INTRODUCTION

Editorial

Jana Šeblová

Contents

     CONCEPTION, MANAGEMENT, ORGANIZATION

Crisis preparedness and specific training of Emergency Medical Services and hospitals

Pavel Urbánek, Jan Urbánek

Abstract

Crisis preparedness in the health care system is the ability of health care providers and health care facilities to ensure necessary care to the population in crisis incidents and in disasters. The quality of the care must be high and must be provided by prepared, trained and specialised professionals. If the professionals should be prepared they must be educated and trained using real-life scenarios and plans and their competences must be evaluated.

The authors tried to analyze the Emergency Medical Services´ (EMS) and hospitals training for crisis incidents and disasters in recent years. If we consider emergency system as a functional linkage of acute and emergency care providers being a basic tool for health care system preparedness, then training and preparedness of these organisations reflects their effectivity.

Guidelines for management of sport and cultural mass gatherings

Jiří Knor

     EDUCATION, EXPERIENCE

Czech Red Cross´ actitivities during floods in Mělnicko Region in the year 2013

Lucie Balarinová, Kateřina Ivanová

Abstract

Česká republika patří mezi území sužované mimořádnými událostmi jak menšího rozsahu (dopravní a jiné nehody, požáry, tor­náda, nehody v horách či ve vodě atd.), tak i větší mimořádné události, mezi které patří i povodně. Události doprovází poskyto­vání pomoci zasaženým osobám, na kterém se podílí profesionálové z řad složek integrovaného záchranného systému ale i dob­rovolníci různých nestátních neziskových organizací. V případové studii se zabýváme konkrétní událostí (povodně v roce 2013) se zaměřením na jednu organizaci (Český červený kříž) a lokalitu (Mělnicko). Výzkumná otázka zní: „Jaká byla krizová připravenost ČČK při povodních v roce 2013 na Mělnicku?“ Výsledkem je případová studie obsahující tři celky: (1) fakta o vzniku a vývoji po­vodní na Mělnicku v roce 2013, (2) zapojení ČČK do poskytování pomoci při povodních na Mělnicku, (3) reflexe ČČK v období po povodni. Studie může být základem pro vytvoření dalších případových studií např. poskytování pomoci ČČK při povodních v roce 2010, 2009 a následnou vzájemnou komparaci všech studií. Katastrof přibývá a autoři citované literatury se shodují v tom, že klíčová je kvalitní krizová připravenost na všech úrovních tzn. jednotlivců, organizací, státu.

The activities of medical component in the integrated rescue system for high-rise building fire

Robin Šín, David Steindl, Pavel Böhm

Abstract

The article presents the components of medical activities during the intervention of the integrated rescue system for high-rise building fire. There are described the specifics of intervention associated with the nature of the incident and the involvement of forces and means of emergency medical services, which form the basis of a standard component of medical intervention. The practical approach is presented via the case report of intervention by a burning high-rise building in Chodov, Sokolov district.

     CLINICAL TOPICS AND RESEARCH

Sepsis in emergency medicine: difficult diagnostics, low priority, high mortality

Jana Šeblová, Štěpánka Burešová

Abstract

Diagnostics of sepsis in prehospital care is generally low. Diagnosis can be based on case history, vital signs measurement (body temperature, heart rate, respiratory rate, blood pressure) and clinial examination. Therapy includes i.v. access and volumotherapy which is available in the prehospital phase, too.

The aim of our retrospective pilot study was to examine how many septic patients are treated in emergency care and what are their clinical manifestation and symptoms. Secondly, we wanted to evaluate vital signs of septic patients and differences between patients with infection transported by EMS and those who reached hospital other way.

1036 patients were treated in Emergency Department of Regional Kladno Hospital between 1st January 2013 and 28th February 2014 and 68 (7 %) of them were septic. 42 (62 %) of septic patients were transported by EMS. In-hospital mortality of all patients and of both groups was 26 % and 27 %, respectively. Patients transported by EMS were in 75 % assigned low priority ad so they were transported by non-physician team. Diagnosis of infecion was stated only in 10 % of patients, 28 % of the rest had symptomatic diagnose of febrile condition.

Sepsis and infection are quite frequent and severe diagnoses with high mortality. Septic patients in the prehospital phase have either dyspnea (in case of respiratory etiology) or they present general non-specific symptoms (in case of other etiology of infection). Identification of septic patients in prehospital emergency care is very difficult and unsatisfactory examination of the patient decreases the chance of correct diagnosis. The diagnostics can be improved by routine measurement of body temperature, respiratory rate, heart rate and blood pressure.

      ETHICS, PSYCHOLOGY, LAW

Bystander effect in penetrating abdominal trauma

Tibor A. Brečka, Veronika K. Netušilová

Abstract

Authors describe in this paper the theory of the phenomenon called „bystander effect“ and the factors that contribute to its
development and progress. A case report of the patient with hypogastrium penetrating trauma treated by EMS demonstrates this
phenomenon in practice and subsequently brings these theoretical knowledge closer to the introductory example of the case
study. In conclusion, the authors provide some possible recommendations for practice, especially for the area of prevention and
education of the civilian population.

Emergency Medical Services Competitions and their place in Emergency Medical Services´ History
in Slovakia

Andrea Smolková

Abstract

The roots of the rescue service in Slovakia go back to the year 1872 when a fire-fighter association in Kosice was founded (fire-fighters also educated the first Samaritans). The first station of the EMS in the Bratislava region was founded in 1907, where, some time later, a dispatch centre with a telephone was created. In serious cases, a doctor was sent to the patient as well. In 1966, the Medical Care Act was adopted. This Act also covered pre-hospital care and as well as transport, it also included an early examination and securing of the vital functions of a patient. The corollary between an adequate securing of the patient before transport to a strong impact on the result started to be emphasized. The Slovak competition of EMS (Emergency Medical Service) crews is the oldest rescue competition in the world. It brings together EMS crews (paramedics only or a crew with a doctor) from the whole country to compete in solving tasks which simulate everyday rescuers’ experience. Analysis of the outcome of these simulated tasks is used as valuable feed-back for participants. The first competition took place in 1979 as a competition for two-member teams of EMS drivers; the members competed in driving skills, a knowledge test and physical capacity. In 1984 resuscitation on a dummy was added. The competitions have a special atmosphere and to take part in them is a great experience for the competitors, referees and figurants alike. Many useful ideas have been discussed at the competition forums and they have become an impulse for change – both practical and legislative.

     INFORMATION

Report on Society for Emergency and Disaster Medicine CzMA JEP 2011 – 2014

Jana Šeblová

International conferences in 2014

Jana Šeblová

Content 4/2014