The organization of pediatric care at the obstetric units
An important part of the activities of the assistant is to protect the health of children.An important place in this work takes patronage.According to the current position of a paramedic (midwife) visits the newborn in the first three days after discharge from the hospital;if a family's first child was born, his visit on the first day after discharge, and later - after 2-3 days during the first week and weekly during the first month of life.On examination, pay attention to the general condition of the child, as well as on the status of various organs and systems, especially the nervous system, skin, umbilical ring, the presence of anomalies.Attendant (midwife) must see the child during the first year of life, 12 times on preventive methods and 20 times under the patronage at home.In the second year of a child's life paramedic gives a detailed opinion on his state of health, evaluates the physical and psychological development.This conclusion should be brought to the attention of parents, focusing on the
paramedics and midwives serving students (where there is no school nurse) must:
• participate in medical examinations of schoolchildren conducted by a pediatrician, to prepare medical records and fill them with a common part;
• recorded history, complaints, information on illnesses and vaccinations;
• conduct anthropometric measurements, to determine visual acuity and hearing;
• sent to the doctor's instructions to medical institutions for additional laboratory tests, consultations with medical specialists;
• bring to the attention of teachers of the school of medical examinations with the recommendations of medical specialists;
• monitor the organization of a rational mode of the day and food, hygienic education of students, the organization of labor education;
• monitor the implementation of sanitary and anti-epidemic regime, implementation of sanitary requirements for food preparation technologies, washing the dishes, as well as compliance timing of products and prepared food;
• to work for the prevention of child injury (including sports), accounting and analysis (with a doctor) of all injuries;
• inspection carried out after the doctor and under his control immunizations to students pre-notifying parents about this, keep their records and isolation of sick students;inspections, thermometers and other events for children coming into contact with infectious patients, tell your doctor rural medical district, the school director in SES of each case of an infectious disease;
• examine students on helminths and under the supervision of a pediatrician and epidemiologist to conduct deworming.
paramedic work includes medical care at home acutely ill children or children with acute exacerbations of chronic diseases, rehabilitation and medical examinations of children with congenital and chronic diseases without exacerbation.
Clinical work at home provides the following responsibilities:
• visit to a sick child in a call the day;
• priority service of young children with high fever, abdominal pain;
• active surveillance for sick children until they are cured.
Multiplicity and visits range of children depend on the age of the child, the nature and severity of the disease, social and living conditions.Children of the first year of life are observed on a daily basis at home until they are cured or their admission to hospital.
Indications direction following the hospital sick children:
• the children of the first three months of life with any disease;
• children with infectious diseases that occur with moderate to severe form of the disease;
• the ineffectiveness of the activities in the first 3-5 days of treatment, or deterioration, that endanger the life of a sick child;
• if poor social and living conditions of the family.
in the direction of the hospital paramedic must specify the diagnosis, disease severity, comorbidities, duration and severity of
disease, current treatment and its effectiveness, the results of laboratory and instrumental studies, medical history, individual characteristics of the child, past illnesses, epidemiological environment.
After hospital discharge, not later than one day, you must visit the child at home, and after examination, taking into account the recommendations of the hospital doctors to carry out rehabilitation measures.
When providing medical care paramedic is required to own methods of emergency treatment for various conditions and injuries, especially to know their children, have knowledge posindromnoy therapy and the latest methods of healing and nursing of children with various infectious diseases.
paramedic Organizational work consists of several sections.The main ones are: analysis and planning activities, working with accounting and reporting documentation, the introduction of advanced experiences and forms of work, training, work and interaction with civil society organizations.
basic accounting and reporting documents in the child population are as follows: Account form number 112 / the "History of development of the child", the form number 63 / the "Karga preventive vaccination", account form number 026 / the "medical card on entering the child inpreschool, school, boarding school, and others. ";form № 025-2 / y "Statistical coupon";form № 058 / y "Emergency notification on infectious patient," account number Form 298 "spa card" account form number 025 / y and 086 / the "Medical outpatient map";"Help for entering the secondary and higher education";form number 027 / the "Extract from the medical records of outpatient, inpatient";form № 079 / y "medical certificate to the student, departing in the summer camp", the form number 039 / the "Diary of work nursing clinic (dispensary), dispensary, medical and obstetric point";form number 029 / the "Journal of Accounting Procedures".
Besides filling registration forms and statistical analysis to work with them, a paramedic at the site should have a log of the child population census plot passport card file with registration form number 63 for each child up their work with children.The plan shall be prepared in three versions: a year, a quarter, and the most specific - for each month.In terms of institutional arrangements should be reflected, prevention, medical section, dispensary work, training and health education.
reporting forms paramedic its activities should reflect the following sections:
• the child population (held every 6 months);
• performance monitoring of pregnant women and their structure of morbidity;
• structure of neonatal morbidity;
• indicators of children of 1st year of life;
• indicators of the children of the 2nd year of life;
• indicators of children coming to school;
• indicators of teenagers;
• indicators and the percentage of coverage of the child population immunization;
• report on the incidence of disease entities;
• report on the medical examination of the child population;
• report on the work with children from large families, wards, and socially disadvantaged families;
• report on health education.
When working with children paramedic comes from the fact that the main problem in the maintenance and protection of the child's health now and in the future - reducing child morbidity and mortality, reducing the amount of labor losses due to parents caring for a sick child.