Introduction of both the usual and the current epidemic period, the primary health care institutions because of the infusion was fined events always occur. The reason for this is summarized in five words "do not comply with the regulations". I believe that we all have no intention of stepping on the mine, today to help you organize the latest regulations on primary infusion. I hope you can grasp the latest developments, to avoid being penalized, so what are the new regulations of infusion in 2020?
Conducting infusion conditions:
1, at least one practicing (qualification) physician, and participated in the relevant training
(1) clinic, health clinic (room), medical clinic: at least one practicing physician (clinical or traditional Chinese medicine category) to participate in the rational application of antimicrobial drugs and emergency emergency first-aid knowledge training and assessment of qualified, the main The practicing institution must be this medical institution; at least one licensed nurse.
(2) village health center (community health service station): at least one qualified physician (licensed physician, (township) assistant physician or village doctor), to participate in the rational application of antimicrobial drugs and emergency first aid knowledge training and assessment.
2, July 1, 2020 onwards, the institution's floor area of not less than 40 square meters
Treatment room, disposal room, observation room independently set up (July 1, 2020 onwards, the floor area of not less than 40 square meters, of which no less than 10 square meters of treatment room area, disposal room area of no less than 10 square meters), in line with the requirements of hospital sensory management.
3, must be equipped with 17 kinds of first aid drugs and 6 kinds of first aid equipment
(1) 17 kinds of first aid drugs include: epinephrine, isoprenaline, dopamine, niclosamide, dexamethasone, tachycardia, iproniazid, 0.9% sodium chloride injection, calcium gluconate, atropine, cediran, lidocaine, lopressor, magnesium sulfate, nitroglycerin, mannitol and other respiratory, circulatory system emergency drugs.
(2)6 First-aid equipment includes: oxygen cylinders (bags), oxygen masks or oxygen tubes, mouthpieces, dental pads, artificial respirators, sputum aspirators, etc.
4, standardized disposal of medical waste (classification, ligature, weighing, handover situation)
5, no medical liability accidents in the past three years
6, standardized and rational use of antibiotics
Approved that can be intravenous infusion of health care institutions is not a one-off, to be in strict accordance with the "Management of Clinical Application of Antimicrobial Drugs," the provisions of the standardization of the rational use of Antibiotics. City Health Supervision will regularly or irregularly supervise, if found that the medical institutions misuse antibiotics or do not carry out intravenous infusion in accordance with the norms, cancel the qualification of the institution of intravenous infusion and antimicrobial intravenous infusion, involving illegal issues, according to the law, investigate and deal with.
Special period can not be transfused patients:
Primary doctors meet the fever patients, suspected cases or diagnosed cases should be promptly reported and referral, can not be admitted on their own, not to mention unauthorized for their infusion.
Drugs that need to be used with caution for infusion:
Whether it's usual or now, the national to local regulation of the behavior of infusion in primary care institutions is for safety reasons. The frequent occurrence of infusion accidents in primary care institutions reminds us once again to be cautious when using the following drugs.
1, clindamycin
Clindamycin is widely used as a panacea in primary care, but it also has serious safety risks. For example, the use of clindamycin in penicillin-allergic patients, high-dose or rapid titration of clindamycin, clindamycin in combination with amikacin, and clindamycin in combination with dexamethasone are all at high risk.
2, 654-2 injection + gastrofibromyalgia injection
Gastrofibromyalgia can accelerate the gastric sinus emptying, at this time, such as the combined use of 654-2, will undoubtedly produce antagonistic effects. In addition, gastrografin can easily cause cramps and extrapyramidal reactions. And 654-2 will be because of the antispasmodic and analgesic effect to mask the condition, resulting in missed misdiagnosis.
3, ceftriaxone sodium + calcium gluconate
Cephalosporin antibiotics and calcium infusion together, there is a great risk. The combination of ceftriaxone sodium and calcium or calcium-containing products is a major cause of "adverse events with lethal outcome," and can induce biliary and renal calculi and related complications with calcium ceftriaxone as the main ingredient, and is more common in infants and young children.
4, ceftriaxone sodium + dexamethasone
While there is no contraindication to these two drugs, but for safety reasons, it is better to separate the injection. The National Center for Case Reporting database shows that there are serious cases of intravenous use of ceftriaxone sodium mixed with other drugs, with ceftriaxone sodium mixed with dexamethasone accounting for the majority of intravenous use.
5. Oxyfloxacin + cefoperazone sulbactam
Mixing the two drugs at the same time produces a white, insoluble, flocculent, turbid precipitate, which clogs the infusion set and makes it difficult to titrate and use.
6, gentamicin + minomycin
The combined application of the two drugs, not only serious damage to renal function, but also easily damage the auditory nerve, resulting in deafness and deafness.
Now it is a special period of time, health care workers must know points and usually than there will be some changes, so health care workers must carefully read the relevant policies to ensure that their behavior in line with the provisions of the law, so that the standardization of the practice of medicine.