Tavis tvinis mwvave dazianebis mqone pacientTa marTva ...

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yvela saxis travmis dros, pacientis mkurnaloba iwyeba sasunTqi gzis da xerxemlis kisrisnawilis dacviT, sunTqvisa da cirkulacia-hemoragiis kontroliT.amis Semdeg iwyeba nevrologiuri Sefaseba. am dros yuradReba eqceva or komponents (a)cnobierebis donis gansazRvra gkS-is mixedviT da (b) pacientis gugebis zomis,simetriulobis da reaqciis Sefaseba. yoveli maTgani detalurad aris qvemoT ganxiluli.a. glazgos komis Skalaglazgos komis Skala aris Tavis tvinis dazianebis mniSvnelovani indikatori,gansakuTrebiT ki im SemTxvevaSi Tu vimeorebT am Sefasebas drois monakveTSi da avRniSnavTmdgomareobis gamosworebas Tu gauaresebas. umaRlesi qula aris 15, xolo yvelaze dabali3. ori maCveneblis daqveiTeba miuTiTebs mniSvnelovan dazianebaze. uneblie paTologiuripozac aris mniSvnelovani maCvenebeli (dekortikaciuli-fleqsoruli Tu decerebraciulieqstenzoruli).glazgos komis SkaliT Sefaseba unda moxdes rogorc sasunTqi gzis,ventilaciis da cirkulaciis pirveladi Sefasebisas, aseve unda gameordes yovelireanimaciuli Carevis an sedaciuri saSualebebis micemis Semdeg. glazgos komis SkaliTavadmyofi unda Seafasos saTanadod momzadebulma personalma da saTiTaod unda aRniSnossami damoukidebeli reaqcia:Tu pacienti imyofeba alkoholis an wamlis zemoqmedebis qveS, es unda aRiniSnospirveladi Semowmebisas, magram ar unda imoqmedos glazgos komis Skalis qulaze.danarTi # 1glazgos komis SkalakriteriumebiTvalebis gaxelaspontanuri (mizanmimarTuli)reaqcia xmazereaqcia tkivilzereaqcia ar aRiniSnebaqulebi4321verbaluri (metyvelebiTi) reaqciakiTxvebze iZleva swraf da swor pasuxebs (orientirebulia)pasuxobs abneulad (dezorientirebulia)pasuxobs araadeqvaturadwarmoTqvams gaurkvevel bgerebsver laparakobsmoZraobiTi reaqciaasrulebs miTiTebul moZraobebsSesabamisi reaqcia tkiviliT gaRizianebazetkiviliT gaRizianebaze amoZravebs kidurebstkivilze - kidurebis paTologiuri moxra (dekortikacia)tkivilze - kidurebis paTologiuri gaSla (decerebracia)moZraoba ar aRiniSneba54321654321
a. gugebis Sefasebagugebis sawyisi da ganmeorebiTi Semowmeba gvexmareba im pacientebis gamovlenaSi, romelTacaReniSnebaT Tavis tvinis mZime dazianeba da mentaluri statusis cvlileba. prehospitaluretapze damxmare personalma unda icodes sinaTlis refleqsis da gugebs Soris 1 mm-ze anmeti sxvaobis Sefaseba. gugas, romelic aranair reaqcias ar iZleva sinaTleze ewodebaarareaqtiuli, fiqsirebuli guga da SeiZleba iyos unilateraluri an bilateraluri.unilateraluri dilatirebuli, neli an arareaqtiuli guga miuTiTebs iseT fokalurdazianebaze, rogoricaa epiduruli an subduruli hematoma, an mxedvelobis nerviskompresia. bilateralurad fiqsirebuli da dilatirebuli gugebi miuTiTebs TvinisSeSupebis an hemoragiis Sedegad intrakranialuri wnevis momatebaze. bilateraluradSeviwrovebuli gugebi SeiZleba gamowveuli iyos xidis doneze arsebuli dazianebebiT,metaboluri encefalopaTiiT an wamlebiT (opiatebi). aqedan gamomdinare, is dro rodesacpacientis guga gaxdeba arareaqtiuli an aRiniSneba 1mm-ze meti sxvaoba gugebs Soris undaaRiniSnos pacientis nevrologiur monacemebSi. SeniSvna: gugebis monacemebis prognozuliRirebuleba mcirdeba wamlebis gamoyenebis, hipoTermiis, orbitaluri travmis an hipoqsiisSemTxvevaSi. gugebis reaqcia unda aRiniSnos vitaluri funqciebis yoveli Semowmebisas(yovel 5 wT-Si), transportirebamde da transportirebis Semdeg, da yovelTvis rocaaRiniSneba pacientis zogadi mdgomareobis cvlileba.• glazgos komis SkaliT Sefaseba 15-ze naklebi quliT travmis Semdeg;• cnobierebis dakargva travmis Sedegad;• raime fokaluri nevrologiuri deficiti gamowveuli tramviT;• eWvi Tavis qalas dazianebaze an Tavis Semavali Wriloba;• travmis Semdgomi amnezia;• travmis Semdgomi Tavis tkivili;• travmis Semdgomi Rebineba;• travmis Semdgomi gulyra;• glazgos komis SkaliT (gkS) Sefaseba 3-8 bali (danarTi #1).VI. gamokvlevis sqemaa. pirveladi mkurnalobis prioritetebi.pirveladi Sefaseba- sasunTqi gza- sunTqva- cirkulacia da kisrisimobilizacia- mini-nevrologiuriSemowmebatravmuli pacientis daxmarebisas, prioritetadiTvleba sabaziso reanimaciuli Sesafasebeli dasamkurnalo protokolebis miyola. sasunTqi gzis,sunTqvis, cirkulaciis Sefaseba da kisris sayelosstabilizacia Tavis travmis mqone yvela pacientSi,sawyisi Sefasebis dros.stabilizaciis Semdeg, pacients SeiZleba davusvaTSekiTxva, raTa miviRoT verbaluri pasuxi angaaxilos Tvalebi. Tu spontanurad ar aRiniSneba Tvalebis gaxela, maSin gamoiyenebafrCxilis baliSebze dawola. Semdgom fasdeba motoruli pasuxi, gkS srulad da gugebisreaqcia.aucilebelia, rom saSualo simZimiT an mZime travmiT pacientitransportirebapirdapir gadayvanil iqnes umaRlesi donis travmis centrSi.sasurvelia transportireba moxdes maSinve da ar gadadoT raime arakritikulimaCveneblis gamo. Tu SesaZlebelia, sasurvelia pacientis kisris stabilizaciada transportireba mwoliare mdgomareobaSi.
Page 1 and 2: Tavis tvinis mwvave dazianebis mqon
Page 3: yovelwliur SemTxvevaTa raodenoba ar
Page 7 and 8: ekomendirebuli da nazaluri intubaci
Page 9: ‣ hospitalSi transportirebis gada

Tavis tvinis mwvave dazianebis mqone pacientTa marTva ...

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