Analiza perioperativne računalniške simulacije P.O.P.S. - Perioperative patient simulation

(diplomsko delo)

Tamara Praznic (Avtor), Miljenko Križmarić (Mentor), Dušan Mekiš (Komentor)

Povzetek

Razne simulacije v medicini in zdravstveni negi postajajo temelj učenja študentov, ki izboljšujejo kakovost njihovega dela v realnem kliničnem okolju. Omogočajo trening sposobnosti, ki jih v resničnih situacijah ne morejo izkusiti. Namen diplomskega dela je bil preučiti in predstaviti računalniško simulacijo P.O.P.S. (ang. perioperative patient simulation). Simulacijo smo analizirali z dovajanjem specifičnih zdravil v vseh treh primerih, ki so na voljo: kardiogeni šok, hipovolemični šok in septični šok. Pri tem smo opazovali reakcije in beležili čas trajanja simulacije. Zanimalo nas je, kako je videti računalniško okolje simulacije, koliko in katere funkcije imamo na voljo pri reševanju kliničnih zapletov, kako je simulacija P.O.P.S. približana realnemu reševanju problemov v praksi ter katere intervencije in tehnologije imamo na voljo. Do simulacije lahko brezplačno dostopa vsak neregistrirani uporabnik. Preden se odločimo za vstop v simulacijsko okolje, nam spletna stran ponudi navodila za upravljanje simulacije. Simulacijo lahko kadarkoli ustavimo, si ogledamo navodila, pregledamo stanje vitalnih funkcij, aplicirana zdravila, intervencije in diagnostiko. Ugotavljamo, da lahko z razpoložljivimi zdravili, tekočinami in intervencijami stabiliziramo bolnika. Pri kardiogenem šoku smo bolnika uspešno zdravili s 5 mikrogrami dobutamina na kilogram telesne mase, s čimer smo povečali porabo kisika v srčni mišici. Vitalne funkcije v šokovnem stanju smo vzdrževali z infuzijo Ringerjeve raztopine 1000 ml. Bolnik je preživel. Pri krvavitvah smo nadomeščali izgubljen volumen tekočine. Uporabljajo se kristaloidi, koloidi in krvni pripravki. Naš bolnik je prejel infuzijo Ringerjeve raztopine 1000 ml in 250 ml koncentriranih eritrocitov ter preživel. Pri septičnem šoku nadomeščamo tekočino in uporabljamo zdravila z inotropnim delovanjem, vazokonstriktorje in vazodilatatorje. Bolnik s septičnim šokom je preživel z aplikacijo 0,2 mikrograma noradrenalina na kilogram telesne mase, dovajanjem tekočine Ringerjeve raztopine 1000 ml in ohlajanjem telesa zaradi povišane telesne temperature. S spletne strani Edwards Lifesciences smo pridobili strokovne članke, ki se nanašajo na hemodinamično spremljanje in šokovna stanja, zato je simulacija primerna za vse, ki želijo dopolniti svoje znanje na tem področju.

Ključne besede

P.O.P.S.;simulacije;monitor Vigileo;EV 1000;kardiogeni šok;hipovolemični šok;septični šok;

Podatki

Jezik:	Slovenski jezik
Leto izida:	2015
Tipologija:	2.11 - Diplomsko delo
Organizacija:	UM FZV - Fakulteta za zdravstvene vede
Založnik:	[T. Praznic]
UDK:	616-083:004.94(043.2)
COBISS:	2164132
Št. ogledov:	910
Št. prenosov:	116
Ocena:	0 (0 glasov)
Metapodatki:

Ostali podatki

Sekundarni jezik:	Angleški jezik
Sekundarni naslov:	An analysis of perioperative computer simulation P.O.P.S.-perioperative patient simulation
Sekundarni povzetek:	Various simulations in medicine and health care are becoming the foundation for the learning of students, as they improve the quality of their work in the real clinical environment. Moreover, simulations provide training of skills which students cannot experience in real-life situations. The aim of the thesis was to examine and present the P.O.P.S. (perioperative patient simulation) computer simulation. The simulation was analysed by administering specific medications in all three cases, which are available: cardiogenic shock, hypovolaemic shock and septic shock. At the same time, the reactions were observed and the duration of the simulation was recorded. We were interested in how a computer simulation environment looked like, how many and which functions were available for resolving clinical complications, how effective was the P.O.P.S. simulation compared to the resolving of problems in practice, and which procedures and technologies were available to us. Simulation can be accessed free of charge by any unregistered user. Prior to entering the simulation environment, you can read the simulation management instructions on the website. The simulation can be stopped at any time, you can consult the instructions as well as check the vital functions, the administered medications, procedures and diagnostics. We found that the patient could be stabilised through the use of available medicines, liquids and procedures. The patient experiencing cardiogenic shock was successfully treated with 5 micrograms/kg of dobutamine in order to increase the oxygen consumption of the cardiac muscle. The vital functions of the patient in shock were maintained by the infusion of 1000 ml of Ringer's solution. The patient survived. In the case of bleeding, the lost fluids were replaced by administering crystalloids, colloids and blood preparations. Our patient received the infusion of 1000 ml of Ringer's solution and 250 ml of concentrated erythrocytes, and survived. In a patient with septic shock, their fluids are replaced and medications with inotropic effect, vasoconstrictors and vasodialators are administered. Our patient experiencing septic shock survived by administering 0.2 microgram/kg of noradrenaline, receiving the infusion of 500 ml of Ringer's solution and cooling the patient's body due to elevated body temperature. Professional articles on haemodynamic monitoring and types of shock were obtained on the Edwards Lifesciences website; therefore, the simulation is suitable for anyone who wishes to broaden their knowledge in this area.
Sekundarne ključne besede:	P.O.P.S.;simulation;Vigileo monitor;EV 1000;cardiogenic shock;hypovolaemic shock;septic shock;
URN:	URN:SI:UM:
Vrsta dela (COBISS):	Diplomsko delo/naloga
Komentar na gradivo:	Univ. v Mariboru, Fak. za zdravstvene vede
Strani:	V, 42 f.
ID:	9055894