The patient sees the emergency call and depends on the condition " On your mark "

The patient sees the emergency call and depends on the condition " On your mark "
The patient sees the emergency call and depends on the condition " On your mark "
Staff reporter Kong LingMin Ministry of Public Health <>The opinion is solicited and over a few days ago. In each side feedbacks the opinion, anyone proposes some doubts, such as sueing and labouring and delaying some patients' condition according to this principle? How to grade etc. for patients. For this reason, Ministry of Public Health organizes the medical expert of the emergency call to write " to answer questions the letter " answers questions and explains the puzzle. The emergency case no longer comes to see and confirm the order of going to a doctor in the past in accordance with the weight of condition first first, no matter how the patient's critical intensity of condition is, most emergency cases are to go to a doctor according to the order that first come, first served, such a the intersection of visit and way will let real the intersection of acute disease and patient those, face great potential medical risk while waiting. " answer questions letter " say face numerous urgent critical the intersection of disease and patient, emergency call medical treatment and requirement of validity more urgent to time limit, carry on condition grade and not dangerous to divide layer to emergency case, help, reduce the intersection of emergency case and risk, it is a key ring of standardized construction of emergency department. Before this, Ministry of Public Health has issued " standard that the emergency case goes to a doctor ", but issue this time <>Different from it. One of the draughtsmans of " guideline ", Deputy Director of BJ Union Hospital emergency department Wang Zhong say, " standard of going to a doctor " is whether the patient depends on the standard of the emergency call, and " guideline " is the regulation how to grade according to the condition after entering emergency call to the patient. " standard of going to a doctor " stipulates, the fevered patient if the body temperature can not reach 38.5 ��, have a stomachache and can not reach certain time limit, do not allow to see that should see the clinic in but the emergency call in principle. But the hospital which Ministry of Public Health launched managed the annual activity in 2005, the requirement needed only patients to see the doctor, emergency department must connect, examine, invisible and medium-sized until " standard of going to a doctor " be abrogated. Wang Zhong says, the emergency department should be open in 24 hours to the patient, should see the emergency call should depend on patient's own demand. " guideline " distinguishes the order of importance and emergency out according to the condition again on the premise of connecting all patients and examining, aim at shunting heavily and chosenly urgently and rationally. " answer questions letter " say the intersection of emergency case and mainly on the basis of two respects basis that condition grade. First, the severity of patient's condition. Determine the preferential order that the patient goes to a doctor in view of the above, confirm it on the premise of not influencing patient's prognosis, rational time to allow to wait in its condition. Second, the emergency case needs to take up the amount of the medical resources of emergency call. It is arranged in an order for patients that emergency case's condition is graded, but should shunt patients, make the patient go to the appropriate area to get appropriate making a diagnosis in appropriate time. Come emergency call as one lying-in woman of massive haemorrhage, consciousness unclear examining by blood pressure, should assign to and examine or rescue first first? Wang Zhong says, assigns to according to the condition, this kind of patient belongs to the first class endangered patient, should enter and rescue the room at once at first, will implement trachea and intravenous intubate,etc. and rescue the measure, meanwhile call for the doctor of gynaecology and obstetrics and cooperate and treat again. So, grade in fact before dividing ordinarily examining according to the condition, has added a security for the endangered patient. Aim at, reduce patient wait medical risk and condition grade should not the careful king say while being second, in fact, the present emergency department will grade too, but this is mainly a doctor's conscientious behavior. With the fast increase of the emergency case, patients presents dangerous examples while waiting in the waiting area more and more too, this requires what a clear standard graded must be issued one, further strengthen the medical worker hierarchical consciousness, its hierarchical behavior of the norm. According to " guideline ", our country divides the emergency case into moderate breeze according to the condition: Endangered, critical, acute disease and it is not acute disease. From world-wide to come on, look, most country divide for being tertiary: Critical, acute disease, it is not acute disease. Some countries are divided into five grades: Recover, not critical, acute disease, time urgent, acute disease. " answer questions letter " say, the reason why adopt the classification of moderate breeze, is mainly based on our country's conditions. Because it needs the emergency call resources much to get thinly, and our country is vast in territory, it is very uneven that medical science of the emergency call is developed, it is careful and apt to bring uncertainty to grade too at crowded emergency department condition, thus cause the injury to the patient. A lot of country wait to different the intersection of rank and patient time have a clear regulation too, for example the endangered patient must go to a doctor within 0~10 minutes, go to a doctor within 0~20 minute by critical patient, acute disease patient go to a doctor within 2 hour and it is acute disease that should not less than 4 hours by waiting time by patient. As to this, Wang Zhong says, do not make concrete regulation to the time of waiting in " guideline ", it is not the same in resource allocation that this mainly comes from number of patient of different areas and emergency call, even if stipulate that it is very difficult to operate by force. But in principle, the endangered patient must deal with at once, critical and the acute disease patient should deal with as soon as possible, the person who didn't get acute disease should wait to deal with. Different hierarchical patients go to a doctor in different areas the critical patient will get the operator that grade of more medical care conditions to assign and examine the nurse of Taiwan at first. " answer questions letter " emphasize nurse these work more than the intersection of training and nurse for less than 5 year in emergency department usually, some medical organization require they must for 7 years 8 year working experience of the above. Wang Zhong says, nurses should make relevant foundation to check for the patient first, fruit to grade according to the patient's symptom and inspection. Blood pressure, pulse and these 3 results checked of blood and oxygen saturation lever can basically prove patient's condition is light and serious. The grading of the patient is a continuous course. " answer questions letter " say condition it grades to be only the intersection of emergency case and result that condition assess initially, the medical personnel of emergency call will observe the dynamic change of patient's condition closely, make a round of visits while wanting while waiting, leaving the view, treating the district definitely, find patient's condition worsens in the course of treating, should raise the condition to grade in time, and formulation and implementation of these supplementary measures are the focal point of the next work. According to this thinking, " guideline " requires the emergency department to be divided into red, yellow, 3 green areas the function structure, principle of looking first that the patient in the same area gets first. Wang Zhong says, at present, connecting the consulting room and is mainly divided into 2 areas of emergency department: Rescue room and ordinary consulting room. In the consulting room, when the doctor should insert a team for more serious who is not serious patient of a condition, the other patients who lack medical knowledge will often misunderstand. After examining and dividing the emergency call into 3 areas, the patient who different doctors tackled different ranks, even paying attention to in the same examining area first come, first served, will not affect more serious patient's condition adversely either. After the emergency call subregion, leaving areas such as the view room,etc. will not change to set up. Zhong Wang say emergency call subregion to connect, examine, divide 3 district into patient, but room patient connect leave the institute examine, Area observed. However, must need to reallocate as to emergency call resources after the emergency call subregion, resource that critical patient need can more, but resource that person who didn't get acute disease distribute into can stand opposite each other a little less.


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