important branch of activity paramedics is to provide medical care to patients at home.The procedure for the treatment of patients at home, doctors determine the local hospital or Central Regional Hospital (CRH), and only in some cases, a paramedic himself.Patients were left at home, you need to constantly monitor their recovery.This applies particularly to children.Patients from remote settlements from the FAP be hospitalized;while leaving the patient at home paramedic inform the doctor of the rural medical district and monitors the patient.
outpatient care of patients with tuberculosis paramedic, being the direct executor of medical appointments, conducts immunohimioprofilaktiku, medical examinations, anti-epidemic measures in the foci of tuberculous infection, the work on health education, and others.
attendant working for FAP, must possess the simplest methods of resuscitation in the prehospitalespecially sudden cardiac arrest or respiratory depression, can be due to serious injuries, blood loss
major role belongs to the paramedics in the clinical examination of the rural population.The main purpose of it is to implement a set of measures aimed at creating, maintaining and strengthening public health, prevention of diseases, disease reduction, increase in active creative longevity.
for the general clinical examination carried out personal records of all people living in the catchment area hospitals, dispensaries and FAPs, in accordance with the "Instruction on the order of registration of the annual medical examination of the entire population."In rural areas, lists of inhabitants are nurses FAP.
For a personal account of each resident nurses fill "Card account clinical examination" (training form № 131 / y - 86) and numbered according to its medical card number ambulatory (account number Form 025 / y).After clarification of the composition of the population is "Maps clinical examination of accounting" is transmitted to the card index.
attendant or midwife monitor to patients in need of seasonal (fall, spring) anti-treatment, to receive him in a hospital or on an outpatient basis.Important to reduce morbidity is the proper organization of the examination of temporary disability in the FAP.
In accordance with the "Regulation on the head of the FAPs" Head paramedic FLP may be entitled to issue medical certificates, certificates and other documents of a medical nature in the manner prescribed by the Russian Federation Ministry of Health.
basis for granting extradition character Sick is the assistant chief physician of the application area, which should be indicated:
• FAP distance from the hospital (ambulance), to which he is assigned;
• the number of serviced settlements of the farm and the number of employees in them;
• condition of communications;
• paramedic work experience and level of training;
• knowledge of and compliance with the doctor's assistant foundations temporary disability examinations and "Instruction on the procedure for issuing sick leave."Allowance granted sick leave is a paramedic in the "Book of registration of sick leave" (form number 036 / y) with the required filling all its graph.
Therapeutic and preventive care for women and children.Each FLP paramedic (midwife) is a card index of the personal account of the women starting at the age of 18, which make passport details, past illnesses, information about all pregnancies (years than ended with each pregnancy, complications).Survey every pregnant the first time a paramedic (midwife) starts with a general survey, measures the length and body weight, blood pressure in the common hands, within its competence determines the condition of the heart, lungs and other organs, examines the urine for protein.Through prenatal care, paramedic (midwife) FAP is required each of them to show your doctor;in cases where a woman has found the slightest deviations from the normal development of the pregnancy, she should be immediately directed to the doctor.
One of the important sections of paramedics activity of FAP is to hold in the event of the primary foci of infectious disease control activities, the timeliness and the quality of which depends on the effectiveness of the prevention of infection arising out of focus.In this connection, great importance is the organization of activity of FLP workers, aimed at the detection of infectious diseases among the population.
When the diagnosis of infectious diseases (or suspected it) nurses should FAP:
• carry out the primary anti-epidemic measures in the hearth;
• isolate the patient at home and organize current disinfection before hospitalization;
• identify all persons exposed to patients, take them to register and set them under medical surveillance;
• implement (with a doctor) quarantine measures against contact with patients persons attending preschool institutions, schools or working in the epidemiologically important objects;
• report at the place of work, school, in day care centers, residence for sick and exposed him to the people;
• directed by the pediatrician or epidemiologist conduct gamma globulin prophylaxis for contacts of patients with hepatitis A.
infectious patients hospitalized during the first day of the disease on a special transport.In its absence, the patient can be transported by any transport followed by disinfection.In the future, the health worker performs the FAP indication epidemiologist (assistant epidemiologist) and provides:
• collection of material in individuals exposed to the sick, for laboratory research in order to identify bacteria carriers;
• vaccinations for epidemiological indications and chemoprophylaxis;
• dynamic monitoring of the persons in contact with patients during the term of the incubation period of the infection.
great role played by medical assistants and midwives FAP to conduct recreational activities, hygiene education of the rural population and promoting healthy lifestyles.To properly assess the level of well-being of the object, paramedics are trained simple laboratory analysis, rapid methods and provide them with hiking express laboratories.With the help of such a laboratory can determine the residual amount of chlorine in disinfecting solutions, on objects and surfaces (yodokrahmalny method), residual amounts of detergent dinnerware (with phenolphthalein test).
FAP paramedics often have to take part in the analysis of occupational accidents and the development of measures to reduce it, so it should be familiar with the main causes of accidents: technical, organizational and sanitation.More than half of all victims are traded on the FAP, so from the nursing staff requires constant improvement of knowledge, in particular, first aid for injuries.In addition to first aid to the victim, paramedics FAP registration and record of injuries;identify, study and analyze the causes, depending on various factors;together with doctors develop specific measures to address the identified causes;monitor compliance with safety regulations;train agricultural workers in first aid techniques.
When working as part of the medical team medical assistant while making a call is completely subordinate to the doctor.His task - to accurately and quickly complete all assignments.The responsibility for decisions lies with the doctor.Paramedic must own technique of subcutaneous, intramuscular and intravenous injections and ECG, be able to quickly establish a system for drip fluid, measure blood pressure, count pulse, and the number of respiratory movements, enter the duct, carry out CPR and others. It should also be able to splintand a bandage to stop the bleeding, transporting patients to know the rules.
In the case of independent work of a paramedic "Ambulance" is completely responsible for all so it must fully own the methods of diagnosis in the prehospital phase.It needs knowledge of emergency medicine, surgery, traumatology, gynecology, pediatrics.He must know the basics of toxicology, to be able to take their own labor, to evaluate the neurological and psychological state of the patient, not only register but also roughly estimate the ECG.
application number 10 to the RF Ministry of Health order № 100 from 26.03.99
«The position of the mobile team paramedic ambulance»
I. General Provisions
1.1.The post of the assistant brigade "ambulance" is assigned to a specialist with a secondary medical education in the specialty "Medicine", having a diploma and a certificate.
1.2.In carrying out the duties to provide emergency care as a part of medical assistant paramedic team is the executive in charge of all the work, and as a part of the medical team operates under the guidance of a doctor.
1.3.Paramedic mobile team "ambulance" is guided by the legislation of Russian Federation, normative and methodological documents of the Russian Federation Ministry of Health, the Charter of the station, "ambulance", orders and directives of the administration station (substation, offices), these Regulations.
1.4.Paramedic mobile team "ambulance" is appointed and dismissed in accordance with the law.
attendant visiting team "ambulance" is obliged:
2.1.Provide immediate departure brigade after receiving the call and its arrival on the scene within a set time standard for the area.
2.2.Provide emergency medical care to the sick and injured at the scene and during transport to hospital.
2.3.Enter the sick and injured drugs for medical reasons, to carry out a stop bleeding, to carry out resuscitation in accordance with the approved industry standards, rules and standards for paramedical staff to provide emergency medical care.
2.4.To be able to use the available medical equipment, own transport overlay technique tire dressings and methods of basic cardiopulmonary resuscitation.
2.5.Own equipment electrocardiogram.
2.6.Knowing the disposition of health care institutions and the areas of service stations.
2.7.To ensure portability of the patient on the stretcher, if necessary, take part in it (in carrying crews operating conditions of the patient on a stretcher is regarded as a form of medical care).When transporting the patient to be near him, carrying out the provision of necessary medical assistance.
2.8.If you need to transport the patient is unconscious or intoxicated inspect to detect documents, valuables, money, indicating in the "calling cards" to pass them in a hospital emergency department with a note by hand in the direction of staff on duty.
2.9.When providing medical assistance in emergency situations, in case of damage violent act in the manner prescribed by law (report to the police).
2.10.To ensure infectious safety (follow the rules of sanitary-hygienic and anti-epidemic mode).In identifying a patient quarantine infections provide him with the necessary medical care, observing the precautions and inform senior doctor about changing clinical-epidemiological and passport patient data.
2.11.Ensure proper storage, accounting and writing off of drugs.
2.12.After the duty to check the status of the medical equipment, transport buses, to fill work expended during drugs, oxygen, nitrous oxide.
2.13.Inform the administration station "ambulance" on all the emergencies that have arisen in the implementation of the call period.
2.14.At the request of employees of law enforcement to stop for emergency medical care, regardless of where the patient's location (the victim).
2.15.Conduct approved records and reports.
2.16.In accordance with established procedure to improve their skills, to improve practical skills.
attendant visiting team "ambulance" has the right to:
3.1.Call in case of need to help the medical team "ambulance."
3.2.Make suggestions to improve the organization and the provision of emergency medical care, improvement of working conditions of health personnel.
3.3.Improve their skills in the specialty at least once in five years.Pass to the established procedure certification and re-certification.
3.4.To take part in the work of medical conferences, meetings, seminars, conducted by the administration.
attendant visiting team "ambulance" is responsible in accordance with legislation:
4.1.For the professional activity carried out in accordance with approved industry standards, rules and standards for paramedical personnel "ambulance."
4.2.For wrongful acts or omissions, entailing damage to the patient's health or his death.
In accordance with the order of Ministry of Health of the Russian Federation № 100 mobile teams are divided into medical and paramedical.Paramedical team includes in its composition of two paramedics, paramedic and driver.The medical team includes a physician, two paramedics (or paramedic and nurse-anesthetist), a medic and driver.
tactics behavior paramedic "first aid" during a call."Ambulance" staff, including medical assistants, working in very difficult conditions.During the call, the medical assistant may encounter any, the most unexpected pathology.He needs to be broad-minded, to have knowledge of the various fields of medicine, be able to quickly orient themselves in a difficult situation, keep cool, in a short time to make the right decision.It is not enough alone, special training is required, and even a certain moral quality, wellness and life experience.
One of the main difficulties is the fact that at the time of departure to the call never knows exactly what lies ahead."Heart attack" can turn into anything - from hysteria to poisoning pills, while leaving about a hand injury at the site may be a patient with a gunshot wound, massive blood loss and shock.Therefore, the medical assistant must always be ready for any situation.But we should not long maintain itself in a state of nervous tension - we must be able to quickly orient and mobilize, arriving at the site.
Already approaching to place a call, you must begin to observe and draw conclusions.Meet you or not;look like meet - are concerned, to cry, alarmed or indifferent and unhurried;whether they are in a state of alcoholic intoxication, Do not look strange for these circumstances.Common law is not, but as a rule, when there is something really serious, "soon" meet even on the street.Unusual behavior may come across the idea of insincerity called.In the case of departure for obviously criminal about (fights, riots, etc.) it is necessary to request a police escort.