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Title:UPORABA ENOTE HELIKOPTERSKE NUJNE MEDICINSKE POMOČI PRI OBRAVNAVI BOLNIKOV Z AKUTNIM KORONARNIM SINDROMOM
Authors:Bregant, Gorazd (Author)
Koželj, Anton (Mentor) More about this mentor... New window
GRMEC, ŠTEFEK (Co-mentor)
Files:.pdf VS_Bregant_Gorazd_2009.pdf (17,00 MB)
 
Language:Slovenian
Work type:Undergraduate thesis (m5)
Organization:FZV - Faculty of Health Sciences
Abstract: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.
Keywords:- 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 (
Year of publishing:2009
Publisher:[G. Bregant]
Source:Maribor
UDC:614.88
COBISS_ID:1487524 Link is opened in a new window
Views:2799
Downloads:402
Metadata:XML RDF-CHPDL DC-XML DC-RDF
Categories:FZV
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Secondary language

Language:English
Title:THE ROLE OF HELICOPTER EMERGENCY MEDICAL SERVICE IN THE MANAGEMENT OF PATIENTS WITH ACUTE CORONARY SYNDROME
Abstract:In the thesis is presented the HEMS unit in Slovenia, its history and current operation. The efficency of the HEMS operation was reviewed on a sample of 252 patients with acute coronary syndrome, that the HEMS unit managed according to contemporary guidelines for the management of these patients and transported in the first five years (16.7.2003 – 16.7.2008).We have used the descriptive method of studying the literature for the management of ACS. We used the retrospective method of studying data from protocol forms filled for each interventions. The gathered data was analized (graphicons). Of the 252 patients with ACS, 139 (55,15%) patients had STEMI, 10 patients (3.96%) unstable pectoral angina, and 12 patients (4,76%) had NSTEMI. For 91 patients (36,11%) the leading diagnosis was not defined by the medical doctors. The mean values were calculated for the response times of the HEMS unit according to the flight crew – police, army or Flycom. Total mean times were calculated from the call until the arrival to the patient, from the call until arrival with the patient to hospital, and the mean time from landing at the helioport Roška, until arrival at the hospital by ambulance car. On the map of Slovenia the locations of intervention by the HEMS unit are graphically presented. The management of patients with acute coronary syndrome was studied. We concluded, that the HEMS unit provides good management of patients with ACS, that the staff are highly qualified, that the equipment used is of high standard and up to date, and that the service takes care of continuous education of its members. We also concluded, that there is a deficiency in implementation of the HEMS in Slovenia, limitation of service time to bright time of day, limitations in activation protocols, too long activation times, and too long times until arrival of the patient to hospital. There is considerable loss of time because of the inappropriateness of the helioport of the University clinical centre, Ljubljana. The dispatch system of the health service system was also found to be inappropriate.We also concluded, that the unit does not have a permanent flight crew, that there is daily change of helicopter type used for interventions, that none of the helicopters are intended for the sole use in HEMS, and that one unit in Slovenia is not efficient enough to cover all the population of the republic of Slovenia.
Keywords:- 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 (nestabilna angina pektoris) - NMP (nujna medicinska pomoč) - NSTEMI (non-ST segment elevation miocardial infarction) - OZG (Osnovno zdravstvo Gorenjske) - PHE (Prehospitalna enota) - PPCI (primarna perkutana koronarna intervencija) - STEMI (ST segment elevation miocardial infarction) - UKC (Univerzitetni klinični center) - VAS (vizualna analogna skala) - VF (ventrikularna fibrilacija) - VT (ventrikularna tahikardija


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