Hastane Öncesi Dönemde Crush Sendromu ve Yönetimi
Crush Syndrome and Management in the Pre-Hospital Period
Özet Görüntüleme: 290 / PDF İndirme: 118
Anahtar Kelimeler:
Hastane Öncesi Acil Sağlık Hizmetleri, Crush Sendromu, Paramedik, Afet TıbbıÖzet
Crush sendromu, insan kaynaklı afetler ve doğal afetler dahil olmak üzere ciddi yaralanmalarla birlikte toplu kaza olaylarında sıkça meydana gelen ciddi klinik bir durumdur. Yaralılarda meydana gelen ezilme yaralanmaları sonucu ortaya çıkan komplikasyonlar crush sendromuna neden olur. Crush sendromu erken tanınıp tedavi edilmezse mortalite oranı çok yüksek çıkacaktır. Bu nedenle hastane öncesi acil sağlık hizmetleri personeli yaralı bakımını optimize etmek için crush sendromu tanıma ve tedavi konusunda yeterli bilgiye sahip olmalıdır. Crush sendromuna eşlik eden önemli durumlardan birisi de hiperpotasemidir. Bu hastalarda hastaya ulaşınca enkazda IV sıvı replasmanı tedavisine başlanmalı ve durdurulmadan hastaneye sevki sağlanmalıdır. Crush sendromu tedavisinde IV sıvı olarak %0.9’luk NaCI gibi potasyum içermeyen sıvılar tercih edilmelidir. Hastane öncesi acil sağlık hizmetleri personeli, crush sendromu ile karşılaştığında vakayı hızlıca değerlendirebilmeli ve gerekli IV sıvı replasman tedavisine olay yerinde başlayıp gelişebilecek akut böbrek yetmezliğini ve prognozun kötüye gitmesini önleyebilir. Bu nedenle hastane öncesi acil sağlık hizmetleri personelinin crush sendromu hakkında yeterli bilgi ve donanıma sahip olması mortalite oranını oldukça düşürecektir. Bu çalışma, crush sendromu gelişen hasta veya
yaralıda, hastane öncesi acil sağlık personelinin vakaya ulaşıp hastaneye sevkine kadar geçen sürede müdahale ve tedavi yöntemlerini bir araya getirmek amacıyla crush sendromuna genel bir bakış sunmaktadır.
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