Searching for ways to survive cardiac arrest and extracorporeal oxygen therapy - ECPR.

Modern cardiopulmonary resuscitation and its introduction into wide practice has more than sixty years of history. Despite all efforts to improve the original procedures and improve the results of care for patients with cardiac arrest, the basic recommendations and rules of modern emergency resuscitation remain practically the same as at the time of its inception. In recent years, in order to increase the number of patients surviving cardiac arrest, urgent resuscitation has been used in combination with the method of extracorporeal cardiopulmonary oxygenation (ECPR).

Palliative versus intensive care from the perspective of the medical rescue service.

According to surveys conducted over the last 10 years, more than 80 % of our population want to live with their loved ones at the end of life. With the ageing of the population and the success of medicine in the early stages of terminal illness, the trajectory and needs at the end of life are gradually changing. The need for health care support is increasing, and for most patients this means the need for 24/7 availability of health care, in this context in the home environment of the terminally ill patient.

[Fascia iliaca Block with General Anaesthesia vs. Subarachnoid Morphine Block in Total Hip Arthroplasty].

PURPOSE OF THE STUDY Many physicians believe that loco-regional anaesthesia and analgesia improve the postoperative course of patients indicated for total hip arthroplasty compared to general anaesthesia. However, there are many patients who refuse subarachnoid or epidural anaesthesia, or have contraindications or conditions making the use of such techniques impossible. An alternative option is the combination of general anaesthesia and a peripheral nerve blockade.

[Severe Head Injury in Childhood: the Importance of Early Offensive Therapy].

The case report presents the case of a five-year-old boy who fell off a scooter and sustained a blow to the left temporal region of his head. During a CT examination in the district hospital he suddenly showed a deterioration in the level of consciousness. Subsequent treatment along with transport to a specialized department were aimed at preventing secondary pathological changes and maintaining pressure-volume homeostasis of the brain.

Qualitative Research of Violent Incidents Toward Young Paramedics in the Czech Republic.

Introduction: Prehospital and emergency medical services (EMS) providers are usually the first to respond to an individual's urgent health needs, sometimes in emotionally charged circumstances. Because violence toward EMS providers in the Czech Republic is often overlooked and under-reported, we do not have a complete understanding of the extent of such violence, nor do we have recommendations from EMS professional organizations on how to resolve this problem in prehospital emergency medicine.

Methods: We conducted this study to explore the process of violence against EMS providers, using the Strauss/Corbin systematic approach of grounded theory to create a paradigm model.

Novel patterns of left ventricular mechanical activity during experimental cardiac arrest in pigs.

We conducted an experimental study to evaluate the presence of coordinated left ventricular mechanical myocardial activity (LVMA) in two types of experimentally induced cardiac arrest: ventricular fibrillation (VF) and pulseless electrical activity (PEA). Twenty anesthetized domestic pigs were randomized 1:1 either to induction of VF or PEA. They were left in nonresuscitated cardiac arrest until the cessation of LVMA and microcirculation.

The presence of gasping predicts long-term survival in out-of-hospital cardiac arrest patients.

Background: The presence of gasping in out-of-hospital cardiac arrest (OHCA) patients predicts short-term prognosis. We performed a retrospective study to evaluate whether the presence of gasping at the time of Emergency Medical Service (EMS) arrival in the case OHCA patients of presumed cardian origin has any impact on six-month survival and/or sustained return of spontaneous circulation (ROSC).

Methods: We collected and analyzed Utstein Style data for all patients resuscitated for OHCA of presumed cardiac origin by the EMS of the Central Bohemian Region from July 1, 2013 to June 30, 2014.

Circadian variation of cardiogenic pulmonary oedema.

Introduction: Circadian variation of in-hospital acute cardiogenic pulmonary oedema (CPE) with the highest occurrence in the early morning has been reported repeatedly. However, no study evaluating circadian variation of CPE in the field has been published. Therefore, we decided to evaluate the circadian variation of CPE in the Central Bohemian Region of the Czech Republic in the patients treated by regional emergency medical service (EMS) and analyse its association with baseline blood pressure in the field.

Intra-arrest formation of right-heart thrombi -- a case illustrated by real-time ultrasonography.

The presence of free-floating right-heart thrombus has been reported in a cardiac arrest patient in the periarrest period. Free-floating right atrial thrombus is a rare phenomenon seen in patients developing severe pulmonary embolism, and is associated with increased mortality. However, there have been no previously reported cases of right-heart thrombus formation during a resuscitated cardiac arrest.

Prehospital cooling by cold infusion: searching for the optimal infusion regimen.

Background: The cooling efficacy of intravenous administration of cold crystalloids can be enhanced by optimisation of the procedure. This study assessed the temperature stability of different application regimens of cold normal saline (NS) in simulated prehospital conditions.

Methods: Twelve different application regimens of 4 °C cold NS (volumes of 250, 500 and 1000 ml applied at infusion rates of 1000, 2000, 4000 and 6000 ml/h) were investigated for infusion temperature changes during administration to an artificial detention reservoir in simulated prehospital conditions.

The practice of therapeutic mild hypothermia in cardiac arrest survivors in the Czech republic.

Background: The proper performance of therapeutic mild hypothermia (TH) in cardiac arrest survivors is a prerequisite for achieving the best possible outcome. We analyzed the recent technical issues of in-hospital TH practices in the Czech Republic.

Methods: As the second project of the PRE-COOL (Pre-hospital Cooling in Cardiac Arrest Patients) working group, we compiled the directory of all non-surgical intensive care units (ICUs) in the Czech republic.

[Current cooling methods for induction of mild hypothermia in cardiac arrest survivors].

Induction of mild therapeutic hypothermia early after return of spontaneous circulation improves prognosis of cardiac arrest survivors. Rapid cooling of the patients and correct maintainance of the target therapeutic temperature followed by controlled slow rewarming can be achieved by several noninvasive and invasive methods of various efficacy. Elementary and the most frequently used methods are surface cooling via ice-packs and rapid intravenous administration of cold crystaloids.

[Knowledge level of cardiopulmonary resuscitation in secondary school students of non-medical specialisation in the Czech Republic].

Background: Knowledge of cardiopulmonary resuscitation (CPR) is essential part of the first aid skill. Constant attention is given to education in CPR mainly among adolescents. The aim of our epidemiological study was to asses the actual level of theoretical knowledge in CPR.

[Alcohol, unintentional injuries and violence against emergency health care workers].

Epidemiological data about unintentional injuries under the influence of alcohol are presented. Moreover, the violence against emergency health care workers in this country succeeds mainly the alcohol abuse. The taxation of alcoholic beverages should be increased.

[Adverse hemodynamic changes during laparoscopic cholecystectomy and their possible suppression with clonidine premedication. Comparison with intravenous and intramuscular premedication].

Laparoscopic cholecystectomies have adverse haemodynamic effects which limit their use in risk patients with heart disease. This applies in particular to significant hypertension. The etiology is analysed in detail in a review of the literature.

Diversity of metabolic patterns in human brain tumors: enzymes of energy metabolism and related metabolites and cofactors.

Biopsies from 15 human gliomas, five meningiomas, four Schwannomas, one medulloblastoma, and four normal brain areas were analyzed for 12 enzymes of energy metabolism and 12 related metabolites and cofactors. Samples, 0.01-0.