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The Possibilities of Artificial Lung Ventilation in Pre-hospital Emergency Care
NOVÁKOVÁ, Simona
The bachelor thesis deals with the possibilities of artificial pulmonary ventilation in pre-hospital emergency care. The thesis consists of theoretical and practical parts. The theoretical part first informs the reader about the anatomy and physiology of the respiratory system. Then it deals with the topic of artificial pulmonary ventilation, focusing, for example, on its history, goals, indication or complications. The thesis also introduces the topics of non-invasive ventilation or oxygen therapy. We must not forget to introduce the possibilities of securing the airway and the competences of paramedics. The practical parts contains the results of a research survey obtained from paramedics by means of semi-structured interviews. The collected data were analyzed and divided into 11 categories based on open coding. The results of the research investigation showed that the most commonly used method of artificial pulmonary ventilation in prehospital emergency care is an invasive method. Most paramedics have experience with this method only as a witness to it. Paramedics are aware of this issue mainly through annual training.
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Reasons and Frequency of Ventilatory Circuit Disconnection in Patients on Artificial Pulmonary Ventilation
Ševčíková, Klára ; Línková, Šárka (advisor) ; Kravcová, Kateřina (referee)
The thesis deals with the reasons for disconnecting the ventilation circuit and the frequency of individual causes. It is part of a broader and more comprehensive study whose common goal is to combat ventilator-associated pneumonia (VAP). The theoretical part of the thesis briefly describes the definition of VAP and its preventive elements. However, it highlights the conflict between manufacturers' recommendations and the results of the latest studies regarding the interval for replacing individual components of the ventilation circuit. Furthermore, it draws attention to the limited and insufficient emphasis placed on this issue both in the theoretical sphere and in clinical practice. The practical part of the thesis presents the results of the conducted observation, whose main objective is to identify the most common cause of ventilation circuit disconnection. The assumption was a high proportion of the frequency of replacing individual circuit components,especiallythe passive heat and moisture exchanger,which was confirmed by the results of the research survey. Another objective was to observe hygiene practices in the care of the ventilation circuit, which had not been fully defined before. Equally important was the establishment of foundations for creatingstandardized procedures and highlighting...
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Problematics of transferring the patient onto home artificial pulmonary ventilation
HRBKOVÁ, Lenka
Home artificial lung ventilation (DUPV) is very current topic these days. It provides great hope for the possible return of a patient permanently dependent on artificial lung ventilation back to the home environment. Due to injuries or the development of the disease, some patients are permanently dependent on the support of artificial lung ventilation (UPV). Staying at home with the support of DUPV brings many benefits for these patients. The theoretical part of the diploma thesis is divided into six parts. The first part is devoted to a historical view of the development of artificial lung ventilation. The second part describes the respiratory system. The third part is devoted to artificial lung ventilation, where in the subchapters the indications for connection to UPV, physiological goals, clinical goals and also the subsequent intensive care are analyzed in more detail. The third part comprehensively describes DUPV. The subchapters are devoted to indications for connecting the patient to DUPV, there are described organizations dealing with DUPV. It describes the application for the implementation of DUPV, preparation before the patient goes home, provided nursing care and equipment and medical supplies necessary for implementation. The fourth part focuses on an overview of social benefits and the fifth part on the implementation. Two goals were set for the diploma thesis: 1. To find out, with what problems, including artificial nursing care, do patients face with artificial lung ventilation. 2. Identify what problems, including nursing care, patients experience with home artificial lung ventilation. To meet the objectives, three research questions were created: 1. What problems, including nursing care, occur to patients dependent on artificial lung ventilation in the Follow-up Intensive Care unit? 2. What problems, including nursing care, occur to patients dependent on home artificial lung ventilation? 3. What are the changes in the quality of life and nursing care of patients dependent on ventilator in the hospital and patients dependent on ventilator at home? The empirical part of the diploma thesis is processed in the form of a qualitative research survey. The method of semi-structured interview with NIP general nurses of an unnamed district hospital, caregivers and patients at DUPV was chosen. The method of self-observation and examination of decurses was also used. The interviews were conducted on the basis of pre-arranged questions with four nurses, three caregivers and three patients. The "pencil and paper" method and the open coding method were used to analyze the interviews. For grater clarity, the categories and subcategories were visualized in graphic diagrams. They were also used to compile three case studies. The results of the research survey show that general nurses deal with nursing care, respiratory care and also listen appropriately to the needs of patients. The most common problem that was mentioned was the implementation of personal hygiene, due to the mental and physical dufficulty for patients. Furthermore, problems with defecation, immobility and problems with gestures and communication. An unpleasant problem was also the irritation of the airways during suction. Patients 'and carers' responses show that the most common problem is dependence on the carer for personal hygiene and excretion. Also problems with falling asleep. Social isolation and deteriorated possibility of communication are also problems. A change in the quality of life and nursing care of UPV-dependent and DUPV-dependent patients at home was also found. The answer to this question is that a hospital stay is physically and mentally demanding. It has been said that being at home is real luck. The opportunity to be with family and be able to do everything by yourself. I believe that the work could serve to improve the awareness of family members of patients at DUPV. The work could be used to collaborate in a GAIA grant project.
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The problematics of securing airways of a patient with an acute respiratory disease
BABOUČKOVÁ, Martina
The topic of our Bachelor's thesis is "Problematics of securing airways of a patient with an acute respiratory disease". The aim of this thesis is to map the issue. The thesis contains the theoretical part and the research part. The theoretical part focuses on anatomy and physiology of the respiratory tract, monitoring of respiratory system, monitoring of consciousness, securing of the respiratory system and caring for the patient connected to the artificial pulmonary ventilation. Furthermore, this work also deals with nosocomial and professional infection and especially with acute respiratory disease. The research was conducted through qualitative research using a semi-structured interview with 10 qualified specialists and paramedics working at the department of Anaesthesiology and Resuscitation and at Emergency Medical Services. To designe researche were chosen for these research questions: 1. How do the paramedics protect themselves when securing the airways of a patient with acute respiratory disease? 2. How often do paramedics encounter the activity of securing airways of a patient with acute respiratory disease? 3. What is the attitude of paramedics in practice when it comes to securing the airways of a patient with acute respiratory disease? The purpose of this Bachelor's thesis is to find out how the paramedics proceed in securing the airways and how they react when they encounter the acute respiratory disease. This Bachelor's thesis serves as a material that points to the correct use of barrier protection. The result of the research shows that the paramedics meet with the respiratory disease only rarely. The questions were also aimed at the compliance with barrier protection. The main benefit of this Bachelor´s thesis should be the awareness of non-compliance with barrier protection and subsequent use of protection against respirátory disease.
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Nursing care of patients with acute respiratory failure
NĚMCOVÁ, Kateřina
Acute respiratory failure is a state when the respiratory tract suddenly is not able to carry out its functions. The disorder can be both at the inflow of the air into the respiratory tract or at the point of the gas exchange between the alveoli and the blood. The most severe form of acute respiratory failure is the acute respiratory distress syndrome-ARDS. It is necessary to treat acute respiratory failure immediately when it appears because it can cause serious damage to the organism or death. The treatment requires securing the respiratory pathway. A theoretical knowledge of the possible causes of the origin and development of ARDS, and its treatment using artificial pulmonary ventilation helps to correctly understand the problems of this illness. Nursing care is essential while treating severe respiratory failure. The care is highly specialized in this case. The nurses participate in the securing of respiratory pathway, beginning and progress of artificial pulmonary ventilation and the process of weaning of mechanical ventilation. The aim of this bachelor's thesis is to determine the basic terms and issues of acute respiratory failure. This is necessary to properly understand the case and the subsequent treatment of respiratory failure with mechanical ventilation. The study deals with defining and comparing particular guidelines of the complex nursing care of the patients with acute respiratory failure. This project was defined because of the continual development and improvement of the care of critical status patients. This thesis, entitled "Nursing Care of Patients with Acute Respiratory Failure," expounds on its topic only as a theoretical work based on both Czech and international scientific resources. Knowledge of particular parts of the thesis was obtained from various scientific and professional books, magazines and Internet resources of professional associations. The Czech authors most frequently cited are MUDr. Pavel Dostál PhD. MBA, who is focused on the issue of artificial pulmonary ventilation, and MUDr. Bronislav Stibor, who is dedicated chiefly to ARDS and revitalizing methods. Based on the studied literature, basic theoretical terms and issues were expounded concerning acute respiratory failure and acute respiratory distress syndrome. Particularly emphasized was the artificial pulmonary ventilation. The theoretical part gradually joins the part dealing nursing care of those patients suffering from acute respiratory failure. The part contains every guideline concerning the most recent developments and the latest innovations in the field of nursing of the critically ill. After studying the scientific sources, it was concluded that there were some differences regarding each authors´ guidelines. The guidelines differed from each other only slightly. Each guideline is mentioned in the thesis and analyzed at the end of the thesis. There is a comparison of competences of general nurses and specialized nurses for intensive care. According to Czech law, the patients with the failure of a vital function should be treated by specialized nurses. The range of permitted treatment attended by an intensive care nurse is plentiful when compared to general nurses. If the only one student carried out one of the proposed guidelines from my thesis and was able to use them at work, she or he would help to improve the complex treatment at intensive care units and my study would fulfil its propose.
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Ventilation support in prehospital care and during transport of the patient
PETROVIČ, Pavel
The topic of presented bachelor thesis is ventilation support in prehospital care and during transport of the patient. Consciousness, breathing and blood circulation belong among basic life functions. Thanks to ventilation support we are able to provide full or partial pulmonary ventilation. For this we use aids such as resuscitation masks meant for lay public or aids for trained paramedics like laryngeal masks, endotracheal tube and ventilator for artificial pulmonary ventilation. Prehospital care is not only about professional first aid, but about giving first aid by lay public as well. That is why aids for pulmonary ventilation are included in this thesis. This bachelor thesis had two aims; to map and compare knowledge of students attending the last year of high school in kiss of life and map experiences of paramedics with a laryngeal mask Supreme and capnometry. The research was implemented with mixed method research. Knowledge of students were found out by tests which were give in class "Z4" at Střední odborná škola veterinární, mechanizační a zahradnická a Jazyková škola s právem státní jazykové zkoušy and in class "4.B" Gymnázium Jírovcova. At Z4 class research took place on 14th March 2014. There were 25 students in this class, 4 men and 21 women. At class of 4.B students' knowledge was tested on 2nd April 2014 with presence of 26 students, 16 women and 10 men. At the beginning of test the anonymity of respondents was stressed, and then all respondents were acquainted with the character of my research and its aim. At the start of the test there were two statistic questions; if the respondent is either man or woman and whether the respondent has his/her driving license. There were 15 closed questions in the test and students were supposed to choose one right. After handing all the tests, the correct results were told to students. 51 tests altogether were given. Experiences of paramedic with the laryngeal mask and capnometry were found out in a form of five short dialogues in a week from 7th to 11th April 2014. The research group include paramedics of Zdravotnická záchranná služba Jihočeského kraje. Gained data from tests were evaluated, each question separately and then transformed in graphs which show the number of wrong and right answers. The aim of this thesis was to map and compare knowledge of students in the last year of their studies. Evaluated tests show us, that students of Z4 class have more knowledge about kiss of life or with cardiopulmonary resuscitation. In seven questions these students were more successful than their same-age colleagues from Gymnázium, who were better at three questions only. Experiences of paramedic with laryngeal masks Supreme are positive and if ensuring of air passages is needed, when a doctor is not present, they choose LMA Supreme. Paramedics agreed on that following ventilation via LMA Supreme is sufficient as long as we choose the right size. Paramedics ask for capnometer device in all cars EMS. Paramedics of the research group do not daily meet patients who would need or used at controlled ventilation. Students of the last year at high school have basic knowledge about kiss of life or about giving first aid. This knowledge is not 100% and teaching of giving first aid should be as a subject at high schools. Paramedics accept new aids and machines and use them during their practise. Thanks to this, first aid is becoming more beneficial for patients and for paramedics.
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Possibilities of artificial pulmonary ventilation in urgent care and anesteziological resuscitation department
BINTEROVÁ, Jana
The aim was to explore the possibilities of mechanical ventilation in prehospital emergency care and Anesthesiology and Intensive Care qualitative research method. The first part of the research was focused on finding out how the use, including the most frequently used modes of ventilation, and frequency of artificial ventilation. Research has found that in pre-hospital care are used methods of invasive and noninvasive ventilation and ventilatory modes most widely used in prehospital care are IPPV, CPAP and SIMV. In the second part of the research focuses on the possibility of mechanical ventilation on Anesthesiology-Intensive Care and neužívanějších detection schemes. They are IPPV, BIPAP, SIMV, APRV, PS and CPAP. The last part of the research deals mainly comparing the possibilities of mechanical ventilation at the base emergency medical services of the Liberec Region and South Region. I ran into very different views on the importance of mechanical ventilation in prehospital emergency care, but the result is the possibility of artificial ventilation in different regions does not differ much.
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Clearing the airway by an emergency care provider in the prehospital emergency care
NOVOTNÁ, Magdalena
Clearing an obstructed airway to facilitate breathing is a critical element of airway management. It is the emergency care provider who administers first aid and he/she has to master the technique of opening the airway as well as the aspiration prevention. The right airway management may avert the life-threatening condition of an injured person. The thesis is focused on the possibilities of clearing the airway by the emergency care provider in the Central Bohemian region. Techniques of opening and clearing the airway both without or with aids, which are at the emergency care provider´s disposal in prehospital care, are mentioned. The research set was formed by emergency care providers in transit first-aid stations providing emergency care in the Central Bohemian region. The research was conducted by the quantitative method. To collect data, the questionnaire method was used. I handed out 100 questionnaires in transit first-aid stations in the Central Bohemian region. The research was anonymous. The rate of return was 76%, it means I was given back 76 anonymously filled in questionnaires. The objective of the research was to survey possibilities of clearing the airway by the emergency care provider in the Central Bohemian region {--} and the objective was accomplished. The hypothesis I {--} on the part of an emergency care provider the most effective way how to clear the airway is endotracheal intubation {--} was confirmed {--} as well as the hypothesis II - emergency care providers do not use the {\clqq}LMA- Fastrach`` to clear the airways.The conclusions of the thesis may be used in making up standardized methods and techniques of clearing the airway in the prehospital emergency care. They may also be used for further education of university students of nursing and medical care.
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