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The role of emergency medical services in the incident with mass health disabilities
ZRŮSTOVÁ, Simona
Medical rescue workers are routinely employed in emergency medicine. In emergencies where a large number of people are affected, knowledge of medical disaster practices is necessary. Within a second, the intervening crews should switch to another mode with a different approach to the patients than they use daily. The diploma thesis has set the following goals: to map the level of knowledge of medical rescuers in the field of emergency response with mass health impairment, their personal experience and, last but not least, education and training. Three research questions were asked to reach these objectives. What are the skills of medical rescuers in dealing with emergency health issues with mass health impairment? How do medical rescuers assess incidents with mass health impairment at which they were present and what is their attitude towards training and education in the field of dealing with emergencies with mass health impairment? The research part consists of interviews with two groups of participants: eight medical rescuers of the Medical Rescue Service of the Pardubice Region and the same number of medical rescuers of the Medical Rescue Service of the South Bohemian Region. These interviews supplemented the information provided by the crisis preparedness managers of both medical rescue services. The survey used a qualitative research strategy, conversations were recorded on a dictaphone, then processed into categories, subcategories, tables and evaluated. From the results of the work, a great difference in the knowledge of health rescuers in the field of emergency health problems can be seen. Participants of the South Bohemian Medical Emergency Rescue Service showed shortcomings in both the basic terminology and the solving of extraordinary events in particular, from reporting the situation with a report form to the classification of the disabled. On the contrary, the majority of participants in the Paramedical Rescue Service of the Pardubice Region would be able to file an initial emergency report and categorize and transport patients correctly. On the basis of the evaluated results, this difference in knowledge can be attributed mainly to the frequency and content of the training provided. In the case of South Bohemian participants, we can find the cause in the absence of practical training. The alarming results were noted in the participants' ability to use the START sorting method, from all of the sixteen respondents only one was able to answer there. The elaborated case report of an extraordinary event points to the fact that theoretical shortcomings can subsequently be transferred into practice.
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Patient's status and rights during emergency medical services
ZRŮSTOVÁ, Simona
It is necessary to consider each patient to be a unique entity and respect his or her rights. This position requires an individual approach of paramedics. They should give the client a sense of security, certainty of assistance and take into account the fact that the patient is exposed to stress, which can change his behaviour. The paramedic must cope with these facts, he cannot be influenced, he must know how to prevent conflicts and behave according to the rules of medical ethics. The aims of this thesis was to map out the level of knowledge of patients in the area of their rights, and to find out their views on the attitude and behaviour of the paramedics during an intervention of a medical rescue service. The third part of this bachelor thesis deals with the knowledge of paramedics in the area of the patients' rights and their observance of these rights. Three research questions were set up. Whether the legal awareness among patients regarding the intervention of medical rescue services is sufficient and how patients evaluate the attitude and behaviour of paramedics during the intervention. A research question was also set up for the third aim of this thesis: what is the point of view of paramedics on respecting the patients' rights during pre-hospital emergency care. In the theoretical part I focused on explaining of the basic concepts of the medical ethics issues, its history and development. The most important part of the thesis is the ethic of emergency medicine and the issues of the rights of patients during prehospital emergency care. The thesis also discusses the ethical dilemmas that paramedics deals with during their responses and an equally important area is focused on different patients' rights, including legal standards that modify them. The research part consists of interviews with two groups of respondents: eight paramedics of the Ambulance Service of Pardubice Region and eight patients who used their services. The research showed that the legal awareness of patients is inadequate. At first glance, all patients were satisfied with the intervention of the medical rescue service and had no objections. After targeted questions targeted on the compliance of individual patient's rights, I concluded that in some cases the right to privacy and dignity of the patient was not respected. The patients were not sufficiently informed about their health and procedures that paramedics performed. None of the interviewed paramedics complied the patient's right to know the name of the medical staff member who treated him. The paramedics themselves commented on the issue of the rights of patients during the pre-hospital emergency care in the sense that they try to comply these rights, but they had problems with is not always possible. They are aware of the ethical code of the rights of patients, but they had problems with telling its content. The most frequent reason for non-compliance of the rights of patients was reported in connection with responses to people under the influence of alcohol, drugs or to patients with disorders of consciousness. The surprising result of the research was the finding that half of the responding paramedics have used violence against a patient during their practice. Among the groups of patients, to whom the responding paramedics do not like to drive, are mostly Romani people, homeless people and repeatedly calling patients. This bachelor thesis will contribute to a better awareness of paramedics and the general public about the respecting the rights of patients. Paramedics can use the observations of patients and by that remove the deficiencies they have been committing during their responses.
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