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Indications and Contraindications of Cardiopulmonary Resuscitation in Context of Establishing Death by a Paramedic
URBANOVÁ, Alena
Recently, the Czech Republic has seen more and more developing trends of increasing the number of paramedic assistance units, particularly in towns with a short time interval of getting to hospital, but often in peripheral areas as well. A problem occurs when the emergency condition of a patient must be treated right at the place and the paramedic assistance crew does not have the same authority as the medical emergency crew. Paramedic assistance units in the Region of South Bohemia can be named as an example. The paramedic does not have to start with cardiopulmonary resuscitation if certain signs of death are present and the injuries are incompatible with life. On the other hand, a doctor can pronounce death and not start cardiopulmonary resuscitation. This thesis titled ?Indications and Contraindications of Cardiopulmonary Resuscitation in the Context of Establishing Death by a Paramedic? aims to chart the procedures of paramedics in connection with starting or not starting cardiopulmonary resuscitation directly at the place when death is suspected. The qualitative research concentrates on paramedics of the South Bohemian Medical Emergency Service. The theoretical part introduces medical emergency services, a paramedic, cardiopulmonary resuscitation, death and the ethical issue of death as well as dying, with a large focus on medical law. The thesis established that some paramedics act in a completely opposite way than their competences allow them to do. Furthermore, a complete lack of knowledge regarding the medical law and legislation specifying the competences of paramedics occurred. Therefore I had to establish a hypothesis that paramedics do not always follow their competences in connection with starting or not starting cardiopulmonary resuscitation directly at the place. The thesis indicates that paramedics should be more educated in the area of medical law and well trained in respect of 2011 medical acts. At the same time I believe that paramedics should not only follow their intuition in emergency situations when a doctor is not present.
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The resuscitation issue from the perspektive of a nurse working in the subsequent care hospital
HOLÍKOVÁ, Sandra
Cardiopulmonary resuscitation is a complex of procedures that are carried out at an acute stage when afflicted patient?s life functions have been failing and the resuscitation is aimed at his/her life saving. These efforts to save a man are as old as the mankind itself. Over time those procedures were getting better and they were given a certain order i.e. method. Nowadays those procedures are summarized in the so called ?Guidelines? that are accepted as established rules to carry out the resuscitation. This work?s title sounds ?Resuscitation Problems Perceived by a Nurse Working in Subsequent Care?. Theoretical part of the work is divided into four main chapters. The first section explains the definition of subsequent care. It describes a sort of provided care, an indication of admission to a bed of subsequent care and patient types who are admitted to these departments. The second section is concerned with a geriatric patient who is admitted to those beds the most frequently. The third section is focused on the resuscitation itself. The history of resuscitation is described here in brief, its dividing, particular components at the resuscitation performance, legal responsibility of employees working in health service in relation to the resuscitation and principal alterations in Guidelines 2010. The last section is aimed at solution of the resuscitation particularity with older people. Practical part is consequently focused on a research of status of nurses? resuscitation knowledge. An investigation was executed based on research which was composed of a questionnaire, an observation and an internal audit. The goal of the work was to find out whether nurses were familiar with the cardiopulmonary resuscitation procedures and further to ascertain whether nurses adhered to the principles of cardiopulmonary resuscitation. To match the above goals hypotheses were set, i.e. hypotheses being engaged in nurses? knowledge concerning the resuscitation. Those hypotheses were confirmed in term of the theoretical viewpoint. However, they were disconfirmed in term of the practical viewpoint. The nurses know the theoretical resuscitation procedures and aids very well but they aren?t able to utilize this knowledge practically. The hypothesis was confirmed that the nurses keep the aids applied for resuscitation at their disposal. Appropriate results were worked up into graphical appearance by help of charts. Information resulting from this work will provide service to management of the Subsequent Care Hospital Hospice Horaždovice s.r.o1. Based on those findings, the resuscitation standard was worked up which should improve the nurses? knowledge of resuscitation. The biggest shortcomings were discovered in the area of breathing practice and airways safeguarding. At the same time, the regular nurses training of resuscitation will be better focused thereon in this hospital. Just big shorts were found out in the practical area of resuscitation performance. 1
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The Awareness of Pupils in Selected Primary Schools in České Budějovice of Non-Professional First Aid Administration
KUČEROVÁ, Olga
The thesis is devoted to the issue of non-professional first aid provision. Everyone should have knowledge of first aid procedures, because in the Czech Republic there is a statutory duty to provide first aid. It is therefore necessary to start training as soon as possible, already in school-aged children. The thesis is focused on pupils of 8th grade of primary schools in České Budějovice and their knowledge of first aid. The thesis is divided into two parts, theoretical and practical. In the theoretical part basic information on first aid is given. News and changes brought about by global directive in resuscitation Guidelines 2005. It also gives and account of individual diseases with brief descriptions, causes and emergency procedures. The last two chapters are focused on the Red Cross activities and first aid training in schools. The practical part examines the attitude of pupils to first-aid provision and their first aid knowledge. In this section, the following two objectives and hypotheses were stated: The first objective is to determine the pupils´ interest to get involved in first aid training. The other objective is to monitor the first aid knowledge and skills of primary school pupils before and after the training implementation. Hypothesis 1 assumes that primary school pupils are interested in obtaining information relating to first aid. The second hypothesis determines if the pupils´ awareness got improved after the training. To meet the goals of the thesis quantitative research was used. To pupils interested in the issue, professional instruction in first aid, led by a worker of the Red Cross in České Budějovice, was provided. Based on the pre and post test, a questionnaire survey was carried out when the pupils responded in writing to questions in two questionnaires. The first questionnaire contained 19 and the second 21 questions. Total 122 questionnaires were distributed. The goals of the thesis were met and after the questionnaires evaluation, both my hypothesis were confirmed. The research has shown the pupils' interest in the issue and a better understanding after the training. In order to improve basic first aid knowledge in primary school pupils it would certainly be beneficial to put emphasis on first aid training in schools.
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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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Regular Trainings for Nurses as an Integral Part of Preparation for Accreditation Survey.
MATĚJČKOVÁ, Marie
Regular trainings are to ensure an employee maintains or enhances his/her knowledge and skills he/she needs to do his/her job and for his/her professional development. Therefore quality regular trainings are one of the conditions for successful accreditation survey, too. In order to reach our survey targets we have chosen a qualitative research method, we used an anonymous questionnaire intended for all nurses working at the standard departments and at the Department of Anaesthesia and Intensive Care (ARIP) at Šumperk Hospital a.s. We have defined two goals. The first goal is to find out what the extent of the regular trainings for nurses is. The other goal is to find out the nurses{\crq} level of knowledge of the issues of cardiopulmonary resuscitation, occupational safety and health, and hygiene regime. Both goals have been fulfilled by obtaining the results of the research. Six hypotheses have been defined. The first hypothesis that the nurses are trained in the issue of cardiopulmonary resuscitation at least once a year was confirmed with table No. 21. The second hypothesis whether the nurses are trained in occupational safety and health at least once a year was confirmed with table No. 35, too. Even the third hypothesis that the nurses are trained in hygiene regime at least once a year was confirmed with table No. 50. The success rate of answering questions on the issue of cardiopulmonary resuscitation was 85.5 % which confirmed the fourth hypothesis that the nurses know the principles of cardiopulmonary resuscitation. The success rate of answering questions on the issue of occupational safety and health was 57.9 % which did not confirmed the fifth hypothesis that the nurses know the principles for occupational safety and health. And the success rate of answering questions on the issue of hygiene regime was 57.7 % which did not confirmed the sixth hypothesis that the nurses are aware of the principles for the issue of hygiene regime. The results of the research obtained for the bachelor thesis will be provided to Šumperk Hospital a.s. for internal purposes to improve the quality of these regular trainings.
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