General principles for the provision of ambulance
Historically organization "ambulance" has arisen due to the increasing number of accidents related to the intensive growth of cities and industries.In 1881, the first station of the service was set up in Vienna.In Russia, the ambulance first emerged on the basis of charity hospital emergency in 1844
held with diseases and conditions that are dangerous to life, and the clock is provided by the station, "ambulance".The reasons for the above conditions can be life-threatening sudden illness, attempted murder and suicide, poisoning, natural disasters, and others. This service also includes transportation problems in childbirth maternity hospital and patients, in addition to infectious diseases, at the request of doctors.The list of activities that are carried out workers "Ambulance" at the scene or during transport to a specialized medical institution, include ensuring patient safety and conducting prevention of complications.In the case of injury or acute illness, patients are sent for treatment in specia
functions of the emergency services staff are not regular treatment and monitoring of patients and victims, examination of alcohol intoxication, issuance of certificates and sick leave.
This service operates in settlements with a population of over 50 thousand. The station "Ambulance" can both be an independent medical institution, and enter into the structure of the city hospital emergency care.Emergency medical care also provides emergency and routine medical care counseling department, are part of the regional hospital.Such a system of providing emergency medical service is organized in remote areas of the country.The development plan of the service activity should be performed taking into account the age structure and morbidity of the population density, geographical location, area and others. One of the structural units of the station, "ambulance" are substations, which are calculated on a 15-minute transport accessibility.The local health authority regulates the territory served by one station.Staff service "Ambulance" together in teams to work in one shift.There are teams that specialize in one profile (cardiology, trauma, mental health, etc.).Urgent measures are carried out on the way to the hospital or at the scene.Emergency medical staff carried out CPR and closed heart massage, stopping the bleeding, blood transfusions.They also produce a number of diagnostic procedures: determining prothrombin index, duration of bleeding, relieve ECG, etc. In this regard, transport ambulance service has the necessary medical intensive care and diagnostic equipment..
Activity Station "Ambulance" is complex and multifaceted.Machinery "Ambulance" obliged to go smoothly on all calls.Doctor or nurse first aid, and ensure the speedy and skilled service of the sick or injured person to a specialized medical facility should be provided.According to the profile, in the brigade must be present all the necessary medicines.Reducing the number of complications and deaths but the way the hospital provides volume expansion and improvement of care.
Currently there is a dual system of emergency medical organization, considering the prehospital and hospital stages.In large cities are combining ambulance, which include hospital emergency medical care and emergency advisory department.This structure is concerned with the organization of the emergency and consultative medical care to the population using sanitary aviation and land transport.On the basis of emergency services under the supervision of department clinics organized home care.This allows you to improve the organization of the activities of emergency services and increase the responsibility of clinics for providing medical service attached to it of the population.
The duties of the department include: the provision of appropriate medical care to patients with acute diseases, providing on-demand call Brigade "Ambulance".The majority of patients after first aid go further investigation in order to avoid complications.
qualitative level of implementation of patient care at home contributes to more efficient work of the hospital.In the clinics, various forms of assistance:. Emergency room department care for the sick and elderly, separation of the active patronage, short-term or day care, followed by after-care of the patient at home, etc. When handling patients accounted for the reasons, goals and nature of complaints (primary or recurrent), forms of diseases (chronic or acute), seasonality, and other applications. mainly dominated treatment of therapeutic profile.
It is important for the treatment of patients at home laboratory diagnostic and therapeutic support services.Evaluate the effectiveness of emergency medical care is necessary, taking into account the timeliness of call per cent discrepancy diagnosis established by employees of the ambulance service and the hospital.One of the main indicators of the quality of the work is, as indicated by the number of repeat calls and the ratio of the number of hospitalizations and the total number delivered to a specialized agency.
ambulance service - a very important stage in the structure of health care delivery to the population.Employees of the organization must be highly qualified by their activity depend the lives of thousands of patients.It was found that "ER" annually produces more than 100 million visits.Employees of the service is fast reaction, the hardness and the ability to quickly focus in all conditions.The doctor "first aid" should have a certain level of medical thinking, so that in a few minutes to establish the diagnosis and to provide appropriate assistance.Skilled this service you must have a clear knowledge of the differential diagnosis, able to navigate in the symptoms of the disease and the patient's complaints.Ambulance Physicians should correctly assess the symptoms and syndromes, the clinical picture of the disease, which is extremely important in the diagnosis.They need to learn the ropes and have a deep knowledge of many medical disciplines.Straight civil and human duty of every health professional is to provide first aid, failure to which entail disciplinary or criminal liability.
In our country, there is a network of health facilities providing emergency care.These include specialized emergency hospital, research institutes, clinics of medical schools and universities.
The recent trend to improve the quality of emergency care.This is achieved by continuous improvement of emergency structure: the use of new equipment, increasing network of medical institutions, increasing the number of health care workers and others must be stressed the importance of activities aimed at warning and teaching people the rules of first aid..So simple, yet vital activities are taught from school age.First Aid - a system of urgent measures aimed at the injured or suddenly ill person at the scene or en route to a medical facility.
There are several types of first aid.First medical aid is unskilled non-medical worker, as a rule, without any medicines and medical equipment.The first medical expert (pre-medical) care provides medical specialist (nurse, paramedic, etc..), Who has been trained.The first medical care is provided by a physician with the necessary devices, tools and medicines.
accident - a defeat or a violation of human organ function the sudden adverse effects of the environment.The risk of accidents is the difficulty in communication about the incident at the emergency medical station.In this case, a great responsibility falls on the victim of other people who have not qualified to provide first medical aid before the arrival of medical teams.
specialists with medical education must be highly competent.Therefore, one of the most important parts of training of students of different medical specialties is the course "First Aid."For correct and accurate approach to the provision of emergency medical worker is obliged to know the basic symptoms of disease, symptoms of various injuries and danger to the life of the injured or ill.
First aid should include three groups of activities.The first involves a rapid cessation of exposure to the damaging agent (electric current, high or low temperature, heavy objects) and immediate transportation of the victim from the adverse environment (extraction from the reservoir, and the smoke of burning poison gas facilities, etc..).The second group of measures relates directly to provide medical aid to the victim according to the nature and type of injury, accident or sudden illness (resuscitation, haemostasis, bandaging the wound, anesthesia, etc.).Carry out this kind of help medical professionals.The third group includes the immediate delivery of the patient to a specialized agency.
activities related to the first group, relate to the interaction and self-help and first aid are in general.First aid is necessary to implement as soon as possible, with a view to damaging effect was minimal.In order to prevent complications it is important to immediately and most importantly - the right to transport the victim to a hospital.In accordance with the nature of the disease or injury, the patient is delivered to the various fixed positions of the body.For example, when in an unconscious victim vomiting condition conveyed in the lateral position;in case of damage of the pelvic bones - on the back with your knees bent and feet.To deliver the patient to the hospital using ambulance and aircraft, and in their absence - any available vehicle.In some cases, the victim is transferred to the hands through improvised stretchers, etc. tarpaulin. Depending on the conditions during transport affected varies from a few minutes to several hours.Every health care worker should be fluent in the patient's transfer rules, shifting from one stretcher to the other, as well as to know the causes that lead to complications during transport (shaking, violation of immobilization, hypothermia, etc.).First aid rendered correctly and as quickly as possible, will keep the victim lives, ensure the success of further treatment and prevent a number of serious complications.
In any medical facility (hospital, pharmacy, clinic, laboratory) for emergency treatment should be a first aid kit that contains essential drugs (antiseptics, analgesics, antipyretics, anti-bacterial, etc..) And simple medical supplies (thermometer, hemostatictourniquet, sterile bandages, cotton wool, etc.)."Ambulance" The station has a lot of cars with a full set of medicines and medical equipment to carry out their goals.Ambulances are equipped with a respirator, a set of medicines needed in an emergency, bandages, medical instruments (forceps, syringes, etc.), A set of tires and stretchers, etc.
Ambulance is available to every citizen of our country.This is due not only to the medical service of the extended network of institutions, but also a single phone number to call (03).Emergency care is provided by doctors and paramedics in rural medical institutions in rural areas.There ambulance institutions involved in scientific development issues emergency care.Stations "Ambulance" work together with hospitals, ambulance services, that provides a common tactic of providing emergency assistance as the pre-hospital and hospital.It also improves the qualification of teams and ambulance.One of the functions of emergency hospital is actively engaged in various conferences and meetings, to discuss the problems of providing emergency aid to the population.For each hospital ambulance secured a defined territory, a population that is served by the hospital.This medical institution assesses and monitors the work of emergency hospital care.The emergency hospital tasks also include carrying out health education among the population.The medical staff of the hospital every 5 years pass refresher courses in first aid issues.Poison, trauma, burn centers are based on the activity of an emergency hospital.The units of the hospitals are station (office) ambulance, administrative and economic department, medical units (hospitals).Machines "ambulance" victims transported to the hospital, which provides their reception and distribution of offices according to the nature of the illness or injury.There are carried out a thorough examination and a full range of treatment and the victims.Activities hospital ambulance based on the basic provisions of the work of any of the city hospital.
The structure of hospital emergency department consists of the following:. Surgical, therapeutic, neurological, pediatric, gynecological, etc. One of the main structural units of these hospitals is the intensive care unit, which provides care to patients with severe respiratory and circulatory.It was established that 10 thousand. Adults must be 14 beds.So count the number of beds in the intensive care center.An important place in the structure of hospitals, ambulance takes rapid diagnostic laboratory.Further treatment of patients from the intensive care unit or operating room, performed in intensive care units.The number of beds in these wards should be 15% of the total number of beds of therapeutic, surgical, trauma, and other offices.Admissions Office should be ready around the clock to enroll patients.The complexity of the activities of its employees is the need for immediate diagnosis and providing appropriate patient care.Therefore, a part of the admissions in the first part of a complex of diagnostic cabinets (X-ray, functional diagnostics, and others.) And laboratories (biochemical, serological, hematological, and others.).It was found that more than 30% of patients who entered the emergency room, urgent needs rapid analysis of blood and urine;10% of the required x-ray;5% is removed electrocardiogram.In cases of foreign bodies in the airways, or lesions of the esophagus, the thoracic and abdominal organs, or bleeding from the gastrointestinal tract of great importance is attached to the endoscopic examination.
Reception affected patients and carries out the doctor on duty.He appoints the number of diagnostic procedures and is directly involved in the examination of patients with an unclear diagnosis.Due to acute illness, especially in comprehensive defeat of various organs, there are certain difficulties in establishing a correct initial diagnosis.Therefore, health care providers are forced to the front desk to use special methods of investigation.In the waiting room are organized by the Chamber, in which a certain time are patients with an unclear diagnosis.