| Abstract | CILJ: Cilj završnog rada je prikazati složenost zbrinjavanja politraumatiziranog bolesnika, kao i aktivnosti
medicinske sestre pri prijemu životno ugroženog bolesnika. U radu će biti prikazan slučaj
politraumatiziranog bolesnika od dolaska na Objedinjeni hitni bolnički prijem, zbrinjavanje u sobi za
reanimaciju, pratnja na radiološke dijagnostičke pretrage te aktivnosti medicinske sestre u operacijskoj
dvorani.
RASPRAVA: Bolesnik K.Š. dovezen na OHBP kao sudionik prometne nesreće, u ulozi vozača. Po prijemu
spojen na kontinuirani monitoring: RR niži, 100/60 mmHg, puls ubrzan 105 o/min, disanje plitko i ubrzano
23 u/min, SpO2 92%, uzeti uzorci krvi, urina te uzorak krvi za KG. Po dolasku somnolentan, na poziv
otvara oči, reagira na bolni podražaj, GCS 11. Pri dolasku politraumatiziranog bolesnika na OHBP u
reanimacijsku salu započinje primarni pregled bolesnika s ciljem identifikacije stanja koja neposredno
ugrožavaju bolesnikov život. Aktivnosti medicinske sestre uključuju: monitoring vitalnih funkcija,
neinvazivno mjerenje krvnog tlaka, mjerenje pulsne oksimetrije, EKG monitoring, postavljanje venskog
puta, uzorkovanje krvi i urina, pratnja na dijagnostičju obradu uz kontinuirani monitoring. Po završetku
radiološke obrade bolesnika se odvozi u operacijsku dvoranu te se pristupa operacijskom zahvatu.
Aktivnosti medicinske sestre u operacijskoj dvorani uključuju brzinu i spretnost jer je u kratko vrijeme
potrebno izvršiti niz popstupaka kako bi se operacijski zahvat nesmetano odvijao. Te aktivosti uključuju:
postavljanje dodatnih venskih puteva, priprema anesteziloškog uređaja, pribora, opreme i lijekova za
endotrahealnu intubaciju, asistenciju pri postavljanje invazivnog monitoringa (arterijska kanila i CVK),
uzimanje uzoraka krvi za analizu tijekom operacijskog zahvata.
ZAKLJUČAK: Multidisciplinarni pristup politraumatiziranom bolesniku uključuje brojne specijalnosti, a
uloga medicinske sestre u ovom je timu neizostavna. Kontinuirana edukacija, dobra komunikacija i izražene
vještine važne su karakteristike za kvalitetno zbrinjavanje vitano ugroženog bolesnika. |
| Abstract (english) | AIM OF THE PAPER: The aim of the final paper is to show the complexity of caring for a
polytraumatized patient, as well as the nurse's activities when receiving a life-threatening patient. The paper
will present the case of a polytraumatized patient from the time he arrived at the Emergency service,
treatment in the resuscitation room, accompanying him to diagnostic tests and the activities of the nurse in
the operating room.
DISCUSSION: Patient K.Š. brought to Emergency service as a participant in a traffic accident, driver.
Upon admission connected to continuous monitoring: RR lower, 100/60 mmHg, pulse accelerated 105
r/min, breathing shallow and accelerated 23 r/min, SpO2 92%, laboratory tests taken, urine sample, as well
as sample for blood type. Upon arrival, he is somnolent, opens his eyes when called, reacts to a painful
stimulus, GCS 11. When a polytraumatized patient arrives at the OHBP in the resuscitation room, the
primary examination of the patient begins with the aim of identifying conditions that directly threaten the
patient's life. The nurse's activities include: monitoring of vital functions, non-invasive blood pressure
measurement, pulse oximetry measurement, EKG monitoring, venous line placement, blood and urine
sampling, accompaniment to diagnostic processing with continuous monitoring. At the end of the
radiological treatment, the patient is taken to the operating room and the surgical procedure is started. The
activities of the nurse in the operating room include promptness and dexterity, as a series of procedures
must be performed in a short time in order for the operation to proceed smoothly. These activities include:
setting up additional venous lines, preparation of anesthesiology device, accessories, equipment and drugs
for endotracheal intubation, assistance in setting up invasive monitoring (arterial cannula and CVC), taking
blood samples for analysis during surgery.
CONCLUSION: A multidisciplinary approach to a polytraumatized patient includes numerous specialties,
and the role of the nurse in this team is indispensable. Continuous education, good communication and
expressed skills are important characteristics for quality care of a critically endangered patient. |
