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2020, vol. 20, br. 2, str. 20-28
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Prehospitalno zbrinjavanje hipoglikemije
Prehospital care of hypoglycaemia
aSlužba hitne medicinske pomoći, Novi Pazar bOpšta bolnica, Novi Pazar cZavod za hitnu medicinsku pomoć, Kragujevac dSlužba hitne pomoći, Novi Pazar
e-adresa: elviralukac001@gmail.com
Sažetak
Uvod: Hipoglikemija je kliničko stanje koje karakteriše vrednost glukoze u krvi manja od 3,5mmol/l. Teška hipoglikemija ukoliko se na vreme ne prepozna i terapijski ne reaguje može uzrokovati oštećenje mozga, a koja traje više od jednog sata moždanu smrt. Cilj rada: je analiza učestalosti hipoglikemijske krize kod pacijenata obolelih od diabetes mellitus-a pregledanih u ambulanti i na terenu Službe hitne medicinske pomoći (SHMP) u Novom Pazaru. Metod rada: Sprovedena je retrospektivna analiza 52593 pacijenta koji su pregledani u SHMP u periodu od 01.01.2019. do 31.12.2019.god. Analizirani su podaci iz protokola pacijenata obolelih od diabetes mellitus-a kod kojih je potvrđena hipoglikemija. Analizirana je demografska struktura, distribucija poziva po mesecima kao i dnevni vremenski intervali kad su ekipe hitne medicinske službe reagovale. Poseban osvrt smo imali na pacijente mlađe i starije životne dobi koji su pored hipoglikemijske krize imali i epileptični napad. Rezultati: U periodu od 01.01.2019. do 31.12.2019. godine u SHMP pregledano je 52593 pacijenta. Od ovog broja 7201 su oboleli od diabetes mellitusa tip 1 i tip 2, što predstavlja 13,69% od ukupnog broja pregledanih. Žene su bile zastupljenije 3728 (51,77%), dok je muškaraca bilo 3473. Glikemija je izmerena 2794 puta, od toga je kod 752 pacijenta potvrđena hipoglikemija ( 10,44%). Najviše hipoglikemija bilo je na terenu 701 ( 93,21%), dok je u ambulanti bilo 51 ( 6,78%). Vrednosti glikemije od 3,5 do 3,2 mmol/l imalo je 323 (42,95%) pacijenta. Između 3,1 i 2,2 mmol/l imalo je 207 (27,52%) pacijenata. Vrednosti 2,1 mmol/l i niže imalo je 222 (29,52%) pacijenata. U ovoj grupi od 222 pacijenta epileptični napad je zabeležen kod 151 pacijenta (68,01%). Zaključak: Hipoglikemija je dijagnostikovana kod 10% pacijenata obolelih od dijabetes melitusa. Tešku hipoglikemiju smo dijagnostikovali kod 222 pacijenta. Više intervencija je bilo na terenu, najviše u toku avgusta meseca i u ranim jutarnjim satima.
Abstract
Introduction: Hypoglycemia is clinical condition characterized by the level of glucose in the blood less than 3,5mmol/l. Severe hypoglycemia, unless is detected on time and treated, can cause brain damage, while Hypoglycemia lasting more than an hour can cause brain death. Objectives: to analyze the frequency of hypoglycemia crises within the patients with diabetes mellitus, examined on site and at the Emergency Room of Emergency Department in Novi Pazar (EDNP). Methodology: Retrospective analysis of 52593 patients, examined at ER, from January 01, 2019. Till December 31, 2019. Has been conducted. Protocol data of the patients with diabetes mellitus and confirmed diagnosis of hypoglycemia have been analyzed. Moreover, demographic structure, distribution of calls by months and time interval when the ER teams reacted, have been analyzed. Special attention paid to the patients (younger and older) who, besides hypoglycemic crisis, had epileptic seizures. Results: In the period from January 01, 2019. Till December 31, 2019. at Emergency Department in Novi Pazar 52593 patients have been examined. Out of that number 7201 were diagnosed with diabetesmellitus type 1 and type 2, or 13,69% from the total number of examined patients. Women were more represented with the number of 3728 (51,77%), while 3473 patients were men. Glycaemia test was done 2794 times, where among 752 (10,44%) patients hypoglycemia was confirmed. Most cases of the hypoglycemia were diagnosed on the site, 701 (93,21%), while 51 cases (6,78%) were diagnosed at the ER. The value of Glycaemia from 3,5 till 3,2 mmol/l was measured within 323 (42,95%) patients, whereas 207 patients (27,52%) were with the value from 3,1 and 2,2 mmol/l. Value of 2,1 mmol/l and less was measured among 222 (29,52%) patients. In the group of 222 patients, epileptic seizure was detected within 151 (68,01%) patients. Conclusion: Hypoglycemia was diagnosed in 10% of patients with diabetes mellitus. We diagnosed severe hypoglycemia in 222 patients. There were several such out of the hospital interventions, mostly during August and usually in the morning hours.
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