Imisebenzi yabahlengikazi ababhalisiwe abafuna ukuba ngaphandle
Ama-paramedics aphendulela emisebenzini yabo yezokwelapha futhi ababhalisa esikoleni sokuhlengikaza bavame ukuziphindela ebhizinisini lokuthutha iziguli lapho bethola amalayisensi. Kujwayele futhi kuhle kakhulu emsebenzini. Ama-paramedics afunda ukucabanga ngokuzimela ngesikhathi sezinkinga futhi angasabela ngokushesha uma isimo sesiguli siwohloka.
Akuvamile ukusebenza njengama-paramedics. Esikhundleni salokho, abezimo eziphuthumayo bezitholakala ezikhundleni ezihloselwe abahlengikazi abangaphandle kwezindawo ezijwayelekile ze-RN njengalezi ezibhedlela nasemitholampilo. Ngokungafani nendima ejwayelekile ye-ambulance ye-paramedic, elawulwa ngokuphendula izingcingo ezingu-911 kanye neminye imisebenzi ephuthumayo, imisebenzi yokunakekela abahlengikazi igxila ekuthuthweni kweziguli phakathi kwezikhungo.
Ukuba usizo lwezokwelapha ngaphambi kokuba ube ngumhlengikazi akuyona into ebalulekile yokuthutha abahlengikazi. Iningi labahlengikazi ababhalisiwe lifanelwe kahle kulo mboni. Abahlengikazi abaningi abazi nje ukuthi le misebenzi ikhona noma abazi ukuthi bangangena kanjani.
I-Silos yezokwelapha ne-Interfacility Transportation
Ukuze kuhlinzeke ukunakekelwa okukhulu kwesiguli futhi kuqukethe izindleko, izibhedlela sezigxile kakhulu emisebenzini abanikezayo esikhungweni ngasinye. Ngawo-1990, izibhedlela zaqala ukuhamba ngezinsizakalo ezijwayelekile ezazijwayele kakhulu futhi zithuthukile ezikwazi ukuthatha isikhungo sonke.
Izibhedlela zezingane ziyaziwa ngokukhipha ngokuphelele iziguli ezikhulile-noma zivimbela ukukhathazeka kwabantu abadala kuphela ezinsizeni ezinomzimba nezinsizwa.
Kunezibhedlela ezizinikezelwe nge-neurology kanye nezinye ezizinikezele ekuzileni kwezinhliziyo. Ngezinye izikhathi, isibhedlela sizohlukaniswa sibe amakilasi amabili noma ngaphezulu ukuhlinzeka ukwesekwa okwanele ukunakekelwa okukhethekile endaweni eyodwa noma ezimbili eziqondile.
Konke lokhu okukhethekile kubandakanya ukusetshenziswa kwezinsiza zokuthutha ukuhambisa iziguli phakathi kwezikhungo. Yini eyaziwa embonini ye-ambulensi njengokudluliselwa kwe- interfacility (IFTs) .
Ama-ambulensi abelokhu ehlinzeka ngamasevisi e-IFT iminyaka eminingi esebenzisa izimo eziphuthumayo kanye nochwepheshe bezokwelapha eziphuthumayo (EMTs). Kwezinye izimo, iziguli zidinga ukwelashwa ngaphandle kokusebenza komuthi wezokwelapha noma i-EMT . Uma lokho kwenzeka, ngokuvamile isibhedlela sinikeza umhlengikazi noma udokotela ukuba ahambisane nesiguli endaweni.
Abahlinzeki ababhekene nezibhedlele abagibela ngemuva kwe-ambulensi ukunikeza ukunakekelwa akuncane kangako namuhla. Ukukhathazeka kwezibopho kanye nezinga lokududuza kwabahlinzeki ngokuphatha ukunakekelwa kwesiguli endaweni engafanele eholele ezibhedlela eziningi abasavumeli abahlinzeki babo ukuba bahambe ne-ambulensi. Ngakho-ke, i-ambulensi yaqala ukuletha abahlengikazi bayo, futhi kwavulwa i-ambulensi yezokuthutha okubhekene nokukhathazeka (CCT).
Ukuthutha Okunzima Okubalulekile
I-CCT (ngezinye izikhathi ebizwa ngokuthi i-SCT, yokuthutha okukhethekile okunakekelwa) iyinkinga ehlukile yenkonzo kunele-ambulensi engu-911. Umbuso ngamunye unemithethonqubo yawo uma kuziwa kuma-EMTs, izimo eziphuthumayo nabahlengikazi, kodwa okuyisisekelo kuhle kakhulu.
Ama-paramedics asebenza emiyalweni yokuma (ngokuvamile ebizwa ngokuthi imihlahlandlela noma izivumelwano ) ezakhiwe ngabaqondisi bezokwelapha odokotela.
Kwamanye amazwe athi, iziguli eziphuthumayo zinelayisensi ngenkathi ezinye izifunda zibhekwa njengeziqinisekisiwe. Abanye bangasho ukuthi umehluko awunalutho ngesikhathi sokusebenza okusebenzayo futhi kusebenza kuphela endaweni yomthetho. Ngeke ngifinyelele kulokhu ngaphandle kokusho ukuthi ukulinganiselwa kwelayisensi yokuphazamiseka kwezimo eziphuthumayo emazweni amaningi kuyisisusa sabahlengikazi abakhuphuka ngemuva kwe-ambulensi ukuhlinzeka ukunakekelwa.
Abahlengikazi yilokhu okuqhubekayo kwabahlinzeki bokunakekelwa. Abahlengikazi baphatha izandla-ekunakekelweni kwezempilo kwansuku zonke iziguli ezidinga esibhedlela. Odokotela benza izinqumo futhi benza izinqubo ezithile eziguqula ngokuqondile isimo somuguli-ukuhlinzwa, njengesibonelo-kodwa ukunakekelwa okulandelwayo kuqhutshwa ngokuphelele ngumhlengikazi.
Uma udokotela enza isinqumo sokunakekelwa, unikeza umyalo ovame ukugcwaliseka ngumhlengikazi.
Yiziphi abahlengikazi abanalo abasizo lwezokwelapha abangenalo ikhono lokuvumelanisa nezinketho ezintsha zokunakekelwa. Ama-paramedics avame ukuchaza ngokucacile izigaba zomkhuba ezigxile ekwenzeni ukunakekelwa kokulondoloza impilo nokuzinza iziguli ngezimo eziphuthumayo. Umqondo wonke wokungenelela kwe-paramedic ukuqinisekisa ukuthi isiguli sithunyelwa ngokuphepha emnyangweni ophuthumayo lapho angathola khona ukunakekelwa okuqondile.
Ama-paramedics angenza ukunakekelwa okugxile esimweni esiphuthumayo, ngokuvamile ngaphandle kokuqondisa odokotela ngqo. Baye baqeqeshwa ekusetshenzisweni kwezobuciko zokunakekelwa kwezempilo ukuze bafinyelele imiphumela efunayo endaweni elula emiphakathini ephuthumayo. Ngakolunye uhlangothi, abahlengikazi, yizinsizakalo zesistimu yezempilo. Bangakwazi ukwenza cishe noma yini udokotela ababuza ngayo. Uma kuyisidakamizwa noma idivayisi entsha, umhlengikazi angasisebenzisa ngemva kokuqondiswa nesevisi esebenzayo nezinkinga ezithile. Ukuthi ukuhambisana nokulingana yisona sizathu sokuthi kungani abahlengikazi badinga ama-ambulensi we-IFT.
Njengoba izibhedlela seziye zaba izisulu zokunakekelwa kwezempilo, iziguli ezidinga ukuthuthwa kusuka esikhungweni kuya endaweni ziye zagula kakhulu futhi zidinga ukunakekelwa okunzima kakhulu. Esinye sezibonelo ezidlulele kakhulu kungaba iziguli ezingxenyeni ze- extracoral membrane oxygenation (ECMO ) . Lezo ziguli zinomshini othatha igazi lawo emzimbeni wazo, azikhiphe ngaphandle, futhi abuyisele kubo. Uma nje kuphela ukuhlinzwa kokuhlinzwa kwe-cardiac bypass, imishini ye-ECMO manje isetshenziselwa ukugcina iziguli ziphila ezimweni eziningi ezihlukene ngesikhathi eside kakhulu. Uma lezo ziguli kudingeka zisuke kwenye indawo ukuya kwesinye, abahlengikazi, kunokuba bezokwelapha, banikeze ukunakekelwa.
Ukulindela abahlengikazi be-CCT noma abahlengikazi
Esinye sezizathu ezenza abahlengikazi bezokwelapha bezokwenza abahlengikazi be-CCT abahle ngoba banemibuzo efanele ekushintsheni okubucayi esimweni sesiguli. Bangakwazi ukuqaphela izimo eziphuthumayo futhi basabele masinyane ukubhekana nabo.
Yilokho okulindeleke kunazo zonke umhlengikazi we-CCT: isinyathelo esinqunyiwe. Abahlengikazi be-CCT kumele bakwazi ukwenza izinqumo ezingavumelani ngesikhathi sokushisa okwamanje bese bethatha isinyathelo egameni lesiguli. Kumele akulungele ukwenza izinto ngaphandle kokufaka udokotela. Ezimweni eziningi, abahlengikazi be-CCT basebenza bodwa noma nge-EMT ngemuva kwe-ambulensi. Ezweni le-interfacility, ububanzi bokusebenza kwe-EMT bukhawulelwe kakhulu. I-EMTs iqeqeshwe ukuthola izidingo-ngokushesha, izimo ezisongela ukuphila. Ukuguquka kwesimo sengqondo esinezinambuzane ezivame ukuhanjiswa kwe-CCT kudinga umhlengikazi oqinile ukuze aqaphele futhi aqondise.
Abahlengikazi be-CCT kumele bajabule ngezibalo eziyinkimbinkimbi zokudonsa ngaphakathi. Cishe zonke iziguli ze-CCT ziza ne-IV futhi iningi likwazi ukukhipha imithi eyodwa ngesikhathi sokuthutha. Ukuze uphumelele, umhlengikazi we-CCT kumele akwazi ukubhekana ne-spangle ye-spaghetti efana nemigqa engu-IV ephuma ezinkalweni eziyinkimbinkimbi kakhulu. Uzoba nomthelela we-infusions ngesikhathi sokuthutha futhi noma yikuphi ukusebenzisana okuyinkimbinkimbi kulabo abathintekayo abangela isiguli. Ukwenza izinto zibe zimbi nakakhulu, ukucindezeleka kwesiguli esivela endaweni esesimweni esibhedlela esibhekene ne-ambulance enkulu kakhulu, ingashintsha indlela imithi ethile ehlangana ngayo.
Iziguli eziningi ezidinga ukuhamba nge-ambulensi ye-CCT ziyi-intubated futhi zixhomeke ekuqhumeni umoya. Ngokungafani nesibhedlela, abahlengikazi be-CCT abavamile ukuba nomthelela wokuphefumula ukuze babasize. Umhlengikazi we-CCT kufanele alungele ukusetha umoya futhi uxazulule lapho izinto zihamba kahle. Ngaphandle kwalokho, abahlengikazi be-CCT kumele bakwazi ukwenza ukuthungulwa kwe-endotrachial. Kuyinto enye inzuzo kulabo abadinga usizo oluphuthumayo; bebelokhu bexoxa ngokusuka esikoleni sama-paramedic. Ungakhathazeki uma ucabanga ngokufaka isicelo somsebenzi, noma kunjalo. Abahlengikazi be-CCT bavame ukufundiswa ukuba bafundise inkampani ye-ambulensi njengengxenye yenqubo yokuqondisa.
Abahlengikazi bezindiza
Ama-ambulensi akagcini nje ukuhamba emgwaqweni. Baphinde bagweme umgwaqo. Ngokuphathelene nabahlengikazi be-CCT, abahlengikazi bezindiza benza ukunakekelwa okufanayo emoyeni.
Kunezinhlobo ezimbili zemisebenzi yokwelapha indiza: iphiko elihleliwe nephiko elijikelezayo (i-helicopter). Abahlengikazi bezindiza ze-wing bahamba phambili kakhulu. Lezi yimisebenzi efana kakhulu nalokho okwenziwa yizimo eziphuthumayo kuma-ambulensi angu-911. Ama-helicopter wezokwelapha abanikeza ukunakekelwa kokubili kokudluliselwa kwe-interfacility nasezindaweni zezimo eziphuthumayo, ngokuvamile ezindaweni ezihlala emaphandleni noma ehlane.
Ama-helicopter abaqeqeshiwe bezokwelapha, okungenani labo abamukela izigcawu eziphuthumayo, bavame ukuba nomhlengikazi kanye nomuthi wezokwelapha, kanye nomshayeli. Umhlengikazi uhola lapho umsebenzi unemvelo yokuxhumana-isiguli sisuswa esibhedlela esisodwa kuya kwesinye-futhi izinyathelo zezokwelapha zihola ukuhola lapho isiguli sithunyelwa eceleni kwetaba.
Amathimba wezokwelapha aphikisiwe ahlukene kakhulu ezindaweni zabo. Ngokuvamile kunomhlengikazi wezindiza futhi ngezinye izikhathi ukuphazamiseka kwendiza. Ama-crew aphikisayo angaba nezinkinga zokuphefumula ezindizayo, odokotela bezindiza, abahlengikazi bezindiza, kanye ne-EMTs yendiza. Lezi zingcweti zinesibopho sokuhambisa iziguli ezindaweni ezide.
Iziguli ezinamaphiko zivame ukufana neziguli ezigulini ze-CCT. Ngezinye izikhathi, i-ambulensi ye-CCT ihambisa isiguli esibhedlela esibhedlela sezindiza ukuze ihlangabezane nabasebenzi bezindiza ezihleliwe. Ngokuvamile, i-ambulensi evamile yokuphulukisa imithi izokhipha abasebenzi bezindiza futhi ibayise esigulini. Bayolungisa isiguli ngendiza futhi i-ambulensi izohambisa lonke iqembu, isiguli kanye nabo bonke, babuyele esikhumulweni sezindiza ngokuthatha.
Amaqembu Okunakekela Okukhethekile
Njengeqembu elihamba ngezindiza zezindiza elisezingeni eliphezulu, amaqembu okunakekelwa okukhethekile ahlinzekela ukunakekelwa kweziguli ezikhethekile emhlane we-ambulensi yomhlaba. Okuvamile kula maqembu okunakekelwa okukhethekile yiqembu le-neonatal elikhulu lokunakekelwa (ithimba le-NICU). Ngokujwayelekile, kunomhlengikazi okhethekile we-neonatal, ochwepheshe bokuphefumula, kanye nomhlengikazi obelethwe yi-neonatal kulezi zimbulensi. I- EMT izokwenza ukunakekelwa kokushayela nokusekela okunye. Kwezinye izimo, kuzoba ne-EMT yesibili.
Amathimba wokunakekela okukhethekile ayinqunyelwe ukunakekelwa kwe-NICU. Kunamaqembu okhethekile okunakekelwa ngesifo socansi, ukunakekelwa kwenhliziyo, ukunakekelwa kwezingane-cishe noma yisiphi isiguli esithile esikhethekile esingaguli ongacabanga ngakho. La maqembu ajwayelekile kakhulu ezindaweni ezifundiswa izibhedlela, kodwa njengoba amazinga okunakekelwa ahlonyiswa futhi ahlanjululwa, amaqembu akhule ezindaweni ezingaphandle kwamandla ezikoleni zezokwelapha. Amaqembu e-NICU ajwayelekile manje ezweni lonke.