Hastanelerde kardiyak arrestlerin nasıl önlenebileceğine ilişkin model önerileri

Yıl 2019, Cilt: 1 Sayı: 4, 92 - 98, 22.09.2019

Yasemin Aslan , Şule Erişkin

https://doi.org/10.38053/agtd.585431

Öz

Amaç: Kardiyak arrestler hastanelerde
sık görülür ve tedavideki gecikmeler düşük sağkalım ve kötü nörolojik sonuçlara
neden olur. Kanıtlar, kardiyak arrestten önce hastaların fizyolojik
parametrelerinin bozulmaya başladığını ve bunların büyük bir çoğunluğunun
önlenebileceğini göstermektedir. Bu çalışmanın amacı, kardiyopulmoner arrest
gelişmeden önce yüksek riskli pediatrik ve erişkin hastaların fiyolojik
parametrelerindeki değişikliklerin erken tanımlanmasını sağlayacak erken uyarı
skorlama modellerinin geliştirilmesidir.

Gereç ve Yöntem: Erken uyarı skoru ile ilgili
kanıta dayalı çalışmalar gözden geçirildi, pediatrik ve erişkin hastalar için
uzman görüşleri alınarak model önerileri geliştirildi.

Bulgular: Yetişkin hastalar için kalp atım
hızı, solunum sayısı, vücut sıcaklığı ve bilinç durumu parametreleri, referans
aralıkları ve hastaya uygulanan tıbbi müdahaleyi içeren bir algoritma önerildi.
Pediatrik hastalar için solunum, dolaşım, davranışsal / nörolojik sistem
parametreleri, referans aralıkları, hastaya uygulanan tıbbi müdahaleyi içeren
bir algoritma önerildi.

Sonuç:
Kötüleşen
hastaların erken tanımlanması hastanelerde mortaliteyi, hastanede kalış
süresini ve maliyetleri azaltır.

Anahtar Kelimeler

Erken uyarı sistemi, kardiyak arrest

Destekleyen Kurum

Destekleyen Kurum Bulunmamaktadır.

Model recommandations for how to prevent cardiac arrest in hospitals

Öz

Aim: Cardiac arrests
are common in hospitals, and delays in treatment have resulted in lower
survival and worse neurological outcomes. Evidence shows that patients'
physiological parameters begin to deteriorate before cardiopulmonary arrest and
vast majority of them can be prevented. The aim of this study is to develop
early warning scoring models that will enable early identification of the
changes in the physiological parameters of pediatric and adult patients with
high risk before cardiopulmonary arrest.

Material and Method: Evidence-based studies on early
warning scoring have been reviewed, and model recommendations have been
developed for pediatric and adult patients by taking specialist opinions.

Results: An algorithm that includes heart
rate, blood pressure, respiratory rate, body temperature, state of
consciousness parameters, reference intervals and medical interventions given
to the patient has been recommended for adults. For pediatric patients, an
algorithm that includes respiratory, circulatory and behavioral / neurological
system parameters, reference intervals and medical interventions given to the
patient has been recommended.

Conclusion: Early recognition of
deterioriation patients reduces mortality, length of stay and costs in
hospitals.

Anahtar Kelimeler

Early warning system, cardiac arrest

Kaynakça

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