Organization of surgical care for phage

Surgical service of the district is headed by a surgeon - head of the surgical department of the Central District Hospital. In his subordination are surgeons of the hospital, as well as a district traumatologist( in his absence, these duties are performed by one of the resident-surgeons), urologist and oncologist. The next link is the surgical department of the district hospitals. The district surgeon distributes all resident surgeons as district hospitals and CRH as curators of rural medical stations. Usually there are 2-3 rural medical stations for one surgeon-curator, which includes several FAPs.

In his work, the FAD paramedic seldom follows the directions of the regional surgeon of the Central District Hospital and works under the direct supervision of one of the surgeons of the Central District Hospital or the district hospital, in charge of which this site is located.

The main direction of the medical assistant's work is carrying out measures for the prevention of surgical diseases and the prevention of injuries. Another very important area of ​​work is the diagnosis and timely hospitalization of patients with acute surgical diseases.

The third part of rendering assistance to surgical patients is outpatient treatment, including discharged from the hospital. Treatment of all groups of patients is performed by a paramedic under the direct supervision of one of the surgeons - curators of the precinct hospital or CRH.

The fourth most important section is the clinical examination of surgical patients.

This list can not limit all those tasks and manipulations that the feldsher decides and performs in his multifaceted work, including assisting surgical patients.

The organization of outpatient admission of surgical patients

The hours of admission to patients should be appointed at the most convenient time for the population, with due consideration of the seasonality of agricultural work. The schedule of work of the FAP specifies the dates of arrival of the local therapist and curator specialists. These dates must be agreed in advance. By the day of arrival of the surgeon, the paramedic should call all surgical, traumatological, urological patients currently in treatment at the FAP.

The paramedic himself has the right to perform the following manipulations:

• to produce intramuscular and intravenous injections;

• perform small surgical operations( opening of superficial abscesses, removal of superficially located foreign bodies, primary surgical treatment of superficial wounds, etc.);

• tamponade with nasal bleeding;

• correction of uncomplicated dislocations;

• Imposition of transport immobilization;

• catheterization of the bladder with a soft catheter;

• gastric lavage, staging of enemas.

In the therapeutic activity of the FAP, the primary focus is on the provision of pre-hospital care. Therefore, it is necessary to strive for every patient with surgical pathology to be examined by a surgeon or to a FAP during planned visits of a doctor, or in a precinct hospital integrated with a polyclinic, or in a CRH.

Depending on specific local conditions, the volume of care for surgical patients can vary greatly. At the primary reference of the patient to the FAP, in addition to establishing the diagnosis, the following questions must first of all be solved.

1. A thorough assessment of the general condition of the patient or the affected person. At the same time, it is extremely important not only to establish the existing severity of the condition at the moment, but also to provide for the possibility of its rapid deterioration. In such situations, a thorough, consistent examination of the patient and the establishment of an accurate diagnosis will help the medical assistant.

2. The question of the amount of emergency first aid to the patient, depending on the diagnosis and severity of his condition.

3. Determination of the place where the patient will be treated - at the FAP or in the polyclinic or surgical department, where he should receive the appropriate direction from the paramedic.

4. No less important is the way of transportation: lying down, sitting in the car or other transport, accompanied by a paramedic or not.

In all cases of a serious condition of the patient, not even associated with the reason of treatment in the FAP, it is better to transport it to the doctor. In sparsely populated areas, there may be cases when a patient or a victim requires immediate resuscitation assistance, without which transportation to the hospital becomes impossible. More often such cases happen at traumas, internal bleedings. Then you need to call the doctor to the patient at the FAP or contact him by phone and get the necessary instructions.

The paramedic should correctly orient himself not only in the nature of the illness or injury to the patient, but also know the methods of the forthcoming treatment. He must immediately send the patient to the institution, where he will be provided with qualified assistance.

When sending a patient to any medical institution, he or an accompanying person is given a completed "Direction ticket"( form No. 28).Severe patients or patients with an unclear diagnosis should be accompanied personally.