{"id":913,"date":"2019-08-01T11:44:20","date_gmt":"2019-08-01T09:44:20","guid":{"rendered":"http:\/\/urgentnimedicina.cz\/?p=913"},"modified":"2019-08-01T11:44:20","modified_gmt":"2019-08-01T09:44:20","slug":"obsah-2-2019","status":"publish","type":"post","link":"https:\/\/urgentnimedicina.cz\/?p=913","title":{"rendered":"Obsah 2\/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>Mezin\u00e1rodn\u00ed redak\u010dn\u00ed rada<\/li>\n<\/ul>\n<p><b>URGENTN\u00cd P\u0158\u00cdJMY<\/b><\/p>\n<ul>\n<li>Non-adherence k terapii arteri\u00e1ln\u00ed hypertenze v kontextu urgentn\u00ed medic\u00edny \u2013 <i>Marcel Nesvadba, Petr Bure\u0161, Alena Kohlov\u00e1, Patrik Christian Cmorej<\/i><\/li>\n<li>Pacient s bolest\u00ed b\u0159icha na urgentn\u00edm p\u0159\u00edjmu \u2013 <i>Jana Berkov\u00e1<\/i><\/li>\n<\/ul>\n<p><b>PEDIATRIE V URGENTN\u00cd MEDIC\u00cdN\u011a<\/b><\/p>\n<ul>\n<li>Ne\u00farazov\u00e9 bolesti b\u0159icha u d\u011bt\u00ed \u2013 <i>Pavel Heinige<\/i><\/li>\n<\/ul>\n<p><b>P\u0158\u00cdSTROJE A TECHNIKA<\/b><\/p>\n<ul>\n<li>Telemedic\u00edna v p\u0159ednemocni\u010dn\u00ed neodkladn\u00e9 p\u00e9\u010di: novinky 2019 \u2013 <i>Roman S\u00fdkora, Metod\u011bj Renza<\/i><\/li>\n<\/ul>\n<p><b>FYZIOLOGIE A URGENTN\u00cd MEDIC\u00cdNA<\/b><\/p>\n<ul>\n<li>\u00dalevov\u00e1 poloha p\u0159i du\u0161nosti \u2013 co n\u00e1m t\u00edm pacient \u0159\u00edk\u00e1? \u2013 <i>David Astapenko, Vladim\u00edr \u010cern\u00fd<\/i><\/li>\n<\/ul>\n<p><b>VZD\u011aL\u00c1V\u00c1N\u00cd A ATESTA\u010cN\u00cd OT\u00c1ZKY<\/b><\/p>\n<ul>\n<li>Syst\u00e9m vzd\u011bl\u00e1v\u00e1n\u00ed na Zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eb\u011b hl. m. Prahy \u2013 <i>David Pe\u0159an, Radom\u00edr Vlk, Petr Pavl\u00ed\u010dek, Jarmila Paukertov\u00e1, Dagmar Vyso\u010dansk\u00e1, Viktor Ba\u017eant, Jaroslav Pekara, Robert Tomka, Vladim\u00edr Nedv\u011bd, Radana Krtilov\u00e1, Petr Kolouch<\/i><\/li>\n<\/ul>\n<p><b>INFORMA\u010cN\u00cd SERVIS<\/b><\/p>\n<ul>\n<li>Den urgentn\u00ed medic\u00edny \u2013 Emergency medicine Day 27. kv\u011btna \u2013 <i>Jana \u0160eblov\u00e1<\/i><\/li>\n<li>Recenze knihy Jana Smetany et al.: \u201eVysoce nebezpe\u010dn\u00e9 n\u00e1kazy\u201c \u2013 <i>Patrik Christian Cmorej<\/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>International Editorial Board of \u201eUrgentn\u00ed medic\u00edna\u201c journal<\/li>\n<\/ul>\n<p><b>EMERGENCY DEPARTMENTS<\/b><\/p>\n<ul>\n<li>Nonadherence to antihypertensive therapy in emergency medicine \u2013 <i>Marcel Nesvadba, Petr Bure\u0161, Alena Kohlov\u00e1, Patrik Christian Cmorej<\/i><\/li>\n<li>Patient with abdominal pain at emergency department \u2013 <i>Jana Berkov\u00e1<\/i><\/li>\n<\/ul>\n<p><b>PAEDIATRICS IN EMERGENCY MEDICINE<\/b><\/p>\n<ul>\n<li>Non-traumatic abdominal pain in children \u2013 <i>Pavel Heinige<\/i><\/li>\n<\/ul>\n<p><b>MEDICAL DEVICES<\/b><\/p>\n<ul>\n<li>Telemedicine in pre-hospital emergency care: 2019 update \u2013 <i>Roman S\u00fdkora, Metod\u011bj Renza<\/i><\/li>\n<\/ul>\n<p><b>PHYSIOLOGY AND EMERGENCY MEDICINE<\/b><\/p>\n<ul>\n<li>Relief position in dyspnea \u2013 what does patient tell us? \u2013 <i>David Astapenko, Vladim\u00edr \u010cern\u00fd<\/i><\/li>\n<\/ul>\n<p><b>EDUCATION<\/b><\/p>\n<ul>\n<li>Education at Prague Emergency Medical Services \u2013 <i>David Pe\u0159an, Radom\u00edr Vlk, Petr Pavl\u00ed\u010dek, Jarmila Paukertov\u00e1, Dagmar Vyso\u010dansk\u00e1, Viktor Ba\u017eant, Jaroslav Pekara, Robert Tomka, Vladim\u00edr Nedv\u011bd, Radana Krtilov\u00e1, Petr Kolouch<\/i><\/li>\n<\/ul>\n<p><b>INFORMATION<\/b><\/p>\n<ul>\n<li>Emergency Medicine Day 27th May \u2013 <i>Jana \u0160eblov\u00e1<\/i><\/li>\n<li>Review of the book by Jan Smetana et al.: \u201eHighly infectious diseases\u201c \u2013 <i>Patrik Christian Cmorej<\/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>NON-ADHERENCE K TERAPII ARTERI\u00c1LN\u00cd HYPERTENZE V KONTEXTU URGENTN\u00cd MEDIC\u00cdNY<\/b><\/p>\n<p><b>Marcel Nesvadba, Petr Bure\u0161, Alena Kohlov\u00e1, Patrik Christian Cmorej<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Non-adherence pacient\u016f k terapii arteri\u00e1ln\u00ed hypertenze je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou zd\u00e1nliv\u011b rezistentn\u00ed hypertenze. Non-adherence pacient\u016f je odpov\u011bdn\u00e1 za vy\u0161\u0161\u00ed v\u00fdskyt urgentn\u00ed a emergentn\u00ed hypertenze, a to a\u017e o 6,3 % v porovn\u00e1n\u00ed s adherentn\u00edmi pacienty. V prost\u0159ed\u00ed urgentn\u00ed medic\u00edny non-adherence vede \u010dasto ke stanoven\u00ed myln\u00e9 diagn\u00f3zy rezistentn\u00ed hypertenze. C\u00edlem \u010dl\u00e1nku je pouk\u00e1zat na problematiku non-adherentn\u00edch pacient\u016f v kontextu urgentn\u00ed medic\u00edny.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>arteri\u00e1ln\u00ed hypertenze \u2013 non-adherence \u2013 rezistentn\u00ed hypertenze \u2013 urgentn\u00ed medic\u00edna<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>NONADHERENCE TO ANTIHYPERTENSIVE TREATMENT IN EMERGENCY MEDICINE<\/b><\/p>\n<p>Nonadherence to antihypertensive treatment is a common cause of pseudo-resistant hypertension. Nonadeherence is responsible for a higher incidence of hypertensive crisis. Patient nonadherence to antihypertensive treatment causes false diagnosis of resistant hypertension in emergency departments. This article explores factors that have an impact on patient antihypertensive medication nonadherence.<\/p>\n<p><b>Key words: <\/b>hypertension \u2013 nonadherence \u2013 resistant hypertension \u2013 emergency medicine<\/p>\n<p>&nbsp;<\/p>\n<p><b>PACIENT S BOLEST\u00cd B\u0158ICHA NA URGENTN\u00cdM P\u0158\u00cdJMU<\/b><\/p>\n<p><b>Jana Berkov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Bolest b\u0159icha je jedn\u00edm nej\u010dast\u011bj\u0161\u00edch d\u016fvod\u016f n\u00e1v\u0161t\u011bvy urgentn\u00edho p\u0159\u00edjmu. Kvalitn\u00ed odb\u011br anamn\u00e9zy a klinick\u00e9 vy\u0161et\u0159en\u00ed tvo\u0159\u00ed z\u00e1klad diagnosticko-terapeutick\u00e9ho postupu. V r\u00e1mci managementu je z\u00e1sadn\u00ed rozpozn\u00e1n\u00ed z\u00e1va\u017en\u011b nemocn\u00e9ho pacienta, pro kter\u00e9ho m\u016f\u017ee b\u00fdt bolest b\u0159icha \u017eivot ohro\u017euj\u00edc\u00ed stav. Sou\u010d\u00e1st\u00ed tohoto managementu je co nej\u010dasn\u011bj\u0161\u00ed vy\u0161et\u0159en\u00ed chirurgem a indikace urgentn\u00edho opera\u010dn\u00edho \u0159e\u0161en\u00ed.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>akutn\u00ed bolest b\u0159icha \u2013 urgentn\u00ed p\u0159\u00edjem \u2013 diferenci\u00e1ln\u00ed diagnostika<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>PATIENT WITH ABDOMINAL PAIN AT EMERGENCY DEPARTMENT<\/b><\/p>\n<p>Abdominal pain is one of the most common reasons of emergency department\u00b4s visit. Accurate medical history and clinical examination forms the basis of the diagnostic-therapeutic approach. Recognition of severely ill patient is a crucial part of this management, as the abdominal pain could be lifethreatening in this case. A timely surgical examination and the earliest indication of surgical treatment are important parts of symptom\u00b4s management, too.<\/p>\n<p><b>Key words: <\/b>acute abdominal pain \u2013 emergency department \u2013 differential diagnosis<\/p>\n<p>&nbsp;<\/p>\n<p><b>NE\u00daRAZOV\u00c9 BOLESTI B\u0158ICHA U D\u011aT\u00cd<\/b><\/p>\n<p><b>Pavel Heinige<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Bolesti b\u0159icha jsou v d\u011btsk\u00e9m v\u011bku jednou z nej\u010dast\u011bj\u0161\u00edch p\u0159\u00ed\u010din vyhled\u00e1n\u00ed l\u00e9ka\u0159sk\u00e9 pomoci. Bolesti b\u0159icha jsou symptom, kter\u00fdm se prezentuje mnoho r\u016fzn\u00fdch onemocn\u011bn\u00ed. N\u011bkter\u00e9 z nich mohou b\u00fdt urgentn\u00ed a \u017eivot ohro\u017euj\u00edc\u00ed. Nejd\u016fle\u017eit\u011bj\u0161\u00edm \u00fakolem zdravotnick\u00e9ho person\u00e1lu je identifikovat manifestaci n\u00e1hl\u00e9 p\u0159\u00edhody b\u0159i\u0161n\u00ed.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>Bolest b\u0159icha \u2013 d\u00edt\u011b \u2013 n\u00e1hl\u00e1 p\u0159\u00edhoda b\u0159i\u0161n\u00ed<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>NON-TRAUMATIC ABDOMINAL PAIN IN CHILDREN<\/b><\/p>\n<p>Acute abdominal pain is in childhood one of the most frequent reasons to seek a medical help. Pain of abdomen is a symptom, that can be presented in large volume of diseases. Some of those may be urgent and potentially life threatening. The most important task for the medical staff is to identify a manifestation of a acute abdomen.<\/p>\n<p><b>Key words: <\/b>Acute abdominal pain \u2013 child \u2013 acute abdomen<\/p>\n<p>&nbsp;<\/p>\n<p><b>TELEMEDIC\u00cdNA V P\u0158EDNEMOCNI\u010cN\u00cd NEODKLADN\u00c9 P\u00c9\u010cI: NOVINKY 2019<\/b><\/p>\n<p><b>Roman S\u00fdkora, Metod\u011bj Renza<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p><strong>\u00davod:<\/strong> Sou\u010dasn\u00e1 \u00farove\u0148 informa\u010dn\u00edch a komunika\u010dn\u00edch technologi\u00ed vede k dramatick\u00e9mu roz\u0161i\u0159ov\u00e1n\u00ed vyu\u017eit\u00ed a v\u00fdzkumu telemedic\u00ednsk\u00fdch metod (TM) v p\u0159ednemocni\u010dn\u00ed neodkladn\u00e9 p\u00e9\u010di (PNP). C\u00edl: Pr\u00e1ce p\u0159edstav\u00ed souhrn novinek, mo\u017enost\u00ed, v\u010detn\u011b vlastn\u00ed zku\u0161enosti ze Zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby Karlovarsk\u00e9ho kraje (ZZS KVK) a nast\u00edn\u00ed budouc\u00ed mo\u017en\u00e9 sm\u011b\u0159ov\u00e1n\u00ed vyu\u017eit\u00ed TM.<br \/>\n<strong>Metodika:<\/strong> V datab\u00e1zi Pubmed byly aktivn\u011b vyhled\u00e1v\u00e1ny recentn\u011b publikovan\u00e9 pr\u00e1ce na toto t\u00e9ma. Vzhledem k jejich nehomogenit\u011b a z\u00e1sadn\u00ed metodologick\u00e9 odli\u0161nosti byly nalezen\u00e9 pr\u00e1ce hodnoceny bez konkr\u00e9tn\u00ed systematick\u00e9 metodiky, ale pouze dle krit\u00e9ri\u00ed aktu\u00e1lnosti, relevance \u010di zaj\u00edmavosti pro prezentaci v tomto souhrnu. Sou\u010dasn\u011b jsou komentov\u00e1ny v\u00fdstupy z projekt\u016f technick\u00e9 proveditelnosti realizovan\u00fdch na ZZS KVK v letech 2016\u20132019, kter\u00e9 m\u011bly za c\u00edl vyu\u017eit\u00ed st\u00e1vaj\u00edc\u00edch, b\u011b\u017en\u011b vyu\u017e\u00edvan\u00fdch technologi\u00ed v PNP pro audiovizu\u00e1ln\u00ed konzultace l\u00e9ka\u0159e s v\u00fdjezdovou skupinou rychl\u00e9 zdravotnick\u00e9 pomoci na m\u00edst\u011b z\u00e1sahu.<br \/>\n<strong>V\u00fdsledky:<\/strong> TM v r\u016fzn\u00fdch podob\u00e1ch je v PNP ve sv\u011bt\u011b i \u010cR ji\u017e vyu\u017e\u00edv\u00e1na a zkoum\u00e1na. M\u016f\u017ee se ji\u017e op\u0159\u00edt o celou \u0159adu publikovan\u00fdch pozitivn\u00edch v\u00fdsledk\u016f. TM je vyu\u017e\u00edv\u00e1na zejm\u00e9na u pacient\u016f s akutn\u00edm koron\u00e1rn\u00edm syndromem nebo c\u00e9vn\u00ed mozkovou p\u0159\u00edhodou. Stran p\u00e9\u010de o traumata jsou dostupn\u00e9 d\u00edl\u010d\u00ed v\u00fdsledky. Audiovizu\u00e1ln\u00ed TM asistence u traumat byly poskytov\u00e1ny v\u00fdjezdov\u00fdm skupin\u00e1m, kdy c\u00edlem bylo proveden\u00ed n\u011bkter\u00e9ho \u00fakonu (perikardiocent\u00e9za, thorakostomie, intubace, pop\u00e1leniny, prov\u00e1d\u011bn\u00ed ultrazvukov\u00e9ho vy\u0161et\u0159en\u00ed). Popsan\u00e9 slibn\u00e9 v\u00fdsledky byly bohu\u017eel dosa\u017eeny p\u0159edev\u0161\u00edm v simulac\u00edch, m\u00e9n\u011b v\u0161ak byla o\u010dek\u00e1v\u00e1n\u00ed napln\u011bna v b\u011b\u017en\u00fdch klinick\u00fdch podm\u00ednk\u00e1ch PNP. Zaj\u00edmav\u011bj\u0161\u00ed je situace p\u0159i v\u0161eobecn\u00e9m vyu\u017eit\u00edm TM v PNP. Nejrozs\u00e1hlej\u0161\u00edm TM programem je v\u00fdzkum TM v Houstonu zam\u011b\u0159en\u00fd na aplikaci audiovizu\u00e1ln\u00edch konzultac\u00ed u v\u00fdjezd\u016f s n\u00edzkou klinickou z\u00e1va\u017enost\u00ed respektive nal\u00e9havost\u00ed. S ohledem na m\u00edstn\u00ed podm\u00ednky do\u0161lo k v\u00fdznamn\u00e9mu zkr\u00e1cen\u00ed doby v\u00fdjezdu RZP, zejm\u00e9na d\u00edky konzultaci l\u00e9ka\u0159e a doporu\u010den\u00ed alternativn\u00edho transportu pacienta na urgentn\u00ed p\u0159\u00edjem. P\u0159i ov\u011b\u0159ov\u00e1n\u00ed technick\u00e9 proveditelnosti TM na ZZS KVK za vyu\u017eit\u00ed st\u00e1vaj\u00edc\u00edch technologi\u00ed (v\u00fdjezdov\u00fd tablet a mobiln\u00ed telefon), je patrn\u00e9, \u017ee dominantn\u00ed sm\u011br rozvoje TM asistenc\u00ed bude pr\u00e1v\u011b v p\u0159\u00edpadech s ni\u017e\u0161\u00ed nal\u00e9havost\u00ed \u010di diagnostick\u00e9 nejistot\u011b.<br \/>\n<strong>Z\u00e1v\u011br:<\/strong> P\u0159es ve\u0161ker\u00e9 technick\u00e9 limitace lze pova\u017eovat TM za podobor, kter\u00fd d\u00edky sv\u00e9mu dynamick\u00e9mu rozvoji bude individu\u00e1ln\u011b \u010di systematicky st\u00e1le v\u00edce pronikat i do pr\u00e1ce v PNP. Skute\u010dn\u011b relevantn\u00ed data z\u00edskan\u00e1 prospektivn\u00edmi a randomizovan\u00fdmi studiemi jsou dostupn\u00e1 zat\u00edm zejm\u00e9na v urgentn\u00ed kardiologii a neurologii. Obecn\u00e9 a \u0161iroce mezioborov\u00e9 vyu\u017eit\u00ed audiovizu\u00e1ln\u00edch p\u0159enos\u016f v PNP je technicky snadno provediteln\u00e9 a implementovateln\u00e9, nicm\u00e9n\u011b dosud se jedn\u00e1 o velmi nesystematicky zkoumanou oblast, ve kter\u00e9 je t\u0159eba nastavit v\u00fdzkumn\u00e9 ot\u00e1zky a metodiku sb\u011bru dat pro spr\u00e1vn\u00e9 sm\u011b\u0159ov\u00e1n\u00ed budouc\u00edho vyu\u017eit\u00ed.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>telemedic\u00edna \u2013 telehealth \u2013 p\u0159ednemocni\u010dn\u00ed neodkladn\u00e1 p\u00e9\u010de \u2013 telemedic\u00ednsk\u00e1 asistence<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>TELEMEDICINE IN PRE-HOSPITAL EMERGENCY CARE: 2019 UPDATE<\/b><\/p>\n<p><strong>Introduction:<\/strong> The current level of information and communication technologies leads to extensive development and research in the use of telemedicine (TM) methods in pre-hospital emergency care (PEC). Objective: To present a summary of news, possibilities, including own experience from the Emergency Medical Service of the Karlovy Vary Region (EMS KV) and possible future directions for the use of TM.<br \/>\n<strong>Methods:<\/strong> The recently published papers on this topic were actively searched for in the Pubmed database. However, with regard to their inhomogeneity and fundamental methodological differences, these researched publications were further evaluated without a specific systematic methodology, but only according to the criterion of topicality, relevance or interest for presentation in this summary. As a part of this review, there are commented the outcomes of technical feasibility implemented at the EMS KV in the years 2016\u20132019, which aimed to utilize existing, commonly used technologies in the PEC for audiovisual consultations of distant physicians with the paramedics at scene.<br \/>\n<strong>Results:<\/strong> In some sub-specialisations of the PEC, TM is well used in the world and Czech Republic. Nowadays, it is possible to rely on a number of data showing better outcomes in patients especially with acute coronary syndrome or stroke. Partial results are available for trauma care. Audiovisual TM assistance was provided to the paramedics, where the goal was to perform a supervised procedure or action (pericardiacentesis, thoracostomy, intubation, burns, ultrasound examination). However, described promising results have been achieved mainly in simulations and expectations were less fulfilled under normal clinical conditions. More complicated is the general use of TM in the PEC. An example is the Houston research programme, which is probably the largest so far. It is based on application of the audiovisual consultations to events with low clinical severity or urgency. In those local conditions, there was a significant reduction in crews \u201cback in service time\u201d, mainly due to the physician\u00b4s consultation and the recommendation of alternative patient transport to an emergency department. During verifying the technical feasibility of TM in the EMS KV with use of available and currently used technologies (computer and mobile phone), it is suggestive that the dominant direction of the development of TM assistance will be in lower urgency or diagnostic uncertainties.<br \/>\n<strong>Conclusion:<\/strong> Despite all technical limitations, TM can be considered a sub-discipline that, thanks to its dynamic development, will increasingly penetrate into the work of the PEC, either individually or systematically. Truly relevant data on patient\u00b4s outcomes from prospective and randomized studies are currently available, particularly in urgent cardiology and neurology. The general and wide interdisciplinary use of audiovisual consultations or TM assistances is technically easy to implement, but it is still a very unsystematic subject in which research questions, methodology and data collection need to be set for future direction.<\/p>\n<p><b>Key words: <\/b>telemedicine \u2013 telehealth \u2013 pre-hospital emergency care \u2013 telemedicine assistance<\/p>\n<p>&nbsp;<\/p>\n<p><b>\u00daLEVOV\u00c1 POLOHA P\u0158I DU\u0160NOSTI \u2013 CO N\u00c1M T\u00cdM PACIENT \u0158\u00cdK\u00c1?<\/b><\/p>\n<p><b>David Astapenko, Vladim\u00edr \u010cern\u00fd<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Du\u0161nost je subjektivn\u011b nep\u0159\u00edjemn\u00fd pocit dechov\u00e9 nedostate\u010dnosti, kter\u00fd vznik\u00e1 na podklad\u011b r\u016fzn\u00fdch patologick\u00fdch stav\u016f. V diferenci\u00e1ln\u00ed diagnostice m\u016f\u017ee napomoci tzv. \u00falevov\u00e1 poloha, kterou pacient spont\u00e1nn\u011b zauj\u00edm\u00e1, a kter\u00e1 m\u016f\u017ee do ur\u010dit\u00e9 m\u00edry reflektovat etiopatogenezi dan\u00e9ho stavu. V \u00falevov\u00e9 poloze pacient zapojuje pomocn\u00e9 d\u00fdchac\u00ed svaly, optimalizuje rozlo\u017een\u00ed ventilace a perfuze v plic\u00edch, m\u016f\u017ee zv\u00fd\u0161it \u017eiln\u00ed n\u00e1vrat a pln\u00edc\u00ed tlaky prav\u00e9ho srdce. Ortopnoe spojuje dekompenzaci mnoha chronick\u00fdch onemocn\u011bn\u00ed. Naproti tomu platypnoe je pom\u011brn\u011b vz\u00e1cn\u00fdm stavem, kter\u00fd umo\u017e\u0148uje nasm\u011brovat dal\u0161\u00ed diagnostiku.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>du\u0161nost \u2013 \u00falevov\u00e1 poloha \u2013 ortopnoe \u2013 platypnoe<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>RELIEF POSITION IN DYSPNEA \u2013 WHAT DOES PATIENT TELL US?<\/b><\/p>\n<p>Dyspnoea is a subjectively unpleasant feeling of breathing deficiency that can arise from a variety of pathological conditions. In the differential diagnosis, the so-called relief position, which the patient takes spontaneously, and which is related to pathogenesis can help. In the relief position the patient can optimally utilize the accessory respiratory muscles, the distribution of ventilation and perfusion in the lungs or increase venous return and right heart filling pressures. Orthopnoea links the decompensation of many chronic diseases. In contrast, platypnoe is a relatively rare condition that can guide us quite accurately in diagnosis.<\/p>\n<p><b>Key words: <\/b>dyspnoea \u2013 relief position \u2013 orthopnoea \u2013 platypnoea<\/p>\n<p>&nbsp;<\/p>\n<p><b>SYST\u00c9M VZD\u011aL\u00c1N\u00cd NA ZDRAVOTNICK\u00c9 Z\u00c1CHRANN\u00c9 SLU\u017dB\u011a HL. M. PRAHY<\/b><\/p>\n<p><b>David Pe\u0159an, Radom\u00edr Vlk, Petr Pavl\u00ed\u010dek, Jarmila Paukertov\u00e1, Dagmar Vyso\u010dansk\u00e1, Viktor Ba\u017eant, Jaroslav Pekara, Robert Tomka, Vladim\u00edr Nedv\u011bd, Radana Krtilov\u00e1, Petr Kolouch<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Vzd\u011bl\u00e1vac\u00ed a v\u00fdcvikov\u00e9 st\u0159edisko (VVS) Zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby hl. m. Prahy (ZZS HMP) organizuje a zaji\u0161\u0165uje vzd\u011bl\u00e1v\u00e1n\u00ed v\u0161ech zam\u011bstnanc\u016f ZZS HMP ve spolupr\u00e1ci s Person\u00e1ln\u00edm odd\u011blen\u00edm ZZS HMP. VVS se star\u00e1 o zam\u011bstnance od jejich v\u00fdb\u011bru, p\u0159es adapta\u010dn\u00ed proces, a\u017e po kontinu\u00e1ln\u00ed celo\u017eivotn\u00ed vzd\u011bl\u00e1v\u00e1n\u00ed, kter\u00e9 je rozd\u011bleno na vzd\u011bl\u00e1v\u00e1n\u00ed povinn\u00e9, rozvojov\u00e9 a voliteln\u00e9.<br \/>\nVVS buduje syst\u00e9m vzd\u011bl\u00e1v\u00e1n\u00ed podle modelu blended learning, co\u017e je sdru\u017een\u00e1 metoda vzd\u011bl\u00e1v\u00e1n\u00ed, kdy doch\u00e1z\u00ed ke kombinov\u00e1n\u00ed prezen\u010dn\u00ed formy v\u00fduky s formou distan\u010dn\u00ed, k \u010demu\u017e slou\u017e\u00ed vlastn\u00ed vzd\u011bl\u00e1vac\u00ed modul.<br \/>\n\u010cl\u00e1nek popisuje jednotliv\u00e9 \u010d\u00e1sti vzd\u011bl\u00e1v\u00e1n\u00ed a rovn\u011b\u017e p\u0159ehled v\u00fdstup\u016f vzd\u011bl\u00e1v\u00e1n\u00ed v letech 2016\u20132018.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>Vzd\u011bl\u00e1v\u00e1n\u00ed \u2013 blended learning \u2013 zdravotnick\u00e1 z\u00e1chrann\u00e1 slu\u017eba \u2013 vzd\u011bl\u00e1vac\u00ed a v\u00fdcvikov\u00e9 st\u0159edisko (VVS)<\/p>\n<p><b>Abstract <\/b><\/p>\n<p><b>EDUCATION AT PRAGUE EMERGENCY MEDICAL SERVICES<\/b><\/p>\n<p>Education and Training Centre (ETC) of the Prague Emergency Medical Services is with the Personal department responsible for the education of all employees of the organisation. ETC takes care of employees from their selection through the adaptation process to continuous lifelong learning, which is divided into compulsory, developmental and voluntary education.<br \/>\nETC builds an education system based on the blended learning model \u2013 a combined method of learning, combining a class room education and distance learning with a special virtual learning environment.<br \/>\nThe article describes different parts of education and presents data from the years 2016\u20132018.<\/p>\n<p><b>Key words: <\/b>Education \u2013 blended learning \u2013 emergency medical services \u2013 Education and Training Centre (ETC)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00daVOD \u00davodn\u00ed slovo \u2013 Jana \u0160eblov\u00e1 Obsah Mezin\u00e1rodn\u00ed redak\u010dn\u00ed rada URGENTN\u00cd P\u0158\u00cdJMY Non-adherence k terapii arteri\u00e1ln\u00ed hypertenze v kontextu urgentn\u00ed medic\u00edny \u2013 Marcel Nesvadba, Petr Bure\u0161, Alena Kohlov\u00e1, Patrik Christian Cmorej Pacient s bolest\u00ed b\u0159icha na urgentn\u00edm p\u0159\u00edjmu \u2013 Jana<\/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-913","post","type-post","status-publish","format-standard","hentry","category-rocnik-2019"],"_links":{"self":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/913","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=913"}],"version-history":[{"count":0,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/913\/revisions"}],"wp:attachment":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=913"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=913"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=913"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}