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Case Study of physiotherapeutic care of a polytraumatic patient diagnosed with proximal humerus fracture
Lichnovská, Bára ; Neuwirthová, Svatava (advisor) ; Nový, Filip (referee)
Author: Bára Lichnovská Title: Case study of physiotherapeutic care of a polytraumatic patient diagnosed with proximal humerus fracture Head of the thesis: Mgr. Svatava Neuwirthová Aim: The main aim of this bachelor thesis is to outline the possibilities of physiotherapeutic care of a patient with polytrauma, whose main limitations result from the consequences of multiple fractures such as HKK and DKK. Introduction to the problem of fractures - classification, solution of the case study of physiotherapeutic care of a patient with a diagnosis of proximal humerus fracture. Methods: The theoretical part of the thesis is prepared in the form of a literature search. The knowledge of anatomy, kinesiology of the shoulder joint area, humerus is mentioned. It also describes the types of fractures and their division, treatment options - invasive or non- invasive, the course of bone healing and the procedure of subsequent rehabilitation after fractures. The special part includes a complete case report of the patient, initial kinesiological analysis, record of therapeutic units completed by the patient and then the output kinesiological analysis. In the final part I discuss the evaluation of the overall effect of the therapy. Keywords: case study, physiotherapy, brachial plexus, shoulder joint, humerus,...
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Diagnostic imaging of patients with polytrauma
FIŠER, Martin
The bachelor thesis deals with diagnostic imaging methods in polytraumatized patients. Diagnostic imaging methods play a big role in the examination of these patients, where the main goal is an early diagnosis, which should help, in severe cases, even save the patient's life. This thesis is divided into theoretical and practical part. The first half of the theoretical part explains the definition of polytrauma and the mechanisms of its formation. The most common causes of multiple injuries are described. The second half describes the imaging methods that are used in the examination of polytraumas. First, I explain the basic radiological procedures and their algorithm in polytrauma. Then the thesis focuses on the principles of computed tomography, ultrasonography, skiagraphy and magnetic resonance. Contrast agents that we use in the diagnosis of a polytraumatized patient are listed. In the practical part, using the obtained data from the Hospital České Budějovice a.s., it was statistically examined whether the number of patients has increased over the past five years or not. In addition, the gender and age distribution of patients with polytrauma were investigated. The statistical representation of the causes of injury is also examined. The practical part also deals with what examination is performed most often. All data are clearly processed into tables and graphs. This bachelor thesis can serve as an educational material for students of medical disciplines and radiological assistants.
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Admission of polytraumatized patient to the hospital - preparation of simulated scenarios for paramedics and nurses
ŠEVČÍKOVÁ, Tereza
The most common cause of death of children and adolescents is trauma. The Czech Republic is dominating and ranks in leading positions in Europe. Children mostly occur in situations such as falls, traffic accidents, when the child is in the position of a passenger or is represented as a pedestrian or cyclist. Other causes include burns, drowning or suffocation. Treatment in the first 20 minutes is most important for the patient's further prognosis. Therefore, it is necessary to proceed quickly during treatment and provide emergency assistance first - which means securing the airways and circulation. A polytraumatized patient is considered as one in a very serious condition who needs acute assistance from rescue services. When admitting a polytraumatized patient to the hospital, it is important for the rescue team to organize the work and provide it to the patient with the fastest and highest quality care. The diploma thesis is elaborated in theoretical form and is divided into four parts. Scientific information was obtained when studying professional literature. It was Czech and foreign literature and both monographic works and scientific periodicals were used. The process of nursing care procedures for children with polytrauma and my personal experience as a nurse working at the resuscitation department for children greatly contributed to the extended data collection for the diploma thesis. The diploma thesis creates a summary of procedures for the admission of a polytraumatized patient and enables a better orientation in the provision of nursing care for children. It focuses on differences in the provision of emergency care for children and highlights priorities in the treatment of patients in pre-hospital and hospital care. It also points to the clash of non-medical staff with doctors and the ability to cooperate in the provision of care within the rescue team. The diploma thesis provides information on the topic of admission of a polytraumatized patient to the hospital and is intended primarily for non-medical healthcare professionals, but also for the professional and lay public.
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Case Study of The Physiotherapeutic Treatment of a Patient with Polytrauma; Recurrent Central Vestibular Syndrome
Hutchinson-Proske, Jadée Alyssa ; Chroustová, Kristina (advisor) ; Vomáčková, Helena (referee)
The aim of the following thesis is to present the case study of a patient during the rehabilitation process with a diagnosis of polytrauma; recurrent central vestibular syndrome, with special mention to diffused axonal injury from polytrauma. The document is divided into two (2) parts the general/theoretical part and the practical or case study part. The general/theoretical part consist of an introduction of polytrauma and recurrent central vestibular syndrome/dysfunction, followed with characteristics of the disease; epidemiology; etiopathogenesis; incidence; pathokinesiological consequences for the musculoskeletal system; classification; clinical examination; therapy / treatment; pharmacotherapy; conservative treatment; or surgical treatment; examination methods performed by a physiotherapist; physiotherapeutic methods and procedures; physical therapy; occupational therapy; regime measures and prognosis. In conclusion of the general/theoretical part is the effect of therapeutic approaches and procedures with high level of medical based evidence for therapy. The second part consists of the case study which includes the patients' medical history, initial and final kinesiological exam with comparisons to spotlight effect of therapy, short- and long-term therapy plan, evaluation of the therapy and a...
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Pathophysiological aspects of critically ill patients and its influencing with hormonal and nutritional support.
Kafková, Anežka ; Hronek, Miloslav (advisor) ; Kovařík, Miroslav (referee)
The state of critically ill patients suffering from polytrauma or sepsis is characterised by pathophysiologic processes, which cause significant changes in an organism on both a local and a systematic level. A stressful situation elicits an acute inflammatory response. This response is primarily meant to be a defence mechanism; however, this mechanism might become harmful to a certain degree. Hormones, cytokines and growth factors are included among the main control mechanisms activated during inflammatory response. A metabolic response to a stressful situation is characterized by an increased turnover of proteins, lipids, and glucose. Clinical consequences may develop as a result of these metabolic responses and include inflammation, anorexia, immobility, increased vascular permeability (which results in edema), vasodilation, tachycardia, and increased cardiac output. There are some key factors which have a negative contribution on an inflammatory response. Those factors may include malnutrition, pre-existing inflammatory activity, severe infection, obesity, ageing, genotype, and finally gender-gene effects, which may also play a role. The development of significant hormonal changes can be typified for critically ill patients. Such changes are particularly connected to catecholamines, thyroid...
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Case study of physiotherapy treatment of a pacient after fracture of the distal radius and acetabulum
Svobodová, Zuzana ; Stupková, Michaela (advisor) ; Slezáková, Petra (referee)
Autor: Zuzana Svobodová Název: Case study of physiotherapy treatment of a pacient after fracture of the distal radius and acetabulum Vedoucí práce: Mgr. Michaela Stupková Cíl: The aim of this bachelor thesis a summary of general knowledge about the issue of fracture of the distal part of the radius and fracture of the acetabulum. In the practical part, a detailed case report of the patient is elaborated and the subsequent rehabilitation care is described together with the results of the therapy. Metody: The bachelor thesis was written within the practice at the Department of Aftercare and Rehabilitation in the Havlíčkův Brod Hospital. The general part describes the anatomy, biomechanics and kinesiology of the forearms and acetabulum, along with the classification of fractures and rehabilitation procedures. In a special part of the bachelor thesis, a case report of a patient after polytrauma is processed, focusing mainly on the rehabilitation of the upper limb. Výsledky: The patient completed nine therapeutic units during the hospitalization, during which there was a significant improvement in range of motion, reduction of swelling and reduction of pain. The patient also reported subjective improvement in his mental health. Klíčová slova: Fractures, distal radius, acetabulum, polytrauma, rehabilitation
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Nursing care of the multiple trauma patient with communication barriers
Vojčíková, Žaneta ; Pražáková, Zuzana (advisor) ; Bauerová, Jana (referee)
Trauma is one of the most common causes of death in the population under the age of 40. Trauma causes irreversible and permanent disabilities and economically incalculable losses. In the Czech Republic, it ranks fifth among the most common causes of death. Trauma represents an extreme stressful situation for the human body. It burdens it and manifests itself with the disability of physical and mental functions. The man finds himself unexpectedly outside his social background and life security with an uncertain prognosis for a return to the lifestyle he had before the accident. In the theoretical part, this case study focuses on trauma and its division, specifically it deals with polytrauma and its pathophysiology and states the probability of survival. It points to the routinely used trauma protocol ATLS. The diagnostics and therapies in pre-hospital and hospital care are mentioned in the thesis as well as the most common complications of polytrauma. The conclusion of the theoretical part is devoted to communication, communication barriers and the definition of the nursing model according to V. Henderson. The practical part is represented by a specific case study of the patient. The nursing plan is created based on V. Henderson's concept and deals in detail with the main problem - communication...
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Professional first aid in motorcycle racings in the Czech republic and abroad
SEJK, Lukáš
This Bachelor thesis deals with providing of professional first aid during motorcycle races in Czech Republic and abroad. A notion "motorcycle races" in this work is narrowed down only to "sidecarcross". In this field there is a high risk of injury because of the variable nature of the track, weight and power of the machine. These injuries are most frequent causes of death of working-age people. Therefore it is so important to provide pre-hospital care immediately after any accident right on the track. The objective of this thesis is to map these types of races from the point of view of health insurance and to determine qualification of personnel at the place of accident. The thesis is compiled from semi-structured interviews at sporting venues. Interviews were conducted with two groups of respondents. The first was group of organisers of international championship races in Czech Republic and world championship. The second group was composed of medical personnel providing health care right at the tracks. The research has pointed out missing legislative support of this issue and the resulting disunity during providing sporting events.
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Professional first aid in motorcycle racings in the Czech republic and abroad
SEJK, Lukáš
This Bachelor thesis deals with providing of professional first aid during motorcycle races in Czech Republic and abroad. A notion "motorcycle races" in this work is narrowed down only to "sidecarcross". In this field there is a high risk of injury because of the variable nature of the track, weight and power of the machine. These injuries are most frequent causes of death of working-age people. Therefore it is so important to provide pre-hospital care immediately after any accident right on the track. The objective of this thesis is to map these types of races from the point of view of health insurance and to determine qualification of personnel at the place of accident. The thesis is compiled from semi-structured interviews and participation right at sporting venues. Interviews were conducted with two groups of respondents. The first was group of organisers of international championship races in Czech Republic and world championship. The second group was composed of medical personnel providing health care right at the tracks. The findings of interviews were confronted with findings acquired from participating observation at the venues of races. The research has pointed out missing legislative support of this issue and the resulting disunity during providing sporting events.
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Effect of nutritional support on energy expenditure and nutritive substrate oxidation in polytrauma patients.
Vlnová, Jana ; Hronek, Miloslav (advisor) ; Herink, Josef (referee)
In this study, examinations of 6 patiens of the ICU of the University Hospital in Hradec Kralove were included. The aim of this study was to describe case reports of individual patients and to look for statistically significant correlations between nutritional support, oxidation of nutrients and other parameteres. Anthropometric measuring and indirect calorimetry were used for the examination of patients. The case reports show the individuality that occurs in patients. Spearman's correlation analysis was used to evaluate measured data. Statistically significant correlations were proven, among them relations between enterally given nutrition and the creation/loss of muscle tissue (carbohydrates: P = 0,000189, lipids: P = 0,001284, proteins: P = 0,000255), between carbohydrate oxidation, resp. protein oxidation and the number of hours spent on ventilation (carbohydrates: P = 0,041278, proteins: P = 0,02185), between respiratory quotients and the duration of the trauma (respiratory quotient: P = 0,014695, nonprotein respiratory quotient: P = 0,027904), between carbohydrate oxidation related to ideal body weight and lipid intake (P = 0,014085) and between protein oxidation and carbohydrate intake (P = 0,012703). Key words: polytrauma, indirect calorimetry, nutritional support, malnutrition
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