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Readiness of healt care providers to mass disasters
Opltová, Kateřina ; Prošková, Eva (advisor) ; Hošťálková, Monika (referee)
Reception of a large number of the injured to a medical facility as a result of a mass disaster or a catastrophe puts high demands on health care. Such situations can not be dealt with the mere improvisation; it is necessary to create unified organizational procedures defining the composition of medical teams and their activities during the multiple reception of the injured to a medical facility. The theoretical part of this thesis provides a comprehensive overview of the current state of emergency preparedness in healthcare facilities. In the empirical part, I analyzed the readiness of health facilities for a mass disaster in the capital city of Prague. A structured interview with open questions was chosen as a method of data collection. Based on the survey, I concluded that the readiness of health facilities in the capital city of Prague differs. I recommend setting up a phone line while receiving patients as a result of a mass disaster in order to improve the situation in Prague. The sole purpose of such a line would be reporting emergencies. I also recommend health care facilities participate actively in exercises within the integrated rescue system and clearly identify and determine facilities where the reception of the injured takes place if a mass disaster occurs. Keywords: mass disaster,...
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Psychology in Crisis Management: Stressful and Protective Factors in Police Officers working in Mass Casualty Disaster
Vymětal, Štěpán ; Balcar, Karel (advisor) ; Spurný, Joža (referee) ; Bahbouh, Radvan (referee)
Key words: coping, disaster psychology, Integrated Rescue System, mass causalty incident, police, psychology in crisis management, psychosocial support, resiliency, risk and protective factors. This work focuses on the area of coping in members of intervening Integrated Rescue System (IRS) bodies in rescue and disaster work following a mass traffic accident. The assumptions is that a vast mass traffic accident is a type of disaster that places increased demands on coping not only for affected citizens concerned, but also on intervening professionals. It is an unexpected, urgent, and emotionally and physically demanding event that requires flexibility, heightened cooperation between different professions, and a non-standard work performance. It is an event where it is not possible to apply routine operative procedures and management. A specific group, which this work explores in depth, is that of police officers. This professional group can be expected, in the given context, to be subjected to an increased burden in comparison to other IRS bodies - medics and firefighters. The reason for this consideration is the following list of burdensome specifics, which relate to the work of police officers in mass disasters: worse material equipment for intervention and worse availability of basic needs,...
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Possibilities of social work in the situation of huge disaster in the relation to victims' needs
Ivanko, Dana ; Vodáčková, Daniela (advisor) ; Matoušek, Oldřich (referee)
IVANKO, Dana. Possibilities of social work in a situation of mass disasters in relation to the needs of victims. Prague: Faculty of Arts of Charles University in Prague, 2013. 87 pp. Diploma thesis. Diploma Thesis - Possibilities of social work in a situation of mass disasters in relation to the needs of victims - focuses on the area of psychosocial assistance and social work in mass disasters. It describes in deeper details the types of assistance in mass disasters, focusing on psychosocial assistance. The focus is on human, with its biological, psychological, spiritual and social needs. Then, social work in situations of mass disaster and competences of a social worker are introduced. A separate chapter discusses mobile crisis teams. To achieve the goals of this work, it presents an overview of standards of psychosocial assistance, including legislative basis of help in mass disasters in the Czech Republic. Research section provides an insight into the work of mobile crisis teams in the Czech Republic in the form of examples of good practice. The methodology will be elaborated based on the examples of work of mobile crisis teams, on what has proved successful in providing psychosocial assistance. Keywords Social work in mass disasters, psychosocial assistance, mass disaster, victims, needs of...
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Readiness of healt care providers to mass disasters
Opltová, Kateřina ; Prošková, Eva (advisor) ; Hošťálková, Monika (referee)
Reception of a large number of the injured to a medical facility as a result of a mass disaster or a catastrophe puts high demands on health care. Such situations can not be dealt with the mere improvisation; it is necessary to create unified organizational procedures defining the composition of medical teams and their activities during the multiple reception of the injured to a medical facility. The theoretical part of this thesis provides a comprehensive overview of the current state of emergency preparedness in healthcare facilities. In the empirical part, I analyzed the readiness of health facilities for a mass disaster in the capital city of Prague. A structured interview with open questions was chosen as a method of data collection. Based on the survey, I concluded that the readiness of health facilities in the capital city of Prague differs. I recommend setting up a phone line while receiving patients as a result of a mass disaster in order to improve the situation in Prague. The sole purpose of such a line would be reporting emergencies. I also recommend health care facilities participate actively in exercises within the integrated rescue system and clearly identify and determine facilities where the reception of the injured takes place if a mass disaster occurs. Keywords: mass disaster,...
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Multidisciplinary Cooperation and the Role of a Nurse in Patient Care Affected by Blast Syndrome
KOPULETÁ, Martina
Blast injury is a very serious lesion caused by the shock wave resulting from an explosion. Further secondary injuries can arise from burying under debris, pieces of shards from the explosive cover, at burning, poisonous gases created by chemical reactions during detonation. The injuries often happen to be fatal and the percentage of people who survive it depends on the fact how far from the epicentre they were situated. If the individual is very close, there is almost no chance to survive, if, however, the individual is situated further from the epicentre, a few tens of meters, the chance is higher. It is so called mass disaster, which includes more injured people at an explosion. Therefore it is necessary for nurses and the hospital staff to know what the procedures are at this incident and how to take medical and nursing care of higher number of such patients suffering from blast injury. The care itself is extremely demanding, since the injured are often in critical condition. The aim of this diploma thesis, the topic of which is multidisciplinary cooperation and the role of a nurse when taking care of the patients suffering from blast injury, was to find out the information based on the latest Czech and foreign literature and create a compact overview of the knowledge of this issue, for it is necessary to have this knowledge to carry out nursing care of such patients. The second aim of this diploma thesis was to map the role of a nurse in details when taking care of a patient suffering from blast injury. This aim was stated for the reason of the demanding character and complexity of nursing care at urgent reception and anaesthesiology and resuscitation unit because the nurses at these units are placed demands on high qualification and requirements. This diploma thesis was purely elaborated as theoretical thesis based on Czech and foreign sources. The given pieces of information were obtained from a great deal of professional and scientific publications, monographs, professional journals and internet sources for each chapter. The first part of the thesis was dedicated to the description of the given issue, pre-hospital care and classifying algorithms that are used at mass health losses in such way so that the injured people have a higher chance to survive. The crisis management at hospitals, the reception of the injured, the care at the urgent unit and finally the follow-up care at the anaesthesiology and resuscitation unit are worked out in the following part. Thereafter the theoretical part focuses on nursing care at the critical care department where the nursing care of a patient suffering from blast injury is described as well as the duties of a nurse. The needed competences of a nurse working at the urgent unit, anaesthesiology and resuscitation unit are also defined in this chapter. According to the valid Czech legislation, only specially trained nurses for intensive care should take care of the patients with blast injury because the extent of their competence for intensive care is many times higher than general nurses have. The last chapter deals with team and multidisciplinary cooperation among the doctors and hospital staff as well as the cooperation concerning the pre-hospital care of the emergency services at emergency incident, for their active and quality communication are the keys for good and well done work with the least consequences.
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Cooperation of the Trauma Centre of the Hospital České Budějovice and Medical Operation Center of the Emergency Medical Service of the South Bohemian Region in the Event of Mass-Casualty Incident
URBANOVÁ, Alena
In 2011 and 2012, dramatic changes were made to the health care reform in the Czech Republic. As a consequence, almost the complete legislation related to traumatological planning was changed. This reform primarily introduced two new types of operating divisions; a department of emergency preparedness, as for the emergency medical service providers, and a contact point, from the aspect of emergency inpatient care providers. Emergency preparedness primarily processes a concept of the traumatological plan for the emergency medical service and introduces potential changes. The contact point, as a department of the emergency inpatient care with continuous operation, receives calls from the emergency medical service, especially in the event of emergencies and crisis situations. The given Master's Diploma Thesis entitled "Cooperation of the Trauma Centre of the Hospital České Budějovice and Medical Operation Center of the Emergency Medical Service of the South Bohemian Region in the Event of Mass-Casualty Incident" develops a key issue of the interconnection of traumatological plans established by health service providers within the South Bohemian Region and the level of their cooperation. Then the work analyses three mass-casualty incidents which happened in the past within the area and the level of involvement and cooperation of the aforementioned departments, i.e. the Hospital's trauma centre and Medical Operation Centre upon the Medical Emergency Centre of the Region of South Bohemia. The Diploma Thesis proceeds from the qualitative research which is divided into two parts. The first one defines the V1 research question specifying the role of the Traumatological Plan of the South Bohemian health care during the cooperation with the trauma centre under the Hospital České Budějovice and medical operation centre of the Medical Emergency Service of the South Bohemian Region in the event of a mass-casualty incident. By using a comparative method, which assessed the three traumatological plans, the level of cooperation did not exceed more than 20 % owing to the fact that the Traumatological Plan of the South Bohemian health care is out-dated. As a consequence, the answer to the V1 research question was following: The role of the Traumatological Plan of the South Bohemian health care with the cooperation of the trauma centre under the Hospital České Budějovice and Medical operation centre of the Medical Emergency Service of the South Bohemian Region in the event of a mass-casualty incident is insignificant. The second part develops the V2 research question: whether the failure in communication between the aforementioned trauma centre and medical operation centre could have any impact on the injured in the event of a mass-casualty incident. The qualitative research with the use of a method of analysis implemented during the previous mass-casualty incidents and interviews with four operators working for the medical operation centre and four doctors working at the accident, emergency and plastic surgery department provided the second answer to the V2 research question: Failure in communication between the two aforementioned departments could have a significant impact on the injured in the event of a mass-casualty incident. In the end, the thesis refers to the dramatic difference between the ideal traumatological planning and the current situation pointing out the Traumatological Plan of the South Bohemian healthcare which has not been updated for three and a half years since the reform. The given work also describes the issue of the ideal solution to the establishment of contact points in hospitals and compares it with the current situation at the Hospital České Budějovice where the contact point was established only in order to comply with the legislation, i.e. the contact point is based in the operating centre of medical transport.
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Study of emergency medical service preparedness for large number of injuries and casualties - bus accident
PRUDEL, Ondřej
This diploma thesis deals with problematic of emergency medical service preparedness in the Czech Republic, in the place of disaster and during this situation especially in bus accident with large number of injuries and casualties. Bus accident can create high risk of forming mass disaster due to many people transported in small area with low safety components. High risk of many injuries and casualties with chaotic first call make hard decision to activate plans to solve this situation for emergency services. Theoretical part of diploma thesis maps transformation of Czech paramedic system organization from districts to regions and new legislations for emergency medical service that solve preparedness, organization and duties during large incidents. Due to this new legislations were formed offices for emergency preparedness which ensure this preparedness. Practical part of diploma thesis is analysis of Czech paramedic preparedness that solve bus accidents as disaster. For this analysis were used data from regional emergency medical service headquarters (EMS HQ) - bus accident reports, drills for staff and special material equipments. But only 3 EMS HQ provided acceptable data and 1 EMS HQ partly acceptable data. Aim of this study is assessment in preparedness change for disaster during examined time (2000 - 2011) and comparison of real event to training drills. This part of thesis is supplied by statistic data (transformed into graphs) of bus accidents with injuries and casualties from department of Transportation Police of the Czech republic and Fire Rescue Service Directorate. Whole practical part is made by analysis of primary (documents, EMS HQ personal visits) and secondary information (information servers, journals). Within this analysis was made evaluation of Czech emergency medical preparedness for bus accidents with large number of injuries and casualties. This analysis shows that in area of the Czech Republic is missing central directorate for Czech paramedic system. Which is shown in varying material, drill and whole preparedness for disaster situation. This problem is also made by new legislation that were not here before (law for emergency medical system and law notices). High variation of equipments and procedures in solving disasters can cause difficulties during accident intervention on the borders of paramedic regions. For comparison to other countries preparedness is in this thesis mentioned Poland - special training course for specialist in disaster management, USA - Medical Alert Center (MAC) and Israel - control system for disaster drills.
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Analysis of the readiness of hospitals with an acute inpatient care in the Pardubice region in the event of a direct threat of CBRN substance to the Pardubice regional hospital.
KRATOCHVÍLOVÁ, Martina
This work focuses on finding state of preparedness of hospitals with acute inpatient care in the Pardubice region in the case of a direct threat to the Pardubice Regional Hospital, Inc. (hereinafter "PRH") by chemical, biological, radiological or nuclear agents (hereinafter referred to as "CBRN"). The thesis is based on a comparison between the trauma plans that have been established as an indicator of a preparedness of hospitals in case of mass disaster and the legal standard, i.e. Decree No. 101 of 2012 Sb. dealing with the details of the content of trauma plan of the one-day or inpatient medical care and process for its preparation and negotiation, as amended (hereinafter the "Decree 101 of 2012"). The theoretical work describes the applicable laws governing the conditions for the provision of health care, trauma plan content and procedures of the Emergency Service (ES) components in preparation for dealing with emergencies. The next part discusses the characteristics of CBRN agents. Furthermore, the work focuses on defining terrorism and CBRN terrorism. The chapter also includes a brief historical summary of the use of CBRN agents and their threats. The following section describes the Security System of the Czech Republic and its elements. It is crucial to mention its existence in relation to the prevention of emergencies and crisis situations and elimination of their consequences. This part also introduces a selection of documents, which have a direct relationship to the security policy of the country and to this thesis. It may be noted that most of these documents have been prepared, inter alia, on the basis of current CBRN threats. The penultimate section characterizes individual hospitals with acute inpatient care in the Pardubice region and includes also a risk analysis of this region. The analysis is based on the Emergency Plan of Pardubice region. I believe that the knowledge of the possible threats pointed out in the risk analysis is important in a preparation for an emergency response in the relation to an emergency medical care. Analysis of risks and threats, based on the Decree 101 of 2012, is also a part of the trauma hospital plans. The last part of the thesis describes the different types of trauma plans and certain procedures in the process of an activation of these plans. Even though, the theme of the work is focused more on trauma plans of hospitals, in cooperation with ambulance services and regional authorities in addressing the consequences of emergencies, I find it important to pay attention to a trauma plan for emergency medical services, and also the one, which is part of the emergency plan of the region. Based on the practical experience it was decided the readiness of hospitals with acute inpatient care in the Pardubice region in case of a threat PRH is sufficient. Subsequently, a relative comparison of interdependence trauma plans was performed in selected hospitals to evaluate their index of readiness by means of comparative analysis. The overall index IPi scales the state of preparedness of the hospitals. The input parameter?s values for the index evaluation were determined based on the contents of the trauma plans. The concluding chapter presents the results evaluated by the described method. This uncovered that the degree of readiness of the examined hospitals, based on the mentioned parameters, was insufficient in three cases. Only Chrudimska Hospital, Inc. achieved satisfactory results. Based on these results, the specific measures were recommended to be taken the level of preparedness of the hospitals. The findings and the results of this thesis are mainly practical. The most important benefit of this work is the suggested measures for the activation of trauma plans for hospitals with acute inpatient care in the Pardubice region.
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