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Management of pre-hospital care in patients with refractory ventricular fibrillation.
ZEMAN, Denis
Ventricular fibrillation is a life-threatening arrhythmia that manifests as rapid and irregular contraction of the heart chambers. If not treated immediately, it can lead to circulatory arrest and death of the patient. Treatment of ventricular fibrillation consists of immediate cardiopulmonary resuscitation and defibrillation, which restores normal heart rhythm with an electrical shock. However, some patients may be refractory, that is, resistant to repeated defibrillation bursts. The first aim of my bachelor's thesis was to find out what awareness paramedics have of the options for managing refractory ventricular fibrillation. The second aim was to find out what methods paramedics use for refractory ventricular fibrillation in practice. The research investigation was carried out by means of semi-structured interviews with paramedics working at the South Bohemia Region ambulance service. The results show that paramedics are sufficiently familiar with the treatment options for refractory ventricular fibrillation. A negative finding was that not every rescuer was able to mention all the options for changing electrode positions and the correct pharmacological management. Another negative finding was that rescuers could not agree on the number of times that ventricular fibrillation is refractory. On the contrary, the investigated method of double sequential external defibrillation was found to be very successful and thus more beneficial than conventional methods in the treatment of refractory ventricular fibrillation. The results of the bachelor thesis may offer a way for paramedics to approach refractory ventricular fibrillation. This bachelor thesis may improve the management of refractory ventricular fibrillation, which should be approached differently than classical ventricular fibrillation.
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New trends in cardiopulmonary resuscitation and their possible benefits for the treatment of patients in pre-hospital care
ŠKOLAUDY, Vojtěch
Cardiopulmonary resuscitation is a set of interrelated logical procedures that is essential for the survival of patients with sudden circulatory arrest. In recent decades, there have been significant advances in cardiopulmonary resuscitation methods and techniques, which have led to the development of new trends to potentially improve the outcomes of resuscitation efforts. The first aim of the bachelor thesis was to map new trends in cardiopulmonary resuscitation from the perspective of paramedics and the benefits of the trends for patients in pre-hospital emergency care. The second aim was to evaluate the differences between new and old trends in cardiopulmonary resuscitation. The practical part was developed using two qualitative investigations. The first research investigation was carried out by means of semi-structured interviews with paramedics working at the South Bohemian Region Ambulance Service. The second research investigation was conducted using document analysis, which focused on the Guidelines documents from 2000, 2005, 2010 and 2015. In these documents, we focused on the development of trends and practices within cardiopulmonary resuscitation. The results of the first survey show that paramedics are sufficiently familiar with new trends in cardiopulmonary resuscitation. A negative finding was that the general public does not use an automated external defibrillator in emergency resuscitation. Another negative finding was that although paramedics are professionally educated and trained, they have to consult a physician for administration of drugs during cardiopulmonary resuscitation. The second research investigation shows that trends and practices in cardiopulmonary resuscitation now focus on early defibrillation and well-performed cardiac massage. Based on the results, the bachelor thesis can provide the differences between new and old trends and the perspective of paramedics on current trends.
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