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1.
UPORABA ENOTE HELIKOPTERSKE NUJNE MEDICINSKE POMOČI PRI OBRAVNAVI BOLNIKOV Z AKUTNIM KORONARNIM SINDROMOM
Gorazd Bregant, 2009, diplomsko delo

Opis: V diplomskem delu smo predstavili enoto HNMP v Sloveniji, njeno delovanje in zgodovino. Obravnavali smo učinkovost njenega delovanja na vzorcu 252 bolnikov z akutnim koronarnim sindromom, ki jih je enota oskrbela po principih sodobnih smernic oskrbe takšnih bolnikov in prepeljala v prvih petih letih delovanja službe (16.7.2003 — 16.7.2008). Uporabili smo deskriptivno metodo s študijem literature za področje AKS. Uporabili smo retrospektivno metodo (študija izpolnjenih protokolov intervencij). Podatke smo analizirali (grafi). Prepeljanih je bilo 252 bolnikov z AKS, od tega 139 (55,15%) bolnikov z STEMI, 10 bolnikov (3.96%) z nestabilno angino pektoris, in 12 bolnikov (4,76l%) z NSTEMI. Za 91 bolnikov (36,11%) se zdravniki niso natančno opredelili o vodilni diagnozi. Ugotovili smo skupno število prepeljanih bolnikov in razloge za intervencijo, izračunali povprečne odzivne čase enote HNMP glede na prevoznika, skupne povprečne čase od klica do prihoda do bolnika, čas od klica do prihoda z bolnikom v bolnišnico ter čas od pristanka na pristajališču Roška do prihoda v bolnišnico z reševalnim vozilom. Na zemljevidu Slovenije smo grafično prikazali kraje posredovanja enote HNMP. Preučevali smo oskrbo bolnikov z akutnim koronarnim sindromom. Ugotovili smo, da nudi služba HNMP dobro oskrbo bolnikom, da so kadri enote na visokem nivoju, da je oprema, ki jo uporabljajo ustrezna in sodobna, in da služba HNMP skrbi za stalno dodatno izobraževanje svojega kadra. Ugotovili smo tudi pomanjkljivosti pri umeščenosti službe HNMP v Sloveniji, omejenost na dnevni čas delovanja, omejen način aktivacije, dolgi časi aktivacije in do prihoda bolnika v zdravstveno ustanovo, izguba časa zaradi neurejenega helioporta v Univerzitetnem kliničnem centru Ljubljana in neurejenega dispečerstva v zdravstvu. Ugotovili smo, da enota nima stalne posadke prevoznika, da se dnevno menja tip helikopterja s katerim posreduje, da so vsi helikopterji nenamenski in omejeno uporabni, in da ena enota v Sloveniji ni dovolj učinkovita za vse prebivalce Slovenije.
Ključne besede: - AKS (akutni koronarni sindrom) - AVPU (alert, verbal, pain, unresponsive) - CIIM (Center za intenzivno interno medicino) - EKG (elektrokardiogram) - ERC (European Resuscitation Council) - GCS (Glasgow coma scale) - GRZS (Gorska reševalna zveza Slovenije) - HEMS (Helicopter emergency medical service) - HNMP (Helikopterska nujna medicinska pomoč) - IPP (Internistična prva pomoč) - LKB (levokračni blok) - LPE (Letalska policijska enota) - MONA (morfij, kisik, nitroglicerin, aspirin) - NAP (
Objavljeno: 15.07.2009; Ogledov: 2793; Prenosov: 402
.pdf Celotno besedilo (17,00 MB)

2.
The impact of demographic changes on the organization of emergency medical services
Tatjana Kitić Jaklič, Jure Kovač, 2015, izvirni znanstveni članek

Opis: Background and Purpose: The modern environment requires that organizations (profit and non-profit) continually harmonize their organizational models with changes in their respective environments and with their own visions and strategies for further development. The organizational structure of Emergency Medical Services (hereinafter EMS) is currently a very topical issue in Slovenia, given that a project to establish a new organization of EMS is currently underway at the national level. By examining the case of one region in Slovenia, this article presents an analysis of factors that impact on the number and types of EMS activities and depicts a forecast of future trends for the requirement of EMS. The analysis presents the initial phase of a strategic planning process for the mentioned activity and consequently, a starting point for the formation of an organizational EMS model. Methodology: This article presents an analysis of factors that impact on the formulation of an EMS model on the basis of research carried out for one geographical region of Slovenia. For the previous period, data was collected from 2002 to 2014. The software tool used for the analysis was STATA 13.0. For the purpose of forecasting a five-year period trend we used statistical package RStudio and Hyndman’s Forecast package given that this package contains algorithms for forecasting univariate time series including exponential smoothing using automated spatial models and ARIMA modelling. Results: The research has confirmed a correlation between social/environmental factors and the rate of increase in the demand for EMS. A population’s age structure has been identified as the key social factor that increases the need for EMS. On the basis of this finding, this article presents a model for forecasting growth trends in the scope of EMS activities. Conclusion: The research study has identified some important elements that are imperative to take into consideration when formulating an EMS network at the prehospital level. Population ageing has emerged as a key social factor. In the accordance with forecasted trends, an increase in the burden placed on EMS activities may also be anticipated in the future.
Ključne besede: strategic planning, foresight, trends, emergency medical services, Slovenia
Objavljeno: 04.04.2017; Ogledov: 340; Prenosov: 54
.pdf Celotno besedilo (1,13 MB)
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3.
Factors impacting on the activation and approach times of helicopter emergency medical services in four Alpine countries
Iztok Tomazin, Miljana Vegnuti, John Ellerton, Oliver Reisten, Guenther Sumann, Janko Kersnik, 2012, izvirni znanstveni članek

Opis: Background: The outcome of severely injured or ill patients can be time dependent. Short activation and approach times for emergency medical service (EMS) units are widely recognized to be important quality indicators. The use of a helicopter emergency medical service (HEMS) can significantly shorten rescue missions especially in mountainous areas. We aimed to analyze the HEMS characteristics that influence the activation and approach times. Methods: In a multi-centre retrospective study, we analyzed 6121 rescue missions from nineHEMS bases situated in mountainous regions of four European countries. Results: We found large differences in mean activation and approach times among HEMS bases. The shortest mean activation time was 2.9 minutes; the longest 17.0 minutes. The shortest mean approach time was 10.4 minutes; the longest 45.0 minutes. Short times are linked (p < 0.001) to the following conditions: helicopter operator is not state owned; HEMS is integrated in EMS; all crew members are at the same location; doctors come from state or private health institutions; organization performing HEMS is privately owned; helicopters are only for HEMS; operation area is around 10.000 km2; HEMS activation is by a dispatching centre of regional government who is in charge of making decisions; there is only one intermediator in the emergency call; helicopter is equipped with hoist or fixed line; HEMS has more than one base with helicopters, and one team per base; closest neighboring base is 90 km away; HEMS is about 20 years old and has more than 650 missions per year; and modern helicopters are used. Conclusions: An improvement in HEMS activation and approach times is possible. We found 17 factors associated with shorter times.
Ključne besede: emergency medical services, air ambulances, emergency helicopters, quality of health care, activation and approach time
Objavljeno: 29.06.2017; Ogledov: 437; Prenosov: 51
.pdf Celotno besedilo (1,22 MB)
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