{"id":901,"date":"2023-06-06T07:36:17","date_gmt":"2023-06-06T05:36:17","guid":{"rendered":"https:\/\/urgentnimedicina.cz\/en\/?p=901"},"modified":"2023-09-14T07:55:06","modified_gmt":"2023-09-14T05:55:06","slug":"content-1-2023","status":"publish","type":"post","link":"https:\/\/urgentnimedicina.cz\/en\/?p=901","title":{"rendered":"Content 1\/2023"},"content":{"rendered":"<p><b>INTRODUCTION<\/b><\/p>\n<ul>\n<li>Contents<\/li>\n<li>Editorial \u2013 Jana \u0160eblov\u00e1<\/li>\n<\/ul>\n<p><b>EMERGENCY DEPARTMENTS<\/b><\/p>\n<ul>\n<li>Selected emergency conditions in connective tissue diseases and systemic vasculitis \u2013 Johana \u0160id\u00e1kov\u00e1, Tom\u00e1\u0161 Veleta, Tom\u00e1\u0161 Soukup<\/li>\n<\/ul>\n<p><b>PHYSIOLOGY AND EMERGENCY MEDICINE<\/b><\/p>\n<ul>\n<li>The role of chest tube in the prehospital care in trauma \u2013 Jana Berkov\u00e1<\/li>\n<\/ul>\n<p><b>MEDICAL DEVICES<\/b><\/p>\n<ul>\n<li>Defibrillation from the point of view of electrophysiology \u2013 David Astapenko, David \u0158eh\u00e1k, Vladim\u00edr \u010cern\u00fd<\/li>\n<\/ul>\n<p><b>EDUCATION<\/b><\/p>\n<ul>\n<li>Statement of the Expert Discussion Panel of the 1st Conference on Point-of-Care Ultrasonography \u2013 Roman \u0160kulec, Martin Bal\u00edk, Vladim\u00edr \u010cern\u00fd, David Dole\u017eal, David Halata, Zden\u011bk Monhart, Martin \u0160t\u011bp\u00e1n<\/li>\n<li>Extracorporeal resuscitation of a patient in cardiac arrest and severe accidental hypothermia \u2013 Robert Nagyp\u00e1l, Marek Smole\u0148\u00e1k, Vladim\u00edr Fedor\u00e1k, Jozef Valky<\/li>\n<li>How to pass the specialisation exam in emergency medicine? \u2013 Katar\u00edna Vesel\u00e1, Jana \u0160eblov\u00e1, Jana Kubalov\u00e1<\/li>\n<\/ul>\n<p><b>ETHICS, PSYCHOLOGY, LAW<\/b><\/p>\n<ul>\n<li>Death of a patient from acute coronary syndrome after refusal of the provision of health services \u2013 Robin \u0160\u00edn<\/li>\n<\/ul>\n<p><b>INFORMATION<\/b><\/p>\n<ul>\n<li>Annual report from Non-physician section of the Society for Emergency and Disaster Medicine Czech Medical Assocoation JEP 2021\u20132022 \u2013 David Pe\u0159an, Ji\u0159\u00ed Kodet<\/li>\n<li>From the review of the book \u0160eblov\u00e1, Mat\u011bjek et al.: Ethics in Emergency Medicine in daily practice, Grada 2023 \u2013 Franti\u0161ek Du\u0161ka<\/li>\n<\/ul>\n<hr>\n<p><span style=\"text-decoration: underline;\"><strong>ABSTRACTS<\/strong><\/span><br \/>\n<b>SELECTED EMERGENCY CONDITIONS IN CONNECTIVE TISSUE DISEASES AND SYSTEMIC VASCULITIS<\/b><\/p>\n<p><b>Johana \u0160id\u00e1kov\u00e1, Tom\u00e1\u0161 Veleta, Tom\u00e1\u0161 Soukup<\/b><\/p>\n<p><b>Abstract <\/b><\/p>\n<p>A physician treating a potential rheumatology patient often works with a limited amount of information. They must assess the risks and correctly refer the patient for further care to the regional healthcare facility or tertiary center. In this article, we therefore focus on the typical clinical picture of selected emergency conditions in connective tissue diseases and systemic vasculitis with the aim of adopting an approach to the patient corresponding to this urgent situation.<br \/>\nIn most cases, it is an inflammatory condition associated with the involvement of the locomotor system (especially arthritis), but also other organs and systems (heart, lungs, kidneys, nervous system and others), and\/or fever. Most of them are reliably diagnosed by a combination of common laboratory, imaging and immunological examinations, where the typical finding of autoantibodies is mostly from the ANA or ANCA family.<br \/>\nFor individual systemic diseases, specific emergency situations are discussed, such as neurolupus, conditions associated with thrombotic microangiopathy (scleroderma renal crisis, catastrophic antiphospholipid syndrome), swallowing disorder with risk of aspiration, anterior ischemic optic neuropathy, and diffuse alveolar hemorrhage syndrome. Their urgency lies, among other things, in the fact that this may be the very first manifestation of a systemic disease that has not been diagnosed yet. They have a high mortality rate and a poor prognosis if not diagnosed and treated quickly enough. High-dose pulses of intravenous glucocorticoids remain the gold standard for treatment.<br \/>\nIt is always difficult, complex and responsible to be among the first on the way to knowing a serious emergency diagnosis. It is easier to walk prepared.<\/p>\n<p><b>Key words: <\/b>connective tissue diseases, systemic vasculitis, thrombotic microangiopathy, diffuse alveolar hemorrhage, scleroderma renal crisis<br \/>\n<b>DEFIBRILLATION FROM THE POINT OF VIEW OF ELECTROPHYSIOLOGY<\/b><\/p>\n<p><b>David Astapenko, David \u0158eh\u00e1k, Vladim\u00edr \u010cern\u00fd<\/b><\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Defibrillation is an integral part of the treatment of malignant arrhythmias, and it is embedded in the international guidelines on cardiopulmonary resuscitation. Since its first clinical use in the 1940s, it has undergone considerable progress, miniaturization, and research-based knowledge of myocardial electrophysiology. The development of knowledge of myocardial electrophysiology was based on a number of theories and models, but even nowadays the effect of electrical shock on the myocardium is not fully explained. The first defibrillators produced a monophasic shock, but later biphasic shocks proved to be more effective and safer in terms of reducing the shock energy.<\/p>\n<p><b>Key words: <\/b>defibrillation \u2013 myocardial electrophysiology \u2013 malignant arrhythmia<\/p>\n<p><b>EXTRACORPOREAL RESUSCITATION OF A PATIENT IN CARDIAC ARREST AND SEVERE ACCIDENTAL HYPOTHERMIA<\/b><\/p>\n<p><b>Robert Nagyp\u00e1l, Marek Smole\u0148\u00e1k, Vladim\u00edr Fedor\u00e1k, Jozef Valky<\/b><\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Severe accidental hypothermia refers to a drop in the core body temperature of the human body below 28 \u00b0C. It is characterized by impaired consciousness and malignant rhythm disorders often leading to circulatory arrest. However, due to the low applicability of the classification of accidental hypothermia according to core body temperature in pre-hospital health care, today the revised Swiss classification of hypothermia is the AVPU scale, which prioritizes the patient\u2018s clinical condition. Severe hypothermia falls into the state of \u201epainful\u201c with preserved signs of life and or \u201eunresponsive\u201c with cessation of circulation. Extracorporeal circulation is today the gold standard in the treatment of patients with severe hypothermia and possible circulatory arrest. The article presents the case of a patient with severe hypothermia (initial body temperature 22 \u00b0C in the core) and circulatory arrest in a malignant rhythm of ventricular fibrillation. By standard ALS protocol (Advance Life Support) until the connection to extracorporeal circulation with heating. By subsequent restoration of heart activity after reaching the patient\u2018s core body temperature responding to the delivered defibrillation shock and cardiopulmonary recovery of the patient without neurological deficit. The published article aim is to familiarize the professional society with the protocolized, integrated concept of extracorporeal heating of the patient using the ECMO methodology and to point out the opportunities and challenges of ECPR implementation in Slovakia.<br \/>\n<b>Key words: <\/b>hypothermia \u2013 ECPR \u2013 ECMO \u2013 ectracorporeal active rewarming \u2013 protocol<\/p>\n<p><b>DEATH OF A PATIENT FROM ACUTE CORONARY SYNDROME AFTER REFUSAL OF THE PROVISION OF HEALTH SERVICES<\/b><\/p>\n<p><b>Robin \u0160\u00edn<\/b><\/p>\n<p><b>Abstract <\/b><\/p>\n<p>This case report presents the case of a 73-year-old man who freely decided, in accordance with the Health Services Act, to refuse the provision of health services by an Emergency medical service despite repeated warnings from EMS physician on scene that his actions could endanger his health and life. The patient died approximately two hours after the first contact with the Emergency medical service at the place of his residence. An autopsy revealed acute myocardial infarction as the immediate cause of death.<br \/>\n<b>Key words: <\/b>refusal of medical services \u2013 prehospital emergency care \u2013 acute coronary syndrome<\/p>\n","protected":false},"excerpt":{"rendered":"<p>INTRODUCTION Contents Editorial \u2013 Jana \u0160eblov\u00e1 EMERGENCY DEPARTMENTS Selected emergency conditions in connective tissue diseases and systemic vasculitis \u2013 Johana \u0160id\u00e1kov\u00e1, Tom\u00e1\u0161 Veleta, Tom\u00e1\u0161 Soukup PHYSIOLOGY AND EMERGENCY MEDICINE The role of chest tube in the prehospital care in trauma<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[22],"tags":[],"_links":{"self":[{"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=\/wp\/v2\/posts\/901"}],"collection":[{"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=901"}],"version-history":[{"count":1,"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=\/wp\/v2\/posts\/901\/revisions"}],"predecessor-version":[{"id":902,"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=\/wp\/v2\/posts\/901\/revisions\/902"}],"wp:attachment":[{"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=901"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=901"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/en\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=901"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}