Behaviour at the scene of an accident.

Remember that your behaviour at the scene of an accident will directly influence the actions of the other people present. Be aware of your own safety at all times. Double-check that vehicles, machinery and smokers involved in the accident pose no further threat. Be mindful of spinal injuries. Do not move injured patients unless their lives are in immediate danger. Never leave an unconscious patient's airway unsupervised. If a motor cyclist's helmet is removed, it must be done slowly and smoothly.     

建立灾害事故现场消防紧急医疗救助体系的初步探讨

目的 探讨我国建立消防紧急医疗救助体系的必要性和可行性,进一步完善我国的急救医疗服务体系,提高救援医疗水平.方法 以美国、法国、德国、日本及中国的香港和台湾地区的消防紧急医疗救助体系的信息数据和我国现行的急救医疗服务体系的现状为基本资料,对开展灾害事故现场消防紧急医疗救助体系进行分析和归纳.结果 借鉴国外和港台消防医疗救助体系的先进经验,建立符合我国现阶段国情的新型消防医疗救助体系,填补我国急救医疗服务体系中"现场消防医疗救助"的空白.结论 尽快建立一套科学、完整、高效的灾害事故现场消防紧急医疗救助体系并且发挥其作用势在必行.     

Physician assistants in Australasian emergency departments

A physician assistant (PA) is a university qualified health professional who's primary role is to provide medical care under the direction and supervision of medical staff. This is a new profession in Australasia. The PA is well suited to working in both rural, regional and urban settings that deliver emergency medical care. A perspective is presented on their role and scope of practice within the Australasian emergency care system supported by some early findings from their use in a tertiary ED.     

急诊情景模拟演练在急诊团队配合培训中的应用

[目的]探讨急诊团队在抢救危重病人时的配合培训内容与方法。[方法]采用通过单项操作模拟训练及模拟急诊真实病例进行系统情景模拟演练的方法对44名医护人员进行培训。[结果]培训前后,抢救危重病人时间的差异具有统计学意义(P<0.01);培训后急诊团队合作满意度及专业技术能力提高。[结论]情景模拟演练技术从训练掌握急诊抢救基本技能、非技术能力训练到模拟临床真实病例,进行救治过程中的应急能力训练,可提高急救成员的配合能力,缩短急救时间,从而保证抢救时效性及实效性。     

急诊情景模拟演练在急诊团队配合培训中的应用

[目的]探讨急诊团队在抢救危重病人时的配合培训内容与方法。[方法]采用通过单项操作模拟训练及模拟急诊真实病例进行系统情景模拟演练的方法对44名医护人员进行培训。[结果]培训前后,抢救危重病人时间的差异具有统计学意义（P〈0.01）;培训后急诊团队合作满意度及专业技术能力提高。[结论]情景模拟演练技术从训练掌握急诊抢救基本技能、非技术能力训练到模拟临床真实病例,进行救治过程中的应急能力训练,可提高急救成员的配合能力,缩短急救时间,从而保证抢救时效性及实效性。     

情景教学在临床急诊护理带教中的应用

[目的]探讨一种更为适合护理本科生急诊护理的临床带教方法.[方法]以右江民族医学院附属医院急诊科实习的护生62名为研究对象,按抛币法随机分为实验组和对照组,实验组在进科前通过创设急救情景、进行模拟急救训练后才进入临床跟班,对照组以传统的带教方式(即直接跟班),分别于急诊科实习结束出科和整个实习阶段结束时进行急救理论、急救技能考核,比较两组教学效果.[结果]实验组在出科和实习结束急救理论及技能考试成绩均高于对照组.[结论]情景教学符合人的认知规律,提高了护生学习兴趣和自信心,巩固实习效果.     

Rapid Implementation of Inpatient Electronic Physician Documentation at an Academic Hospital

Electronic physician documentation is an essential element of a complete electronic medical record (EMR). At Lucile Packard Children’s Hospital, a teaching hospital affiliated with Stanford University, we implemented an inpatient electronic documentation system for physicians over a 12-month period. Using an EMR-based free-text editor coupled with automated import of system data elements, we were able to achieve voluntary, widespread adoption of the electronic documentation process. When given the choice between electronic versus dictated report creation, the vast majority of users preferred the electronic method. In addition to increasing the legibility and accessibility of clinical notes, we also decreased the volume of dictated notes and scanning of handwritten notes, which provides the opportunity for cost savings to the institution.     

现场讲解在急诊护理临床教学中的应用

急诊科是急危重症病人最集中、病种最多、抢救和管理任务最重的科室,是抢救病人生命的最前线,同时也是最易产生矛盾纠纷和投诉的科室.护生初到急诊室,面对危急而复杂的场面,往往被紧张的气氛、残酷的场面吓倒,产生恐惧心理,不知从何学起.而面对危急、异常情况时值班护士需迅速、果断地做出反应,准确快速地实施抢救,不可能也不允许边操作边耐心讲解.因此急诊带教工作往往是工作与带教脱节,达不到教学要求.我校与教学医院合作,采取值班护士操作,带教老师负责带领护生在一旁按抢救步骤逐一讲解[1],并配合护生讲解的带教方法,使护生尽快熟悉,适应急诊工作环境,熟练掌握急诊基础知识和急救操作技术,取得了满意的效果.现总结报告如下.     

急诊科情景模拟带教的做法与体会

为适应护理教学改革,培养护生在急诊临床抢救工作中的配合能力,采用情景模拟带教的方式,根据情景分析病情,提出问题,总结抢救过程,提高护生的抢救配合能力,取得了良好的效果。     

Caring for older patients at an emergency department -- emergency nurses' reasoning

Aim. The aim of the study was to use the experiences of emergency nurses to illuminate what constitutes good nursing care for patients 75 years or older transferred to emergency departments. Background. Emergency departments have a medical technical character and the number of visits there increases dramatically as people age. Older patients require increased healthcare services in terms of nursing care, interventions and hospitalizations due to an increased complexity of their problems. For these reasons it is important to study what good nursing care of the older patients consists of at an emergency department from the emergency nurses’ point of view. Method. Ten emergency nurses from a university hospital emergency department in Sweden were interviewed. A thematic content analysis was performed. Results. The study showed that it was necessary to be knowledgeable, to be understanding of the older patients’ situation and to take responsibility for them in order to be able to provide good nursing care. The emergency nurses shifted focus from describing the central aspect of good nursing care to describing what hinders the provision of it. Their experience was that prioritizing medical procedures, everyday tasks and routines threatens good nursing care of older patients in emergency departments. The emergency nurses held that the older patient is often sent to an emergency department where the level of care is not appropriate to their needs. Conclusions. The result can be seen as a challenge for the organization and the nurses in the future; to prioritize differently, thereby maintaining a balance between good nursing and medical/technical tasks when treating older patients. Relevance to clinical practice. The present day healthcare system is not organized to appropriately meet the needs of the older patients. Nurses themselves hold they can better serve the older patient. By sharing their experiences, both can be accomplished.     

情景教学法在急诊临床护理教学中的应用研究

目的:探讨情景教学法在急诊教学中的应用效果。方法:将120名护理大专生随机分为对照组和试验组各60名,对照组采用传统教学法,试验组采用情景教学法开展临床带教,比较两组学生的教学效果。结果:试验组学生的理论成绩、操作技能成绩、预检分诊能力、病情评估能力、急救配合能力得分均高于对照组(P<0.05),试验组学生对情景教学法的满意度为96%。结论:情景教学法在急诊临床带教中开展有利于提高临床教学效果,促进护生急诊救护综合素质的提升。     

Masks of acute pneumonia at an emergency care unit

Clinical studies in an acute medical unit were aimed at the analysis of the onset and clinical appearance of masked acute pneumonia. Such acute pneumonia masks as pulmonary edema, paroxysmal tachycardia, infective toxic shock, acute surgical conditions, hepatitis, pneumothorax considerably complicate the diagnosis of the underlying disease. However, some manifestations typical for acute pneumonia are recognizable. These, in combination with the above misleading symptoms, can be managed properly only provided close comprehensive examination of the patients is carried out.