УЛОГА НА МЕДИЦИНСКАТА СЕСТРА - АНЕСТЕТИЧАР ВО ПЕРИОПЕРАТИВНИОТ МЕНАЏМЕНТ ПРИ ХИРУРШКИ ТРЕТМАН НА ПАЦИЕНТИ СО СУБАРАХНОИДАЛНА ХЕМОРАГИЈА
ROLE OF THE NURSE - ANESTHETIST IN THE PERIOPERATIVE MANAGEMENT OF SURGICAL TREATMENT OF PATIENTS WITH SUBARACHNOIDAL HEMORRHAGIA

Summary/Abstract: Subarachnoid hemorrhage is a neurological emergency characterized by bleeding into the subarachnoid space. Patients with subarachnoid hemorrhage are a particularly vulnerable category due to the risk of rebleeding, vasospasm, and increased intracranial pressure. Therefore, the nurse-anesthetist must be not only technically prepared, but also clinically aware, capable of quickly recognizing complications and cooperating with the entire medical team. Causes of subarachnoid hemorrhage are: increased blood pressure, arteriosclerosis, rupture of intracranial aneurysm, and rupture of AV malformation. The history of this condition very often indicates physical exertion or emotional stress. Successful diagnosis of subarachnoid hemorrhage is based on a combination of clinical assessment and the use of modern diagnostic technologies, in order to quickly detect the hemorrhage and its etiology, which is crucial for planning further treatment. The treatment of subarachnoid hemorrhage is a multidisciplinary process that requires urgent intervention, intensive monitoring, and careful management of complications. The goal is to stabilize the patient, prevent rebleeding, and minimize secondary brain tissue damage. First, the patient is placed in an intensive care unit, where vital signs, neurological status, and adequate oxygenation and hemodynamic stability are monitored. Arterial hypertension is carefully controlled to reduce the risk of re-rupture, but without compromising cerebral perfusion. A key step in treatment is to secure the source of the bleeding, usually a ruptured aneurysm. This is achieved through one of two basic interventions: 1. Surgical clipping (where the aneurysm is closed mechanically through a craniotomy) 2. Endovascular treatment (a minimally invasive procedure in which metal coils are placed through a catheter to stabilize the aneurysm from the inside). The role of the nurse is not limited to the operating room, but also continues in postoperative care, where monitoring, communication with the patient and support for the family are of particular importance. By acting according to protocols, but also with empathy and clinical intuition, the nurse anesthetist contributes to safer treatment, faster recovery and better quality of care for these patients

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