Uporaba manšete za bledo stazo med operativnim posegom : pregled literature

Lužar, Anja (author), Pajnič, Manca (mentor), Trotovšek, Tatjana (comentor)

Uvod: Manšeta za bledo stazo je tlačna naprava, ki zaustavi venski in arterijski dotok krvi v okončino med operativnim posegom. Ob pravilni uporabi zagotavlja nekrvavo kirurško polje, zmanjša izgubo krvi in skrajša čas operativnega posega. Namen: Namen diplomskega dela je s pomočjo pregleda literature predstaviti vlogo operacijske medicinske sestre pri operacijskem posegu, med katerim je nameščena manšeta za bledo stazo. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom domače in tuje literature. Iskali smo v časovnem okviru od leta 2006 do 2017, preko naslednjih tujih podatkovnih baz: Cinahl with Full Text in Medline. Iskali smo z angleškimi ključnimi besedami: pneumatic tourniquet, surgery in nurse. Rezultati: Znano je, da nižji pritiski in čim krajši čas delovanja manšete za bledo stazo zmanjšujejo število in obseg poškodb. Poškodbe, ki nastanejo zaradi uporabe manšete za bledo stazo, so lahko trajne ali reverzibilne. Med uporabo manšete za bledo stazo je potrebno ukrepati preventivno, da zmanjšamo verjetnost zapletov in poškodb. Potrebno je izbrati ustrezno manšeto in jo pravilno namestiti na okončino. Kožo pod manšeto moramo zaščiti z mehko oblazinjeno zaščito. Med uporabo naprave moramo pacienta spremljati, saj se mu povišajo srčni utrip, krvni pritisk in telesna temperatura. Po deflaciji manšete mora operacijska medicinska sestra oceniti in dokumentirati stanje pacienta. Pooperativna ocena vključuje kontrolo vitalnih znakov, pulzov na okončinah, nasičenosti krvi s kisikom in stanje kože pod manšeto. Razprava in sklep: Določitev napihnjene manšete in vrednosti pritiska, pod katerim se napihne, ter čas, v katerem se sprosti manšeta, so odgovornosti zdravnika. Pomembno je, da se ob napihnjenju manšete čas zabeleži, da se nadzoruje čas trajanja inflacije in da je ta čas čim krajši. Operacijska medicinska sestra je pomemben člen kirurške ekipe, ki na podlagi ocene pacienta izbire in namesti ustrezno manšeto za bledo stazo. Glavno vodilo pri izbiri manšete je varnost pacienta. V slovenskem jeziku nismo našli navodil za varno uporabo manšete za bledo stazo. Dopuščamo možnost, da jih bolnišnice imajo, vendar kot interne dokumente.

• Language: Slovenian
• Keywords: manšeta za bledo stazo, operacijska medicinska sestra, varnost pacienta
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-100678
• COBISS.SI-ID: 5424747
• Publication date in RUL: 05.04.2018

Secondary language

• Language: English
• Title: The use of tourniquet during surgery : literature review

Abstract

Introduction: A tourniquet is a pressure device that stops vein and artery blood inlet into a limb during an operating procedure. When used correctly, this guarantees a bloodless surgical area, reduces the loss of blood and reduces the time taken for the operating procedure. Purpose: The purpose of this paper is to present the role of a surgical nurse during an operating procedure, during which a tourniquet is used, with literature review. Methods: The paper was written using a descriptive method with a review of domestic and foreign literature. We've researched the time frame from 2006 to 2017 with a foreign database named Cinahl with Full Text in Medline. We've used the following keywords: pneumatic tourniquet, nurse in surgery. Results: It is known that lower pressure and the short amount of time that a tourniquet is used, reduces the number and extent of injury. Injury that is a result of the use of tourniquet can be permanent or reversible. During the use of a tourniquet, we have to take preventive measures so that we reduce the likelyhood of complication and injury. Additionally, it is necessary to choose a correct tourniquet and properly apply it to the limb. The skin beneath the tourniquet must be protected with a soft, padded, protective material. During the use of the device, we must monitor the patient's condition because there is a rise of heart rate, blood pressure and body temperature. After the deflation of the tourniquet, the nurse must assess and document the patient's condition. Assessment of the patient's condition after surgery includes: the check of all vital signs, heart rates of limbs, blood oxygen saturation and the condition of the skin beneath the tourniquet. Discussion and conclusion: Determination of the properly inflated tourniquet, pressure amount, duration of inflation and the time of release is a doctor's responsibility. It is of highimportant that a note is made when the tourniquet has been inflated so that the duration of tourniquet inflation can be monitored and so that this will be as short as possible. The surgical nurse is an important part of a surgical team who assesses the patient's condition; she participates with a surgical and an anesthesiological teams and takes care of patient's safety during a procedure. We haven't found any instructions on safe usage of the tourniquet during a surgical procedure in Slovene language. There is a possibility that hospitals do have them but as internal documents.

• Keywords: tourniquet, operating room nurse, patient safety