1.untimely diagnosis
In pre-hospital emergency time is life, emergency, critical and serious patients died less than 10% of the original disease, mostly due to the delay in the timing of the resuscitation, complications aggravated and death. Incident within 1h for the rescue of the golden time, in the shortest possible time to the ambulance staff and medicines and equipment to the side of the patient is the key to the success of first aid. Due to the lack of a person to answer the phone, resulting in the inability to answer the 120 phone in a timely manner, or after answering the phone failed to ask for details of the address and contact phone number, doctors, nurses, and drivers out of the slow path, path is not familiar with the poor traffic conditions, poor weather, etc. prolonged the time to reach the scene, the medical staff can not be timely and effective treatment of the patient, can be delayed in the resuscitation of the time of the emergency and critical patients. The prolongation of the treatment-free period is critical to the life safety and prognostic impact of prehospital patients.
2. The hidden danger of on-site first aid
In the pre-hospital emergency by the environment and conditions, the nurse is the implementation of the verbal medical advice. On-site first aid, not only require "three check seven right" to emphasize the "three clear a review", that is, listen to clear, ask clear, see clear, and the physician's review, to ensure that the process of resuscitation busy but not chaotic. Due to the call did not ask the patient's situation in detail, the patient's assessment is insufficient, the clinic failed to carry drugs and equipment for the patient's actual situation, and the emergency scene of many people, the environment is noisy, resulting in the arrival at the scene, the patient's delayed treatment, increasing the chances of misdiagnosis and miscarriage of justice.
3. First aid equipment
facilities and medicines exist in the insecurity: pre-hospital emergency scene, not only the health conditions of the natural conditions are poor, but also by the instruments and equipment and medicines that can be carried by the limitations. This objectively for the pre-hospital emergency safety and add a certain degree of difficulty.
4. First aid technology is not skilled
Pre-hospital first aid is the object of patients with acute and critical illnesses, requiring medical personnel to master difficult rescue techniques, rapid and effective cardiopulmonary resuscitation, shock defibrillation, endotracheal intubation, a variety of puncture, monitoring and so on. In the pre-hospital emergency treatment of the condition of judgment and disposal errors, operation is not standardized, unskilled, such as venous puncture, tracheal intubation failed many times, cardiopulmonary resuscitation chest compressions, the site, technique, frequency, the amplitude of the chest depression is not in place, shock defibrillation in a timely manner, the choice of the energy is not correct, the rescue medication is not reasonable, will directly affect the effect of the resuscitation, especially when the sudden acute disease, the young patients failed to be resuscitated, the families are difficult to accept!
These are the most common problems in the medical field.
5. Safety hazards during transportation
①Improper placement of patients: fracture patients are not properly fixed limbs, bumps on the way to cause secondary injury; infusion patients are not properly protected, resulting in oozing liquid or needles dislodged; sputum suction is incomplete, and can not effectively keep the airway open; patients with cranial hypertension vomit inconvenient to clean up the easy obstruction of the airway caused by asphyxiation; some patients with internal hemorrhage may aggravate the bleeding and worsen the condition after moving. may aggravate the bleeding to make the condition worse.
② monitoring is not strict observation is not careful, failed to detect changes in the condition in a timely manner, such as whether consciousness is clear, breathing is smooth, there is no secondary injury, wounds and internal organs continue to bleed, if not dealt with in a timely manner, it will worsen or deteriorate the condition.
3 to the patient's family account is not detailed, open pre-hospital emergency environment more harm than good: in the open environment, medical personnel to the patient to implement the first aid, treatment, care, etc., the family are witnessed. If the transfer on the way to the condition of the explanation is not detailed, did not explain to the patient or family members of the possible dangers on the way, such as asphyxia, shock, respiratory arrest, and so on. Critical patient's condition suddenly changed and rescue failed, the patient's family psychological pressure, easily agitated, easy to cause unnecessary disputes, directly interfering with the rescue of medical personnel.
4 outpatient records are not standardized, lack of legal concepts out-of-hospital resuscitation records are incomplete, outpatient time, reception time, arrival time in the hospital records are inaccurate, the doctor and the nurse record time is not the same, and even due to the resuscitation of the patient did not write nursing records in a timely manner. Records are not detailed, key positive signs are omitted, the language description is not accurate, medical terminology is not used; the time is scribbled; the resuscitation records are not written in a standardized manner, too simple, and the resuscitation drugs used are not recorded in time. The attendance record is the main legal basis for pre-hospital emergency care when it becomes a dispute, it should be carefully, timely and accurate record without omission, alteration phenomenon, to ensure the quality of medical and nursing paperwork writing.