work is the use of sedation during child injuries in pre-hospital emergency care. Children injuries are serious health, economic, and social problems in the Czech Republic, particularly infant, toddler and preschool age children due to their rapid development of physical skills, but this time the development of intellectual abilities does not allow the recognition of dangerous situations. Any sudden deterioration of health of the child is a burden not only for him but also for the parents and all others in its surrounding. Due to a smaller representation of pediatric patients compared with other broad spectrum of health services interventions, young children require more care and therefore paramedics need to be oriented in this field. This thesis focuses on mapping the knowledge of paramedics in connection with the administration of sedation for injuries of children in pre-hospital emergency care. Quantitative research is focused on paramedics working in emergency medical service in Ceske Budejovice and ARO department in the hospital in Ceske Budejovice. At the beginning of the theoretical part, I tried to describe pre-hospital emergency care and specifics of childhood. A large proportion of theoretical work I devoted to chapter about sedation, which is a look into the history of where they could be seen the beginnings of analgesia and pain management. I thought it was important to mention the principle of medication, application paths or drug usage. Therefore, attention is on the chapter of pain, its definition, types, children experiencing pain and elaboration of rating scales. As has been said, injuries are a hot topic, and therefore the next part of the theoretical part is dedicated to injuries. The practical part focuses on the mapping of knowledge concerning the administration of sedation for injuries of children in pre-hospital emergency care. Data were collected from January to March in 2014. Questionnaires were personally handed in the form of printed questionnaires, forms were also distributed electronically. A total of 70 questionnaires were handed in, that is 50 questionnaires to the "RZP" center in Ceske Budejovice and 20 questionnaires to "ARO" department in a hospital in Ceske Budejovice. The return was 82.8 %, which represents 58 returned questionnaires, which were included in the subsequent evaluation of the research. Interviewed paramedics were at the beginning informed with the nature of the research, with an emphasis on confidentiality. Individual questions were designed to obtain the information needed to answer the research question ("what is knowledge of paramedics administering sedation to children in pre-hospital emergency care"), and they fulfilled the objectives of this thesis. The questionnaire contained a total of 15 questions, the questions 1-3 were used for further mapping of the respondents. The following 12 questions were deliberately chosen to find out whether paramedics have the knowledge of sedation during children injuries. These data were then graphically represented and each question separately evaluated. Only questions number 4, 8, 9, 10, 11, 12, 13 and 14 were included in the survey to be able to answer the research question. Research questions were statistically using the chi- square test evaluated. The level of significance rejected the claims set ("sufficient knowledge will have 75 % of the respondents") and confirmed the results of research that paramedics knowledge is not sufficient. Finally, research shows that paramedics should be more interested in the area related to sedation, its administration, dosage and possible complications. A training for emergency workers at least once but preferably twice a year could be a solution.
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