Tavis tvinis mwvave dazianebis mqone pacientTa marTva ...

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.