Content 1/2018

INTRODUCTION

  • Editorial – Jana Šeblová
  • Contents

CLINICAL TOPICS AND RESEARCH

  • The results of co-operation between EMS of the Vysočina Region, Traumacenter of Brno Bohunice University Hospital and Traumacenter of Military University Hospital Prague –Tomáš Vaňatka, Kateřina Vaníčková, Pavel Kupka
  • Brugada syndrome in Prehospital Emergency Care – Patrik Christian Cmorej, Barbora Ježková,
    Marcel Nesvadba, Ilja Deyl
  • Intoxications in children – the first impression may be false… – Jana Vidunová, Marcela Kreslová, Jakub Sunkovský
  • Ammonia intoxication – Lucie Křivohlavá, Simona Dobisová
  • Suicides and suicidal attempts in clinical practice of emergency medicine –Jana Šeblová, Taťána Suchánková-Kočí, Světlana Kroftová

INFORMATION

  • Report from the congress – Vyhne hosted Slovak emergency physicians for the fourth time – Táňa Bulíková, Štefan Trenkler
  • Golden rescue cross 2017
  • News from Society for Emergency and Disaster Medicine CzMA JEP 2017 – Jana Šeblová
  • Report from Non-physician section of Society for Emergency and Disaster Medicine CzMA JEP 2017 – Jiří Kodet, David Peřan

 

ABSTRACTS

 

THE RESULTS OF CO-OPERATION BETWEEN EMS OF THE VYSOČINA REGION, TRAUMACENTER OF BRNO BOHUNICE UNIVERSITY HOSPITAL AND TRAUMACENTER OF MILITARY UNIVERSITY HOSPITAL PRAGUE

TOMÁŠ VAŇATKA, KATEŘINA VANÍČKOVÁ, PAVEL KUPKA

Abstract

Introduction: The prehospital phase of patient with multiple trauma (ISS > 15) is an important part of care. If there is a cooperation with an emergency department (ED) of a traumacenter (TC), it is possible to optimise the results of the patients during prehsopital care.
Methods: We compared the results of a retrospective study of 2013 and 2014 (160) which were published in 2015 and retrospective results obtained from traumaprotocol [15] for 2015 – 2017, a total of 207 patients with ISS> 15.
Results: The patients profit mainly from primary activation of HEMS (HI / I). If HEMS is activated by the EMS team after they come to site of injury (HI / II) the advantage of rapid transport is lost due to lenght of stay on site. The main indications for advanced airway management is imminent or already present hypoxia, which significantly affects the development of acidosis [3]. Trauma-induced coagulopathy (TIC) was found in both trials in more than ¼ patients: slight decrease from the 28,75 % to 27,05 % when comparing study I and study II . The mortality rate shows a clear difference between I and II studies for HEMS and ground EMS. Mortality rate decrese was found in HI, in study I HI/I 11,42 % v. in study II 7,7 %, HI/2 in study I 16,98 % v. 14,08 %. Decrease of patients with MODS was not confirmed between 2013 and 2014, on contrary there was an increase from 3,75 % to 7, 73 % between studies I and II, which was due to higher survival of the most seriously injured patients.
Conclusion: We had compared and analysed defined parameters of 160 patients in study I and 207 patients in study II. The prehospital care of patient starts at medical dispatch center with rapid assessment of the condition of the patient (triage) and sending an adequate EMS team. Our study proves the benefits of primary dispatch of HEMS (HI /I) for patients. Further improvement can be reached by better coordination with HEMS and dispatch center during night shifts.

Key words: coagulopathy – multiple trauma – volumotherapy – hypothermia

 

BRUGADA SYNDROME IN PREHOSPITAL EMERGENCY CARE

PATRIK CHRISTIAN CMOREJ, BARBORA JEŽKOVÁ, MARCEL NESVADBA, ILJA DEYL

Abstract

Brugada syndrome is a genetically conditioned, arrhythmogenic syndrome with a characteristic ECG finding. This syndrome is responsible for about 4–12 % of all sudden cardiac deaths, in patients without structural disease up to 20 % of deaths. Patients with polymorphic ventricular tachycardia or ventricular fibrillation are indicated for implantation of an implantable cardioverter defibrilator (ICD). In pre-hospital emergency care, it is necessary to think about this syndrome in young patients with any episode of syncope. The ECG image of Brugada syndrome can be unmasked by number of medications or fever. We describe a 35-year old patient with a typical ECG finding of Brugada syndrome type 1 treated by emergency medical service in this article.

Key words: Brugada syndrome – prehospital Emergency Care – sudden cardiac arrest

 

INTOXICATIONS IN CHILDREN – THE FIRST IMPRESSION MAY BE FALSE…

JANA VIDUNOVÁ, MARCELA KRESLOVÁ, JAKUB SUNKOVSKÝ

Abstract

Intoxications occur both in children and adults. Emergency medicine focuses predominantly on acute intoxications with non-specific symptoms. Key items at the very beginning of care are: safety of all persons engaged, patient´s vital functions stabilisation and last but not least a precise case history related to the current condition. The article describes two case reports of intoxicated girls treated in the prehospital phase and then in the hospital emergency care environment.

Key words: intoxication – case history – children – case report

 

AMMONIA INTOXICATION

LUCIE KŘIVOHLAVÁ, SIMONA DOBISOVÁ

Abstract

Ammonia is a colorless, highly irritating gas with a sharp, suffocating odour. It is one of the most commonly produced chemicals all over the word. It is used in agriculture (fertilizers), industry (cleaning solutions and in the manufacture of plastics, explosives, pesticides, and other chemicals) and in many households (window cleaners, floor waxes). It is also used as a refrigerant gas (for example dairies, breweries, ice rinks). In case of accident a lot of people could be affected.The main toxic effects of ammonia are restricted to the sites of direct contact with substance (i.e. respiratory tract, eyes, skin, mouth, and digestive tract).

Key words: amonia – refrigerant gas – accident

 

SUICIDES AND SUICIDAL ATTEMPTS IN CLINICAL PRACTICE OF EMERGENCY MEDICINE

JANA ŠEBLOVÁ, TAŤÁNA SUCHÁNKOVÁ-KOČÍ, SVĚTLANA KROFTOVÁ

Abstract

The paper presents the problems of suicides and suicidal behaviour in emergency medicine. Suicides are not so frequent but due to unavailability of 24/7/365 psychiatric care, emergency health care professionals both in prehospitltal care (emergency medical services, EMS) and at emergency departments face these patients quite often. Some of the scales and inventories for suicide risk assessment are presented in the text and basic principles of management of suicidal patients are also desribed. Suicides and suicidal attempts of children, adolescents, senior patiens and excluded social groups are also mentioned.

Key words: suicidum – self-harm – emergency medicine – suicide risk assessment

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