Organization of surgical care during field work
In winter, before beginning intensive fieldwork, the paramedic should conduct a prophylactic examination of the working population. This task is solved according to the work plan of the FAP under the guidance of the district doctor with the involvement of a surgeon and other specialists. There are several methods for conducting such a medical examination. The so-called brigade method is most effective when a team of doctors comes to the FAP on a pre-appointed day, including a therapist, a surgeon, a urologist, a gynecologist, an oculist, a dentist, etc. To this day, the paramedic must ensure the attendance of the necessary contingents in need of examination. The date of arrival is coordinated with the management of the settlement, the agricultural enterprise, etc., so that the turnout of the surveyed is as complete as possible.
If any chronic diseases requiring operative, planned treatment are identified, a plan is prepared for sending these patients to the CRH or district hospital. Feldsher controls the timing of referral of patients.
To reach the field camps and strengthen the medical service during the field work, outpatient outpatient clinics are created. They work according to the previously approved plan, compiled by the organizational and methodological office of the Central District Hospital. In this plan, the exact locations of outpatient dispensaries and the time of admission are indicated.
However, in many field camps or remote farms, pastures, etc., the number of employees is small, and arranging an outpatient clinic is unprofitable. Then the strengthening of the medical service can be achieved by the method of planned departure of medical workers in these areas. This method is not without serious shortcomings, since collective farmers and other workers in agricultural enterprises can not seek medical care at any time of the day.
The indicated deficiency is deprived of temporary medical points, in which the average medical worker is taking a reception. These points are organized on the basis of the FAP( they are, as it were, a branch of the FAP) with the involvement of paramedics of the CRH, a district hospital or a polyclinic for work during field or other seasonal work. The work of temporary medical posts is supervised by the head of the FAP.
With a small number of workers at each field camp and a small distance from the central farmstead, it is more expedient to organize a mobile paramedic station on a motor vehicle or a motorcycle. At the same time, a schedule of visits to each unit is created. With proper medical examination, patients are few, and the paramedic manages to visit all teams almost daily.
In addition to organizing the most close to the public medical care, the allocation of sanitary posts plays a very important role. Before the start of field work, usually in March, an annual retraining of the sanitary asset is carried out under a special program. The paramedic should once again check the availability and completeness of collective and individual first-aid kits and first aid;to work out a connection in case of emergency call of a medical worker;check whether safety training has been conducted by machine operators, stockbreeders and other workers.
During the installation of the sanitary post, the completeness of the first aid kit must be checked, the methods of transportation of the seriously ill or injured are prepared or processed. At the sanitary post should be posted hours of reception of a medical assistant, a doctor, the time of arrival of a health worker, etc.
The FAP should be collected bag for emergency care, preparations for immobilization, dressing, tourniquet, etc. are kept. In a bag in a permanent sterile package must be stored: a syringe(or disposable syringes), intravenous infusion systems and infusion solutions. All that may be needed for resuscitation assistance should be collected and maintained in the FAP.This is especially important during the fieldwork season, when the incidence of injuries, acute diseases, etc. is increasing.
A very important part of the work in preparation for field work is the conduct of training sessions - in particular, lectures on self- and mutual assistance in case of injuries and acute surgical diseases. This activity the paramedic should pay a lot of attention throughout the year.