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The spectrum of surgical procedures in the conditions of pre-hospital emergency care
MONDEK, Jan
The bachelor's thesis is focused on surgical procedures in pre-hospital emergency care within solving reversible causes. The bachelor's thesis consists of a theoretical and research part. At the beginning of theoretical part, I deal with surgical procedures that belong to the environment of pre-hospital emergency care and describe their division, indications, risks and practical procedure for their application. I also describe traumatic circulatory arrest and extended cardiopulmonary resuscitation. In other chapters of the work, I deal with patient monitoring and examination, which is important for revealing reversible causes. I discuss the need for analgesia in pre-hospital care, and the last chapter focuses on the importance of maintaining an aseptic environment and risk sepsis. The research part covers qualitative research in the form of a semi-structured interview, while the research team consisted of 9 paramedics from the South Bohemian Region. The aim of the research was to map the indication and risks of surgical procedures in the conditions of pre-hospital emergency care. Another aim was to find out what awareness and experience the paramedics of the South Bohemian Region have in this issue. All research questions were answered and the aims of the thesis were fulfilled. The research found that the experience and knowledge of the paramedics at the various sites are very similar, the paramedics are sufficiently familiar with the issue, while the station in Jindřichův Hradec is objectively slightly better. This work could be used as study material in the education of paramedic students or for the self-education of paramedics.
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A sudden cardiac arrest and use of capnometry in cardiopulmonary resuscitation
Pokorná, Milana ; Nečas, Emanuel (advisor) ; Málek, Jiří (referee) ; Bělohlávek, Jan (referee)
The study is focused on advanced life support (ALS) performed by rescue team physicians in an out-of-hospital setting. The first part of the study analyzes diagnostic possibilities and correctness of assumed aetiology of the sudden cardiac arrest during cardiopulmonary resuscitation (CPR) in the field. It introduces an original method of "Crosscheck Tables" and applies this method to 211 cases of CPR provided by physicians of the Emergency Care Service. The study demonstrates that significantly misleading conclusions can result from a global analysis of a set of cases. It stresses importance of diagnostic analyses applied to individual cases. The second part of the study concentrates on changes in PETCO2 level as related to the return of spontaneous circulation (ROSC - Return of Spontaneous Circulation) as opposed to the circulation fully dependent on chest compressions. The study demonstrates that in constantly ventilated patients undergoing CPR in an out-of-hospital setting, PETCO2 is significantly higher (about 10 mmHg) after ROSC than before ROSC. It demonstrates that a sudden increase in PETCO2 exceeding 10 mmHg is likely to indicate the moment of ROSC. The study also support a view that steadily low levels of PETCO2 values (<10 mmHg) indicate a low chance for a successful resuscitation outcome. Key...
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The role of a paramedic in care of cardiac arrest patient in special circumstances
SAMCOVÁ, Markéta
The bachelor thesis is focused on the advanced life support during the cardiac arrest in special circumstances. The thesis is divided in two parts theoretical and research. In the theoretical part, the pre-hospital care is briefly defined and it covers also the anatomy and physiology of a heart. Described are selected heart rhythm disorders and a cardiac arrest. In more detail, the thesis describes the cardiac arrest in special circumstances. In this bachelor thesis, qualitative research was carried out covering medical rescue procedures in patient care with a cardiac arrest in special circumstances in pre-hospital emergency care. Subsequently, their procedure was compared with the current recommended procedures of the European Resuscitation Council for Resuscitation in 2015. The research found that the health rescuers who were questioned were sufficiently oriented in the issue of cardiac arrest in specific circumstances within pre-hospital emergency care. An exception is the advanced life support of a patient burriend by an avalanche. In this part, respondents did not have sufficient knowledge of the guidelines. In all other situations, questioned parademics would follow the suit with the current recommended procedures of the European Resuscitation Council in 2015. The thesis can be used as a study material for the paramedic students and as well as for the lay and professional community.
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Need of CPR (cardiopulmonary resuscitation) team in hospital
GRAUSAM, Tomáš
In the introduction of the theoretical part of the Bachelor's thesis, we learn about the history and development of life support and we explain the role of a resuscitation team (RT). The practical part focuses on mapping of the existence and activities of resuscitation teams in seven South Bohemian hospitals in case of a necessity for advanced life support (ALS) in sudden circulatory failures (SCF) that arise in a hospital. Data collection took place in the form of questionnaires based on a guided interview of the author with randomly chosen respondents, at previously determined workplaces with the highest probability of SCF. All questioning was anonymous and both respondents and hospitals were subsequently assigned code indications. The thesis should be beneficial for acquisition of information on current state of resuscitation teams in hospitals of the South Bohemian region and on provision of qualified resuscitation care according to valid rules updated by the European Resuscitation Council in October 2015. From the results of the research part, it is evident that resuscitation teams are active in all the South Bohemian hospitals. Their activities, personnel and technological equipment correspond to a standard and they are comparable in all the hospitals. Some shortcomings that may lead to not quite as optimal CPR results were found in the initial phases in first providers on standard inpatient wards.
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A sudden cardiac arrest and use of capnometry in cardiopulmonary resuscitation
Pokorná, Milana ; Nečas, Emanuel (advisor) ; Málek, Jiří (referee) ; Bělohlávek, Jan (referee)
The study is focused on advanced life support (ALS) performed by rescue team physicians in an out-of-hospital setting. The first part of the study analyzes diagnostic possibilities and correctness of assumed aetiology of the sudden cardiac arrest during cardiopulmonary resuscitation (CPR) in the field. It introduces an original method of "Crosscheck Tables" and applies this method to 211 cases of CPR provided by physicians of the Emergency Care Service. The study demonstrates that significantly misleading conclusions can result from a global analysis of a set of cases. It stresses importance of diagnostic analyses applied to individual cases. The second part of the study concentrates on changes in PETCO2 level as related to the return of spontaneous circulation (ROSC - Return of Spontaneous Circulation) as opposed to the circulation fully dependent on chest compressions. The study demonstrates that in constantly ventilated patients undergoing CPR in an out-of-hospital setting, PETCO2 is significantly higher (about 10 mmHg) after ROSC than before ROSC. It demonstrates that a sudden increase in PETCO2 exceeding 10 mmHg is likely to indicate the moment of ROSC. The study also support a view that steadily low levels of PETCO2 values (<10 mmHg) indicate a low chance for a successful resuscitation outcome. Key...
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