Anesteziološko zbrinjavanje politraumatiziranog bolesnika

master's thesis

• Title (english): Trauma patient anesthesiology managment
• Author: Dorotea Stričević
• Mentor: Tomislav Radočaj (mentor)
• Committee member: Marinko Vučić (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Tomislav Radočaj (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Politrauma se definira kao istovremeno postojanje teških ozljeda barem dviju tjelesnih regija pri čemu je najmanje jedna od tih ozljeda ili kombinacija više njih opasna po život. Zbrinjavanje bolesnika s politraumom izazovno je zbog zahvaćenosti više organa i organskih sustava, ozbiljnosti ozljeda, teško dostupnih i ograničenih informacija o bolesniku, patofizioloških zbivanja koji se razvijaju, prisutnosti akutne boli te ograničenog preoperativnog vremena unutar kojeg je potrebno stabilizirati bolesnika. Unatoč tim činjenicama, poboljšano razumijevanje patofiziologije politraume evoluiralo je tijekom posljednja tri desetljeća, uključujući razvijanje algoritama zbrinjavanja traume koji su olakšali zbrinjavanje i skrb o bolesnicima tijekom njihove hospitalizacije. Optimalno zbrinjavanje bolesnika s traumom zahtijeva multidisciplinarni, multimodalni i koordinirani timski pristup za uspješan ishod. Postupak zbrinjavanje politraume započinje prije hospitalizacije bolesnika pri čemu je najvažnija njegova stabilizacija, nakon toga slijede sedacija i analgezija u objedinjenom hitnom bolničkom prijemu, kontinuirana hemodinamska stabilizacija, rješavanje koagulopatije povezane s traumom, preoperativna priprema, osiguravanje dišnog puta i ventilacije, adekvatna operativna i postoperativna kontinuirana skrb te rehabilitacija. Za uspješan ishod tijekom liječenja politraume potreban je iskusan i stručan anesteziolog, ali i suradnja s ostalim medicinskim djelatnicima kao što su medicinske sestre i tehničari, specijalisti transfuzijske medicine, specijalisti hitne medicine i kirurzi.

Abstract (english)

Polytrauma is described as the simultaneous existence of severe injury of at least two body regions and at least one injury or a combination of several injuries that are life-threatening. The management of polytrauma patients can be challenging due to multi-organ involvement, occult injuries, limited information about patient history, evolving physiological derangements, presence of acute pain, limited time available to stabilize the patient in the pre-operative period. Despite these facts, improved understanding of the pathophysiology of polytrauma has evolved over the past three decades including evolving models of trauma care which has helped guide the medical care of patients during their hospitalization. Optimal management of patients of trauma requires a multi-disciplinary, multimodal, and coordinated team approach for a successful outcome. Trauma anaesthesia begins before the patient arrives with a role in pre-hospital set-up followed by sedation and analgesia in the Accident and Emergency Department, on-going haemodynamic resuscitation, dealing with trauma associated coagulopathy, preoperative optimization, ventilatory strategies, intensive care monitoring, and rehabilitation including pain management. A successful outcome during the treatment of polytrauma requires an experienced and professional anesthesiologist, but also cooperation with other medical professionals such as nurses and technicians, transfusion medicine specialists, emergency medicine specialists and surgeons.

• Keywords: politrauma; ozljeda; politraumatizirani bolesnik; anesteziološka skrb; anestezija politraumatiziranog bolesnika
• Keywords (english): polytrauma; injury; polytraumatized patient; anesthesiological care; anesthesia of a polytraumatized patient
• Language: croatian
• URN:NBN: urn:nbn:hr:105:118544
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-02-24 13:39:55