{"id":11385855,"date":"2010-10-15T00:00:00","date_gmt":"2010-10-14T22:00:00","guid":{"rendered":"https:\/\/alertdiver.eu\/uncategorized-fi_fi\/on-site-neuro-assessment\/"},"modified":"2010-10-15T00:00:00","modified_gmt":"2010-10-14T22:00:00","slug":"on-site-neuro-assessment","status":"publish","type":"post","link":"https:\/\/alertdiver.eu\/fi_FI\/artikkelit\/on-site-neuro-assessment\/","title":{"rendered":"On-Site Neuro Assessment"},"content":{"rendered":"<p style=\"text-align: justify;\">Suurin piirtein kaksi-kolmasosaa v\u00e4henev\u00e4n paineen aiheuttamista sairauksista (DCI) sis\u00e4lt\u00e4\u00e4 hermoston vamman. N\u00e4iden merkit ovat usein ep\u00e4m\u00e4\u00e4r\u00e4iset ja voivat j\u00e4\u00e4d\u00e4 sukeltajilta huomaamatta. T\u00e4m\u00e4 saattaa aiheuttaa sen, ett\u00e4 kyseiset merkit j\u00e4tet\u00e4\u00e4n huomioimatta merkityksett\u00f6min\u00e4 tai sukellukseen kuulumattomina.<br \/>&nbsp;<\/p>\n<p style=\"text-align: justify;\">Auttaakseen sukeltajia m\u00e4\u00e4rittelem\u00e4\u00e4n aiheutuuko vamma pelk\u00e4st\u00e4\u00e4n pullojen kantamisesta (ks. Aiheeseen liittyv\u00e4 juttu selk\u00e4kivusta, EAD 2-10) vai sukeltamisesta on DAN kehitt\u00e4nyt On-site Neurological Assessment for Divers program (Sukelluspaikalla tapahtuva neurologinen arviointi). Perusteellinen, tehokas, mutta yksinkertainen neurologinen arviointi auttaa sukeltajien hoitoa kolmella tavalla:<\/p>\n<ol>\n<li style=\"text-align: justify;\">L\u00e4\u00e4ketieteen ammattilaisilla ja DAN-l\u00e4\u00e4k\u00e4reill\u00e4 on luotettava keino arvioida sukellusonnettomuuden kiireellisyys perustuen sukeltajien onnettomuuspaikalta raportoimiin oireisiin.<\/li>\n<li style=\"text-align: justify;\">L\u00e4\u00e4kint\u00e4henkil\u00f6st\u00f6n kouluttaminen syrj\u00e4seuduille, miss\u00e4 sukelletaan, on usein vaikeaa ja ep\u00e4luotettavaa.<\/li>\n<li style=\"text-align: justify;\">DAN Researchin mukaan sukeltajat usein viiv\u00e4stytt\u00e4v\u00e4t h\u00e4t\u00e4suunnitelmansa toteuttamista, happiensiapua ja hoitoon menoa kielt\u00e4m\u00e4ll\u00e4 oireiden olemassaolon. Kun on olemassa yksinkertainen tutkimus joka osoittaa ett\u00e4 vammautuneella sukeltajalla on ongelma, saattaa vammautunut sukeltaja alkaa paikalla tapahtuvan hoidon (esim. happiensiavun) nopeammin jolloin oireet helpottamiseen.<\/li>\n<\/ol>\n<p style=\"text-align: justify;\">Ainoastaan l\u00e4\u00e4ketieteen ammattilaisten tulisi tehd\u00e4 diagnoosi terveydentilasta (Suomessa vain l\u00e4\u00e4k\u00e4ri voi tehd\u00e4 diagnoosin suom.huom.). Neurologisen arvioinnin aikana ker\u00e4tty informaatio on k\u00e4ytt\u00f6kelpoista kun l\u00e4\u00e4k\u00e4ri yritt\u00e4\u00e4 ymm\u00e4rt\u00e4\u00e4 vamman laajuuden sek\u00e4 kuinka se on muuttunut sukelluspaikalta hoitoon tultaessa.<\/p>\n<ul>\n<li>Sukelluspaikalla teht\u00e4v\u00e4n arvioinnin viisi osa-aluetta ovat:<\/li>\n<li>Mentaalit toiminnot<\/li>\n<li>Kasvolihasten toiminnot<\/li>\n<li>Motoriset toiminnot<\/li>\n<li>Tuntoherkkyys<\/li>\n<li>Koordinointi ja tasapaino<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>Muita vaihtoehtoja<\/strong><br \/>Kent\u00e4ll\u00e4 teht\u00e4vi\u00e4 neurologisia arviointiohjelmia on ollut olemassa jo vuosien ajan ja niist\u00e4 on olemassa useita kirjoja, kuten U.S. Navyn ja NOAAn. K\u00e4yty\u00e4\u00e4n n\u00e4m\u00e4 ohjelmat l\u00e4pi DAN huomasi kuitenkin, ett\u00e4 useat noista ohjelmista eiv\u00e4t olleet k\u00e4ytt\u00f6kelpoisia keskivertosukeltajalle virkistyssukellusymp\u00e4rist\u00f6ss\u00e4. Ne on tarkoitettu sukeltajille, joilla on eritt\u00e4in hyv\u00e4 tukiasema, ei sukeltajille sukellusaluksella. DAN American Medical Director Dr. Richard Moon, apunaan Dr.&nbsp; Wayne Massey, Duke University Medical Centerin neurologisti, jolla on kokemusta vammautuneiden sukeltajien hoidossa k\u00e4vi l\u00e4pi olemassa olevat ohjelman ja m\u00e4\u00e4ritteli, mik\u00e4 on oikeasti t\u00e4rke\u00e4\u00e4 ja k\u00e4yt\u00e4nn\u00f6llist\u00e4 kentt\u00e4oloissa tapahtuvalle tutkimukselle.<\/p>\n<p style=\"text-align: justify;\"><strong>Keksi, mit\u00e4 todella on tapahtumassa<\/strong><br \/>DAN Report on Decompression Illness, Diving Fatalities and Project Dive Exploration-kirja on t\u00e4ynn\u00e4 tapauksia, joissa sukeltajilla on neurologisia komplikaatioita sukellusten j\u00e4lkeen. Oireet j\u00e4\u00e4v\u00e4t tunnistamatta usein tuntikausiksi tai p\u00e4iviksi, koska kukaan ei tutkinut asiaa sen enemp\u00e4\u00e4. Useimmassa raportissa on keskim\u00e4\u00e4r\u00e4inen viive oireiden alkamisesta hoidon alkamiseen 19 tuntia.<br \/>&nbsp;<\/p>\n<p style=\"text-align: justify;\">Vertailun vuoksi: suurin osa ensioireista kehittyi tunnin sis\u00e4ll\u00e4 pintautumisesta sukellukselta. Toinen merkitt\u00e4v\u00e4 m\u00e4\u00e4r\u00e4 oli sukeltajat, jotka alkoivat saada v\u00e4henev\u00e4n paineen aiheuttaman sairauden (DCI) oireita, mutta palasivat silti veteen tekem\u00e4\u00e4n viel\u00e4 toisen sukelluksen.<br \/>Toistaiseksi kolme yleisint\u00e4 v\u00e4henev\u00e4n paineen aiheuttaman sairauden oiretta ovat tunnottomuus, pistely ja lihasheikotus. Kaikki kolme oiretta merkitsev\u00e4t neurologisia ongelmia ja v\u00e4henev\u00e4n paineen aiheuttamaa sairautta.<br \/>&nbsp;<\/p>\n<p style=\"text-align: justify;\">On usein huomautettu, ett\u00e4 sukeltajat odottavat niin pitk\u00e4\u00e4n ennen kuin hakeutuvat hoitoon oireiden alettua, koska he kielt\u00e4v\u00e4t ongelman.<br \/>Tai he huomaavat heill\u00e4 olevan ongelman, mutta keksiv\u00e4t sille syit\u00e4. Kun ongelma ei sitten poistukaan, soitetaan viimein apua. Yhdess\u00e4 tapauksessa sukeltaja tunsi olonsa irralliseksi pintautumisensa j\u00e4lkeen eik\u00e4 pystynyt muistamaan muiden veneell\u00e4 olleiden sukeltajien nimi\u00e4 noin puoleen tuntiin. L\u00e4\u00e4ketieteellisin termein t\u00e4t\u00e4 kutsutaan &ldquo;tajunnantason muuttumiseksi&rdquo; ja se vaatii v\u00e4lit\u00f6nt\u00e4 toimimista. <br \/>&nbsp;<\/p>\n<p style=\"text-align: justify;\">T\u00e4ss\u00e4 nimenomaisessa tapauksessa mit\u00e4\u00e4n ei tehty ja h\u00e4n jatkoi sukeltamista. H\u00e4nen DCI:t\u00e4\u00e4n hoidettiin muutaman p\u00e4iv\u00e4n kuluttua. T\u00e4ytt\u00e4m\u00e4ll\u00e4 arvioinnin historiaosion alat m\u00e4\u00e4rittelem\u00e4\u00e4n, onko kyseess\u00e4 sukellusonnettomuus vai onko oireet aiheuttanut joku sukellusta edelt\u00e4v\u00e4 sairaus. On-Site Neuro-koe on periaatteessa haastattelu.<br \/>Varsinainen arviointi auttaa kaventaman mahdollisuuksia ja antaa sinulle tietoa kerrottavaksi hoitavalle l\u00e4\u00e4k\u00e4rille. On t\u00e4rke\u00e4 ensiaskel tehd\u00e4 nopea tilannearvio ja houkutella sukeltaja my\u00f6nt\u00e4m\u00e4\u00e4n, ett\u00e4 ongelma on olemassa. Viiveiden pienent\u00e4minen oireiden tunnistamisessa ja hoitoon hakeutumisessa on ensiavun keskeisin tekij\u00e4.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Suurin piirtein kaksi-kolmasosaa v\u00e4henev\u00e4n paineen aiheuttamista sairauksista (DCI) sis\u00e4lt\u00e4\u00e4 hermoston vamman. N\u00e4iden merkit ovat usein ep\u00e4m\u00e4\u00e4r\u00e4iset ja voivat j\u00e4\u00e4d\u00e4 sukeltajilta huomaamatta. T\u00e4m\u00e4 saattaa aiheuttaa sen,&#8230;<\/p>\n","protected":false},"author":1,"featured_media":11373811,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[385],"tags":[],"authors":[967],"class_list":["post-11385855","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-artikkelit","authors-eric-douglas-fi_fi"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>On-Site Neuro Assessment - Alert Diver<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/alertdiver.eu\/fi_FI\/artikkelit\/on-site-neuro-assessment\/\" \/>\n<meta property=\"og:locale\" content=\"fi_FI\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"On-Site Neuro Assessment - Alert Diver\" \/>\n<meta property=\"og:description\" content=\"Suurin piirtein kaksi-kolmasosaa v\u00e4henev\u00e4n paineen aiheuttamista sairauksista (DCI) sis\u00e4lt\u00e4\u00e4 hermoston vamman. 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