Vloga medicinske sestre pri obravnavi pacienta z zmečkaninskim sindromom : diplomsko delo

Veselič, Tina (author), Sotler, Robert (mentor), Kramar, Janez (comentor), Prestor, Jože (reviewer)

Uvod: crush poškodbe se pojavljajo pri naravnih nesrečah in nesrečah, ki so posledica človeškega delovanja. Zmečkaninski sindrom je posledica dolgotrajnega pritiska večje sile na del telesa z veliko mišično maso. Pri tem pride do razpada mišic oziroma rabdomiolize, ki povzroči prehod znotraj celičnih komponent v krvni obtok. Namen: namen diplomskega dela je s pregledom literature opisati zmečkaninski sindrom in vlogo medicinske sestre pri obravnavi pacienta izven bolnišničnega okolja. Metode dela: uporabili smo deskriptivno metodo dela s sistematičnim pregledom domače in tuje literature. Za iskanje literature smo uporabili iskalnike PubMed, GoogleScholar in DiKUL ter podatkovne baze MedLine, CINAHL in Cochrane Library. Uporabili smo recenzirane članke s prosto dostopnim celotnim besedilom, ki so bili objavljeni med letoma 2010 in 2019. Rezultati: poškodovanci sprva ne kažejo znakov prizadetosti. Njihovo zdravstveno stanje se nato hitro spremeni. Zaradi redkosti pojava zmečkaninskega sindroma imajo reševalci lahko težave pri prepoznavanju. Ob oteženem reševanju ekipe nujne medicinske pomoči za pomoč prosijo druge službe, ki s tehničnim reševanjem omogočijo hitrejšo oskrbo poškodovancev. Pristop in obravnava poškodovanca potekata po algoritmu ITLS. Najustreznejši ukrep pri obravnavi zmečkaninskega sindroma je nadomeščanje tekočin. Razprava: obravnava poškodovanca se naj začne takoj, ko je pristop varen. Upoštevanje algoritma ITLS omogoči hitrejši proces dela in sistematičnost oskrbe. Čeprav točno določenega protokola za nadomeščanje tekočin ni na voljo, ta ukrep zmanjšuje pojavnost ledvične odpovedi in umrljivost. Zaključek: redkost pojava zmečkaninskega sindroma zahteva dodatno izobraževanje zdravstvenega kadra o redkih nujnih stanjih.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, zmečkaninski sindrom, crush poškodba, utesnitveni sindrom, rabdomioliza
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [T. Veselič]
• Year: 2020
• Number of pages: 29 str.
• PID: 20.500.12556/RUL-116727
• UDC: 616-083
• COBISS.SI-ID: 22210051
• Publication date in RUL: 06.06.2020

VESELIČ, Tina, 2020, Vloga medicinske sestre pri obravnavi pacienta z zmečkaninskim sindromom : diplomsko delo [online]. Bachelor’s thesis. Ljubljana  : T. Veselič. [Accessed 1 April 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=116727

Secondary language

• Language: English
• Title: The role of medical nurses in treating patients with crush syndrome : diploma work

Abstract

Introduction: crush injuries appear as a result of natural disasters and accidents resulting from human activity. Crush syndrome is the result of long-term major pressure exerted on a body part with high muscle mass. This causes muscles to break down, which is known as rhabdomyolysis, causing the release of myoglobin into the bloodstream. Aim: The thesis aims to utilize a literature review to describe crush syndrome and the role of medical nurses working with crush syndrome patients. Methodology: a descriptive method was applied to a systematic overview of Slovenian as well as foreign literature. The relevant literature was sought through PubMed, GoogleScholar and DiKUL, as well as the MedLine database, CINAHL, and Cochrane Library. Peer reviewed articles published between 2010 and 2019 and freely available in full were used. Results: the injured patients initially show no signs of affliction but their medical condition quickly changes. Since crush syndrome occurs rarely paramedics can have difficulties diagnosing it. When it is difficult for the first responders to get to the injured, they call upon other services able to provide technical support for help in reducing the time needed to help the injured. The injured are approached and treated in accordance with ITLS guidelines. The most appropriate measure in treating crush syndrome is fluid replacement. Discussion: The treatment of the injured must begin as soon as it is safe to approach. Adhering to ITLS guidelines enables a quicker work process and a more systematic treatment. Even with no precisely defined protocol for fluid replacement this measure reduces the occurrence of kidney failure and fatality rate. Conclusion: The rare occurrence of crush syndrome demands further training of medical personnel in rare medical emergency situations.

• Keywords: diploma theses, nursing care, crush syndrome, crush injury, compartment syndrome, rhabdomyolysis