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Title:Oživljanje podprto s telefonskimi navodili dispečerja - temeljni člen v verigi preživetja
Authors:ID Kešpert, Branko (Author)
ID Križmarić, Miljenko (Mentor) More about this mentor... New window
Files:.pdf MAG_Kespert_Branko_2013.pdf (1,09 MB)
MD5: 9669EE384EDB0C3959E35FA01B28F9B3
 
Language:Slovenian
Work type:Master's thesis/paper
Typology:2.09 - Master's Thesis
Organization:FZV - Faculty of Health Sciences
Abstract:Uvod: Dispečerska služba v zdravstvu je pomemben sestavni del verige preživetja in ima pomembno vlogo pri zgodnjem prepoznavanju nenadnega zastoja srca (NZS) na terenu. Z zgodnjo identifikacijo problema pri bolniku lahko dispečer zagotavlja kratke dostopne čase ekip nujne medicinske pomoči (NMP), očividcem poda navodila za izvajanje TPO in s tem prispeva k večjemu preživetju bolnikov. Raziskovalne metode: V raziskovalnem delu smo uporabili kvantitativno metodologijo. Najprej smo opravili Utstein analizo primerov NZS, pri katerih so ekipe PHE pristopile k oživljanju. Nato smo opravili retrospektivno raziskavo pri izbrani skupini 98 bolnikov z NZS pred očividci v PHE Celje v obdobju treh let. Pri izbranih bolnikih smo analizirali podatke iz zapisnikov o nujni intervenciji in tonske zapise pripadajočih nujnih telefonskih klicev ter ugotavljali značilnost njihovega vpliva na preživetje bolnikov do prihoda v bolnišnico. Rezultati: V izbrani skupini 98 bolnikov z NZS v PHE Celje je bilo 63 % moških. Moški so bili v povprečju mlajši (65 ± 13 let) kot ženske (72 ± 12 let). Dispečerji so dosegali pričakovani odzivni čas v 86,7 %, povprečni reakcijski čas je znašal 84 ± 76 sekund. Od skupaj 41 bolnikov z agonalnim dihanjem so navodila za oživljanje podali v 26,8 % primerih. Očividci so na podlagi podanih navodil pristopili k oživljanju v 53,3 %, medtem ko so brez navodil pristopili le še v 20,7 %. Če so očividci oživljali, je ROSC pri bolnikih znašal 48,6 %, brez oživljanja pa le 28,6 %. Sklep: Dispečerji ob NZS niso dosegali priporočenih standardov v odzivnih in reakcijskih časih. Ob prisotnem agonalnem dihanju se značilno niso odločali za podajanje navodil za TPO. Očividci so na podlagi podanih navodil za TPO pogosteje pristopili k oživljanju. Na preživetje bolnikov do prihoda v bolnišnico so značilno vplivali kratki odzivni časi dispečerja, kratki dostopni časi ekip PHE, dogodki v mestu, začetni srčni ritem VT/VF in oživljanje očividcev na podlagi podanih navodil.
Keywords:nenadni zastoj srca, agonalno dihanje, navodila za oživljanje, preživetje
Place of publishing:Maribor
Publisher:[B. Kešpert]
Year of publishing:2013
PID:20.500.12556/DKUM-41059 New window
UDC:616.1-083.98(043.2)
COBISS.SI-ID:1933732 New window
NUK URN:URN:SI:UM:DK:N0XRPOET
Publication date in DKUM:06.08.2013
Views:2755
Downloads:481
Metadata:XML DC-XML DC-RDF
Categories:FZV
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Secondary language

Language:English
Title:Dispatcher-assisted telephone cardiopulmonary resuscitation - the anchor link in the chain of survival
Abstract:Introduction: The dispatch service in health care is an important component part of the chain of survival and has an important role in early recognition of sudden cardiac arrest (SCA) in the field. With early identification of the patient’s problem the dispatcher can ensure fast access times of the Ambulance and provide eyewitnesses with the basic life support (BLS) instructions and thus contribute to an increased survival rate. Research methodology: In the research part we used quantitative methodology. First we carried out the Utstein’s analysis of SCA, where Pre-hospital units performed CPR. Then we made a retrospective research in a group of 98 patients with SCA in front of eyewitnesses in the pre-hospital unit Celje over three years. In selected patients we analyzed the data from records on urgent intervention and audio records of the corresponding emergency phone calls and analyzed the characteristics of their impact on the survival of patients until the arrival to the hospital. Results: In the selected group of 98 patients with CSA in the Pre-hospital unit Celje 63 % were men. They were in average younger (65 ± 13 years) then women (72 ± 12 years). The dispatchers reached the expected reaction time in 86.7 %, the average reaction time was 84 ± 76 seconds. From a total of 41 patients with gasping respiration they provided the CPR instructions in 26.8 % of the cases. Eyewitnesses have based on these instructions performed CPR in 53.3 % and without the instruction only in 20.7 % of cases. When they have performed CPR, ROSC in patients was 48.6 % and without CPR only 28.6 %. Conclusion: Dispatchers have failed to reach the expected reaction times. In present gasping respiration they have not typically decided to provide CPR instructions. Eyewitnesses did, based on the instructions, more often provide CPR. The survival of patients until the arrival to the hospital was significantly influenced by fast response times of the dispatcher, short access times of the Pre-hospital units, cases in the city, initial cardiac rhythm VT/VF and CPR of eyewitnesses based on provided instruction.
Keywords:sudden cardiac arrest, gasping respiration, CPR manual, survival


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