Content 2/2017

INTRODUCTION

  • Editorial – Jana Šeblová
  • Contents

CONCEPTION, MANAGEMENT, ORGANIZATION

  • Importance of the out-of-hours emergency service in the system of healthcare facilities – Marina Levko, Miloś Velemínský sr., Ingrid Baloun
  • Multiple victims incident´s management in prehospital emergency care – only quickly and furiously from now? – Pavel Urbánek, Martin Doleček, Antonín Koukal, Petr Nestrojil

EDUCATION, EXPERIENCE

  • Utilization of patient simulator manikin for evaluation of START triage tool – Michal Veselý

CLINICAL TOPICS AND RESEARCH

  • Cardiac arrest centers – Consensual statement of scientific societies – Petr Ošťádal, Richard Rokyta, Martin Balík et al.
  • Consensual statement for targeted temperature management in patients after out-of-hospital cardiar arrest in prehospital emergency care – Roman Škulec, Jana Šeblová, Anatolij Truhlář
  • Guidelines for prehospital burn trauma – Pavel Brychta, Robert Zajíček, Yvona Kaloudová et. al.
  • Providing telephone information about common management in cases of minor medical emergencies – Ondřej Franěk
  • Are providing of telephone information about common management and alternative solution in cases of minor medical emergencies safe and effective? – Marie Stránská, Jaroslava Janouchová, Ondřej Franěk
  • Using of NACA score in prehospital emergency care – Ondřej Franěk

ETHICS, PSYCHOLOGY, LAW

  • Collecting passion – David Dvořáček

DISCUSSION, OPINION

  • Never-ending story of Czech disaster medicine – Pavel Urbánek

INFORMATION

  • Information about 8th Central European Congress of Disaster and Emergency Medicine – Táňa Bulíková

 

ABSTRACTS:

 

IMPORTANCE OF THE OUT-OF-HOURS EMERGENCY SERVICE IN THE SYSTEM OF HEALTHCARE FACILITIES

MARINA LEVKO, MILOŠ VELEMÍNSKÝ SR., INGRID BALOUN

Abstract

The importance of the out-of-hours emergency services is widely discussed at the time. There is a tendency to cancel this type of service.

The aim of the presented paper is to emphasize the necessary existence of these organizations during evenings, weekends and holidays in locations without inpatient departments of hospitals, provided the quality of equipment and personnel is of a high level.

Methods: The authors performed a detailed evaluation of three out-of-hours emergency services located in the South-Bohemian Region. They were interested in staff members and equipment of these organizations, frequency of diagnoses in patients, management of patient care and numbers of patients directly referred to higher level facilities, i.e. “to examine, to report and to send off”. Quality of care and virtual economic demands were also evaluated from this point of view.

Results: Based on organizational and professional analyses of the three out-of-hours emergency services, the authors concluded that the existence of these organizations is necessary during evenings, weekends and holidays in locations without inpatient departments of hospitals, provided the quality of equipment and personnel is of a high level.

Conclusion: Based on analyses of activities of the three organizations, the authors suggest that appropriately equipped and functional out-of-hours emergency services should be maintained in locations without inpatient departments. Their existence is beneficial for the patients particularly during the tourist season when one needs not complicated contacts with physicians. Fear of duplicity in financial covering of the first line treatment is not justified.

Key words: out-of-hours emergency services – position in system – organizational, personal and technical resources

 

MULTIPLE VICTIMS INCIDENT´S MANAGEMENT IN PREHOSPITAL EMERGENCY CARE – ONLY QUICKLY AND FURIOUSLY FROM NOW?

PAVEL URBÁNEK, MARTIN DOLEČEK, ANTONÍN KOUKAL, PETR NESTROJIL

Abstract

Timely and appropriate triage of all patients on scene of multiple victim incident or disaster is essential for successful management of any multiple victim incident and disaster. Individual treatment provided immediately after reaching the site of incident is not a solution in these situations. There is general consensus about this statement but part of the experts suggests revision of current guidelines in favour of more simple and rapid triage. The authors clarify in presented paper why the current guidelines offer the best solution for definitive rescue of majority of affected population. The priorities of treatment and priorities of transport must be decided with the utmost responsibility in the prehospital phase of mass casualty management which is not possible without decrease of quality of care by using just colours instead of triage tags.

Key words: mass casualty incident – disaster medicine – disaster – START – triage – triage and identification tag – emergency medical service – health care facility

 

UTILIZATION OF PATIENT SIMULATOR MANIKIN FOR EVALUATION OF START TRIAGE TOOL

MICHAL VESELÝ

Abstract

The use of START disaster triage by Emergency Medical Service (EMS) is discussed nowadays. The aim of this paper is to set initial values for further testing and to suggest a way of cooperation of fire rescue and EMS at the scene of mass casualty incident while providing START disaster triage. A patient simulator was tested whether it can be used to evaluate triage practising. A questionnaire and a patient simulator were used to obtain the data. 126 fire fighters and 68 EMS providers participated in this research. Each participant was asked to assign priority to 20 patients in the questionnaire and at the simulator. Parameters such as total accuracy, overtriage, undertriage, sensitivity and specificity for red priority and total time for assigning priorities were evaluated, each parameter in the questionnaire and on the simulator. Statistically significant difference was found between the results in the questionnaire and at the patient simulator. EMS providers were more successful in priorities assigning. The simulator was proved to be a suitable tool to evaluate triage practising. Initial values for further testing were set successfully.

Key words: mass casualty incident – primary triage – START disaster triage – patient simulator

 

ARE PROVIDING OF TELEPHONE INFORMATION ABOUT COMMON MANAGEMENT AND ALTERNATIVE SOLUTION IN CASES OF MINOR MEDICAL EMERGENCIES SAFE AND EFFECTIVE?

MARIE STRÁNSKÁ, JAROSLAVA JANOUCHOVÁ, ONDŘEJ FRANĚK

Abstract

Pilot evaluation of safety of telephone information provided to callers of emergency medical line (155 in CR) who presented with low priority medical cases (uncomplicated fever) is the goal of this paper.

Pilot study took place at EMS of the Capital Prague. A structured interview with callers was provided within 1 – 4 weeks after primary dispatch contact for fever.

Contacting emergency line 155 was solved by alternative way without dispatching EMS ambulance to scene. Presented method is appropriate for random safety check and further patient´s condition develepment monitoring. This alternative solution was positively accepted in 100 % of callers. Based on our feedback analysis we have found that 72 % of cases were redirected away from emergency medical system and 87 % away from prehospital emergency care. No serious adverse effect with consequent EMS intervention nor any hospitalisation was reported.

Key words: medical dispatch center – patient safety – low priority medical cases

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