{"id":2081,"date":"2026-07-13T15:26:57","date_gmt":"2026-07-13T13:26:57","guid":{"rendered":"https:\/\/www.angryowl.lt\/uncategorized\/co-ukazuje-vyzkum-a-co-byste-meli-vedet-pri-pouzivani-skrtidla\/"},"modified":"2026-10-13T07:28:44","modified_gmt":"2026-10-13T05:28:44","slug":"co-ukazuje-vyzkum-a-co-byste-meli-vedet-pri-pouzivani-skrtidla","status":"publish","type":"post","link":"https:\/\/www.angryowl.lt\/cs\/uncategorized-cs\/co-ukazuje-vyzkum-a-co-byste-meli-vedet-pri-pouzivani-skrtidla\/","title":{"rendered":"Co ukazuje v\u00fdzkum \u2014 a co byste m\u011bli v\u011bd\u011bt p\u0159i pou\u017e\u00edv\u00e1n\u00ed \u0161krtidla"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">\u0160krtidlo je p\u0159ilo\u017eeno, vratidlo oto\u010deno a zaji\u0161t\u011bno. Zven\u010d\u00ed vypad\u00e1 v\u0161e spr\u00e1vn\u011b \u2014 krv\u00e1cen\u00ed v\u0161ak pokra\u010duje a perifern\u00ed puls je st\u00e1le hmatn\u00fd. Tato situace se neust\u00e1le opakuje p\u0159i v\u00fdcviku i ve v\u00fdzkumu a jej\u00ed p\u0159\u00ed\u010dina b\u00fdv\u00e1 stejn\u00e1: chyba vznikla je\u0161t\u011b p\u0159edt\u00edm, ne\u017e se v\u016fbec za\u010dalo utahovat.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B\u011b\u017en\u011b se p\u0159edpokl\u00e1d\u00e1, \u017ee ne\u00fasp\u011b\u0161n\u00e9 p\u0159ilo\u017een\u00ed \u0161krtidla je zp\u016fsobeno p\u0159\u00edli\u0161 mal\u00fdm po\u010dtem ot\u00e1\u010dek vratidla. V\u00fdzkum ukazuje, \u017ee nej\u010dast\u011bj\u0161\u00edm probl\u00e9mem je popruh, kter\u00fd nebyl p\u0159i p\u0159ikl\u00e1d\u00e1n\u00ed \u0161krtidla dostate\u010dn\u011b uta\u017een. Zb\u00fdvaj\u00edc\u00ed v\u016fle vypad\u00e1 jako drobn\u00fd detail, kter\u00fd lze odstranit ot\u00e1\u010den\u00edm vratidla \u2014 ale pr\u00e1v\u011b to \u010dasto rozhoduje o tom, zda bude \u0161krtidlo spr\u00e1vn\u011b fungovat.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Kam se ztr\u00e1c\u00ed tlak<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Utahovac\u00ed s\u00edla vratidla a vnit\u0159n\u00edho p\u00e1su je omezen\u00e1. Kdy\u017e popruh t\u011bsn\u011b p\u0159il\u00e9h\u00e1 ke kon\u010detin\u011b je\u0161t\u011b p\u0159ed zah\u00e1jen\u00edm utahov\u00e1n\u00ed, ka\u017ed\u00e1 ot\u00e1\u010dka vratidla zvy\u0161uje tlak. Kdy\u017e je popruh voln\u00fd, prvn\u00ed ot\u00e1\u010dky vratidla nevytvo\u0159\u00ed \u017e\u00e1dn\u00fd tlak \u2014 pouze vyberou v\u016fli.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">V tom je z\u00e1sadn\u00ed rozd\u00edl. Vratidlo nakonec vykon\u00e1v\u00e1 pr\u00e1ci, kterou m\u011bla ud\u011blat ruka, a jeho s\u00edla u\u017e nemus\u00ed sta\u010dit na v\u00fdsledn\u00fd tlak. T\u00edm vznik\u00e1 riziko: krv\u00e1cen\u00ed se zastav\u00ed pomaleji, ztrat\u00ed se v\u00edce krve a v nejhor\u0161\u00edm p\u0159\u00edpad\u011b nedojde k uz\u00e1v\u011bru tepny v\u016fbec \u2014 p\u0159esto\u017ee se u\u017eivateli zd\u00e1, \u017ee v\u0161e ud\u011blal podle p\u0159\u00edru\u010dky.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Co zjistily studie<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Studie Polstona a koleg\u016f \u201eNo Slackers in Tourniquet Use&#8220; (2013) uk\u00e1zala, \u017ee nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou nespr\u00e1vn\u00e9ho uta\u017een\u00ed \u0161krtidla nebylo nedostate\u010dn\u011b oto\u010den\u00e9 vratidlo, ale v\u016fle ponechan\u00e1 v popruhu p\u0159ed zah\u00e1jen\u00edm utahov\u00e1n\u00ed. Pokusy odstranit ji siln\u011bj\u0161\u00edm ot\u00e1\u010den\u00edm vratidla \u010dasto nevedly k tlaku pot\u0159ebn\u00e9mu k uzav\u0159en\u00ed tepny. Naopak dob\u0159e napnut\u00fd popruh umo\u017enil zastavit krv\u00e1cen\u00ed rychleji \u2014 ot\u00e1\u010dky vratidla se p\u0159\u00edmo m\u011bnily v tlak.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Baruch a kolegov\u00e9 (2017), kte\u0159\u00ed zkoumali u\u017eivatele \u0161krtidel bez zdravotnick\u00e9ho vzd\u011bl\u00e1n\u00ed, popsali nesoulad mezi sebed\u016fv\u011brou a skute\u010dnou schopnost\u00ed: \u00fa\u010dastn\u00edci byli p\u0159esv\u011bd\u010deni, \u017ee \u0161krtidlo p\u0159ilo\u017eili spr\u00e1vn\u011b, p\u0159esto\u017ee objektivn\u011b nefungovalo. Tato chyba se net\u00fdk\u00e1 jen za\u010d\u00e1te\u010dn\u00edk\u016f \u2014 d\u011blaj\u00ed ji i zku\u0161en\u00ed u\u017eivatel\u00e9, zejm\u00e9na pod stresem, ve tm\u011b nebo v rukavic\u00edch.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pr\u00e1ce Kragha a koleg\u016f, v\u010detn\u011b anal\u00fdzy \u0161krtidel z\u00edskan\u00fdch z operac\u00ed Enduring Freedom a New Dawn (2013), podporuje stejn\u00fd celkov\u00fd z\u00e1v\u011br: a\u010dkoli auto\u0159i pou\u017eili r\u016fzn\u00e9 metody a hodnotili r\u016fzn\u00e9 modely \u0161krtidel, o \u00fa\u010dinnosti \u010dast\u011bji rozhodoval nikoli po\u010det ot\u00e1\u010dek, ale napnut\u00ed popruhu p\u0159ed zah\u00e1jen\u00edm ot\u00e1\u010den\u00ed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Praktick\u00e9 z\u00e1v\u011bry<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">P\u0159i v\u00fduce pou\u017eit\u00ed \u0161krtidla by d\u016fraz nem\u011bl b\u00fdt kladen na po\u010det ot\u00e1\u010dek vratidla, ale na sled \u00fakon\u016f a na v\u00fdsledek. Po\u010det ot\u00e1\u010dek se p\u0159irozen\u011b li\u0161\u00ed podle obvodu kon\u010detiny a napnut\u00ed popruhu, tak\u017ee existuje jedin\u00e9 spolehliv\u00e9 krit\u00e9rium: krv\u00e1cen\u00ed se zastavilo a perifern\u00ed puls vymizel.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pokud vratidlo vy\u017eaduje neobvykle vysok\u00fd po\u010det ot\u00e1\u010dek nebo se ot\u00e1\u010d\u00ed jen velmi obt\u00ed\u017en\u011b, prvn\u00ed v\u011bc, kterou je t\u0159eba zkontrolovat, je napnut\u00ed popruhu \u2014 nikoli vyvinout v\u011bt\u0161\u00ed s\u00edlu. P\u0159\u00edm\u00fd v\u00fdzkum k tomuto t\u00e9matu neexistuje, ale je pravd\u011bpodobn\u00e9, \u017ee voln\u00fd popruh zvy\u0161uje i riziko mechanick\u00e9ho selh\u00e1n\u00ed: kdy\u017e se zdvih vratidla spot\u0159ebuje na vybr\u00e1n\u00ed v\u016fle, je mechanismus zat\u00ed\u017een nad r\u00e1mec toho, s \u010d\u00edm konstrukce po\u010d\u00edt\u00e1.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Praktick\u00e1 doporu\u010den\u00ed:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Popruh ut\u00e1hn\u011bte co nejv\u00edce a zajist\u011bte jej \u2014 v\u016fle v popruhu se nikdy nesm\u00ed kompenzovat na \u00fakor vratidla.<\/li>\n\n\n\n<li>Posuzujte celkov\u00fd v\u00fdsledek, ne po\u010det ot\u00e1\u010dek vratidla.<\/li>\n\n\n\n<li>Ot\u00e1\u010d\u00ed se vratidlo p\u0159\u00edli\u0161 ztuha nebo p\u0159\u00edli\u0161 dlouho? Zkontrolujte napnut\u00ed popruhu.<\/li>\n\n\n\n<li>Tr\u00e9nujte pravideln\u011b pod dohledem instruktora \u2014 tuto chybu si u\u017eivatel\u00e9 sami jen z\u0159\u00eddka v\u0161imnou.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Z\u00e1v\u011br<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">O \u00fasp\u011bchu \u0161krtidla se rozhoduje d\u0159\u00edve, ne\u017e si v\u011bt\u0161ina lid\u00ed mysl\u00ed \u2014 ve chv\u00edli, kdy se popruh obt\u00e1\u010d\u00ed kolem kon\u010detiny. Popruh napnut\u00fd na maximum umo\u017e\u0148uje vyu\u017e\u00edt celou s\u00edlu vratidla k vytvo\u0159en\u00ed tlaku, m\u00edsto aby se promrhala na vyb\u00edr\u00e1n\u00ed v\u016fle.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Nejprve ut\u00e1hnout. Teprve potom ot\u00e1\u010det.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Zdroje<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Polston RW, Clumpner BR, Kragh JF Jr, Jones JA, Dubick MA, Billings S. No Slackers in Tourniquet Use to Stop Bleeding. J Spec Oper Med. 2013;13(2):12\u201319. PMID: 23817873.<\/li>\n\n\n\n<li>Baruch EN, Kragh JF Jr, Berg AL, Aden JK, Benov A, Shina A, et al. Confidence\u2013competence mismatch and reasons for failure of non-medical tourniquet users. Prehosp Emerg Care. 2017;21(1):39\u201345. doi:10.1080\/10903127.2016.1209261<\/li>\n\n\n\n<li>Altamirano MP, Kragh JF Jr, Aden JK, Dubick MA. Role of the windlass in improvised tourniquet use on a manikin hemorrhage model. J Spec Oper Med. 2015;15(2):42\u201346.<\/li>\n\n\n\n<li>Kragh JF Jr, Burrows S, Wasner C, Ritter BA, Mazuchowski EL, Brunstetter T, et al. Analysis of recovered tourniquets from casualties of Operation Enduring Freedom and Operation New Dawn. Mil Med. 2013;178(7):806\u2013810.<\/li>\n\n\n\n<li>Kragh JF Jr, Walters TJ, Baer DG, Fox CJ, Wade CE, Salinas J, et al. Practical use of emergency tourniquets to stop bleeding in major limb trauma. J Trauma. 2008.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>\u0160krtidlo je p\u0159ilo\u017eeno, vratidlo oto\u010deno a zaji\u0161t\u011bno. Zven\u010d\u00ed vypad\u00e1 v\u0161e spr\u00e1vn\u011b \u2014 krv\u00e1cen\u00ed v\u0161ak pokra\u010duje a perifern\u00ed puls je st\u00e1le hmatn\u00fd. Tato situace se neust\u00e1le opakuje p\u0159i v\u00fdcviku i ve v\u00fdzkumu a jej\u00ed p\u0159\u00ed\u010dina b\u00fdv\u00e1 stejn\u00e1: chyba vznikla je\u0161t\u011b p\u0159edt\u00edm, ne\u017e se v\u016fbec za\u010dalo utahovat. B\u011b\u017en\u011b se p\u0159edpokl\u00e1d\u00e1, \u017ee ne\u00fasp\u011b\u0161n\u00e9 p\u0159ilo\u017een\u00ed \u0161krtidla je zp\u016fsobeno p\u0159\u00edli\u0161 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2919,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2081","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/posts\/2081","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/comments?post=2081"}],"version-history":[{"count":1,"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/posts\/2081\/revisions"}],"predecessor-version":[{"id":3327,"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/posts\/2081\/revisions\/3327"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/media\/2919"}],"wp:attachment":[{"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/media?parent=2081"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/categories?post=2081"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.angryowl.lt\/cs\/wp-json\/wp\/v2\/tags?post=2081"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}