{"id":1283,"date":"2023-02-21T11:46:07","date_gmt":"2023-02-21T09:46:07","guid":{"rendered":"https:\/\/urgentnimedicina.cz\/?p=1283"},"modified":"2023-02-21T11:46:08","modified_gmt":"2023-02-21T09:46:08","slug":"obsah-3-4-2022","status":"publish","type":"post","link":"https:\/\/urgentnimedicina.cz\/?p=1283","title":{"rendered":"Obsah 3-4\/2022"},"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>Traumatick\u00e1 z\u00e1stava ob\u011bhu \u2013 dv\u011b kazuistiky \u2013 Miroslav Durila, Kl\u00e1ra Valch\u00e1\u0159ov\u00e1, Tom\u00e1\u0161 Kouba, Marcel Truelle, Barbora Za\u010dalov\u00e1, Michal Fric, Jaroslav Pa\u017eout<\/li>\n<\/ul>\n<p><b>P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c1 P\u00c9\u010cE<\/b><\/p>\n<ul>\n<li>Role hrudn\u00ed dren\u00e1\u017ee v p\u0159ednemocni\u010dn\u00ed p\u00e9\u010di u traumat \u2013 Jana Berkov\u00e1<\/li>\n<\/ul>\n<p><b>P\u0158\u00cdSTROJE A TECHNIKA<\/b><\/p>\n<ul>\n<li>Dani\u0161ov stent na zastavenie krv\u00e1cania z pa\u017eer\u00e1kov\u00fdch varixov v kritick\u00fdch situ\u00e1ci\u00e1ch \u2013 Daniel Ty\u010d, Michal Vran\u00fd<\/li>\n<\/ul>\n<p><b>T\u00c9MA: INTOXIKACE<\/b><\/p>\n<ul>\n<li>Intoxikace paracetamolem v \u010cesk\u00e9 republice a aktu\u00e1ln\u00ed terapeutick\u00e1 doporu\u010den\u00ed \u2013 Ji\u0159\u00ed Hlu\u0161i\u010dka, Viktorie Kolesnikova, Kate\u0159ina Kot\u00edkov\u00e1, Daniela Pelclov\u00e1<\/li>\n<li>Intoxikace p\u0159i n\u00e1hodn\u00e9m po\u017eit\u00ed dimetindenu u d\u011bt\u00ed \u2013 Michal \u010ce\u010drle, Daniela Pelclov\u00e1<\/li>\n<li>\u017divot ohro\u017euj\u00edc\u00ed intoxikace vitam\u00ednem B17 \u2013 Patrik Christian Cmorej, Petr Bure\u0161, Ond\u0159ej Kounovsk\u00fd, Martin Kub\u00e1t, Alena Kohlov\u00e1<\/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 Katar\u00edna Vesel\u00e1, Jana \u0160eblov\u00e1, Jana Kubalov\u00e1<\/li>\n<\/ul>\n<p><b>ETIKA, PSYCHOLOGIE, PR\u00c1VO<\/b><\/p>\n<ul>\n<li>Historick\u00fd v\u00fdvoj poskytov\u00e1n\u00ed neodkladn\u00e9 p\u00e9\u010de \u2013 Robin \u0160\u00edn<\/li>\n<\/ul>\n<p><b>INFORMA\u010cN\u00cd SERVIS<\/b><\/p>\n<ul>\n<li>Prohl\u00e1\u0161en\u00ed o minim\u00e1ln\u00edch standardech pro bezpe\u010dn\u00e9 pracovn\u00ed podm\u00ednky v urgentn\u00ed medic\u00edn\u011b \u2013 Roberta Petrino, Luis Garcia Castrillo, Basak Yilmaz, Christoph Dodt, Eeva Tuunainen, Abdo Khoury a pracovn\u00ed skupina Dne urgentn\u00ed medic\u00edny<\/li>\n<li>Stanovisko k p\u0159et\u00ed\u017een\u00ed urgentn\u00edch p\u0159\u00edjm\u016f \u2013 International Federation for Emergency Medicine (IFEM)<\/li>\n<li>In memoriam prof. William Gunn MD, MS, FRCSC, FRCSI (Hon), DSC (Hon), dr h c (10. 2. 1926 \u2013 1. 11. 2022) \u2013 Leo Klein<\/li>\n<li>AZZS \u010cR ve spolupr\u00e1ci s Nada\u010dn\u00edm fondem Kry\u0161t\u016ffek pom\u00e1haj\u00ed z\u00e1chran\u00e1\u0159\u016fm v t\u00ed\u017eiv\u00e9 \u017eivotn\u00ed situaci<\/li>\n<\/ul>\n<hr>\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>Traumatic cardiac arrest \u2013 two case reports \u2013 Miroslav Durila, Kl\u00e1ra Valch\u00e1\u0159ov\u00e1, Tom\u00e1\u0161 Kouba, Marcel Truelle, Barbora Za\u010dalov\u00e1, Michal Fric, Jaroslav Pa\u017eout<\/li>\n<\/ul>\n<p><b>PREHOSPITAL EMERGENCY CARE<\/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>Danis stent for management of bleeding from esophageal varices in critical situations \u2013 Daniel Ty\u010d, Michal Vran\u00fd<\/li>\n<\/ul>\n<p><b>TOPIC: INTOXICATIONS<\/b><\/p>\n<ul>\n<li>Paracetamol (acetaminofen) intoxications in the Czech Republic and current therapeutical guidelines \u2013 Ji\u0159\u00ed Hlu\u0161i\u010dka, Viktorie Kolesnikova, Kate\u0159ina Kot\u00edkov\u00e1, Daniela Pelclov\u00e1<\/li>\n<li>Accidental dimetindene intoxications in children \u2013 Michal \u010ce\u010drle, Daniela Pelclov\u00e1<\/li>\n<li>Life-threatening vitamine B17 intoxication \u2013 Patrik Christian Cmorej, Petr Bure\u0161, Ond\u0159ej Kounovsk\u00fd, Martin Kub\u00e1t, Alena Kohlov\u00e1<\/li>\n<\/ul>\n<p><b>EDUCATION<\/b><\/p>\n<ul>\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>Historical development of emergency care provision \u2013 Robin \u0160\u00edn<\/li>\n<\/ul>\n<p><b>INFORMATION<\/b><\/p>\n<ul>\n<li>Policy statement on minimal standards for safe working conditions in Emergency Medicine \u2013 Roberta Petrino, Luis Garcia Castrillo, Basak Yilmaz, Christoph Dodt, Eeva Tuunainen, Abdo Khoury and the Emergency Medicine Day working group<\/li>\n<li>Position Statement on Over-crowded Emergency Departments \u2013 International Federation for Emergency Medicine (IFEM)<\/li>\n<li>In memoriam prof. William Gunn MD, MS, FRCSC, FRCSI (Hon), DSC (Hon), dr h c (10. 2. 1926 \u2013 1. 11. 2022) \u2013 Leo Klein<\/li>\n<li>The Czech EMS Association and Kry\u0161t\u016ffek foundation help paramedics in difficult life situations<\/li>\n<\/ul>\n<hr>\n<p><span style=\"text-decoration: underline;\"><strong>ABSTRAKTY<\/strong><\/span><\/p>\n<h6><b>TRAUMATICK\u00c1 Z\u00c1STAVA OB\u011aHU \u2013 DV\u011a KAZUISTIKY<\/b><\/h6>\n<p><b>TRAUMATIC CARDIAC ARREST \u2013 TWO CASE REPORTS<\/b><\/p>\n<p><b>Miroslav Durila, Kl\u00e1ra Valch\u00e1\u0159ov\u00e1, Tom\u00e1\u0161 Kouba, Marcel Truelle, Barbora Za\u010dalov\u00e1, Michal Fric, Jaroslav Pa\u017eout<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Traumatick\u00e1 z\u00e1stava ob\u011bhu je prognosticky extr\u00e9mn\u011b nep\u0159\u00edzniv\u00fdm stavem pro pacienta, ale je n\u00e1ro\u010dnou situac\u00ed i pro zdravotnick\u00fd person\u00e1l, kter\u00fd poskytuje pacientovi zdravotn\u00ed p\u00e9\u010di od p\u0159ednemocni\u010dn\u00edho a\u017e po poopera\u010dn\u00ed obdob\u00ed. Prezentujeme dva p\u0159\u00edpady \u00fasp\u011b\u0161n\u00e9 terapie traumatick\u00e9 z\u00e1stavy ob\u011bhu, z \u010deho\u017e k jedn\u00e9 z\u00e1stav\u011b do\u0161lo v p\u0159ednemocni\u010dn\u00edm obdob\u00ed a v druh\u00e9m p\u0159\u00edpadu do\u0161lo k z\u00e1stav\u011b ob\u011bhu jak v p\u0159ednemocni\u010dn\u00edm obdob\u00ed, tak i z\u00e1hy po p\u0159ed\u00e1n\u00ed pacienta na odd\u011blen\u00ed urgentn\u00edho p\u0159\u00edjmu. Jedn\u00e1 se o pom\u011brn\u011b typick\u00e9, nicm\u00e9n\u011b m\u00e1lo \u010dast\u00e9 kazuistiky. C\u00edlem publikov\u00e1n\u00ed je krom\u011b sd\u00edlen\u00ed zku\u0161enost\u00ed i motivace a edukace zejm\u00e9na za\u010d\u00ednaj\u00edc\u00edch zdravotn\u00edk\u016f v oblasti urgentn\u00ed medic\u00edny.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>trauma \u2013 z\u00e1stava ob\u011bhu \u2013 krv\u00e1cen\u00ed<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Traumatic cardiac arrest is an extremely unfavorable prognostic condition for the patient, but also a challenging situation for the medical personnel who care for the patient from the prehospital period to the postoperative period. We present two cases of therapy of a traumatic cardiac arrest, of which one arrest occurred in the prehospital period and in the other case cardiac arrest occurred both in the prehospital period and soon after admission at the emergency department. These rather typical but rare case reports are published not only for sharing experience, but also for motivational and educational reasons, especially for beginning health professionals in the field of emergency medicine.<\/p>\n<p><b>Key words: <\/b>trauma \u2013 cardiac arrest \u2013 bleeding<\/p>\n<h6><b>ROLE HRUDN\u00cd DREN\u00c1\u017dE V P\u0158EDNEMOCNI\u010cN\u00cd P\u00c9\u010cI U TRAUMAT<\/b><\/h6>\n<p><b>THE ROLE OF CHEST TUBE IN THE PREHOSPITAL CARE IN TRAUMA<\/b><\/p>\n<p><b>Jana Berkov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>K \u017eivot ohro\u017euj\u00edc\u00edm poran\u011bn\u00edm hrudn\u00edku, kter\u00e1 je nutn\u00e9 \u0159e\u0161it v p\u0159ednemocni\u010dn\u00ed p\u00e9\u010di, pat\u0159\u00ed obstrukce d\u00fdchac\u00edch cest, tracheobronchi\u00e1ln\u00ed poran\u011bn\u00ed, tenzn\u00ed pneumotorax a otev\u0159en\u00fd pneumotorax. P\u0159edm\u011btem tohoto sd\u011blen\u00ed je p\u0159ehled mo\u017en\u00e9ho \u0159e\u0161en\u00ed tenzn\u00edho a otev\u0159en\u00e9ho pneumotoraxu v p\u0159ednemocni\u010dn\u00ed p\u00e9\u010di v kontextu sou\u010dasn\u00fdch doporu\u010den\u00ed a roli hrudn\u00ed dren\u00e1\u017ee v t\u011bchto procesech. Ze sou\u010dasn\u00fdch doporu\u010den\u00ed vypl\u00fdv\u00e1, \u017ee preferovan\u00fdm zp\u016fsobem o\u0161et\u0159en\u00ed tenzn\u00edho pneumotoraxu v p\u0159ednemocni\u010dn\u00ed p\u00e9\u010di je jehlov\u00e1 dekomprese, p\u0159\u00edp. torakostomie, a vyu\u017eit\u00ed komer\u010dn\u011b vyr\u00e1b\u011bn\u00e9ho kryt\u00ed u otev\u0159en\u00e9ho pneumotoraxu. Zaveden\u00ed hrudn\u00edho dr\u00e9nu nen\u00ed v p\u0159ednemocni\u010dn\u00ed p\u00e9\u010di z d\u016fvodu \u010dasov\u00e9 n\u00e1ro\u010dnosti, mo\u017en\u00fdch komplikac\u00ed a nutnosti z\u00e1cviku obecn\u011b doporu\u010deno. Hrudn\u00ed dr\u00e9n m\u00e1 svou d\u016fle\u017eitou roli p\u0159i \u0159e\u0161en\u00ed v\u00fd\u0161e uveden\u00fdch poran\u011bn\u00ed v r\u00e1mci prim\u00e1rn\u00edho o\u0161et\u0159en\u00ed a\u017e v nemocnici.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>trauma hrudn\u00edku \u2013 pneumotorax \u2013 hrudn\u00ed dr\u00e9n \u2013 dekomprese hrudn\u00edku \u2013 torakostomie<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>The airway obstruction, tracheobronchial injury, tension pneumothorax and open pneumothorax are life-threatening chest injuries must be treated immediately in the prehospital care. The aim of this paper is an overview of the possible treatment for the tension and open pneumothorax in the context of current recommendations and the role of a chest tube insertion. The preferred method of treatment for tension pneumothorax is needle decompresion or thoracostomy, and for open pneumothorax vented chest seal. In general, the chest tube insertion in the prehospital care is not recommended because of the time comsumption, complications and training issues. The role of the chest tube is during the primary survey and management in the hospital.<\/p>\n<p><b>Key words: <\/b>chest injury \u2013 pneumothorax \u2013 chest tube \u2013 needle decompression \u2013 thoracostomy<\/p>\n<h6><b>DANI\u0160OV STENT NA ZASTAVENIE KRV\u00c1CANIA Z PA\u017dER\u00c1KOV\u00ddCH VARIXOV V KRITICK\u00ddCH SITU\u00c1CI\u00c1CH<\/b><\/h6>\n<p><b>DANIS STENT FOR MANAGEMENT OF BLEEDING FROM ESOPHAGEAL VARICES IN CRITICAL SITUATIONS<\/b><\/p>\n<p><b>Daniel Ty\u010d, Michal Vran\u00fd<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Krv\u00e1canie z pa\u017eer\u00e1kov\u00fdch varixov je u pacientov s port\u00e1lnou hypertenziou sp\u00e1jan\u00e9 s vysokou mortalitou. T\u00edto pacienti sa k zdravotnej starostlivosti \u010dasto dost\u00e1vaj\u00fa prostredn\u00edctvom ambulanci\u00ed z\u00e1chrannej slu\u017eby a pr\u00edjmov\u00fdch ambulanci\u00ed nemocn\u00edc. K endoskopick\u00e9mu rie\u0161eniu sa v\u0161ak \u010dasto dostan\u00fa a\u017e po nieko\u013ek\u00fdch hodin\u00e1ch. V situ\u00e1ci\u00e1ch prednemocni\u010dnej a neodkladnej nemocni\u010dnej starostlivosti, kedy kriticky chor\u00fd pacient nereaguje na farmakologick\u00fa lie\u010dbu je potrebn\u00e9 zv\u00e1\u017ei\u0165 prechodn\u00e9 rie\u0161enie. Na tento \u00fa\u010del je dnes k dispoz\u00edcii Sengstaken-Blakemorov\u00e1 sonda (a jej r\u00f4zne varianty) alebo pa\u017eer\u00e1kov\u00fd stent (Dani\u0161ov stent). \u00da\u010delom tohto preh\u013eadu bolo n\u00e1js\u0165 a pop\u00edsa\u0165 inform\u00e1cie o pou\u017eite\u013enosti pa\u017eer\u00e1kov\u00e9ho stentu v kritick\u00fdch situ\u00e1ci\u00e1ch urgentnej starostlivosti (pri nereaguj\u00facej farmakologickej lie\u010dbe a \u010dasovej nedostupnosti ak\u00fatneho endoskopick\u00e9ho rie\u0161enia). Do preh\u013eadu boli zahrnut\u00e9 publik\u00e1cie od roku 2010. S\u00fa\u010dasn\u00e9 \u0161t\u00fadie, ktor\u00e9 popisuj\u00fa klinick\u00e9 \u00fadaje o Dani\u0161ovom stente, s\u00fa v\u0161ak zameran\u00e9 na situ\u00e1cie po zlyhan\u00ed predch\u00e1dzaj\u00facej lie\u010dby. Ch\u00fdbaj\u00fa tak priame klinick\u00e9 \u00fadaje o vyu\u017eit\u00ed tejto met\u00f3dy pred endoskopickou intervenciou. Dostupn\u00e9 klinick\u00e9 \u0161t\u00fadie a doporu\u010den\u00e9 postupy v danej oblasti v\u0161ak uv\u00e1dzaj\u00fa, \u017ee Dani\u0161ov stent vo v\u0161eobecnosti dosahuje lep\u0161\u00ed pomer pr\u00ednosov a riz\u00edk a takisto aj lep\u0161iu n\u00e1kladov\u00fa efektivitu v porovnan\u00ed so Sengstaken-Blakemorovou sondou. V bud\u00facnosti by boli vhodn\u00e9 \u010fal\u0161ie \u0161t\u00fadie, ktor\u00e9 by poskytli klinick\u00e9 \u00fadaje o pou\u017eit\u00ed pa\u017eer\u00e1kov\u00e9ho stentu ako prim\u00e1rneho rie\u0161enia \u017eivot ohrozuj\u00facich stavov bez predch\u00e1dzaj\u00facich intervenci\u00ed.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>pa\u017eer\u00e1kov\u00e9 varixy, tampon\u00e1da, Dani\u0161ov stent, neodkladn\u00e1 starostlivos\u0165<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Bleeding from esophageal varices is associated with high mortality in patients with portal hypertension. These patients often get access to health care through ambulances of the emergency service and emergency departments of hospitals. However, it often takes several hours to get the endoscopic treatment. In situations of pre-hospital and urgent hospital care, when a critically ill patient does not respond to pharmacological treatment, it is necessary to consider a temporary solution. For this purpose, a Sengstaken- Blakemore tube (and its variants) or an esophageal stent (Danis stent) are available today. The purpose of this review was to find and describe the information on the esophageal stent applicability in critical situations of urgent care (when pharmacological treatment failed, and acute endoscopic solution is temporarily unavailable). Publications since 2010 were included in the review. However, the current studies describing clinical data on Danis stent are focused on situations after failure of previous treatment. Thus, there is a lack of direct clinical data on the use of this method before endoscopic intervention. However, available clinical studies and guidelines in the field indicate that the Danis stent generally achieves a better benefit-risk ratio and also better cost-effectiveness compared to the Sengstaken\u2013Blakemore tube. Future studies would be useful to provide clinical data on esophageal stenting as a primary treatment for life-threatening conditions without prior intervention.<br \/>\n<b>Key words: <\/b>chest injury \u2013 pneumothorax \u2013 chest tube \u2013 needle decompression esophageal varices, tamponade, Danis stent, emergency care<\/p>\n<h6><b>INTOXIKACE PARACETAMOLEM V \u010cESK\u00c9 REPUBLICE A AKTU\u00c1LN\u00cd TERAPEUTICK\u00c1 DOPORU\u010cEN\u00cd<\/b><\/h6>\n<p><b>PARACETAMOL (ACETAMINOFEN) INTOXICATIONS IN THE CZECH REPUBLIC AND CURRENT THERAPEUTICAL GUIDELINES<\/b><\/p>\n<p><b>Ji\u0159\u00ed Hlu\u0161i\u010dka, Viktorie Kolesnikova, Kate\u0159ina Kot\u00edkov\u00e1, Daniela Pelclov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Paracetamol (acetaminofen) je od 80. let 20. stolet\u00ed jedn\u00edm z nejobl\u00edben\u011bj\u0161\u00edch analgetik a antipyretik, kter\u00e9 lze u\u017e\u00edt i u osob, kter\u00e9 ostatn\u00ed analgetika netoleruj\u00ed. Stal se tak jedn\u00edm z neju\u017e\u00edvan\u011bj\u0161\u00edch l\u00e9k\u016f v\u016fbec. Ka\u017ed\u00e1 mince m\u00e1 dv\u011b strany, tou odvr\u00e1cenou u paracetamolu je, \u017ee p\u0159ed\u00e1vkov\u00e1n\u00ed vede k po\u0161kozen\u00ed jater, pop\u0159\u00edpad\u011b ledvin. V rozvinut\u00e9m sv\u011bt\u011b jsou intoxikace paracetamolem jednou z nej\u010dast\u011bj\u0161\u00edch p\u0159\u00ed\u010din akutn\u00edho jatern\u00edho selh\u00e1n\u00ed. A\u010dkoliv se hepatotoxicita paracetamolu dost\u00e1v\u00e1 do pov\u011bdom\u00ed lid\u00ed, p\u0159\u00edpad\u016f p\u0159ed\u00e1vkov\u00e1n\u00ed v \u010cesk\u00e9 republice podle dotaz\u016f na Toxikologick\u00e9 informa\u010dn\u00ed st\u0159edisko (TIS) p\u0159ib\u00fdv\u00e1. V letech 2020\u20132022 poskytl TIS celkem 1 712 konzultac\u00ed u pacient\u016f p\u0159ed\u00e1vkovan\u00fdch paracetamolem, co\u017e p\u0159edstavovalo 6,5 % v\u0161ech dotaz\u016f na l\u00e9ky. Za toxickou d\u00e1vku se pova\u017euje mno\u017estv\u00ed v\u011bt\u0161\u00ed ne\u017e 200 mg\/kg t\u011blesn\u00e9 hmotnosti nebo v\u00edce ne\u017e 10 g. Efektivn\u00ed, bezpe\u010dnou a levnou l\u00e9\u010dbou je antidotum N-acetylcystein. Doporu\u010den\u00ed na jeho d\u00e1vkov\u00e1n\u00ed se m\u011bn\u00ed. O indikaci rozhoduje tak\u00e9 hladina paracetamolu v s\u00e9ru, stanovena nejd\u0159\u00edve za 4 hodiny po po\u017eit\u00ed tablet. Hlavn\u00edm c\u00edlem t\u00e9to pr\u00e1ce je popsat aktu\u00e1ln\u00ed doporu\u010den\u00fd postup p\u0159i intoxikaci paracetamolem. P\u0159i v\u010dasn\u00e9 terapii je N-acetylcystein vysoce \u00fa\u010dinn\u00fdm antidotem a hepatocelul\u00e1rn\u00ed i ren\u00e1ln\u00ed l\u00e9ze je reverzibiln\u00ed.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>paracetamol \u2013 intoxikace \u2013 N-acetylcystein \u2013 management<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Paracetamol (acetaminophen) has been one of the most popular analgesics and antipyretics since the 1980s, which can be used even by people who cannot tolerate other analgesics. It thus became one of the most widely used medicines ever. Every coin has two sides, the flip side of paracetamol is that an overdose leads to damage of the liver or kidneys. In the developed world, paracetamol intoxication is one of the most common causes of acute liver failure. Although the hepatotoxicity of paracetamol is becoming known to people, overdose cases in the Czech Republic are increasing according to inquiries to the Toxicology Information Center (TIC). In 2020\u20132022, TIC provided a total of 1,712 consultations for paracetamol overdose patients, which represented 6.5% of all drug inquiries. An amount greater than 200 mg\/kg of body weight, or more than 10 g, is considered as a toxic dose. An effective, safe, and inexpensive treatment is the antidote N-acetylcysteine. Recommendations for its dosage vary. The indication is also determined by the level of paracetamol in the serum, collected no earlier than 4 hours after taking the tablets. The main message of this work is to describe the current recommended procedure for paracetamol intoxication. With early therapy, N-acetylcysteine is a highly effective antidote, and both hepatocellular and renal lesions are reversible.<br \/>\n<b>Key words: <\/b>Paracetamol \u2013 intoxication \u2013 N-acetylcystein \u2013 management<\/p>\n<h6><b>INTOXIKACE P\u0158I N\u00c1HODN\u00c9M PO\u017dIT\u00cd DIMETINDENU U D\u011aT\u00cd<\/b><\/h6>\n<p><b>ACCIDENTAL DIMETINDENE INTOXICATIONS IN CHILDREN<\/b><\/p>\n<p><b>Michal \u010ce\u010drle, Daniela Pelclov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Dimetinden je sedativn\u00ed antihistaminikum indikovan\u00e9 k symptomatick\u00e9 l\u00e9\u010db\u011b ka\u0161le, b\u011b\u017en\u00e9ho nachlazen\u00ed a kop\u0159ivky u d\u011bt\u00ed. \u00dadaje o toxicit\u011b jsou velmi omezen\u00e9 a neexistuje shoda o d\u00e1vce, od n\u00ed\u017e maj\u00ed b\u00fdt d\u011bti hospitalizov\u00e1ny. Podle dotaz\u016f Toxikologick\u00e9ho informa\u010dn\u00edho st\u0159ediska (TIS) v letech 2010\u20132022 se v 95 % p\u0159\u00edpad\u016f intoxikovaly d\u011bti, jen ve zlomku p\u0159\u00edpad\u016f dosp\u011bl\u00ed (5 %). Tento po\u010det konzultac\u00ed nar\u016fst\u00e1. P\u0159i studiu 100 propou\u0161t\u011bc\u00edch zpr\u00e1v z hospitalizac\u00ed d\u011bt\u00ed v letech 2020\u20132022 bylo zji\u0161t\u011bno, \u017ee a\u017e do d\u00e1vky 0,25 mg\/kg t\u011blesn\u00e9 hmotnosti byly d\u011bti asymptomatick\u00e9 a do d\u00e1vky 0,50 mg\/kg se vyskytly jen lehk\u00e9 p\u0159\u00edznaky. D\u011bti byly v 98 % p\u0159\u00edpad\u016f hospitalizov\u00e1ny maxim\u00e1ln\u011b 24 hodin a jejich stav nevy\u017eadoval l\u00e9\u010dbu. Podle t\u011bchto p\u0159edb\u011b\u017en\u00fdch v\u00fdsledk\u016f se progn\u00f3za n\u00e1hodn\u00fdch intoxikac\u00ed dimetindenem u d\u011bt\u00ed jev\u00ed jako dobr\u00e1. P\u0159i p\u0159ekro\u010den\u00ed d\u00e1vky 0,50 mg\/kg nebo p\u0159i pochybnostech v\u0161ak doporu\u010dujeme v\u017edy konzultovat TIS.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>dimetinden \u2013 sedativn\u00ed antihistaminika \u2013 intoxikace v pediatrii<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Dimetindene is a sedative antihistamine indicated for the symptomatic treatment of cough, common cold and urticaria in children. Toxicity data are very limited and there is no consensus on the dose at which children require hospitalization. According to inquiries to Toxicology Information Center (TIC) in the years 2010\u2013 2022, the children were intoxicated in 95% of cases, adults in only a fraction of cases (5%). The number of consultations is increasing. In a study of 100 discharge reports from hospitalizations of children in 2020\u20132022, it was found that up to a dose of 0.25 mg\/kg of body weight, children were asymptomatic, and up to a dose of 0.50 mg\/kg, only mild symptoms occurred. In 98% of cases, the children were hospitalized for a maximum of 24 hours and their condition did not require treatment. According to these preliminary results, the prognosis of accidental dimetinden intoxications in children appears to be good. However, if a dose of 0.50 mg\/kg is exceeded or in case of doubt, we recommend always consulting TIC.<br \/>\n<b>Key words: <\/b>dimetindene \u2013 sedative antihistamines \u2013 intoxication in paediatrics<\/p>\n<h6><b>\u017dIVOT OHRO\u017dUJ\u00cdC\u00cd INTOXIKACE VITAM\u00cdNEM B17<\/b><\/h6>\n<p><b>LIFE-THREATENING VITAMINE B17 INTOXICATION<\/b><\/p>\n<p><b>Patrik Christian Cmorej, Petr Bure\u0161, Ond\u0159ej Kounovsk\u00fd, Martin Kub\u00e1t, Alena Kohlov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Vitam\u00edn B17, zn\u00e1m\u00fd tak\u00e9 jako amygdalin, je p\u0159\u00edrodn\u00ed kyanogenn\u00ed glykosid dostupn\u00fd jako potravinov\u00fd dopln\u011bk, kter\u00fd je vyu\u017e\u00edv\u00e1n v alternativn\u00ed medic\u00edn\u011b. Amygdalin se v t\u011ble hydroxyluje na toxick\u00fd kyanid, kter\u00fd m\u016f\u017ee zp\u016fsobit \u017eivot ohro\u017euj\u00edc\u00ed intoxikaci. V kazuistice je prezentov\u00e1na \u017eivot ohro\u017euj\u00edc\u00ed otrava kyanidem po po\u017eit\u00ed potravinov\u00e9ho dopl\u0148ku obsahuj\u00edc\u00ed amygdalin, kter\u00e1 byla \u00fasp\u011b\u0161n\u011b l\u00e9\u010dena hydroxocobalaminem. Kazuistika d\u00e1le obsahuje management p\u0159ednemocni\u010dn\u00ed neodkladn\u00e9 p\u00e9\u010de u pacienta s akutn\u00ed intoxikac\u00ed.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>amygdalin \u2013 hydroxocobalamin \u2013 intoxikace \u2013 kyanid<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Vitamin B17, well known as amygdalin, is originally a natural cyanogenic glycoside available as a dietary supplement used in the alternative treatment. Amygdalin hydroxylates to toxic cyanide in the body, which can cause life-threatening intoxication. The case report presents a life-threatening cyanide poisoning after ingesting a dietary supplement containing amygdalin identified in pre-hospital care, which was successfully treated with hydroxocobalamin. The case report also contains the management of pre-hospital care in a patient with acute intoxication.<br \/>\n<b>Key words: <\/b>amygdalin \u2013 hydroxocobalamin \u2013 intoxication \u2013 cyanide<\/p>\n<h6><b>HISTORICK\u00dd V\u00ddVOJ POSKYTOV\u00c1N\u00cd NEODKLADN\u00c9 P\u00c9\u010cE<\/b><\/h6>\n<p><b>HISTORICAL DEVELOPMENT OF EMERGENCY CARE PROVISION<\/b><\/p>\n<p><b>Robin \u0160\u00edn<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Ji\u017e od prav\u011bku se p\u0159edkov\u00e9 dne\u0161n\u00edho \u010dlov\u011bka sna\u017eili o\u0161et\u0159ovat si r\u00e1ny a \u0159e\u0161it akutn\u00ed zdravotn\u00ed obt\u00ed\u017ee. Od v\u00edry ve vliv r\u016fzn\u00fdch bo\u017estev na vznik \u00faraz\u016f a akutn\u00edch nemoc\u00ed a jejich l\u00e9\u010dbu se urgentn\u00ed medic\u00edna posunula k dne\u0161n\u00ed terapii zalo\u017een\u00e9 na v\u011bdeck\u00fdch d\u016fkazech. Z\u00e1sadn\u00edm hybatelem ve v\u00fdvoji urgentn\u00ed medic\u00edny sehr\u00e1valy v cel\u00e9 lidsk\u00e9 historii v\u00e1le\u010dn\u00e9 konflikty. Z\u00e1sadn\u00ed byly p\u0159edev\u0161\u00edm v\u00e1lky v 19. stolet\u00ed. Velk\u00e9 mno\u017estv\u00ed zran\u011bn\u00fdch p\u0159in\u00e1\u0161elo pot\u0159ebu jejich t\u0159\u00edd\u011bn\u00ed a o\u0161et\u0159ov\u00e1n\u00ed podle priorit. V\u00e1le\u010dn\u00e9 konflikty 20. stolet\u00ed p\u0159inesly mnoho l\u00e9\u010debn\u00fdch postup\u016f, kter\u00e9 se pou\u017e\u00edvaj\u00ed i v civiln\u00ed medic\u00edn\u011b. Od 60. let minul\u00e9ho stolet\u00ed m\u016f\u017eeme v z\u00e1padn\u00edm sv\u011bt\u011b mluvit o urgentn\u00ed medic\u00edn\u011b jako o samostatn\u00e9m l\u00e9ka\u0159sk\u00e9m oboru. V na\u0161ich podm\u00ednk\u00e1ch pak vznikaly samostatn\u00e9 zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby v 90. letech a v posledn\u00edch p\u0159ibli\u017en\u011b patn\u00e1cti letech pozorujeme vznik velk\u00e9ho mno\u017estv\u00ed urgentn\u00edch p\u0159\u00edjm\u016f.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>historie \u2013 neodkladn\u00e9 p\u00e9\u010de \u2013 zdravotnick\u00e1 z\u00e1chrann\u00e1 slu\u017eba \u2013 urgentn\u00ed p\u0159\u00edjem \u2013 v\u00e1le\u010dn\u00e1 medic\u00edna<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Since prehistoric times, the ancestors of todays humans tried to treat wounds and solve acute health problems. From the belief in the influence of deities on the occurence of injuries and acute diseases and their treatment, emergency medicine has moved to today\u2018s therapy based on scientific evidence. Throughout human history, war conflicts have become a fundamental driving force in the development of emergency medicine. Mainly, the wars of 19th century were crucial. The large number of the injured brought the need for their classification and treatment according to priorities. The war conflicts of the 20th century produced a lot of treatmets that are also used in civilian medicine. Since the 1960s, in the Western world, we can talk about emergency medicine as an independent medical specialty. In our conditions, independent emergency medical services were established in the 1990s, and in the last fifteen years we have monitored the formation of a large amount of emergency departments.<br \/>\n<b>Key words: <\/b>history \u2013 emergency care \u2013 emergency medical service \u2013 emergency department \u2013 war medicine<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00daVOD Obsah \u00davodn\u00ed slovo \u2013 Jana \u0160eblov\u00e1 URGENTN\u00cd P\u0158\u00cdJMY Traumatick\u00e1 z\u00e1stava ob\u011bhu \u2013 dv\u011b kazuistiky \u2013 Miroslav Durila, Kl\u00e1ra Valch\u00e1\u0159ov\u00e1, Tom\u00e1\u0161 Kouba, Marcel Truelle, Barbora Za\u010dalov\u00e1, Michal Fric, Jaroslav Pa\u017eout P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c1 P\u00c9\u010cE Role hrudn\u00ed dren\u00e1\u017ee v p\u0159ednemocni\u010dn\u00ed p\u00e9\u010di u<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[36],"tags":[],"class_list":["post-1283","post","type-post","status-publish","format-standard","hentry","category-rocnik-2022"],"_links":{"self":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1283","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=1283"}],"version-history":[{"count":4,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1283\/revisions"}],"predecessor-version":[{"id":1287,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1283\/revisions\/1287"}],"wp:attachment":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1283"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1283"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1283"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}