The basic knowledge that should be grasped to rescue the injured on the scene is as follows: (1) If the injured person is in the car and cannot get off the car by himself, he should be dragged out of the car as soon as possible.
(2) If the injured in the carriageway, should be quickly dragged away from the carriageway, drag to pay attention to not touch the injured vital parts and wounds. (3) If the injured due to violence *** brain coma or due to hot weather, cold weather, lack of oxygen and various causes of poisoning coma, should be immediately rescued.
(4) respiratory interruption of the injured rescue: If you find the injured no breathing sound and breathing movement, can be concluded that the respiratory interruption, this time should be immediately every second to rescue, regardless of whether you have knowledge of rescue, should be in accordance with the following methods of first aid, or else the injured person will be due to the lack of oxygen in the brain and endanger the life. The method of resuscitation: lift the lower jaw angle of the injured person to make breathing unobstructed, this measure in many occasions on the restoration of breathing plays a big role.
If the injured person still can not breathe, it is necessary to carry out mouth-to-mouth artificial respiration, in doing artificial respiration, to make the injured person's chest cavity and the upper abdomen regularly convex, artificial respiration to play a role. If artificial respiration does not work, we must check the injured person's mouth and throat whether there is a foreign body, and try to exclude, continue to artificial respiration, until the arrival of professional ambulance personnel.
(5) the blood loss of the injured rescue: if the injured person injured blood loss, will appear hemorrhagic shock and other symptoms, serious life-threatening. Therefore, rapid and accurate hemostasis is an important means of effective rescue of the injured.
Dealing with blood loss is mainly realized by elevating the limbs, pressing the blood vessels, tightening the bandage and tying the wound. (6) fracture of the injured rescue: the occurrence of a person with a fracture, first of all, we must pay attention to prevent the casualty from shock, do not move the fracture part of the body, if the spine may be damaged, generally do not change the posture of the injured person, the specific fracture site, be careful to use disinfectant film bandage, and according to the state of the occurrence of the site to keep the site static, in the absence of bandaging supplies, you can take the local materials for the fracture part of the Fixation, in order to reduce the pain of the injured, easy to carry, at the same time can not aggravate the broken bone on the surrounding tissue damage, conducive to the recovery of the function of the injured limb.
2. The basic principles of first aid on the scene
First aid on the scene of the object of rescue, environment, conditions and in the hospital is very different, therefore, grasp its specific characteristics, so that first aiders from the ideological to the work of the fully prepared, conducive to the successful completion of the task.
First, the characteristics of the scene of first aid (a) sudden scene of first aid is often unexpected in the sudden occurrence of catastrophic events outside the people appear injured or sick, sometimes a few, sometimes batches, sometimes scattered, sometimes concentrated. Commonly injured and sick people are dying, not only only the presence of personnel to participate in first aid, often need to call for help outside the field more people to participate in first aid.
(B) urgency after a sudden disaster, the complexity of the situation of the injured more than one person with two or more organs and tubes damaged at the same time, the condition of the dying more people, whether it is the injured or family members to call for help in the mood is very urgent. Cardiac respiratory arrest for 6 minutes, incontinence, coma, irreversible damage to brain cells.
Within 4 minutes of starting CPR, 50% may be saved. 10% of those who start resuscitation in 10 minutes do not survive.
Therefore, time is life, we must fight every second, will be cardiac arrest, respiratory arrest, the use of resuscitation techniques, from the edge of the danger of rescue back to the hemorrhage, fracture and other critical, with bleeding, fixation, rescue back, or else, that is, there will be a "loss of a millimeters, fallacies of thousands of miles," a serious error. (C) tough toughness refers to the disaster occurred in a variety of sick and wounded, heavy injuries, a person may have more than one system, a number of organs and tubes at the same time, need to have a wealth of medical knowledge, excellent technology in order to complete the task of first aid.
In fact, it is often more casualties, urgent requirements, high requirements and knowledge of the less adaptable situation. Some disasters, although fewer patients, but often a sudden emergency situation, and even the sick and wounded around no one, more professional health personnel, can only rely on those with basic life-supporting technology to provide help and first aid passers-by.
This situation is a difficult one for both medically trained and trained or untrained people. (iv) Flexible on-site first aid is often performed in the absence of medical care, and often without adequate resuscitation equipment, medications, and mobilization tools.
Therefore, we must be flexible in the sick and wounded around the search for substitutes, repair the old and make good use of the old, in situ access to rinse disinfectant, bandages, splints, stretchers, etc.; Otherwise, will lose the time to save the collection, to the sick and wounded to cause greater disaster and irreparable consequences. (E) critical medical emergency, including out-of-hospital emergency, the objective requirements of medical technology training, first aid medical equipment and equipment, especially in relation to the first aid professional equipment comprehensive: hospital first aid should be specialized, the popularization of mass first aid, community first aid organization network, first aid command system should be scientific.
These are the key issues to complete the first aid to meet the standard. II. Principles of on-site first aid The overall task of on-site first aid is to take timely and effective first aid measures and techniques to minimize the suffering of the sick and injured, reduce the rate of disability and mortality, and to lay a good foundation for the hospital resuscitation.
After the scene of first aid can survive the injured and sick priority rescue. This is the general principle.
In order to better accomplish this honorable and difficult task, must also comply with the following six principles.
(A) the principle of the first recovery after the fixed refers to the case of cardiac and respiratory arrest and fracture, should be the first mouth-to-mouth breathing and chest compressions and other techniques to make the heart, lungs and brain resuscitation, until the heartbeat and breathing recovered, and then fix the fracture of the principle. (B) the principle of stopping first and then wrapping refers to those who encounter hemorrhage and have wounds, first immediately with finger pressure, tourniquet or drugs to stop bleeding, and then disinfected wounds for bandaging principle.
(C) the principle of the first heavy after the light refers to the encounter of the dying and light casualties, the priority of the rescue of the critical, after the rescue of the light casualties. (D) first save the latter principle in the past encountered the sick and wounded, most of the first to send after the rescue, so often worry about the time to rescue, resulting in the loss of life should not die.
Now it should be reversed, first saved after sending. On the way to the hospital to send the sick and wounded, do not stop rescue measures, continue to observe the changes in the sick and wounded, less bumps, pay attention to warmth, and arrive at the destination safely.
(E) first aid and call for help and the principle of encountering batches of sick and wounded, and there are many people in the present situation, in order to quickly strive for first aid external assistance. (F) the principle of consistency between handling and medical care in the past in the handling of critically ill and injured patients, handling and medical care, guardianship work from the ideological and operational separation phenomenon.
Moving is responsible for the transportation sector, on the way to health care is the health sector to assist, as if only the responsibility to assist. In many cases, the coordination is not good, on the way should continue to rescue but not guaranteed, coupled with the serious bumps in the vehicle and other circumstances, the result increased the sick and wounded undue pain and death.
This situation is common at home and abroad. Medical care and resuscitation should be carried out under the same mission requirements, the same coordination pace, and the same completion of the task.
In the transportation of the critically ill and injured, you can reduce the pain, reduce death, and safely reach the destination. In the past, first aid was a "lift and run" approach, a concept that has been largely replaced on an international scale by the idea of ""waiting and stabilizing injuries".
This stabilization approach has been shown to be effective in reducing mortality and disability in both war and peacetime emergency care. In the ""wait and stabilize"" is not to leave the patient unattended, but first responders in the tension for the immediate transfer of the patient to do what should be done to open the airway, cardiopulmonary resuscitation, control hemorrhage, braking fractures, less handling, untrained people should be more careful.
At present, the advanced countries have strengthened the out-of-hospital first aid and transportation work, such as the United States is currently the transportation of the injured, from receiving the call for help signal to the hospital only 37 minutes or so, greatly reducing the mortality rate, fully explaining that time is life. III. First aid time standards According to a large number of first aid practice, the sooner the first aiders close to the sick and wounded, the more the first aid time will be shortened after the injury, the survival rate of the sick and wounded is higher.
Optimal first aid period: 12 hours after the injury. Better: 24 hours after injury.
Delayed first aid: after 24 hours.
3. What are the basic principles of on-site first aid
1. The principle of restoring first and fixing later.
In case of cardiac arrest, respiratory arrest and bone fracture, first use mouth-to-mouth breathing and chest compressions to revive the heart, lungs and brain until the heartbeat and respiration are restored, and then fix the bone fracture. 2, the first stop after the principle of package.
In case of hemorrhage and wound, first stop the bleeding immediately with acupressure, tourniquet or drugs, and then disinfect and bandage the wound. 3, the principle of first heavy and then light.
It means that in case of dying and light casualties, priority should be given to rescuing the critically ill, and then rescuing and teaching the light casualties. 4, the principle of first rescue and then transportation.
When the sick and wounded are found, they should be saved first and then sent. On the way to the hospital to send the sick and wounded, do not stop rescue measures, continue to observe the sick and wounded changes, less bumps, pay attention to warmth, safe arrival at the nearest hospital.
5, first aid and call for help and the principle of equal importance. In the event of a large number of sick and wounded, there are other people involved in first aid on the scene, we should be nervous and calm to work together, first aid and call for help at the same time, in order to fight for rescue faster.
6, handling and first aid principle of consistency. In the transportation of the critically ill and injured, should be consistent with the steps of first aid work, to buy time, on the way should continue to rescue work, reduce the undue pain and death of the sick and injured, safely to the destination.
Expanded:
3, the length of the splint should be able to fracture the upper and lower joints together to be fixed. 4, the broken end of the bone is exposed, do not pull, do not send back to the wound area.
5. Expose the end of the limb to observe the blood flow. 6, after immobilization of the injured limb, if possible, the injured limb should be elevated.
7. Prevent shock. 8、If the bleeding from the stump of the severed limb is much, in the form of jet, the bleeding should be stopped by finger pressure hemostasis first, and then on the tourniquet, and then bandage.
9, the severed limb, should be triangular towels, sterile dressings or clean fabric bandage, outside a layer of plastic bags, placed in another plastic bag filled with ice or popsicles to save. 10, with a large number of gauze pressed on the limb stump, take the return type bandage method of pressure bandage.
11, if the severed limb is left partially connected, it is wrapped directly and fixed according to the fracture fixation method. 12, if there is a large bone block out, should be wrapped at the same time, together with the hospital.
References:
4. General knowledge of medical emergencies
1. Normal people are clear, fluent in speech, and move freely in behavior.
If someone "does not understand", breathing, heartbeat exists, press or pinpoint "manzhong" point does not respond, it is possible that the coma, the longer the coma, the more serious the condition is relative; 2, the normal adult body temperature is 36-37 ℃; 3, Normal adult pulse 60-100 times / min, even and strong; 4, normal adult respiration 16-20 times / min, a breathing time is equal; 5, normal adult blood pressure is bounded in the 140/90mmHg (18.6/12kpa) -90/60mmHg (12/8kpa). 6, the normal adult pupil diameter 2-4mm, equal to the size of the circle; hand-armed cardiopulmonary resuscitation (CPR) hand-armed cardiopulmonary resuscitation is a rescue technology, it is not the patent of the medical staff, it is the general public should be familiar with and mastered a kind of first aid technology.
Unarmed CPR does not require any medical equipment. Unarmed CPR is mainly used for patients who have died suddenly.
First of all, determine whether the patient is sudden death, including sudden loss of consciousness, carotid artery pulsation disappears, spontaneous respiration stops, bilateral pupil dilatation and so on. ***: The patient is lying on the ground or on a wooden board, without pillows and other objects on his head, which is the correct *** of CPR, if the patient is lying down, he should be turned into a supine position, and the technique should be gentle, especially pay attention to the head and neck, and must not be too much force.
If the patient is lying on a soft bed, the back should be padded with wooden boards. Judgement of sanity: call unresponsive, hand pinch Renzhong, Hegu points unresponsive, bilateral pupil dilation, can be concluded that the patient's sanity is lost.
Tap the shoulder (or face) of the injured patient, and call loudly in his ear: "Hey! What's wrong with you?" To try its response. 7, the total amount of blood in a normal adult body is about 7-8% of body weight.
What does sudden death mean? Normally "healthy" people, or people in basically stable condition, suddenly appeared heartbeat, respiratory arrest, called sudden death. The World Health Organization defines sudden death as the death of a person within six hours from the onset of the disease to the cessation of respiratory and cardiac arrest.
The causes of sudden death are mostly acute attacks of coronary atherosclerotic heart disease (coronary heart disease for short). Seventy percent of sudden deaths from coronary heart disease occur outside the hospital.
Sudden death patients, loss of consciousness, carotid artery fluctuations disappear, spontaneous respiratory arrest, bilateral pupil dilation. Sudden death can be resuscitated.
Sudden death patients should be immediately in the field of unarmed cardiopulmonary resuscitation. Effective CPR within 4-6 minutes has a 50% success rate.
Open the airway: tilt the head and lift the jaw (chin) method, first clean up the oral cavity of foreign objects (vomit, blood clots, etc.) to remove the dentures, the index finger of one hand, the middle finger placed in the chin, lift the chin, so that the head tilted back, one hand to support the back of the neck, the degree of tilt of the head to the lower jaw and the earlobes of the joint line perpendicular to the ground is appropriate, do not tilt back too much. Judgement of breathing: one look, two listen, three feel.
See: the chest or abdomen with or without undulation. Listen: mouth, nose, breathing sound.
Feel: the mouth and nose have no airflow overflow. Call for help The patient does not respond to the tap, call, indicating that it has lost consciousness, and immediately call for help in the same place: "Quickly come to the people ah! Help!" If there are others, first call the emergency telephone, after participating in the *** with the scene rescue.
The scene should try to organize the rescue work of the injured and sick people out of danger, ambulance staff to have a division of labor, but also to have cooperation. Mouth-to-mouth artificial respiration: placed on the forehead of the hand thumb and forefinger pinch nostrils, the mouth wrapped around the patient's mouth, the first deep breath, and then blow 2 times, blowing, do not force too hard.
After blowing, the patient's chest is undulating, indicating that artificial respiration is effective. If the carotid artery pulsation disappears, it can be recognized that the heart stops (the carotid artery is located in the 2-3 centimeters next to the laryngeal node).
Extracardiac compression: Compression site: the middle of the chest, the lower 1/2 of the sternum. Pressure frequency: 60-100 times per minute.
Depth of pressure: 3-5 centimeters. Pressing technique: one palm is placed on the lower 1/2 of the sternum, the palm is parallel to the sternum, the other hand overlaps on the back of the hand, the two fingers are crossed and lifted up, detached from the chest wall, the shoulders are taut, the shoulders are perpendicularly centered above the sternum, and downward pressure is applied with the strength of the shoulders and arms.
Precautions: 1, extracardiac compression should be performed without interruption. 2, vertical force downward, do not swing from side to side.
3, downward pressure and relaxation of equal time. 4、Don't leave the chest wall when relaxing.
If breathing and heartbeat stop, artificial respiration and extracardiac compression should be done at the same time. When blowing, stop compressions.
Do not blow during extracardiac compressions; the two can be rotated. One person to do: according to the ratio of 15:2, that is, first blowing two breaths, and then chest cardiac compression 15 times.
Continue until someone takes over. Two people do it: in a ratio of 5:1, i.e., one person blows a breath, and one person performs 5 external cardiac compressions.
Stop compressions while blowing. Don't blow during the extracardiac compressions, and the two can be rotated.
Until the professional first aiders arrived. First-Responder is a person who has been trained for a short period of time, has a fair amount of medical knowledge, and has even received a certificate of training. The first aid scene advocates the first witnesses to the implementation of the treatment.
The United States has a population of about 200 million, 70 million people have received formal first aid training, the ratio is about 4:1, the United States of America's first aid phone number for 911, the United States of America's public **** place configuration defibrillator. Norway has incorporated CPR into secondary school textbooks.
In Germany, will not stop the bleeding and bandaging not issued a driver's license ... First aid faces all levels of society, but also involves all corners of society. With the high development of human civilization in recent times, the cardiovascular and cerebrovascular diseases have been on the rise, first aid has long been not only a simple treatment of traumatic injuries such as bleeding and bandaging, but also focus on the popularization of the public to cardiopulmonary resuscitation as the basic content, and supplemented by the knowledge of trauma care skills training.
As early as the end of the 80s, the early 90s, the international medical emergency community formally proposed to the community to carry out the "first eyewitness" popularization of training and teaching, in order to compete in the field to save the life of the patient due to critical emergency or accidental injuries caused by life-threatening injuries in a moment. In real life, the real cardiac emergencies and other critical emergencies occur in the vast majority of the environment outside the hospital, the scene of first aid to fight for time and seconds, before the arrival of medical personnel, "the first witness" shoulders a particularly important responsibility.
The purpose and principles of first aid at the scene: 1, rescue life, reduce mortality. 2, to prevent the condition from deteriorating. 2, to prevent the continued deterioration of the condition.
3, alleviate the pain, reduce accidental damage, reduce the rate of disability. 1, calm and bold, careful and responsible, distinguish light, heavy, slow and urgent, decisive real.
5. "Emergency medicine and emergency medicine" concept dispute
"Emergency medicine" and "emergency medicine" which concept more aptly reflect our specialty? The debate has been going on for a long time, and no convincing conclusion has been reached.
The editors of the Chinese Journal of Internal Medicine invited Prof. Shao to write a paper on "Emergency Medicine", which Prof. Shao translated as "Emergency Medicine". Prof. Shao translated "Emergency Medicine" as "急救医学", and the title of the paper was "Emergency Medicine". Since this was a new discipline at that time, Prof. Shao did not dare to send it out for publication, so he asked Prof. Zhang Xiaoqian to review it, and Prof. Zhang Xiaoqian changed the title to "Emergency Medicine", which Prof. Zhang considered to have a wide scope. Prof. Zhang believes that "emergency medicine" includes a wide range of medical conditions, and that "first aid" is an important clinical treatment in emergency medicine, just as surgery is the most important means of diagnosis and treatment in surgery, but we can not change the name of "Surgery" to "Surgery" (or equate it to "Surgery"). "
This is the first time that we have seen the same thing in the world.
Despite the fact that 20 years have passed since the incident, there are still a lot of doctors in China who confuse emergency medicine with emergency medicine, especially some pre-hospital emergency specialists, and even think that emergency medicine should be changed to emergency medicine, and appeal to the media and professional magazines that "emergency medicine should not be narrowly construed as emergency medicine". In the media and professional magazines, some experts even think that emergency medicine should be changed into emergency medicine. It is not known that the development of emergency medicine to the present, the field of emergency medicine has far exceeded "(pre-hospital) emergency", covering medical treatment, prevention, teaching, research, management and many other aspects.
"Emergency medicine" is not a very beautiful word, and there is no such thing as "emergency medicine", but "internal medicine, surgery, pediatrics, obstetrics and gynecology," and other specialties. However, the names of other specialties such as "Internal Medicine, Surgery, Pediatrics, Obstetrics and Gynecology" are all very simple without exception, but they have not hindered the development of their disciplines. The most important thing for the development of a discipline is to recognize its own professional characteristics and areas of specialization, so that it can be recognized by the public and the medical profession.
6. Is there a book in emergency medicine that focuses on first aid for everyday use
There is a book that focuses on first aid for everyday use.
You can search in the search engine Baidu, Sina Phoenix reading channel search. Such as Baidu on the search: Author Name: Ma Yu Liu light by the Author: Works: "modern family common first aid knowledge" Description Modern family life is colorful, but some accidents often catch people unawares, such as trauma, bite and sting, poisoning, heat stroke, electrocution, drowning, stroke, sudden delivery, etc., in the encounter with such a situation, timely, scientific and effective to the necessary rescue is very important.
Based on the years of experience of the expert group of China Institute of Health Education, this book summarizes the basic skills of first aid, first aid for common emergencies, first aid for poisoning, first aid for internal medicine, first aid for surgery, first aid for obstetrics and gynecology, first aid for the five senses, first aid for stings and bites, and so on, and introduces first aid and first aid knowledge in daily life in a concise way. It provides an easy-to-learn and easy-to-use guidebook for home life. Book Summary I. Main Tasks of First Aid Treatment (1) The main tasks of first aid scene treatment are: Rescue life Reduce disability Reduce the pain of the injured Timely call to the rescue service system (e.g., 120, 999, 110, 119, and other emergency systems) to correctly and quickly transfer the sick and injured to the hospital.
(ii) In the first aid scene to pay attention to the following matters: 1. On-site assessment The assessment must quickly control emotions and understand the situation as soon as possible.
Pay attention to the safety of the scene, the state of the patient to judge, distinguish the severity of the disease.
Emergency call for help After the scene assessment and judgment of the condition, you need to call the professional emergency services immediately. Effective call for help is crucial to the rescue of critically ill patients.
3. Rapidly exclude fatal and injury-causing factors such as moving away from the heavy objects pressed on the body; quickly evacuate the scene of poisoning; if it is an electrocution accident, the power supply should be cut off immediately; remove the mud, sand, vomit, blood clots, or other foreign objects in the mouth and nose of the injured or sick person, and keep the respiratory tract open, and so on.
4. Rescue, prolong the patient's life Check the patient's consciousness, breathing, heartbeat, pulse.
If there is respiratory arrest, CPR should be performed immediately on the spot. 5.
Reduce bleeding, prevent shock Those who have trauma bleeding should be quickly bandaged to stop bleeding, in situ, available pressure bandage, on the tourniquet or acupressure hemostasis. At the same time as soon as possible to the hospital.
6. Protect the wound The wound of open injury should be properly dressed.
Protecting the wound prevents and reduces wound contamination, reduces bleeding, and protects deep tissues from further injury. 7.
Those with fractures should be temporarily fixed with wooden boards, etc. 8. Prevent complications During the on-site rescue, attention should be paid to prevent spinal cord injury, ischemia caused by tourniquet over-tightening _: blood necrosis, and vascular and nerve injuries caused by improper fracture fixation, and other complications.
9. quickly and correctly turn According to the different injuries and conditions, according to the priority to choose the appropriate tools for transportation.
During transportation, pay attention to the changes in the condition of the injured and sick at any time. In short, in situ rescue to ensure that the maintenance of the injured and sick under the premise of life, divided into priority, orderly, do not be busy, so as not to delay the time, the loss of favorable timing.
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7. What is emergency medicine
With the continuous development and progress of society, the occurrence of various human diseases and disasters is also more and more, emergency medicine covers more and more extensive, emergency medicine also carries more and more heavy tasks and responsibilities.
Emergency medicine includes pre-hospital emergency, hospital emergency two major parts, the current pre-hospital emergency is mainly 120 emergency system, while the hospital emergency is based on the hospital emergency department, some areas of the emergency 120 and the local hospital emergency department combined into one. Whether it is pre-hospital or in-hospital first aid, are involved in first aid software and hardware issues.
The so-called software is the personnel quality and regulations. From the current history of China's first aid development, the establishment of a real secondary disciplines short time, the lack of effective and sound emergency practitioners training system and access system, so the personnel is not whole, uneven technology, the degree of standardization is not enough, affecting the development of emergency medicine.
In addition, the vast majority of medical schools lack of emergency professional training and training, only a very small number of colleges and universities to establish the Department of Emergency Medicine and emergency medicine teaching and research departments, medical graduates also lack of standardized training rotation system. The author combined with foreign emergency medicine, the development of China's emergency medicine and standardization of construction to discuss.
Hardware equipment Emergency department status quo Emergency department is often not large enough, the layout is unreasonable, emergency room access is not smooth, no independent access, access to the rescue room is not smooth, more curves, not conducive to rapid access; clinic settings or layout is not in place, clinic is not large enough, no necessary examination instruments, no activity examination bed, the occurrence of a sudden * * * situation, is not conducive to the transfer of patients into the rescue room; not have operation room and orthopedic plaster room (or too simple), can not meet the trauma first aid used; first aid vehicle equipment is unreasonable, no oxygen, respirator, monitor and defibrillation equipment, etc., the stretcher can not be folded and lifted, there is no special shovel stretcher. First-aid vehicle should be equipped with equipment First-aid vehicle should be equipped with simple first-aid box, including simple auxiliary respirator, conventional oxygen equipment, oral cavity protection equipment, tracheal intubation equipment, vein opening equipment, trauma protection equipment (including neck brace, etc.), cardiac and electric monitoring and defibrillator, etc.; First-aid department should be equipped with equipment As a first-aid department, the equipments should be sound, including respiratory, hemofilter, ultrasonic examiner, cardiac and electric monitor, defibrillator , gastric lavage machine, etc.; in addition, flat cars and wheelchairs are seriously insufficient, resulting in unnecessary aggravation of the patient's condition during the examination process, and even sudden death in the emergency department.
Emergency sub-specialty clinics should be set up reasonably, a variety of diagnosis and treatment of the necessary instruments to be equipped with a comprehensive and so on, such as checking the buckle diagnostic whacking, flashlight, sphygmomanometer, funduscope, laryngoscope and suction, etc., should be equipped in each clinic. The emergency department needs more than one rescue car, each rescue car should have a set of rescue drugs, monitoring defibrillator, surgical bag and tracheal intubation and other equipment, and a list of drugs and auxiliary items of the schedule, every day by the nurse in charge of inventory and signature, and record the inventory time.
More importantly, the emergency examination equipment and instruments (including X-ray and ultrasound instruments, gastroscopy and tracheoscopy, etc., of which the X-ray machine should be placed above the resuscitation bed and be portable) should be fully in place, and be conveniently accessible, with a green light all the way around the clock. In addition, the emergency should be set up in the isolation area, in case of special cases, the corresponding measures can be implemented, can not be temporary.
Emergency, emergency medical personnel training The lack of emergency department professionals, the past situation is that medical students are directly assigned to the emergency department after graduation, there is no corresponding specialty training, or by the internal medicine transferred to the emergency department. Currently there is a part of the training, but the training is not standardized, the standardized project can not reach, rotation time is not enough, the necessary training is not or not enough, especially cardiovascular and respiratory internal medicine training, surgical care unit, anesthesiology, neurology, surgery, infectious disease, radiology and so on, at least 3 years, in order to reach the degree of general practice.
Today's international generalist literacy is very much in line with the characteristics of emergency care, including prehospital and in-hospital emergencies, which are timely, accurate, and comprehensive, and do not lose time or delay, avoiding medical disputes due to waiting or untimely calls. Emergency physicians in both the United States and Singapore are required to rotate for at least three years in departments including surgery, orthopedics, pediatrics, ophthalmology, urology, otolaryngology, neurology, dermatology, obstetrics and gynecology and anesthesiology, etc., and are required to pass the training tests in critical care, resuscitation, toxicology and traumatology.
An access system for emergency physicians should be established so that all medical personnel involved in the emergency system must complete a training program, take an exam, and receive a certificate of passing resuscitation. It is not possible to become an emergency physician without various training certificates.
Resuscitation training should include primary CPR, advanced CPR, primary trauma resuscitation, and advanced trauma resuscitation techniques to produce true emergency medicine physicians. To accomplish or achieve the above, training centers at all levels must be established to domesticate, institutionalize, and standardize our training.
It is a long-term institutionalized task to train not only medical personnel, but also relevant personnel in the society. At present, our country still follows the system of running training courses (e.g., temporary, irregularly organized training in Chinese and American resuscitation, etc.), which can not achieve the purpose of popularization and standardization at all, not to mention the goal of regular updating.
Rules and regulations of the Emergency Department At present, people's awareness of the law has increased, the awareness of self-protection has also increased, which requires doctors to regulate their behavior, especially the norms of diagnosis and treatment behavior, in strict accordance with the standards of diagnostic and treatment operations to do, too much or too little, will bring problems. For different levels of doctors and nurses, it is necessary to set the scope of their operations.
At present, what we lack is that no one to develop various diagnostic and therapeutic operation norms, completely based on experience and feeling, this situation is bound to be for the occurrence of medical disputes and accidents buried hidden dangers. As an academic institution, the Society should be responsible for the development of a variety of emergency medicine, including a variety of diagnosis of acute and critical illnesses, treatment and other specific steps, such as chest pain diagnosis and treatment procedures, abdominal pain diagnosis and treatment procedures, gastrointestinal hemorrhage diagnosis and treatment procedures, trauma diagnosis and treatment procedures and poisoning disposal norms, etc., and should also be made to produce a detailed record of the form.
As long as the doctor's advice suggests that the patient's chest pain observation, the nurse will naturally follow the protocol to carry out electrocardiograms, myocardial enzymes and other tests. When the results are available, the nurse calls the doctor to look at the results.
This can form a virtuous circle, reducing errors. Another example is the head trauma observation protocol, the nurse triage when the patient's vital signs are stable, no obvious head contusion, Glasgow score is normal.
However, if the head trauma is not hospitalized for observation, it is easy to overlook the ensuing intention.