UPORABA ZDRAVIL V NUJNI MEDICINSKI POMOČI PRI PACIENTU Z AKUTNIM KORONARNIM SINDROMOM - Tomplak, Renata (R. Tomplak, 2016)
Teoretična izhodišča: Bolezni srca in ožilja so eden glavnih vzrokov umrljivosti v Sloveniji in v Evropi, ne samo pri starejših, tudi pri srednjih generacijah. Akutni koronarni sindrom (AKS), ki v večini primerov nastane zaradi nestabilne aterosklerotične lehe in posledično tromboze, predstavlja eno najpomembnejših zdravstvenih težav in je glavni vzrok umiranja bolnikov s koronarno boleznijo. Raziskovalne metode: V diplomskem delu smo predstavili zgradbo srca in ožilja ter smernice za obravnavo pacientov z akutnim koronarnim sindromom. Želeli smo izvedeti ali se le –te upoštevajo v vsakdanji praksi pri obravnavi pacientov z AKS. Opravili smo analizo Protokolov nujne intervencije v Zdravstvenem domu Šmarje, v letih 2002, 2007 ter 2012 in jih grafično prikazali. Predstavljena so tudi zdravila, ki se uporabljajo pri zdravljenju AKS na terenu, ter vloga reševalca pri aplikaciji terapije. Rezultati: Rezultati analize protokolov v desetletnem obdobju so zadovoljivi, saj se smernice za obravnavo pacientov z AKS s strani ekip NMP v veliki meri upoštevajo. Analiza pričakovano kaže, da so srčno – žilne bolezni v porastu, da pogosteje obolevajo moški ter, da so le – ti v povprečju skoraj deset let starejši od žensk. Ugotovili smo, da največji problem predstavljata čas in mesto začetka zdravljenja, saj je bila ekipa NMP s strani pacienta aktivirana do 1,5 ure po pojavu bolečine v prsnem košu, ter da pacienti s tovrstnimi težavami največkrat kar sami pridejo v ambulanto NMP. Sklep: Ker je največji problem dokaj pozna aktivacija ekipe NMP s strani pacienta, menim, da so osebe z dejavniki tveganja za koronarno bolezen premalo osveščene o vzrokih, nevarnostih in zapletih, ki jim lahko pretijo ob nenadnem pojavu bolečine v prsnem košu. V veliki meri bi k prepoznavanju težav in zapletov oseb s koronarno boleznijo pripomogle zdravstveno –vzgojne delavnice ter mediji. Theoretical Background: Cardiovascular diseases are one of the main reasons for mortality in Slovenia and Europe not only with elderly but also with middle generation. Acute coronary syndrome (ACS) which in most cases occurs due to unstable atherosclerotic plaques and subsequent thrombosis is one of the most common health problems and is a major cause of death of patients with coronary artery disease. Methodology: Thesis presents the structure of the cardiovascular system and guidelines for the treatment of patients with acute coronary syndrome. We wanted to find out whether they are taken into account in everyday practice in the treatment of patients with ACS. We have analysed the Protocols of urgent intervention in the Health care centre Šmarje in the years 2002, 2007 and 2012 which were graphically shown. Medicines that are used in the treatment of ACS in the field are presented as well as the role of paramedic rescuer in the application of therapy. Results: The results of the analysis of protocols over a ten year period are satisfactory following the trends for the treatment of patients with ACS by Emergency Medical Service (EMS) which are largely considered. Analysis shows, as expected, that the cardio - vascular diseases are on the rise, that men suffer from it more often, and that they are in average almost ten years older than women. We have found out that the biggest problem represents the time and the place of beginning of the treatment, as the EMS is activated by the patient to 1.5 hour after the chest pain has begin, and that patients with these problems often come to the ambulance of EMS by themselves. Concluson: The biggest problem is quite late activation of EMS by the patient, which is why it is believed that persons with risk factors for coronary artery disease have a lack of awareness on the causes, dangers and complications that can threaten the sudden occurrence of a chest pain. Health workers and the media could to a large extent help to the identification of problems and complications for people with coronary artery disease.