INTRODUCTION
- Contents
- Editorial – Jana Šeblová
EMERGENCY DEPARTMENTS
- Management of a patient with bacterial meningitis at the emergency department: case report and literature review – Robin Šín, Jana Váchalová
PREHOSPITAL EMERGENCY CARE
- Pragmatic differential diagnostics of acute shortness of breath in the prehospital emergency care – personal algorithm (READY protocol) – Roman Škulec
SYSTEMS´ ORGANIZATION AND MANAGEMENT
- Motoric tests for evaluation of paramedics’ physical fitness – Václav Bunc, Jan Lodin, Jaroslav Pekara, Petr Kolouch, David Peřan
PHYSIOLOGY AND EMERGENCY MEDICINE
- Pulse oximetry and its use in emergency medicine – David Astapenko, Vladimír Černý
GUIDELINES
- Interdisciplinary statement on management of patients with haemophilia and von Willebrand disease in the prehospital care (PHC) – Jan Blatný (editor), Jana Šeblová (co-editor), Zdeňka Hajšmannová, Tomáš Votava, Antonín Hluší, Radka Hrdličková, Petr Kessler, Světlana Köhlerová, Miroslav Penka, Jana Ullrychová, Ondřej Franěk, Jiří Knor, Anatolij Truhlář, Marek Slabý, Roman Gřegoř
- Guidelines for use of personal protective measures in patients with suspected or confirmed COVID-19 in the prehospital emergency care – Eva Smržová (editor), Roman Gřegoř, Jaroslav Kratochvíl, Josef Škola, Roman Škulec
- Criteria for outpatient care for patients with clinical signs of COVID-19 – Jana Šeblová (editor), Josef Škola, Roman Škulec, Anatolij Truhlář
- Triage and admission of patients with suspected or confirmed COVID-19 – Roman Škulec (editor), Jana Flajšingrová, Roman Gřegoř, Jaroslav Kratochvíl, Zdena Lepší, Tomáš Pařízek, Jana Šeblová
- Specifics of invasive procedures and techniques in the prehospital emergency care for patients with suspected or confirmed COVID-19 – Robin Šín (editor), Roman Škulec, Anatolij Truhlář
- Cardiopulmonary resuscitation of patients with suspected or confirmed COVID-19 – Vladimír Černý (editor), Anatolij Truhlář (editor), Renata Černá Pařízková, Jana Djakow, Martina, Kosinová, Roman Škulec, Petr Šťourač
EDUCATION
- How to pass the specialisation exam in emergency medicine? – Katarína Veselá, Jana Šeblová, Jana Kubalová
INFORMATION
- A book´s review: „Marcel Nesvadba, Patrik Christian Cmorej, David Peřan: ECG of the first contact in eight steps“ – Táňa Bulíková
- Emergency Medicine Day 2020 – Jana Šeblová
- Brno EM Days online – Jana Kubalová
- In memoriam MUDr. Josef Mucha
ABSTRACTS
MANAGEMENT OF A PATIENT WITH BACTERIAL MENINGITIS AT THE EMERGENCY DEPARTMENT: CASE REPORT AND LITERATURE REVIEW
Robin Šín, Jana Váchalová
Abstract
Bacterial meningitis is a severe infectious disease of the brain protective membranes occurring worldwide and threatening the lives of people of all age groups. The most frequent pathogens of the disease are Streptococcus pneumoniae, Neisseria meningitidis and Listeria monocytogenes. The classic triad of symptoms composes of, in adult patients, a fever, nuchal rigidity and alteration of mental status. In children, we may observe headaches, fever, vomiting and positive meningeal phenomena. In new-borns, only non-specific symptoms predominantly occur. To determine the diagnosis of bacterial meningitis, it is essential to examine the cerebrospinal fluid. In bacterial meningitis, a classic finding in liquor is represented by leucocytosis with a predominance of polynuclear, low concentration of glucoses and high protein levels. An early initiation of empirical antibiotic treatment is very important as for the development of the condition, followed by, after the diagnosis of the pathogen, the targeted therapy. The time from admission to the hospital to the administration of the first dose of antibiotics should not exceed 1 hour. Administration of dexamethasone is a routine part of the treatment. The article introduces a case report of a typical example of bacterial meningitis with primary management of a patient at the emergency department.
Key words: bacterial meningitis – Streptococcus pneumoniae – Neisseria meningitidis – Listeria monocytogenes – lumbar puncture
PRAGMATIC DIFFERENTIAL DIAGNOSTICS OF ACUTE SHORTNESS OF BREATH IN THE PREHOSPITAL EMERGENCY CARE – PERSONAL ALGORITHM (READY PROTOCOL)
Roman Škulec
Abstract
Acute shortness of breath is a severe subjective symptom that accounts for approximately one-tenth of all indications of medical emergency services dispatches. The common approach to differential diagnostics targeted to determine the nosological unit is often complicated. Therefore, pre-hospital management must reflect real possibilities and must be a compromise of the time spent at the field and realistic diagnostic accuracy in close relation to the subsequent treatment we can safely provide. The author presents a pragmatic algorithm for the pre-hospital management of patients with acute shortness of breath based on a simple assessment of respiratory sounds with the possible implementation of Point-of-Care ultrasound.
Key words: shortness of breath – pre-hospital care – algorithm
MOTORIC TESTS FOR EVALUATION OF PARAMEDICS’ PHYSICAL FITNESS
Václav Bunc, Jan Lodin, Jaroslav Pekara, Petr Kolouch, David Peřan
Abstract
Physical capability is one of the basic prerequisites for successful work performance of a paramedic. Evaluation of physical capability, in laboratory or field conditions, allows to reduce the risk of work-related injuries and professional failure when dealing with work tasks. The aim of the article is to introduce a system of evaluation of the basic components of physical capability – both in general (body composition, strength of upper and lower limbs, muscle endurance) and specific (step test with 6 kg load, resuscitation and handling of a 70 kg manikin). This physical capability is evaluated along with the standards which are used by the staff of the Prague Emergency Medical Services. The proposed battery of tests is feasible in normal conditions and it takes 60 minutes. The results can be used both for the assessment of the entry level of newly recruited workers (paramedics) and for the design of the intervention program for the continuous evaluation of working pre-requisites.
Key words: motoric test – paramedic – physical fitness – work performance
PULSE OXIMETRY AND ITS USE IN EMERGENCY MEDICINE
David Astapenko, Vladimír Černý
Abstract
Pulse oximetry is used for basic instrumental examination of the cardiopulmonary system. It is non-invasive, fast and can be used continuously. The method facilitates the decision making in starting the oxygen therapy and helps to evaluate the patient’s response to it. Complex monitors of life functions (eg. LifePack) also provide a plethysmographic curve which can further inform us about the state of the cardiovascular system. Although modern devices are capable of software compensation for movement artifacts and excessive ambient lighting the method is still limited in the case of intoxications (eg. carbon monoxide, oxidizing agents), arrhythmias, in dark ethnicities and dark nail polish.
Key words: pulse oximetry – hypoxia – hypoperfusion – intoxication