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Posebnosti imobilizacije pri poškodbah vratne hrbtenice : pregled literature
ID Marković, Gordana (Author), ID Prestor, Jože (Mentor) More about this mentor... This link opens in a new window

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Abstract
IZVLEČEK Uvod: Najpogostejši vzroki za poškodbo vratne hrbtenice so padci z višine, prometne nesreče ter nesreče pri športnih dejavnostih. To so aktivnosti, pri katerih so najpogosteje prisotni mladi, zato so poškodbe vratne hrbtenice tudi velik javnozdravstveni problem. Poškodovanca s poškodbo vratne hrbtenice je treba ustrezno imobilizirati ter preprečiti tako nadaljnje poškodbe kot tudi negativne učinke imobilizacije. Namen: Namen diplomskega dela je na podlagi pregleda domače in tuje literature predstaviti indikacije in kontraindikacije za imobilizacijo vratne hrbtenice ter posebnosti pri imobilizaciji vratne hrbtenice. Metode dela: Uporabila sem deskriptivno metodo dela s pregledom domače in tuje strokovne ter znanstvene literature. Rezultati: Patološko premikanje poškodovane vratne hrbtenice lahko povzroči ali poslabša poškodbo hrbtenjače ali spinalnih živcev. Ravno strah pred posledicami sekundarnih poškodb je privedel do zlatega standarda imobilizacije vratne hrbtenice pri vsakem poškodovancu z najmanjšim sumom na poškodbo poškodbo vratne hrbtenice, čeprav so poškodbe slednje zelo redke. V zadnjem času pa je bilo narejenih več raziskav, ki niso naklonjene sistematični imobilizaciji, temveč podpirajo selektivni pristop pri imobilizaciji vratne hrbtenice. Kažejo namreč, da lahko imobilizacija negativno vpliva na zdravje pacienta in je lahko škodljiva. Najpogostejši zapleti, ki se pojavljajo pri imobilizaciji vratne hrbtenice, so: nelagodje, razjede zaradi pritiska, podaljšan čas obravnave pacienta na kraju dogodka, otežena učinkovita oskrba dihalne poti, možnost prikritja kliničnih znakov poslabšanja stanja pacienta, imobilizacija pa vpliva tudi na povišan intrakranialni tlak zaradi pritiska na jugularni veni, kar onemogoča normalen odtok krvi iz možganov. Imobilizacijo vratne hrbtenice v primeru penetrantnih poškodb povezujemo tudi z večjo umrljivostjo, kot je ta pri poškodovancih, ki niso bili imobilizirani. Razprava in sklep: V Sloveniji nam na področju predbolnišnične nujne medicinske pomoči manjkajo raziskave, ki bi z gotovostjo dokazale ustreznost ali neustreznost imobilizacije vratne hrbtenice s trdo vratno opornico ter zajemalnimi nosili, kljub temu pa bi morali po najnovejših smernicah pri imobilizaciji vratne hrbtenice bolj uporabljati selektivni pristop. Potrebujemo tudi lokalne smernice, ki bodo določale kriterije za imobilizacijo vratne hrbtenice, sredstva za imobilizacijo ter ustrezna pravila, kdo lahko imobilizacijo strokovno opravi.

Language:Slovenian
Keywords:vratna opornica, poškodba vratne hrbtenice, imobilizacija vratne hrbtenice
Work type:Bachelor thesis/paper
Organization:ZF - Faculty of Health Sciences
Year:2018
PID:20.500.12556/RUL-101381 This link opens in a new window
COBISS.SI-ID:5434731 This link opens in a new window
Publication date in RUL:31.05.2018
Views:1525
Downloads:356
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Secondary language

Language:English
Title:Specialties in cervical spine injury immobilisation : literature review
Abstract:
ABSTRACT Introduction: The most common causes of damage to the cervical spine are falls from height, traffic accidents and accidents in sport activities. These are the activities most often attended by young people and therefore damage to the cervical spine is also a major public health problem. Injured with damage to the cervical spine should be appropriately immobilized, to prevent further injuries as well as the negative effects of immobilization. Purpose: The purpose of the diploma work is to present indications and contraindications for the immobilization of the cervical spine and special features in the immobilization on the basis of a review of domestic and foreign literature. Methods: We used a descriptive metod of work with an overview of domestic and foreign professional and scientific literature. Results: The pathological movement of the damaged cervical spine can cause or worsen the damage of the spinal cord or spinal nerves. The fear of the consequences of secondary injuries led to the golden standard oft he cervical spine immobilization for each injured person, with the slightest suspicion of damage tot he cervical spine, although the damage of cervical spine is very rare. Recently, several studies have been done that are not favorable to systematic immobilization, but support a selective approach to immobilization of the cervical spine. Researches show that immobilization can have a negative impact on the patients health and can be harmful. The most common complications that occur in the immobilization oft he cervical spine are discomfort, ulcers, prolonged treatment time, ineffective respiratory care, the possibility of concealing the clinical signs of patients bad condition and also affects the increased intracranial pressure due to pressure jugular veins, which prevents the normal drainage of blood from the brain. Immobilization of the cervical spine is also associated with penetrant injuries with higher mortality compared to those who have not been immobilized. Discussion and conclusion: In Slovenia, in the field of prehospital emergency medicine, there is certainly no research that would confirm with certainty the adequacy or inadequacy of the cervical spine immobilizatio with collar and spine board , but nevertheless in the spirit of the most recent guidelines, a more selective approach to the immobilization of the cervical spine should be used. We also need guidelines for determining the criteria for, immobilization of the cervical spine, devices for immobilization and who can professionally stabilize the cervical spine.

Keywords:collar, cervical spine injury, cervical spine immobilization

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