SANTRAUKA Autorė: Kačėnaitė I. Tema: Politrauminių ligonių slaugos poreikiai ir ypatumai priėmimo skyriuje. Slaugos magistro baigiamasis darbas Darbo vadovas: med.m.dr. G. Laužikas Vilniaus universitetas Medicinos Fakultetas Bendrosios medicinos ir slaugos katedra, Antakalnio 57, Vilnius, Lietuva. 2006 06 14 Puslapių skaičius – 65. Tikslas: Išanalizuoti svarbiausius slaugos aspektus ir išnagrinėti slaugos optimizavimą teikiant pagalbą ligoniams, patyrusiems politraumą, priėmimo skyriuje. Uždaviniai: 1. Išanalizuoti kokių organizmo gyvybynių veiklų sutrikimai įtakoja ligonių, patyrusių politraumą, slaugą. 2. Nustatyti ligonių, patyrusių politraumą, dažniausias slaugos problemas. 3. Nustatyti priėmimo skyriuje dažniausiai atliekamus slaugos veiksmus teikiant pagalbą pacientams, patyrusiems politraumą. 4. Ištirti priežastis, sąlygojančias ligonio, patyrusio politraumą, slaugos trukmę priėmimo skyriuje. Tyrimo metu buvo išanalizuotos slaugos istorijos bei apžiūros protokolai 99 ligonių, atvykusių į VšĮ Vilniaus greitosios pagalbos universitetinės ligoninės priėmimo skubiosios pagalbos ir konsultacijų skyrių su diagnoze politrauma nuo 2005 11 01 iki 2005 12 31. Taip pat buvo apklaustos slaugytojos, dirbančios Vilniaus greitosios pagalbos universitetinės ligoninės (26 slaugytojos), Vilniaus universiteto ligoninės Santariškių klinikų Centro filialo (10slaugytojų) bei Kauno miesto universitetinių klinikų (16 slaugytojos) priėmimo skyriuose. 1. Paciento, patyrusio dauginę traumą... [toliau žr. visą tekstą] / SUMMARY Author: Kačėnaitė I. Title: Needs and Peculiarities of Nursing Polytraumatic Patients at Reception Department Work on completion of the nursing specialty Work supervisor: D. m. sc. G. Laužikas Vilnius University Medical Faculty Department of General Medicine Practice and Nursing, Antakalnio 57,Vilnius, Lithuania 2006 06 14 Number of pages – 65 Aim: To analyse the main nursing aspects as well as nursing optimisation while providing aid at the reception department to patients who suffer from polytrauma. Objectives: 1. To analyse body’s vital activity disorders which have impact upon nursing patients who have experienced polytrauma. 2. To establish the most common problems while nursing patients with polytrauma. 3. To establish the most common accomplished nursing activities while providing aid at the reception department to patients who have experienced polytrauma. 4. To analyse the causes, which determine the nursing term at the reception department of a patient with polytrauma. During the course of investigation case records as well as examination reports of 99 patients who arrived at the Ambulance and Consultation Department of the Reception Department of Vilnius Ambulance University Hospital with the diagnosis of polytrauma from 2005 11 01 to 2005 12 31 have been analysed. Besides, the nurses working at the reception departments of Vilnius Ambulance University Hospital (26 nurses), Santariskiu Clinics Branch of Vilnius University Hospital (10 nurses) as well as... [to full text]

Submitted by (edna.saturno@ufrpe.br) on 2016-08-11T16:21:32Z No. of bitstreams: 1 Bruno Martins Araujo.pdf: 2084941 bytes, checksum: 63b9d4471e02acbbd35a879b95c57ae3 (MD5) / Made available in DSpace on 2016-08-11T16:21:32Z (GMT). No. of bitstreams: 1 Bruno Martins Araujo.pdf: 2084941 bytes, checksum: 63b9d4471e02acbbd35a879b95c57ae3 (MD5) Previous issue date: 2013-02-02 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Vertebral fractures and luxations (VFL) are one of the most common and severe neurological issues found in clinical practice, with an elevated risk of permanent damage to the spinal cord. Our objective was to study the characteristics and implications associated with thoracolumbar VFL in 37 dogs examined at the Veterinary Hospital of the Universidade Federal Rural de Pernambuco. Each patient had detailed history obtained, followed by clinical, neurologic and radiographic exams. The dogs were submitted to conservative or surgical treatment according to each case. The VFL were more common in intact males with access to the street. Regarding etiology, 32 dogs were involved in car accidents. Of the dogs included in this research, 14 had non-neurological issues in other systems. Radiographic exams were 100% effective in diagnosing VFL, but 42.8% of the dogs treated surgically had vertebral lesions that weren't detected radiographically. Mean time until initial neurologic exam was 35 days, and most dogs were reffered without external coaptation. There was a significant difference in recovery of the dogs when comparing a degree of dislocation of 0 – 25% and 76 – 100%. Presence of two or three severe neurological signs was associated with a poor prognosis, while lack or just one of these indicated a favorable prognosis. Deep pain perception (DPP) was present in 37.7% of the dogs. Twenty dogs received conservative treatment, 14 underwent surgery and three dogs died before treatment for the acute spinal trauma. Of the dogs with intact DPP, 100% recovered, while none of the dogs that lost DPP recovered voluntary motion (five developed spinal walk). Presence or absence of DPP is a reliable prognostic indicator. However, there was no significant difference in time for recovery of voluntary motion in dogs with intact DPP when comparing surgical versus conservative treatment. The percentage of euthanasia was less than in other reports, probably due to the greater awareness and protectiveness of owners nowadays. Of the dogs without DPP treated either surgically or conservatively, 31.25% recovered the ambulation without recovery of DPP. / Fraturas e luxações vertebrais (FLV) são uma das afecções neurológicas mais graves e comumente encontradas na prática clínica, com elevado risco de danos permanentes à medula espinal. Objetivou-se estudar as características e implicações associadas às FLV toracolombares em 37 cães atendidos no Hospital Veterinário da Universidade Federal Rural de Pernambuco. Cada paciente passou por anamnese, seguida por exames clínicos, neurológico e radiográfico. Os cães foram submetidos ao tratamento conservativo ou cirúrgico de acordo com cada caso. As FLV foram mais comuns em machos não castrados com acesso a rua. Dentre a etiologia, 32 cães foram acometidos por acidente automobilístico. Dos animais da pesquisa, 14 apresentaram lesões não neurológicas em outros sistemas. Por meio do exame radiológico se diagnosticou FLV em 100% dos casos, mas nos cães submetidos ao tratamento cirúrgico, observou-se uma grande quantidade destes apresentavam lesões vertebrais não detectadas nas radiografias convencionais (42,8%). O tempo médio ate o atendimento neurológico inicial foi de 35 dias, no qual a maioria foi encaminhada sem imobilização externa. Houve diferença estatisticamente significante ao se comparar os graus de deslocamento de 0 a 25% e de 76 a 100%. A presença de dois ou três sinais neurológicos graves esteve relacionada a prognóstico desfavorável, enquanto que a ausência ou presença de apenas um destes indicou um prognóstico favorável. A percepção de dor profunda (PDP) estava presente em 37,7% dos animais. Vinte animais foram submetidos ao tratamento conservativo, 14 ao tratamento cirúrgico e três animais faleceram antes de ser realizado o tratamento do traumatismo medular agudo propriamente dito. Dos animais que mantiveram a PDP intacta, a taxa de recuperação foi de 100%, enquanto que dos animais que perderam a PDP nenhum recuperou a deambulação voluntária (cinco adquiriram caminhar espinal). O parâmetro de ausência ou presença de PDP é um confiante indicativo do prognóstico desta afecção. Apesar de que nos animais que mantiverem a PDP intacta, independente do tratamento instituído e do grau de comprometimento neurológico, não houve diferença significante nas taxas nem no tempo de recuperação da deambulação voluntária. A taxa de eutanásia foi menor que em outros trabalhos descritos na literatura, provavelmente devido a conscientização e protecionismo dos tutores nos dias atuais. Dos animais sem PDP submetidos ao tratamento conservativo ou cirúrgico, 31,25% readquiriram a capacidade de caminhar sem recuperar a PDP.

<p>Pod pojmom politraume se podrazumeva te&scaron;ka istovremena povreda najmanje dve regije tela sa anatomskom težinom povrede AIS koja je jednaka ili veća od tri kao i ukupna izračunata anatomska težina povreda izražena ISS zbirom mora da bude veća od 15. Cilj istraživanja je da se primenom upitnika (SF36, PTSD&ndash;testa i Glazgov skale ishoda) proceni kvalitet života između politraumatizovanih pacijenata sa prelomomima dugih kostiju i politraumatizovanih bez preloma duge kosti kao i da se uoče rani pokazatelji lo&scaron;e prognoze kvaliteta života nakon zavr&scaron;etka lečenja. Istraživanje je prospektivnog karaktera i obuhvatilo je 202 politraumatizovana pacijenta koji su bili povređeni u periodu 2010-2014 godine i bili lečeni u Urgentnom Centu Kliničkog Centra Vojvodine. Od 202 politraumatizovana pacijenta na kontrolne preglede se odazvalo ukupno 72 pacijenta, 37 sa prelomima dugih kostiju - ispitivana grupa i 35 politraumatizovanih pacijenata bez preloma duge kosti koji su činili kontrolnu gupu. Godinu dana nakon zavr&scaron;etka hospitalizacije svaki ispitanik je popunjavao upitnik( SF36, PTSD test i Glazgov skala ishoda ), načinjen je klinički pregled i standardna radiografija predela preloma duge kosti. Rezultati ukazuju da ukupni kvalitet života nakon zavr&scaron;etka lečenja se ne razlikuje značajno između ispitivanih grupa, iako politraumatizovani sa prelomima dugih kostiju imaju niži kvalitet života, odnosno značajno lo&scaron;ije fizički funkcioni&scaron;u i imaju značajno če&scaron;će psihičke poremećaje (postraumatski stresni poremećaj, depresija) u odnosu na kontrolnu grupu. Tip preloma duge kosti nije uticao na krajnji kvalitet života politraumatizovanih, dok su oni sa dva i vi&scaron;e preloma imali značajno lo&scaron;iji kvalitet života. Na osnovu dobijenih rezultata konstatovali smo da veću &scaron;ansu za bolji kvalitet života imaju pacijenti mlađi od 44 godine, ukoliko su inicjalno imali vrednost ISS skora manji od 30,5 bodova, vrednosti sistolnog i dijastolnog arterijskog pritiska u referentnim vrednostima, kao i broja eritrocita i trombocita, i ukoliko su primili manje od 4 jedinica transfuzije krvi u prva 24 časa.</p> / <p>The term of polytrauma means, a patient with multiple severe injuries in at least two regions of the body with anatomical severity of trauma AIS equal or greater than three and the total calculated weight anatomical injuries expressed by ISS score must be greater than 15. The aim of our study is early estimate of quality of life in polytrauma patients with multiple fractures of the long bones and polytrauma patients without fractures of long bones as well as to detect early indicators of poor prognosis of quality of life after treatment, using questionnaires (SF 36, PTSD test and Glasgow Outcome Scale). This was prospective study and included 202 polytrauma patients who were injured during the period 2010-2014 and were treated in the Emergency Center of Clinical Center of Vojvodina. From 202 polytrauma patients, on control examinations responded 72 patients, 37 with fractures of long bones - study group and 35 polytrauma patients without fractures of long bones and they were control group. One year after the end of hospitalization each patient filled out a questionnaire (SF36, PTSD test and Glasgow Outcome Scale), made a clinical examination and standard X-rays of long bone fractures. Our results indicate that the overall quality of life after treatment is not significantly different between the groups, although polytraumatized patients with fractures have a lower quality of life and significantly worse physical functioning and have significantly more mental disorders (post-traumatic stress disorder, depression) compared to the control group. Type of long bone fractures did not affect on the final quality of life, while those patients with two or more fractures had a significantly poorer quality of life. Based on these results we concluded that greater chance for a better quality of life have patients younger than 44 years, unless they had initially ISS score less than 30.5 points, systolic and diastolic blood pressure in the reference values as well as the number of red blood cells and platelets, and if they received less than 4 units of blood transfusions in the first 24 hours.</p>