| Abstract | CILJ: Cilj završnog rada je prikazati kompleksnost skrbi politraumatiziranog bolesnika, kao i provedene postupke medicinskog tima u kojem medicinska sestra ima važnu ulogu. U radu će biti prikazan slučaj politraumatiziranog bolesnika od dolaska na Objedinjeni hitni bolnički prijem, zbrinjavanja u operacijskoj dvorani, potom Jedinici intenzivnog liječenja i na Odjelu kirurške intenzivne njege.
RASPRAVA: Bolesnica P.B., rođena 1949. godine, dovezena je na OHBP u popodnevnim satima kao sudionica prometne nesreće u ulozi pješaka. Prilikom prelaska ceste, na mjestu nepredviđenom za pješake, udario ju je motocikl. Pri dolasku na OHBP pacijentica je bila nekontaktibilna, reagirala samo na bolni podražaj, nepokretna, afebrilna, tahipnoična, blijeda, bolna, GCS 9, trijažne kategorije dva. Po dolasku na OHBP i u op. sali zbrinute su ozljede krvnih žila te otvoreni i zatvoreni prijelomi ekstremiteta osteosintezom, reponiranjem, postavljenjem vanjskih fiksatora i sadrene imobilizacije. Prijelomi su predstavljali najveću opasnost po život pacijentice uz hemodinamsku nestabilnost (traumatski i hipovolemični šok). Devetodnevno liječenje u JILu bilo je uspješno uz primjenu raznovrsnih lijekova, medicinsko- tehničkih postupaka te liječničke i sestrinske skrbi. U tom vremenskom razdoblju izvršena je reoperacija (osteosinteza desnog femura i prefiksacija lijevog). Plastični kirurg zbrinuo je ozljede mekih tkiva. Operacijski zahvat i postoperativni oporavak protekli su bez poteškoća. Pacijentica je ubrzo prebačena na OKINJ, a nedugo zatim na Odjel za opću i gerijatrijsku ortopediju i traumatologiju.
ZAKLJUČAK: Politrauma je jedna od najučestalijih vrsta ozljeda današnjeg doba. Postoji mnoštvo literature koja opisuje definicije, mehanizme nastanka i prikaze slučaja politrauma. Dio te literature su i ljestvice za procjenu težine i klasifikacije politraume koje uvelike olakšavaju njeno zbrinjavanje posebno u vanbolničkim uvjetima gdje je bitan čimbenik vrijeme. |
| Abstract (english) | AIM OF THE STUDY: The goal of the final paper is to show the complexity of the care of a polytraumatized patient, as well as the procedures performed by the medical team in which the nurse plays an important role. The paper will present the case of a polytraumatized patient from the time he arrived at the Emergency Department until treatment in the operating room, then the Intensive Care Unit and the Surgical Intensive Care Department.
DISCUSSION: Patient P.B., born in 1949, was brought to ER in the afternoon as a participant in a traffic accident as a foot passenger. While crossing the road, in a place not intended for pedestrians, she was hit by a motorcycle. On arrival at the ER, the patient was uncommunicative, reacted only to painful stimulation, immobile, afebrile, tachypneic, pale, painful, GCS 9, triage category two. Upon arrival at ER and in operation room, blood vessel injuries were treated. Open and closed limb fractures are treated with osteosynthesis, repositioning, placement of external fixators and plaster immobilization. Fractures were the greatest danger to the patient's life along with hemodynamic instability (traumatic and hypovolemic shock). The nine-day treatment in the ICU was successful with the use of various drugs, medical-technical procedures and medical and nursing care. In that time period, a reoperation was performed, osteosynthesis of the right femur and prefixation of the left femur. Plastic surgeon took care of damaged soft tissues. The operation and post-operative recovery were successful. The patient was soon transferred to Surgical ICU, and then to the Department of General and Geriatric Orthopedics and Traumatology.
CONCLUSION: Polytrauma is one of the most common types of injuries nowdays. There is a wealth of literature that describes definitions, mechanisms of occurrence and case reports of polytrauma. Futhermore, scales for assessing the severity and classification of polytrauma are also part of this literature, which greatly facilitate its management, especially in outpatient settings where time is an important factor. |
