TIME MANAGEMENT IS A KEY FACTOR IN ASSESSMENT ON INJURED PATIENT IN PREHOSPITAL ENVIRONMENT

Pri zbrinjavanju ozlijeĊene osobe u izvanbolniĉkim uvjetima, najbolju šansu za preţivljavanje imaju pacijenti koji su od trenutka nastale ozljede transportirani do kirurga unutar 60 minuta, što se zove „ zlatni sat―. Medicinska sestra vrlo je bitan ĉlan tima u izvanbolniĉkim uvjetima. Njezina funkcija kao ĉlana tima u zbrinjavanju ozlijeĊene osobe je da zna sve korake pristupa ozlijeĊenoj osobi, komponente trauma pregleda, naĉine imobilizacije, te da tijekom transporta pruţi pacijentu psihološku podršku jer su takve situacije obiĉno stresne. Cilj rada je bio prikazati ukupan broj prometnih nezgoda po ispostavama Zavoda za hitnu medicinu Zadarske ţupanije, broj zbrinutih ozlijeĊenih osoba u „zlatnom satu―, te prikazati vremena trajanja intervencije od primljenog poziva do završetka zbrinjavanja. Postavljena hipoteza rada je: OzlijeĊene osobe u prometnim nezgodama Zavoda za hitnu medicinu Zadarske ţupanije zbrinute su unutar „zlatnog sata―. Ispitanici su bili ozlijeĊene osobe u prometnim nezgodama po ispostavama Zavoda za hitnu medicinu Zadarske ţupanije u periodu od 1.1.2015. – 31.12.2017., materijali su prikupljeni od informatiĉkog sustava Rinels uz dozvolu etiĉkog povjerenstva Zavoda. Najveći broj intervencija bilo je crvenog stupnja hitnosti, a najviše intervencija bilo je na podruĉju koje pokriva Zadar. Vrijeme do dolaska tima na mjesto intervencije bilo je u prosjeku 11- 15 minuta, a zbrinjavanje na mjestu intervencije trajalo je 5- 20 minuta. U 2015. godini 82, 75% ozlijeĊenih osoba zbrinuto je u „zlatnom satu―, 2016. godine njih 83, 03%, a tijekom 2017. godine 81, 5%. Hipoteza rada je potvrĊena, ozlijeĊene osobe zbrinute su u periodu „zlatnog sata―. Tijekom rada na terenu bitan je timski rad kako bi se svi postupci pri zbrinjavanju pacijenta obavili istovremeno. Na taj naĉin skraćuje se vrijeme polaska s mjesta nesreće prema bolnici. Bitna je dobra komunikacija s PDJ, unutar tima i sa samim pacijentom kako bi put zbrinjavanja od poĉetka do kraja intervencije bio što kraći.When taking care of a patient in out of hospital scene, we should have in mind the golden hour. Golden hour refers to the period of time following a traumatic injury, during which there is the highest likelihood that prompt medical and surgical treatment will prevent death. The nurse is a very important member of the team in prhospital environment conditions. Its function as a member of the hostage care team is to know all the steps of accessing the injured person, components of the trauma examination, the ways of immobilization, and to provide the patient with psychological support during the transport that such situations usually are stressful. In our study, we determine the total number of traffic accidents in every branch office of the Department of Emergency Medicine of the County of Zadar and the number of patients transferred to the hospital within the golden hour. Furthermore, the aim was to indicate the duration of the intervention from the receiving the call until the end of the transfer. The hypothesis is that the time is crucial in the treatment of the injured. Persons in this study were injured patients in road accidents by the branch offices of the Department of emergency medicine of Zadar County in the period from 1.1.2015. — 31.12.2017., the data is collected from the information system Rinels with the permission of an Ethics Committee of the Department. The largest number of interventions was a red emergency, and most interventions were in the area covered by Zadar. Response interval (time from alarm activation to arrival of first responding vehicle on a scene) was 11-15 minutes, and on-scene interval (time arrival of first EMS responding vehicle on scene until leaving the scene) ranged from 5 to 20 minutes. The hypothesis of the work is confirmed, time is essential for the treatment of the injured. In out of hospital conditions, teamwork is essential, in order for all of the procedures during the treatment to be made at the same time. In that way on scene interval is shortened. What is most important is good communication with the dispatch, within the team and with the patient