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Hypercapnia and diffusion of gases in avalanche (Changes in functional parameters of individuals in a crisis situation)
Mašek, Michal ; Bartůňková, Staša (advisor) ; Roubík, Karel (referee) ; Rotman, Ivan (referee)
Název: Hyperkapnie a difuse plynů ve sněhové lavině - (Změny funkčních parametrů jedinců v krizové situaci) Cíle práce: Cílem studie bylo kontinuální sledování kompenzačních mechanismů, zejména změn ventilačně-respiračních ukazatelů, v simulované sněhové lavině. Metoda: K získání dat byl použit experiment a nestandardizovaný dotazník. Výběr souboru byl vzhledem ke sledované problematice přísně selektivní. Výzkumu se účastnilo 22 probandů, ale po analýze dat bylo pro nesplnění požadovaných kritérií 11 osob vyřazeno. Soubor tedy tvořilo 11 zdravých mužů průměrného věku 25,3 let. Před vlastním experimentem byla pomocí osobního spirometru testována senzitivita na hyperkapnii a hypoxii (výdrž v apnoi) a dechová zdatnost (vitální kapacita plic s usilovným výdechem). Experimentální situaci představovalo jak dýchání do uzavřeného objemu (8 l), tak do vytvořené vzduchové kapsy ve sněhu (400 ml). Kontinuální záznamy oběhových funkcí (srdeční frekvence, krevní tlak) a ventilačně-respiračních parametrů (dechová frekvence, dechový objem, minutová ventilace, obsah O2 a CO2 ve vdechovaném a vydechovaném vzduchu, odpor při výdechu a saturace krve kyslíkem) byly snímány pacientským monitorem DATEX Ohmeda. Vzhledem k charakteru dat byla využita analýza rozptylu při opakovaném měření se dvěma faktory (dvoucestná...
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Non-professional rescue in high mountains
VAVRDA, Lukáš
The thesis deals with risks of travelling to high mountains and rescue in high mountains before provision of professional rescue. It summarizes major risks and most common injuries in high mountains and researches preparedness and equipment of laymen to provide first aid. It also proposes procedures to increase the chance of surviving in high mountains through education of people, going to high mountains, which can contribute on potentional increase of successfull rescue operations, initiated by laymen. Object of the thesis is to research risks of travelling to high mountains and rescue operations before professional rescue, which can last longer than in valley due to either arduous terrain or bad weather conditions and it is necessary to provide first aid in order to rescue the patient. This target was reached by qualitative research, dealing with six respondents. Scientific contribution of the tesis are the rescue cards, usable to educate laymen those cards were made according to conclusion, that lamen have got lack of skills in rescue techniques, required for travelling to high mountains.
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Hypothermia in paramedic practice
LOUŽENSKÁ, Petra
This thesis deals with the topic of hypothermia in a rescuer's practice. Hypothermia is one of the reasons, why rescuers intervene. The problem of hypothermia is known for many years and the stress is laid on in it during the first aid. Hypothermia is a very serious condition which is needed to be solved without any suspension. Rescuers who work at Water rescue service deals with hypothermia the most. Their first task is to find a hypothermic person, move him to a safe place and give him a professional aid. Then they provide a transport to the hospital by Emergency medical services. In the theoretical part of my thesis is explained what is hypothermia, other related terms, description of manifests and a treatment of hypothermia is also mentioned. The next chapter mentions groups of people who are threatened the most. The last chapter deals with Emergency service. The research part of the thesis consists of qualitative method using questionnaires. It contains both polar and non-polar questions. At the beginning of the questionnaire there are three personal questions which are aimed at sex, education and how long do you do for Water rescue service. Other questions are aimed at rescuer's techniques and means. Rescuers working at Water rescue services were addressed. They were from South Bohemia, Central Bohemia and Vysocina Region. The purpose of this thesis was to evaluate methodical techniques, certain activities and following care provided by the rescuers at Water rescue services while they are saving a hypothermic person. The theoretical part of my thesis could be used as a study material for everyone who studies to be a rescuer. On the bases of the research part's results a description of methods for rescuers will be compiled. This will be useful for rescuers who work at Water rescue services.
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The Changes of Body Temperature of Patients during a Medical Procedure in Total Anesthesia
BENEŠOVÁ, Monika
The first part of the present dissertation shows mechanisms of keeping of body temperature in an optimum range as well as it divides and evaluates range of body temperature. My dissertation also deals with the ways of measurement of body temperature, methods of measurement and tools which are neccessary for measurement of body temperature. Another part presents characteristics of aneshtesia its division, ways of application and tools which are used for total anesthesia. It is also described an observation of body temperature during total anesthesia, negative consequences of hypothermia, regulations of body temperature during total anesthesia and prevention and treatment of hypothermia. There are descriptions of targets and hypothesis in the second part. There were made five hypothesis. The third part shows methods of collecting data itself. They are results of stucture observation of changes of body temperature of patiens in total anesthesia during surgery.The fourth part are charts and graphs showing results of measurements of body temperature of our patients in total anesthesia as well as results of the questionnaires based on answers from asked nurses. There are particular hypothesis and their results in discussion part. Hypothesis H1 was proved. Hyphothesis H2 is not possible to be disproved. Hyphothesis H3 was not proved. Hyphothesis H4 was proved and hyphotesis H5 was proved. We can deduce from the results that active use of tools for keeping body temperature in a physiological range can prevent decrease of body temperature. It is clear from the questionnaires that nurses are aware of complications connected to hypothermia. They actively use tools for keeping body temperature in physiological range. There is a summary in the conclusion of the dessertation whether all estimated targets were accomplished. As a result of the dissertation we can assume that using of tools for keeping body temperature of total anasthesia patients should be a standard. There should be also a standard to measure body temperature during an operation in total anasthesia itself.
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Pre-hospital Emergency Care for Person with Hypothermia
HONZEJKOVÁ, Barbora
Hypothermia is condition, when the temperature of the body drops below 35 °C. This specific shock caused by unfavourable surrounding circumstances can lead into a seriously threatening life condition of the patient. It is necessary to recognize the hypothermia and give the patient adequate care. The aim of my work is to map the knowledge to recognize the area of Hyperthermia for the medical rescue staff of the Medical rescue services in South Bohemia. Hypothesis was given one, H 1: Medical rescue workers know how to review the problems of hypothermia as a whole complex. In the practical part was used quantitative research. All the data were gathered via questionnaires which were distributed in regional centres for Medical Rescue services in South Bohemia. Record were evaluated and processed into the Pie and column graphs. The representation of respondents was almost equal according to gender of the participants with the various length of practice in this service. Only four out of twenty trivia questions related to problems of hypothermia reached the set limits of 75 % correctness. The results of this research show that the medical rescue worker do not have sufficient knowledge about the hypothermia. This could be caused by lack of information about this subject in Czech literature. Problems of hypothermia should be more taught at Medical schools for future medical rescue workers. And for those who are already employed by the Medical rescue service should be provided training courses or seminar on this subject. Medical rescue workers in South Bohemia region do not have sufficient knowledge about the problems of hypothermia which means that the hypothesis H 1 was not proved.
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Technical intensity and time demandigness of a nursing care while using different techniques of cooling during a controlled hypothermia therapy from the view of a nurse
GALUŠKOVÁ, Soňa
ABSTRACT: My thesis deals with therapeutic hypothermia and associated methods of cooling. Focus is given to technical and time demands of the methods in terms of reaching the target body temperature and nursing care complexity. The first theoretical part gives a brief introduction to history of hypothermia and the first existent records of the technique. Another chapter is focused on the current use of induced hypothermia, medical fields in which induced hypothermia is used both in the local or overall controlled hypothermia. Physiology and pathophysiology of thermoregulation in humans is described. More details are given on classification of hypothermia and hyperthermia. Changes in the organism during shifts in body temperature and their causes, positive and negative effects of temperature changes on the organism are discussed. Another chapter covers the issue of controlled hypothermia, its definition, positive treatment effects, negative effects on the organism and methods of cooling. External and internal methods as well as nursing procedure while the methods are applied are described in detail. The final chapter of the theoretical part of my thesis summarizes comprehensive nursing care for patients with controlled hypothermia. The objective of my thesis was to evaluate the utilization of therapeutic hypothermia in intensive care units, assessment of technical and time demands of cooling methods for comprehensive nursing care from the view of a nurse, and to find the optimal combination of cooling methods to achieve the desired core body temperature as soon as possible and to maintain the temperature. The first assumption was that therapeutic hypothermia utilization would be influenced by the patients structure on the wards. The second hypothesis was that utilization of physical cooling methods and more technically and time demanding methods such as coolgard and extracorporeal circulation would be more time consuming for nurses. The method of quantitative research, the questionnaire method, was chosen to comply with objectives of the thesis. The questionnaire contained open questions with the possibility of more responses, closed questions and one semi-closed question. The following nursing staff members were addressed: diploma nurses, registered nurses, specialized nurses working in intensive care units and resuscitation departments of four different hospitals. The research was conducted in 2009. In the concluding part of my thesis results of my work are shown in the graphic form. Discussions with literary sources on the use and application of therapeutic hypothermia are brought in. A large proportion is devoted to practical experience with cooling methods, which are compared with the results of the questionnaire. The results of my theses may be used to make the comprehensive nursing care for patients with therapeutic hypothermia more effective, with increased comfort for patients in intensive care units and resuscitation departments .
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Thermic injuries in adults
BĚTÁKOVÁ, Pavlína
Burns is a type of injury which is lawfully regarded as one of the heaviest injuries in the area of human traumatology. This kind of thermic injury has already damaged many human lives and left many psychical and physical consequences. Injuries of this kind require the most complicated, longest and thus the most expensive treatment. Some burned clients are deformed by scars for life and gradually start to realize their social limitation. Crucial part in these cases is played by good family background and simultaneously sensitive attitude of society, which has a significant influence on the patient life quality. As a consequence of this injury most people tend to insulate from society and simultaneously change his or her value system and life style. From the psychic point of view the most serious are the cases where on the basis of thermic effect affection and deformity of face occurred. . The people affected like this are frustrated by views of strange people who are determined to have two types of feelings-antipathy or sympathy. The aim of my thesis was to map the level of burned people knowledge of prevention measures and laic first aid during thermic injuries. Research group was created by the clients of The Burn Medicine Clinic at Královské Vinohrady, who were hospitalized or treated as outpatients in consequence of thermic injury from 1 August to 31 October 2007. The collection of data was carried out by means of anonymous questionnaire. With the view of this I asked the personnel of the clinic for cooperation; the personnel took willingly charge of the mediator and continued to distribute the questionnaires to clients older than eighteen years, who were affected by thermic injury. The clients filled in 95 questionnaires of the total number of 150 (63.34%); filled in questionnaires were used for the processing of experimental part of my thesis. The final part of this thesis will be the processing of an information leaflet proposal concerning the primary prevention and administration of laic first aid at thermic injuries; this leaflet may be applied in terms of certain prevention programmes or in the area of further research.
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