Title ZBRINJAVANJE DIŠNOG PUTA I VASKULARNI PRISTUP KOD PACIJENATA TIJEKOM REANIMACIJE OD STRANE DJELATNIKA ZZHM PGŽ U 2017. GODINI
Title (english) AIRWAY MANAGEMENT AND VASCULAR APPROACHES IN PATIENTS DURING CARDIOPULMONARY RESUSCITATION THAT WAS EXECUTED BY STAFF OF INSTITUTE OF EMERGENCY OF PRIMORJE-GORSKI KOTAR COUNTY
Author Marin Vlašić
Mentor Vlatka Sotošek Tokmadžić (mentor)
Committee member Sandra Bošković (predsjednik povjerenstva)
Committee member Daniela Malnar (član povjerenstva)
Committee member Vlatka Sotošek Tokmadžić (član povjerenstva)
Granter University of Rijeka Faculty of Health Studies (Department of Clinical Sciences 2) Rijeka
Defense date and country 2018-09-19, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Anesthesiology and Reanimatology
Abstract UVOD: Zbrinut i osiguran dišni put, vanjska masaţa srca te osiguran vaskularni pristup kod pacijenata, čine temelj svake kardiopulmonalne reanimacije. Cilj ovog retrospektivnog istraţivanja bio je analizirati medicinske podatke bolesnika koji su doţivjeli kardijalni ili respiratorni arest tijekom 2017. godine u Zavodu za hitnu medicinu Primorsko-goranske ţupanije te su uslijed navedenog kardiopulmonalno reanimirani u izvanbolničkim uvjetima.
ISPITANICI I METODE: U ovom retrospektivnom
... More istraţivanju koristili su se medicinski podaci bolesnika, dobiveni iz medicinske dokumentacije Zavoda za hitnu medicinu Primorsko-goranske ţupanije. Istraţivanjem su se analizirali medicinski podaci ukupno 855 bolesnika u 2017. godini u Zavodu za hitnu medicinu Primorsko-goranske ţupanije. Medicinski podaci koji su se analizirali bili su: zdravstveno stanje pacijenta, dob i spol pacijenata koji su doţivjeli kardijalni ili respiratorni arest te su uslijed istog kardiopulmonalno reanimirani, medicinska pomagala koja su korištena za zbrinjavanje i osiguravanje dišnog puta tijekom kardiopulmonalne reanimacije, način kako je osiguran vaskularni pristup tijekom kardiopulmonalne reanimacije te učestalost intravenskog u odnosu na intraosealni pristup u kardiopulmonalnoj reanimaciji. Medicinska dokumentacija koja se analizirala je Dokumentacijski list hitnog slučaja, pohranjen u sustavu hitne medicine koji se zove eHitna.
REZULTATI: Od 855 bolesnika koji su doţivjeli kardijalni ili respiratorni arest u izvanbolničkim uvjetima, 268 (31,3 %) je kardiopulmonalno reanimirano. Kod 587 (68,7 %) pacijenata KPR se nije provodila. Od 268 kardiopulmonalno reanimiranih pacijenata, kod 56 (20,9 %) je došlo do povratka spontane cirkulacije (eng. ROSC) te transporta do Kliničkog bolničkog centra Rijeka. Kod 212 (79,1 %) pacijenata nije došlo do povratka spontane cirkulacije (eng. ROSC) te je proglašena smrt. Od 855 pacijenata, 350 pacijenata su muškarci dobne skupine 65 godina i više, a 278 su pacijentice dobne skupine 65 godina i više. Od 268 kardiopulmonalno reanimiranih pacijenata, kod 182 dišni put je zbrinut i osiguran i-gelom. Ukupan trošak medicinskih pomagala za zbrinjavanje i osiguravanje dišnog puta tijekom kardiopulmonalne reanimacije za 2017. godinu u ispostavama Zavoda za hitnu medicinu Primorsko-goranske ţupanije iznosio je 20.995,44 kuna. Najviše sredstava utrošeno je za nabavu i-gela veličine 4 u iznosu od 20.412,00 kuna. Kod 237 pacijenata osiguran je intravenski pristup, dok je kod 15 pacijenata osiguran intraosealni pristup tijekom kariopulmonalne reanimacije. Kod 16 pacijenata vaskularni pristup nije bio osiguran.
ZAKLJUĈAK: Dobiveni rezultati govore u prilog slabog uspjeha kardiopulmonalne reanimacije u izvanbolničkim uvjetima. Razlozi tako slabog uspjeha su mnogi: neprovoĎenje osnovnih mjera odrţavanja ţivota do dolaska tima izvanbolničke HMP, udaljenost pacijenta, manjak kompetencija i vještina timova izvanbolničke HMP, povijest bolesti pacijenta, uzroci kardijalnog/respiratornog aresta, itd. Less
Abstract (english) Introduction: An airway that has been safely secured, external heart massage and a secured vascular approach in patients are the foundation of every cardiopulmonary resuscitation. The goal of this retrospective research was to analyse medical data of patients who have had a cardiac or respiratory arrest during 2017 at the Institute of emergency of Primorje-Gorski Kotar County, and were cardiopulmonary resuscitated in out-of-hospital conditions.
Subjects and methods: In this
... More retrospective research, medical data of patients were used that were attained from the medical documentation of the Institute of emergency of Primorje-Gorski Kotar County. The research analysed the medical data of a total of 855 patients in 2017 at the Institute of emergency of Primorje-Gorski Kotar County. The medical data analysed were: a patient’s health condition, age and sex of patients who had had a cardiac or respiratory arrest and were cardiopulmonary resuscitated, the way in which the vascular approach was secured during the cardiopulmonary resuscitation, and the frequency of the intravenous approach in relation to the intraosseous approach during cardiopulmonary resuscitation. The medical documentation that was analysed was the Emergency documentation form that is stored in a system of emergency medicine called eHitna.
Results: Out of 855 patients that had an out-of-hospital cardiac or respiratory arrest, 268 (31,3 %) were cardiopulmonary resuscitated. 587 patients (68,7 %) were not cardiopulmonary resuscitated. Out of 268 cardiopulmonary resuscitated patients, 56 (20,9 %) experienced a return of spontaneous circulation (ROSC) and were transported to the Clinical Hospital Centre of Rijeka. 212 patients (79,1 %) did not experience a return of spontaneous circulation (ROSC) and were pronounced dead. Out of 855 patients, 350 were male patients aged 65 or older, a 278 were female patients aged 65 or older. Out of 268 cardiopulmonary resuscitated patients, in 182 patients the airway was safely secured using i-gel. The total cost of medical equipment used for securing the airway during cardiopulmonary resuscitation in 2017 in all the subsidiaries of the Institute of emergency of Primorje-Gorski Kotar County was 20,995.44 kn. The most resources were spent on procurement of the i-gel size 4, which cost 20,412.00 kn. During cardiopulmonary resuscitation, an intravenous approach was secured in 237 patients, and an intraosseous approach was secured in 15 patients. A vascular approach was not secured in 16 patients.
Conclusion: The obtained results confirm the low likelihood of success of out-of-hospital cardiopulmonary resuscitation. The reasons for this are several: failing to follow the basic life support measures until the arrival of the out-of-hospital emergency medical team, the patient’s distance, the lack of competence and skills of out-of-hospital emergency medical teams, the patient’s medical history, the causes of cardiac/respiratory arrests, etc. Less
Keywords
dob
endotrahealni tubus
i-gel
intraosealni pristup
intravenska kanila
kardiopulmonalna reanimacija
spol
Keywords (english)
age
endotracheal tube
i-gel
intraosseous approach
intravenous cannula
cardiopulmonary resuscitation
sex.
Language croatian
URN:NBN urn:nbn:hr:184:739747
Study programme Title: Graduate university study of Nursing: Healthcare Management (Biomedicine and Healthcare; clinical medical sciences) Study programme type: university Study level: graduate Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Access restricted to students and staff of home institution
Terms of use
Created on 2018-12-11 14:36:20