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The problematics of securing airways of a patient with an acute respiratory disease
BABOUČKOVÁ, Martina
The topic of our Bachelor's thesis is "Problematics of securing airways of a patient with an acute respiratory disease". The aim of this thesis is to map the issue. The thesis contains the theoretical part and the research part. The theoretical part focuses on anatomy and physiology of the respiratory tract, monitoring of respiratory system, monitoring of consciousness, securing of the respiratory system and caring for the patient connected to the artificial pulmonary ventilation. Furthermore, this work also deals with nosocomial and professional infection and especially with acute respiratory disease. The research was conducted through qualitative research using a semi-structured interview with 10 qualified specialists and paramedics working at the department of Anaesthesiology and Resuscitation and at Emergency Medical Services. To designe researche were chosen for these research questions: 1. How do the paramedics protect themselves when securing the airways of a patient with acute respiratory disease? 2. How often do paramedics encounter the activity of securing airways of a patient with acute respiratory disease? 3. What is the attitude of paramedics in practice when it comes to securing the airways of a patient with acute respiratory disease? The purpose of this Bachelor's thesis is to find out how the paramedics proceed in securing the airways and how they react when they encounter the acute respiratory disease. This Bachelor's thesis serves as a material that points to the correct use of barrier protection. The result of the research shows that the paramedics meet with the respiratory disease only rarely. The questions were also aimed at the compliance with barrier protection. The main benefit of this Bachelor´s thesis should be the awareness of non-compliance with barrier protection and subsequent use of protection against respirátory disease.
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Non-invasive ventilation in patients with COPD
AUGUSTÍNOVÁ, Markéta
The thesis begins with a theoretical part containing a general description of artificial pulmonary ventilation, invasive pulmonary ventilation and a detailed description of non-invasive pulmonary ventilation and chronic obstructive pulmonary disease. This section also focuses on a detailed description of non-invasive pulmonary ventilation in patients with chronic obstructive pulmonary disease. The aim of this thesis is to find out the real usability and success of non-invasive pulmonary ventilation in patients with chronic obstructive pulmonary disease received in 2018 at the department of ARO in the Hospital Jindřichův Hradec. The data was obtained from the patient documentation for 2018 from the ARO department and subsequently entered in the tables. The research found that in 2018, 162 patients had undergone the selected department, of whom 63 patients suffered from chronic obstructive pulmonary disease. Noninvasive pulmonary ventilation was used in 75 patients. Of the total number of non-invasive pulmonary ventilation applications, 30 were used in patients with chronic obstructive pulmonary disease. The success of non-invasive pulmonary ventilation in chronic patients reached 90 %. The main benefit is the fact that the number of patients with chronic obstructive pulmonary disease is increasing and that indeed chronic obstructive pulmonary disease is aggravated in the winter months. Another benefit is the finding that the success and true utility of non-invasive pulmonary ventilation in patients with chronic obstructive pulmonary disease is very good.
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Prevention of Complications in Patients with Secured Airways
Trojáková, Miluše ; Heczková, Jana (advisor) ; Srpová, Daniela (referee)
The thesis reviews airway management practices in intubated a tracheostomised patients. Patients requiring mechanical ventilation have their airways secured mostly by endotracheal or tracheostomy tubes. Such patients are in a great risk of developing serious complications. One of the most common is the ventilator-acquired pneumonia (VAP). Currently, VAP represents a major problem not only in the Czech Republic but globally. In the USA, VAP is the most common nosocomial infection and represents 25% of all ICU infections. VAP complications lead to deterioration of the patients' condition, extend the total duration of hospitalization and some present a mortality risk. The VAP mortality rate has been reported to be 20-50%. Moreover, VAP complications lead to an increase in health care costs. The goal of the thesis is the comparison of the state of the art scientific knowledge, clinical guidelines and current clinical practices. The thesis describes the practice in the highly specific nursing aktivity - airway management, using case studies. My research took place at ARO (ICU - intensive care unit). The first case study involves an intubated patient, the second one a patient with the tracheostomy tube. The analysis has shown that the clinical practice guidelines of the ARO department are being followed...
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Intensive home care - Home care with elements of intensive nursing
Králová, Eva ; Hošťálková, Monika (advisor) ; Meisnerová, Eva (referee)
The master thesis deals with an intensive home care - home care of intensive nursing and maps the situation concerning the home mechanical ventilation. The theoretical part draws from the researchers' reviews. It clarifies the basic concepts, intensive home care and trends in providing the home mechanical ventilation. Furthermore, this part of the thesis explains the term mechanical ventilation. To facilitate long-term ventilation of a chronic patients it is necessary to ensure an adequate airway. Therefore, it is included a chapter dealing with a tracheostomy and its treatment.The first part of the survey summarizes a statistical overview of the home mechanical ventilation used in the Czech Republic till 31th March 2013. Next section includes a qualitative form research, which is observing the whole indicating and transferring process of a patient from a hospital to the home environment where the home mechanical ventilation is assured. I have concluded that men are more ill and women, mothers or wives are taking part in the healing process according to the investigation results. We have 81 ventilated patients in home care in total. Mechanical ventilation is mostly indicated for children with spinal muscular atrophy disease. Men compared to women are more often affected by traumatic conditions,...
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Cardiopulmonary resuscitation and the use of special instruments
KUBAL, Lukáš
The bachelor thesis analyzes cardiopulmonary resuscitation and the use of special equipment related with cardiopulmonary resuscitation in pre hospital emergency care. The main study introduces practical application of special equipment and expertise experience of paramedics and nurses with use of this equipment.Theoretical section consists of two parts definition of using special instruments and description of cardiopulmonary resuscitation. The first one describes specified equipment related to cardiopulmonary resuscitation in pre hospital emergency care and legislative standards specified for operation of emergency services in Czech Republic. The second deals with the issues of cardiopulmonary resuscitation. Basic and advanced methods of urgent cardiopulmonary resuscitation in pre hospital care and updates of Guidelines from the years 2010 and 2015 related to cardiopulmonary resuscitation are also introduced here.The practical part contains transcribed interviews with professionals, which were obtained by qualitative semi-structured interviews. Paramedics, nurses and a physician at Emergency. Medical Services in South Bohemia were selected as interviewees. Altogether, six people were contacted. Interviews contained 15 questions related to the issues of practical application, interpretation of values and personal experience with special technology used in urgent emergency resuscitation.The study of this thesis shows that health care workers do not have a problem with the interpretation of data available thanks to this technology. In some cases, there is a problem with the proper use of technology or differences of opinions on the application itself among workers from different ambulance stations. It was also found that no one is happy with trainings and the amount of information provided by an employer, because all respondents look up information concerning the technology beyond their job duties. As a contribution of this work I see a brief equipment overview non medical staff use during cardiopulmonary resuscitation. The thesis summarizes everything from the description of basic values to actual applications of the equipment.
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Options airway paramedics in terms of prehospital emergency care
KOZELKA, Pavel
This bachelor thesis deals with establishing an airway by a paramedic service in terms of pre-hospital emergency care. Considering unexpected accidents and life-threatening situations, securing the airway is one of the most important performances in pre-hospital care. Proper airway securing covers both effective ventilation and oxygenation. It is not always possible to secure using usual techniques. Therefore, alternative methods of airway management are introduced in this thesis as well. The theoretical part is concerned with the airway management. The first chapter aims at the historical background and describes the development of airway securing techniques. Following parts provide with a short introduction to the anatomy and physiology of the human respiratory tract. The thesis describes the concept of pre-hospital care and competencies of a paramedic. It focuses on airway management with or without medical devices and characterizes the main techniques, such as, the oral cavity examination, head-tilt method, the triple airway manoeuvre and Heimlich and Gordon manoeuvres. Regarding airway devices, the thesis mentions pharyngeal airway, combitube, laryngeal tube and laryngeal mask, I-gel, endotracheal intubation and alternative airway securing including coniotomy and laryngectomy. The last chapter of the theoretical part deals with the modes of artificial ventilation. The practical part compares the options of airway management and monitors the level of theoretical knowledge of airway establishing among emergency paramedics in South Bohemia, Central Bohemia and Pilsen Region.
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Ventilation support in prehospital care and during transport of the patient
PETROVIČ, Pavel
The topic of presented bachelor thesis is ventilation support in prehospital care and during transport of the patient. Consciousness, breathing and blood circulation belong among basic life functions. Thanks to ventilation support we are able to provide full or partial pulmonary ventilation. For this we use aids such as resuscitation masks meant for lay public or aids for trained paramedics like laryngeal masks, endotracheal tube and ventilator for artificial pulmonary ventilation. Prehospital care is not only about professional first aid, but about giving first aid by lay public as well. That is why aids for pulmonary ventilation are included in this thesis. This bachelor thesis had two aims; to map and compare knowledge of students attending the last year of high school in kiss of life and map experiences of paramedics with a laryngeal mask Supreme and capnometry. The research was implemented with mixed method research. Knowledge of students were found out by tests which were give in class "Z4" at Střední odborná škola veterinární, mechanizační a zahradnická a Jazyková škola s právem státní jazykové zkoušy and in class "4.B" Gymnázium Jírovcova. At Z4 class research took place on 14th March 2014. There were 25 students in this class, 4 men and 21 women. At class of 4.B students' knowledge was tested on 2nd April 2014 with presence of 26 students, 16 women and 10 men. At the beginning of test the anonymity of respondents was stressed, and then all respondents were acquainted with the character of my research and its aim. At the start of the test there were two statistic questions; if the respondent is either man or woman and whether the respondent has his/her driving license. There were 15 closed questions in the test and students were supposed to choose one right. After handing all the tests, the correct results were told to students. 51 tests altogether were given. Experiences of paramedic with the laryngeal mask and capnometry were found out in a form of five short dialogues in a week from 7th to 11th April 2014. The research group include paramedics of Zdravotnická záchranná služba Jihočeského kraje. Gained data from tests were evaluated, each question separately and then transformed in graphs which show the number of wrong and right answers. The aim of this thesis was to map and compare knowledge of students in the last year of their studies. Evaluated tests show us, that students of Z4 class have more knowledge about kiss of life or with cardiopulmonary resuscitation. In seven questions these students were more successful than their same-age colleagues from Gymnázium, who were better at three questions only. Experiences of paramedic with laryngeal masks Supreme are positive and if ensuring of air passages is needed, when a doctor is not present, they choose LMA Supreme. Paramedics agreed on that following ventilation via LMA Supreme is sufficient as long as we choose the right size. Paramedics ask for capnometer device in all cars EMS. Paramedics of the research group do not daily meet patients who would need or used at controlled ventilation. Students of the last year at high school have basic knowledge about kiss of life or about giving first aid. This knowledge is not 100% and teaching of giving first aid should be as a subject at high schools. Paramedics accept new aids and machines and use them during their practise. Thanks to this, first aid is becoming more beneficial for patients and for paramedics.
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Possibilities of artificial pulmonary ventilation in urgent care and anesteziological resuscitation department
BINTEROVÁ, Jana
The aim was to explore the possibilities of mechanical ventilation in prehospital emergency care and Anesthesiology and Intensive Care qualitative research method. The first part of the research was focused on finding out how the use, including the most frequently used modes of ventilation, and frequency of artificial ventilation. Research has found that in pre-hospital care are used methods of invasive and noninvasive ventilation and ventilatory modes most widely used in prehospital care are IPPV, CPAP and SIMV. In the second part of the research focuses on the possibility of mechanical ventilation on Anesthesiology-Intensive Care and neužívanějších detection schemes. They are IPPV, BIPAP, SIMV, APRV, PS and CPAP. The last part of the research deals mainly comparing the possibilities of mechanical ventilation at the base emergency medical services of the Liberec Region and South Region. I ran into very different views on the importance of mechanical ventilation in prehospital emergency care, but the result is the possibility of artificial ventilation in different regions does not differ much.
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Prehospital urgent care about patient with inspiration pursiness
KRATOCHVÍL, Ivo
ABSTRACT This Bachelor thesis deals with the providing of urgent care to inspiratory dyspnoea patients. It contains definition of the inspiratory dyspnoea, description of each state of the inspiratory dyspnoea, differentially diagnostic and therapeutic procedures. It presents latest findings from specialized literature on this topic. The theoretical part of the thesis mentions different diseases related to inspiratory dyspnoea states. Furthermore, the theoretical part includes therapeutic means and procedures that can be used for live-saving actions and within pre-hospital care for clients with inspiratory dyspnoea. The intention of this thesis was to point out differences between children and adult patients and differences between care for children and adults. Practical part of the thesis is focused on the degree of paramedics' orientation in the theory of pre-hospital urgent care in inspiratory dyspnoea and their theoretical knowledge and skills in treating these states. It is them who decide on life and death, which is a very serious fact particularly in case of children patients, but also adults. A quantitative research was conducted through a questionnaire. The goal was to map out the knowledge of differentially diagnostic procedures and subsequent appropriate therapy in employees of Emergency Medical Service of the Vysočina Region. Two hypotheses were drawn up to achieve the goal. The first hypothesis claimed that paramedics knew urgent care procedures and treatment for inspiratory dyspnoea patients at juvenile age. The second hypothesis said that paramedics did not have enough opportunities to practice securing air passages in children. The questionnaire survey has confirmed both hypotheses. The thesis should serve to improve theoretical preparedness of paramedics for providing urgent care to inspiratory dyspnoea clients and can be used as a study material on the topic.
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