The basic knowledge that should be mastered in on-site rescue of the wounded is as follows: (1) If the injured person is in the car and cannot get off by himself, he should be dragged out of the car as soon as possible.
(2) If the injured person is in the roadway, quickly drag the injured person away from the roadway, and be careful not to touch the vital parts and wounds of the injured person during the dragging process. (3) If the injured person is unconscious due to violence or coma due to hot weather, cold, lack of oxygen and poisoning for various reasons, he should be rescued immediately.
(4) Rescuing the injured due to respiratory interruption: If the injured person is found to have no breathing sounds or breathing movements, it can be concluded that his breathing has been interrupted. At this time, we should race against time to save him immediately. No matter whether you have rescue knowledge or not, you should follow the following methods to give first aid, otherwise the injured person will be life-threatening due to lack of oxygen in his brain. Rescue method: raise the mandibular angle of the injured person to make breathing smooth. This measure has a great effect on restoring breathing on many occasions.
If the injured person still can't breathe, then mouth-to-mouth resuscitation is needed. When doing artificial respiration, the chest and upper abdomen of the injured person should be raised regularly, and artificial respiration can work. If artificial respiration doesn't work, it is necessary to check whether there is any foreign body in the mouth and throat of the injured person, and try to eliminate it, and then continue artificial respiration until the professional ambulance personnel arrive.
(5) Rescue of blood-loss patients: If someone is injured and loses too much blood, there will be symptoms such as hemorrhagic shock, which will be life-threatening in severe cases. Therefore, quick and accurate hemostasis is an important means to effectively rescue the wounded.
The treatment of blood loss is mainly achieved by raising limbs, compressing blood vessels, tying bandages and pricking wounds. (6) Rescue of the wounded with fracture: When someone has a fracture, first of all, pay attention to prevent the injured from going into shock, and don't move the fractured part of the body. If the spine may be damaged, generally do not change the posture of the injured person. For the specific fracture site, carefully wrap it with sterile film, and keep the site still according to the state after the occurrence. In the absence of bandages, the fracture site can be fixed with local materials, which can alleviate the pain of the injured and facilitate transportation, but it is not necessary at the same time.
2. The basic principles of on-site first aid
The object, environment and conditions of on-site first aid are very different from those of hospitals. Therefore, mastering its specific characteristics will make emergency workers fully prepared from thought to work, which is conducive to the smooth completion of the task.
First, the characteristics of on-site first aid (1) Sudden on-site first aid often leads to the emergence of wounded or patients in sudden catastrophic events, sometimes in small numbers, sometimes in batches, sometimes dispersed, and sometimes concentrated. Most of the common patients are dying. Not only people at the scene need to participate in first aid, but also people outside the call center need more people to participate in first aid.
(2) Urgency After sudden disasters and accidents, the situation of the wounded is much more complicated. Many people have more than two musical instruments damaged at the same time, and many people are dying. The injured and their families are in a very urgent mood for help. Cardiac arrest for 6 minutes, incontinence, coma, irreversible damage to brain cells.
Start cardiopulmonary resuscitation within 4 minutes, which may save 50%. 10% of the people who started to recover after 0/0 minutes could not survive.
Therefore, time is life, and every minute counts. People with cardiac arrest and respiratory arrest should be rescued from the edge of the cliff by resuscitation technology, and those with severe bleeding and fracture should be rescued by hemostasis and fixation. Otherwise, there will be a serious mistake of "losing a mile, losing a thousand miles". (3) Difficulty refers to the variety of the wounded and sick in the disaster and the serious injuries. A person may involve multiple systems and instruments at the same time, and needs rich medical knowledge and excellent technology to complete the first aid task.
In fact, there are often cases where there are many patients, urgent requirements, high requirements and little knowledge. Some disasters, although there are fewer patients, are often in a sudden state of emergency. Even there are no people around the patients, let alone professional health personnel, and they can only rely on passers-by with basic life support technology to provide help and first aid.
This situation is a difficult problem for people who have studied medicine and those who have been trained or untrained. (4) Flexibility On-site first aid is often carried out under the condition of lack of medical care and medicine, and there are often no complete rescue equipment, medicines and rotating tools.
Therefore, we should flexibly look for substitutes around the wounded and sick, repair the old and make use of the waste, and obtain washing disinfectants, bandages, splints, stretchers and so on. Take local materials; Otherwise, the chance of rescue will be lost, which will cause greater disasters and irreparable consequences to the wounded and sick. (5) Key medical first aid includes out-of-hospital first aid, which objectively requires medical technical training, first aid medical equipment and equipment, especially comprehensive first aid professional equipment: hospital first aid should be specialized, mass first aid should be popularized, community first aid organizations should be networked, and first aid command system should be scientific.
These are the key problems to complete the first aid. Second, the principle of on-site first aid The general task of on-site first aid is to take timely and effective first aid measures and techniques to minimize the pain of the wounded and sick, reduce the disability rate and mortality rate, and lay a good foundation for hospital rescue.
Priority is given to the wounded and sick who can survive the first aid at the scene. This is the general principle.
In order to better accomplish this glorious and arduous task, we must also follow the following six principles.
(1) The principle of resuscitation before fixation refers to the principle of resuscitating the heart, lungs and brain through mouth-to-mouth resuscitation and chest compressions in the case of cardiac arrest and fracture, and then fixing the fracture. (2) The principle of stopping bleeding first and then bandaging refers to the principle that in case of massive bleeding and wound, acupressure, tourniquet or medicine should be used immediately to stop bleeding, and then the wound should be disinfected and bandaging.
(3) The principle of emphasizing first and then neglecting, refers to the wounded and sick who emphasize first and then neglect. (4) The principle of saving the latter first In the past, most of the wounded and sick were sent first and then saved, which often delayed the rescue opportunity and led to the death of people who didn't deserve to die.
It's time to reverse, save first and then send. On the way to the hospital, don't stop the rescue measures, continue to observe the changes of the injury, avoid bumping, pay attention to keep warm and reach the destination safely.
(5) The principle of paying equal attention to first aid and calling for help. When encountering a large number of wounded and sick people, many people can quickly win first-aid foreign aid in the current situation. (VI) The principle of consistency between treatment and medical care In the past, when dealing with critically ill patients, treatment was separated from medical care and guardianship in thought and action.
The transportation department is responsible for handling, and the health department is responsible for medical treatment on the way. It seems that it is only the responsibility of rescue. Many times, the coordination is not good, and we have to continue to rescue on the way, but there is no guarantee. In addition, the vehicle was severely bumped, resulting in excessive pain and death of the wounded and patients.
This situation is not uncommon at home and abroad. Medical rescue should be carried out under the conditions of consistent task requirements, coordinated pace and consistent task completion.
When transporting critically ill patients, it can alleviate the pain, reduce the death and reach the destination safely. In the past, the first aid was the method of "lifting up and running", which has been basically replaced by the idea of "waiting for the injury to stabilize the injury" in the international scope.
This stable policy shows that it can effectively reduce the mortality and disability rate of first aid in wartime and peacetime. When "wait for a while, stabilize the injury", it is not that the wounded and sick are left unattended, but that the emergency personnel are nervously doing what they should do, opening the airway, CPR, controlling bleeding, braking fractures and carrying less, so untrained people should pay more attention.
At present, advanced countries have greatly strengthened out-of-hospital first aid and transshipment. For example, in the United States, it only takes about 37 minutes from receiving the distress signal to transporting the wounded to the hospital, which greatly reduces the mortality rate and fully shows that time is life. Third, the standard of first-aid time According to a large number of first-aid practices, the sooner the first-aid person approaches the wounded and sick, the shorter the first-aid time after the injury, and the higher the survival rate of the wounded and sick.
The best first aid period: within 0/2 hours after injury. Better first aid period: within 24 hours after injury.
Delayed first aid period: 24 hours after injury.
3. What are the basic principles of on-site first aid?
1, the principle of restoring first and sorting later.
If there is heartbeat, respiratory arrest, fracture, etc., cardiopulmonary cerebral resuscitation should be carried out by mouth-to-mouth resuscitation and chest compression, and then fracture fixation should be carried out. 2, the first stop after the package principle.
If there is massive bleeding and wound, first stop the bleeding immediately with finger pressure, tourniquet or medicine, and then disinfect and bandage the wound. 3, the principle of first heavy and then light.
It means that in case of dying and underage patients, the critical patients should be rescued first, and then the underage patients should be educated. 4. The principle of storing before transporting.
When the sick and wounded are found, they should be rescued first and then evacuated. On the way to the hospital, don't stop the rescue measures, continue to observe the changes of illness and injury, avoid bumping, pay attention to keep warm, and arrive at the nearest hospital safely.
5. The principle of paying equal attention to first aid and calling for help. When a large number of wounded and other personnel participate in first aid, they should work together nervously and calmly, and first aid and call for help can be carried out at the same time in order to strive for rapid rescue.
6. The principle of consistency between handling and first aid. When transporting critically ill patients, we should strive for time according to the steps of first aid, continue the rescue work on the way, reduce the undue pain and death of patients, and reach the destination safely.
Extended data:
On-site rescue steps and precautions are as follows: 1, check consciousness, breathing, pulse, etc. and deal with massive bleeding. 2. Fix the injured part with bandage, triangle towel and splint.
3. The length of splint should be able to fix the fractured upper and lower joints together. The broken end of the bone is exposed. Don't pull, and don't send it back to the wound.
5. Expose limbs to observe blood flow. 6. After fixing the injured limb, if possible, the injured limb should be raised.
7. Prevent the occurrence of shock. 8. If there is a large amount of bleeding at the stump, which is in the form of a jet, you should first press it with your fingers to stop bleeding, then bandage it with a tourniquet, and then bandage it.
9. For the severed limb, wrap it with a triangular towel, sterile dressing or clean cloth, wrap it in a plastic bag and put it in another plastic bag filled with ice or popsicles for preservation. 10, a large amount of gauze was pressed on the stump of the limb, and the pressure bandage was performed by the return bandage method.
1 1. If the severed limb is partially connected, it should be directly bandaged and fixed according to the fracture fixation method. 12. If there is a big bone protrusion, it should be bandaged at the same time and sent to the hospital together.
References:
Baidu encyclopedia-on-site first aid.
4. Common sense of medical first aid
1. Normal people are clear-headed, fluent in language and free to act.
If someone "doesn't understand", breathing and heartbeat exist, and pressing or needling "Renzhong" point has no response, it may be a coma. The longer the coma, the more serious the condition; 2. The body temperature of normal adults is 36-37℃; 3. The pulse of normal adults is 60- 100 beats/min, which is even and powerful; 4. Normal adults breathe 16-20 times/minute, and the breathing time is equal; 5. Normal adult blood pressure ranges from140/90mmhg (18.6/12kpa) to 90/60 mmHg (12/8 kPa). 6. The pupil diameter of normal adults is 2-4mm, which is completely consistent with the circle; Hand-held Cardiopulmonary Resuscitation (CPR) Hand-held Cardiopulmonary Resuscitation (CPR) is a rescue technique, which is not a patent of medical personnel, but a first-aid technique that the general public should be familiar with and master.
Hands-on CPR does not require any medical equipment. Hand-held cardiopulmonary resuscitation is mainly used for patients with sudden death.
First, determine whether the patient died suddenly, including sudden loss of consciousness, disappearance of carotid pulse, spontaneous breathing stop, dilated pupils on both sides and so on. * * *: The patient is lying on his back on the ground or on a wooden board, and there are no pillows and other items on his head. This is the correct way of cardiopulmonary resuscitation. If the patient is prone, he should be turned to supine position by gentle means, paying special attention to the head and neck, and must not use too much force.
If the patient lies on a soft bed, his back should be padded with boards. Conscious judgment: no response to the call, no response to the pinch of the middle and Hegu points, and dilated pupils on both sides, it can be concluded that the patient is unconscious.
Pat the injured person on the shoulder (or face) and shout in his ear: "Hello! What's wrong with you? " To test its response. 7. The total blood of normal adults accounts for about 7-8% of body weight.
What is sudden death? A normal "healthy" person, or a person whose condition is basically stable, suddenly has a heartbeat and respiratory arrest, which is called sudden death. The World Health Organization defines a case of death within 6 hours from onset to respiratory and cardiac arrest as sudden death.
The cause of sudden death is mostly acute attack of coronary atherosclerotic heart disease (referred to as coronary heart disease). 70% of sudden death caused by coronary heart disease occurred outside the hospital.
Sudden death patients lost consciousness, carotid artery fluctuation disappeared, spontaneous breathing stopped, and bilateral pupils dilated. Patients with sudden death can be rescued and resurrected.
Patients with sudden death should be given hands-free cardiopulmonary resuscitation immediately. Effective cardiopulmonary resuscitation was performed within 4-6 minutes, and the rescue success rate was 50%.
Open the airway: raise your head and chin. First, clean up foreign bodies (vomit, blood clots, etc.). ) In your mouth, take out your false teeth, put your forefinger and middle finger on your chin with one hand, lift your chin and tilt your head back. After holding the neck with one hand, the degree of head back should be perpendicular to the ground with the line between chin and earlobe. Don't lean back too much. Judging breathing: seeing, listening and feeling.
Look: whether there are ups and downs in the chest or abdomen. Listen: Is there breathing sound in the nose and mouth?
Feeling: whether there is air escaping from the nose and mouth. Calling for help loudly The injured person didn't respond to the slapping and calling for help, indicating that he had lost consciousness. He immediately called for help in the same place: "Somebody! Help! " If there are others, call the emergency number first and then participate in the on-site rescue.
The scene should try to organize the rescue work of the wounded and sick, and the ambulance personnel should work together. Mouth-to-mouth artificial respiration: put your thumb and forefinger on your forehead to hold your nostrils, wrap your mouth around the patient's mouth, take a deep breath first, then blow twice, and don't use too much force when blowing.
After blowing, the patient's chest fluctuates, indicating that artificial respiration is effective. If the carotid pulse disappears, it can be considered that the heartbeat stops (the carotid artery is located 2-3 cm next to the Adam's apple).
Extracardiac compression: compression position: in the middle of the chest, under the sternum 1/2. Pressing frequency: 60- 100 times per minute.
Pressing depth: 3-5cm. Pressing technique: place one hand under the sternum12, with the palm parallel to the sternum and the other hand overlapping on the back of the hand. Lift the two fingers crosswise, leave the chest wall, straighten the shoulders, and press down with shoulder arm strength.
Note: 1. Extracardiac compressions should continue. 2, vertical downward force, don't swing from side to side.
3. Press down and relax. 4. Don't leave the chest wall when relaxing.
If breathing and heartbeat stop, artificial respiration and cardiac compression should be performed at the same time. When blowing, stop pressing.
Don't blow when pressing the heart, the two can be done alternately. Do it alone: according to the ratio of 15:2, that is, blow twice first, and then press 15 times on your chest.
It goes on and on until someone takes over. Two people do it: according to the ratio of 5: 1, that is, one person blows one breath and one person presses the heart five times.
Stop pressing when blowing. Don't blow when pressing the heart, the two can be done alternately.
Until the professional emergency personnel arrive. Call 120 at the same time of self-help and mutual rescue.
First-aider: The first-aid scene strongly calls for the "first witness", so what is the "first witness"? That is, after short-term training, I have mastered considerable medical knowledge and even obtained relevant training certificates. The first-aid scene advocates the first witness for treatment.
There are about 200 million people in the United States and 70 million people have received formal first aid training, accounting for about 4: 1. The emergency telephone number in America is 9 1 1, and defibrillators are equipped in public places in America. Norway has included CPR in middle school textbooks.
In Germany, you can't stop bleeding and get a driver's license ... first aid faces all levels of society and involves all corners of society. With the rapid development of modern human civilization and cardiovascular and cerebrovascular diseases, first aid is not only the treatment of bleeding, dressing and other trauma, but also the popularization of cardiopulmonary resuscitation, supplemented by the training of trauma rescue knowledge and skills.
As early as the end of 1980s and the beginning of 1990s, the international medical emergency community formally proposed to the society to carry out the universal training and teaching of "first witness" in order to race against time to rescue the patients whose lives were endangered by critical emergencies or accidental injuries. In real life, most real cardiac emergencies and other critical emergencies occur outside the hospital, and on-site first aid is a race against time. Before the arrival of medical staff, the "first witness" shoulders a particularly important responsibility.
The purpose and principle of on-site first aid: 1, saving lives and reducing mortality. 2. Prevent the disease from getting worse.
3. Relieve pain, reduce accidental injuries and reduce disability rate. 1, calm and bold, careful and responsible, prioritize, use your quick wits and be decisive.
5. The origin of the concept of "emergency medicine and emergency medicine"
Which concept of "emergency medicine" or "emergency medicine" can better reflect our major? This kind of argument has a long history, and no convincing conclusion has been reached so far.
The editor of Chinese Journal of Internal Medicine invited Professor Shao Xiaotong to write a paper introducing Emergency Medicine. Professor Shao Xiaotong translated "emergency medicine" into "emergency medicine", and his thesis was entitled "emergency medicine". As it was a new subject at that time, Professor Shao dared not publish it rashly, and asked Professor Zhang to review it. Professor Zhang changed the title of the book to Emergency Medicine. Professor Zhang believes that "emergency medicine" covers a wide range, and "first aid" is an important clinical treatment method of emergency medicine, just as surgery is the most important diagnosis and treatment method of surgery, but "surgery" cannot be renamed (or equivalent) as "surgery".
Although it has been 20 years, there are still many doctors in China who confuse emergency medicine with emergency medicine, especially some experts in pre-hospital emergency medicine. They even think that emergency medicine should be changed to emergency medicine, and call on the media and professional magazines that "emergency medicine cannot be narrowly understood as emergency medicine". As we all know, with the development of emergency medicine, the field of emergency medicine has gone far beyond "(pre-hospital) emergency", covering medical treatment, prevention, teaching, scientific research, management and many other aspects.
"Emergency medicine" is not a flowery rhetoric, and there is no sound like "emergency medicine", but the names of other specialties such as "internal medicine, surgery, pediatrics, obstetrics and gynecology" are all 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 fields, so as to be recognized by the public and the medical community.
6. Does emergency medicine specialize in daily first aid knowledge?
There are books devoted to daily first aid knowledge.
You can search on the search engines Baidu and Sina Phoenix Reading Channel. For example, Baidu found: Author's brief introduction Name: Ma Guang Author's brief introduction: Works: Modern families often use first-aid knowledge to introduce modern family life, but some accidents often make people unprepared, such as trauma, bites and stings, poisoning, heatstroke, electric shock, drowning, stroke, sudden delivery and so on. In this case, it is very important to carry out necessary rescue in time, scientifically and effectively.
On the basis of summarizing many years' popular science experience of the expert group of China Institute of Health Education, this book briefly introduces the most common first aid situations and knowledge in daily life from the aspects of basic first aid skills, common emergencies, poisoning, internal medicine, surgery, obstetrics and gynecology, five senses and biting. , provides an easy-to-learn and easy-to-use guide manual for home life. Abstract 1. The main tasks of first aid treatment (1) The main tasks of first aid on-site treatment are: saving lives, reducing disability, alleviating the pain of the wounded, and calling the rescue service system in time (e.g. 120, 999,111)
(2) Pay attention to the following items at the emergency site: 1. We must control our emotions quickly and understand the situation as soon as possible during the on-site evaluation.
Pay attention to the safety of the site, judge the patient's state and the priority of his illness. 2。
After on-site assessment and illness judgment, the emergency telephone needs to call professional emergency agencies immediately. Effective call for help is very important for the treatment of critically ill patients.
3。 Quickly eliminate fatal and harmful factors, such as moving heavy objects on your body; Evacuate the poisoning scene quickly; If it is an electric shock accident, immediately cut off the power supply; Remove mud and sand, vomit, blood clots or other foreign bodies from the mouth and nose of the wounded and sick, and keep the respiratory tract unobstructed.
4。 Save and prolong the patient's life, and check the patient's consciousness, breathing, heartbeat and pulse.
If breathing or heartbeat stops, cardiopulmonary resuscitation should be performed immediately on the spot. 5。
In order to reduce bleeding and prevent traumatic bleeding from shock, we should quickly bandage and stop bleeding, take local materials and stop bleeding with pressure bandage, tourniquet or finger pressure. At the same time, send it to the hospital as soon as possible.
6。 Protect the wound. Open wounds should be properly bandaged.
Protecting the wound can prevent and reduce wound pollution, reduce bleeding and protect deep tissue from further damage. 7。
If there is a fracture, it should be temporarily fixed with wooden boards. Prevention of Complications During on-site rescue, attention should be paid to prevent complications such as spinal cord injury, blood necrosis caused by tight tourniquet, and vascular nerve injury caused by improper fracture fixation.
9。 Rotate quickly and correctly according to different injuries and situations, and choose the appropriate transport tools according to the priority.
Pay attention to the patient's condition changes at any time during transportation. In short, on-site rescue should be carried out in an orderly manner on the premise of ensuring the life of the wounded and sick, so as not to delay time and lose favorable opportunities.
…… 。
7. What is emergency medicine?
With the continuous development and progress of society, there are more and more human diseases and disasters, the content of emergency medicine is more and more extensive, and the field of emergency medicine is also bearing more and more heavy tasks and responsibilities.
Emergency medicine includes pre-hospital first aid and in-hospital first aid. At present, 120 emergency system is the main emergency system before hospital, and emergency departments in hospitals are the main emergency departments in hospital. In some areas, 120 emergency aid is integrated with the emergency department of local hospitals. No matter pre-hospital or in-hospital first aid, it involves first aid software and hardware problems.
The so-called software is personnel literacy and rules and regulations. Judging from the development history of first aid in China at present, the real two disciplines has been established for a short time, and there is no effective and sound training system and access system for emergency medical practitioners, with incomplete personnel, uneven technology and insufficient standardization, which has affected the development of emergency medicine.
In addition, most medical colleges and universities lack the training and cultivation of emergency specialty, only a few colleges and universities have established emergency departments and emergency medicine teaching and research departments, and medical graduates also lack a standardized training rotation system. According to the present situation of emergency medicine abroad, the author discusses the development and standardization of emergency medicine in China.
The status quo of hardware equipment emergency department Emergency department is often not large enough, the layout is unreasonable, the access to the emergency room is not smooth, there is no independent access, the access to the rescue room is not smooth, and there are many bends, which is not conducive to rapid access; The setting or arrangement of the consultation room is not in place, the consultation room is not big enough, there is no necessary inspection equipment, and there is no movable examination table. Sudden * * *, is not conducive to transporting patients into the emergency room; There is no operating room and orthopedic plaster room (or it is too simple) to meet the needs of trauma first aid; The rescue equipment is unreasonable, and there is no oxygen, ventilator, monitor and defibrillation equipment. The stretcher cannot be folded and lifted, and there is no special shovel stretcher. Ambulances should be equipped with simple first aid kits, including simple auxiliary breathing apparatus, conventional oxygen equipment, oral protection equipment, tracheal intubation equipment, vein opening equipment and trauma protection equipment (including neck support, etc.). ), ECG monitoring and defibrillator, etc. As an emergency department, emergency department should be equipped with complete equipment, including ventilator, hemofilter, ultrasonic tester, ECG monitor, defibrillator, gastric lavage machine and so on. In addition, there is a serious shortage of flat cars and wheelchairs, which leads to the unnecessary aggravation of patients' condition during examination and even sudden death in emergency.
The setting of the emergency room should be reasonable, and all kinds of instruments needed for diagnosis and treatment should be equipped, such as examination hammer, flashlight, sphygmomanometer, ophthalmoscope, laryngoscope and aspirator. Every clinic should be equipped with. The emergency department needs multiple rescue vehicles, and each rescue vehicle should have a set of rescue drugs, monitoring defibrillators, surgical kits, tracheal intubation and other equipment, with a detailed list of drugs and auxiliary items, which should be counted and signed by the nurse in charge every day, and the counting time should be recorded.
More importantly, the equipment and instruments for emergency examination (including X-ray and ultrasonic instruments, gastroscope and bronchoscope, etc.). The X-ray machine should be placed above the rescue bed. It should be completely in place, convenient and fast, and always turn green. In addition, the emergency department should set up an isolation zone. In case of special circumstances, corresponding measures can be taken, and cramming is not allowed.
The training of emergency and emergency medical personnel is short of emergency professionals. In the past, medical students were directly assigned to the emergency department after graduation without corresponding specialist training, or transferred from internal medicine to emergency department. At present, although there are some trainings, the trainings are not standardized, the standardized items can't be achieved, the rotation time is not enough, and the necessary trainings are insufficient or insufficient, especially in cardiovascular and respiratory medicine, surgical intensive care unit, anesthesiology, neurology, surgery, infectious diseases and radiology. It will take at least 3 years to reach the level of general practice.
At present, the quality of general practice in the world is very consistent with the characteristics of first aid, including pre-hospital first aid and in-hospital first aid. It is timely, accurate and comprehensive, and will not delay the opportunity and delay the illness, so as to avoid medical disputes caused by waiting or calling in time. Emergency doctors in the United States and Singapore have to rotate for at least 3 years, and the rotating departments include surgery, orthopedics, pediatrics, ophthalmology, urology, otolaryngology, neurology, dermatology, obstetrics and gynecology, and anesthesiology. They must pass the training and evaluation of critical illness, resuscitation, toxicology and traumatology.
An access system for emergency doctors should be established, and all medical personnel involved in the emergency system must complete the training plan, take the exam and obtain the certificate of resuscitation. Without various training certificates, it is impossible to become an emergency doctor.
Resuscitation training should include primary cardiopulmonary resuscitation, advanced cardiopulmonary resuscitation, primary trauma resuscitation and advanced trauma resuscitation techniques to train real emergency doctors. In order to accomplish or achieve the above objectives, we must establish training centers at all levels to localize, institutionalize and standardize our training.
It is a long-term institutionalized task to train not only medical personnel, but also relevant social personnel. At present, China still follows the system of holding training courses (for example, holding Sino-US recovery training temporarily and irregularly), which simply fails to achieve the goal of popularization and standardization, let alone the goal of regular updating.
At present, people's awareness of law and self-protection is enhanced, which requires doctors to standardize their behavior, especially the norms of diagnosis and treatment, and strictly follow the norms of diagnosis and treatment. Too much or too little will cause problems. For different levels of doctors and nurses, it is necessary to set their operating range.
At present, what we lack is that there is no one to formulate various diagnostic and therapeutic operation norms, relying entirely on experience and feelings. This situation will inevitably lay a hidden danger for medical disputes and accidents. As an academic institution, the Society should be responsible for formulating various emergency medical diagnosis and treatment routines, including specific steps such as the diagnosis and treatment of various acute and critical diseases, such as the diagnosis and treatment of chest pain, abdominal pain, gastrointestinal bleeding, and the treatment of trauma and poisoning. And you should also make a table that can be recorded in detail.
As long as the doctor's advice suggests observing the patient's chest pain, the nurse will naturally check the electrocardiogram and myocardial enzymes according to the rules. After the test results came out, the nurse called the doctor to see the results.
This can form a virtuous circle and reduce the occurrence of mistakes. Another example is the observation rules of head trauma. When the nurse triaged, the patient's vital signs were stable, there was no obvious contusion on the head, and Glasgow score was normal.
However, if you don't stay in the hospital for observation according to the head injury, it is easy to ignore the follow-up significance.