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Practical approach to a patient with accidental hypothermia and possible solutions in the conditions of ZZS JčK
MASAŘ, Jakub
The topic of this bachelor thesis is Practical approach to the patient with accidental hypothermia and the possibilities of its management in conditions of the South Bohemian Health Service. The theoretical part of this thesis deals with manifestations and mechanisms of hypothermia, division and classification systems of hypothermia and risk groups with predisposition to hypothermia. The main part of the thesis is the management of prehospital care in accidental hypothermia. The thesis concludes with possible interventions for the hypothermic patient after a transportation to a medical facility. Two objectives and two research questions were set in the practical part. The first aim was to map an issue of accidental hypothermia and the experience of paramedics with calls to cases of accidental hypothermia in the South Bohemian Health Service. The second aim was to map the current options of dealing with accidental hypothermia and the best possible practical approach to it within the resources of the South Bohemian Health Service. Later on, another two research questions were set, namely, what are the most common cases of accidental hypothermia encountered by paramedics of the South Bohemian Health Service, and what is the best possible care we can provide to a patient with accidental hypothermia within the resources of the South Bohemian Health Service. The practical part was carried out by means of semi-structured interviews with six paramedics from the regions of South Bohemia. The interview included 25 questions and the results of these interviews were divided into 12 categories. The objectives of the bachelor's thesis were fulfilled by answering both research questions. Paramedics understand the basics of the topic of accidental hypothermia. There is a need to update the awareness and information of paramedics regarding the specifics of pharmacotherapy, cardiopulmonary resuscitation, and the options for transporting a patient affected by hypothermia. This could be achieved by increasing the number of trainings of paramedics. This bachelor thesis could be used as a teaching material for these trainings and for setting up the methodology in accidental hypothermia in the future.
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Hypothermia from the point of view of a paramedic
ŠTĚCHOVÁ, Karolina
Theme of bachelor thesis is a hypothermia from a look of the Emergency Medical Service, (paramedic). The theoretical part of this thesis focuses on the main causes of hypothermia, physiological and anatomic knowledge about a skin, diagnostic hypothermia, procedure in the pre-hospital emergency care, cardiopulmonary resuscitation in a patient with hypothermia and the subsequent intensive care. In the practical part of the thesis, we set one goal and three research questions too.This bachelor thesis maps the awareness of paramedics about the issue of hypothermia. The first research question is aimed at ensuring that the members of Emergency Medical Service (or paramedics) have a sufficient theoretical knowledge of hypothermia.The second research question is focused on the general knowledge of the Emergency Medical Service on specific cardiopulmonary resuscitation in a patient with hypothermia.The third research question examines the paramedics´ expertise in the subsequent intensive care of a patient with hypothermia. The practical part of the thesis consists of a semi-structured interview with twelve paramedics from the South Bohemian Region.The interview included 23 questions. For better orientation, were results seperated to 12 categories.The goal of the bachelor thesis was accomplished thanks to answering all questions related to the research. Paramedics Responders have some knowledge about the topic of hypothermia but it is important to provide more information about the specifics of pharmacotherapy during cardiopulmonary resuscitation on a patient with hypothermia.I rate the research questions about intensive care very positively. This bachelor thesis could be used as a basis for educating students of non-medical pharmaceutical specializations in the future.
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Rescue people on the frozen water surface
Truhlář, Filip ; Novotný, Petr (advisor) ; Vondrášek, David (referee)
Title: Rescue people on the frozen water surface Aim: The aim of this thesis is to give a comprehensive overview of the rescue people on the frozen water surface. Methods: This bachelor thesis is based on a literature review, and does not contain experimental suggestions. It is a qualitative research that has been tested and completed by the author. The conclusions were made without any quantitative experiments or statistical analysis. Key words: Integrated Rescue System, rescue, first aid, hypothermia
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Hypercapnia and diffusion of gases in avalanche (Changes in functional parameters of individuals in a crisis situation)
Mašek, Michal ; Bartůňková, Staša (advisor) ; Roubík, Karel (referee) ; Rotman, Ivan (referee)
Název: Hyperkapnie a difuse plynů ve sněhové lavině - (Změny funkčních parametrů jedinců v krizové situaci) Cíle práce: Cílem studie bylo kontinuální sledování kompenzačních mechanismů, zejména změn ventilačně-respiračních ukazatelů, v simulované sněhové lavině. Metoda: K získání dat byl použit experiment a nestandardizovaný dotazník. Výběr souboru byl vzhledem ke sledované problematice přísně selektivní. Výzkumu se účastnilo 22 probandů, ale po analýze dat bylo pro nesplnění požadovaných kritérií 11 osob vyřazeno. Soubor tedy tvořilo 11 zdravých mužů průměrného věku 25,3 let. Před vlastním experimentem byla pomocí osobního spirometru testována senzitivita na hyperkapnii a hypoxii (výdrž v apnoi) a dechová zdatnost (vitální kapacita plic s usilovným výdechem). Experimentální situaci představovalo jak dýchání do uzavřeného objemu (8 l), tak do vytvořené vzduchové kapsy ve sněhu (400 ml). Kontinuální záznamy oběhových funkcí (srdeční frekvence, krevní tlak) a ventilačně-respiračních parametrů (dechová frekvence, dechový objem, minutová ventilace, obsah O2 a CO2 ve vdechovaném a vydechovaném vzduchu, odpor při výdechu a saturace krve kyslíkem) byly snímány pacientským monitorem DATEX Ohmeda. Vzhledem k charakteru dat byla využita analýza rozptylu při opakovaném měření se dvěma faktory (dvoucestná...
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Rescue people on the frozen water surface
Truhlář, Filip ; Novotný, Petr (advisor) ; Vondrášek, David (referee)
Title: Rescue people on the frozen water surface Aim: The aim of this thesis is to give a comprehensive overview of the rescue people on the frozen water surface. Methods: This bachelor thesis is based on a literature review, and does not contain experimental suggestions. It is a qualitative research that has been tested and completed by the author. The conclusions were made without any quantitative experiments or statistical analysis. Key words: Integrated Rescue System, rescue, first aid, hypothermia
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Effect of incubation temperature on growth of the working and conducting myocardium in the embryonic chick
Skuhrová, Kristýna ; Sedmera, David (advisor) ; Gregorovičová, Martina (referee)
It was shown almost 50 years ago that hypothermic incubation of chicken embryos results in a reduction in the size of embryos and an increase in the heart weight, presumably by hypertrophy (increase in cell volume). The chicken embryos were incubated in normothermia (37.5 ř C) and hypothermia (33.5 ř C) from the eleventh embryonic day. On the 17th day, the embryos were weighed and then their hearts were weighed. In agreement with the previous results, hypothermic embryos were 29% smaller and their hearts 18% heavier. The heart-to-body weight ratio was 67% higher in the hypothermic group. The measured cell size was very similar in the target areas and it was also between the two groups. The left ventricle width was twofold that the right one and the difference was not significantly higher in the hypothermia model. Purkinje fibers, the terminal part of the conduction system, were smaller than the working cardiomyocytes. Purkinje fibers were slightly enlarged after hypothermic incubation. The proliferation rate was measured by immunohistochemical labeling of anti-phospho histone H3. The experimental group showed much higher proliferation rate; it reached statistical significance in the right ventricle. Thus, hypothermic incubation resulted in increased growth of embryonic heart based on hyperplasia...
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Molecular mechanisms of metabolic syndrome with focus on new hormones produced by adipose tissue, liver and skeletal muscle
Kloučková, Jana ; Haluzík, Martin (advisor) ; Šenolt, Ladislav (referee) ; Bužga, Marek (referee)
1 Abstract The cluster of obesity, insulin resistance and other associated comorbidities represents a significant health risk for the affected individuals as well as the whole population. Chronic low-grade inflammation of adipose tissue is considered one of the main mechanisms respon- sible for the progression from simple obesity to a fully developed metabolic syndrome. The aim of our study was to explore two different approaches that could potentially ameliorate adipose tissue inflammation - therapeutic hypothermia and the adipocytokine clusterin. In the first part, we showed that a period of deep hypothermia associated with the an- oxic phase of cardiac surgery significantly delayed the onset of systemic inflammatory re- sponse induced by surgery. The relative gene expression of the studied genes was not altered during the hypothermic period, but was significantly increased in five out of ten studied genes (IL-6, MCP-1, TNF-α, HIF1-α, GLUT1) and decreased in two genes (IRS1, GPX1) at the end of surgery. We conclude that deep hypothermia delays the onset of local adipose tissue hy- poxia and inflammation. These results could partially explain the positive effects of therapeu- tic deep hypothermia on postoperative morbidity and mortality in cardiac surgery patients. In the second part, we examined plasma...
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Prevention of perioperative hypothermia
Miketová, Štěpánka ; Heczková, Jana (advisor) ; Hakenová, Renata (referee)
Perioperative hypothermia, defined as a core body temperature lower than 36řC, is associated with increased perioperative complications and prolonged hospitalization. The aim of this thesis is to analyze measures that are taken to prevent perioperative hypothermia at the Orthopedic Clinic of one Czech hospital and compare them with the current recommendations of the American Society of PeriAnesthesia Nurses, Association of Operating Room Nurses and the National Institute for Health and Care Excellence. The study included 223 patients who underwent a planned orthopedic surgery and who were more than 18 years old. As a method of data collection I chose studying the medical documentation. The obtained data were processed quantitatively. The recommended body temperature range 36.5-37.5řC before leaving an operating room had total of 60.55% of cases. Neither one patient has been no action in terms of prevention of hypothermia. Body temperature was taken in 22.4% of cases at the beginning of and during the surgery. Except for a cotton sheet, which was used in 100% of patients, no additional measures were taken in 18,4% of patients. Thermal insulation was used in 41,7% of patients, in-line warming system of infusion fluids in 65% of patients, forced air warming system in 17.9% of patients, and disposable...
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