| Popis: |
Ishemijska bolest srca i kardiovaskulane bolesti općenito, među vodećim su uzrocima smrti globalno. Nadalje, akutni koronarni sindrom često je hitno stanje s kojim se susreće tim izvanbolničke hitne službe. Intervencije hitne medicinske pomoći zahtijevaju promptno i kompetentno donošenje prosudbi, a to ponajviše ovisi o spremnosti i stručnosti tima. Na ishod intervencije utječe i rano prepoznavanje simptoma od strane pacijenta, kako bi pravovremeno zatražio medicinsku pomoć i time si osigurao povoljan ishod liječenja. U ovom radu opisana je obrada pacijenta s akutnim koronarnim sindromom od prepoznavanja simptoma do transporta u bolničku ustanovu sekundarne razine zdravstvene zaštite. Djelovanje hitne pomoći organizirano je kroz timove T1 i T2 koji se razlikuju po ulogama i kompetencijama. U prvom djelu rada prikazane su osnove anatomije i fiziologije srca kao i osnove patofiziologije kod akutnog koronarnog sindroma. Opisan je i elektrokardiogram (EKG) koji pokazuje srčanu aktivnost te su objašnjeni pojedini dijelovi EKG-a. Objašnjena je terminologija i podjela akutnog koronarnog sindroma; klinička slika, epidemiologija i etiologija angine pektoris i akutnog infarkta miokarda te dijagnostički postupci. Opisan je način zbrinjavanja oboljelog od akutnog infarkta miokarda na terenu te uvjeti i specifičnosti transporta. Spomenute su i potencijalne komplikacije akutnog infarkta miokarda. Također, obrađena je uloga medicinske prijavno-dojavne jedinice. U zadnjem djelu rada izneseni su statistički podaci Zavoda za hitnu medicinu Međimurske županije za razdoblje od 2018. do 2021.godine. Prikazan je ukupan broj bolesnika sa akutnim infarktom miokarda, usporedba oboljelih prema spolu, te usporedba ukupnog broja intervencija i onih izvršenih u „zlatnom satu“. Ischemic heart disease and cardiovascular diseases in general are among the leading causes of death globally. Furthermore, acute coronary syndrome is often an emergency encountered by an outpatient emergency team. Emergency medical interventions require prompt and competent judgment, and this largely depends on the team's readiness and expertise. The outcome of the intervention is also influenced by the early recognition of symptoms by the patient, in order to seek medical help in a timely manner and thus ensure a favorable outcome of treatment. This paper describes the treatment of a patient with acute coronary syndrome from symptom recognition to transport to a hospital. The operation of the ambulance is organized through teams T1 and T2, which differ in roles and competencies. The first part of the paper presents the basics of anatomy and physiology of the heart as well as the basics of pathophysiology in acute coronary syndrome. An electrocardiogram (ECG) showing cardiac activity is described, and some parts of the ECG are explained. The terminology and division of acute coronary syndrome is explained; clinical picture, epidemiology and etiology of angina pectoris and acute myocardial infarction and diagnostic procedures. The care of a patient with acute myocardial infarction in field conditions, transport and potential complications of acute myocardial infarction are described. Also, the role of the medical reporting unit was discussed. In the last part of the paper, the statistical data of the Institute of Emergency Medicine of Međimurje County for the period from 2018 to 2021 are presented. The total number of patients with acute myocardial infarction, a comparison of patients by gender, and a comparison of the total number of interventions and those performed in the "golden hour" are presented. |
