Ntchito kwa anamwino ovomerezeka amene akufuna kukhala kunja
Anthu odziwa zachipatala omwe amasintha ntchito zawo zachipatala ndikulembetsa sukulu ya unamwino nthaŵi zambiri amadzipeza okha kubwezeretsa odwala akalandira chilolezo. Ndizodziwika bwino ndipo zimakhala zogwirizana kwambiri ndi ntchitoyi. Ma Paramedics amaphunzira kuganiza mozama panthawi yamavuto ndipo amatha kuthamanga msanga pamene mliri wake ukuwonongeka.
Sagwiranso ntchito ngati othandizira odwala. M'malo mwake, akale omwe amathandizira athandizi amapeza maudindo omwe amapatsidwa kwa anamwino kunja kwa ntchito za RN zomwe zimakhala ngati zipatala ndi zipatala. Mosiyana ndi ntchito ya ambulansi yomwe imakhalapo, yomwe imayankhidwa poyankha ma telefoni 911 ndi ntchito zina zosayembekezereka, kuyendetsa ntchito za unamwino kumalo otsogolera odwala.
Kukhala katswiri wa zachipatala asanakhale namwino sikofunikira koyendetsa unamwino. Amwino ambiri olembedwera akuyenerera kwambiri mafakitale ameneŵa. Anamwino ambiri samadziwa ntchito izi zilipo kapena sakudziwa momwe angachitire.
Silos Zamankhwala ndi Interfacility Transportation
Kuti apereke chisamaliro chachikulu cha odwala ndipo ali ndi ndalama, zipatala zakhala zikuyang'ana kwambiri pazinthu zomwe amapereka pa malo alionse. M'zaka za m'ma 1990, zipatala zinayamba kusamuka kuchoka ku maofesi omwe anali ofala komanso opangidwa patsogolo omwe angatenge bungwe lonse.
Zipatala za ana zimadziwika kuti sizimapatula odwala achikulire-kapena kungoletsa anthu akuluakulu kuti azisamalira anthu odwala matenda opatsirana pogonana.
Pali zipatala zoperekedwa kwa neurology ndi zina zopatulira ku thupi. Nthawi zina, chipatala chimagawanika kukhala makampu awiri kapena kupitilirapo kuti athetse chithandizo chokwanira pa malo amodzi kapena awiri.
Zonsezi zimapangitsa kuti ntchito zoyendetsa magalimoto zisamalire pakati pa malo. Chimene chimadziwika mu makampani a ambulansi monga interfacility transfers (IFTs) .
Ambulances akhala akupereka thandizo la IFT kwa zaka zambiri pogwiritsa ntchito odwala matenda opaleshoni komanso odziwa zachipatala (EMTs). Nthaŵi zina, odwala amafunika kusamalidwa kunja kwa kuchuluka kwa ntchito ya opaleshoni kapena EMT . Izi zikachitika, nthawi zambiri chipatala chimapereka namwino kapena dokotala kuti azipita naye kumalo kumene akupita.
Ogwira ntchito kuchipatala akuyenda kumbuyo kwa ambulansi kuti asamalire ndi zochepa kwambiri masiku ano. Mavuto omwe ali nawo komanso ogwira ntchito otonthoza omwe amachititsa kuti asamalidwe ndi odwala matendawa, amachititsa kuti zipatala zambiri zisalole kuti azisamaliro awo apite ndi ambulansi. Choncho, ma ambulansi anayamba kubweretsa anamwino awo, ndipo maulendo ovuta kwambiri oyendetsa galimoto (CCT) anabadwira.
Chisamaliro Chosavuta Chakuyenda
CCT (yomwe nthawi zina imatchedwa SCT, yodzitetezera zamtundu wapadera) ndi ntchito yosiyana yosiyana ndi ya ambulansi 911. Dziko lililonse lili ndi malamulo ake pankhani ya EMTs, othandizira opaleshoni ndi anamwino, koma zikhazikitso ndizofanana.
Ma Paramedics amagwira ntchito kuimira malamulo (omwe nthawi zambiri amawatcha malangizo kapena ma protocol ) omwe amapangidwa ndi adokotala a zachipatala.
M'madera ena, odwala matenda opaleshoni ali ndi chilolezo pamene mayiko ena amawaona kuti ndi ovomerezeka. Ena anganene kuti kusiyana kulibe phindu panthawi yogwiritsira ntchito komanso kuli kofunika palamulo. Sindingalowe m'malo muno kusiyana ndi kunena kuti kulephera kwa azimayi ambiri m'mayiko ambiri ndizochititsa kuti anamwino azikwera kumbuyo kwa ambulansi kuti azisamalira.
Anesi ndizopitirirabe kwa opereka chithandizo. Aanesi amapanga chithandizo chamankhwala tsiku ndi tsiku omwe odwala amafuna kuchipatala. Madokotala amapanga zosankha ndikupanga njira zina zomwe zimasintha mwachindunji mchitidwe wa opaleshoni wa wodwala, monga chitsanzo-koma chisamaliro chotsatira chikuchitika ndi namwino.
Ngati dokotala atasankha chisamaliro, amapereka lamulo lomwe nthawi zambiri limakwaniritsidwa ndi namwino.
Kodi anamwino amene ali ndi othandizira odwala sangathe kusintha malingaliro atsopano. Mafilimu ambiri amatha kufotokozera mwachidule zochitika zomwe zimagwiritsidwa ntchito popereka chisamaliro chokhalitsa moyo ndi kukhazikika kwa odwala panthawi yovuta. Maganizo onse othandizira anthu odwala matendawa ndikutsimikiza kuti wodwalayo aperekedwa mosamala ku dipatimenti yowonjezera kumene angalandire chisamaliro chotsimikizika.
Ma Paramedics akhoza kusamalira mosamala mu malo odzidzimutsa, kawirikawiri popanda kuyang'anitsitsa dokotala. Aphunzitsidwa njira yogwiritsira ntchito zaumoyo kuti akwaniritse zotsatira zofunikira m'madera ochepa. Amwino, komano, ndiwo ntchito zachipatala. Iwo akhoza kuchita pafupifupi chirichonse chimene dokotala akufunsa kwa iwo. Ngati ndi mankhwala kapena chipangizo chatsopano, namwino amatha kuchigwiritsa ntchito atagwiritsidwa ntchito ndi mu-ntchito pamagwiritsidwe ake ndi mavuto ake. Kusakanikirana ndicho chifukwa chomwe anamwino amafunikira kwa ma ambulansi a IFT.
Pamene chipatala chakhala chithandizo cha thanzi, odwala omwe akuyenera kusuntha kuchokera ku malo kupita ku malo akhala akudwala kwambiri ndipo akusowa chisamaliro chovuta kwambiri. Chimodzi mwa zitsanzo zowopsa kwambiri zidzakhala odwala pa membrane oxygenation (ECMO ) yowonjezereka . Odwalawa ali ndi makina akutenga magazi awo mthupi lawo, amawapaka kunja, ndikuwabwezera iwo. Kamodzi kokha ndi opaleshoni ya mtima pamtima, makina a ECMO tsopano akugwiritsidwa ntchito kuti odwala azikhala amoyo muzochitika zosiyanasiyana muzitali zambiri. Pamene odwalawo asamuka kuchoka ku malo amodzi kupita nawo kumalo ena, anamwino, m'malo mwa opaleshoni, amapereka chisamaliro.
Zoyembekeza za anamwino a CCT kapena SCT
Chimodzi mwa zifukwa zomwe okalamba odwala matenda opatsirana pogonana amathandizira anamwino a CCT ndi chifukwa chakuti ali ndi mayankho olondola pa kusintha kwakukulu kwa chikhalidwe cha odwala. Amatha kuzindikira zoopsa ndikuchitapo kanthu mwamsanga.
Ichi ndicho chiyembekezero chofunikira kwambiri kwa namwino wa CCT: chosankha chotsimikizika. Axamwali a CCT ayenera kukwanitsa kupanga zosankha zosiyana panthawi yotentha ndikuchitapo kanthu m'malo mwa wodwalayo. Ayenera kukhala wokonzeka kuchita zinthu popanda dokotala. Nthaŵi zambiri, amishonale a CCT amagwira ntchito okha kapena ali ndi EMT kumbuyo kwa ambulansi. M'dziko la interfacility, ntchito ya EMT yachita zambiri. EMTs amaphunzitsidwa zofunikira, zomwe zimawopseza moyo. Kuwonjezera apo, mkhalidwe wodwala wosasintha womwe umapezeka pa CCT zotenga katundu amafuna namwino wamphamvu kuti adziwe ndikuwongolera.
Mankhwala a CCT ayenera kukhala omasuka ndi ziwerengero zovuta zowonongeka. Pafupifupi odwala onse a CCT amabwera ndi IV ndipo ambiri amakhala ndi kulowetsedwa kwa mankhwala kamodzi pakutha. Kuti apambane, namwino wa CCT ayenera kukhala wokhoza kuthana ndi mitsempha yambiri ya spaghetti yomwe imatuluka mwa odwala kwambiri. Adzakhala ndi udindo wothandizana ndi anthu odwala matendawa pa nthawi yozembetsa komanso zovuta zomwe zimachitika pakati pa odwala. Kuti zinthu ziipireipire, nkhawa ya wodwala yosamuka kuchokera kuchipatala chokhazikika kwambiri kupita ku makulansi amkokomo, amatha kusintha momwe mankhwala ena amathandizira.
Ambiri mwa odwala omwe akufunikira kukwera mumtunda wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtundu wa amtunduwu amadziwika kuti ndi otetezeka. Mosiyana ndi chipatala, anamwino a CCT sakhala ndi katswiri wodzizira kupuma kuti awathandize. Namwino wa CCT ayenera kukhala wokonzeka kupanga mpweya wabwino ndikusokoneza pamene zinthu zikuyenda molakwika. Komanso, anamwino a CCT ayenera kukhala okwanitsa kuchita malingaliro a endotrachial. Ndipindulanso imodzi mwa omwe anali opaleshoni; iwo akhala akulowetsa chidziwitso kuyambira sukulu yopereka chithandizo. Musadandaule ngati mukuganiza zogwira ntchito, komabe. Ophunzira a CCT amaphunzitsidwa kuti aziwongolera ndi kampani ya ambulansi monga gawo la njira yolongosolera.
Ndege za Ndege
Maambulansi samangoyendayenda mumsewu. Amagwiranso ntchito pamsewu. Okhudzana ndi anamwino a CCT, anamwino akuthawa amatha kusamalira mofanana mumlengalenga.
Pali mitundu iwiri ya kuthawa kwaukhondo ntchito: mapiko otchinga ndi phiko lozungulira (helikopita). Mapiko oyendetsa ndege oyendetsa ndege ndi omwe amadziŵika kwambiri. Awa ndiwo ntchito zofanana kwambiri ndi omwe opaleshoni amachititsa pa 911 ambulansi. Helikopita ogwira ntchito zachipatala amapereka chisamaliro pothandizira pa interfacility ndikupita kumalo a zochitika zoopsa, kawirikawiri kumalo akumidzi kapena m'chipululu.
Helikopita ogwira ntchito zachipatala, makamaka omwe amavomereza zochitika zosavuta, nthawi zambiri amakhala ndi namwino ndi achipatala, pamodzi ndi woyendetsa ndege. Namwino amatsogolere pamene ntchitoyo ili ndi chiyankhulo-wodwala akusunthira kuchoka kuchipatala kupita ku chimzake - ndipo opaleshoni imayendetsa kutsogolera pamene wodwalayo akutulutsidwa kumbali ya phiri.
Ogwira ntchito zachipatala amatha kusintha kwambiri ntchito zawo. Kawirikawiri amakhala namwino wothandizira ndege ndipo nthawi zina amathawi a ndege. Ogwiritsira ntchito mapiko othamanga angathe kukhala ndi opaleshoni yothamanga, madokotala a ndege, akatswiri othandizira kuthawa, ndi EMTs kuthawa. Ogwira ntchitoyi ali ndi udindo wotsogolera odwala pamtunda wautali.
Odwala othamanga nthawi zambiri amakhala ofanana kwambiri ndi odwala pamagalimoto a CCT. Nthaŵi zina, ambulansi ya CCT imapereka wodwalayo kuchokera kuchipatala kukafika ku eyapoti kukakumana ndi gulu lothawira ndege. Kawirikawiri, ambulansi yowonjezera maulendo imatenga antchito othawa ndege ndi kuwabweretsa kwa wodwalayo. Amakonzekera wodwalayo kuti ayambe kuthawa ndipo ambulansi idzatumiza gulu lonse, wodwala ndi onse, kubwerera ku eyapoti chifukwa chothawa.
Maphunziro Othandiza Othandiza
Mofanana ndi gulu la anthu ogwira ntchito yothandiza anthu othawa, magulu a chisamaliro chapadera amapereka chisamaliro kwa anthu odwala apadera kumbuyo kwa ambulansi. Ambiri mwa magulu odziperekawa ndi ofesi ya nicu (NICU). Kawirikawiri, pali namwino wapadera odwala matenda opatsirana pogonana, odwala opatsirana pogonana, komanso dokotala yemwe akudwala matendawa. EMT idzayendetsa galimoto komanso chisamaliro chothandizira. Nthawi zina, padzakhalanso kachiwiri la EMT.
Magulu apadera osocheretsa samangopereka chisamaliro kwa NICU. Pali magulu apadera a chisamaliro cha kudwala, kusamalira mtima, chisamaliro cha ana-pafupifupi aliyense wapadera wodwala omwe mungaganize. Magulu amenewa amavomereza kwambiri m'madera omwe amaphunzitsa zipatala, koma ngati miyezo ya chisamaliro imakonzedwa ndikuyengedwa bwino, maguluwo amakula m'madera bwino popanda maphunziro a sukulu zamankhwala. Magulu a NICU amapezeka tsopano lonse.