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Pre-hospital and intensive care for patients after a stroke
KULHAVÝ, Jakub
The thesis is divided into two main parts (theoretical and empirical) and deals with prehospital and intensive care for patients with stroke. The thesis has a total of three objectives. The first objective was to map selected aspects of the process of providing prehospital emergency care to patients suspected of having an acute stroke. The second objective was to describe the course of intensive nursing care for patients after a stroke, and the third objective was to determine the differences in nursing care between patients with ischemic stroke and hemorrhagic stroke. The empirical part focused on studying medical and, primarily, nursing documentation. The obtained data were processed using a quantitative research method based on retrospective data analysis, which was then interpreted. The data was recorded in record sheets created specifically to adhere to the predetermined objectives and hypotheses. The contribution of the thesis is primarily its unusual approach to the issue, addressing at the same time both prehospital and intensive care for patients after both ischemic and hemorrhagic strokes. The results indicate that crucial aspects of prehospital care include correct and rapid diagnosis, assessment of vital functions, consultation of the condition of a patient with a stroke physician and rapid transportation to the nearest appropriate medical facility. The course of intensive care focuses primarily on continuous monitoring of vital functions and their potential stabilization combined with comprehensive nursing care, which depends on the level of self-sufficiency of a patient and includes all care for basic human needs, primarily aimed at restoring the patient's ability to manage basic daily activities. In summary, it could be said that patients with hemorrhagic stroke required more demanding and comprehensive nursing care compared to patients with ischemic stroke.
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Communication of paramedic with patients with panic attack and anxiety in the prehospital care
KLEINOVÁ, Elena
Departures for anxious patients and patients having a panic attack are a relatively common case when it comes to prehospital care. Correct attitude and communication style are crucial for primary care and stabilization of such a patient. The theoretical part of this work is dedicated to the issue of states of anxiety and panic attacks, their symptoms, causes of emergence and ways of possible intervention in premedical care. It further covers communication with a patient and psychological intervention. The aim of this work was to find out about the awareness of paramedics concerning panic attacks and states of anxiety, how do they perceive those patients, how do they gain knowledge and skills in the area of communication with anxious and panic patients and how do they use these in action. Looked into were also the methods, with which paramedics achieve psychological stabilization of the patient, how do they handle such cases and how do the patients react to this. There was also an emphasis on communication and its influence on the patient. Research was done qualitatively in a form of semi-structured interviews, which were conducted with paramedics of the South Bohemia and Karlovy Vary regions. Set goals were fulfilled by the research. It has been shown that each of these case sis very individual, for this reason it was often difficult for the paramedics to form their answers to be generally valid. When it comes to knowledge and handling the situations alone, the paramedics draw on their own experiences, because their awareness in this area has shown itself to be very superficial. Despite this, their practical and communication skills are on a very good level. I firmly hope that both the theoretical and practical information contained in this work will find their use and will eventually serve the paramedics or anyone else, to whom it may be useful in any way, either to gain information or practical use. I believe, that modern technological possibilities, such as programs offering practical methods for effective providing of first psychological aid, will find their use even in the field of premedical care.
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Measuring body temperature in pre-hospital care
DEJMEK, Michal
The thesis deals with the problematic of measurement of body temperature in the prehospital emergency care. The theoretical part focuses on the physiology of thermoregulation, on the generation of heat in the body, on its expenditure and on the control of body temperature. Furthermore, it deals with measurement of body temperature, its classification, places for measurement and description of the individual types of thermometers. The conclusion of the thesis is focused on the pathological conditions connected with the body temperature, which we can meet with in prehospital emergency care. The individual conditions are analyzed from pathophysiology to treatment. The empiric part is divided into two parts. In the first part, two thermometers are compared, how they differ in measured values and further, the results are statistically compared. The research sample was made up of random patients in prehospital emergency care. In the second part of the research, the method of qualitative research based on semi-structured interviews was used. The first objective was to find out which options of body temperature measurement do paramedics have in ambulances. The second objective was to map the experience of paramedics with monitoring of body temperature in the prehospital emergency care. The research sample was made up of 5 professional paramedics from the South Bohemian Region and Vysočina Region. The results were categorized into 13 categories. From the results of the research is apparent that there is a significant statistical difference between the used thermometers, which differ from each other in measured values. The second part of the research shows that paramedics consider the current state to be insufficient for the reason that they do not have thermometer with a larger temperature range available. All respondents agreed they would welcome having a thermometer with a larger temperature range in their ambulances.
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Management of patient with critical thorax injury in prehospital care.
HARUDA, Stanislav
This bachelor thesis is mainly focused on critikal thorax injury in prehospital care. This thesis had two goals. First was theoreticly described critical thorax injury and the second goal was compare five cases from praxis with the theoretical part of this work. On the beginig of this work was discribed anatomy of thorax and phyziology of respiratory system. Next is discribed an introduction to critacal thorax injury, how they usually arise and how to provide a better prognosis for the patient. In the next chapter we are dealing with primary and secondary survay as well as the basic device examination of the patient. The following chapter is the critical chest injury itself, which is presented according to scholarly sources as life-threatening chest injury. This chapter describe symptoms, their pathophysiology and the appropriate therapy. This chapter includes these serious injuries: tension pneumothorax, massive hemotorax, open pneumothorax, flail chest with pulmonary contusion and cardiac tamponade. In other chapter are mentioned life saving skills including: needle thoracentesis, chest tube insertion and pericardiocentesis. There is also brief talk about analgesia, and the last chapter of the theoretical section is about immediate transport. In the empirical part, was used a qualitative analysis in five cases from praxis. These analysed cases were classified into categories, and then in the discussion were compared with the theoretical part of the thesis. The result of this work is that there is a correct final solution to all five critical chest injuries in pre-hospital care, but in some cases we experience incomplete examinations and there are certain differences in the treatment of these critical injuries than the scholarly sources mentioned.
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Management of patient with cranial trauma in prehospital care.
BAXA, Radim
The bachelor thesis is entitled: "Management of patient with cranial trauma in prehospital care". The teorethical part thoroughly deals with the characteristic of craniocerebral trauma and its management in prehospital emergency care. There is an overview of anatomy and physiology of head with an emphasis on perfusion and brain vascular supply. Further ways of origin, types, symptoms and assesment of the severity of craniocerebral injuries. Within the management of prehospital care, the teorethical part deals with the individual steps in examination and stabilising the patient and thr pointing to the target medical institution for final treatment. In the practical part there were set two objetives. The first objective was to map the issue of cranial trauma and the management of the patient with cranial trauma in prehospital care, based on expert literature. The second objective was to evaluate the practical procedure for six cases and how much it actually matches with the recomended procedure. A qualitative research approach was used to process the research part. The data was collected in form od cases reports, which were subsequently categorized into nine categories. According to the results, there was found that the paramedics are partly familiar and control the procedures for patient examination, its monitoring and the criteria for its targeting to the definitive health facility. The management problems may result into unequal use of fixation tools and inconsistency in the use of pharmacotherapy and volume therapy. The output of this bachelor thesis could serve as a basis for teaching paramedics dealing with craniocerebral injury and management in prehospital care. Furthermore, the work could be used to increase or supplement the awarness of paramedics when they meet a patient with trauma brain injury.
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Evaluation quality of the treatment of the most common injuries in medical first aid.
LEVKO, Marina
The theoretical part of this bachelor thesis deals with the medical first aid service (emergency) and its current status in the Czech Republic with a focus on the South Bohemian region. I also describe the difference between the ambulance and the emergency because patients often mislead those two terms. The theoretical part focuses too on the trauma issue. Children and teenagers are the most endangered by suffering a trauma. That is why I describe the problematic of children in premedical care. The objective of the thesis was to find out the number of the most common children traumas on the three departments of the medical first aid service in the South Bohemian region and evaluate the quality of treatment. I was trying to meet the goals through a data collection from the three departments of the emergency service in the South Bohemian region from 2013 to 2014. The research was conducted through qualitative and quantitative data analysis. Based on the available documentation on emergency, I was retrospectively finding out the number of all patients treated on the emergency. From this data I subsequently learned the numbers of treated children with a trauma in years 2013 and 2014. All the data learned are worked out into charts to make them more transparent. The qualitative form of the research was done by the method of casuistry analysis. By analysing the casuistries I was also finding out what were the most common children traumas treated on the emergency, its diagnosis and the process of the treatment of each of the children patients in years 2013 and 2014. Two research questions were stated for this thesis. What are the most common traumas which are treated on emergencies and what is the way to treat such traumas and whether it corresponds with lege artis. For better orientation, the data learned about the most frequent children traumas treated on the emergency are put into graphs. After the evaluation of results I found out that the most common children traumas on all three departments of the emergency in years 2013 and 2014 were: injury caused by a sharp object then fall or a blunt impact to an object and burns of I. and II. degree burns. Those results matches with the results presented in other works dealing with the most frequent children traumas. The casuistry analysis implies that all the three departments of the emergency treat the most common types of a light injury the same way, in comparison with the reference literature in all the cases the procedure of treatment was correct. In cases when the trauma was not possible to be solved on the emergency, because of need of a laboratory or projecting medical examination which are not available on emergency, the ambulance was called to a patient, or the patient was redirected to another specialised department to be provided with safe and lege artis diagnosis. While evaluating the quality of the treatment I also focused on the evaluation of the medical documentation which is, on the emergency, represented by the book of daily records. On the emergency 1 and 2 I have met a serious failure with managing this book. Those failures were recorded only within the casuistries dealing with the treatment of adults. When evaluating the quality of treatment of children patients I have not met any wrong or partly filled documentation. To make the transparency better and have the unified form it would be adequate to keep the books in an electronic way at all three emergencies. This is where we are confronted by financial background of the emergency services. In the Czech republic there have not been institutionalized the form of the emergency, its function neither the network of emergencies, have not been specified by any law yet. If the function, provision, availability and the financial background of the emergency is united it would have a positive impact even to patients who this service is meant for.
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Intraoseal approach - an alternative to peripheral venous entry
TUROŇ, Jiří
The intraoseal approach is an alternative method how to ensure bloodstream in cases when it is difficult or impossible to use venous entry. It is used mostly in children, but it is possible to apply it to adults too. This bachelor?s thesis called ?Intraoseal approach - an alternative to peripheral venous entry? deals with theory of using intraoseal approach in conditions of pre-hospital urgent care. The practical part of this thesis surveys the frequency of using intraoseal implant and screens the knowledge of rescuers working in Salvage and rescue service of Moravian-Silesian district. The method of quantitative research was used to validate the hypothesis. Obtained data were collected by method of anonymous questionaires. These questionaires were distributed to Salvage and rescue service of Moravian-Silesian district, to resorts of Ostrava, Opava, Havířov, Karviná, Krnov, Třinec and Frýdek ? Místek in the concrete. The results of this work showed practical and theoretical knowledge of paramedics of Moravian-Silesian district. Their orientation in the problematics of using alternative venous entry in conditions of pre-hospital urgent care is mostly correct even if there was few wrong answers. Nevertheless the results of research were excellent. These are hypotheses defined ? H1: Paramedics know the process of using intraoseal approach, and H2: The intraoseal approach is used less than venous cannulation in life endangering cases. Both of these hypotheses were verified. The frequency of using this entry is not so high, but I believe it becomes more common with increasing knowledge of rescuers, especially in cases of immediate threat of life with impossibility of using peripheral venous entry.
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Cooperation of the Mountain Rescue Service of the Czech Republic, Šumava region, with basic units of the integrated rescue system
HLAVÁČEK, Jan
The topic I selected for my bachelor degree thesis is a not-very-well-mapped area of cooperation between basic units of the Integrated Rescue System and the Mountain Rescue Service, Šumava region. I have described the content of works performed by the Mountain Rescue Service and their points of contact with the Emergency Medical Service, Police of the Czech Republic and Fire Rescue Service of the Pilsen and South Bohemian region, in connection with rescue of persons and their health. In my thesis I have attempted to describe situations typical for cooperation between the units, as well as the quality of cooperation, mutual interconnection between the organizations and potential possibilities to expand the cooperation in order to ensure safe movement and stay of persons in the mountain region of Šumava. The qualitative research used a method of semi-structured interview with members of the individual above-mentioned organizations. The research has shown that the cooperation functions at a very good level, it develops continually and that it is indispensable in the conditions existing in one of the country´s biggest mountain regions. One particular measure that could ensure further improvement is the development of a legislative document accurately defining competences of mountain rescuers.
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Logistic indemnity of medical interference within the area of multiple victim accidents
KŘIVÁNKOVÁ, Petra
The theme of my diploma is the Logistic indemnity of medical interference within the area of multiple victim accidents. The world was struck by natural disasters during its long history. As well as the strengthening of natural disasters, the appearance of the disasters caused by human activity has been increasing in recent times, and at present and their after-affects are more destructive. This diploma is taken as a overall cross {--} sectional study of the topic of logistic indemnity of medical interference within the area of multiple victim accidents. After a brief approach of the history of prehospital care the diploma is focused on legislative regulation of this theme including processing of emergency plans and traumatological plans, financing of crisis set-ups, special training, procedure of salvage and liquidation operations of the units of integrated rescue systems and logistic indemnity of medical interference in the form of material and technical special equipment including human sources and psychological support. This diploma also includes some special problems of this topic (e.g. processing of traumatological plans, financing of crisis set-ups, labels of multiple victim accidents).
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Suffering, dying and death in prehospital care
MAJSTR, Jiří
This thesis is topically focused on suffering, dying and death of a patient (patients) in fore hospital urgent care. It deals with above mentioned phenomena from the paramedic point of view. It refers to the impact of these events on paramedics, their perception of patients at sudden worsening of chronic disease, acute worsening of health state, immediate life threatening or death. The aim of the thesis is to map and interpret the attitude of addressed paramedics to given facts, which they normally encounter in their practice, and the evaluation of reflexive projection of above mentioned experiences into ethical attitude to the patients. The thesis is based on qualitative research. It uses the methods of controlled interview with ten chosen paramedics who have different period of professional practice. The dialogues are transcribed in the chapter called Results of Research. In the thesis the answers to particular questions are compared and the results of the research are the hypotheses which can be evaluated by means of quantitative research in the future.
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