Algorithms of the year 2019

We are happy to present you 14 brand new interactive algorithms created by students of Faculty of Medicine together with doctors from educational portal AKUTNE.CZ, reviewed by specialists from all over the Czech Republic.

Czech version  

Carotid arterial atherosclerosis is a common cause of stroke. The internal carotid artery and the carotid bifurcation are the locations most frequently affected by carotid atherosclerosis. Carotid endarterectomy (CEA) is an established revascularization intervention that removes atherosclerotic plaque. In this algorithm, we will review the anaesthetic management of an elderly patient undergoing CEA, utilizing two possible options.

22. 5. 2019 | Veronika Tomášková, MD, Martin Helán, MD, PhD, Richard Bašista, Ondrej Bilec

Decompression sickness (also known as caisson disease) affects mainly divers, but may also affect airmen or astronauts. It is a very dangerous condition that can easily kill the person. In our algorithm, we focused on highlighting the various symptoms of decompression sickness, the importance of pre-hospital care, and the hyperbaric chamber. Furthermore, we want to familiarize the investigator with the indications and contraindications of therapy in the hyperbaric chamber. Although this is not a common disease in our country, anything can happen and you will find yourself in a situation where you will have to deal with decompression sickness.

22. 5. 2019 | Michal Vondráček, MD, Lenka Šrahulková, MD, Ľubica Joppeková, Martin Janků

The aim of this algorithm is to offer 2 difficult intubation situations in a paediatric patient. In the first case  it is possible to try a protocol for the unexpected difficult intubation. The second one in an expected difficult intubation. Step by step and you can go throught the procedure for these clinicaly truly important situations.

22. 5. 2019 | Tamara Skříšovská, MD, Alena Trčková, MD, Zuzana Fusková

Enhanced Recovery After Surgery (ERAS) is a multimodal, multidisciplinary, evidence-based approach to perioperative care. The purpose of the ERAS concept is to minimize complications related to the surgical procedure and early recovery of physiological functions, which results in reduced rates of morbidity, faster recovery and shorter length of stay in hospital. Interdisciplinary collaboration, especially anaesthesiologist, surgeon, nurse and physiotherapist, is essential.

22. 5. 2019 | Martina Kosinová, MD, PhD, Barbara Baloghová, Anežka Schreierová

Febrile seizures are a serious condition of children from 6 months to 5 years old. The occurrence of their uncomplicated form is more common. Other serious illnesses such as meningitis or epilepsy must be excluded in differential diagnosis. The diagnostic procedure contained in this algorithm serves to this purpose. Our algorithm emphasizes the correct diagnotics of the cause of the fever, the determination of the basic course of treatment in the acute phase and an adequate pharmacotherapy.

Other version of this algorithm: Febrile seizures - 2015
21. 5. 2019 | Prof. Petr Štourač, MD, PhD, Vladislav Nezval, MD, Gabriela Kubicová, Dalibor Zimek

Decreasing fertility of the population, related to the higher age of primigravidae among other thing, leads to the fact, that people more and more frequently turn to the assisted reproduction centers. Methods of in vitro fertilization nowadays help many infertile couple start a family. However, every intervention into the organism has an adverse effect. In the algorithm, we face the serious complication of pharmacological ovarian stimulation.

21. 5. 2019 | Jitka Chlupová, MD, Petr Zámečník, MD, Michal Matava, Barbara Szilárdyová. Illustrations: Romana Molitorová

Potassium is a main intracellular ion participating in maintaining intracellular tonicity, transmission of nerve impulses, renal functions and contractions of muscles. Disturbances of its plasmatic concentration are very common and serious problem in the intern medicine and belong between 4H/4T reversible causes of cardiac arrest. In this algorithm you will learn how to diagnose them with ECG and how to treat them efficiently. 

21. 5. 2019 | Tereza Prokopová, MD, Deana Slovjaková, MD, Kateřina Šalandová, Tereza Šiprová. Illustrations: Tereza Šiprová

Venous catheterization is one of the most basic skills necessary for providing any further health care. Due to lack of knowledge and experience the patient may be endangered both during the procedure itself and by incorrect decisions and following complications as well. Our algorithm deals with all three basic methods for obtaining a venous acces in a model situation, where those are used sequentially considering current indications and contraindications. Essential technical approaches are depicted in step-by-step description for each method. 

Other version of this algorithm: Serious head injuries - invasive monitoring, Traumatic life-threatening hemmorhage
21. 5. 2019 | Jan Hudec, MD, Kateřina Matoušková, MD, Tomáš Fecko, Katarína Figurová

The aim of Cardiac anesthesia algorithm is to point out specifics of this branch of anesthesia. The main one is ECC (extracorporeal circulation) during cardiac surgeries. Other specifics include open chest surgery, application of cardio-plegic solution, vascular graft harvesting, or placing epi-myocardial electrode.

21. 5. 2019 | Peter Kľúčovský, MD, Sabina Baumlová, Artem Fatkhutdinov

The management of anesthesia for non-obstetric surgery during pregnancy is not so common. However, this kind of an intervention includes some specifics that a capable anesthesiologist should know and also the risks he should have in mind and know how to prevent them or how to deal with them. This algorithm is supposed to show you how to proceed in this situation. It includes choice of anesthesia, anesthesia management, post-operative care, as well as right diagnosis and surgery indications. It marginally touches any complications associated with this intervention.

21. 5. 2019 | Prof. Petr Štourač, MD, PhD, Esther Cheng, MD, Lucia Šmahovská, Jakub Švec. Illustrations: Eliška Křížová

The therapy of post-operative pain is an important part of every surgical proccedure and with the development of therapeutic possibilities, the new, better and more effeicient ways such as the PCA pump are introduced.  

21. 5. 2019 | Ivo Křikava, MD, PhD, Matej Koštialik, Soňa Řezníčková

A number of external influences (traumas, chemical and biological effects, local disproportionate shear stress, friction and pressure, etc.) may lead to the deterioration of skin cover integrity, followed by impaired tissue repair and ulceration. A non-healing wound must always be seen as a symptom of another serious, often chronic, disease. The formation of the wound and its healing process is modified by several factors such as physiological skin againg, associated diseases, nutritional condition, pharmacotherapy, age and other. All these attributes are fulfilled with an algorithm for the prevention and treatment of decubitus ulcers.The algorithm published on the web portal represents an innovative educational material for healthcare professionals who are not primarily established specialists in the care of non-healing wounds. It helps to better understand the context of decubitus ulcers formation, which is needed not only for its treatment but also as prevention. I believe that this algorithm will be frequently visited and used by the web portal users.

21. 5. 2019 | Michaela Březovská, MSN

Sepsis is a life-threatening dysregulated response of the organism to an infectious stimulus that persists even after removal of this stimulus. Sepsis can occur very quickly and severely, under the picture of septic shock with multiorgan failure and the need for organ function support. Therefore, early recognition of this critical condition and early initiation of treatment should be considered. In treatment, emphasis is placed on initiating it within the first hour of suspected sepsis to maximize the patient's chances of recovery. 

Other version of this algorithm: Surviving sepsis
21. 5. 2019 | Marek Kovář, MD, Lucie Bánovská, Veronika Kočí. Illustrations: Veronika Kočí

Food or other foreign body aspiration represents a frequent life threatening condition, mainly in children under the age of 3, who already possess the ability of independent movement and use it to discover their surroundings. The management of these situations has a number of significant characteristics, from active expectoration support and eventual resuscitation to often necessary invasive intervention. How to perform the first aid and remove the foreigner body from the airway? With this algorithm, we invite you to experience a model situation that each of us can go through.

21. 5. 2019 | Martina Klincová, MD, Lucie Moťková, MD, Tereza Kramplová, Jozef Sklenka