Basa revanamukoti vakanyoreswa Vanoda kuva kunze
Paramedics vanotora matanho emabasa avo ezvokurapa uye vanyoresa kuchikoro chekurera vanowanzozviwana zvakare mubhizinesi rekutakura varwere kana vawana mvumo. Inowanzoziva uye inonyatsokodzera basa racho. Paramedics dzinodzidza kufungidzira zvisingabatsiri munguva yechirwere uye inogona kukurumidza kukurumidza kana chirwere ichi chichikurira.
Ivo havawanzoshanda sevashandi vezvematongerwo enyika. Panzvimbo pezvo, vekare vehurumende vanozviwanika munzvimbo dzakagadzirirwa vanachiremba kunze kwemaitiro eRN akafanana neaya muzvipatara nemakiriniki. Kusiyana nemafambisirwo emapurisa ekurasikirwa, ayo anotungamirirwa nokupindura nhamba dze 911 uye mamwe mabasa epfungwa, kuendesa kutora mabasa kunotarisa pane kutakura varwere pakati pezvivako.
Kuva weperiki asati ava mukoti hachisi chinhu chinodiwa kuti utakure unesi. Vazhinji vanamukoti vakanyoreswa vakakodzera zvakakwana kune iyi indasitiri. Vanamukoti vakawanda havazive kuti mabasa aya aripo kana kuti havazivi kuti vangapinda mavari sei.
Chirwere cheSylos uye Interfacility Transportation
Kuti upe hutano hwakanaka uye huine mari, zvipatara zvakanyanya kunyanya kumira mumashandiro avanoita pane imwe nzvimbo. Mumakore ekuma1990, zvipatara zvakatanga kutamira kure nemasangano makuru ayo aive akajairika uye akakwidziridzwa aigona kutora nzvimbo yose.
Zvipatara zvevana zvinonyatsozivikanwa nekusaisa zvachose varwere vakuru-kana kungorega kutarisira vanhu vakuru kune zvipembenene uye zvekuita mabasa evanhukadzi.
Kune zvipatara zvakatsaurirwa neurology uye zvimwe zvakatsaurirwa kuhupenyu. Dzimwe nguva, chipatara chichaparadzaniswa kuva maviri kana kupfuura mamwe makambani kuti ape rubatsiro rwakakwana rwekuchengetedzwa kwakanaka mune imwe kana maviri nzvimbo dzakasiyana.
Zvose izvi zvinoshandiswa zvinoshandisa kushandiswa kwemashumo ekufambisa varwere pakati pezvivako. Chii chinozivikanwa mumakambani emabulensi sezvo sangano rekugadzirisa (IFTs) .
Ambulisheni vave vachipa hurumende yeHTT kwemakore mazhinji vachishandisa varapi vezvematongerwo enyika uye vezvehutano vezvehutano (EMTs). Mune zvimwe zviitiko, varwere vaida kutarisirwa kunze kwehuwandu hwemhizha yehutachiona kana EMT . Apo izvo zvakaitika, kazhinji chipatara chichatipa mukoti kana chiremba kuti aende nemurwere kusvika kune imwe nzvimbo.
Zvipatara-based providers vanotasva pamwe nechekunze kwema ambulensi kuti vatarisire zvakanyanya kudarika nhasi. Kunetseka kwehutano uye vanopa 'nyaradzo yepamusoro nekubata kutarirwa kwevarwere mumamiriro ezvinhu akasiyana-siyana kwakatungamirira kune zvipatara zvakawanda zvisingabvumiri vatarisi vavo kuenda neamulensi. Saka, ambulensi yakatanga kuuya nevanamukoti, uye kutakura kwekutakura kwekutakura (CCT) yakamera yakazvarwa.
Kutarisira Kunokosha Kutakura
CCT (dzimwe nguva inonzi SCT, yehutano hwekuchengetedza kutakura) ndiyo yakasiyana yehutano kunze kweyoye ambulensi 911. Hurumende imwe neimwe ine mirairo yayo pachayo painouya kuEEMTs, varayiriki nevanamukoti, asi zvakakosha zvakanyanya zvakafanana.
Paramedics inoshanda pakumira mirairo (inowanzonzi mirayiridzo kana mitemo ) inokurudzirwa nachiremba vatungamiri vezvokurapa.
Mune dzimwe nyika, varapi vakwegura vanopiwa mvumo apo dzimwe nyika dzinozviona dzichivimbiswa. Vamwe vangareva kuti musiyano hauna maturo panguva yekushanda kwekushanda uye inongoshanda chete munharaunda yepamutemo. Handizopindi mune izvi pano kunze kwekutaura kuti kukwana kwemvumo yepamutemo mune zvematongerwo enyika akawanda ndiko kukurudzira vanamukoti vachikwira kumashure kwema ambulensi kuti vatarise.
Vanamukoti ndeyekuenderera mberi kwevanopa rubatsiro. Vanamukoti vanoita maoko-pane hutano hwezuva nezuva hunodiwa nevarwere muchipatara. Vanachiremba vanoita zvisarudzo uye vanoita dzimwe nzira dzinoshandura zvakananga mamiriro ekurapa-chirwere, semuenzaniso-asi kuchengetedzwa kwekutevera kunenge kwakanyatsotungamirirwa nakoti.
Apo chiremba anoita chisarudzo chekutarisira, anorayira iyo inowanzozadzirwa nemureri.
Ko vanamukoti vane avo vanobatsira varapiriniki havasi kukwanisa kugadzirisa maitiro matsva ekutarisira. Paramedics inowanzonyatsotsanangura zvinyorwa zvekuita izvo zvinowedzera kupa nekuchengetedza upenyu nekuchengetedza kune varwere munguva dzenjodzi. Pfungwa yose yekupindira kwepamuviri ndechekuita chokwadi kuti murwere anonunurwa akachengeteka kune dhipatimendi rekukurumidza uko iye anogona kugamuchira kuchengetedza kwakakwana.
Paramedics inogona kunyanya kutarisirwa mumamiriro ezvinhu ekukurumidzira, kazhinji pasina kutungamirirwa kwechiremba chaiyo. Ivo vakarovedzwa nenzira yekushandiswa kwehutano hwehutano kuti vawane zvidikanwi zvakadikanwa munzvimbo dzakasiyana-siyana dzemamiriro ekunze. Vanamukoti, kune rumwe rutivi, ndiwo magwaro ehutano hwehutano. Vanogona kuita chero chinenge chiremba achikumbira kwavari. Kana iri mushonga mutsva kana chipangizo, mukoti anowanzozvishandisa mushure mekutarisana ne-in-service pamashandisirwo ake uye zvinetso. Izvozvo zvakakonzerwa ndicho chikonzero nei vanachiremba vachidikanwa kuIndaneti maAmbulensi.
Sezvo zvipatara zvakagadzirwa kuva utano hwehutano silos, varwere vanoda kuendeswa kubva kuchipatara kusvika kune zvigaro vave vava kurwara zvikuru uye vachida kubatikana kwakanyanya kwakaoma. Chimwe chezviitiko zvakanyanyisa kuve kuve varwere pamusana pekuwedzera membrane oxygenation (ECMO ) . Varwere ivavo vane mishonga inotora ropa ravo kubva mumitumbi yavo, ichiipinza kunze, uye ichidzorera iyo kwavari. Pane imwe chete kungofanirwa kwepfungwa mukati mekuvhiya, magetsi ECMO ari kushandiswa kuchengetedza varwere vari vapenyu mumamiriro ezvinhu akasiyana-siyana mumafaira akawanda kwenguva yakareba. Apo varwere ivavo vanofanira kutama kubva kune imwe nzvimbo kuenda kune imwe, vanachiremba, panzvimbo pevashandi vepamapfungwa, vanopa rubatsiro.
Zvatinotarisira zveCCT kana vadzidzisi veSCT
Chimwe chezvikonzero izvo vekare vakashandura mishonga vanoita zvakanaka CCT vanamukoti ndechokuti vane mhinduro dzakarurama kune kuchinja kwakanyanya mumamiriro ezvinhu evarwere. Vanogona kuziva zvinoitika uye vanoita nokukurumidza kuti vataure navo.
Ndicho chirevo chakakosha zvikuru chemukoti weCCT: chiito chekusarudza. CCT vanamukoti vanofanira kunge vachikwanisa kuita zvisarudzo zvisingabvumirwi mumhepo panguva iyo uye kutora matanho panzvimbo yemurwere. Anofanirwa kunge akagadzirira kuita zvinhu kunze kwechipo chechiremba. Muzviitiko zvakawanda, CCT vanoita basa roga kana kuti neEEM kumashure kwema ambulensi. Munyika ye interfacility, huwandu hweEEMT hwekuita huri shoma. EMTs akadzidziswa nguva pfupi-kuda, mamiriro ezvinhu anotyisidzira upenyu. Kunyanya kufanana nemamiriro ezvinhu emurwere mamiriro ezvinhu anowanikwa muCCT kutakura anoda mukoti ane simba kuti azive uye atarise.
CCT vanamukoti vanofanira kuva vakasununguka nezvakaoma zvakawandisa zvinokonzera kuverenga. Vanenge vose veCCT varwere vanouya neAv uye vazhinji vane kunyanya kushandiswa kwemishonga kunoshanda panguva yekutakura. Kuti zvibudirire, mukoti weCCT anofanira kunge akakwanisa kubata spaghetti-se tangle yemiganhu IV iyo inyoka kubva kune yakaoma zvikuru varwere. Achave ari kukonzera kushungurudzika panguva yekutakura uye chero kuwirirana kunokonzerwa nevanoshungurudzwa vanoita mukati memurwere. Kuita kuti zvinhu zviwedzere, kushungurudzika kwemurwere ari kubva kuchipatara chisinganyatsochengetedze kusvika kune mhepo inofara, yakakura inogona kunyatsochinja nzira iyo mamwe mishonga inobatanidza.
Vakawanda vevarwere vanoda kutasva muCCT ambulense intubated uye ventilator-vanovimba. Kusiyana nechipatara, vanachiremba veCCT havana kazhinji vane chirwere chekufema kuti vavabatsire. Mukoti weCCT anofanira kunge akagadzirira kuisa ventilator uye kunetseka kana zvinhu zvisingakanganisi. Kunyanya, vanachiremba veCCT vanofanira kunge vachigona kuita endotrachial intubation. Ndiyo imwezve rubatsiro rwevaya vaimbova mishonga yepamusoro; ivo vave vachinyora kubva kuchikoro chepachikoro. Usafunganya kana iwe uri kufunga nezvekushandira basa, zvakadaro. CCT vanesi kazhinji vanodzidziswa ku intubate nekambani yeku ambulensi sechikamu chekutungamira.
Flight Nurses
Ambulance haisi kungotsika mumugwagwa. Vanowirawo pasi mumugwagwa. Zvine chokuita nevanamukoti veCCT, vanachiremba vari kumhanya vanoita zvakanyanya kufanana mumhepo.
Iko kune marudzi maviri ehurumende yekufambisa inoshandiswa mabasa: aigadziriswa wing uye rotary wing (helicopter). Rotary mapairi anomhanya vanamukoti ndivo vanozivikanwa kwazvo. Aya ndiwo mabasa akaenzana zvikuru kune avo vanofambisa mishonga vanoita ma 9 ambulensi. Helicopter vashandi vezvokurapa vanopa rubatsiro rwekugadziriswa kwe interfacility uye munzvimbo yekukurumidzira, kazhinji mumaruwa kana murenje.
Helicopter vashandi vezvokurapa, kunyanya avo vanopindura zviitiko zvinokurumidzira, vanowanzowanzobatwa nemureri uye mishonga yepamuviri, pamwe chete nomutyairi wengarava. Mukoti anotungamira apo basa iri rekushandura-murwere ari kutamirwa kubva kune chimwe chipatara kuenda kune imwe-uye chirwere chinotarisa chinotungamirira kuti utungamirire apo murwere ari kutumirwa kubva kurutivi rwegomo.
Vashandi vezvokurapa vane hutano hwakasiyana-siyana vari mumhando dzavo. Iko kazhinji kanoti mukoti anomhanya uye pane dzimwe nguva chirongwa chekuendesa ndege. Fixed-wing crews vanogonawo kuva nemapurisa ekudzidzira kuputira, vanachiremba vendiza, vacheti vanodzika ndege, uye ndege EMTs. Vashandi ava vane mutoro wekutamisa varwere pamakungwa marefu.
Mafungiro ehutachiona anowanzofanana zvakafanana nevarwere vari mumatunhu eCCT. Dzimwe nguva, chirwere cheCCT chinosunungura murwere kubva kuchipatara kusvika kudivi rekudenga kuti asangane nevashambadziri vanoenda kunhandare. Kazhinji kacho, chirwere chemajeri chinogara chichienderera mberi chichatora vashandi vendiza uye vauye nadzo kumurwere. Vachagadzirira murwere kutizai uye ambulensi inotakura boka rese, murwere uye vose, kudzokera kudivi yepamusoro nekuda kwekutora.
Matambudziko Okutarisira Matambudziko
Kungofanana neboka rakagadziriswa remapirisa rezvokurapa, mapoka ekuchengetedza mazano anopa hutano hwevanhu vanorwara vane hutano mushure meguru rembulensi. Nyaya inonyanya kukosha yezvikwata zvekuchengetedza iyi ndeye neonatal intensive care unit (NICU) team. Kazhinji, kune chiremba anonyanya kuberekwa neonatal, muongorori wemapfupa ekuberekwa neononatal, uye chiremba wekuneatalatal ari mumabhiriji aya. EEMT ichaita kutyaira uye zvimwe zvinotsigira. Mune zvimwe zviitiko, kuchava neEEMT yechipiri zvakare.
Mapoka ezvekuchengetedza zvakasarudzwa haasi kungotarirwa neNICU. Iko kune mikanzvi yemasikirwo ekurasikirwa kwepfungwa, kushushika kwemoyo, kutarisira kwevana-inenge ipi zvayo yehuwandu hwehutano hwehutano iwe unogona kufunga. Aya mapoka akawanda kwazvo munzvimbo dzine dzidzo dzekudzidzisa dzidzo, asi sezvo mitemo yekuchengetedza ichigadziridzwa uye yakanatswa, mapoka anokura munzvimbo dzakanaka kunze kwesimba rezvikoro zvezvoutano. NICU mapoka zvino anowanikwa munyika yose.