Izvanbolničko zbrinjavanje dišnoga puta

master's thesis

• Title (english): Prehospital airway management
• Author: Samir Ćoralić
• Mentor: Vesna Degoricija (mentor)
• Committee member: Ivan Gornik (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Vesna Degoricija (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2017-09-26, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Zbrinuti dišni put u izvanbolničkim uvjetima od ključne je važnosti u trenucima kada je potrebno zbrinuti naglo oboljelog / unesrećenoga s ili bez opstrukcije dišnog puta. Tada se pristupa osnovnim manualnim metodama, zabacivanjem glave i podizanjem brade ili potiskivanjem donje čeljusti prema naprijed, nakon čega se osigurava prohodnost osnovnim pomagalima, orofaringealnim ili nazofaringealnim tubusom. Na taj način se omogućava normalno disanje ako osoba diše spontano. Ako osoba ima nadražaj na povraćanje ili se opire, ne smije ga se postaviti jer može doći do povraćanja. Oprema za sukciju uvijek mora biti spremna u trenucima zbrinjavanja dišnoga puta. Kako bi se osigurao dišni put, a naročito u slučaju zastoja disanja, te omogućilo kvalitetno ventiliranje i oksigenacija, potrebna su naprednija pomagala i tehnike. U tome slučaju potrebna je endotrahealna intubacija kao zlatni standard u osiguranju dišnoga puta. U slučaju otežane intubacije i nemogućnosti to jest neuspješnosti iste, postavlja se alternativno pomagalo. To su supraglotična pomagala koja se brzo i efikasno postavljaju te se time osigurava prohodnost dišnoga puta i ventilacija. U slučaju da se radi o opstrukciji gornjih dišnih puteva iznad glotisa niti jedna od navedenih tehnika neće biti uspješna za osiguravanje dišnoga puta. Tada se izvodi krikotiroidotomija s kojim se osigurava prohodan dišni put. Nakon osiguranja dišnoga puta s bilo kojim od navedenih tehnika i pomagala, mora se osigurati kvalitetna oksigenacija i ventilacija, kontrolirana ili asistirana.

Abstract (english)

Prehospital airway management has a crucial importance in moments when it is necessary to take care of the critically ill / injured person with or without the airway obstruction. Then, by using basic manual methods, head tilt and chin lift or jaw-thrust, it is necessary to ensure the airway with the adjunct to basic airway techniques, oropharyngeal or nasopharyngeal tubes. This allows normal breathing if the person breathes spontaneously. If the person has gags or strains it is forbidden to use it because of the possible vomiting. Suction equipment must always be ready at the time of airway management. In order to provide the airway, and particularly in the case of respiratory arrest, and to provide good ventilation and oxygenation, more advanced techniques are needed. In that case, endotracheal intubation is needed as a gold standard to protect the airway. In the case of a difficult intubation and the inability to do so, it is necessary to think about alternative techniques. These are supraglottic devices that can be set up quickly and efficiently and ensuring the airway and ventilation. In the case of obstruction of the upper airway above glottis, none of the above techniques will be successful to ensure and protect the airway. Then it is a cricothyroidotomy that ensures the airway. After ensuring airway with any of the above techniques and devices must be provided with high-quality oxygenation and ventilation, controlled or assisted.

• Keywords: zbrinjavanje dišnoga puta; izvanbolnički uvjeti; manualne vještine; osnovna pomagala; napredne tehnike; sukcija; ventilacija; oksigenacija
• Keywords (english): airway management; prehospital; manual skills; basic techniques; advanced techniques; suction; ventilation; oxygenation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:326296
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-03-19 13:40:25