135 KB34 KB199420252002Švigelj, Viktorštevilka:2/3letnik:41str. 201-210ISSN:0025-8121COBISSID:15898073URN:URN:NBN:SI:doc-SWE4NQLAslMedicinski razglediMedicinski razglediCerebral HemorrhageCerebral InfarctionCerebral IschemiaCerebrovascular DisordersCerebrovaskularne motnjediagnostikaEmergency Medical Servicesmožganska kapMožganska krvavitevMožganski infarktSubarachnoid HemorrhageSubarahnoidna krvavitevThrombolytic TherapyTrombolitično zdravljenjeurgentna medicinaUrgentne, medicinske službeObravnavanje bolnikov z možgansko kapjo na terenu| Prehospital management of patients with cerebovascular diseases|Acute stroke is increasingly recognized as one of the leading factors of morbidity and mortality in adult worldwide population, with a mortality rate in the acute stage of more than 20%. Ischemic stroke is by far the most frequent subtype of acute stroke (> 80%). Successful stroke management begins by recognizing stroke as a medical emergency, such as acute myocardial infarction or severe trauma and, even more importantly, recognizing that a patient presenting as a medical emergency has had a stroke. Initial evaluationof stroke patients includes assessment of breathing and circulation.Neurological assessment can also be performed when the patient is first seen and, if necessary, therapeutic measures can be instituted. The goalis to ascertain the severity and type of neurological impairment. The differential diagnoses which should be considered include coma of another origin, trauma, drug overdose; post-seizure states or metabolic disorders. Effective treatment of patients who have sustained an acute ischemic stroke requires rapid assessment and early intervention. The window of opportunity for thrombolytic therapy is limited to the first few hours after the onset of stroke. In all other types of cerebrovascular incidents, such as intracerebralbleeding, posttraumatic hemorrhage and subarachnoid hemorrhage, hospital management is also mandatoryMožganska kap je tretji najpogostejši vzrok smrti in vodilni vzrok invalidnosti med odraslimi, smrtnost v akutni fazi pa je več kot 20%. Ishemična možganska kap predstavlja najpogostejšo (> 80 %) obliko možganske kapi. Uspešno zdravljenje možganske kapi se začne s prepoznavo simptomov in znakov bolezni in pomeni stanje medicinske nujnosti, podobno kot je to pri akutnem srčnem infarktu ali hudi poškodbi. Pomembno je tudi, da po nastanku urgentne situacije zdravnik spozna, da ima bolnik možgansko kap. Poskrbimo, dabolnik ni vitalno ogrožen in napravimo nevrološko oceno stanja ter po potrebi tudi terapevrsko ukrepamo. Treba je tudi oceniti, ali gre morda za kakšen drug vzrok zožanja zavesti, npr. poškodbo glave, zastrupitev z drogami,zdravili, stanje po epileptičnem napadu ali presnovno motnjo. Uspešnost zdravljenja možganske kapi je odvisna od hitrega ukrepanja. Pri ishemični možganski kapi je časovno okno za zdravljenje s trombolitičnimi zdravili omejeno na prvih nekaj ur po nastanku možganske kapi. Tudi pri drugihoblikah možganske kapi (znotrajmožganske krvavitve, popoškodbene krvavitve, subarahnoidna kvavitev) je potrebna čimprejšnja bolnišnična obravnavaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaDruštvo Medicinski razgledi