Infuzija tekočin pod tlakom v prehospitalnem okolju nujne medicinske pomoči

Viher, Tomaž

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Title:	Infuzija tekočin pod tlakom v prehospitalnem okolju nujne medicinske pomoči
Authors:	ID Viher, Tomaž (Author) ID Križmarić, Miljenko (Mentor) More about this mentor... ID GRMEC, ŠTEFEK (Comentor)
Files:	VS_Viher_Tomaz_2010.pdf (3,31 MB) MD5: 20654E88D9942D141E76C59E5DACD734 PID: 20.500.12556/dkum/3d1a1e87-f38c-43f6-8306-9b23d5ba7b57
Language:	Slovenian
Work type:	Undergraduate thesis
Organization:	FZV - Faculty of Health Sciences
Abstract:	Diplomsko delo je kontrolirana eksperimentalna študija, kjer smo ugotavljali učinkovitost različnih metod infuzij pod tlakom. V laboratorijskem okolju smo merili pretok infuzije po treh metodah: manšeta pod različnim tlakom (150, 200 in 250 mmHg), z Esmarchovo prevezo in s stiskom z golimi rokami. Dodatno smo s kratkim anketnim vprašalnikom zbirali podatke o pogostosti infuzij pod tlakom v enotah nujne medicinske pomoči. Rezultati so pokazali najučinkovitejšo metodo infuzije s pomočjo manšete pod tlakom 250 mmHg, kjer smo dobili pretok 346,85±1,46 ml/min pri i.v. kanili 14G v primerjavi z Esmarchovo prevezo s pretokom 224,80±2,55 ml/min (p<0,0001). Pri i.v. kanili 16G so pričakovano moški ustvarili večje pretoke v primerjavi z ženskami (216,81±28,42 proti 184,99±21,78 ml/min) (p<0,0001). Zdravstveno osebje je dosegalo višje pretoke pri stisku z golimi rokami 210,70±30,97 ml/min v primerjavi z laiki 191,10±25,27 ml/min (p<0,0001). Pri primerjavi med laiki in Esmarchovo prevezo smo pri i.v. kanili 16G dosegli večje pretoke pri laikih (191,10±25,27 proti 184,50±2,44 ml/min) (p<0,0001). Pričakovano smo v vseh primerih dobili statistično signifikantne razlike med različnimi premeri i.v. kanil. Pri infuziji pod visokimi tlaki (300 mmHg) moramo biti pozorni na plastenko, ki lahko poči. V tem primeru predlagamo infuzijo iz vrečke, ki jo namestimo znotraj manšete. Pretoki z infuzijo pod tlakom so približno 30% višji od deklariranih pretokov. Ugotavljamo, da se ekipe NMP poslužujejo infuzije pod tlakom v 56%.
Keywords:	Infuzija tekočin pod tlakom, agresivno nadomeščanje tekočin, prehospitalno okolje nujne medicinske pomoči, i.v. kanila, manšeta za merjenje centralnega arterijskega krvnega tlaka, Esmarch podveza, stisk z rokami
Place of publishing:	Maribor
Publisher:	[T. Viher]
Year of publishing:	2010
PID:	20.500.12556/DKUM-16393
UDC:	615.471
COBISS.SI-ID:	1642916
NUK URN:	URN:SI:UM:DK:LATRJ1BE
Publication date in DKUM:	17.11.2010
Views:	3942
Downloads:	380
Metadata:
Categories:	FZV
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Secondary language

Language:	English
Title:	High pressure fluid infusion in emergency prehospital settings
Abstract:	The diploma work on hand is a controlled experimental study where the effectiveness of different methods of infusion under pressure has been evaluated. In a laboratory environment, the flow of infusion has been measured using the following methods: cuffs with different pressure (150, 200 and 250 mmHg), the Esmarch's bandage and a compression using hands only. Additionally, a brief questionnaire was used to collect data on the use frequency of the infusions under pressure in emergency medical units. The results have shown that the most effective method is an infusion with a cuff under pressure of 250 mmHg; the measured flow was 346.85±1.46 ml/min using the i.v. cannula 14G compared to the Esmarch's bandage, where the flow was 224.80±2.55 ml/min (p <0.0001). Using the i.v. cannula 16G men have achieved higher flow rates than women (216.81±28.42 to 184.99±21.78 ml/min) (p <0.0001). The medical staff has achieved higher flow rates using the compression with hands (210.70±30.97 ml/min) compared to laymen (191.10±25.27 ml/min) (p <0.0001). There has also been a comparison made between the laymen and the Esmarch's bandage: the laymen have achieved higher flow rates (191.10±25.27 to 184.50±2.44 ml/min) (p <0.0001) using the i.v. cannula 16G. As it was expected, the study has shown a statistically significant difference between the different diameters of i.v. cannulas. The infusions under high pressure (300 mmHg) should be handled very carefully as the bottle may break. In this case it is recommended to use an infusion from a bag, which is placed inside the cuffs. The flow rates acquired from infusions under pressure are approximately 30% higher than the declared flows. It has been established that the emergency medical teams use the infusions under pressure in 56% of all cases.
Keywords:	Infusion of fluids under pressure, aggressive fluid substitution, prehospital medical emergency care, i.v. cannula, central arterial blood pressure measuring cuff, Esmarch's bandage, compression using hands

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