Avtor/Urednik		Kodrič, Nada; Renko-Diallo, Doroteja; Kremesec, Milena; Šervicl-Kuchler, Darja; Vlahovič, Dušan
Naslov		Sodelovanje anesteziologa z zdravniki različnih strok v pripravi bolnika za operativni poseg
Prevedeni naslov		Multidisciplinary approach to preoperative patients assessment for surgery
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 72, št. 11
Leto izdaje		2003
Obseg		str. 625-30
Jezik		slo
Abstrakt		Background. A good cooperation of the anaesthesiologist with doctors of other specialities is needed in preoperative assessment of the patient to increase efficiency, lower the costs and improve quality of patients' assessment for surgery in anaesthesia. Methods. Fundamental processes for the anaesthesiologist when preparing the patient before surgery are taking a detailed history and performing a systematic clinical examination. They are followed by specific examinations according to the results of physical examination, age of the patient, coexisting diseases, bad habits and extent of the surgery. The anaesthesiologist can then take a decision about the most suitable type of anaesthesia for the patient in accordance with the accepted guidelines. A family practitioner can play a crucial role in the preoperative assessment as he/she knows the patient best Foremost, he/she can also decide which examinations should the patient undergo before admission to the hospital for the elective surgery. At the hospital, consultants of different specialities are asked to cooperate with the anaesthesiologist according to the nature of the patient disease. The ward doctors are informed about the patientš special needs after the surgery. The anaesthesiologists play a crucial role in taking care of badly injured and critically ill patients. As the head of the trauma team, the anaesthesiologist has to cooperate with the doctors of different specialities, such as general practitioners, who are in charge of the prehospital care, then with surgeonstraumatologists and other specialists according to the pathology of the patient. Results. Cooperation of doctors of different specialities is valuable in the preoperative assessment of the patient, though it is sometimes time consuming. The lost time can be fatal for the patient. Conclusions. A more personal approach in communication with consultants is needed. Merely writing notes is just not enough. (Abstract truncated at 2000 characters).
Izvleček		Izhodišča. Z dobrim sodelovanjem anesteziologa z zdravniki različnih strok bi v predoperacijski pripravi bolnika povečali učinkovitost, zmanjšali stroške in izboljšali kakovost pri obravnavi bolnikov za operacije v anesteziji. Metode. V pripravi bolnika za operacijski poseg sta najpomembnejša za anesteziologa natančna anamneza in pregled bolnika. Nato sledijo preiskave, ki jih narekujejo izsledki fizikalnega pregleda, starost, spremljajoče bolezni, škodljive razvade in obsežnost operacije. Na osnovi tega se anesteziolog odloči za vrsto anestezije, ki je po znanih doktrinah za bolnika najboljša. Potrebno je upoštevati vlogo družinskega zdravnika, ki praviloma bolnika dobro pozna in lahko glede na omenjene napotke presodi, katere preiskave naj bolnik opravi pred prihodom v bolnišnico za načrtovani operativni poseg. V bolnišnici pa se nadaljuje sodelovanje anesteziologa z drugimi specialisti, če je to potrebno, in obveščanje lečečih zdravnikov po operaciji. Anesteziolog ima tudi ključno vlogo pri oskrbi hudo poškodovanih bolnikov in bolnikov v kritičnem stanju. Anesteziolog kot vodja t. i. travma tima mora sodelovati z zdravniki različnih specialnosti. Najprej so tu zdravniki splošne medicine, ki so v našem sistemu nosilci predbolnišnične oskrbe, nato s kirurgi travmatologi ter različnimi specialisti glede na patologijo bolnika. Rezultati. Sodelovanje zdravnikov različnih strok v pripravi bolnika na operativni poseg je dobro, vendar gre za marsikdaj zamuden postopek, ki je lahko tudi usoden za bolnika. Zaključki. Želeli bi si bolj oseben pristop do konziliarnih zdravnikov in ne le pisanje konziliarnih listov. Tako bi konziliarni zdravnik dobil bolj jasno sliko o bolniku, anesteziolog pa hitrejši in izčrpen odgovor na svoja vprašanja. Med zdravniki na terenu in anesteziologom, ki vodi t. i. travma tim v bolnišnici, je zelo pomembno obveščanje. Za ustrezno komunikacijo bi morale bolnišnice zagotoviti boljše tehnične pogoje.
Deskriptorji		ANESTHESIA PREOPERATIVE CARE INTERPROFESSIONAL RELATIONS PATIENT CARE TEAM