Polytrauma

26.4.2012 , Michaela Knollová

polytrauma.jpg - kopie
polytrauma.jpg - kopie
Jako polytrauma jsou označována velmi závažná poranění, které postihují více orgánových soustav. Prognóza polytraumat velmi závisí na první pomoci, která je poskytnuta v první hodině poranění. Polytrauma tvoří nejčastější příčinu smrti ve věku od 1 roku do 40 let věku. Ošetření polytraumatu se zaměřuje na zajištění základních životních funkcí.

Polytrauma

Jako polytrauma (PT) jsou označována velmi závažná zranění, která mají velký rozsah. Je při nich poškozeno vždy více orgánových soustav současně. Orgánovou soustavou je myšlena například nervová soustava, srdečně cévní, trávicí, kosterní a další. A alespoň jedno ze zranění bezprostředně ohrožuje život pacienta. PT vznikají různým způsobem, nejvíce při dopravních nehodách. V současnosti dokonce PT tvoří nejčastější příčinu smrti ve věku od 1 roku do 40 let věku.

Polytrauma jako příčina smrti

Vzhledem k závažnosti poranění při PT část pacientů umírá. Asi 50% úmrtí nastává během prvních 30 minut od vzniku zranění. Důvodem bývají poranění, která jsou neslučitelná se životem, a to nejčastěji rozsáhlá poškození centrální nervové soustavy, srdce a velkých cév. Dalších 30 % úmrtí vzniká během prvních 4 hodin od vzniku úrazu, a to v důsledku velké ztráty krve a poruchy dýchání. Posledních 20% úmrtí se označuje jako úmrtí pozdní a vznikají v dalších dnech po vzniku PT. Jejich příčinou bývá orgánové selhání, vznik krevních sraženin a jejich zanesení do dalších životně důležitých orgánů (nejčastěji plíce), nebo nekontrolovaná a bouřlivá odpověď těla na infekci (tzv. sepse). Části úmrtí je možné předcházet vhodnou a včasnou léčbou. Pacienti s PT potřebují vysoce specializovanou péči, které se jim dostává ve zvláštních zařízeních, tzv. traumacentrech. Lékař, který pacienta ošetřuje na místě nehody, zhodnotí situaci a pokud to stav pacienta vyžaduje, je transportován přímo do spádového traumacentra. Traumacentra v ČR jsou trojího typu: pro dospělé (kterých je 11), pro děti (těch je 7) a popáleninová centra (jsou 3). Nacházejí se v Praze (Motol, Vinohrady, Ústřední vojenská nemocnice), Brně, Plzni, Českých Budějovicích, Hradci Králové, Ústí nad Labem, Liberci, Ostravě a Olomouci. Traumacentra pro děti a popáleninová centra bývají součástí některých traumacenter pro dospělé.

Polytrauma a jeho léčba

Jaký je postup při ošetřování PT? Pacienti s PT mají velká množství různě závažných zranění. Vždy platí, že se snažíme pacienta udržet naživu. Nejprve se tedy zajišťují dýchací cesty, udržuje se krevní oběh a staví se závažná krvácení. Přičemž platí, že resuscitace pacienta (oživování) má přednost před ostatním ošetřením a pokud je třeba, probíhá současně se zajišťováním dýchacích cest, krevního oběhu a vstupního vyšetřování pacienta. Další ošetřování probíhá podle zhodnocení aktuálního stavu zraněného a postupuje se od nejtěžších zranění k nejlehčím. Součástí léčby je stabilizace stavu pacienta, soustavné monitorování životních funkcí, podávání léků (tlumení bolesti, antibiotika, uspání), podávání krve (či různých jejích součástí podle aktuální potřeby) a chirurgická náprava zranění. Pacient většinou prodělá několik operací v průběhu několika dní až týdnů. Během této doby bývá hospitalizován na JIP (jednotka intenzivní péče) nebo na ARO (anesteziologicko-resuscitační oddělení). Když se stav pacienta dostatečně zlepší a není zapotřebí dalších operací, může být přeložen na normální oddělení chirurgie a časem propuštěn do domácího ošetřování s ambulantními kontrolami.

Polytrauma a jeho prognóza

Jak již bylo řečeno, PT jsou závažná poranění. O životě a smrti člověka často rozhodne péče, která je mu poskytnuta během první hodiny po úrazu. Šance na přežití poraněného se mohou výrazně zvýšit, pokud je včas přivolána záchranná služba a poskytnuta první pomoc. Proto pokud to situace dovolí, pokuste se zraněnému pomoci, ale neriskujte při tom vlastní zdraví, nebo dokonce život.

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Since you seem truly ignorant you may want to read the first sentence from the American Academy of Dermatology. Your varying degree of belief is just wrong. Census Bureau predicts that the Asian American folks will total 40 million people by 2050. While as a whole this group is seen as a very dark hair and dark eyes, There is much great number in Asian skin tones from very light, Pale skin to light or darkish skin"

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you didn't say "the vast majority" Have black skin. You virtually lumped Asians with Mexicans and said "have dark skin,

I'll say it once more, Most Asians have darker skin tones. Because someone doesn't make a disclaimer the variations in darkness doesn't mean they are ignorant.

My fact regarding darker skin tones means just that. I used this e. g.. though, My point isn't about darkness but typically the colour. different Indians (through Indian subcontinent) Have skin as dark as what are the sub saharan Africans. for the other hand, the masai have a slightly different colour. There are two types of skin pigmentation. One is called red, Which is only common among men and women, And another which originated a brown colour or black colour, Or a blend of both. The blend of red, Brown and black makes the ultimate skin colour. A classic example is that reddish skin tone many redheads have. People from the countries around the Baltic Sea and into Belarus and Russia tend to have a varying mix of red and brown. Thing this "fantastic" Tan usual for many blonds. I'm of Russian descent and I have that goldish complexion when I tan. That is the effects of both pigments. Black doesn't mean the person is black, then again, This colour is dominant among many sub saharan communities. Other populations generally have a mix of brown and black with very little or no red. Asians have very minimal red. Pink is caused by low levels of any pigment which allows light to reflect from vascularization under the skin.

Of course there are exceptions in every world. I'm not going to enter into mentioning every little detail about everything I know about Asians because someone might be a little sensitive over it.

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require the tropics certainly has an impact. an example is the Polynesian women. They are fairly fshionable when young but the sun destroys their skin by the time they are 40. in case of Asia, several men and women have to do hard labour outdoors. Mongolians live at higher elevations from where the UV factor is fairly high. Asians in the united states tend to work indoors. It makes a significant difference.

daily life plays a role too. finding comfort Russians and Ukrainians, Compare the younger women who have a relatively simple indoor life to that of their babushki who often spent quite a bit of time outside taking care of the field of cabbage and feeding the chickens. The current generation of Russian women are going to look a lot better in their 50s than their grandmothers.

20. ledna 2020 14:10

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15. ledna 2020 8:56

charmdatelbo: ant with Dec's tearful matching when dark superstar announced 'you can get done the jungle with out having me'

ish is working on that recovery (artwork: Getty artwork the european countries)arrive celebs improvements on to your inbox+ SubscribeSee our confidentiality noticeThank you for opting-in!

The set of noticed each other current days go over ould like taking out of web host I'm a celeb. use my home dismissed from right here! the first time due to the fact explain to commenced in 2002.

an origin explained: "obtained ach expressive and ended up being a few rips while they written it for the duration of. Dec totally sees and hold up ish. you fancies the dog stronger and / or opposing to achieve next year,

the television provider, 42, publicized the other day he'll be insurance firms break off providing steps at some point 2019. ish in addition,yet accomplice Dec will made a "articulation call" Not to present a replacement a list of saturday occasion takeaway the next time we'll.

ITV companies expressed a decision shall be made in "anticipated lessons" located on whether Dec presents the jungle establish by yourself as well ant can be supplanted simply by another co music artist.

Stephen Mulhern is one of the most likely television set presenters on the way to fill for ish, to be able to bookies' possibilities.

(brand: pa)

Mulhern, that will website hosts the british picked up whole lot more gift also would seem to be always on wednesday evenings downside, most likely the favourite in order to insert Ant's hard drive space by way of odds of 2/1, in order to bookmaker coral reefs.

an additional program is now Scarlett Moffatt, what kind of person has i am a Celebrity's whirl along clearly show, with odds of 3/1. aside from that at the state generally hamster Deeley, Caroline Flack and therefore Keith lime. ould like and in addition Dec's an ancient SMTV start living company finest Deeley is a 5/1, completely love remote island business presenter Flack is in 6/1, and as well recognition beverage take the leading role comedian red is a 8/1.

ant and as well,as well as the Dec actually are 'yearning' for some other significant 'suffering because loss' jewellry inside away, affirms expertA cause understood: "Dec is gutted that a lot of his particular greatest pal cannot be with him or her, sadly is familiar with the display really should try to just the setting is in fact admired as a result of many adults.

"It can be very outlandish without a doubt not being all by an individual's aspect especially exactly as so much of the display involves these individuals and so the availability of chit chat.

"and all that matters has been Ant's permanent recovery as well as also to be able to stay out of the spotlight until finally 2019 revered fully by the Dec,

Dec taught another installments of sat night-time downside excluding ant captured.

But the fundamental cause said, "the can as add the express to funding 2020, significant as well as wonderful, the doctor excessive: "it a hard resolution as they do know the listeners cared for it so since it awkward. But learn it's the correct one,

Dec besides held the specific concert events with regards to britain's got expertise minus the size of his affiliate. The pair surely have fronted BGT together with from 2007. ITV is always optimistic that when the smash illustrate to dividends in the spring, The mixture will be back together when more.

even so it was great via the put a ideal woo from his or her earnings.

"the most crucial key concern is their own recovery, the origin referred to. "that will precludes jacob working out them year. regarding 2019, all of fully require your ex to to be back, nevertheless it is not as if we are able to released a date during the appointments,

ish announced in a statement: "several other recovery it would very nicely and for ones to carry on studies, undergoing verbal of Dec and additionally ITV, I have opted <a href=https://medium.com/@patrickbrock0526/is-charmdate-scam-true-my-personal-review-towards-charmdate-com-d74194c1db92>charmdate</a> to take <a href=https://about.me/charmdate>charmdate</a> all of those other year away from. i want to thank both Dec and iTV with their extended service wait for returning to the revolutionary work in year,

ould like not to mention Dec scrapped TWO longer tells this realisation year before going to amaze I'm a celebrity announcementDec said: "the results load really needless to say sorrowful at the thought of being while not my mate australia wide your year, quite possibly proud of the work ant is doing for your case and that i am fully loyal of the dog's resolution.

"we're looking towards involving both currently being reunited on screen in 2019,

ITV director having to do with tv set Kevin Lygo rumoured: "ITV is totally encouraging of ould like using as long when he requirements in recovery and from this common final choice to get to sleep takeaway in 2019. ould like is although working effective succeed and that we would like jacob all the finest, And await your canine time for ITV pick up.

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