{"id":694,"date":"2015-04-02T10:18:00","date_gmt":"2015-04-02T08:18:00","guid":{"rendered":"http:\/\/urgentnimedicina.cz\/?p=694"},"modified":"2015-10-05T12:09:01","modified_gmt":"2015-10-05T10:09:01","slug":"obsah-12015","status":"publish","type":"post","link":"https:\/\/urgentnimedicina.cz\/?p=694","title":{"rendered":"Obsah 1\/2015"},"content":{"rendered":"
\u00a0 \u00a0 \u00a0\u00daVOD<\/span><\/h6>\n

\u00davodn\u00ed slovo<\/h4>\n

Jana \u0160eblov\u00e1<\/em><\/p>\n

Obsah<\/h4>\n
\u00a0 \u00a0 \u00a0KONCEPCE, \u0158\u00cdZEN\u00cd, ORGANIZACE<\/span><\/h6>\n

N\u00e1vrh koncepce vzd\u011bl\u00e1v\u00e1n\u00ed pracovn\u00edk\u016f \u0161kol v oblasti prvn\u00ed pomoci<\/h4>\n

Pavla Tr\u010dkov\u00e1<\/em><\/p>\n

Abstrakt<\/strong><\/p>\n

Z\u00e1kladn\u00ed a st\u0159edn\u00ed \u0161koly maj\u00ed legislativn\u011b ulo\u017een\u00e9 povinnosti v oblasti poskytov\u00e1n\u00ed prvn\u00ed pomoci sv\u00fdm pracovn\u00edk\u016fm i \u017e\u00e1k\u016fm a tak\u00e9 v zaji\u0161t\u011bn\u00ed v\u00fduky \u017e\u00e1k\u016f v t\u00e9to oblasti. Co v\u0161ak chyb\u00ed, to jsou standardy, kter\u00e9 by jednozna\u010dn\u011b definovaly obsah i rozsah vzd\u011bl\u00e1v\u00e1n\u00ed pracovn\u00edk\u016f \u0161kol i v\u00fduky \u017e\u00e1k\u016f v prvn\u00ed pomoci a to v n\u00e1vaznosti na sou\u010dasn\u00fd syst\u00e9m fungov\u00e1n\u00ed p\u0159ednemocni\u010dn\u00ed neod\u00adkladn\u00e9 p\u00e9\u010de. V p\u0159\u00edsp\u011bvku p\u0159edstavujeme v\u00fdstupy vzd\u011bl\u00e1vac\u00edch projekt\u016f, kter\u00e9 byly zam\u011b\u0159eny na komplexn\u00ed zpracov\u00e1n\u00ed t\u00e9matu prvn\u00ed pomoci pro pot\u0159eby \u0161kol. P\u0159edstavujeme n\u00e1vrh koncepce vzd\u011bl\u00e1v\u00e1n\u00ed pracovn\u00edk\u016f \u0161kol a \u0161kolsk\u00fdch za\u0159\u00edzen\u00ed a tak\u00e9 vhodnou metodiku, kterou jsme za t\u00edmto \u00fa\u010delem vypracovali a kterou jsme v r\u00e1mci projekt\u016f na c\u00edlov\u00e9 skupin\u011b ov\u011b\u0159ili.<\/p>\n

\u00a0 \u00a0 \u00a0VZD\u011aL\u00c1N\u00cd, ZKU\u0160ENOSTI<\/span><\/h6>\n

Workshop NATO o pl\u00e1nov\u00e1n\u00ed zabezpe\u010den\u00ed provozu nemocnic a jejich \u0159\u00edzen\u00ed p\u0159i napaden\u00ed a mimo\u0159\u00e1dn\u00fdch situac\u00edch<\/h4>\n

Leo Klein, Moshe Michaelson, Gila Hyams<\/em><\/p>\n

Abstrakt<\/strong><\/p>\n

Na nenad\u00e1l\u00e9 situace spojen\u00e9 s v\u00fdskytem velk\u00e9ho po\u010dtu ran\u011bn\u00fdch a zasa\u017een\u00fdch, kter\u00e9 jsou zp\u016fsobeny teroristick\u00fdmi akcemi nebo p\u0159\u00edrodn\u00edmi katastrofami, mus\u00ed b\u00fdt p\u0159ipravena ka\u017ed\u00e1 nemocnice bez ohledu na svou velikost. Touto problematikou se zab\u00fdvala ji\u017e t\u0159i odborn\u00e1 setk\u00e1n\u00ed v izraelsk\u00e9 Haif\u011b uspo\u0159\u00e1dan\u00e1 s podporou NATO v r\u00e1mci program\u016f Partnerstv\u00ed pro m\u00edr a Dialogu zem\u00ed kolem St\u0159edozemn\u00edho mo\u0159e. Workshopy se uskute\u010dnily v letech 2005, 2009 a v listopadu 2014. C\u00edlem posledn\u011b zm\u00edn\u011bn\u00e9ho bylo umo\u017enit konstruktivn\u00ed v\u00fdm\u011bnu n\u00e1zor\u016f a mezin\u00e1rodn\u00edch zku\u0161enost\u00ed civiln\u00edch i vojensk\u00fdch odborn\u00edk\u016f, kte\u0159\u00ed se zab\u00fdvaj\u00ed medic\u00ednou katastrof zam\u011b\u0159enou na poskytov\u00e1n\u00ed v\u010dasn\u00e9 a \u00fa\u010dinn\u00e9 zdravotnick\u00e9 pomoci p\u0159i hromadn\u00e9m v\u00fdskytu ob\u011bt\u00ed. Hlavn\u00ed okruhy jedn\u00e1n\u00ed byly zam\u011b\u0159eny zejm\u00e9na na (1) zodoln\u011bn\u00ed budov, existuj\u00edc\u00ed infrastruktury a budov\u00e1n\u00ed nov\u00e9 infrastruktury nemocnic (v\u010detn\u011b komunika\u010dn\u00edch a po\u010d\u00edta\u010dov\u00fdch s\u00edt\u00ed), aby byly schopny odolat teroristick\u00e9mu \u00fatoku \u010di jin\u00e9 katastrof\u011b, (2) teoretickou p\u0159\u00edpravu i praktick\u00fd n\u00e1cvik pro situace s hromadn\u00fdm v\u00fdskytem ob\u011bt\u00ed, (3) vyu\u017e\u00edv\u00e1n\u00ed v\u00fdjezdn\u00edch zdravotnick\u00fdch prvk\u016f a poln\u00edch nemocnic pro p\u0159ibl\u00ed\u017een\u00ed pomoci do m\u00edst s v\u011bt\u0161\u00edm v\u00fdskytem ran\u011bn\u00fdch a (4) materi\u00e1ln\u00ed a logistick\u00e9 zabezpe\u010den\u00ed t\u011bchto situac\u00ed. Vzhledem k tomu, \u017ee takov\u00e9to situace jsou mimo\u0159\u00e1dn\u00e9 a relativn\u011b m\u00e1lo \u010dast\u00e9, byla pozornost v\u011bnov\u00e1na rovn\u011b\u017e cen\u011b, jakou stoj\u00ed zaji\u0161t\u011bn\u00ed st\u00e1l\u00e9 p\u0159ipravenosti p\u0159i ne p\u0159\u00edli\u0161 \u010dast\u00e9m re\u00e1ln\u00e9m vyu\u017eit\u00ed. Dosa\u017een\u00ed p\u0159ipravenosti na situace s hromadn\u00fdm v\u00fdskytem ob\u011bt\u00ed p\u0159edstavuje komplexn\u00ed organiza\u010dn\u00ed, logistick\u00fd ale i politick\u00fd probl\u00e9m. Jeho \u0159e\u0161en\u00ed vy\u017eaduje vz\u00e1jemnou spolupr\u00e1ci nejen zdravotnick\u00fdch slo\u017eek, ale i civiln\u00edch a vojensk\u00fdch a to na mnoha \u00farovn\u00edch, po\u010d\u00ednaje vl\u00e1dn\u00ed. Pro tyto situace toti\u017e plat\u00ed, \u017ee mohou vzniknout v kter\u00e9mkoli okam\u017eiku, co\u017e znamen\u00e1, \u017ee p\u0159ipravenost k jejich zvl\u00e1dnut\u00ed je nejen z\u00e1kladn\u00edm c\u00edlem, ale v\u00fdchoz\u00edm p\u0159edpokladem.<\/p>\n

\u00a0 \u00a0 \u00a0ODBORN\u00c9 T\u00c9MA L\u00c9KA\u0158SK\u00c9<\/span><\/h6>\n

Mana\u017ement ak\u00fatnej exacerb\u00e1cie chronickej ob\u0161truk\u010dnej choroby p\u013e\u00fac<\/h4>\n

Darina Kov\u00e1\u010dov\u00e1, Oto Mas\u00e1r<\/em><\/p>\n

Abstrakt<\/strong><\/p>\n

V prednemocni\u010dnej etape, ale i na oddeleniach urgentn\u00fdch pr\u00edjmov nemocn\u00edc, s\u00fa \u010doraz \u010dastej\u0161ie zdravotn\u00edci konfrontovan\u00ed s pacientom s ak\u00fatnou exacerb\u00e1ciou chronickej ob\u0161truk\u010dnej choroby p\u013e\u00fac. Vzh\u013eadom na obmedzen\u00e9 diagnostick\u00e9 mo\u017enosti je najm\u00e4 na prednemocni\u010dnej etape stanovenie diagn\u00f3zy zlo\u017eit\u00e9. Oddialenie adekv\u00e1tnej terapie m\u00f4\u017ee ma\u0165 z\u00e1va\u017en\u00e9 d\u00f4sledky na pre\u017eitie, ale i na kvalitu \u017eivota pacienta. Predkladan\u00e1 pr\u00e1ca si kladie za cie\u013e poskytn\u00fa\u0165 lek\u00e1rom urgentnej medic\u00edny preh\u013ead o tejto z\u00e1va\u017enej problematike.<\/p>\n

Vyhodnocen\u00ed spolupr\u00e1ce Zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby kraje Vyso\u010dina a traumacentra Fakultn\u00ed nemocnice Brno Bohunice<\/h4>\n

Tom\u00e1\u0161 Va\u0148atka, Kate\u0159ina Van\u00ed\u010dkov\u00e1<\/em><\/p>\n

Abstrakt<\/strong><\/p>\n

\u00davod: Spolupr\u00e1ce zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby a traumacentra a jej\u00ed vyhodnocen\u00ed je pro kvalitn\u00ed p\u00e9\u010di o pacienty s \u00farazem nezbytn\u00e9.
\nMetodika:Retrospektivn\u011b jsme zpracovali 160 pacient\u016f s ISS (Injury Severity Score) > 16, p\u0159edan\u00fdch leteckou a pozemn\u00ed z\u00e1chrannou slu\u017ebou do traumacentra (TC). Sledovali jsme tyto parametry: \u010das na m\u00edst\u011b a dobu transportu, volumoterapii, koagulopathie v souvislosti s volumoterapi\u00ed, v TC hladina lakt\u00e1tu, hemoglobinu a ISS, v p\u0159ednemocni\u010dn\u00ed f\u00e1zi zaji\u0161t\u011bn\u00ed d\u00fdchac\u00edch cest v souvislosti s hypoxi\u00ed a v roce 2014 i t\u011blesnou teplotu p\u0159i p\u0159\u00edjmu pacienta v TC.
\nV\u00fdsledky: Nejv\u00fdhodn\u011bj\u0161\u00edm transportem je pro pacienty s traumatem prim\u00e1rn\u00ed aktivace LZS, aktivace na z\u00e1klad\u011b po\u017eadavku pozemn\u00ed skupiny je nev\u00fdhodn\u00e1, prodlu\u017euje \u010das o\u0161et\u0159en\u00ed. Objemy tekutin nad 1500 ml zvy\u0161uj\u00edc riziko vzniku koagulopatie, volumoterapie ovliv\u0148uje i sn\u00ed\u017een\u00ed t\u011blesn\u00e9 teploty pacient\u016f. P\u0159esto jsme v roce 2014 pozorovali vy\u0161\u0161\u00ed p\u0159e\u017eit\u00ed pacient\u016f se vstupn\u00ed hodnotou lakt\u00e1tu oproti roku 2013 (78 % versus 31 %).
\nDiskuze: zjistili jsme souvislost s mno\u017estv\u00edm podan\u00fdch n\u00e1hradn\u00edch roztok\u016f s v\u00fdskytem koagulopatie (medi\u00e1n 1500 ml), p\u0159\u00edm\u00e1 souvislost je i se sn\u00ed\u017een\u00edm t\u011blesn\u00e9 teploty pacienta a mno\u017estv\u00edm podan\u00fdch n\u00e1hradn\u00edch roztok\u016f. Pro pacienta v PNP s traumatem ISS > 16 je nejv\u00fdhodn\u011bj\u0161\u00ed zaji\u0161t\u011bn\u00ed a transport prim\u00e1rn\u011b LZS. Potvrdili jsme souvislost hladiny lakt\u00e1tu jako predik\u010dn\u00ed hodnotu \u0161okov\u00e9ho stavu. Hladina hemoglobinu souvis\u00ed se vznikem koagulopatie, ale nen\u00ed to jedin\u00e1 p\u0159\u00ed\u010dina. V\u00fdznamn\u011b se zlep\u0161ilo p\u0159e\u017e\u00edv\u00e1n\u00ed pacient\u016f se zaveden\u00edm nov\u00fdm metod a postup\u016f TC \u2013 ROTEM, TEG.
\nZ\u00e1v\u011br: Vypracovali jsme novou metodiku spolupr\u00e1ce \u2013 traumaprotokol, kter\u00fd zlep\u0161\u00ed vyhodnocen\u00ed spolupr\u00e1ce ZS a TC. D\u00e1le roz\u0161i\u0159ujeme spolupr\u00e1ci i s traumacentrem \u00daVN Praha St\u0159e\u0161ovice.<\/p>\n

Rozd\u00edly ve vyu\u017e\u00edv\u00e1n\u00ed Leteck\u00e9 zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby v r\u00e1mci \u010cesk\u00e9 republiky<\/h4>\n

Ond\u0159ej Fran\u011bk<\/em><\/p>\n

Abstrakt<\/strong><\/p>\n

C\u00edlem pr\u00e1ce bylo porovnat vyu\u017eit\u00ed LZZS na jednotliv\u00fdch z\u00e1kladn\u00e1ch v \u010cR ve vztahu k po\u010dtu obyvatel p\u0159irozen\u011b sp\u00e1dov\u00e9ho \u00fazem\u00ed. V\u00fdsledky porovn\u00e1n\u00ed nevylu\u010duj\u00ed, \u017ee ve vyu\u017e\u00edv\u00e1n\u00ed LZZS existuj\u00ed v \u010cesk\u00e9 republice markantn\u00ed rozd\u00edly mezi jednotliv\u00fdmi z\u00e1kladnami. P\u0159\u00ed\u010dina zji\u0161t\u011bn\u00fdch rozd\u00edl\u016f nen\u00ed zn\u00e1ma, mohou b\u00fdt v\u0161ak sign\u00e1lem neracion\u00e1ln\u00edho vyu\u017e\u00edv\u00e1n\u00ed t\u00e9to finan\u010dn\u011b extr\u00e9mn\u011b n\u00e1ro\u010dn\u00e9 slu\u017eby. Z d\u016fvodu prevence pod- a nadu\u017e\u00edv\u00e1n\u00ed LZZS by bylo vhodn\u00e9 stanovit, sledovat a publikovat funk\u010dn\u00ed parametry sleduj\u00edc\u00ed efektivitu nasazen\u00ed LZZS.<\/p>\n

P\u011bt let traumatologick\u00e9 triage v p\u0159ednemocni\u010dn\u00ed p\u00e9\u010di v \u010cesk\u00e9 republice<\/h4>\n

Zden\u011bk Tlust\u00fd, Patrik Merhaut<\/em><\/p>\n

Abstrakt<\/strong><\/p>\n

Retrospektivn\u00ed anal\u00fdza \u010dinnosti ZZS v p\u00e9\u010di o \u00farazov\u00e9 pacienty v roce 2014 ukazuje funguj\u00edc\u00ed praxi p\u0159ednemocni\u010dn\u00ed triage traumatologick\u00fdch pacient\u016f ve St\u0159edo\u010desk\u00e9m kraji. Porovn\u00e1v\u00e1 \u010dinnost p\u0159ed uveden\u00edm triage do praxe s fungov\u00e1n\u00edm sou\u010dasn\u00e9ho syst\u00e9mu.<\/p>\n

Ako resuscitujeme?<\/h4>\n

T\u00e1\u0148a Bul\u00edkov\u00e1, Patr\u00edcia Kraj\u0148\u00e1kov\u00e1, Gabriel Tomko, Franti\u0161ek Majersk\u00fd<\/em><\/p>\n

Abstrakt<\/strong><\/p>\n

Z\u00e1chran\u00e1rska s\u00fa\u0165a\u017e RESCUE LESNICA v Slovenskom raji m\u00e1 vy\u0161e desa\u0165ro\u010dn\u00fa trad\u00edciu a medzi z\u00e1chran\u00e1rmi je obl\u00faben\u00e1. Minul\u00fd rok 19.9.2014 organiz\u00e1tori pri\u0161li s novinkou uskuto\u010dni\u0165 Majstrovstv\u00e1 Slovenska v KPR. Autori pr\u00edspevku pon\u00fakaj\u00fa \u010ditate\u013eom v\u00fdstupy zo spom\u00ednan\u00e9ho podujatia, kde cie\u013eom bolo overi\u0165 optim\u00e1lnos\u0165 KPR: adekv\u00e1tnos\u0165 objemu vdychov a spr\u00e1vna r\u00fdchlos\u0165 vdychu, dostato\u010dn\u00e1 h\u013abka kompresi\u00ed a frekvencia, spr\u00e1vna poloha r\u00fak a \u00faplnos\u0165 uvo\u013enenia. Pre n\u00e1zornos\u0165 s\u00fa v texte uveden\u00e9 tabu\u013eky a grafy s kompletn\u00fdmi v\u00fdsledkami anal\u00fdzy KPR v\u0161etk\u00fdch 28 z\u00fa\u010dastnen\u00fdch pos\u00e1dok. Pos\u00e1dky \u0161tartovali vo dvojiciach v zlo\u017een\u00ed vodi\u010d, z\u00e1chran\u00e1r, lek\u00e1r, oper\u00e1tor alebo \u0161tudent (+ jedna pos\u00e1dka laick\u00e1 TV JOJ). Uk\u00e1zalo sa, \u017ee \u00farove\u0148 znalost\u00ed u sledovan\u00fdch pos\u00e1dok je do zna\u010dnej miery rozdielna. Od najlep\u0161\u00edch, kde hodnoty dosiahli 100 % alebo tesne 100 % vo v\u0161etk\u00fdch hodnoten\u00fdch krokoch (dychov\u00fd objem, r\u00fdchlos\u0165 vdychu, poz\u00edcia r\u00fak, uvolnenie hrudn\u00edka a frekvencia kompresi\u00ed) a\u017e po najslab\u0161ie pos\u00e1dky, kde hodnotenie nedosiahlo ani tretinu z maxima.<\/p>\n

\u00a0 \u00a0 \u00a0INFORMA\u010cN\u00cd SERVIS<\/span><\/h6>\n

Recenze knihy Mas\u00e1r, O. a kol.: Vybran\u00e9 kapitoly zo v\u0161eobecn\u00e9ho lek\u00e1rstva<\/h4>\n

Josef \u0160torek<\/em><\/p>\n

Recenze knihy T\u00e1\u0148a Bul\u00edkov\u00e1: EKG pre z\u00e1chran\u00e1rov nekardiol\u00f3gov<\/h4>\n

Viliam Dobi\u00e1\u0161<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

\u00a0 \u00a0 \u00a0\u00daVOD \u00davodn\u00ed slovo Jana \u0160eblov\u00e1 Obsah \u00a0 \u00a0 \u00a0KONCEPCE, \u0158\u00cdZEN\u00cd, ORGANIZACE N\u00e1vrh koncepce vzd\u011bl\u00e1v\u00e1n\u00ed pracovn\u00edk\u016f \u0161kol v oblasti prvn\u00ed pomoci Pavla Tr\u010dkov\u00e1 Abstrakt Z\u00e1kladn\u00ed a st\u0159edn\u00ed \u0161koly maj\u00ed legislativn\u011b ulo\u017een\u00e9 povinnosti v oblasti poskytov\u00e1n\u00ed prvn\u00ed pomoci sv\u00fdm pracovn\u00edk\u016fm<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[28],"tags":[],"class_list":["post-694","post","type-post","status-publish","format-standard","hentry","category-rocnik-2015"],"_links":{"self":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/694","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=694"}],"version-history":[{"count":0,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/694\/revisions"}],"wp:attachment":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=694"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=694"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=694"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}