أبريل 13, 2017
Out of doors of the medical institution state of affairs, there is a clear organizational hierachy
▪ The police are in standard manage of the scenario.
▪ The fire carrier is in control of rescue and extrication
▪ The ambulance provider is accountable for evacuation of casualties
▪ The clinical crew is gift on the request of the ambulance group
Entrapment of casualties is now the maximum not unusual motive for paramedics to request the help of a scientific group - either prolonged entrapment or conditions wherein analgesia is required.
An on website online medical group need to be fashioned from experienced staff who have excessive visibility protective clothing, ok gadget and insurance for this type of paintings. however this isn't always viable in rural and other underserviced regions.
A current idea this is believed to enhance general final results at some point of screw ups is the Incident Command machine. this sort of gadget is based on the philosophy that diverse sectors (triage, communications, transportation) are below the command of a unmarried authority which can offer adequate control. The reason of this kind of gadget is to lessen the amount of time and treasured resources wasted on sufferers who do now not want them (minor accidents) or will now not advantage from them (sufferers of unsurvivable injuries, given the placing). The incident command device presents a shape that can prevent the misuse of sources (together with transporting patients earlier than triage happens).
Triage method "to kind". despite the fact that numerous structures exist for triaging accident victims, the basic idea identifies four businesses of patients:
a) minor contamination or injury (strolling wounded)
b) extreme however now not life threatening contamination or damage (which include a patient with intra stomach harm who is currently not in shock)
c) crucial or right away existence threatening contamination or damage
dead or unsalvageable. The actual categorization is different in diverse types and magnitudes of disaster. therefore a seriously injured affected person who might get hold of the advantage of a complete life saving effort in a three affected person incident is probably deemed unsalvageable in a catastrophe with 1000 victims.
The fine of medical care is directly associated with the experience of employees. A catastrophe has been defined as "many human beings looking to do fast what they do no longer mostly do in an environment with which they're acquainted". regardless of how experienced an man or woman is, the extent of care, assets available, and entire framework for useful resource management go through primary changes in the course of a catastrophe. for this reason the development of a clean plan for the control of multiple casualties is imperative to make sure most suitable final results for the victims, given the sources to be had. disaster making plans need to not be visible in a vacuum, however as a substitute need to include applicable businesses in the network, such as police and hearth departments, ambulance group, communications and hospitals. no matter how well prepared a trauma centre might be to care for a couple of casualties, if the transportation of disaster sufferers is disrupted or misdirected, affected person outcome is adversely affected.
The most effective measures that have been proven conclusively to save lives inside the pre-health facility situation are ABC:
Airway Clearance, upkeep and protection respiratory Oxygenation and ventilation circulate Chest compression and defibrillation
massive medical examination and the establishment of IV infusions are of no demonstrated gain. but, different pre-clinic remedies may additionally make a contribution significantly to the comfort of pain and suffering.
Time on the scene ought to not be extended by using anything other than vital treatment. the concern is to get the affected person to the medical institution as soon as feasible.
The fundamental concepts of pre-medical institution care are similar to those for in health center care. particular resuscitation courses at the moment are available wherein the implemented abilties may be mastered.
the overall practitioner is now and again called away via patients, family, nurses, police or others to take care of emergencies. The lay concept of what constitutes an emergency includes no longer most effective physical issues, but additionally emotional and social. the overall practitioner wishes to recognize the patient's feeling of urgency and reassurance won't continually be easy, however can require exquisite talent and understanding. regardless of this, the overall practitioner should be available and prepared to cope with the medically defined emergency when it comes. Emergency care out of doors the medical institution represents one of the maximum thrilling and profitable regions of medical exercise. metropolis docs will must regulate their degree of availability, equipment and abilities in line with paramedical emergency offerings, even as others, in particular faraway medical doctors, will want general information and gadget to provide most useful occasions to keep patients lives.
▪ The police are in standard manage of the scenario.
▪ The fire carrier is in control of rescue and extrication
▪ The ambulance provider is accountable for evacuation of casualties
▪ The clinical crew is gift on the request of the ambulance group
Entrapment of casualties is now the maximum not unusual motive for paramedics to request the help of a scientific group - either prolonged entrapment or conditions wherein analgesia is required.
An on website online medical group need to be fashioned from experienced staff who have excessive visibility protective clothing, ok gadget and insurance for this type of paintings. however this isn't always viable in rural and other underserviced regions.
A current idea this is believed to enhance general final results at some point of screw ups is the Incident Command machine. this sort of gadget is based on the philosophy that diverse sectors (triage, communications, transportation) are below the command of a unmarried authority which can offer adequate control. The reason of this kind of gadget is to lessen the amount of time and treasured resources wasted on sufferers who do now not want them (minor accidents) or will now not advantage from them (sufferers of unsurvivable injuries, given the placing). The incident command device presents a shape that can prevent the misuse of sources (together with transporting patients earlier than triage happens).
Triage method "to kind". despite the fact that numerous structures exist for triaging accident victims, the basic idea identifies four businesses of patients:
a) minor contamination or injury (strolling wounded)
b) extreme however now not life threatening contamination or damage (which include a patient with intra stomach harm who is currently not in shock)
c) crucial or right away existence threatening contamination or damage
dead or unsalvageable. The actual categorization is different in diverse types and magnitudes of disaster. therefore a seriously injured affected person who might get hold of the advantage of a complete life saving effort in a three affected person incident is probably deemed unsalvageable in a catastrophe with 1000 victims.
The fine of medical care is directly associated with the experience of employees. A catastrophe has been defined as "many human beings looking to do fast what they do no longer mostly do in an environment with which they're acquainted". regardless of how experienced an man or woman is, the extent of care, assets available, and entire framework for useful resource management go through primary changes in the course of a catastrophe. for this reason the development of a clean plan for the control of multiple casualties is imperative to make sure most suitable final results for the victims, given the sources to be had. disaster making plans need to not be visible in a vacuum, however as a substitute need to include applicable businesses in the network, such as police and hearth departments, ambulance group, communications and hospitals. no matter how well prepared a trauma centre might be to care for a couple of casualties, if the transportation of disaster sufferers is disrupted or misdirected, affected person outcome is adversely affected.
The most effective measures that have been proven conclusively to save lives inside the pre-health facility situation are ABC:
Airway Clearance, upkeep and protection respiratory Oxygenation and ventilation circulate Chest compression and defibrillation
massive medical examination and the establishment of IV infusions are of no demonstrated gain. but, different pre-clinic remedies may additionally make a contribution significantly to the comfort of pain and suffering.
Time on the scene ought to not be extended by using anything other than vital treatment. the concern is to get the affected person to the medical institution as soon as feasible.
The fundamental concepts of pre-medical institution care are similar to those for in health center care. particular resuscitation courses at the moment are available wherein the implemented abilties may be mastered.
the overall practitioner is now and again called away via patients, family, nurses, police or others to take care of emergencies. The lay concept of what constitutes an emergency includes no longer most effective physical issues, but additionally emotional and social. the overall practitioner wishes to recognize the patient's feeling of urgency and reassurance won't continually be easy, however can require exquisite talent and understanding. regardless of this, the overall practitioner should be available and prepared to cope with the medically defined emergency when it comes. Emergency care out of doors the medical institution represents one of the maximum thrilling and profitable regions of medical exercise. metropolis docs will must regulate their degree of availability, equipment and abilities in line with paramedical emergency offerings, even as others, in particular faraway medical doctors, will want general information and gadget to provide most useful occasions to keep patients lives.
VORHOSPITALPFLEGE
Außerhalb der Krankenhauslage gibt es eine klare organisatorische Hierarchie▪ Die Polizei kontrolliert die Situation.▪ Die Feuerwehr hat die Kontrolle über Rettung und Erpressung▪ Der Rettungsdienst ist für die Evakuierung von Verlusten verantwortlich▪ Das medizinische Team ist auf Antrag des Ambulanzteams präsentEntrapment von Opfern ist heute der häufigste Grund für Sanitäter, um die Unterstützung eines medizinischen Teams zu beantragen - entweder verlängerte Einnahme oder Situationen, in denen Analgesie erforderlich ist.Ein vor Ort medizinisches Team muss aus erfahrenen Mitarbeitern, die hohe Sichtbarkeit Schutzkleidung, angemessene Ausrüstung und Versicherung für diese Art von Arbeit gebildet werden. Dies ist jedoch nicht immer möglich in ländlichen und anderen unterversorgten Gebieten.Ein neues Konzept, das vermutlich das Gesamtergebnis bei Katastrophen verbessern wird, ist das Incident Command System. Ein solches System basiert auf der Philosophie, dass verschiedene Sektoren (Triage, Kommunikation, Transport) unter dem Kommando einer einzigen Behörde stehen, die eine angemessene Kontrolle bieten kann. Der Zweck eines solchen Systems ist es, die Menge an Zeit und kostbare Ressourcen zu reduzieren, die bei Patienten, die sie nicht brauchen (geringfügige Verletzungen) oder nicht von ihnen profitieren (Opfer von unerschütterlichen Verletzungen, bei der Einstellung) verschwendet werden. Das Incident-Befehlssystem bietet eine Struktur, die den Missbrauch von Ressourcen verhindern kann (z. B. Transport von Patienten vor der Triage).Triage bedeutet "zu sortieren". Obwohl zahlreiche Systeme für die Auslösen von Unfallopfern existieren, identifiziert das Grundkonzept vier Gruppen von Patienten:A) geringfügige Erkrankung oder Verletzung (Wandern)B) ernsthafte, aber nicht lebensbedrohliche Erkrankung oder Verletzung (wie ein Patient mit Intra-Bauchschaden, der derzeit nicht im Schock ist)C) kritische oder sofort lebensbedrohliche Krankheit oder VerletzungTot oder unbesiegbar Die tatsächliche Kategorisierung unterscheidet sich in verschiedenen Arten und Größenordnungen der Katastrophe. So könnte ein kritisch verletzter Patient, der den Vorteil einer umfassenden lebensrettenden Anstrengung bei einem Patienten mit drei Patienten erhalten könnte, in einer Katastrophe mit tausend Opfern als unbegrenzt angesehen werden.Die Qualität der medizinischen Versorgung steht in direktem Zusammenhang mit der Erfahrung des Personals. Eine Katastrophe wurde definiert als "viele Leute versuchen schnell zu tun, was sie normalerweise nicht in einer Umgebung tun, mit der sie vertraut sind". Egal wie erfahrene Person ist, das Niveau der Pflege, die verfügbaren Ressourcen und das gesamte Framework für das Ressourcenmanagement unterliegen großen Veränderungen während einer Katastrophe. So ist die Entwicklung eines klaren Plans für das Management von Mehrfachverlusten zwingend erforderlich, um ein optimales Ergebnis für die Opfer zu gewährleisten, angesichts der verfügbaren Ressourcen. Katastrophenplanung muss nicht im Vakuum gesehen werden, sondern muss auch relevante Agenturen innerhalb der Gemeinde, wie Polizei und Feuerwehr, Ambulanz-Team, Kommunikation und Krankenhäuser. Egal wie gut vorbereitet ein Trauma-Center könnte für mehrfache Opfer sorgen, wenn der Transport von Katastrophenopfern gestört oder fehlgeleitet wird, wird das Patientenergebnis negativ beeinflusst.Die einzigen Maßnahmen, die schlüssig gezeigt wurden, um Leben in der Vor-Krankenhaus-Situation zu retten, sind ABC:Atemwege Abstand, Wartung und Schutz Atem Oxygenierung und Belüftung Kreislauf Brustkompression und DefibrillationEine umfassende klinische Untersuchung und die Etablierung von IV-Infusionen sind nicht erwiesen. Allerdings können andere vor-Krankenhaus-Behandlungen dazu beitragen, die Erleichterung von Schmerzen und Leiden.Die Zeit an der Szene darf nicht um etwas anderes als eine wesentliche Behandlung erweitert werden. Die Priorität ist es, den Patienten so schnell wie möglich ins Krankenhaus zu bringen.Die Grundprinzipien der Krankenhausversorgung sind die gleichen wie bei der Krankenhausversorgung. Spezielle Reanimation Kurse sind jetzt verfügbar, wo die angewandten Fähigkeiten beherrscht werden können.Der Hausarzt wird manchmal von Patienten, Verwandten, Krankenschwestern, Polizisten oder anderen aufgerufen, um Notfälle zu besuchen. Das Laienkonzept, was einen Notfall darstellt, umfasst nicht nur körperliche Probleme, sondern auch emotionale und soziale. Der Hausarzt muss das Gefühl der Dringlichkeit des Patienten verstehen und die Beruhigung kann nicht immer einfach sein, sondern kann große Geschicklichkeit und Verständnis erfordern. Trotzdem muss der Hausarzt zur Verfügung stehen und organisiert sein, um den medizinisch definierten Notfall zu bewältigen, wenn es kommt. Die Notfallversorgung außerhalb des Krankenhauses stellt eine der interessantesten und lohnenden Gebiete der medizinischen Praxis dar. Die Stadtärzte müssen ihren Grad an Verfügbarkeit, Ausrüstung und Fähigkeiten entsprechend den paramedizinischen Notdiensten ändern, während andere, vor allem Fernbediener, ein komplettes Fachwissen und eine Ausrüstung benötigen, um optimale Umstände zu schaffen, um Patientenleben zu retten.
