pregled literature
Kristina Raca (Author), Jože Prestor (Reviewer), Robert Sotler (Mentor), Andreja Bevk Prek (Co-mentor)

Abstract

Uvod: Intubacija s hitrim zaporedjem postopkov je tehnika, zasnovana za lažjo endotrahealno intubacijo pri pacientih z visokim tveganjem za aspiracijo. Aspiracija je povezana z nastankom zapletov med anestezijskimi postopki in je pomemben vzrok mortalitete in morbiditete v anesteziji. Medicinska sestra se mora pogosto seznaniti z novostmi, da lahko zagotovi najbolj optimalne tehnike za pacientovo varnost. Namen: Namen diplomskega dela je predstaviti intubacijo s hitrim zaporedjem postopkov, njeno uspešnost, prednosti in slabosti krikotiroidnega pritiska, vlogo medicinske sestre pri izvajanju intubacije s hitrim zaporedjem postopkov v bolnišničnem in izvenbolnišničnem okolju ter z metasintezo znanstvene literature potrditi naslednje trditve: intubacija s hitrim zaporedjem postopkov je v primerjavi z intubacijo brez premedikacije uspešnejša; medicinska sestra je kompetentna in usposobljena za pomoč pri izvajanju intubacije s hitrim zaporedjem postopkov; krikotiroidni pritisk preprečuje aspiracijo želodčne vsebine. Metode dela: Metoda dela je deskriptivna. Opravljena sta pregled literature obravnavane teme in metasinteza znanstvenih študij. Uporabili smo spletni portal COBISS.si in podatkovne baze Cohrane, Cinahl with full text, Wiley, NIH (National Institutes of Health), Medline in PubMed. Rezultati: Metasinteza kliničnih študij je bila narejena po štiristopenjskem vrednotenju z lestvico avtorjev Eccles in Mason. Največjo veljavo imajo dokazi prve stopnje, označeni z I, najmanjšo pa četrte stopnje, označeni z IV. Potrjena je bila samo ena trditev, in sicer da je intubacija s hitrim zaporedjem postopkov v primerjavi z intubacijo brez premedikacije uspešnejša. Trditve, da so medicinske sestre usposobljene za pomoč pri izvajanju intubacije s hitrim zaporedjem postopkov, nismo dokazali, saj so raziskave pokazale, da čeprav medicinske sestre, ki delajo na urgentnih oddelkih, pri postopkih pomagajo pri intubaciji s hitrim zaporedjem postopkov, se ti postopki ne izvajajo dovolj pogosto in zaradi tega tudi niso pokazale ustrezne ravni usposobljenosti. Pri trditvi, da krikotiroidni pritisk preprečuje aspiracijo, so si mnenja in raziskave zelo različna, tako da trditve nismo potrdili. Razprava in zaključek: Intubacija s hitrim zaporedjem postopkov je učinkovita metoda intubacije tako v predbolnišnični kot bolnišnični oskrbi, njen cilj je preprečiti regurgitacijo in aspiracijo. Mnenja o uporabi krikotiroidnega pritiska so še vedno deljena, saj obstaja vedno več dokazov, ki postavljajo pod vprašaj njegovo učinkovitost in varnost, zato je njegova uporaba odvisna od posameznega anesteziologa. Da medicinske sestre lahko sodelujejo in pomagajo pri intubaciji s hitrim zaporedjem postopkov, potrebujejo dodatna usposabljanja s simulacijskimi treningi, saj na njihovo znanje in kompetentnost vpliva frekvenca izvajanja določenih posegov. Intubacija je kritičen postopek, ki se ne izvaja zelo pogosto, kar vpliva na samostojnost in samozavest medicinske sestre.

Keywords

diplomska dela;zdravstvena nega;endotrahealna intubacija;krikotiroidni pritisk;aspiracija želodčne vsebine;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [K. Raca]
UDC: 616-083
COBISS: 5434987 Link will open in a new window
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Other data

Secondary language: English
Secondary title: ǂThe ǂrole of a nurse in the implementation of intubation with rapid sequence induction - RSI ʺrapid sequence inductionʺ
Secondary abstract: Introduction: Intubation with rapid sequence induction is a technique designed to facilitate endotracheal intubation in patients with a high risk of aspiration. Aspiration is associated with the onset of complications during anaesthetic procedures and is an important cause of mortality and morbidity in anaesthesia. The nurse must often be familiar with novelties in order to provide the most optimal techniques for patient’s safety. Purpose: The purpose of this thesis is to present the intubation with rapid sequence induction, the success of intubation with rapid sequence induction, the advantages and disadvantages of the cricoid pressure, to present the role of a nurse in performing intubation with rapid sequence induction in and out of hospital environment, and to confirm the three hypotheses through a meta-syntheses of clinical studies: intubation with rapid sequence induction is compared to intubation without premedication more effective; the nurse is competent to assist in the implementation of intubation with rapid sequence induction; cricoid pressure prevents aspiration od gastric contents. Methods: A descriptive method is used. We have performed a literature review on the topic discussed and meta-syntheses of scientific studies. Literature search methods included COBISS.si portal and different databases, namely Cohrane, Cinahl with full text, Wiley, NIH (National Institutes of Health), Medline, and PubMed. Results: Meta-synthesis of clinical studies was performed using a four-level scale by Eccles and Mason. The highest valued arguments are marked as level I, whilst the lowest are marked with IV. Only one hypothesis was confirmed, and that was that intubation with rapid sequence induction, compared with intubation without premedication, is more effective. The hypothesis that nurses are capable to assist in the implementation of intubation with rapid sequence induction was not proven, as the research has shown that in spite of the fact that nurses work in emergency departments, in procedures where they help, they do not perform the intubation often enough and because of that they had not shown adequate level of competence. The hypothesis that cricoid pressure prevents aspiration, research and opinions are divergent, so we could not confirm it. Discussion and conclusion: Intubation with rapid sequence induction is an effective method of intubation both in prehospital and hospital care, which aims to prevent regulgitation and aspiration. Opinions on the use of cricoid pressure are still opposite, as there are more and more evidence that call into question the efficacy and safety of cricoid pressure, so that the application itself lies in the hands of individual anaesthetist. The nurse can cooperate and assist in intubation with rapid sequence induction if she has additional simulation training as the knowledge and competence of nurses is influenced by the frequency of performing certain intervention. Intubation is a critical procedure that is not performed very often, which affects the independence and self-confidence of a nurse.
Secondary keywords: diploma theses;nursing care;endotracheal intubation;cricoid pressure;aspiration of gastric content;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Embargo end date (OpenAIRE): 1970-01-01
Thesis comment: Dipl. delo (bolonjski študij), Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Pages: 31 str.
ID: 10938262