{"id":1302,"date":"2023-09-14T07:49:30","date_gmt":"2023-09-14T05:49:30","guid":{"rendered":"https:\/\/urgentnimedicina.cz\/?p=1302"},"modified":"2023-09-14T07:49:30","modified_gmt":"2023-09-14T05:49:30","slug":"obsah-2-2023","status":"publish","type":"post","link":"https:\/\/urgentnimedicina.cz\/?p=1302","title":{"rendered":"Obsah 2\/2023"},"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 \u2013 T\u00c9MA: INTOXIKACE<\/b><\/p>\n<ul>\n<li>Smrteln\u00e1 intoxikace MDMA: kazuistika \u2013 Tom\u00e1\u0161 Veleta, Martina \u010cerm\u00e1kov\u00e1<\/li>\n<li>Intoxikace l\u00fdkovcem jedovat\u00fdm: kazuistika \u2013 Martina \u010cerm\u00e1kov\u00e1, Tom\u00e1\u0161 Veleta<\/li>\n<\/ul>\n<p><b>ORGANIZACE A \u0158\u00cdZEN\u00cd SYST\u00c9M\u016e<\/b><\/p>\n<ul>\n<li>Ponech\u00e1n\u00ed pacienta na m\u00edst\u011b z\u00e1sahu v Karlovarsk\u00e9m kraji \u2013 Michaela Adamcov\u00e1, Nikola Brizgalov\u00e1, David Pe\u0159an, Milo\u0161 Kuka\u010dka, Ji\u0159\u00ed Smetana, Jaroslav Pekara, Roman S\u00fdkora<\/li>\n<li>Vyu\u017eit\u00ed videop\u0159enos\u016f z mobiln\u00edch aplikac\u00ed pro p\u0159ivol\u00e1n\u00ed pomoci zdravotnick\u00fdmi opera\u010dn\u00edmi st\u0159edisky v \u010cesk\u00e9 republice \u2013 Gabriela Divi\u0161kov\u00e1, Jan Mu\u017e\u00edk<\/li>\n<\/ul>\n<p><b>PEDIATRIE V URGENTN\u00cd MEDIC\u00cdN\u011a<\/b><\/p>\n<ul>\n<li>Diabetick\u00e1 ketoacid\u00f3za u d\u011bt\u00ed, p\u0159ednemocni\u010dn\u00ed p\u00e9\u010de, diferenci\u00e1ln\u00ed diagnostika a \u010dasn\u00e1 nemocni\u010dn\u00ed p\u00e9\u010de \u2013 Pavel Heinige<\/li>\n<li>Upozorn\u011bn\u00ed pracovn\u00ed skupiny sekce intenzivn\u00ed medic\u00edny p\u0159i \u010cesk\u00e9 pediatrick\u00e9 spole\u010dnosti \u010cLS JEP na opakovan\u00fd v\u00fdskyt velmi z\u00e1va\u017en\u00fdch invazivn\u00edch infekc\u00ed pyogenn\u00edmi streptokoky \u2013 Pavel Heinige, Martin Prchl\u00edk, Tom\u00e1\u0161 Zaoral, Petr Pavl\u00ed\u010dek, Tom\u00e1\u0161 Habanec, Petr Dominik, Miroslav Jir\u00e1nek, Marie V\u00e1chov\u00e1, Marie Kopeck\u00e1, Pavel Leden, Pavel Vojtovi\u010d, Alena Koke\u0161ov\u00e1, Vratislav Smolka, Marie Rohanov\u00e1, Martin \u017d\u00e1\u010dek, Lum\u00edr \u0160a\u0161ek, Ji\u0159\u00ed Fremuth, Ren\u00e9 Hrdli\u010dka, Jana Koz\u00e1kov\u00e1, Sandra Vohrnov\u00e1<\/li>\n<\/ul>\n<p><b>DOPORU\u010cEN\u00c9 POSTUPY<\/b><\/p>\n<ul>\n<li>Jednotn\u00e1 metodika pro p\u0159\u00edjem t\u00eds\u0148ov\u00fdch SMS (a obdobn\u00e9 t\u00eds\u0148ov\u00e9 komunikace) na linku 155 \u2013 Ond\u0159ej Fran\u011bk<\/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, Jana Kubalov\u00e1, Katar\u00edna Vesel\u00e1<\/li>\n<li>Mimotelov\u00e1 resuscit\u00e1cia pacienta so zastaven\u00edm obehu a \u0165a\u017ekou hypotermiou \u2013 Robert Nagyp\u00e1l, Marek Smole\u0148\u00e1k, Vladim\u00edr Fedor\u00e1k, Jozef Valky<\/li>\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<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 \u2013 TOPIC: INTOXICATIONS<\/b><\/p>\n<ul>\n<li>Lethal MDMA intoxication: a case report \u2013 Tom\u00e1\u0161 Veleta, Martina \u010cerm\u00e1kov\u00e1<\/li>\n<li>Daphne mezereum poisoning: a case report \u2013 Martina \u010cerm\u00e1kov\u00e1, Tom\u00e1\u0161 Veleta<\/li>\n<\/ul>\n<p><b>SYSTEMS\u00b4 ORGANIZATION AND MANAGEMENT<\/b><\/p>\n<ul>\n<li>Non-conveyance of patients following prehospital emergency care: Karlovy Vary region \u2013 Michaela Adamcov\u00e1, Nikola Brizgalov\u00e1, David Pe\u0159an, Milo\u0161 Kuka\u010dka, Ji\u0159\u00ed Smetana, Jaroslav Pekara, Roman S\u00fdkora<\/li>\n<li>The use of video transmissions via mobile applications to call for help to medical dispatch centers in the Czech Republic \u2013 Gabriela Divi\u0161kov\u00e1, Jan Mu\u017e\u00edk<\/li>\n<\/ul>\n<p><b>PAEDIATRICS IN EMERGENCY MEDICINE<\/b><\/p>\n<ul>\n<li>Paediatric diabetic ketoacidosis, prehospital care, differential diagnosis and an early hospital care \u2013 Pavel Heinige<\/li>\n<li>Warning of the working group of the Section of intensive medicine of the Czech paediatric society CzMA JEP about repeated occurence of very severe invasive infections caused by Streptococcus pyogenes \u2013 Pavel Heinige, Martin Prchl\u00edk, Tom\u00e1\u0161 Zaoral, Petr Pavl\u00ed\u010dek, Tom\u00e1\u0161 Habanec, Petr Dominik, Miroslav Jir\u00e1nek, Marie V\u00e1chov\u00e1, Marie Kopeck\u00e1, Pavel Leden, Pavel Vojtovi\u010d, Alena Koke\u0161ov\u00e1, Vratislav Smolka, Marie Rohanov\u00e1, Martin \u017d\u00e1\u010dek, Lum\u00edr \u0160a\u0161ek, Ji\u0159\u00ed Fremuth, Ren\u00e9 Hrdli\u010dka, Jana Koz\u00e1kov\u00e1, Sandra Vohrnov\u00e1<\/li>\n<\/ul>\n<p><b>GUIDELINES<\/b><\/p>\n<ul>\n<li>Methods for recieving emergency SMS messages (and similar emergency communication) on 155 national emergency line \u2013 Ond\u0159ej Fran\u011bk<\/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, Jana Kubalov\u00e1, Katar\u00edna Vesel\u00e1<\/li>\n<hr>\n<p><span style=\"text-decoration: underline;\"><strong>ABSTRAKTY<\/strong><\/span><\/p>\n<h6><b>SMRTELN\u00c1 INTOXIKACE MDMA: KAZUISTIKA<\/b><\/h6>\n<p><b>LETHAL MDMA INTOXICATION: A CASE REPORT<\/b><\/p>\n<p><b>Tom\u00e1\u0161 Veleta, Martina \u010cerm\u00e1kov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Ext\u00e1ze (3,4-methylendioxy-N-methyl-amphetamin, MDMA) pat\u0159\u00ed mezi t\u0159i nej\u010dast\u011bji u\u017e\u00edvan\u00e9 drogy v Evrop\u011b. Je u\u017e\u00edv\u00e1na pro sv\u00e9 stimula\u010dn\u00ed a halucinogenn\u00ed \u00fa\u010dinky. Nej\u010dast\u011bji se vyskytuje ve form\u011b tablet nebo tobolek. Z\u00e1va\u017en\u00e9 intoxikace jsou relativn\u011b vz\u00e1cn\u00e9. Jejich symptomy jsou podm\u00edn\u011bny zv\u00fd\u0161en\u00edm hladiny serotoninu, dopaminu a noradrenalinu. Nej\u010dast\u011bji se jedn\u00e1 o serotoninov\u00fd syndrom se z\u00e1va\u017enou hypertermi\u00ed, rhabdomyol\u00fdzou a ren\u00e1ln\u00edm selh\u00e1n\u00edm, a d\u00e1le ob\u011bhov\u00e9 p\u0159\u00edznaky (hypertenze, tachykardie, srde\u010dn\u00ed selh\u00e1n\u00ed, poruchy rytmu). Kazuistika popisuje z\u00e1va\u017enou intoxikaci mlad\u00e9ho mu\u017ee, u kter\u00e9ho do\u0161lo k progresi popisovan\u00fdch p\u0159\u00edznak\u016f do multiorg\u00e1nov\u00e9ho selh\u00e1n\u00ed refraktern\u00edho ke v\u0161em pou\u017eit\u00fdm terapeutick\u00fdm metod\u00e1m.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>ext\u00e1ze \u2013 MDMA \u2013 intoxikace \u2013 hypertermie \u2013 serotoninov\u00fd syndrom<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is among the three most commonly used drugs in Europe. It is used for its stimulating and hallucinogenic effects. MDMA is most often used as tablets or capsules. Serious intoxications are rare. Their symptoms are determined by an increase in the level of serotonin, dopamine and noradrenaline. These severe symptoms are serotonin syndrome with severe hyperthermia, rhabdomyolysis and renal failure, as well as circulatory symptoms (hypertension, tachycardia, heart failure, dysrhythmias). The case report describes a case of severe intoxication of a young man in whom the symptoms progressed to multiorgan failure refractory to all used therapeutic methods.<\/p>\n<p><b>Key words: <\/b>MDMA \u2013 intoxication \u2013 hyperthermia \u2013 serotonin syndrome<\/p>\n<h6><b>INTOXIKACE L\u00ddKOVCEM JEDOVAT\u00ddM: KAZUISTIKA<\/b><\/h6>\n<p><b>DAPHNE MEZEREUM POISONING: A CASE REPORT<\/b><\/p>\n<p><b>Martina \u010cerm\u00e1kov\u00e1, Tom\u00e1\u0161 Veleta<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Intoxikace rostlinami jsou v \u010cesk\u00e9 republice \u010dast\u00fdm d\u016fvodem pro konzultaci s Toxikologick\u00fdm informa\u010dn\u00edm st\u0159ediskem. \u010c\u00e1st t\u011bchto otrav m\u016f\u017ee m\u00edt z\u00e1va\u017en\u00fd pr\u016fb\u011bh vy\u017eaduj\u00edc\u00ed hospitalizaci. P\u0159edkl\u00e1dan\u00e1 kazuistika pojedn\u00e1v\u00e1 o n\u00e1hodn\u00e9m po\u017eit\u00ed l\u00fdkovce jedovat\u00e9ho. Toxiny daphnetoxin a mezerein jsou nebezpe\u010dn\u00e9 svou nefro- a hepatotoxicitou. Mezi z\u00e1kladn\u00ed l\u00e9\u010dbu intoxikace touto rostlinou \u0159ad\u00edme p\u0159edev\u0161\u00edm elimina\u010dn\u00ed metody \u2013 \u017ealude\u010dn\u00ed lav\u00e1\u017e, p\u0159\u00edpadn\u011b v\u00fdplach st\u0159ev.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>intoxikace \u2013 otrava \u2013 intoxikace rostlinami \u2013 ABCDE p\u0159\u00edstup \u2013 \u017ealude\u010dn\u00ed lav\u00e1\u017e \u2013 dekontaminace GIT<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>In the Czech Republic, plant intoxication is a frequent reason for consultation with the Toxicology Information Center. Some poisonings can have a serious progress of the disease. This presented case report deals with the accidental use of a poison ivy. The toxins daphnetoxin and mezerein are dangerous due to their nephro- and hepatotoxicity. Among the basic treatment of intoxication with this plant, we primarily include elimination methods \u2013 gastric lavage or intestinal lavage.<\/p>\n<p><b>Key words: <\/b>Intoxication \u2013 poisoning \u2013 plant intoxication \u2013 ABCDE approach \u2013 gastric lavage \u2013 GIT decontamination<\/p>\n<h6><b>PONECH\u00c1N\u00cd PACIENTA NA M\u00cdST\u011a Z\u00c1SAHU V KARLOVARSK\u00c9M KRAJI<\/b><\/h6>\n<p><b>NON-CONVEYANCE OF PATIENTS FOLLOWING PREHOSPITAL EMERGENCY CARE: KARLOVY VARY REGION<\/b><\/p>\n<p><b>Michaela Adamcov\u00e1, Nikola Brizgalov\u00e1, David Pe\u0159an, Milo\u0161 Kuka\u010dka, Ji\u0159\u00ed Smetana, Jaroslav Pekara, Roman S\u00fdkora<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>\u00davod: Ponech\u00e1n\u00ed pacienta na m\u00edst\u011b z\u00e1sahu v p\u0159ednemocni\u010dn\u00ed neodkladn\u00e9 p\u00e9\u010di (PNP) je aktu\u00e1ln\u00ed problematika. Na n\u00e1rodn\u00ed \u00farovn\u00ed nejsou dostupn\u00e1 komparativn\u00ed data ohledn\u011b ponech\u00e1n\u00ed pacienta na m\u00edst\u011b z\u00e1sahu ani hodnocen\u00ed bezpe\u010dnosti postupu.<br \/>\nC\u00edl: Zjistit \u010detnost ponech\u00e1n\u00ed pacienta na m\u00edst\u011b z rozhodnut\u00ed zdravotnick\u00fdch pracovn\u00edk\u016f a popsat charakteristiky t\u011bchto p\u0159\u00edpad\u016f. Zhodnotit m\u00edru opakovan\u00fdch v\u00fdjezd\u016f k pacient\u016fm ponechan\u00fdm na m\u00edst\u011b z\u00e1sahu.<br \/>\nMetodika: Data byla sb\u00edr\u00e1na z datab\u00e1ze v\u00fdjezdov\u00e9 \u010dinnosti Zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby Karlovarsk\u00e9ho kraje (ZZS KVK) za m\u011bs\u00edc leden 2023. Celkem bylo identifikov\u00e1no 335 pacient\u016f ponechan\u00fdch na m\u00edst\u011b z rozhodnut\u00ed v\u00fdjezdov\u00e9 skupiny (z 3005 pacient\u016f).<br \/>\nV\u00fdsledky: Pacienti z prim\u00e1rn\u00edch v\u00fdjezd\u016f jsou ponech\u00e1v\u00e1n\u00ed na m\u00edst\u011b v 11,1 % (335\/3005). Dominuje rozhodnut\u00ed zdravotnick\u00fdch z\u00e1chran\u00e1\u0159\u016f, kte\u0159\u00ed konzultuj\u00ed stav pacienta po telefonu s l\u00e9ka\u0159em (90 % p\u0159\u00edpad\u016f) nad ponech\u00e1n\u00edm na m\u00edst\u011b v\u00fdjezdovou skupinou rychl\u00e9 l\u00e9ka\u0159sk\u00e9 pomoci. Mezi pacienty, kte\u0159\u00ed jsou ponech\u00e1v\u00e1ni na m\u00edst\u011b, p\u0159eva\u017euj\u00ed nespecifick\u00e9 zdravotn\u00ed obt\u00ed\u017ee, ebrieta a psychiatrick\u00e9 stavy. Opakovan\u00e9 v\u00fdjezdy se uskute\u010dnily k pacient\u016fm ponechan\u00fdm na m\u00edst\u011b v 11,0 % (n = 37). Nejv\u00edce opakovan\u00fdch v\u00fdjezd\u016f se uskute\u010dn\u00ed do 24 hodin (51 % (n = 19)), respektive do 72 hodin (87 % (n = 32)). Vy\u0161\u0161\u00ed \u010detnost opakovan\u00e9ho v\u00fdjezdu k t\u011bmto pacient\u016fm byla u star\u0161\u00edch pacient\u016f. Exitus pacienta ponechan\u00e9ho na m\u00edst\u011b nebyl zaznamen\u00e1n.<br \/>\nZ\u00e1v\u011br: V Karlovarsk\u00e9m kraji je ponech\u00e1v\u00e1no na m\u00edst\u011b p\u0159es jeden\u00e1ct procent pacient\u016f z prim\u00e1rn\u00edch v\u00fdjezd\u016f. Ponech\u00e1n\u00ed pacienta na m\u00edst\u011b z\u00e1sahu lze pova\u017eovat za bezpe\u010dnou sou\u010d\u00e1st poskytov\u00e1n\u00ed PNP. Chyb\u00ed doporu\u010den\u00fd postup na n\u00e1rodn\u00ed \u00farovni, kter\u00fd by zohled\u0148oval stratifikaci rizik pro ponech\u00e1v\u00e1n\u00ed pacient\u016f na m\u00edst\u011b z\u00e1sah\u016f.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>zdravotnick\u00e1 z\u00e1chrann\u00e1 slu\u017eba \u2013 p\u0159ednemocni\u010dn\u00ed neodkladn\u00e1 p\u00e9\u010de \u2013 zdravotnick\u00fd z\u00e1chran\u00e1\u0159 \u2013 ponech\u00e1n\u00ed pacienta na m\u00edst\u011b z\u00e1sahu<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Introduction: Non-conveyance of patients following prehospital emergency care is a current issue. There are no available national comparative data on non-conveyance of the patient from scene or evaluation of the safety of the procedure.<br \/>\nAim: To evaluate the frequency of non-conveyance of the patient by the decision of healthcare workers and describe the characteristics of these cases. To find out the rate of repeated visits to patients left at the scene of intervention.<br \/>\nMethods: The data was collected from the database of the Emergency medical services of Karlovy Vary region from 1st to 31st January 2023. A total of 335 patients were left on the place based on the decision of the ambulance crew (out of 3005 patients).<br \/>\nResults: The non-conveyance rate of patients from primary calls was 11.1% (335\/3005). The decision of paramedics, who consult the patient\u2018s condition over the phone with physician (90% of cases) dominates over leaving the patient on site by the ambulance crew with physician. The most common reasons for non-transport of the patient are non-specific health conditions, alcohol intoxication and psychiatric conditions. Repeated visits occurred to these patients in 11.0% (n = 37). Most of the repeated calls took place within 24 hours (51% (n = 19)) or within 72 hours (87% (n = 32)). A higher frequency of repeated visits to these patients was more common in older patients. No death of the patient left on the scene was recorded.<br \/>\nConclusion: In the Karlovy Vary region, over eleven percent of patients from primary visits during January 2023 were left on place. Non-conveyance of the patient can be considered safe part of providing prehospital emergency care. However, there is a lack of a national recommendations or guidelines that would consider the risks stratification for non-transport of the patient.<br \/>\n<b>Key words: <\/b>emergency medical services \u2013 pre-hospital emergency care \u2013 paramedic \u2013 non-conveyance of the patient<\/p>\n<h6><b>VYU\u017dIT\u00cd VIDEOP\u0158ENOS\u016e Z MOBILN\u00cdCH APLIKAC\u00cd PRO P\u0158IVOL\u00c1N\u00cd POMOCI ZDRAVOTNICK\u00ddMI OPERA\u010cN\u00cdMI ST\u0158EDISKY V \u010cESK\u00c9 REPUBLICE<\/b><\/h6>\n<p><b>THE USE OF VIDEO TRANSMISSIONS VIA MOBILE APPLICATIONS TO CALL FOR HELP TO MEDICAL DISPATCH CENTERS IN THE CZECH REPUBLIC<\/b><\/p>\n<p><b>Gabriela Divi\u0161kov\u00e1, Jan Mu\u017e\u00edk<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Videop\u0159enosy jsou relativn\u011b novou funkc\u00ed umo\u017e\u0148uj\u00edc\u00ed oper\u00e1tor\u016fm zdravotnick\u00fdch opera\u010dn\u00edch st\u0159edisek (ZOS) z\u00edsk\u00e1n\u00ed nov\u00fdch informac\u00ed prost\u0159ednictv\u00edm p\u0159enosu obrazu z m\u00edsta mimo\u0159\u00e1dn\u00e9 ud\u00e1losti (MU). Pomoc\u00ed strukturovan\u00fdch rozhovor\u016f s oper\u00e1tory ZOS jsme zji\u0161\u0165ovali \u00farove\u0148 vyu\u017eit\u00ed a p\u0159\u00edpadn\u00e9 p\u0159ek\u00e1\u017eky vy\u0161\u0161\u00ed m\u00edry vyu\u017e\u00edv\u00e1n\u00ed videop\u0159enos\u016f. Osloveno bylo v\u0161ech 14 ZOS v \u010cesk\u00e9 republice (\u010cR) a i n\u011bkolik zahrani\u010dn\u00edch. Z\u00edsk\u00e1no bylo celkem 7 rozhovor\u016f z \u010cR a 4 ze zahrani\u010d\u00ed. V \u010cR je funkce zavedena na v\u011bt\u0161in\u011b ZOS, av\u0161ak \u010detnost jej\u00edho vyu\u017eit\u00ed dosahuje velmi n\u00edzk\u00fdch \u010d\u00edsel. Jedn\u00e1 se o m\u00e9n\u011b n\u011b\u017e 10 aktivovan\u00fdch videop\u0159enos\u016f za cel\u00fd rok v r\u00e1mci jednotliv\u00fdch ZOS, ve srovn\u00e1n\u00ed se zahrani\u010dn\u00edmi st\u0159edisky je to zcela nedostate\u010dn\u00e9. Nap\u0159\u00edklad Norsko uv\u00e1d\u00ed, \u017ee a\u017e 10 % z celkov\u00e9ho po\u010dtu t\u00eds\u0148ov\u00fdch vol\u00e1n\u00ed jsou p\u0159evedeny na videop\u0159enosy. Oper\u00e1to\u0159i na technologickou novinku do jist\u00e9 m\u00edry nahl\u00ed\u017e\u00ed negativn\u011b, nebo\u0165 neo\u010dek\u00e1vaj\u00ed nov\u00e9 informace z\u00edskan\u00e9 prost\u0159ednictv\u00edm videa, a tak\u00e9 i vzhledem k celkov\u00e9mu prodlou\u017een\u00ed \u010dasu dan\u00e9ho hovoru. Videop\u0159enosy p\u0159\u00ednosn\u00e9 zcela jist\u011b jsou, av\u0161ak ve specifick\u00fdch p\u0159\u00edpadech. P\u0159ed samotnou aktivac\u00ed je t\u0159eba zv\u00e1\u017eit celkov\u00fd benefit, technick\u00e9 mo\u017enosti volaj\u00edc\u00edho, jeho schopnost spolupr\u00e1ce a schopnost ovl\u00e1dat technologii, \u010dasovou dotaci a dal\u0161\u00ed rizikov\u00e9 faktory.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>videop\u0159enos \u2013 zdravotnick\u00e9 opera\u010dn\u00ed st\u0159edisko \u2013 telefonicky asistovan\u00e1 neodkladn\u00e1 resuscitace<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Video calls are a relatively new function that enables dispatchers of medical dispatch centers to obtain new information through the transmission of images from the scene. We examined the level of use and potential barriers to the increased use of video calls using structured interviews with dispatchers. All 14 centers in the Czech Republic and several foreign ones were contacted. A total of 7 interviews were obtained from the Czech Republic and 4 from abroad. In the Czech Republic, the function is implemented in most of the dispatch centers, but the frequency of its use is very low. It is less than 10 activated video calls in the whole year within each center. Compared to foreign centres, this is quite insufficient. For example, Norway reports up to 10 % of the total number of emergency calls which are converted to video calls. Technological innovation is also often viewed negatively by dispatchers due to the lack of expectation of new information obtained through video and the overall increase of time for a given call. Video calls are certainly beneficial, but in specific cases. The overall benefit, the technical capabilities of the caller, their ability to collaborate and to control the technology, the time commitment and other risk factors need to be considered before the actual activation.<br \/>\n<b>Key words: <\/b>video call \u2013 medical dispatch center \u2013 telephone-assisted cardiopulmonary resuscitation<\/p>\n<h6><b>DIABETICK\u00c1 KETOACID\u00d3ZA U D\u011aT\u00cd, P\u0158EDNEMOCNI\u010cN\u00cd P\u00c9\u010cE, DIFERENCI\u00c1LN\u00cd DIAGNOSTIKA A \u010cASN\u00c1 NEMOCNI\u010cN\u00cd P\u00c9\u010cE<\/b><\/h6>\n<p><b>PAEDIATRIC DIABETIC KETOACIDOSIS, PREHOSPITAL CARE, DIFFERENTIAL DIAGNOSIS AND AN EARLY HOSPITAL CARE<\/b><\/p>\n<p><b>Pavel Heinige<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Diabetick\u00e1 ketoacid\u00f3za je \u017eivot ohro\u017euj\u00edc\u00ed stav, souvisej\u00edc\u00ed s onemocn\u011bn\u00edm diabetes mellitus a z\u00e1rove\u0148 hlavn\u00ed p\u0159\u00ed\u010dinou mortality d\u011bt\u00ed s diabetem. Je asociov\u00e1na ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f s diabetem 1. typu, vz\u00e1cn\u011b se m\u016f\u017ee objevit u pacient\u016f s diabetem 2. typu. Vedouc\u00edmi p\u0159\u00edznaky jsou dehydratace, metabolick\u00e1 acid\u00f3za, hyperglykemie a ketonurie, v t\u011b\u017e\u0161\u00edch p\u0159\u00edpadech Kussmaulovo d\u00fdch\u00e1n\u00ed, peritonismus, zvracen\u00ed a t\u011b\u017ek\u00e1 porucha v\u011bdom\u00ed. Nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou smrti je ed\u00e9m mozku. Laboratorn\u011b je jako t\u011b\u017ek\u00e1 diabetick\u00e1 ketoacid\u00f3za hodnocen stav s pH pod 7,1, a koncentrac\u00ed bikarbon\u00e1t\u016f pod 5 mmol\/l.<br \/>\nV d\u011btsk\u00e9m v\u011bku se pom\u011brn\u011b \u010dasto diabetes poprv\u00e9 manifestuje pr\u00e1v\u011b diabetickou ketoacid\u00f3zou, bez p\u0159edchoz\u00ed pozitivn\u00ed osobn\u00ed anamn\u00e9zy. Nel\u00e9\u010den\u00e1 diabetick\u00e1 ketoacid\u00f3za je smrteln\u00e1. Velmi nebezpe\u010dn\u00e1 m\u016f\u017ee b\u00fdt z\u00e1m\u011bna za jinou diagn\u00f3zu nebo neadekv\u00e1tn\u00ed terapie.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>Diabetes mellitus \u2013 ketoacid\u00f3za \u2013 pediatrick\u00fd v\u011bk<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Diabetic ketoacidosis is a life threatening event, associated with diabetes mellitus. Diabetic ketoacidosis is the main reason of mortality in pediatric diabetic population. It is usually associated with the first type of diabetes mellitus, however, it can rarely appear in patient with diabetes type two, too. Dehydration, metabolic acidosis with Kussmaul breathing, hyperglykaemia and ketonuria are the leading symptoms. In severe cases peritonism, vomiting and severe consciousness disorder or even coma can occur. The most frequent reason of death is brain edema. The value of pH lower than 7,1 and sodium bicarbonate concentration lower than 5 mmol\/l are considered severe ketoacidosis.<br \/>\nDiabetic ketoacidosis is a frequent primary presentation of diabetes mellitus in childhood with negative case history. Unrecognized and untreated ketoacidosis may lead to death. Missdiagnosis of diabetic ketoacidosis or inadequate therapy may also lead to severe complications.<br \/>\n<b>Key words: <\/b>Diabetes mellitus \u2013 ketoacidosis \u2013 pediatric age<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00daVOD Obsah \u00davodn\u00ed slovo \u2013 Jana \u0160eblov\u00e1 URGENTN\u00cd P\u0158\u00cdJMY \u2013 T\u00c9MA: INTOXIKACE Smrteln\u00e1 intoxikace MDMA: kazuistika \u2013 Tom\u00e1\u0161 Veleta, Martina \u010cerm\u00e1kov\u00e1 Intoxikace l\u00fdkovcem jedovat\u00fdm: kazuistika \u2013 Martina \u010cerm\u00e1kov\u00e1, Tom\u00e1\u0161 Veleta ORGANIZACE A \u0158\u00cdZEN\u00cd SYST\u00c9M\u016e Ponech\u00e1n\u00ed pacienta na m\u00edst\u011b z\u00e1sahu v<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[37],"tags":[],"class_list":["post-1302","post","type-post","status-publish","format-standard","hentry","category-rocnik-2023"],"_links":{"self":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1302","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=1302"}],"version-history":[{"count":1,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1302\/revisions"}],"predecessor-version":[{"id":1303,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1302\/revisions\/1303"}],"wp:attachment":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1302"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1302"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}