Algorithms of the year 2014

We are happy to present you algorithms created by students of Faculty of Medicine together doctors from educational portal AKUTNE.CZ, reviewed by specialist from all over the Czech Republic.

Czech version 

Malignant hyperthermia is a rare life-threatening disease that is
characterised by pathologic hypermetabolic condition at the muscle tissue level. Susceptibility to MH is often inherited as an autosomal dominant disorder and the episode is triggered by esposure to certain drugs - succinylcholine and volatile anesthetic agents. It usually occurs during general anesthesia or within the first few hours of recovery from anesthesia.
In the following algorithm you will learn how to recognise MH episode and how to deal with such situation.

Other version of this algorithm: Malignant Hyperthermia - 2020
13. 9. 2014 | Lukáš Dadák, MD, PhD, Veronika Gulová, Eva Hoštáková

Pulmonary embolism is a life-threatening condition in which the main artery of the lung or one of its branches is blocked by a substance that is most commonly a blood clot. The blood clot is formed mainly in the deep veins of the legs or pelvis. Embolization is then the process of breaking off the thrombus from its origin and migrating to the lung. There are many patients affected by this condition and often it is not recognised properly. It is very important to be able to diagnose this condition and to cure it.

Other version of this algorithm: Pulmonary embolism II
13. 9. 2014 | Ivo Křikava, MD, PhD, Martin Minárik, Eva Mikulčíková

Pulmonary oedema is fluid accumulation in the lungs. It leads to impaired gas exchange and may cause respiratory failure. It is due to either failure of the heart to remove fluid from the lung circulation or a direct injury to the lung parenchyma. Treatment depends on the cause, but focuses on maximizing respiratory function and removing the cause. Terapy must be fast and intensive. This algorithm takes us through the situation from ensuring the patient in prehospital care until professional treatment and therapy in the hospital.

26. 8. 2014 | Ivo Křikava, MD, PhD, Markéta Kleinová, Lucie Jamborová

Laryngospasm is an acute life-threatening condition caused by reflex closure of the rima glotidis by the vocal cords. Presence of saliva, blood, stomach contents, supraglottic airway device and manipulation with laryngoscope in the hypopharynx in state of partial consciousness may contribute to the development of this condition. Laryngospasm occurs more often in children, young adults or in obese people during extubation procedure when the patient is not yet fully recovered from general anaesthesia. The following algorithm introduces a recommended management of severe laryngospasm.

2. 7. 2014 | Hana Harazim, MD, PhD, Monika Ďuricová, Jan Blahut

Difficult airway management is an urgent, life threatening situation, which is a nightmare of every anaesthesiologist. We can speak about difficult airway managent if we repeteadly cannot intubate or if it takes longer then 10 minutes. Difficult airway management it to be expected when the pacient has limited cervical spine movement, neck and face injury or in pregnancy.

Other version of this algorithm:
29. 6. 2014 | Lukáš Dadák, MD, PhD, Adéla Sotolářová, Karolina Steinerová

The wrong therapeutic approach in some cases of drug intoxication can cause worse consequences than the intoxication itself and therefore it is important to think of the drug intoxication in terms of differencial diagnosis. Our algorithm describes the diagnosis and possible solutions of complications caused by the intoxication with recreational drugs.

26. 6. 2014 | Roman Štoudek, MD, Ľubomíra Ventrčová-Longauerová, MD, Adrián Sahaj, Kristína Hübschová

Asthma is a chronic inflammatory disease of the airways that is associated with airway hyperresponsiveness and leads to recurrent episodes of dyspnea, wheezing, chest tightness and coughing. Acute asthma is a life-threatening condition requiring hospitalization. It responds badly to basic treatment. Because of the constantly increasing number of patients with asthma, it is important to know, how to deal with this difficult condition.¨

26. 6. 2014 | Roman Štoudek, MD, Martina Kosinová, MD, PhD, Mária Bačíková, Monika Bendíková

The Caesarean section is an operation, when the baby is delivered by a surgical way. There are many indications for this medical help. Our algorithm follows three types of anaesthesiology (general, epidural and spinal), which can be used, and the complications, which can come during the operation. Unpreparedness and insufficient help could be dangerous not just for the baby, but also for the patient.

26. 6. 2014 | Prof. Petr Štourač, MD, PhD, Tomáš Korbička, MD, Gabriela Matuščinová, Petra Polochová, Klára Svobodová

Life-threatening haemorrhage can be defined in many aspects: by extent of blood loss- loss of blood volume during 24 hours (in an adult of about 10 units of RBC transfusion) or a loss of 50% of blood volume during three hours or continuous blood loss of over 150 ml / min; by the presence of clinical and laboratory signs of tissue hypoperfusion or signs of organ functions failure. Sometimes bleeding is not associated with major blood loss, but it threatens the life by localization of bleeding to the regions important for maintaining vital functions (eg. CNS).

Other version of this algorithm: Life-threatening Bleeding - 2018
26. 6. 2014 | Olga Smékalová, MD, Michaela Vobrová, MD, Veronika Michalčinová, Zuzana Mišutková

Acid base balance is dynamic balance between the formation and elimination of sour and alkaline substances in organism. It is regulated very accurately which is necessary for the right course of a range of metabolic pathways and physiological processes. Disorders of acid base balance are always a complex problem where the whole internal environment of the patient is changing. The ability of timely recognition and of proper solution of those deviations is absolutely radical in clinical practice. Our algorithm is going to show you how to go about it.

25. 6. 2014 | Elena Krátka, MD, Vlastimil Koziel, Daniela Kozielová

Not every gravidity would end up with labor at term. During pregnancy there could be many complications, either with mother or child, that result in premature birth. One of these complications can be hypoxia of baby. In that case premature birth ends with delivering hypoxic baby with very low Apgar score. In Algorithm „Newborn resuscitation“ you can try what to do in such a situation.

25. 6. 2014 | Prof. Petr Štourač, MD, PhD, Ľubomíra Ventrčová-Longauerová, MD, Terezie Lásková, Hana Pulkrábková

Childhood is characterized by the occurrence of large amounts of infectious diseases, some of them even life-threatening. The occurrence of menacing acute epiglottitis in children was reduced by the introduction of vaccination against Haemofillus influenzae B and therefore it is far more frequent to encounter an obstruction of the upper airway caused by acute laryngitis. It starts suddenly from full health or follows catarrh of the upper respiratory tract. Most often occurs at night as inspiratory dyspnea with inspiratory stridor. Now you can learn how to deal with this serious clinical condition through our algorithm.

25. 6. 2014 | Hana Harazim, MD, PhD, Michaela Jelínková

Craniocerebral trauma is the most severe injury group, which is associated with high mortality and severe permanent consequences. At present, the frequency of brain and skull injury is increasing,it often occurs  as a part of a polytrauma. In our algorithm you will get familiar with direct acute brain injury and its treatment.

20. 12. 2011 | Prof. Petr Štourač, MD, PhD, Roman Štoudek, MD, Michal Izakovič, Vendula Štarhová, Kristýna Kopičková

Sepsis is systemic inflammatory response syndrome of organism caused by infection. It can easily extend to a stage of severe sepsis and septic shock with the signs of multiple organ dysfunction even failure requiring extensive organ functions´ support . Increasing number of septic patients revers to the fact that the amount of predisposed individuals in various ways is increasing: patients suffering from imunosupression, undergoing invasive diagnostic and therapeutic procedures. Early diagnose and immediate and accurate therapy is crucial.

Other version of this algorithm: Surviving sepsis - first hour
20. 12. 2011 | Elena Krátka, MD, Lukáš Breyer, MD, Jan Mayer, Marek Kovář, Marek Kubík