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    PRIORITY PROBLEMS IN PATIENTS WITH ACUTE CORONARY SYNDROME

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    Stil života, okolinski čimbenici i upućenost populacije smatraju se glavnim prediktorima pojavnosti kardiovaskularnih bolesti (KVB). Strukturiranom i temeljitom prevencijom KVB, promocijom stila života koji vodi dobrom zdravlju srca i krvnih pozitivno bi utjecalo na slabiju pojavnost ove bolesti. Prioritetni problemi ovakvih bolesnika se mogu pronaći kroz sve obrasce zdravstvenog funkcioniranja, ali isto tako dosta je sestrinsko – medicinskih problema na koje se može utjecati pravilnom prevencijom. Najčešće sestrinske dijagnoze ovakvih bolesnika su nepridržavanje zdravstvenih preporuka, nesurađivanje, stres, bol i smanjeno podnošenje napora. Najučestaliji sestrinsko – medicinski problemi su kardiogeni šok, hipokalijemija, duboka venska tromboza (DVT), anemije te srčane aritmije. Potrebno je adekvatno planiranje plana zdravstvene njege i njegovo provođenje kroz intervencije u djelokrugu rada medicinske sestre/tehničara. Određivanje cilja sestrinskih dijagnoza i sestrinsko – medicinskih problema je od velike važnosti jer nam služi kao temelj daljnim intervencijama. Terapija i zdravstvena njega za bolesnike je vrlo težak posao kako za zdravstvene djelatnike tako i za bolesnika i to ekonomski, financijski te socijalno. Često dolazi do recidiva zbog nepridržavanja zdravstvenih preporuke, točnije, neozbiljnog shvaćanja bolesti. Sav trud koji uloži zdravstveno osoblje nije dovoljan ukoliko obitelj i bližnji bolesniku sami ne budu najveća potpora. Moralna podrška i podizanje svjesnosti o rizicima trebaju biti mjere kojima preveniramo bilo kakvu bolest srca i krvnih žila.Lifestyle, surrounding factors and guidance of allaround population are considered main predictors with incidence of cardiovascular diseases (CVD). With structured and thorough prevention of CVD, promotion of healthy lifestyle which leads to good heart and blood vessel helath, we would make a positive impact on weaker incidence of this disease. Priority problems of this kind of patients could be found in all patterns of health functioning, but also in nursing – medical problems that we can affect on by good prevention. Most commonly nursing diagnoses are non-compliance with health recommendations, non-cooperation, stress, pain and reduced endurance. Most common nursing problems include cardiogenic shock, hypokalemia, deep vein thrombosis, anemia, and cardiac arrhythmias. Adequate planing of heatlth care and its implementation through interventions within scope of work of nurse. Determining the goal of nursing diagnoses and nursing-medical problems is of great importance because it serves as a basis for further interventions. Therapy and health care for patients is a very demanding job for both health care workers and the patients, in economic, financial and social sense. Often patients suffer from relapse of this disease beacuse of not following the given instructions, to be more exact, frivolus comperhanding of their own disease. All the effort that is being put in from health care workers is not enough because, what is more important, is patients family and loved ones support. Moral support and raising awareness of risks should be restrictions that we use to prevent any heart or blood vessel disease

    The role of midwife in the menagement of preterm infants with neonatal repiratory distress syndrome

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    Respiratorni distres sindrom najčešći je respiratorni poremećaj kod nedonoščadi. Nastaje kao posljedica nezrelosti pluća odnosno nedostatka alveolarnog surfaktanta. Mogući faktori rizika su prematuritet, perinatalna asfiksija, dijabetes melitus, muški spol, hipotermija i dr. Tijekom posljednjeg desetljeća, zahvaljujući novim otkrićima u neonatalnoj skrbi, povećanoj upotrebi antenatalnih steroida i nadomjesne terapije surfaktantima, smrtnost uzrokovana respiratornim distres sindromom značajno se smanjila. Specifično liječenje je intratrahealna primjena surfaktanta, a za to je potrebna endotrahealna intubacija koja također može poslužiti za postizanje odgovarajuće ventilacije i oksigenacije . Uloga primalje u liječenju i nadzoru novorođenčeta s respiratornim distres sindromom je od iznimne važnosti. Primaljske intervencije obuhvaćaju praćenje vitalnih znakova i potpornu njegu, održavanje termoregulacije, pravilnu prehranu, prevenciju nastanka infekcija, praćenje znakova i simptoma infekcije, komunikaciju s roditeljima kao i pomoć u uspostavljanju odnosa roditelja s djetetom.Respiratory distress syndrome is the most common respiratory disorder in preterm infants. Occurs as a consequence of lung immaturity or lack of alveolar surfactant. Possible risk factors are prematurity, perinatal asphyxia, diabetes mellitus, male gender, hypothermia, etc. Over the last decade, thanks to new discoveries in neonatal care, increased use of antenatal steroids and surfactant replacement therapy, mortality caused by respiratory distress syndrome has significantly decreased. Specific treatment is intratracheal administration of surfactant, which requires endotracheal intubation which can also serve to achieve adequate ventilation and oxygenation. The role of midwives in the treatment and surveillance of newborns with respiratory distress syndrome is of exceptional importance. Midwifery interventions include monitoring vital signs and supportive care, maintaining thermoregulation, proper nutrition, preventing infections, monitoring signs and symptoms of infection, communicating with parents and helping to establish a parent-child relationship

    Nurse Activities in patients with rib fracture

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    Prijelom rebara je najčešće posljedica traume prsnog koša. Najčešće su zahvaćena rebra u sredini toraksa. S obzirom na težinu prijeloma rebara, prijelomi mogu biti otvoreni, zatvoreni, usitnjeni te impaktni prijelomi. Komplikacije prijeloma rebara mogu biti višestruke, a najčešće su: nestabilan prsni koš, hematotoraks, pneumotoraks i atelektaza. Također, može doći do ozljede unutarnjih organa. Posljedica prijeloma rebara je smanjena respiratorna plućna funkcija koja ometa bolesnikovo normalno disanje. Opće metode liječenja usmjerene su na smanjenje boli, mirovanje i sprječavanje nastanka komplikacija. Specifične metode liječenja uključuju: zbrinjavanje krvarenja, te kirurško liječenje. Uloga medicinske sestre/tehničara je ključna u oporavku bolesnika. Aktivnosti koje medicinska sestra/tehničar provodi su usmjerene na pomoć bolesniku pri zadovoljavanju osnovnih ljudskih potreba te na rješavanje specifičnih prijeloma koje uzrokuju prijelomi rebara.Rib fractures are most often the result of chest trauma. The ribs in the middle of the thorax are most commonly affected. Depending on the severity of the rib fractures, fractures can be open, closed, chipped, and impact fractures. Complications of rib fractures can be multiple, and the most common are: unstable chest, hematothorax, pneumothorax and atelectasis. Injury to internal organs can also occur. The consequence of a rib fracture is reduced respiratory lung function that interferes with the patient's normal breathing. General methods of treatment are aimed at reducing pain, resting and preventing complications. Specific treatment methods include: bleeding management, and surgical treatment. The role of the nurse / technician is crucial in the patient's recovery. The activities carried out by the nurse / technician are aimed at helping the fighter to meet basic human needs and at resolving specific fractures caused by rib fractures

    COMPARSION 3T AND 7T MAGNETIC RESONANCE IN THE DIAGNOSIS OF SPINE

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    Magnetska rezonanca (MR) je neinvazivna dijagnostička pretraga koja koristi snažno magnetsko polje za oslikavanje unutarnjih tjelesnih struktura. MR je najpreciznija metoda za oslikavanje kralježnice i kralježnične moždine koja omogućava jasan prikaz sitnih anatomskih detalja. U svakodnevnoj kliničkoj praksi snimanja magnetskom rezonancijom se izvode pri statičkim magnetskim poljima jakosti1,5T i 3T. Međutim, brojna istraživanja na ljudima su provedena snimanjem uređajima ultravisokog polja (eng. Ultra high field - UHF) s jakostima statičkog magnetskog polja od 7T ili više. Uvođenje MR-a 7T ima mnoge prednosti u usporedbi s rutinski korištenim MR-om 3T. Jedna od prednosti je povećanje omjera signala i šuma što omogućuje snimanje s većom prostornom rezolucijom. Osim toga, MR jakosti 7T ima veću osjetljivost za anatomske detalje i promjene unutar tkiva te time pruža više kliničkih informacija u usporedbi s MR-om 3T. Trenutno su 7T MR skuplji te time manje dostupni bolnicama ili kliničkim centrima, pa se većina rutinskih MR snimanja obavlja korištenjem 3T MR-a. Treba naglasiti kako se istraživanja sve više fokusiraju na nadolazeću generaciju UHF sustava pri čemu će snimanje kralježnične moždine uređajem jakosti 10,5T ili više, jednog dana postati realnost.Magnetic resonance imaging (MR) is a non-invasive diagnostic tool that uses a strong magnetic field to image internal body structures. MR is the most precise method for imaging the spine and spinal cord, which enables a clear presentation of small anatomical details. In everyday clinical practice, magnetic resonance imaging is performed with static magnetic fields of strength 1.5T and 3T. However, numerous studies on humans have been conducted using ultrahigh field (UHF) devices with static magnetic field strengths of 7T or more. The introduction of 7T MR has many advantages compared to the routinely used 3T MR. One of the advantages is the increase in the signal-to-noise ratio, which enables recording with a higher spatial resolution. In addition, 7T MR has a greater sensitivity to anatomical details and changes within the tissue, thus providing more clinical information compared to 3T MR. Currently, 7T MRs are more expensive and thus less available to hospitals or clinical centers, so most routine MR imaging is performed using 3T MRs. It should be emphasized that research is increasingly focusing on the upcoming generation of UHF systems, where imaging of the spinal cord with a device with a strength of 10.5T or more will one day become a reality

    Application of contrast agents in ultrasound diagnostics

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    Ultrazvuk je neionizirajuća dijagnostička metoda koja se temelji na fizici piezoelektričnog kristala i prolasku ultrazvučnih valova kroz tkivo. Napretkom medicine i tehnologije, svakim danom sve više napreduje i zastupljena je u mnogim granama medicine. Najvažnije prednosti ultrazvučne dijagnostike su neionizirajuće zračenje, niska cijena te visoka dostupnost. Posljednjih desetljeća ultrazvučna dijagnostika je unaprijeđena uvođenjem ultrazvučnih kontrastnih sredstava, koja imaju za cilj omogućiti bolji prikaz i karakterizaciju suspektnih patoloških promjena. Uporaba kontrastnih sredstava u ultrazvuku je poznata pod nazivom CEUS, engl. contrast enhanced ultrasound. Mikromjehurići plina, umotani u biorazgradivu ovojnicu, povećavaju refleksiju ultrazvučnih valova, čime dovode do veće ehogenosti tkiva u kojima se nalaze i na taj način omogućuju veći kontrast. Tijekom godina su različitim metodama poboljšana svojstva mikromjehurića te postoji više generacija istih.. Najznačajnije prednosti mikromjehurića u usporedbi s jodnim kontrastnim sredstvima, koja se široko koriste u konvencionalnim radiološkim metodama i kompjuteriziranoj tomografiji, jeste mala incidencija pojave alergijskih reakcija, kao i sigurna primjena kod pacijenta s oslabljenom bubrežnom funkcijom. Ipak, postoje kontraindikacije za uporabu mikromjehurića, koje nisu tako česte, a to su pacijenti sa šantovima, teškom plućnom hipertenzijom, nekontroliranom sistemskom hipertenzijom, kao i u pacijenata sa sindromom respiratornog distresa. Ultrazvučna kontrastna sredstva su pronašla svoje mjesto u dijagnostici raznih patoloških promjena. Prvotno su korištena u kardiologiji, a danas se rutinski koriste u procjeni patologije i opisivanju patoloških stanja abdominalnih organa (jetra, bubreg, gušterača), dojke, kao i krvožilnih poremećaja. Istraživanja su pokazala visoku osjetljivost i specifičnost u raspoznavanju patologije, usporedivu s jodnim kontrastnim sredstvima. Naravno, ukoliko dijagnoza dopušta, CEUS bi trebao imati prednost pred rendgenskim kontrastnim metodama, budući da ultrazvuk nema štetni učinak ionizirajućeg zračenja, a i ultrazvučna kontrastna sredstva su u pravilu sigurnija. Budućnost će sigurno dovesti do bitnih spoznaja, koja će unaprijediti CEUS i raširiti njegovu primjenu u medicinskoj dijagnostici i terapiji.Ultrasound is a non-ionizing diagnostic method, which is based on the physics of a piezoelectric crystal and of the ultrasonic wave’s properties through tissues. With the advancement of medicine and technology, ultrasound develops fast being more present in many branches of medicine. The most important advantages of ultrasound diagnostics are non-ionizing radiation, low cost and high availability. In recent decades, ultrasound diagnostics has been improved by the introduction of ultrasound contrast agents, which aim to provide better cauterization of suspected pathological changes. The use of contrast agents in ultrasound is known as CEUS, contrast-enhanced ultrasound. Gas microbubbles, wrapped in a biodegradable shell, increase the reflection of ultrasonic waves, thus enhancing the echogenicity of the tissues in which they are applicated and providing greater contrast properties. Microbubbles have advanced over decades of use and there are several generations of them. The most significant advantages of microbubbles compared to iodine contrast agents, which are used in X-ray methods and computed tomography, is the low incidence of allergies, as well as safe use in patients with impaired renal function. However, there are contraindications to the microbubbles use, which are not so common, and they are in patients with shunts, severe pulmonary hypertension, uncontrolled systemic hypertension, as well as in patients with respiratory distress syndrome. Ultrasound contrast agents have found their place in the diagnosis of various pathological changes. They were originally used in cardiology, and today they are routinely used in assessing pathology and describing pathological conditions of abdominal organs (liver, kidney, pancreas), breast as well as vascular disorders. Studies have shown high sensitivity and specificity in pathology recognition, comparable to iodine contrast agents. Of course, if the diagnosis allows, CEUS should have the advantage over X-ray contrast methods, since ultrasound does not have the harmful effect of ionizing radiation, and ultrasound contrast agents are generally safe. The future will certainly lead to important insights, which will improve CEUS and expand its application in medical diagnostics and therapy

    Achilles tendon rupture and treatment-systematic review

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    Rad je napravljen kao sustavan pregled literature s ciljem identificiranja randomiziranih studija koje uspoređuju operativne i neoperativne metode liječenja ruptura Ahilove tetive kako bi se moglo zaključiti koja od navedenih je uspješnija po pitanju ponovljenih ruptura, komplikacija i ukupnih funkcionalnih ishoda. Pretraga je izvršena unutar tri baze podataka, uključujući PubMed, ReserchGate i Web of Science, a nakon eliminacije članaka prema postavljenim kriterijima istraživanja, odabrano je pet randomiziranih studija za pristup daljnjoj analizi. Studije obuhvaćaju 484 pacijenta s rupturom Ahilove tetive, od čega ih je 244 podvrgnuto kirurškom, a preostalih 240 neoperativnom liječenju. Rezultati različitih testiranja pokazali su kako kirurški pristup ima manji rizik od ponovne rupture. Naime, u kirurškoj skupini pacijenata ponovna ruptura se dogodila u 3,27% slučajeva, dok je kod nekirurške skupine ovaj udio iznosio 9,58%. Očekivano, u kirurškoj skupini zabilježene su i veće komplikacije, najčešće povezane s infekcijama i stanjem mekog tkiva. Što se tiče funkcionalnih ishoda, većina studija nije pronašla značajne kliničke razlike među skupinama kada je u pitanju snaga, raspon pokreta, opseg potkoljenice ili Leppilahti rezultat. Upravo zbog nižeg rizika povezanog s ponovnom rupturom Ahilove tetive, kirurškom liječenju najčešće se podvrgavaju mlađi pacijenti, dok se stariji pacijenti i osobe s malignitetom većinom upućuju na neoperativno liječenje.This master thesis was done as a systematic review of the literature with the aim of identifying randomized studies that compare operative and non-operative treatment methods for Achilles tendon ruptures in order to conclude which one is more successful in terms of repeated ruptures, complications and overall functional outcomes. The search was performed within three databases, including PubMed, ReserchGate and Web of Science, and after the elimination of articles according to the set research criteria, five randomized studies were selected for access to further analysis. The studies include 484 patients with Achilles tendon rupture, of which 244 underwent surgical treatment and the remaining 240 patients underwent non-operative treatment. The results of various tests have shown that the surgical approach has a lower risk of rerupture. Namely, in the surgical group of patients, rerupture occurred in 3.27% of cases, while in the non-surgical group this proportion was 9.58%. As expected, major complications were recorded in the surgical group, most often related to infections and soft tissue conditions. Regarding functional outcomes, most studies did not find significant clinical differences between groups in terms of strength, range of motion, lower leg circumference, or Leppilahti score. Precisely because of the lower risk associated with rerupture of the Achilles tendon, younger patients are most often subjected to surgical treatment, while older patients and people with malignancy are mostly referred to non-operative treatment

    NURSING CARE OF PATIENT WITH IMPLANTED SPEECH PROSTHESIS

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    Rizični čimbenici koji utječu na pojavnost karcinoma grkljana su u prvom redu pušenje, alkohol, a u novije vrijeme sve veća pojavnost humanog papiloma virusa i gastroezofagealnog refluksa. Preventivnim pregledima i redovitim kontrolama bolesnika koji spadaju u rizičnu skupinu, može se otkriti tumor u ranom stadiju bolesti što uvelike pogoduje uspješnom izlječenju. Kod uznapredovalog operabilnog tumora je pak indicirana totalna laringektomija koja predstavlja opsežan kirurški zahvat u smislu potpunog odstranjenja grkljana. Multidisciplinarnim pristupom je važno fizički pripremiti bolesnika na hospitalizaciju kao i na sve postupke prije i poslije operativnog zahvata. Psihičkom pripremom će se također postići bolja suradnja bolesnika sa zdravstvenim osobljem kao i njegovo povjerenje te smanjena razina straha pri izvođenju svih potrebnih radnji. U radu su prikazane moguće komplikacije samog operativnog zahvata, kao i tehnike uspostave ezofagealnog govora, primjena elektronskog govornog uređaja - pomagala i traheoezofagealnog govora pomoću govorne proteze. Glasovna rehabilitacija ugradnjom govorne proteze danas predstavlja zlatni standard kod totalne laringektomije. Glavni cilj ovog rada je objasniti važnost i ulogu zdravstvenih djelatnika pri samom procesu liječenja te o poteškoćama i sestrinskim intervencijama s kojima se svakodnevno susreću. Također je cilj kroz prikaz slučaja definirati postupke i najčešće sestrinske dijagnoze koristeći proces zdravstvene njege. Kako bi povratak svakodnevnim aktivnostima bio što kvalitetniji, o nastalim promjenama i novom načinu života, važno je educirati samog bolesnika, njegovu obitelj i bliske osobe.The primary risk factors for the occurence of throat cancer are smoking, alcohol, and more recently the growing number of human papilloma virus (HPV) as well as gastroesophageal reflux. Preventive diagnostics and regular screenings of patients with high risk factors can lead to discovering a tumor at an early stage, which can facilitate successful treatment. If advanced operable tumors are in question total laryngectomy is indicated, which is the surgery that involves removing your entire larynx. By multidisciplinary approach it is important to physically prepare the patient for the hospitalization as well as for all the procedures before and after the surgery. Psychical preparation will result in better collaboration between a patient and the medical staff and will build his trust and lower the level of fear in the course of all necessary procedures.This paper outlines all the possible complications of the surgery and the techniques of gaining esophageal speech , the use of electrolarynx and tracheoesophageal speech with the help of prosthesis. Restoring speech communication using the voice prosthesis is a golden standard at total laryngectomy. The main aim of this paper was to point out the importance and the role of medical staff during the treatment, the difficulties and interventions that nurses go through on daily basis as well as, by presenting many cases, to define the procedures and the most common nurse diagnoses during the medical care. For the highest quality return to everyday activities it is of vital importance to educate not only the patient but his family and close friends of the changes and the new way of life

    Ectopic pregnancy

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    Ljudski reproduktivni sustav ima funkciju stvaranja potomstva. Većina trudnoća su inače zdrave i normalne, no postoje i visokorizične te vanmaternične trudnoće. Trudnoća koja se implantira izvan ili na vrat maternice naziva se ektopična trudnoća. Još uvijek ektopična trudnoća može dovesti do morbiditeta i smrtnosti, ali moderne dijagnostičke metode omogućuju rano prepoznavanje većine ektopičnih trudnoća. Najčešći načini liječenja ektopične trudnoće su ekpektativni način, medikamentozni način te kirurški zahvati i metode. Danas primalje imaju bitnu ulogu u skrbi i njezi trudnica i ginekoloških pacijentica, s pozicije zdravstvenog djelatnika, ali i s pozicije da pruže utjehu i suosjećajnost u trenucima kada je to pacijenticama najpotrebnije.The human reproductive system has the function of maintaining the species. Most pregnancies are otherwise healthy and normal, but there are also high-risk and ectopic pregnancies. A pregnancy that implants outside or on the cervix is called an ectopic pregnancy. Ectopic pregnancy can still lead to morbidity and mortality, but modern diagnostic methods allow early recognition of most ectopic pregnancies. The most common methods of treatment for ectopic pregnancy are the expectant method, the medicinal method, and surgical procedures and methods. Today, midwives play an important role in the care of pregnant women and gynecological patients, from the position of a healthcare professional, but also from the position of providing comfort and compassion in moments when patients need it most

    The importance of prehospital airway menagement

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    Zbrinjavanje dišnog puta je jedan od ključnih elemenata kod pružanja pomoći pacijentu sa ili bez opstrukcije dišnog puta posebno kad se radi o vanbolničkim uvjetima. Posebno kad je poznato da već koju minutu po prestanku opskrbe stanica moždanog korteksa kisikom, one odumiru. Stoga, već po dolasku, najbitnije je provjeriti eventualno postojanje stranog tijela, a zatim se pristupa manualnim metodama kao što su zabacivanje glave i podizanje brade ili pak potiskivanje donje čeljusti prema naprijed. Nakon toga prohodnost se osigurava pomagalima tipa orofaringealni i nazofaringealni tubus. Tako se omogućava normalno disanje kod osoba koje samostalno dišu. Ipak, ovo je kontraindicirano kod osoba koje se opiru ili imaju nadražaj na povraćanje. To je razlog zašto oprema za sukciju uvijek treba biti pri ruci. U slučajevima respiratornog aresta za osiguravanje dišnog puta te za kvalitetnu ventilaciju i oksigenaciju, potrebne su naprednije tehnike i pomagala kao što je endotrahealna intubacija koja se s godinama nametnula kao zlatni standard. Ipak, u slučaju nemogućnosti iste ili pak otežanog samog postupka, u cilju što manjeg gubljenja vremena, prohodnost dišnog puta se uspostavlja alterantivnim pomagalima poznatijima kao supraglotička pomagala. Njihova je prednost brzo i efikasno postavljanje čak i kod osoba manje vještih endotrahealnoj intubaciji uzevši u obzir važnost što ranije uspostave adekvatne ventilacije. U slučajevima kada je riječ o opstrukciji gornjih dišnih puteva iznad glotisa, ni jedna od ovih tehnika nije moguća zbog čega se pristupa krikotiroidotomiji. I tek nakon što je diši put osiguran pristupa se ventilaciji, kontroliranoj ili asistriranoj, a sve u cilju postizanja zadovoljavajuće oksigenacije.Airway management is one of the crucial parts in taking care of the patient with or without the airway obstruction especially in prehospital setting. Especially when it is generally known that only a few minutes after the cessation of oxygen supply brain cortex cell die. Therefore, immediately upon arrival, the most important thing is to check the airway for foreign body and then by using basic manual methods, head tilt and chin lift or jaw-thrust, to ensure the airway with the adjunct to airway techniques such as oropharyngeal and nasopharyngeal tubes. This allows normal ventilation in persons who are breathing on their own. Still, this is contrindicated in people who resist or have irritation on vomiting. That is why suction system must always be ready for use. In situation respiratory arrest, in order to provide the airway, especially for providing high-quality ventilation and oxygenation, advanced techniques like endotracheal intubation are needed. With years it become a gold standard. In a situation with a difficult intubation or in inability to do so, in order to waste as little time as possible, it is important to consider alternative techniques such as supraglottic devices. Their advantage is fast and efficient installation even in less skilled people taking into account the importance of establishing the airwy as soon as possible. In the case of obstruction of the upper airway above glottis, none of the te mentioned techniques will be possible which is why it is approached to cricothyroidotomy. And only after ensuring airway high-quality ventilation, controlled or assisted, must be provided in order to ensure efficient oxygenation

    Professional challenges of home care nursing; The contribution of global changes to prevalence of disease and life extension

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    U radu su prikazani utjecaji globalnih promjena na obolijevanje korisnika zdravstvene njege u kući te aktivnosti medicinske sestre zaposlene u zdravstvenoj njezi u kući. Pri tome su prikazani podatci o sadašnjoj strukturi korisnika zdravstvene njege u kući u Republici Hrvatskoj te smrtnost i pobol stanovništva, kako u Republici Hrvatskoj, tako i u svijetu. Također je prikazan utjecaj štetnih zdravstvenih ponašanja, produljenja životnog vijeka, stresa i ostalih čimbenika na pobol i smrtnost stanovnika. U radu je također raspravljano o pozitivnim i negativnim utjecajima globalizacije i globalnih trendova na rad medicinskih sestara zaposlenih u kućnoj njezi te kako suvremeni čimbenici rizika povezani s modernim načinom života utječu na rad medicinske sestre. Na kraju rada je naglašeno da globalni trendovi, zajedno sa starenjem populacije i produljenjem životnog vijeka, koji se odražavaju na svim društvenim razinama, pa tako i na područje zdravstva, predstavljaju izazove za rad medicinskih sestara zaposlenih u kućnoj njezi. Navedeni izazovi će u budućnosti zahtijevati kontinuirane dodatne izobrazbe i stručna osposobljavanja u ovom važnom području rada u zdravstvu, kako bi medicinske sestre mogle na kompetentan način odgovoriti na potrebe korisnika o kojima skrbe.The paper presents the effects of global changes on the morbidity of home health care users and the activities of nurses employed in home health care. Data on the current structure of home health care users in the Republic of Croatia and mortality and morbidity of the population, both in the Republic of Croatia and in the world, are presented. The impact of harmful health behaviors, prolongation of life expectancy, stress and other factors on the morbidity and mortality of the population is also shown. The paper also discusses the positive and negative impacts of globalization and global trends on the work of nurses employed in home care and how contemporary risk factors associated with modern lifestyles affect the work of nurses. At the end of the paper, it was emphasized that global trends, together with the aging population and increasing life expectancy, which are reflected at all levels of society, including health, are challenges for the work of nurses employed in home care. These challenges will in the future require continuous additional training and professional training in this important area of health work, so that nurses can competently respond to the needs of the users they care for

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