NEW interactive algorithms AKUTNĚ.CZ 2020 - vol.1

Dive in the algorithms from the clinical practise!

DAM in pregnancy

Petr Štourač, Marta Juřeníková, Olga Půčková, Ekaterina Fedyukina

Difficult airway management during pregnancy is a life-threatening situation not only for the mother but also for the fetus. In the third trimester of pregnancy, the risk of difficult airway management is ten times higher compared to the non-pregnant population. Therefore, difficult airway management should be recognised in time, it’s important to proceed quickly and to achieve adequate ventilation, otherwise there are serious consequences such as hypoxic brain injury, fetal or maternal death. This algorithm will give you a chance to deal with two situations of difficult airway management. We use different muscle relaxants in each situation.

Suspension syndrome

Deana Slovjaková, Tatiana Králiková, Tomáš Gyönyör

Whether performing high-altitude work or recreational and sport climbing activities, you may encounter the issue of suspension syndrome. It is a life-threatening situation characterized by syncope as a result of brain hypoperfusion, which can develop due to prolonged passive sitting in a harness. Resolving this algorithm, you will gain the knowledge of suspension syndrome prevention, which can be utilized by anyone in such a situation, as well as the knowledge of necessary steps in mountain rescue of two climbers, one conscious and one unconscious.

Malignant arrhytmia in child

Martina Kosinová, Tereza Musilová, Barbora Pitsmausová, Kateřina Popková

Malignant arrhythmias are disorders of a cardiac rhythm, which can lead to a cardiac arrest. They are usually developed in children due to hereditary syndromes like catecholaminergic polymorphic ventricular tachycardia or long QT syndrome. Unfortunately, up to 30 %, the first sign of this disease is a sudden cardiac arrest, which requires immediate intervention. Triggers of these acute states are common situations like higher physical activity, emotional burden, shock or even sleep.

Acetaminophen poisoining

Petr Štourač, Eva Klabusayová, Katarína Zubriková, Vladimír Kurák

Acetaminophen (Paracetamol) intoxication is a life-threatening condition leading potentially to hepatic failure. Acetaminophen has antipyretic and analgesic effect, it does not have anti-inflammatory effect. It is widely used by the general public in the form of over-the-counter medicines. Due to large number of different types and easy availability of drugs containing acetaminophen on the Czech market, accidental or intentional ingestion of a toxic dose may occur. One of these situations is shown by our algorithm.

Acute postoperative pain management- 2020

Ivo Křikava, Štěpán Janíček, Henrieta Hricová

Perioperative pain management and bridging to postoperative period is an important task and has a great impact on chronification of pain in the future. We present you revised algorithm using both paravertebral or epidural block in patient undergoing thoracotomy.
 

Delirium

Marek Kovář, Zuzana Timková, Richard Izák, Mária Štefíčková

Delirium is a life-threatening and highly underdiagnosed condition. It is a reaction of CNS to damage, manifested by a qualitative impairment of consciousness, decreased attention. Delirium usually starts suddenly in the evening and has a fluctuating course. It can have many causes: organic, toxic (caused by the administration of anticholinergics, dopaminergic antiparkinsonian drugs), and may be caused by withdrawal state as well (D. tremens). According to symptoms we distinguish hypoactive, hyperactive or mixed delirium.

MALA - metformin associated lactic acidosis

Jitka Chlupová, Barbora Pernová, Dominik Nedoma

Lactic acidosis is serious acid-base balance disorder, that can occur in patients on metformin therapy. Metformin is currently still one of the most used drugs in the treatment of the type 2 diabetes mellitus. Metformin is still one of the most commonly used drug in therapy of Diabettes Mellitus type 2. The aim of this algorithm is to encounter the solver with this condition and its correct therapy.

Anesthesia in lung pathologies

Veronika Tomášková, Kristýna Cahová, Vanda Hořínková

The educational algorithm Anesthesia in lung pathologies offers the possibility of solving two cases of different pulmonary diseases. Specifically, it is a patient with COPD and a patient with IPF, ie. a restrictive lung disease. The aim of the algorithm is to emphasize the importance of preoperative patient preparation and at the same time to point out possible complications and their subsequent solution, which may occur in patients with lung disease.

Hemodyamic monitoring 

Olga Smékalová, Jakub Kostka, Martina Růžičková, Kristina Šikulová, Tomáš Vobořil, Jan Beneš
 

Knowledge of hemodynamics is not the only domain of anesthesia. It is an integral part of almost all medical disciplines. In our algorithm, the investigator can try several possibilities of monitoring hemodynamics in anesthetized patient: non-invasive blood pressure measurement, continuous blood pressure measurement by invasive and non-invasive method, but also advanced monitoring by pulse contour analysis. It is necessary to realize that correct evaluation of the patient's physiological functions has a significant effect on his outcome, long-term hypotension increases risk of perioperative perioperative myocardial infarction, stroke and acute kidney injury; in contrast, fluid overload can cause pulmonary edema or heart failure.