20.500.12556/DKUM-13420 OCENA DIHALNIH VOLUMNOV VENTILACIJE MED SIMULACIJO IGELNE KONIKOTOMIJE Assessment of tidal volumes ventilation during needle cricothyroidotomy simulation V nujnih stanjih je konikotomija eden izmed zadnjih izborov predihavanja pri zapori zgornjih dihalnih poti, kjer v sapnik skozi krikotiroidno membrano uvedemo kanilo ali cevko. Postopek lahko izvede zdravnik, medicinska sestra ali laik in je edini način, da bolniku rešimo življenje v primeru, da nimamo na razpolago profesionalne opreme za konikotomijo. V diplomskem delu smo simulirali postopek igelne konikotomije, kjer je 75 študentov zdravstvene nege izvajalo ventilacijo z alternativnimi sistemi po dveh tehnikah predihavanja. Pri prvi tehniki smo dihalni balon neposredno spojili na eno ali dve i.v. kanili, pri drugi pa smo predihavanje izvajali z izmenično okluzijo odprtine v cevki za dovod kisika. V raziskavi nas je zanimala učinkovitost obeh tehnik. Vsega skupaj smo izvedli 1125 meritev dihalnih volumnov, tlakov in pretokov pri ventilaciji. Rezultati so pokazali, da lahko z altenativnimi sistemi dosežemo največ 220±38 ml enkratnega volumna pri sinhroniziranem odpiranju/zapiranju i.v. kanile. Najslabša tehnika se je izkazala metoda z dvema i.v. kanilama, kjer smo dosegli najmanjše vrednosti dihalnih volumnov (158±38 ml) v primerjavi s tehniko ene i.v. kanile (223±44 ml) (p<0,001). Največje vrednosti tlakov, smo dobili pri predihavanju z dihalnim balonom skozi eno i.v. kanilo (8,9±1,8 cmH2O) medtem, ko smo pri predihavanju skozi dve i.v. kanili dobili manjše vrednosti (7,8±1,8 cmH2O) (p<0,001). Pri izmenični okluziji odprtine v cevki za dovod kisika smo dobili mejne pretoke, ki znašajo 5 l min-1 pri ventilaciji skozi eno i.v. kanilo, 9 l min-1 pri ventilaciji skozi dve i.v. kanili in 15 l min-1 pri ventilaciji skozi kombinacijo dveh i.v. kanil. Pri igelni konikotomiji s pomočjo alternativnih sistemov tako predlagamo uporabo dveh i.v. kanil in tehniko sinhroniziranega odpiranja/zapiranja sekundarne i.v. kanile. In emergency situations due to blocked upper airway cricothyroidotomy presents one of last chances for overbreathing. It is conducted by inserting cannula or tube into trachea through cricothyroid membrane. Procedure can be managed by a physician, nurse or layman and presents the only way for saving patient's life in a case of lack of professional set for cricothyroidotomy. In dissertation was simulated procedure of needle cricothyroidotomy, where 75 students of health care conducted ventilation with alternative systems with two techniques of overbreathing. The first technique included direct connection of overbreathing to one or two i.v. cannulas, while the second one included conducting of overbreathing by alternate occlusion of orifice of tube for supplying oxygen. In survey was examined efficiency of both techniques. In regard to ventilation were performed 1125 measurements of tidal volume, pressures and flows. Results showed that alternative systems enable reaching of maximal single tidal volume of 220±38 ml at synchronized opening/closing of i.v. cannula. The least efficient technique was method with two i.v. cannulas, where were reached the lowest values of tidal volume (158±38 ml) in comparison with technique of one i.v. cannula (223±44 ml) (p < 0,001). The highest values of pressure were reached by conducting overbreathing with breathing balloon through one i.v. cannula (8,9±1,8 cmH2O), while overbreathing through two i.v. cannulas gave lower values (7,8±1,8 cmH2O) (p<0,001). At alternate occlusion of orifice of tube for supplying oxygen were obtained borderline flows of 5 l min-1 by ventilation through one i.v. cannula, 9 l min-1 by ventilation through two i.v. cannulas and 15 l min-1 by ventilation through combination of two i.v. cannulas. Therefore, at needle cricothyroidotomy supported by alternative systems is suggested application of two i.v. cannulas and performing technique of synchronized opening/closing of secondary i.v. cannula. konikotomija igelna konikotomija simulacije dihalni volumen. cricothyroidotomy needle cricothyroidotomy simulations tidal volume. true true false [D. Flisar] Slovenski jezik Angleški jezik Diplomsko delo 2010-03-15 21:08:04 2010-06-10 14:52:25 2022-04-12 11:10:22 2023-12-16 03:13:31 2010 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616-083.98 1584804 URN:SI:UM:DK:1JGFMTQO VS_Flisar_Danijel_2010.pdf VS_Flisar_Danijel_2010.pdf 1 19A7179859BF152912A69E863552C1DB acbed0ded93756fb2b1ae9e6ea2448a00f5143f8f66ae5ce8c514d13ca8f9d79 e68230c8-7c03-11eb-bb7a-00155d0001ca 20.500.12556/dkum/20529d14-8c60-4fe1-aac9-54f7850ce670 https://dk.um.si/Dokument.php?lang=slv&id=13581 Fakulteta za zdravstvene vede 0 0 0