Opazovanje zenic s pupilometrom

Korošec, Matej (author), Sotler, Robert (mentor), Tomelj, Eva (comentor)

Uvod: Zenica je reža okrogle oblike, ki se nahaja v središču šarenice. Zenici bi morali biti v normalnih pogojih približno enako veliki in reaktivni na svetlobo. Opazovanje zenic je pomembno predvsem z nevrološkega vidika. V preteklosti so za opazovanje zenic uporabljali subjektivno metodo opazovanja, pred nekaj več kot dvajsetimi leti pa so razvili napravo – pupilometer, ki zagotavlja objektivno meritev. Spremembe oziroma reakcije zenic so namreč lahko znak številnih dogajanj v možganih, kot sta na primer herniacija možganov in povišanje znotraj lobanjskega tlaka. Namen: Namen diplomskega dela je odgovoriti na vprašanja: ali obstajajo razlike med opazovanjem zenic s pupilometrom in subjektivnim opazovanjem, katere meritve se izvajajo in njihov pomen ter kateri so vzroki za spremembe zenic. Metode dela: V diplomskem delu je uporabljena deskriptivna metoda dela s sistematičnim pregledom literature. Obdobje uporabljene literature je od leta 2014 do 2018, izjema je en članek. Uporabljeni so samo članki, dobljeni s polnim besedilom, iskanje pa je potekalo s pomočjo spletnega brskalnika Google ter podatkovnih baz Medline in CINAHL with full text. Uporabljene so naslednje ključne besede: pupilometer, medicinska sestra in opazovanje zenic. Rezultati: Rezultati so pokazali, da je opazovanje zenic s pupilometrom učinkovitejše od subjektivnega opazovanja, saj ne prihaja do nesoglasij med opazovalci. Meritve, predvsem nevrološkega indeksa zenice ter hitrosti zožitve zenic, lahko omogočijo pravočasne pomembne ugotovitve o nevarnosti za nastanek patološkega dogajanja v možganih. Avtorji poudarjajo tudi ostale dejavnike, predvsem bolečino ter nekatera zdravila, ki lahko vplivajo na velikost in obliko zenic. Razprava in zaključek: Pupilometer je natančna in zanesljiva naprava, ki prepreči pojavljanje napak, ki lahko nastanejo pri subjektivnem opazovanju zenic. Nevrološki indeks zenice in hitrost njene zožitve opozarjata predvsem na nevarnost nastanka herniacije možganov ter sta med seboj povezana. Ker je pupilometer naprava, ki se je šele začela uporabljati, je potrebnih še veliko študij o dokazih njegove zanesljivosti. Ključne besede: subjektivna ocena zenic, objektivna ocena zenic, nevrološki zapleti, preprečevanje neželenih izidov

• Language: Slovenian
• Keywords: subjektivna ocena zenic, objektivna ocena zenic, nevrološki zapleti, preprečevanje neželenih izidov
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-108312
• COBISS.SI-ID: 5647979
• Publication date in RUL: 28.06.2019

Secondary language

• Language: English
• Title: Observation of pupils with pupillometer

Abstract

Introduction: The pupil is a circular slit located in the center of the iris. The pupils should be approximately large and reactive as in normal conditions. Observation of pupils is important, especially from a neurological point of view. In the past, the subjective method was used for observation of pupils, and just over twenty years ago they developed a device – pupilometer, which provides an objective measurement. Changes or reaction of the pupils can be a sign of many events inside the brain, such as brain herniation and an increase in intracranial pressure. Purpose: The purpose of this diploma work is to answer the questions: are there differences between the observation of pupils with pupillometer and subjective observation, what measurements are carried out and their significance and which are the causes of changes in pupils. Methods: In this diploma work a descriptive method of work was used, with a systematic review of literature. The period of the literature used is from 2014 to 2018, with the exception of one article. Only articles obtained with full text were used, and searches were carried out using Google's web browser and databases Medline and CINAHL with full text. The following keywords are used: pupillometer, nurse and observation of pupils. Results: The results showed that pupillometer is a more effective method than subjective observation, as there are no disagreements between observers. With measurements, especially neurological pupil index and constriction velocity, significant timely findings can be made about the risk of developing pathological events in the brain. The authors also emphasize other factors, especially pain and some medicines that can affect the size and shape of the pupils Discussion and conclusion: Pupilometer is an accurate and reliable device that prevents the occurrence of errors that may occur in subjective observations of pupils. The neurological pupil index and constriction velocity of pupil draw attention primarily to the risk of brain herniation, and this two parameters are interconnected. Because the pupilometer is a device that has just started to use, many more studies are needed for the evidence of its reliability.

• Keywords: subjective assessment of pupils, objective assessment of pupils, neurological complications, preventing unwanted outcomes