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Prva pomoč pri izpahu ramenskega sklepa : diplomsko delo
ID Pahor, Nejc (Author), ID Slabe, Damjan (Mentor) More about this mentor... This link opens in a new window, ID Pintar, Tadeja (Comentor), ID Prestor, Jože (Reviewer)

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Abstract
Uvod: Ramenski sklep je najgibljivejši sklep v človeškem telesu, vendar je zaradi tega tudi najbolj izpostavljen izpahom. Najpogostejša skupina poškodovancev so mladi moški, pri katerih pride do poškodbe statičnih stabilizatorjev sklepa, ali starejši ljudje, ki imajo pogostejše raztrganine rotatorne manšete. Ukrepi prve pomoči pri izpahu ramenskega sklepa so mirovanje in namestitev poškodovane okončine v udoben položaj ter imobilizacija. Izsledki iz pregledane relevantne literature nakazujejo, da je razlog za izpah ramenskega sklepa največkrat travmatični dogodek. Za učinkovitejšo nadaljnjo obravnavo je pomembno sledenje smernicam in ukrepom prve pomoči. Hitra in učinkovita repozicija ramenskega sklepa zagotavlja manjše zaplete in dodatne poškodbe. Namen: Namen diplomskega dela je preučiti problematiko izpaha ramenskega sklepa, ugotoviti, kateri so dejavniki tveganja, kakšne so aktualne smernice prve pomoči za oskrbo takih poškodovancev in katere so prednosti in slabosti repozicije izven bolnišničnega okolja. Metode dela: Z namenom prikaza učinkovitosti prve pomoči ob izpahu ramenskega sklepa smo opravili prospektivno študijo bolnikov z izpahom ramenskega sklepa, obravnavanih v Urgentnem kirurškem bloku UKC Ljubljana, s katerimi smo opravili intervju, pregledali medicinsko in slikovno dokumentacijo ob prvem in kontrolnih pregledih. Rezultati: V raziskavi je sodelovalo 7 poškodovancev, od tega 3 moški in 4 ženske s povprečno starostjo 61,4 leta. Pridobljene rezultate smo interpretirali in prikazali v tabelah. Pet od sedmih intervjuvancev je poročalo o pozitivnih ukrepih prve pomoči ter hitrem izboljšanju stanja po repoziciji izpahnjenega ramenskega sklepa, ki jo je opravil zdravnik. Razprava in zaključek: V prospektivni observacijski raziskavi poškodovancev z luksacijo ramenskega sklepa smo dokazali, da so imeli pravočasni in učinkoviti ukrepi prve pomoči ugoden učinek na potek rehabilitacije po luksaciji rame. Poškodovanci so v povprečju porabili manj protibolečinskih sredstev in hitreje začeli rehabilitacijo. Hkrati pa poškodovanci niso utrpeli nevrovaskularnih poškodb, kar je odlično glede na relevantno literaturo, v kateri opisujejo 19–55 % poškodb živcev in 0–2 % poškodb ožilja ob prvem izpahu ramenskega sklepa. Repozicija ramenskega sklepa v izven bolnišničnem okolju ima nekatere prednosti, kot so hitro zmanjšanje bolečine in lažja repozicija, ker so mišice še relaksirane. Pri neustrezni izkušenosti terapevta obstaja pri repoziciji na terenu tveganje za nevrovaskularne ali kostne poškodbe in je zato izboljšanje rezultatov zdravljenja potrebna ustrezna raven izkušenosti in poznavanja pravilnih postopkov nudenja prve pomoči na terenu. S tega vidika aktualne smernice prve pomoči ne priporočajo repozicije na terenu.

Language:Slovenian
Keywords:diplomska dela, zdravstvena nega, dislokacija, prva pomoč, glenohumeralni sklep, sprednji izpah
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:ZF - Faculty of Health Sciences
Place of publishing:Ljubljana
Publisher:[N. Pahor]
Year:2024
Number of pages:41 str., [7] str. pril.
PID:20.500.12556/RUL-155730 This link opens in a new window
UDC:616-083
COBISS.SI-ID:192454659 This link opens in a new window
Publication date in RUL:13.04.2024
Views:552
Downloads:91
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Secondary language

Language:English
Title:First aid in shoulder dislocation : diploma work
Abstract:
Introduction: The shoulder joint is the most flexible joint in the human body, and consequently it is also the most prone to dislocations. The commonest group of injured persons are young men suffering from damage to the static stabilizers of the joint, or elderly people with frequent rotator cuff tears. First aid measures for shoulder joint dislocation include rest, placing the injured limb in a comfortable position and immobilization. According to the findings from the reviewed literature, the reason for the dislocation is most often a traumatic event. Additionally, it is of great importance to follow the guidelines and first aid measures in order to provide efficient further treatment of the injury. This enables quick and effective repositioning of the shoulder joint, which brings less additional complications and injuries. Purpose: The purpose of this Thesis is to examine the problem of shoulder joint dislocation, to determine the risk factors, study the current guidelines of first aid measures for taking care of such injuries, and finally, to analyze the advantages and disadvantages of repositioning outside the hospital care. Methods: In order to demonstrate the effectiveness of first aid in case of shoulder dislocation, we carried out a prospective study of patients with shoulder dislocation treated at the UKC Ljubljana, Emergency Surgery Unit. We interviewed the patients, and reviewed their medical documentation at the first and follow-up examinations. Results: A total of 7 injured people participated in our research, of which 3 male and 4 female patients with an average age of 61.4 years. We interpreted the obtained results and presented them in tables. Five of the seven interviewees reported positive first aid measures and a rapid improvement in the condition after the doctor’s repositioning of the dislocated shoulder joint. Discussion and conclusion: In our prospective observational study of patients with shoulder joint luxation we proved that timely and effective first aid measures had a beneficial effect on the course of rehabilitation after shoulder luxation. On average, the injured used less painkillers and faster began with rehabilitation. At the same time, the injured did not suffer neurovascular injuries which are, according to the relevant literature, expected to occur. Namely, the literature states there is a 19-55% possibility for nerve injuries and 0-2% for vascular injuries right after the first shoulder dislocation. Repositioning the shoulder joint outside the hospital care proved to have some advantages, such as fast pain reduction and easier repositioning due to relaxed muscles. In case of the therapist's insufficient experience, neurovascular or bone injuries may occur during the repositioning in the field. Therefore, if we want to improve the treatment results, an appropriate level of experience and knowledge of first aid measures in the field are needed. Seen from this point of view, the current first aid guidelines do not recommend repositioning in the field.

Keywords:diploma theses, nursing care, dislocation, first aid, glenohumeral joint, anterior dislocation

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