Protocol de abordare a durerii toracice in urgenta - Cursul national ...
Protocol de abordare a durerii toracice in urgenta - Cursul national ...
Protocol de abordare a durerii toracice in urgenta - Cursul national ...
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ciata ca fi<strong>in</strong>d critica pentru viata pacientului, un al doilea dispecer va puteafi conectat la apel. Sarc<strong>in</strong>a celui <strong>de</strong>-al doilea dispecer este <strong>de</strong> a dispecerizasi directiona echipajul la caz <strong>in</strong> timp ce dispecerul care a primit apelul dasfaturi si <strong>in</strong>structiuni <strong>in</strong> functie <strong>de</strong> tipul urgentei, <strong>de</strong> exemplu <strong>in</strong>structiunile<strong>de</strong> resuscitare cardiorespiratorie pentru martorii unui stop cardiac. Pentrudispecerii d<strong>in</strong> serviciile <strong>de</strong> <strong>urgenta</strong> exista necesitatea educatiei cont<strong>in</strong>ue sirecertificarii (1).Recomandari:1. Dispeceratul 112 necesită tra<strong>in</strong><strong>in</strong>g cont<strong>in</strong>uu, protocoale naţionale şi unsistem <strong>de</strong> control al calităţii (Clasa I, Nivel C) (3).2. Dispeceratul 112 poate aviza pr<strong>in</strong> telefon auto-adm<strong>in</strong>istrarea <strong>de</strong> aspir<strong>in</strong>aoral (<strong>de</strong> mestecat) 150-325 mg <strong>in</strong> cazul <strong>in</strong> care nu exista alergie laaspir<strong>in</strong>a (Clasa IIa, Nivel C) <strong>in</strong>a<strong>in</strong>te <strong>de</strong> ajungerea echipajului <strong>de</strong> <strong>urgenta</strong><strong>in</strong> prespital (3) la pacientul cu durere toracica.597A patra poarta: Serviciile medicale <strong>de</strong> <strong>urgenta</strong> d<strong>in</strong> prespitalEvaluarea si tratamentul <strong>durerii</strong> <strong>toracice</strong> <strong>de</strong> catre serviciile medicale <strong>de</strong><strong>urgenta</strong> prespitalicesti poate fi facuta <strong>de</strong> catre diverse tipuri <strong>de</strong> echipaje <strong>in</strong>functie <strong>de</strong> calificare: <strong>de</strong> la echipaje <strong>de</strong> prim ajutor calificat, la echipajele cuasistent medical, medic sau echipaje <strong>de</strong> terapie <strong>in</strong>tensiva mobila.Pr<strong>in</strong>cipalele obiective ale asistentei medicale <strong>de</strong> <strong>urgenta</strong> <strong>in</strong> prespital <strong>in</strong>cazul pacientului cu durere toracica care apeleaza Dispeceratul 112 sunt:• sust<strong>in</strong>erea functiilor vitale• stabilizarea pacientului• <strong>in</strong>ceperea etapelor <strong>de</strong> diagnostic• <strong>in</strong>ceperea tratamentului simptomatic• prevenirea aparitiei complicatiilor si leziunilor ireversibile.Obiectivul echipajului medical d<strong>in</strong> prespital este <strong>de</strong> a <strong>de</strong>ci<strong>de</strong> daca pacientulare nevoie <strong>de</strong> tratament <strong>de</strong> <strong>urgenta</strong>, evi<strong>de</strong>nt <strong>in</strong> cazul pacientului <strong>in</strong>stabilsau necesitand anamneza si examen fizic complet. Decizia transportului <strong>de</strong><strong>urgenta</strong> la spital va fi luata si daca pacientul are istoric <strong>de</strong> boala ischemicacoronariana sau risc crescut pr<strong>in</strong> prezenta factorilor <strong>de</strong> risc: hiperlipi<strong>de</strong>mie,diabet, fumat, hipertensiune, sex mascul<strong>in</strong> si vârsta peste 50 <strong>de</strong> ani, sex fem<strong>in</strong><strong>in</strong>si vârsta peste 60 <strong>de</strong> ani, antece<strong>de</strong>nte heredocolaterale coronariene.Dar aceste <strong>in</strong>formatii sunt uneori dificil <strong>de</strong> obt<strong>in</strong>ut <strong>de</strong> catre echipajul d<strong>in</strong>prespital la fata locului sau <strong>in</strong> ambulanta.Timisoara 2009
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