Introduction This work is aimed at describing the management of major traumas, with particular reference to the treatment of pelvic fractures, by outlining the fundamental aspects of the clinical-medical approach followed in the integrated trauma assistance structure (SIAT) of the Marche Region and aimed at guaranteeing a fast and effective assistance to the victims of serious traumas, through the optimization of the use of resources. Objectives Within this context, a check has been performed of the most recent literature concerning the way in extra-hospital environments, at the time of the first intervention by nursing staff, PCCDs (pelvic circumferential compression devices) are used as well as the efficacy of such devices in reducing the pelvic volume when fractures occur and bleeding, as well as the incidence of complications. Materials and methods The corpus of this thesis contains information from scientific publications and from websites, which are not all acknowledged the same institutional degree. Publications taken into consideration are: 8 articles from Pubmed, 3 articles by Elsevier and one article from ResearchGate. The research was conducted by checking the most recent guidelines in the online databases and by consulting in addition to the aforementioned sites, also Google Scholar, ATLS manuals (Advanced Trauma Life Support), the International Journal of Emergency Medicine and Medicinaonline. With regard to the use of PCCDs, a review of the relevant literature was carried out, aimed at examining the studies published in the last 10 years available on the main databases, paying particular attention to the studies conducted by James C. Krieg, Marco Mohr and others and by Chih Yuan Fu, Yu-Tung Wu and others. Search results: The application of non-in-vasivtive external circumferential pelvic compression devices (ECDs) offers a positive costs/benefits ratio and improves clinical outcomes in patients with suspected pelvic fracture before hospitalization. In patients with hemorrhagic shock and suspected pelvic fracture, putting in place an ECD in compression mode is considered more useful than not putting it in place. Keywords: Pelvic fracture/injuries, hemorrhage, infection, T-POD and PCCDs, SAM Sling M and Major Trauma.
Introduzione: questo elaborato si propone di descrivere la gestione del trauma maggiore, con particolare riferimento al trattamento delle fratture pelviche, schematizzando gli aspetti fondamentali dell’approccio clinico-assistenziale del sistema integrato di assistenza al trauma (SIAT) della Regione Marche volto a garantire nel minor tempo possibile un'assistenza di qualità ai traumatizzati gravi sul territorio regionale, ottimizzando l'utilizzo delle risorse. Obiettivo: in questo contesto, si esaminano le più recenti evidenze presenti in letteratura attinenti alle modalità di utilizzo in sede extra-ospedaliera, all’atto del primo intervento da parte del personale infermieristico, dei PCCDs (pelvic circumferential compression devi-ces) e alla loro efficacia con riferimento alla contenzione del volume pelvico in presenza di fratture e di riduzione del sanguinamento nonché all’incidenza delle eventuali complicanze. Materiali e metodi Il corpus della presente tesi contiene materiale desunto da pubblicazioni scientifiche e da vari siti internet, ai quali è riconosciuto un non omogeneo livello di istituzionalizzazione; le pubblicazioni prese in considerazione, inclusi in questa tesi, sono: 8 articoli in Pubmed, 3 articoli di Elsevier e un articolo in ResearchGate. La ricerca è stata condotta attraverso la revisione delle più recenti linee guida presenti nelle banche dati online consultando oltre ai citati siti anche Google Scholar, manuali ATLS (Advanced Trauma Life Support), International Journal of Emergency Medicine e Medicinaonli-ne. Per quanto attiene all’impiego dei PCCDs, è stata svolta una revisione della relativa letteratura, finalizzata all’esame degli studi pubblicati negli ultimi 10 anni disponibili sulle principali banche dati, prestando particolare attenzione agli studi condotti da Ja-mes C. Krieg, Marco Mohr e altri e da da Chih Yuan Fu, Yu-Tung Wu e altri. Risultati della ricerca: l'applicazione di dispositivi di compressione pelvica circonferenziali esterni non in-vasivi (ECD) offre un positivo rapporto costi/benefici e migliora gli esiti clinici nei pazienti con sospetto di frattura pelvica in pre-ospedalizzazione. Nei pazienti in shock emorragico e con sospetta frattura pelvica si suggerisce il posizionamento dell’ECD in modalità di compressione rispetto al non posizionamento dell’ECD. Parole chiave: Pelvic Fracture/injuries, emorragia, infezione, T-POD e PCCDs, SAM Sling M e Trauma Maggiore.
LA GESTIONE DEL TRAUMA MAGGIORE NELLE MARCHE, ASSISTENZA INFERMIERISTICA EXTRAOSPEDALIERA NEL TRAUMA DEL BACINO
MENCHI, GIORGIA
2020/2021
Abstract
Introduction This work is aimed at describing the management of major traumas, with particular reference to the treatment of pelvic fractures, by outlining the fundamental aspects of the clinical-medical approach followed in the integrated trauma assistance structure (SIAT) of the Marche Region and aimed at guaranteeing a fast and effective assistance to the victims of serious traumas, through the optimization of the use of resources. Objectives Within this context, a check has been performed of the most recent literature concerning the way in extra-hospital environments, at the time of the first intervention by nursing staff, PCCDs (pelvic circumferential compression devices) are used as well as the efficacy of such devices in reducing the pelvic volume when fractures occur and bleeding, as well as the incidence of complications. Materials and methods The corpus of this thesis contains information from scientific publications and from websites, which are not all acknowledged the same institutional degree. Publications taken into consideration are: 8 articles from Pubmed, 3 articles by Elsevier and one article from ResearchGate. The research was conducted by checking the most recent guidelines in the online databases and by consulting in addition to the aforementioned sites, also Google Scholar, ATLS manuals (Advanced Trauma Life Support), the International Journal of Emergency Medicine and Medicinaonline. With regard to the use of PCCDs, a review of the relevant literature was carried out, aimed at examining the studies published in the last 10 years available on the main databases, paying particular attention to the studies conducted by James C. Krieg, Marco Mohr and others and by Chih Yuan Fu, Yu-Tung Wu and others. Search results: The application of non-in-vasivtive external circumferential pelvic compression devices (ECDs) offers a positive costs/benefits ratio and improves clinical outcomes in patients with suspected pelvic fracture before hospitalization. In patients with hemorrhagic shock and suspected pelvic fracture, putting in place an ECD in compression mode is considered more useful than not putting it in place. Keywords: Pelvic fracture/injuries, hemorrhage, infection, T-POD and PCCDs, SAM Sling M and Major Trauma.| File | Dimensione | Formato | |
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TESI Giorgia Menchi con FS (1).pdf
embargo fino al 24/11/2024
Descrizione: Questo elaborato si propone di descrivere la gestione del trauma maggiore, con particolare riferimento al trattamento delle fratture pelviche.
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1.27 MB
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1.27 MB | Adobe PDF |
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https://hdl.handle.net/20.500.12075/866