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Evaluation of ECG in prehospital care
GROSSMANN, Matyáš
This bachelor thesis deals with the issue of ECG evaluations in pre-hospital emergency care by a paramedic. The thesis is divided into two parts, theoretical and practical. The theoretical part focuses on the definition of a paramedic and his/her competencies, instrumentation, and anatomy of the cardiac conduction system. Furthermore, it describes the methods of ECG evaluations, types of arrhythmias and their treatment in pre-hospital emergency care. The major objective of the thesis was to map the ability of paramedics to interpret the waveforms of ECG recordings. The practical part of the bachelor thesis was based on a quantitative research investigation carried out in the form of non-standardized questionnaires. The research sample consisted of 51 paramedics from the Region of South Bohemia. The research took place from March to April 2023, with the participation in it being entirely voluntary. The collected data were subsequently analysed and compiled into graphs, which were completed with a commentary. The knowledge in interpretation of ECG waveforms was mapped by a series of 24 questions in which the respondents could obtain a total of 35 points. The high knowledge of the respondents is demonstrated by the fact that three quarters of the respondents achieved 80 percent or more correct answers. Two hypotheses were determined in the research part. The first hypothesis suggested that the knowledge in interpreting ECG waveforms is affected by the length of experience. The respondents working in emergency medical services for 0-3 years had the highest score (median 93%). However, the result of the Kruskal-Waliss test revealed no statistically significant difference between the four groups compared (p = 0.51). The second hypothesis assumed that the knowledge in interpreting ECG waveforms is influenced by the type of previous workplace. The respondents who had worked in the accident and emergency department before joining the emergency medical service were the most proficient in ECG assessment and interpretation (median 96%). Here again, the Kruskal-Wallis test revealed no statistically significant difference between the four groups compared (p = 0.31). The obtained results can provide useful information for the possible implementation of an educational seminar for paramedics.
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Death and palliative care in pre-hospital care
NOVOTNÝ, Jan
The bachelor thesis entitled Death and Palliative Care in Pre-hospital Care reports on the interaction of death per se, but also deaths of patients in the care of paramedics. Furthermore, the thesis intersects the medical field called palliative care, which serves as an important agent in the care of patients in the terminal phase of their existence. The subject of death is a entirely timeless topic that has been, is, and always will be with us. Four research objectives were defined: namely to find out the attitude of the paramedic towards the dying of patients in pre-hospital care, to find out how paramedics cope with deaths of patients in pre-hospital care, to find out what communication techniques are used by paramedics with dying patients and their relatives or with bystanders in pre-hospital care and the last research objective was to find out what knowledge paramedics have in palliative care during pre-hospital care. The first, theoretical part deals with the perception of death from the Middle Ages to the present, the discipline of Thanatology and its subgroups. The chapter touches on euthanasia and describes communication, palliative care and its specifics. The second, practical part used qualitative research by conducting semi-structured interviews to gather in-depth data. The interview was conducted with paramedics belonging to the regional centre of Jindřichův Hradec. With the help of open coding and subsequent categorization, the data was analyzed and interpreted using the "show one's cards" technique. According to the analysis, all paramedics perceived death as an inevitable, natural fact, with this group divided by the fact of armouring themselves over their practice. Another finding projected the validity of debriefing as an appropriate factor after a mentally challenging ambulance despatch. Regarding communication, paramedics were not sure about the suitability of the methods used, which stems from the absence of the seminars in question. Awareness of the term palliative care was generally sufficient, but insufficient for the subsequent specification of the therapy. There has been an inconvenience in working with mobile hospice care, or pain alleviation, which is not officially defined and operates on a referral basis.
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Behavioral problems of a patient in a pre-hospital care.
DUŠKOVÁ, Petra
The Bachelor thesis concerns problematic behaviour of patients in pre-hospital care, the paramedics in South Bohemian region were questioned. The theoretical part describes different types of causes and expressions of problematic communication. In detail it concerns alcohol and addictive substances, which are the main cause of aggressive behaviour. The theoretical part also presents a legislative support which regards the paramedics´ work. The practical part ascertains how many paramedics have dealt with patients´ problematic behaviour in pre-hospital care, or more precisely with an aggressive behaviour. The paramedics were questioned whether they have felt prepared for this kind of behaviour, whether they would like to gain a further education in this particular area and whether they have felt a sufficient support in legislation.
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Use of capnometry in emergency care
CIMICKÝ, Vít
The first half of the theoretical part of the work is focused on the physiology of respiration and the effect of carbon dioxide in the human body. The second half of the theoretical part focuses on defining the concept of capnometry, how it is measured and also on the states in which it is used. For specific conditions, it is described why it is used and what limitations it has. The practical part consists of the survey and the results that came from it. The survey was conducted through a semi-structured interview containing eleven questions. Six non-medical health professionals, who represent various positions at the Medical Rescue Service of the South Bohemian Region, joined the interview in April 2022. The aim of the research was to map the frequency and regularity of the use of capnometry in prehospital emergency care. The research answered all the researched questions. Objectively, the goal of the work was only partially fulfilled, based on a small amount of data obtained. However, these data are very similar and supported by recurring arguments. The analysis of the results showed a low frequency and a high rate of irregular use of capnometry in prehospital care. The main reason is the low and irregular occurrence of conditions requiring capnometry measurements.
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The first treatment of a newborn after delivery in pre-hospital care
KOFROŇOVÁ, Erika
The bachelor's thesis discusses the treatment of a newborn after birth in pre-hospital care. In order to elaborate the bachelor's thesis, four objectives were defined. The first objective was to find out how paramedics prepare themselves for taking care of the newborn. The second objective was to record how they handle the situationS psychologically when it comes to the newborn care at fieldwork itself. Furthermore, the third objective ascertained the procedure of the newborn treatment by paramedics in pre-hospital care. Last but not least, the fourth objective was to explore the procedure of a premature newborn treatment. Four research questions were chosen for the research part of the thesis. The first research question dealt with how paramedics prepare themselves for taking care of newborns. The second research question carried out how stressful treating a newborn is for paramedics. The third research question examined the process of treating a newborn. The last research question discusses the treatment procedure in case of the premature newborn. This work highlights the importance of education and implementation of the defined procedure of the newborn treatment in pre-hospital care, as well as the implementation of the most essential interventions which leads to the correct adaptation of the newborn to the new environment. The bachelor's thesis is divided into a theoretical and a practical part. The theoretical part is divided into five main chapters. The first chapter deals with the legal definition of the emergency medical treatment services, pre-hospital emergency care and the profession of a paramedic itself. The competences of a paramedic as well as further educational possibilities are discussed here. In the second chapter, the issue of the childbirth is introduced alongside the labour process itself, its classification, and particular stages. It is complemented by the process of the childbirth and the treatment of the newborn in a health facility as well. The third chapter deals with the childbirth in pre-hospital care. The fourth chapter discusses the various complications that can arise during the birth. The last one describes the care of the pathological newborn and the process of a resuscitation. In the second part of the thesis a qualitative research was applied. The research sample consisted of 8 paramedics who had encountered a newborn after the birth at least once.
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Analgosedation of a child patient in pre-hospital emergency care and children's urgent care
MRÁZ, Štěpán
This bachelor's thesis is focused on the topic of analgosedation of an infant patient in pre-hospital emergency care and children's urgent care. It comprises two parts, the theoretical and the practical one. The theoretical part includes some information about pre-hospital and urgent emergency cares. Furthermore it is mainly focused on specifics of infant patients, analgosedation and last but not least on resuscitation of adults and children. For the practical part of this thesis was chosen one aim. It was to find out how urgent wards are ready to face intake of infant patients. Due to this target came out two investigative questions. The first one:"What facilities can be found in hospitals, which are ready for intake of infant patient?" The second question: "Are hospital workers prepared for infant patients within the framework of PNP and urgent care?" The research was carried by a quantitative method of gathering data through the half structuralized dialogues covering 12 questions. The research sample contained 6 paramedics of an emergency ambulance and 6 hospital employees from an urgent ward. The data obtained by this research are divided into 11 categories. After summarization of all information and data I found out that there is a high standard of facilities covering pre-hospital and hospital care, therefore an infant patient can be provided with a necessary help. Within the investigation was also proved the following fact. Hospital employees are well trained in issues of infant patient. Nevertheless they agreed that there are not so many practical training based on children emergency care organised, therefore they would really welcome them to be able to improve their practical skills in connection of this specific field.
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Use of Mapleson C breathing system in pre-hospital care.
FILIP, Michal
The theoretical part describes the physiology of a human's respiratory tract. The next part focuses on the history of ventilation, non-invasive ventilation and its basic ventilation modes. Then it focuses on Mapleson´s systems, their advantages and disadvantages, then it focuses on Mapleson C, which is a priority for this work. Next is the instruction manual and in the last chapters we will discuss an acute situations in pre-hospital care, where Mapleson C can be used and important laws to clarify whether a paramedic can use this system or not. The practical part is processed by using a quantitative questionnaire which is completed by 38 paramedics and doctors in the South Bohemia region. The first goal of the work was to find out a knowledge about the safe use of this system. The second goal was to find out if the use of Mapleson C by a paramedic is correct with current legislation. The result of this thesis shows how high the level of information about Mapleson C system is. It shows its advantages, disadvantages and justifies why it is rarely used in practice. This work could serve as a protocol for the use of Mapleson C, which would be available to all paramedics.
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The analgosedation of a child patient in the pre-hospital care
DUCHOŇOVÁ, Hana
The topic of this bachelor thesis is "Analgesic sedation of a child patient in prehospital care". This work aims to map the awareness of paramedics from the South Bohemian region with the administration of analgesia to pediatric patients. In the theoretical part, the reader is acquainted with the characteristics of the age of the child and also with pharmacokinetic differences. Furthermore, the work describes the types of pain, which is followed by a chapter on pain assessment tools and then its therapy using a three-stage WHO analgesic ladder. The last and most extensive part describes in more detail the individual drugs, specifically their groups, method of administration, dosage, their use and comment. The practical part aims to find out whether paramedics in the South Bohemian region are aware of the administration of analgesia to pediatric patients. The research was carried out using a quantitative method, namely a questionnaire survey in the form of an electronic questionnaire, which contained 14 questions, where each question had only one correct answer. A total of 40 respondents working as paramedics in the South Bohemian Region took part in the survey. The research showed that the respondents in this area are sufficiently oriented, as the result was 90 % of correct answers. This fulfilled the hypothesis, where it was assumed that health professionals are oriented in this area to 80%. This fulfilled the hypothesis, where the correctness of the answers was assumed to be only 80 %.
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Cardiopulmonary resuscitation from the point of view of emergency medical assistance group
PRAŽÁK, Tomáš
This thesis thoroughly explores the issues that come with cardiopulmonary resuscitation, which in pre-hospital care is handled by emergency medical assistance groups and of which paramedic staff are an inseparable part. These paramedics have a necessity for sufficient, in-depth knowledge and experience. Without the early and critical assistance that paramedics are able to provide, a patient could suffer from irreversible changes in health and are even at a risk of death. This bachelor's thesis is divided into a theoretical section and a research section, further exploring this incredibly important subject. The theoretical section explores the history of cardiopulmonary resuscitation. It also digs into the basic life support provided mainly by lay rescuers, in accordance with the guidelines of the European Resuscitation Council. Furthermore, this section also contains information about advanced life support, once again in accordance with the guidelines of the European Resuscitation Council, which is aimed primarily at health care professionals and particularly those who carry the title of paramedic. The research section on the other hand, is based on qualitative research based on interviews consisting of 13 questions. These questions are targeted towards a research group consisting of a group of 12 paramedics employed in the South Bohemian region. This section includes an analysis of the obtained data and their evaluation. The aim of this work is to map the awareness of paramedics about the latest suggested methods for cardiopulmonary resuscitation according to the guidelines of the European Resuscitation Council and to find out how paramedics view and handle cases of sudden circulatory arrest.
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Feasibility of advance directives in paramedic care
Fajferová, Kristýna ; Lejsal, Matěj (advisor) ; Hradcová, Dana (referee)
This diploma thesis deals with feasibility of advance directives in the practice of emergency medical services. It explores how two emergency medical services deal with rising public interest in this topic - The Emergency medical service of Central Bohemia Region and of Vysočina Region in Czech Republic. The goal of the thesis is to detect under what circumstances can the EMS (emergency medical services) play a functional role in the practice of patients end-of-life decisions and in situations containing advance directives. Another goal is to make a set of recommendations for the organizations which could potentially help with dealing with advance directives in pre-hospital care. The empirical part of the study is constructed using a case study approach, it analyses organizational tools, documentation, and internal legislation. It is also made using semi structured interviews with the employees of both organizations. All acquired information is then divided under several categories that are profitable for the case study. The analysis of preparedness for dealing with patients with advance directives and identification of touchpoints - where certain approaches and opinions collide are considered a contribution of this thesis and were identified based on acquired information. Important factors that...
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