NEW Algorithms of the year 2021

Here we introduce new algorithms created in the academic year 2020/2021 within the subject Independent work at the Faculty of Medicine of Masaryk University. The nine-month process of creating 18 new interactive algorithms was attended by 27 students of the 4th to 6th years of study, supervised by 35 doctors. All algorithms have been reviewed by an expert in the field. Here you can find the first 16 algorithms, the last two of them are heading soon.

Czech version  

Cleft defects are the most common congenital malformations. The initial discovery is already possible with prenatal screening examination, and its finding is not an indication to terminate the pregnancy. Nowadays, the treatment possibilities allow us to unsure little-to-no handicap in adulthood. Surgical treatment and anaesthesiological approach for these defects have their own specifics. This algorithm will apprise the solver with course of treatment, will navigate the solver through perioperative management of each of the reconstructive procedures and will acquaint them with multidisciplinary approach.

31. 10. 2021 | Michaela Richtrová, MD, Prof. Petr Štourač, MD, PhD, Jana Šoltysová, Michal Reška

Regional anesthesia is progressively preferred method in anesthesiology. It provides patients with many advantages in both pre and postoperative period. One of the prerequisites for practicing regional anesthesia is a good knowledge of the area topography, work with ultrasound image, basic indications and contraindications for the specific nerve blocks and recognizing possible complications. The goal of this algorithm is to guide a participant through possibilities for regional anesthesia of the upper extremity and the dealing with possible complications.

31. 10. 2021 | Ivo Křikava, MD, PhD, Marta Juřeníková, MD, Jana Pastoreková, MD, Olha Ihnatenko

Ketoacidosis is an acute, life-threatening condition, which is caused by the presence of ketone bodies in the blood. The treatment has its specifics as well as drawbacks, the knowledge of which is essential for successful therapy. This algorithm is focusing on diabetic ketoacidosis, which occurs mostly in patients with type I diabetes; however, alcoholic ketoacidosis also exists, albeit being less common and having less acute progress. The algorithm introduces typical signs, carries through the therapy with a focus on addressing some of the common setbacks, and provides ways of preventing future similar conditions.

9. 8. 2021 | Hana Harazim, MD, PhD, Pavlína Přikrylová, Michal Reška

Benign prostatic hyperplasia is one of the most common benign tumors in men. Etiology of this condition is thought to be linked to hormonal imbalance and its prevalence increases with age. If pharmacotherapy fails, a surgical procedure is the next therapeutic step, most often a transurethral resection of the prostate (TURP). TURP syndrome is a serious and life-threatening complication of transurethral resection of the prostate. This algorithm aims to familiarize the solver with the pathophysiology, onset risk factors, clinical signs, diagnosis and treatment of this syndrome. At the end of this algorithm the solver should be aware that TURP syndrome can develop both during and after an uncomplicated TURP procedure.

9. 8. 2021 | Jitka Kotolová, MD, Petrana Relovská, MD, Soňa Řezníčková, Kateřina Popková

After a short theoretical introduction you will be able to recognise the basic artifacts and pathological situations on the capnographic waveform in total of 9 clinical cases. Among other you will be explained the significance of this method during the induction to general anaesthesia and cardiopulmonary resuscitation as well. After mastering this algorithm you can rely on this simple but important monitoring method during you clinical practice.

9. 8. 2021 | Vladislav Nezval, MD, Lucie Hajnová

The aim of algorithm is getting to know hemolytic-uremic syndrom, which is one of the most common causes of acute renal failure in childhood. We will look at its clinical manifestations, typical laboratory findings and we will describe two basic forms of this disease. Together we will also clarify the ethiology, pathogenesis, clinical course, treatment and prognosis of hemolytic-uremic syndrom.

9. 8. 2021 | Martina Klincová, MD, Lucie Štětková, MD, Adéla Kotíková, Hana Krobotová

In this algorithm you will learn about infections, which affect our most important belongings. Neuroinfections can be life-threatening conditions and despite all therapy can lead to lasting health problems. So how to recognize them on time? How to treat the patient? And can we prevent these infections? Dealing with our algorithm with fluffy patients you will find answers to all these questions and a lot of other interesting information.

9. 8. 2021 | Kateřina Matoušková, MD, Lucie Moťková, MD, Eliška Moráňová, Mabel Šterclová

Cholangitis (sometimes referred to as cholangoitis) is an inflammation of primarily the intrahepatic bile ducts. It is almost always associated with partial or complete obstruction of the bile ducts. The cause of obstruction may be choledocholithiasis, biliary strictures, primary sclerosing cholangoitis, congenital malformations or tumor obstruction of the bile ducts. Bile that stagnates in the ducts may then be infected with intestinal microorganisms (E. coli) and the process can then proceed intraparenchymatously, leading to multiple microabscesses in the liver and generalized sepsis, which is a life-threatening condition.

9. 8. 2021 | Jan Hudec, MD, Klára Fabiánková, MD, Nhat Linh Ngo, Kristína Slobodová

Structured passing of information about the patient and correctly doing patient handoff is very often considered marginal. However, the correct execution of these procedures significantly increases patient's safety and leads to better classification and passing on essential information. This algorithm aims to point out the possibilities of structured information pass on and safe patient handoff.

5. 6. 2021 | Martin Kutěj, MD, Hana Straková, MD, Karolína Lečbychová, MD, Markéta Bílená, MD, Tereza Ekrtová, MD, Vojtěch Jarkuliš, MD

Coronavirus Disease 2019 (COVID-19) is currently a global problem. Patients require specific care from initial treatment in emergency departments. Many patients with extensive bilateral pneumonia require hospitalization in the intensive care unit and are dependent on high-flow oxygen therapy. In some of them, despite all treatment, lung disease progresses to the form of acute respiratory distress syndrome with the need to be connected to mechanical lung ventilation. Adequate blood gas exchange often cannot be achieved by a protective setting of mechanical ventilation. Therefore, the physician must use the prone position and, in the most severe cases, also consider the extracorporeal membrane oxygenation support. The algorithm is divided into two parts, and the participant can decide whether he wants to take care of the patient with COVID-19 during emergency admission or play the role of an intensive care physician.

5. 6. 2021 | Olga Smékalová, MD, Kateřina Hadrabová, MD, Prof. Jan Beneš, MD, PhD

Acute abdomen refers to a heterogenous group of urgent conditions characterized by the sudden onset of severe abdominal pain. The spectrum of disease encompassed within this term may cause diagnostic difficulty, owing to the considerable diversity in the underlying etiology, which includes, among others, obstructive, inflammatory, vascular, infective, and gynecological processes. Infective intraabdominal processes in particular are a serious cause of mortality and present a unique clinical challenge due to the evolutionarily dynamic nature of the pathogens and the potential for progression of infection beyond the original infectious foci. As a result, diagnosis and management of patients with suspected intraabdominal infections is contingent on obtainment of a comprehensive history, structured evaluation, timely intervention, and prompt initiation of empiric therapy, followed by adjustments in antimicrobial therapy once the causative organism has been identified, if necessary.

5. 6. 2021 | Tamara Skříšovská, MD, Prof. Petr Štourač, MD, PhD, Hiroko Martin

Septic shock is a life threatening condition which needs quick intervention. The treatment and differential diagnosis of septic shock might appear to be quite challeging, but is essential for an optimal outcome for the patient. This algorithm will give a insight into the managment of septic shocks, the differential diagnosis, possible error sources in the diagnosis and characteristics of microbes, that cause shock.

5. 6. 2021 | Tamara Skříšovská, MD, Prof. Petr Štourač, MD, PhD, Madita Binder. Illustrations: Madita Binder

Research shows that 40 % to 60 % of children, especially of pre-school and early school age, experience anxiety and stress before a surgery requiring general anaesthesia. Subsequently, some of them show post-traumatic stress symptoms, which continue to affect the child’s overall condition, recovery, and compliance with any other medical care. Children under seven years of age are considered to be the most endangered group. Several preventive measures can be taken that reduce the risk of developing a post-traumatic stress response. This algorithm endeavours to draw healthcare professionals’ attention to the critical points of the entire procedure of preparing a child for the surgery under general anaesthesia in terms of psychology, that can help children better manage medical intervention.

5. 6. 2021 | Assoc. Prof. PhDr. Miroslav Světlák, PhD, Tereza Stepaková

Peripheral nerve block, as part of a multimodal approach to the treatment of pain, is already a standard part of anaesthesiology care not only in adults but also in pediatric patients. The basic condition for the implementation of peripheral blocks is a perfect knowledge of the topographic anatomy of the area, which together with the use of ultrasound methods allows to minimize possible risks. The aim of the algorithm is to approach the specifics of performing peripheral blockades in children. It shows the advantages that allow a small patient to access the stay in the operating room and in the postoperative period, with emphasis on the adequate effect of postoperative pain.

5. 6. 2021 | Assoc. Prof. Martina Kosinová, MD, PhD, Tereza Musilová, MD, Anna Hrazdírová, Tereza Štenclová

Burns are serious painful injuries. The severity of burn injury depends on the extent, location and the degree of burns. Therapy and subsequent recovery is long. The most common cause of burns in children is heat damage to the skin. This interactive algorithm will comprehensively guide you through all the steps of the treatment of burn injuries in children, from the first aid and pre-hospital care to the anaesthesiology and surgical care of a burnt child.

5. 6. 2021 | Eva Klabusayová, MD, Tereza Kramplová, MD, Alena Brančíková, Aneta Vomelová. Illustrations: Aneta Vomelová

Childbirth is a common part of human life and it can unfortunately be accompanied by complications of the mother or child. In our algorithm, we will look at the prolonged birth of twins, after which it will be necessary to evaluate the condition and decide on the transport of one of the children. Where to transfer a pathological newborn to be provided with adequate care? How to proceed in securing vital functions along the way? How to react to the deterioration of the condition? If you do not know the answers to these questions, we believe that after mastering our story, you will be prepared for such situations.

5. 6. 2021 | Martin Vavřina, MD, Martin Janků, MD, Kateřina Machanová, Tereza Urbánková

Animal bites are a common injury, especially in children. They have a wide scale from small scratches to amputations. Because of the risk of the infections, special care and treatment is needed, different than in any other injury. In our algorithm we focus on dog bites, because that is the most common case. Algorithm has two different branches describing a situation with both rabies vaccinated and non vaccinated dog.

5. 6. 2021 | Tereza Prokopová, MD, Aneta Mrkvičková, MD, Tereza Šiprová, Kateřina Šalandová

Pericardial tamponade is a serious life-threatening condition whose early recognition is crucial for the patient. Therefore when an unfortunate accident happens, it is possible that even a traditional hunting session becomes a battle for life. Pericardial tamponade is one of the so-called "4T" reversible causes of sudden cardiac arrest, and in this algorithm we will guide you through its differential diagnosis and therapy, from prehospital care to definitive hospital treatment.

5. 6. 2021 | Deana Slovjaková, MD, Jana Šimčíková, MD, Ivana Diešková, Tamás Komlósi