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تحقیق آماده در مورد احیای بیماران ترومایی در فایل ورد

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Dear researchers of the Saharamaz file website, today we have prepared an article for you to download about the resuscitation of trauma patients. We hope that you will be satisfied with it. To see more details, please read the text below.


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دانلود تحقیق آماده در مورد احیای بیماران ترومایی در قالب فایل ورد با قابلیت ویرایش

Dear researchers of the Saharamaz file website, today we have prepared an article for you to download about the resuscitation of trauma patients. We hope you will be satisfied with it. To see more details, please read the text below.

The details are as follows

  • عنوان : احیای بیماران ترومایی
  • File format: word doc
  • Applicability with Office versions: 2013 to the latest version
  • It has the ability to edit after downloading
  • Possibility of printing: without any problem in printing
  • تعداد صفحه : 55

قسمتی از متن انتخاب شده از داخل فایل ورد در مورد احیای بیماران ترومایی به صورت زیر است

Resuscitation of trauma patients is carried out with the help of emergency and medical teams and includes measures that help maintain the patient's heart, breathing and brain function. Trauma patients include people who have been injured due to an accident such as a fall, accident, blow, burn, etc., and temporarily do not have access to the normal function of their body.

The goals of reviving trauma patients include maintaining the patient's cardiac and respiratory function, maintaining the patient's brain function, and achieving timely diagnosis and treatment of the causes of brain injuries and creating opportunities for the patient's further recovery.

Resuscitation of trauma patients includes two main stages: cardiopulmonary resuscitation and post-resuscitation care. In the first stage, efforts are made to maintain the patient's heart and breathing. This includes regulating the patient's breathing using a breathing mask and artificial respiration, creating access to the patient's airway using a glottis trachea, performing cardiac massage using manual pressure or using automated devices, and using medications to maintain pressure. The blood and heart beat become sick.

In the second stage, post-resuscitation care is discussed. This includes assessing and managing the patient's blood pressure, heart rate, breathing, and symptoms. At this stage, any side effects or symptoms that may occur after cardiopulmonary resuscitation, such as heart failure, infection, etc., should be prevented.

علاوه بر این، درمان زمان‌بندی شده‌ی علل صدمات مغزی بسیار مهم است. برای این منظور، باید تورم مغزی و فشار درون جمجمه را کنترل کرد و در صورت لزوم، بیمار را جراحی کرد.

In general, the resuscitation of trauma patients is very important due to the importance of maintaining the patient's heart and breathing function and achieving timely diagnosis and treatment of the causes of brain injuries. To perform these measures, emergency and medical teams with sufficient expertise and experience and appropriate equipment should be available

راه هاي هوايي جراحي:
راه هاي هوايي جراحي شامل كريكوتيروئيدوتومي، و تراكئوستومي اورژانس است.
براي كريكوتيروئيدتومي دو كنترا انديكاسيون مطلق وجود دارد:
The first is the patients who have obvious damage to the larynx. The best way to understand the severe damage of the larynx is the disappearance of the consistency of the larynx in the photo, and the second thing is the prohibition of this method in children. Because using this method will lead to subglottis tightness.
The problem of this method is that the tube cannot be passed through this space, but in patients whose intubation is not successful, the next choice is to use this method. To perform this method, we must first find the location of the cricothyroid membrane. In men, finding the thyroid cartilage or the Adam's apple is used as a suitable method to find the location of the cricothyroid membrane. So that if you cut immediately under the thyroid cartilage, you have actually cut the cricothyroid membrane. In women, if we go up on the trachea, the first cartilage of the trachea and the clear search that we can find is the cricoid cartilage. If we cut the top of it, we will still be on the cricothyroid membrane.

شکل 2-10 : ترسیم آناتومی مورد نیاز برای باز کردن راه هوایی بروش های جراحی
روی گردن کریکوتیروئیدوتومی وتراکئوستومی

بنابر آن چه گفته شد يك برش عمودي روي غشاي كريكوتيروئيد ايجادكرده و بدون هيچگونه واهمه اي از آسيب رساندن به عناصر حياتی برش را آن قدر عميق مي كنيم تا وارد فضاي خالي حنجره شويم.
Immediately, widen the hole created with the end of the bistoury handle so that we insert the handle into this hole and turn it, and after removing the bistoury handle, we take a suitable size tube inside, inflate its cuff, and We connect it to the tube and ventilate the patient.

انجام تراكئوستومي اورژانس مشكل تر بوده و انديكاسيون هاي محدودي دارد.
Its indication includes patients who have extensive laryngeal trauma and urotracheal and cricothyroidotomy is not possible for them, or children for whom urotracheal surgery is not successful.
The principles of the work are the same as cricothyroidotomy, only the location is below the cricoid cartilage and above the suprasternal notch. Pay attention that in these conditions, what you are doing is to save the patient's life from death, so no fear or procrastination should prevent this action.

شکل 2-11 : نمایی شماتیک از انجام تراکئوستومی بهترین محل بین غضروف های دوم و چهارم تراشه است
مزيت تراكئوستومي نسبت به كريكوتيروئيدوتومي لوله ي قطوري است که مي توان از طريق آن تعبيه كرد. لازم است پس از اتمام هر كدام از روش هاي فوق از صحت انجام آن اطمينان حاصل كنيم
There are various methods to ensure the airway path, but as mentioned, chest motions, breathing fog in the tracheal tube, two-way auscultation of the chest are the most available measures.
روش هايي مثل استفاده از دستگاه هاي كاپنوگرام و يا سنسورهاي حس گر گاز Co2 معمولاً وسايلی است كه در بسياري از اورژانس ها دركشور ،موجود نيست.
Also, the use of pulse oximeter can be reassuring to some extent if it shows us the appropriate percentage of oxygen saturation. But if the oxygen saturation level is low, it cannot tell us exactly what stage the problem is at. It is not possible for us to perform a chest X-ray at this stage, but we must remember to pay attention to the position of the tracheal tube in the chest X-ray we see later and at a certain stage.
ب) مرحله B : Breathing
در اين مرحله پس از آن كه از راه هوايي اطمينان حاصل شد بايد بلافاصله به ديسترس تنفسي بيمار توجه كنيم.
Respiratory distress includes clear use of respiratory sub-muscles, rapid and ineffective breathing, inability to inhale, thirst for air, etc. At this stage, the steps we must take are as follows.
قدم اول:
به عنوان اولين قدم دست روي نبض راديال بيمار گذاشته و هم زمان با نگاه وريدهاي ژگولار بيمار را وارسي مي كنيم.
در صورتي كه بيمار دچار ديسترس تنفسي كه از مرحله ي A گذشته، نبض راديال ضعيف دارد و ورید های ژگولار برجسته است تشخيص اول، پنومو توراكس فشارنده مي باشد.
آن چه كه در كتاب شوارتز به عنوان تعريف پنوموتوراكس فشارنده مطرح شده به شكل زير است.
بيماري كه افت فشار و دیسترس تنفسي دارد و از سه علامت زير حداقل يك مورد را داشته باشد آمفيزم زير جلدي
شيفت تراشه از خط وسط
كاهش واضح صداي تنفسی يك طرفه در سمع

شکل 2-12 : نمایی شماتیک از پنوموتوراکس فشارنده

But in addition, we come across cases where the diagnosis is very strong. For example, a patient who has respiratory distress has a weak pulse and prominent jugular veins, or a patient who has a weak pulse does not have prominent jugular veins, but has clear respiratory distress, or. . .
What we need to know is that if there is a high suspicion of compression pneumothorax, it is appropriate to do something for the patient. In this step, we perform two actions respectively.
Using a thick needle, we enter the pleural space from the second intercostal space of the midclavicular line and allow the air to come out with pressure. It is easy to notice the release of air under pressure at this stage. Also, the hemodynamic status of the patient and his respiratory distress improve.

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