Operation of emergency medical service in selected regions of the Czech Republic following a mass disaster

The current system and working status of medical rescue service related to mass accidents has undergone changes in recent years, including gradual development, progress, modification and improvement. Together with that development, the conditions and opportunities needed for provision of timely and high-quality urgent pre-hospital care have transformed and improved automatically. The provision of professional pre-hospital urgent care for conditions endangering human life has been becoming the basic contents of activity of the rescue service. The care can be provided through operation centres that should receive and evaluate distress calls on line 155 and through field rescue vehicles pulling out of a network of trip points all over the country. The unification of the procedures and organization when settling mass accidents constitutes an indispensable measure leading to improvement of such interventions. The adequate procedure may lead to life rescue and to mitigation of the consequences of injuries for a number of persons equal to the number of the whole year of standard activity of the medical rescue service. Of course, the opposite may apply too. Therefore each physician or rescue worker should know the basic rules of behaviour at the point of the accident. The goal of the submitted dissertation is to map the general suggestions for the work of the medical rescue service of the Czech Republic, to analyze three medical rescue services related to mass accidents - that of the South Bohemian Region, the South Moravian Region and the Vysočina Region - and to compare weak and strong points of the medical rescue service of the Czech Republic based on the analysis of the three organizations in connection to mass accidents - of the Medical rescue service of the South Bohemian Region, the South Moravian Region and the Vysočina Region. Based on the SWOT analysis of selected medical rescue services, it was possible to identify their strengths and weaknesses, opportunities and threats. Each of the analyzed medical rescue services can see the opportunities of their respective organizations in other points. The medical rescue service of the South Bohemian Region sees its opportunities in the improvement of the education and training centre; the medical rescue service of the South Moravian Region sees its opportunities in the development of solution of mass accidents and the medical rescue service of the Vysočina Region sees its opportunities in finishing the urgent admission and first aid for schools; but all the analyzed medical rescue services see their threats in the expected lack of funds, caused by funding of new ambulances or new trip points or by increasing wages in the public sector. The lack of physicians in permanent employment is not only a matter of the above stated rescue services. The problem has countrywide character at present. The importance of the lack of physicians is not proportionally dependent only on cases of mass accidents. At present, it can be stated in general that there are multiple causes of lack of interest for internal work in rescue service. Low attractiveness of work in ambulance crews of rescue services becomes one of the main causes. Also the working conditions are usually incomparable. The crew of the rescue service must perform actions of pre-hospital urgent care in field under all and any circumstances. Another difference, as compared to the work of a physician in the hospital, consists in the need of right and quick decision-making without the opportunity to consult a specialist and without support of laboratory examinations. So the rescue service physician must constantly master different situations, from childbirth to post-mortem examination