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Unconsciousness of unknown etiology in first contact
KOŠŤÁL, Jan
This Bachelor Thesis deals with the topic: "Unconsciousness of unclear etiology upon the first contact of the emergency services with a "patient". The causes of unconsciousness are generally very diverse, which means that the exact cause can remain unclear during the first contact and during the phase of pre-hospital emergency treatment.Duringthelaterphaseof hospital care,more time and more sophisticated ways of examination are available to clarify the exact cause of unconsciousness. In the theoretical part of this Thesis, was a summarize the basic knowledge on consciousness and on the causes of impaired consciousness or unconsciousness. Next is a describe the diagnostics of unconsciousness during the pre-hospital medical care and present the practical procedures that need to be followed by paramedics taking care for unconscious patient. The most often causes of unconsciousness are: hypoglycemia, intoxications, craniocerebral injuries, hypoxia linked to cardiopulmonar resuscitation, bleeding to brain and brain stroke. From the point of view of the paramedic, the most important is to make early distinction between the states linked to intoxication or metabolic disorders and the states linked to intracranial injuries, bleeding and stroke. While the former states require immediate intervention by paramedic, the later states require neurosurgical intervention in the hospital. In the experimental part of this Thesis, was mapped the practical knowledge of paramedics on pre-hospital medical care for for unconscious patient. The mapping was conduct using the technique of standardized semi-structured dialogues with 14 respondents paramedics selected from all seven regional stations of the Emergency services of the South bohemian district, Czech Republic. The respondents differed in age, duration of their professional career, and level of education. All respondents answered 16 questions. All their answers are presented in the Thesis in the full form as well as processed in the Table form. In investigation proved practical difficulties with the diagnostics of unconscious patients. The results indicate that more attention should be paid by paramedics to obtaining full and correct anamnesis plus general examination of the patient. Based on early diagnosis, paramedics can decide on therapeutical procedures and on directing the patient to relevant hospital. In case of patient with secured life-functions, it is recommended to direct the patient to specialized healthcare facility, which shortens the interval between injury and targeted treatment. Results also point toward the general need that paramedics should undergo regular training in new methods and trends in paramedical care. Using of new methods of capnometry is one case where more widespread usage in paramedical practice could bring significantly better results.
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