{"id":878,"date":"2019-06-12T15:36:20","date_gmt":"2019-06-12T13:36:20","guid":{"rendered":"http:\/\/urgentnimedicina.cz\/?p=878"},"modified":"2019-06-12T15:36:20","modified_gmt":"2019-06-12T13:36:20","slug":"obsah-1-2019","status":"publish","type":"post","link":"https:\/\/urgentnimedicina.cz\/?p=878","title":{"rendered":"Obsah 1\/2019"},"content":{"rendered":"<p><b>\u00daVOD<\/b><\/p>\n<ul>\n<li>\u00davodn\u00ed slovo \u2013 <i>Jana \u0160eblov\u00e1<\/i><\/li>\n<li>Obsah<\/li>\n<li>Nov\u00fd redak\u010dn\u00ed t\u00fdm \u010dasopisu Urgentn\u00ed medic\u00edna<\/li>\n<\/ul>\n<p><b>URGENTN\u00cd P\u0158\u00cdJMY<\/b><\/p>\n<ul>\n<li>Diagnostika a l\u00e9\u010dba ch\u0159ipky na urgentn\u00edm p\u0159\u00edjmu \u2013 <i>Robin \u0160\u00edn, Dalibor Sedl\u00e1\u010dek<\/i><\/li>\n<\/ul>\n<p><b>P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c1 P\u00c9\u010cE<\/b><\/p>\n<ul>\n<li>\u00da\u010dinn\u00e1 laick\u00e1 KPR a otvorenie culprit art\u00e9rie do dvoch hod\u00edn \u2013 komentovan\u00e1 kazuistika \u2013 <i>T\u00e1\u0148a Bul\u00edkov\u00e1, Patrik Christian Cmorej<\/i><\/li>\n<li>Anal\u00fdza zakl\u00edn\u011bn\u00ed pacient\u016f p\u0159i dopravn\u00edch nehod\u00e1ch ve vztahu k t\u00ed\u017ei poran\u011bn\u00ed \u2013 <i>Radek P\u0159ececht\u011bl, Tom\u00e1\u0161 Va\u0148atka<\/i><\/li>\n<li>Crisis Resource Management v p\u0159ednemocni\u010dn\u00ed neodkladn\u00e9 p\u00e9\u010di \u2013 <i>Katar\u00edna Vesel\u00e1<\/i><\/li>\n<\/ul>\n<p><b>P\u0158\u00cdSTROJE A TECHNIKA<\/b><\/p>\n<ul>\n<li>Pacient se subkut\u00e1nn\u00edm implantabiln\u00edm kardioverter defibril\u00e1torem v p\u0159ednemocni\u010dn\u00ed neodkladn\u00e9 p\u00e9\u010di \u2013 <i>Jaroslav Halamka, Luk\u00e1\u0161 Vais, Martin Kub\u00e1t, Radom\u00edr Vlk<\/i><\/li>\n<\/ul>\n<p><b>FYZIOLOGIE A URGENTN\u00cd MEDIC\u00cdNA<\/b><\/p>\n<ul>\n<li>Intraose\u00e1ln\u00ed podan\u00ed l\u00e9k\u016f \u2013 jak to, \u017ee to \u201efunguje\u201c? \u2013 <i>David Astapenko, Vladim\u00edr \u010cern\u00fd<\/i><\/li>\n<\/ul>\n<p><b>DISKUZE, POLEMIKA, N\u00c1ZORY<\/b><\/p>\n<ul>\n<li>Zneu\u017e\u00edv\u00e1n\u00ed zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby? \u2013 <i>Marek Slab\u00fd<\/i><\/li>\n<li>Jsme s pacienty na jedn\u00e9 lodi, co se jmenuje urgentn\u00ed medic\u00edna \u2013 <i>Jana \u0160eblov\u00e1, Ond\u0159ej Fran\u011bk<\/i><\/li>\n<li>Koho ohro\u017euje nadm\u011brn\u00e9 zat\u011b\u017eov\u00e1n\u00ed zdravotnick\u00fdch z\u00e1chrann\u00fdch slu\u017eeb? \u2013 <i>Roman G\u0159ego\u0159<\/i><\/li>\n<\/ul>\n<p><b>INFORMA\u010cN\u00cd SERVIS<\/b><\/p>\n<ul>\n<li>Spr\u00e1va z 10. Stredoeur\u00f3pskeho kongresu urgentnej medic\u00edny a medic\u00edny katastrof vo Vyhniach \u2013 <i>T\u00e1\u0148a Bul\u00edkov\u00e1, \u0160tefan Trenkler<\/i><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><b>INTRODUCTION<\/b><\/p>\n<ul>\n<li>Editorial \u2013 <i>Jana \u0160eblov\u00e1<\/i><\/li>\n<li>Contents<\/li>\n<li>New editorial team of \u201eUrgentn\u00ed medic\u00edna\u201c journal<\/li>\n<\/ul>\n<p><b>EMERGENCY DEPARTMENTS<\/b><\/p>\n<ul>\n<li>Diagnostics and Treatment of Influenza on Emergency Department \u2013 <i>Robin \u0160\u00edn, Dalibor Sedl\u00e1\u010dek<\/i><\/li>\n<\/ul>\n<p><b>PREHOSPITAL EMERGENCY CARE<\/b><\/p>\n<ul>\n<li>Bystander CPR and succesful primary percutaneous coronary intervention of culprit lesion within two hours &#8211; case<br \/>\nreport \u2013 <i>T\u00e1\u0148a Bul\u00edkov\u00e1, Patrik Christian Cmorej<\/i><\/li>\n<li>Analysis of patients\u00b4 entrappment in traffic crashes associated with trauma severity \u2013 <i>Radek P\u0159ececht\u011bl, Tom\u00e1\u0161 Va\u0148atka<\/i><\/li>\n<li>Crisis Resource Management in the prehospital emergency care \u2013 <i>Katar\u00edna Vesel\u00e1<\/i><\/li>\n<\/ul>\n<p><b>TECHNICAL EQUIPMENT AND DEVICES<\/b><\/p>\n<ul>\n<li>The patient with subcutaneous implantable cardioverter defibrilator in the prehospital emergency care \u2013 <i>Jaroslav Halamka, Luk\u00e1\u0161 Vais, Martin Kub\u00e1t, Radom\u00edr Vlk<\/i><\/li>\n<\/ul>\n<p><b>PHYSIOLOGY AND EMERGENCY MEDICINE<\/b><\/p>\n<ul>\n<li>Intraosseous administration of medications \u2013 how does it \u201cwork\u201d? \u2013 <i>David Astapenko, Vladim\u00edr \u010cern\u00fd<\/i><\/li>\n<\/ul>\n<p><b>DISCUSSION, OPINION<\/b><\/p>\n<ul>\n<li>Misuse of Emergency Medical Services? \u2013 <i>Marek Slab\u00fd<\/i><\/li>\n<li>We and our patients are in the same boat &#8211; it&#8217;s name is emergency medicine \u2013 <i>Jana \u0160eblov\u00e1, Ond\u0159ej Fran\u011bk<\/i><\/li>\n<li>Who is endangered by overuse of Emergency Medical Services? \u2013 <i>Roman G\u0159ego\u0159<\/i><\/li>\n<\/ul>\n<p><b>INFORMATION<\/b><\/p>\n<ul>\n<li>A report on 10th Central European Congress of Disaster and Emergency Medicine in Vyhne \u2013 <i>T\u00e1\u0148a Bul\u00edkov\u00e1, \u0160tefan Trenkler<\/i><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><span style=\"text-decoration: underline;\"><strong>ABSTRAKTY<\/strong><\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>DIAGNOSTIKA A L\u00c9\u010cBA CH\u0158IPKY NA URGENTN\u00cdM P\u0158\u00cdJMU<\/b><\/p>\n<p><b>Robin \u0160\u00edn, Dalibor Sedl\u00e1\u010dek<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Ch\u0159ipka je infek\u010dn\u00ed onemocn\u011bn\u00ed zp\u016fsoben\u00e9 ch\u0159ipkov\u00fdmi viry A, B a v\u00fdjime\u010dn\u011b i C, kter\u00e9 pat\u0159\u00ed do \u010deledi ortomyxovir\u016f. Pandemie a epidemie ch\u0159ipky jsou historicky dob\u0159e zdokumentovan\u00e9 a lidstvo prov\u00e1z\u00ed ji\u017e del\u0161\u00ed dobu. Typick\u00e9 p\u0159\u00edznaky ch\u0159ipky zahrnuj\u00ed n\u00e1hl\u00fd n\u00e1stup hore\u010dky se zimnic\u00ed, \u00fanavou a slabost\u00ed. Pacient m\u00edv\u00e1 bolesti hlavy, sval\u016f a kloub\u016f. Vyskytnout se mohou tak\u00e9 p\u0159\u00edznaky z oblasti gastrointestin\u00e1ln\u00edho traktu jako nauzea, zvracen\u00ed a pr\u016fjem. Pozorovat lze t\u00e9\u017e neproduktivn\u00ed ka\u0161el. Ch\u0159ipkov\u00e9 onemocn\u011bn\u00ed mohou doprov\u00e1zet z\u00e1va\u017en\u00e9 komplikace jako bakteri\u00e1ln\u00ed pneumonie, srde\u010dn\u00ed selh\u00e1n\u00ed, myokarditida, perikarditida, encefalopatie nebo encefalitida. V diagnostice je mo\u017en\u00e9 vyu\u017e\u00edt rychl\u00fd diagnostick\u00fd test ch\u0159ipky, RT-PCR, p\u0159\u00edpadn\u011b kultivaci viru. V terapii i chemoprofylaxi je pou\u017e\u00edv\u00e1n standardn\u011b peror\u00e1ln\u00ed oseltamivir, kter\u00fd lze podat i t\u011bhotn\u00fdm \u017een\u00e1m a d\u011btem. K inhala\u010dn\u00ed aplikaci je ur\u010den\u00fd zanamivir, kter\u00fd je vhodn\u00fd i v p\u0159\u00edpadech, kdy do\u0161lo k selh\u00e1n\u00ed chemoprofylaxe oseltamivirem. Pou\u017eit\u00edm vhodn\u00fdch dostupn\u00fdch diagnostick\u00fdch metod a spr\u00e1vnou interpretac\u00ed v\u00fdsledk\u016f na vstupu do nemocnice lze s vysokou pravd\u011bpodobnost\u00ed identifikovat pacienty s ch\u0159ipkou, v\u010das nasadit l\u00e9\u010dbu antivirotiky, omezit nadbyte\u010dn\u00e1 laboratorn\u00ed vy\u0161et\u0159en\u00ed a omezit pou\u017e\u00edv\u00e1n\u00ed antibiotik.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>ch\u0159ipka \u2013 diagnostika \u2013 l\u00e9\u010dba \u2013 oseltamivir \u2013 urgentn\u00ed p\u0159\u00edjem<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>DIAGNOSTICS AND TREATMENT OF INFLUENZA ON EMERGENCY DEPARTMENT<\/b><\/p>\n<p>Influenza is an infectious disease caused by influenza viruses A, B and exceptionally C that belong to the family of orthomyxoviruses. Pandemics and epidemics of the influenza have been historically well documented and have been accompanying the whole mankind for a long time. Typical flu symptoms include sudden onset of fever with chills, fatigue and weakness. The patient has headache, muscle and joint pain. There may also occur a gastrointestinal symptoms such as nausea, vomiting and diarrhea. Non-productive cough can also be observed. Influenza can be accompanied by serious complications such as bacterial pneumonia, heart failure, myocarditis, pericarditis, encephalopathy or encephalitis. The diagnosis can be made by rapid influenza diagnostic test, RT-PCR, possibly virus culture. Oral oseltamivir is also used in therapy and chemoprophylaxis, which can also be given to pregnant women and children. Zanamivir is intended for inhalation and is suitable even when oseltamivir chemoprophylaxis has failed. Using appropriate available diagnostic methods and correctly interpreting hospital entry results, it is possible to precisely identify influenza patients, early use of antiviral therapy, reduce unnecessary laboratory testing and reduce the use of antibiotics.<\/p>\n<p><b>Key words: <\/b>influenza \u2013 diagnostics \u2013 treatment \u2013 oseltamivir \u2013 emergency department<\/p>\n<p>&nbsp;<\/p>\n<p><b>\u00da\u010cINN\u00c1 LAICK\u00c1 KPR A OTVORENIE CULPRIT ART\u00c9RIE DO DVOCH HOD\u00cdN \u2013 KOMENTOVAN\u00c1 KAZUISTIKA<\/b><\/p>\n<p><b>T\u00e1\u0148a Bul\u00edkov\u00e1, Patrik Christian Cmorej<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Snahou autorov je s\u00fastredi\u0165 pozornos\u0165 \u010ditate\u013ea pomocou komentovanej kazuistiky pos\u00e1dky z\u00e1chrannej zdravotnej slu\u017eby (ZZS) na z\u00e1va\u017en\u00fa problematiku mimonemocni\u010dn\u00e9ho zastavenia obehu s inici\u00e1lnym defibrilovate\u013en\u00fdm rytmom pri v\u010dasnej f\u00e1ze ak\u00fatneho infarktu myokardu. Za predpokladu okam\u017eitej laickej kardiopulmon\u00e1lnej resuscit\u00e1cie prv\u00fdm svedkom a v\u010dasnej defibril\u00e1cie s n\u00e1sledn\u00fdm vyhodnoten\u00edm 12 zvodov\u00e9ho EKG prvou pos\u00e1dkou, je mo\u017en\u00e9 odhali\u0165 pr\u00edznaky STEMI a v pr\u00edpade klinick\u00e9ho podozrenia, \u010do najsk\u00f4r transportova\u0165 pacienta k prim\u00e1rnej PKI. \u010casov\u00fd interval od volania na ties\u0148ov\u00fa linku 155 po odovzdanie pacienta v kardiocentre do 90 min\u00fat (aj s KPR) preuk\u00e1zal v\u00fdborn\u00fd outcome pre pacienta.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>mimonemocni\u010dn\u00e9 zastavenie obehu, laick\u00e1 prv\u00e1 pomoc, v\u010dasn\u00e1 defibril\u00e1cia, STEMI, prim\u00e1rna PKI<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>BYSTANDER CPR AND SUCCESFUL PRIMARY PERCUTANEOUS CORONARY INTERVENTION OF CULPRIT LESION WITHIN TWO HOURS \u2013 CASE REPORT<\/b><\/p>\n<p>The authors are presenting a commented case report of outof- hospital cardiac arrest with initial defibrillated rhythm as a deterioration of acute myocardial infarction. Early detection of STEMI and initialisation of rapid transport to PCI depends on several factors as early start of lay CPR provided by bystanders, early defibrillation and achieving of ROSC by the EMS crew and 12leads ECG provided soon after ROSC. The outcome is higher if the time between call to Emergency Medical Dispatching and handover in the hospital is less than 90 minutes.<\/p>\n<p><b>Key words: <\/b>out-of-hospital cardiac arrest, first aid, early defibrillation, STEMI, primary percutaneous coronary intervention<\/p>\n<p>&nbsp;<\/p>\n<p><b>ANAL\u00ddZA ZAKL\u00cdN\u011aN\u00cd PACIENT\u016e P\u0158I DOPRAVN\u00cdCH NEHOD\u00c1CH VE VZTAHU K T\u00cd\u017dI PORAN\u011aN\u00cd<\/b><\/p>\n<p><b>Radek P\u0159ececht\u011bl, Tom\u00e1\u0161 Va\u0148atka<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Zakl\u00edn\u011bn\u00fd pacient je jedn\u00edm z faktor\u016f mechanismu \u00farazu p\u0159i dopravn\u00edch nehod\u00e1ch. Pro zasahuj\u00edc\u00ed v\u00fdjezdov\u00e9 skupiny z\u00e1chrann\u00e9 slu\u017eby b\u00fdv\u00e1 tento faktor velkou nezn\u00e1mou. M\u016f\u017ee se jednat o kriticky zran\u011bn\u00e9ho pacienta, ale tak\u00e9 o \u0159idi\u010de, kter\u00fd se pouze nem\u016f\u017ee dostat z havarovan\u00e9ho vozidla.<br \/>\nHlavn\u00edm c\u00edlem bylo zaznamenat a vyhodnotit vliv faktoru zakl\u00edn\u011bn\u00ed na zran\u011bnou osobu a ur\u010dit mo\u017en\u00e9 predik\u010dn\u00ed faktory ovliv\u0148uj\u00edc\u00ed t\u00ed\u017ei poran\u011bn\u00ed zakl\u00edn\u011bn\u00e9 osoby, kter\u00e9 by vedly k jednodu\u0161\u0161\u00ed tri\u00e1\u017ei na m\u00edst\u011b ud\u00e1losti.<br \/>\nProvedli jsme retrospektivn\u00ed anal\u00fdzu dat za obdob\u00ed 2016 \u2013 2017 z oblasti Kraje Vyso\u010dina formou aplikovan\u00e9ho v\u00fdzkumu. Z 84.336 pacient\u016f bylo vybr\u00e1no 638 tri\u00e1\u017e pozitivn\u00edch pacient\u016f. Sledovali jsme cel\u00fd pr\u016fb\u011bh reanima\u010dn\u00ed f\u00e1ze a\u017e do traumacentra (FNB a \u00daVN). \u00daplnost dat spl\u0148ovalo 81. Sledovali jsme polohu t\u011bl, mechanismus \u00farazu, u\u017eit\u00ed bezpe\u010dnostn\u00edch p\u00e1s\u016f, d\u00e9lku reanima\u010dn\u00ed f\u00e1ze, hodnotu lakt\u00e1tu a hemoglobinu u dvou soubor\u016f s ISS \u2264 15 a ISS \u2265 16.<br \/>\nZ v\u00fdsledk\u016f jsme zjistili, \u017ee nejv\u011bt\u0161\u00edch hodnot ISS bylo dosa\u017eeno p\u0159i front\u00e1ln\u00edm st\u0159etu s polohou \u201eUP\u201c (20,67 ISS), nejni\u017e\u0161\u00edch u polohy \u201eDOWN\u201c (19,70 ISS). Nejv\u00fdznamn\u011bj\u0161\u00edm prediktorem byla hodnota lakt\u00e1tu (1,770;3,503 mmol\/l), d\u00e9lka reanima\u010dn\u00ed f\u00e1ze (81;100,2 min.) a hodnota hemoglobinu (140,6;122,7 g\/l). Z v\u00fdsledk\u016f tak\u00e9 vyplynula predikce u\u017eit\u00ed bezpe\u010dnostn\u00edch p\u00e1s\u016f RISS = 2,65.<br \/>\nAplikovan\u00fdm v\u00fdzkumem jsme zjistili nadhodnocen\u00ed stavu u 57 % pacient\u016f, kte\u0159\u00ed vzhledem k absenci predik\u010dn\u00edch faktor\u016f zakl\u00edn\u011bn\u00ed byli transportov\u00e1ni do traumacenter. Navrhli jsme p\u0159ijet\u00ed krit\u00e9ri\u00ed faktoru zakl\u00edn\u011bn\u00ed zejm\u00e9na faktor d\u00e9lky vypro\u0161t\u011bn\u00ed a vniknut\u00ed konstrukce vozidla do prostoru cestuj\u00edc\u00edch. Velk\u00fd v\u00fdznam bude m\u00edt tak\u00e9 m\u011b\u0159en\u00ed hodnoty lakt\u00e1tu na \u00farovni PNP.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>tri\u00e1\u017e pozitivita \u2013 zakl\u00edn\u011bn\u00ed \u2013 mechanismus \u00farazu \u2013 lakt\u00e1t \u2013 hemoglobin \u2013 reanima\u010dn\u00ed f\u00e1ze<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>ANALYSIS OF PATIENTS\u00b4 ENTRAPPMENT IN TRAFFIC CRASHES ASSOCIATED WITH TRAUMA SEVERITY<\/b><\/p>\n<p>A trapped patient is one of the aspects of mechanism of injury in motor vehicle collisions. This aspect remains unknown to the EMS (emergency medical services). While the patient may be in a critical condition, it may also turn out that the person is simply unable to get out of the crashed vehicle.<br \/>\nThe primary objective is to analyse and evaluate the relevance of being trapped to the extent of the injury. In other words, the work attempts to establish possible predictive aspects relevant to the extent of the injury, thereby enabling easier triage at the scene of the accident.<br \/>\nA retrospective data analysis is carried out in the region of Vyso\u010dina from the period of 2016\u201317 by means of applied research. 638 triage positive patients are selected out of a total of 84,336. The whole process of reanimation is observed until the patient has reached a trauma centre (University Hospital Brno and Military University Hospital Prague). Complete data is available for 81. The following points are analysed: body position, mechanism of injury, use of seatbelts, length of reanimation period, amount of lactate and haemoglobin in two groups ISS \u2264 15 a ISS \u2265 16.<br \/>\nThe results show that the highest amount of ISS is linked with the frontal impact and the \u2018UP\u2019 position (20.67 ISS) whereas the lowest amount of ISS comes with the position \u2018DOWN\u2019 (19.70 ISS). The most significant predictor is the amount of lactate (1,770;3,503 mmol\/l), lenght of reanimation period (81;100,2 min.) and the amount of haemoglobin (140,6;122,7 g\/l). The results also reveal the prediction of the use of seatbelts RISS = 2.65.<br \/>\nThe applied research shows over-triage of 57% of patients who, due to the absence of predictive aspects of being trapped, were transported to trauma centres. We propose the acceptance of criteria of the factor of being trapped, especially the \u2018extrication length\u2019 factor and the \u2018intrusion occupant site\u2019 factor. Finding out the amount of lactate by the EMS is of great significance, too.<\/p>\n<p><b>Key words: <\/b>triage positivity \u2013 being trapped \u2013 mechanism of injury \u2013 lactate \u2013 haemoglobin \u2013 reanimation period<\/p>\n<p>&nbsp;<\/p>\n<p><b>CRISIS RESOURCE MANAGEMENT V P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c9 P\u00c9\u010cI<\/b><\/p>\n<p><b>Katar\u00edna Vesel\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Crisis resource management (CRM, \u0159\u00edzen\u00ed lidsk\u00fdch zdroj\u016f v krizov\u00e9 situaci) znamen\u00e1 koordinaci, pou\u017e\u00edv\u00e1n\u00ed a vyu\u017e\u00edv\u00e1n\u00ed v\u0161ech dostupn\u00fdch zdroj\u016f pro z\u00e1chranu a pomoc pacientovi. Term\u00edn zdroje zahrnuje ve\u0161ker\u00fd person\u00e1l spolu s jeho schopnostmi, techniku, za\u0159\u00edzen\u00ed, informa\u010dn\u00ed zdroje v\u010detn\u011b kognitivn\u00edch pom\u016fcek. Velmi \u00fazce souvis\u00ed s netechnick\u00fdmi dovednostmi, pot\u0159ebn\u00fdmi pro efektivn\u00ed t\u00fdmovou pr\u00e1ci v akutn\u00ed situaci.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>CRM \u2013 krize \u2013 krizov\u00e1 situace \u2013 netechnick\u00e9 dovednosti<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>CRISIS RESOURCE MANAGEMENT IN THE PREHOSPITAL EMERGENCY CARE<\/b><\/p>\n<p>Crisis resource management (CRM) means to coordinate, use and apply all available resources to protect and help the patient as best as possible. The term resources includes all personnel involved, along with all their skills, abilities and attitude. Machines, devices, and information sources, including cognitive aids, are also critical resources. It is very closely related to the non-technical skills needed for effective teamwork in an emergency situation.<\/p>\n<p><b>Key words: <\/b>CRM \u2013 crisis \u2013 soft skills \u2013 nontechnical skills<\/p>\n<p>&nbsp;<\/p>\n<p><b>PACIENT SE SUBKUT\u00c1NN\u00cdM IMPLANTABILN\u00cdM KARDIOVERTER DEFIBRIL\u00c1TOREM V P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c9 P\u00c9\u010cI<\/b><\/p>\n<p><b>Jaroslav Halamka, Luk\u00e1\u0161 Vais, Martin Kub\u00e1t, Radom\u00edr Vlk<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Subkut\u00e1nn\u00ed implantabiln\u00ed kardioverter defibril\u00e1tor je relativn\u011b novou technologi\u00ed v l\u00e9\u010db\u011b \u017eivot ohro\u017euj\u00edc\u00edch arytmi\u00ed. Jeho v\u00fdhodou je subkut\u00e1nn\u00ed ulo\u017een\u00ed elektrody, kter\u00e9 eliminuje komplikace spojen\u00e9 s intraven\u00f3zn\u00edm zaveden\u00edm elektrody u konven\u010dn\u00edho implantabiln\u00edho kardioverter defibril\u00e1toru. Zvy\u0161uj\u00edc\u00ed se po\u010det implantac\u00ed tohoto p\u0159\u00edstroje s sebou p\u0159in\u00e1\u0161\u00ed nov\u00e9 probl\u00e9my tak\u00e9 v p\u0159ednemocni\u010dn\u00ed neodkladn\u00e9 p\u00e9\u010di. Auto\u0159i v \u010dl\u00e1nku prezentuj\u00ed z\u00e1kladn\u00ed informace o tomto typu p\u0159\u00edstroje, v\u010detn\u011b vybran\u00fdch komplikac\u00ed v kontextu p\u0159ednemocni\u010dn\u00ed neodkladn\u00e9 p\u00e9\u010de.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>p\u0159ednemocni\u010dn\u00ed neodkladn\u00e1 p\u00e9\u010de \u2013 subkut\u00e1nn\u00ed implantabiln\u00ed kardioverter defibril\u00e1tor \u2013 neadekv\u00e1tn\u00ed v\u00fdboje<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>THE PATIENT WITH SUBCUTANEOUS IMPLANTABLE CARDIOVERTER DEFIBRILATOR IN THE PREHOSPITAL EMERGENCY CARE<\/b><\/p>\n<p>A subcutaneous implantable cardioverter defibrillator is a relatively new technology in the treatment of life-threatening arrhythmias. Its advantage is subcutaneous electrode placement, which eliminates the complications associated with intravenous electrode insertion used with conventional implantable cardioverter defibrillator. Increasing the number of implantations of this device brings new problems also in pre-hospital emergency care. The authors present basic information about this type of device, including selected complications in the context of pre-hospital emergency care.<\/p>\n<p><b>Key words: <\/b>prehospital emergency care \u2013 subcutaneous implantable cardioverter defibrillator \u2013 inappropriate shocks<\/p>\n<p>&nbsp;<\/p>\n<p><b>INTRAOSE\u00c1LN\u00cd PODAN\u00cd L\u00c9K\u016e \u2013 JAK TO, \u017dE TO \u201eFUNGUJE\u201c?<\/b><\/p>\n<p><b>David Astapenko, Vladim\u00edr \u010cern\u00fd<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Intraose\u00e1ln\u00ed pod\u00e1n\u00ed l\u00e9k\u016f je legitimn\u00ed postup vyu\u017e\u00edvan\u00fd zejm\u00e9na v urgentn\u00ed medic\u00edn\u011b. Z praxe je zn\u00e1mo, \u017ee farmakokinetika pod\u00e1n\u00ed l\u00e9k\u016f touto cestou odpov\u00edd\u00e1 intraven\u00f3zn\u00ed administraci. Anatomick\u00fd podklad t\u00e9to souvislosti nebyl a\u017e do ned\u00e1vna zn\u00e1m\u00fd. Za propojen\u00ed anatomick\u00e9 a funk\u010dn\u00ed kostn\u00ed cirkulace jsou zodpov\u011bdn\u00e9 trans\u2013 kortik\u00e1ln\u00ed spojky.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>intraose\u00e1ln\u00ed vstup \u2013 kostn\u00ed mikrocirkulace<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>INTRAOSSEOUS ADMINISTRATION OF MEDICATIONS \u2013 WHY DOES IT \u201cWORK\u201d?<\/b><\/p>\n<p>Intraosseous administration of drugs is legitimate method used mainly in emergency medicine. It is well known from the practice that the pharmacokinetics of the drug delivery through this way corresponds to the intravenous administration. The anatomical substrate of this connection has been elusive until recently. Trans\u2013cortical junctions are responsible for linking anatomical and functional bone circulation.<\/p>\n<p><b>Key words: <\/b>intraosseous access \u2013 bone microcirculation<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00daVOD \u00davodn\u00ed slovo \u2013 Jana \u0160eblov\u00e1 Obsah Nov\u00fd redak\u010dn\u00ed t\u00fdm \u010dasopisu Urgentn\u00ed medic\u00edna URGENTN\u00cd P\u0158\u00cdJMY Diagnostika a l\u00e9\u010dba ch\u0159ipky na urgentn\u00edm p\u0159\u00edjmu \u2013 Robin \u0160\u00edn, Dalibor Sedl\u00e1\u010dek P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c1 P\u00c9\u010cE \u00da\u010dinn\u00e1 laick\u00e1 KPR a otvorenie culprit art\u00e9rie do dvoch hod\u00edn<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32],"tags":[],"class_list":["post-878","post","type-post","status-publish","format-standard","hentry","category-rocnik-2019"],"_links":{"self":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/878","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=878"}],"version-history":[{"count":0,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/878\/revisions"}],"wp:attachment":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=878"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=878"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=878"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}