{"id":1134,"date":"2021-05-03T11:24:19","date_gmt":"2021-05-03T09:24:19","guid":{"rendered":"http:\/\/urgentnimedicina.cz\/?p=1134"},"modified":"2021-09-13T15:05:22","modified_gmt":"2021-09-13T13:05:22","slug":"obsah-1-2021","status":"publish","type":"post","link":"https:\/\/urgentnimedicina.cz\/?p=1134","title":{"rendered":"Obsah 1\/2021"},"content":{"rendered":"<p><b>\u00daVOD<\/b><\/p>\n<ul>\n<li>Obsah<\/li>\n<li>\u00davodn\u00ed slovo \u2013 Jana \u0160eblov\u00e1<\/li>\n<\/ul>\n<p><b>URGENTN\u00cd P\u0158\u00cdJMY<\/b><\/p>\n<ul>\n<li>Emergentn\u00ed resuscitativn\u00ed torakotomie u polytraumatu. Kazuistika a p\u0159ehled literatury \u2013 Miroslav Durila, Tom\u00e1\u0161 Bro\u017e, Martin \u0160najdauf, Pavla Ba\u0165kov\u00e1, Zuzana P\u0159ikrylov\u00e1<\/li>\n<\/ul>\n<p><b>P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c1 P\u00c9\u010cE<\/b><\/p>\n<ul>\n<li>Raritn\u00ed p\u0159\u00edpad srde\u010dn\u00ed z\u00e1stavy \u2013 kazuistika \u2013 Martin Nov\u00e1k, Jan Stan\u011bk, Petr Handlos, Kl\u00e1ra Handlosov\u00e1, Paula Dzur\u0148\u00e1kov\u00e1, Roman G\u0159ego\u0159<\/li>\n<\/ul>\n<p><b>OPERA\u010cN\u00cd \u0158\u00cdZEN\u00cd<\/b><\/p>\n<ul>\n<li>Vyu\u017eit\u00ed bod\u016f z\u00e1jmu p\u0159i lokalizaci volaj\u00edc\u00edho na t\u00eds\u0148ovou linku 155 \u2013 n\u00e1rodn\u00ed pr\u016fzkum \u2013 David Pe\u0159an, Ond\u0159ej Fran\u011bk, Jaroslav Pekara, Radom\u00edr Vlk<\/li>\n<\/ul>\n<p><b>FYZIOLOGIE A URGENTN\u00cd MEDIC\u00cdNA<\/b><\/p>\n<ul>\n<li>Palpitace \u2013 patofyziologie a klinick\u00fd v\u00fdznam \u2013 David Astapenko, Roman \u0160kulec<\/li>\n<\/ul>\n<p><b>DOPORU\u010cEN\u00c9 POSTUPY<\/b><\/p>\n<ul>\n<li>\u00davod \u2013 Ond\u0159ej Fran\u011bk<\/li>\n<li>Indik\u00e1tory kvality \u010dinnosti zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby \u2013 Ond\u0159ej Fran\u011bk, Jaroslav Kratochv\u00edl, Anatolij Truhl\u00e1\u0159<\/li>\n<li>Indika\u010dn\u00ed krit\u00e9ria a opera\u010dn\u00ed \u0159\u00edzen\u00ed leteck\u00e9 z\u00e1chrann\u00e9 slu\u017eby (LZS) \u2013 Anatolij Truhl\u00e1\u0159, Ond\u0159ej Fran\u011bk, Eva Smr\u017eov\u00e1, Jaroslav Kratochv\u00edl, Roman G\u0159ego\u0159<\/li>\n<li>Mezinemocni\u010dn\u00ed transport pacient\u016f s t\u011b\u017ek\u00fdm a kriticky z\u00e1va\u017en\u00fdm pr\u016fb\u011bhem COVID-19 \u2013 Roman \u0160kulec, Jan Bil\u00edk, Eva Smr\u017eov\u00e1, Vladim\u00edr \u010cern\u00fd<\/li>\n<\/ul>\n<p><b>VZD\u011aL\u00c1V\u00c1N\u00cd A ATESTA\u010cN\u00cd OT\u00c1ZKY<\/b><\/p>\n<ul>\n<li>Jak na atestaci z urgentn\u00ed medic\u00edny? \u2013 Jana \u0160eblov\u00e1, Katar\u00edna Vesel\u00e1, Jana Kubalov\u00e1<\/li>\n<\/ul>\n<p><b>ETIKA, PSYCHOLOGIE, PR\u00c1VO<\/b><\/p>\n<ul>\n<li>D\u00edt\u011b se z\u00e1va\u017en\u00fdm \u017eivot limituj\u00edc\u00edm nebo \u017eivot ohro\u017euj\u00edc\u00edm onemocn\u011bn\u00edm \u2013 aspekty p\u00e9\u010de paliativn\u00ed a intenzivn\u00ed \u2013 Jana Djakow, Mahulena Exnerov\u00e1<\/li>\n<\/ul>\n<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>Emergency resuscitative thoracothomy in multiple trauma. A case report and literature review \u2013 Miroslav Durila, Tom\u00e1\u0161 Bro\u017e, Martin \u0160najdauf, Pavla Ba\u0165kov\u00e1, Zuzana P\u0159ikrylov\u00e1<\/li>\n<\/ul>\n<p><b>PREHOSPITAL EMERGENCY CARE<\/b><\/p>\n<ul>\n<li>A rare case of cardiac arrest \u2013 a case report \u2013 Martin Nov\u00e1k, Jan Stan\u011bk, Petr Handlos, Kl\u00e1ra Handlosov\u00e1, Paula Dzur\u0148\u00e1kov\u00e1, Roman G\u0159ego\u0159<\/li>\n<\/ul>\n<p><b>MEDICAL DISPATCH<\/b><\/p>\n<ul>\n<li>Use of the points of interest in locating a caller on the emergency number 155 \u2013 national survey \u2013 David Pe\u0159an, Ond\u0159ej Fran\u011bk, Jaroslav Pekara, Radom\u00edr Vlk<\/li>\n<\/ul>\n<p><b>PHYSIOLOGY AND EMERGENCY MEDICINE<\/b><\/p>\n<ul>\n<li>Palpitations \u2013 pathophysiology and clinical significance \u2013 David Astapenko, Roman \u0160kulec<\/li>\n<\/ul>\n<p><b>GUIDELINES<\/b><\/p>\n<ul>\n<li>Introduction \u2013 Ond\u0159ej Fran\u011bk<\/li>\n<li>Quality indicators in Emergency Medical Systems performance \u2013 Ond\u0159ej Fran\u011bk, Jaroslav Kratochv\u00edl, Anatolij Truhl\u00e1\u0159<\/li>\n<li>Indication criteria and medical dispatching in Helicopter Emergency Medical Service (HEMS) \u2013 Anatolij Truhl\u00e1\u0159, Ond\u0159ej Fran\u011bk, Eva Smr\u017eov\u00e1, Jaroslav Kratochv\u00edl, Roman G\u0159ego\u0159<\/li>\n<li>Interhospital transport of patients with severe and critical course of COVID-19 \u2013 Roman \u0160kulec, Jan Bil\u00edk, Eva Smr\u017eov\u00e1, Vladim\u00edr \u010cern\u00fd<\/li>\n<\/ul>\n<p><b>EDUCATION<\/b><\/p>\n<ul>\n<li>How to pass the specialisation exam in emergency medicine? \u2013 Jana \u0160eblov\u00e1, Katar\u00edna Vesel\u00e1, Jana Kubalov\u00e1<\/li>\n<\/ul>\n<p><b>ETHICS, PSYCHOLOGY, LAW<\/b><\/p>\n<ul>\n<li>Children with life-limiting and life-shortening conditions \u2013 the aspects of palliative and intensive care \u2013 Jana Djakow, Mahulena Exnerov\u00e1<\/li>\n<\/ul>\n<p><span style=\"text-decoration: underline;\"><strong>ABSTRAKTY<\/strong><\/span><\/p>\n<h6><b>EMERGENTN\u00cd RESUSCITATIVN\u00cd TORAKOTOMIE U POLYTRAUMATU. KAZUISTIKA A P\u0158EHLED LITERATURY<\/b><\/h6>\n<p><b>EMERGENCY RESUSCITATIVE THORACOTHOMY IN MULTIPLE TRAUMA. A CASE REPORT AND LITERATURE REVIEW<\/b><\/p>\n<p><b>Miroslav Durila, Tom\u00e1\u0161 Bro\u017e, Martin \u0160najdauf, Pavla Ba\u0165kov\u00e1, Zuzana P\u0159ikrylov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>V t\u00e9to kazuistice prezentujeme p\u0159\u00edpad pacienta s traumatickou z\u00e1stavu ob\u011bhu, kterou se poda\u0159ilo zvr\u00e1tit a\u017e po proveden\u00ed resuscitativn\u00ed torakotomie se zasvorkov\u00e1n\u00edm descendentn\u00ed aorty. I kdy\u017e KPR trvala celkem 77 minut, pacient p\u0159e\u017eil bez neurologick\u00e9ho deficitu.<br \/>\nJeliko\u017e c\u00edlem prvotn\u00ed KPR je i u polytraumatu &#8222;z\u00e1chrana mozku a srdce&#8220;, tento z\u00e1krok by nem\u011bl b\u00fdt u t\u011bchto pacient\u016f opom\u00edjen. U takto z\u00e1va\u017en\u00fdch typ\u016f poran\u011bn\u00ed je obzvl\u00e1\u0161t\u011b nutn\u00e1 vz\u00e1jemn\u00e1 spolupr\u00e1ce t\u00fdm\u016f NLZP, l\u00e9ka\u0159\u016f urgentn\u00ed medic\u00edny, anesteziolog\u016f\/ intenzivist\u016f a chirurg\u016f, a to od po\u010d\u00e1tku p\u0159ednemocni\u010dn\u00ed p\u00e9\u010de a\u017e po definitivn\u00ed o\u0161et\u0159en\u00ed na opera\u010dn\u00edm s\u00e1le.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>KPR \u2013 trauma \u2013 torakotomie \u2013 z\u00e1stava ob\u011bhu<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>In this case report, we present a case of a patient who suffered a traumatic circulatory arrest that was reversed only after performing a resuscitation thoracotomy with clamping of the descendent aorta. Despite 77 minutes long CPR, he survived without a neurological deficit.<br \/>\nSince the goal of primary CPR in polytrauma is &#8222;saving the brain and heart,&#8220; this procedure should not be neglected in these patients. In the case of such serious types of injuries, the cooperation of paramedics, emergency doctors, anesthesiologists\/intensivists and surgeons is critically important, beginning with pre-hospital care to definitive treatment in the operating room.<\/p>\n<p><b>Key words: <\/b>CPR \u2013 trauma \u2013 thoracotomy \u2013 circulatory arrest<\/p>\n<h6><b>RARITN\u00cd P\u0158\u00cdPAD SRDE\u010cN\u00cd Z\u00c1STAVY \u2013 KAZUISTIKA<\/b><\/h6>\n<p><b>A RARE CASE OF CARDIAC ARREST \u2013 A CASE REPORT<\/b><\/p>\n<p><b>Martin Nov\u00e1k, Jan Stan\u011bk, Petr Handlos, Kl\u00e1ra Handlosov\u00e1, Paula Dzur\u0148\u00e1kov\u00e1, Roman G\u0159ego\u0159<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Malign\u00ed neuroleptick\u00fd syndrom (MNS) je \u017eivot ohro\u017euj\u00edc\u00ed klinick\u00fd syndrom vyskytuj\u00edc\u00ed se u pacient\u016f u\u017e\u00edvaj\u00edc\u00edch antipsychotika a je charakteristick\u00fd tetr\u00e1dou symptom\u016f: kvalitativn\u00ed \u010di kvantitativn\u00ed porucha v\u011bdom\u00ed, svalov\u00e1 rigidita, hyperpyrexie a poruchy autonomn\u00edho nervov\u00e9ho syst\u00e9mu. Incidence se podle sv\u011btov\u00e9 literatury pohybuje od 0,02\u20133 % v\u0161ech pacient\u016f u\u017e\u00edvaj\u00edc\u00edch antipsychotika. V\u00fdskyt MNS je nej\u010dast\u011bji popisov\u00e1n u antipsychotik prvn\u00ed t\u0159\u00eddy \u2013 haloperidolum (Haloperidol), chlorpromazin (Plegomazin), metotrimeprazin (Tisercin), ale tak\u00e9 u jin\u00fdch druh\u016f antipsychotik, jako nap\u0159. clozapine, risperidone, olanzapin. Mezi dal\u0161\u00ed l\u00e9ky zp\u016fsobuj\u00edc\u00ed MNS pat\u0159\u00ed antiemetika, antiparkinsonika, lithium a dal\u0161\u00ed. Diagnostika je velmi obt\u00ed\u017en\u00e1. Laboratorn\u011b je charakteristick\u00e1 metabolick\u00e1 acid\u00f3za, elevace kreatinkin\u00e1zy (CK) vzhledem k rhabdomyol\u00fdze a leukocyt\u00f3ze. Rhabdomyol\u00fdza m\u016f\u017ee v\u00e9st k ledvinn\u00e9mu selh\u00e1n\u00ed s nutnost\u00ed hemodial\u00fdzy. CT mozku b\u00fdv\u00e1 zpravidla negativn\u00ed. Terapie je symptomatick\u00e1, individu\u00e1ln\u00ed a z\u00e1vis\u00ed na aktu\u00e1ln\u00edm projevu MNS. V prvn\u00ed \u0159ad\u011b by m\u011bla b\u00fdt p\u0159eru\u0161ena terapie antipsychotiky, eventu\u00e1ln\u011b jin\u00e9ho farmaka, u kter\u00e9ho m\u00e1me podez\u0159en\u00ed, \u017ee je d\u016fvodem vzniku MNS. N\u011bkolik l\u00e9ku bylo v experimentu testov\u00e1no ke sn\u00ed\u017een\u00ed morbidity a mortality p\u0159i v\u00fdskytu MNS. V dne\u0161n\u00ed dob\u011b jsou pou\u017e\u00edv\u00e1ny bromokriptin a dantrolen, a\u0165 u\u017e samostatn\u011b, \u010di v kombinaci.<br \/>\nV kazuistice p\u0159edstavujeme mlad\u00e9ho pacienta, u kter\u00e9ho byla p\u0159\u00edtomnost malign\u00edho neuroleptick\u00e9ho syndromu skryt\u00e1 za p\u0159\u00edznaky traumatick\u00e9ho stavu se srde\u010dn\u00ed z\u00e1stavou. I p\u0159es \u00fasp\u011b\u0161nou kardiopulmon\u00e1ln\u00ed resuscitaci pacient um\u00edr\u00e1 pod obrazem hepatoren\u00e1ln\u00edho selh\u00e1n\u00ed a refraktern\u00edho \u0161oku. Definitivn\u00ed p\u0159\u00ed\u010dina \u00famrt\u00ed byla stanovena a\u017e po proveden\u00ed zdravotn\u00ed pitvy.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>malign\u00ed neuroleptick\u00fd syndrom \u2013 neodkladn\u00e1 resuscitace \u2013 antipsychotika<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Neuroleptic malignant syndrome (NMS) is a life-threatening clinical syndrome, which occurs in patients using antipsychotic medication, and is characterized with a tetrad of symptoms: qualitative or quantitative disturbance of consciousness, muscle rigidity, hyperpyrexia, and disorders of the autonomous nervous system. The incidence reported in literature ranges between 0.02 and 3% of all patients using antipsychotics. The presence of NMS is most frequently reported in first-generation antipsychotics \u2013 haloperidolum (Haloperidol), chlorpromazine (Plegomazin), methotrimeprazine (Tisercin) but also in other types of antipsychotic medication, such as e.g. Clozapine, Risperidone, Olanzapine. Other medications responsible for the occurrence of NMS include antiemetics, antiparkinsonics, lithium, and others. The diagnostics is very difficult. Laboratory results are characterized with metabolic acidosis and elevation of creatine kinase (CK), due to rhabdomyolysis and leucocytosis. Rhabdomyolysis may result in renal failure requiring haemodialysis. CT examination of the brain is usually negative. The therapy is symptomatic, individual, and depends on the actual manifestation of NMS. In the first place, the therapy with antipsychotics, or possibly other medication, which may be suspected as being responsible for the onset of NMS, should be discontinued. Several medicines have been experimentally tested for decreasing the morbidity and mortality of patients with NMS. At present, Bromocriptine and Dantrolene are being used, either individually or in combination.<br \/>\nThe authors present a case report of a young patient, in whom the presence of neuroleptic malignant syndrome was masked with symptoms of multiple trauma with subsequent cardiac arrest. Despite successful cardiopulmonary resuscitation, the patient died with manifestations of hepatorenal failure and refractory shock. The definitive cause of death was established only after autopsy.<\/p>\n<p><b>Key words: <\/b>Malignant neuroleptic syndrome \u2013 immediate resuscitation \u2013 antipsychotic drugs<\/p>\n<h6><b>VYU\u017dIT\u00cd BOD\u016e Z\u00c1JMU P\u0158I LOKALIZACI VOLAJ\u00cdC\u00cdHO NA T\u00cdS\u0147OVOU LINKU 155 \u2013 N\u00c1RODN\u00cd PR\u016eZKUM<\/b><\/h6>\n<p><b>USE OF THE POINTS OF INTEREST IN LOCATING A CALLER ON THE EMERGENCY NUMBER 155 \u2013 NATIONAL SURVEY<\/b><\/p>\n<p><b>David Pe\u0159an, Ond\u0159ej Fran\u011bk, Jaroslav Pekara, Radom\u00edr Vlk<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>\u00davod: Lokalizace je v r\u00e1mci p\u0159\u00edjmu t\u00eds\u0148ov\u00e9 v\u00fdzvy nejd\u016fle\u017eit\u011bj\u0161\u00edm krokem, kter\u00fd mohou technologie a jejich implementace do dispe\u010dersk\u00fdch syst\u00e9m\u016f zna\u010dn\u011b usnad\u0148ovat. Vyu\u017e\u00edv\u00e1n\u00ed bod\u016f z\u00e1jmu se nap\u0159\u00ed\u010d kraji li\u0161\u00ed. Tento pr\u016fzkum si klade za c\u00edl mapovat v\u00fdvoj vyu\u017e\u00edv\u00e1n\u00ed bod\u016f z\u00e1jmu v \u010cesk\u00e9 republice (\u010cR) v jednotliv\u00fdch kraj\u00edch.<br \/>\nMetoda: Bylo provedeno dotazn\u00edkov\u00e9 \u0161et\u0159en\u00ed na v\u0161ech zdravotnick\u00fdch z\u00e1chrann\u00fdch slu\u017eb\u00e1ch (ZZS) \u010cR v roce 2014 a 2019 \u2013 kompletn\u00ed sb\u011br dat pomoc\u00ed strukturovan\u00fdch ot\u00e1zek s kvantitativn\u00edm vyhodnocen\u00edm.<br \/>\nV\u00fdsledky: V roce 2014 vyu\u017e\u00edvaly ZZS v \u010cR souhrnn\u011b 84 bod\u016f z\u00e1jmu, zat\u00edmco v roce 2019 to bylo ji\u017e 162 (p=0.04). Sloupy ve\u0159ejn\u00e9ho osv\u011btlen\u00ed (SVO) m\u011blo v mapov\u00fdch podkladech v roce 2014 zavedeno 7 zdravotnick\u00fdch opera\u010dn\u00edch st\u0159edisek (ZOS), zat\u00edmco v roce 2019 ji\u017e 10 ZOS.<br \/>\nZ\u00e1v\u011br: Zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby v \u010cR se st\u00e1le pod\u00edl\u00ed na zlep\u0161ov\u00e1n\u00ed datab\u00e1z\u00ed bod\u016f z\u00e1jmu.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>zdravotnick\u00e9 opera\u010dn\u00ed st\u0159edisko \u2013 body z\u00e1jmu \u2013 integrovan\u00fd z\u00e1chrann\u00fd syst\u00e9m<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Introduction: Localization is the most important step in the receiving of an emergency call, which technologies and their implementation in dispatching systems can greatly facilitate. The use of points of interest varies across regions. This survey aims to map the development of the use of points of interest in the Czech Republic (CR) and individual regions.<br \/>\nMethod: A questionnaire survey was conducted at all emergency medical services (EMS) of the CR in the years 2014 and 2019 \u2013 complete data collection using structured questions with quantitative evaluation.<br \/>\nResults: In 2014, EMS in the CR used a total of 84 points of interest, while in 2019 it was already 162 (p = 0.04). Public lighting poles (SVO) had 7 emergency medical dispatching (EMD) introduced in the map data in 2014, while in 2019 it was already 10 EMD.<br \/>\nConclusion: The emergency medical services in the CR is still involved in improving the databases of points of interest.<\/p>\n<p><b>Key words: <\/b>emergency medical dispatching \u2013 points of interest \u2013 integrated rescue system<\/p>\n<h6><b>PALPITACE \u2013 PATOFYZIOLOGIE A KLINICK\u00dd V\u00ddZNAM<\/b><\/h6>\n<p><b>PALPITATIONS \u2013 PATHOPHYSIOLOGY AND CLINICAL SIGNIFICANCE<\/b><\/p>\n<p><b>David Astapenko, Roman \u0160kulec<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Palpitace p\u0159edstavuj\u00ed subjektivn\u00ed nep\u0159\u00edjemn\u00e9 vn\u00edm\u00e1n\u00ed srde\u010dn\u00ed \u010dinnosti. Jsou v\u00fdsledkem komplexn\u00ed senzoriky srde\u010dn\u00edch odd\u00edl\u016f, velk\u00fdch c\u00e9v a mediastina. Jsou asociov\u00e1ny s \u0159adou diagn\u00f3z od zcela benign\u00edch (zv\u00fd\u0161en\u00e9 vn\u00edm\u00e1n\u00ed fyziologick\u00e9 srde\u010dn\u00ed \u010dinnosti p\u0159i \u00fazkosti nebo nadm\u011brn\u00e9 fyzick\u00e9 aktivit\u011b) a\u017e po z\u00e1va\u017en\u00e9 stavy s nejistou progn\u00f3zou (vrozen\u00e9 srde\u010dn\u00ed vady, struktur\u00e1ln\u00ed onemocn\u011bn\u00ed srdce, chlopenn\u00ed patologie, chronick\u00fd ab\u00fazus drog, syst\u00e9mov\u00e1 onemocn\u011bn\u00ed atd.). Pro klinickou praxi jsou palpitace d\u016fle\u017eit\u00fdm impulzem pro zah\u00e1jen\u00ed \u0161ir\u0161\u00ed diagnostiky kardiovaskul\u00e1rn\u00edho apar\u00e1tu.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>palpitace \u2013 arytmie \u2013 \u00fazkostn\u00e1 porucha \u2013 struktur\u00e1ln\u00ed onemocn\u011bn\u00ed srdce<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Palpitations are a subjective unpleasant perception of heart activity. Palpitations are the result of the complex sensation of the cardiac chambers, large vessels and mediastinum. They are associated with a wide range of diagnoses from completely benign (increased perception of physiological heart activity in anxiety or excessive physical activity) to severe conditions with uncertain prognosis (congenital heart defects, structural heart disease, valve pathology, chronic drug abuse, systemic diseases, etc.). For clinical practice, palpitations are an important impulse for initiating a broader diagnosis of the cardiovascular system.<\/p>\n<p><b>Key words: <\/b>palpitations \u2013 arrythmia \u2013 anxiety disorder \u2013 structural heart disease<\/p>\n<h6><b>D\u00cdT\u011a SE Z\u00c1VA\u017dN\u00ddM \u017dIVOT LIMITUJ\u00cdC\u00cdM NEBO \u017dIVOT OHRO\u017dUJ\u00cdC\u00cdM ONEMOCN\u011aN\u00cdM \u2013 ASPEKTY P\u00c9\u010cE PALIATIVN\u00cd A INTENZIVN\u00cd<\/b><\/h6>\n<p><b>CHILDREN WITH LIFE-LIMITING AND LIFE-SHORTENING CONDITIONS \u2013 THE ASPECTS OF PALLIATIVE AND INTENSIVE CARE<\/b><\/p>\n<p><b>Jana Djakow, Mahulena Exnerov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>D\u011bt\u00ed se z\u00e1va\u017en\u00fdm \u017eivot limituj\u00edc\u00edm nebo \u017eivot ohro\u017euj\u00edc\u00edm onemocn\u011bn\u00edm p\u0159ib\u00fdv\u00e1. P\u0159esto\u017ee jde o onemocn\u011bn\u00ed a stavy vz\u00e1cn\u00e9, je t\u0159eba se p\u0159ipravit na to, \u017ee do kontaktu s t\u011bmito pacienty budou st\u00e1le \u010dast\u011bji p\u0159ich\u00e1zet tak\u00e9 l\u00e9ka\u0159i p\u0159ednemocni\u010dn\u00ed a urgentn\u00ed p\u00e9\u010de. Tento \u010dl\u00e1nek se v\u011bnuje aspekt\u016fm p\u00e9\u010de intenzivn\u00ed a paliativn\u00ed. Vysv\u011btluje z\u00e1sadn\u00ed rozd\u00edly mezi d\u011btskou a dosp\u011blou paliativn\u00ed p\u00e9\u010d\u00ed a nej\u010dast\u011bj\u0161\u00ed omyly, se kter\u00fdmi se p\u0159i p\u00e9\u010di o tyto pacienty setk\u00e1v\u00e1me. Pokou\u0161\u00ed se tak\u00e9 nast\u00ednit nej\u010dast\u011bj\u0161\u00ed v\u00fdzvy, se kter\u00fdmi se mohou pot\u00fdkat poskytovatel\u00e9 p\u0159ednemocni\u010dn\u00ed a urgentn\u00ed p\u00e9\u010de, a nab\u00edz\u00ed mo\u017en\u00e1 \u0159e\u0161en\u00ed t\u011bchto situac\u00ed. V neposledn\u00ed \u0159ad\u011b se v\u011bnuje tak\u00e9 problematice komunikace jako\u017eto nejd\u016fle\u017eit\u011bj\u0161\u00ed netechnick\u00e9 dovednosti p\u0159i p\u00e9\u010di o tyto d\u011bti a jejich rodiny.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>d\u011btsk\u00e1 paliativn\u00ed p\u00e9\u010de \u2013 \u017eivot limituj\u00edc\u00ed a \u017eivot ohro\u017euj\u00edc\u00ed onemocn\u011bn\u00ed \u2013 etika \u2013 komunikace \u2013 p\u0159ednemocni\u010dn\u00ed a urgentn\u00ed p\u00e9\u010de<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>There is increasing number of children with life-limiting and lifeshortening conditions (LLC). Although these conditions are usually rare, the contact with such patients might be more and more frequent also in the field of prehospital and emergency care. This text aims to clarify aspects of intensive and palliative care. We explain the main differences between paediatric and adult palliative care as well as the most frequent myths associated with the paediatric palliative care. We also try to outline frequent challenges perceived by prehospital and emergency care staff together with possible solutions of these difficult situations. Lastly, we mention the communication as the most important non-technical skill while taking care of these children and their families.<\/p>\n<p><b>Key words: <\/b>paediatric palliative care \u2013 life-limiting and life-shortening conditions \u2013 ethics \u2013 communication \u2013 prehospital and emergency care<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00daVOD Obsah \u00davodn\u00ed slovo \u2013 Jana \u0160eblov\u00e1 URGENTN\u00cd P\u0158\u00cdJMY Emergentn\u00ed resuscitativn\u00ed torakotomie u polytraumatu. Kazuistika a p\u0159ehled literatury \u2013 Miroslav Durila, Tom\u00e1\u0161 Bro\u017e, Martin \u0160najdauf, Pavla Ba\u0165kov\u00e1, Zuzana P\u0159ikrylov\u00e1 P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c1 P\u00c9\u010cE Raritn\u00ed p\u0159\u00edpad srde\u010dn\u00ed z\u00e1stavy \u2013 kazuistika \u2013 Martin<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[],"class_list":["post-1134","post","type-post","status-publish","format-standard","hentry","category-rocnik-2021"],"_links":{"self":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1134","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1134"}],"version-history":[{"count":2,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1134\/revisions"}],"predecessor-version":[{"id":1136,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1134\/revisions\/1136"}],"wp:attachment":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1134"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1134"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1134"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}