- Editorial – Jana Šeblová
CONCEPTION, MANAGEMENT, ORGANIZATION
- A possible approach of evaluation of EMS crisis preparedness for mass casualties – Irena Švarcová, Josef Navrátil
- Knowledge of Emergency Medical Service members about activities on scene of emergency situation with dozens affected persons – Robin Šín, Luděk Hejkal
- Influence of e-learning texts on nurses´ knowledge of cardiopulmonary resuscitation – Jana Heczková, Alan Bulava
- Patient assessment using ABCDE approach – David Peřan, Radek Mathauser, Jiří Kodet
CLINICAL TOPICS AND RESEARCH
- Fluid resuscitation in prehospital emergency care in the 21st century in the Czech Republic – Jaroslav Pekara, David Peřan
ETHICS, PSYCHOLOGY, LAW
- The quality of life in patients after cardiopulmonary resuscitation – Michal Podzimek, Eva Pfefferová
- Psychosocial interface of integrated rescue system on scene of incident – Bohumila Baštecká
- News from Society for Emergency and Disaster Medicine CzMA JEP – Jana Šeblová
- 2016 Report on Non-physician section of Society for Emergency and Disaster Medicine – Jiří Kodet, David Peřan
A POSSIBLE APPROACH OF EVALUATION OF EMS CRISIS PREPAREDNESS FOR MASS CASUALTIES
IRENA ŠVARCOVÁ, JOSEF NAVRÁTIL
The current level of preparedness of the Integrated Rescue System intervening components becomes evident after the management and evaluation of a mass casualty incident. Individual disproportions in the actions taken are subsequently eliminated, e.g. in the form of updating the emergency documentation. In view of the activities provided by the Emergency Medical Services, which have a direct effect on saving lives and health of people, it is necessary to eliminate these disproportions to the largest extent possible before an emergency event occurs. It is very important to find mechanisms, procedures or, if needed, criteria that will enable the assessment of the preparedness level of the Emergency Medical Services before the occurrence of a mass casualty incident. This paper is, therefore, focused on the emergency preparedness units that play an important role in the training of the Emergency Medical Services to deal with mass casualty incidents. The paper proposes evaluation criteria and indicators that can be used for assessing preparedness within the Emergency Medical Services.
Key words: Emergency medical services – mass casualty incident – emergency preparedness – emergency preparedness unit – criteria – indicators
KNOWLEDGE OF EMERGENCY MEDICAL SERVICE MEMBERS ABOUT ACTIVITIES ON SCENE OF EMERGENCY SITUATION WITH DOZENS AFFECTED PERSONS
ROBIN ŠÍN, LUDĚK HEJKAL
Emergency situation with dozens affected persons is always an event which has an impact on activities of Emergency Medical Services and also directly burdens medical dispatchers and members of the EMS teams involved in rescue operations on scene of multiple victim accident. Knowledge of related legislation, particularly the disaster plan of Emergency Medical Services provider, related type activities for the joint interventions of the Integrated Rescue System and valid nationwide guidelines are needed for the correct application of health care providers´ operations on scene of an emergency situation with mass casualty. A questionnaire was drawn up in order to determine the knowledge of EMS team members, and later it was distributed to Emergency Medical Services providers´ bases. Overall a 300 questionnaires were distributed, of which 215 were returned completed. Results of the questionnaire showed, that EMS team members are not used to deal with the primarily processes of adequate triage and also with the related use of standardized identification and triage tags. Significant problems with using the classification categories I., II.a, II.b, including their possible combinations were found.
Key words: emergency situation – mass casualties – medical service – START – identification and triage tag
INFLUENCE OF E-LEARNING TEXTS ON NURSES´ KNOWLEDGE OF CARDIOPULMONARY RESUSCITATION
JANA HECZKOVÁ, ALAN BULAVA
Introduction: Although the chance for survival of in-hospital cardiac arrest is roughly double compared to out-of-hospital cardiac arrest, the mortality rate is still very high. First step in preventing such an event in healthcare facility is staff education, which should be repeated every 1–2 years. The aim of our study was to analyse impact of pre-course e-learning on cognitive knowledge related to providing cardio pulmonary resuscitation (CPR).
Methods: To evaluate the impact of e-learning implemented prior to instructor-led CPR courses, the results of knowledge tests conducted before (n=122) and after (n=1086) e-learning were used among the group of non-medical healthcare workers in university hospital. The main tested group were nurses.
Results: Nurses working in intensive care units (ICU), followed by nurses working in the regular ward (RW), achieved the highest score in tests conducted prior as well as after the change in pre-course learning. There was also significant improvement in knowledge after implementing e-learning (p < 0.001). Both ICU and RW nurses tested after the change achieved higher score then other non-medical (NM) and auxiliary staff (AU). However, if compared to nurses tested prior the change, NM staff achieved higher results then RW nurses as well as ICU nurses. Similarly, AU staff tested after e-learning education achieved better score when compared to nurses tested before e-learning education.
Conclusion: Our results demonstrated positive impact of e-learning on cognitive knowledge prior subsequent instructor-led training. However, the impact on retention of knowledge as well as the impact on ability to use this knowledge in real practice will require further research.
Key words: CPR courses – e-learning – cognitive knowledge – pre-course learning
PATIENT ASSESSMENT USING ABCDE APPROACH
DAVID PEŘAN, RADEK MATHAUSER, JIŘÍ KODET
Patient assessment is one of the basic skills which are used by all health care professionals. The Advanced Life Support Provider (ALS) Course teaches a standardized approach – the ABCDE, which is focused on the life threatening problems first. Through standardization of this approach it is useful as a protocol for writing a patient report, as well. This article brings the philosophy, content, meaning and importance of the ABCDE approach.
Key words: patient assessment – ABCDE approach – ALS Provider Course
FLUID RESUSCITATION IN PREHOSPITAL EMERGENCY CARE IN THE 21ST CENTURY IN THE CZECH REPUBLIC
JAROSLAV PEKARA, DAVID PEŘAN
This article describes a research between Emergency Medical Services (EMS) in the Czech Republic from the point of using infusion therapy in the emergency medicine. In the methodology we used a mixed design (a qualitative questionnaire research between EMS in the Czech Republic and qualitative interviews with 50 paramedics from whole Czech Republic). The comparison was performed in compliance with guidelines of fluid resuscitation (Czech guidelines for management of critical bleeding, Guidelines NICE, European Guidelines for Management of Bleeding). The main results are: 7 EMS in the Czech Republic subscribes 5 and more infusions, only 2 EMS do not use colloid infusions and 11 EMS use balanced infusions. From the point of qualitative research we found out shortages in fluid resuscitation of hypovolemia and burns. The main outcome of this article is a recommendation about equipment of infusions for EMS in the Czech Republic.
Key words: Hypovolemia – Infusion – Balanced solutions – Paramedic
THE QUALITY OF LIFE IN PATIENTS AFTER CARDIOPULMONARY RESUSCITATION
Intent of this article was to objectively describe the issue of quality of life in patients after cardiopulmonary resuscitation who experienced out-of-hospital cardiac arrest in Pilsen district, Czech republic. Main purpose of theoretical section is to define quality of life and methods of its measurement. In the practical part, we used case studies to investigate the specifics of prehospital and hospital emergency care of two patients after cardiopulmonary resuscitation. Using interviews and questionnaires, we examined the quality of life in these two patients in the context of their physical, psychological and social needs.
Key words: cardiac arrest – cardiopulmonary resuscitation – prehospital emergency care – hospital emergency care – quality of life
PSYCHOSOCIAL INTERFACE OF INTEGRATED RESCUE SYSTEM ON SCENE OF INCIDENT
Integrated rescue system – as every other system – has its borders (boundary, interface). The article aims at the psychosocial interface between the state-guaranteed integrated rescue system and the “lay public” system in the place of operation. It uses the contexts of first psychological aid and gallows humor to illustrate the pitfalls that are embedded in this interface. The perspective of female paramedic who changed her roles from medical rescuer to the bereaved person in the place of operation is introduced.
Key words: shared impact – compassion – first psychological aid – gallows humor – decision-making in uncertainty – the public in the context of extraordinary events