Isu tose tinoziva kuti ambulensi inopindura kune 911 nhare , ichimhanya pasi mumugwagwa nechekuchema nekurira uye mwenje ichipenya. Vachipatara vari munzira yekuponesa upenyu. Pavanosvika panzvimbo yacho, vanozotora mamiriro ezvinhu uye vanowana mhinduro kumatambudziko. Murwere achasimbiswa uye anotungamirirwa kune dhipatimendi rekukurumidzira kuti atarisire.
Kune mifananidzo yakawandisa yemamulensi mumusangano. Paramedics uye vashandi vekurapa vekukurumidzira (EMTs) vanowanzofananidzirwa sevanoponesa vari munjodzi. Asi kubata mamiriro ekukurumidzira haisi iyo nzira chete yevashanduri vehurumende uye EMTs vanobatsira kuhutano hwehutano. Muzvokwadi, zvichida haisi iyo nzira yakajairika iyo vanotarisira varwere.
Ambulance inosunga hutano hwehutano pamwe chete. Pasina ivo, zvakawanda zvemari-mari yawanikwa nhasi haingakwanisi (hongu, kune mazano ekugadzirisa mari muhutano hwehutano).
Kuparadzana Kwevarwere
Zvipatara zvakatanga kunze kwechikwata chemaimba apo vanachiremba vaigona kubata varwere vakawanda munzvimbo imwe. Vasati vashandiswa zvipatara, vanachiremba vakangoita vashanyira varwere mumisha yevarwere. Zvipatara zvakabvumira varwere vane zvishoma zvinoreva kukwanisa kuonekwa navanachiremba.
Pakupedzisira, zvipatara zvikava zvitoro zvemaoko, apo varwere vaigona kuwana mhando dzose dzebasa.
Kunyange zvipatara zviduku mumaruwa zvinogona kupa vana uye kuita chirwere. Pasinei nechipatara chaiva nemabhedha mashomanana kana mazhinji, huwandu hweshumiro hwaizova hwakafanana kunyange kana hutsika hwakasiyana zvikuru. Murwere aigona kutsvaga rubatsiro kune chero nhamba yemamiriro ezvinhu.
Zvipatara zvakashandurwa kuva zvikwata zvemadhidhi, makamuri makuru ane mabhedha akawanda evarwere.
Kazhinji, mapadhi echipatara aizoparadzaniswa namatare nehutano uye nerudzi rwevarwere: Kubata uye Kuendesa, Zvokurapa, uye Kuvhiya kwaive mamwe emadhidhi aiwanzoshandiswa. Gare gare, mapurisa ekukurumidzira (kana kuti makamuri) aizokura. Vamwe vangavewo vane nzvimbo yakasiyana yekurapa.
Healthcare Silos
Kunyange zvazvo zvipatara zvaive nevarwere vakaparadzana mukati memadhidhi, ivo vose vaisvika pane imwe imba. Muhutano hwemazuva ano, haisi nguva dzose. Sezvo kutarisira kwemwoyo murefu kunowedzera zvakanyanya, zvinonzwisisika kusimbisa zvirwere zvevarwere muzvipatara zvakatsaurirwa kune zvigadzirwa.
Kune zvipatara zvekuvhiya, uko kunongorongerwa zvirongwa zvekuvhiya, zvakadai sokugadziriswa kwechikafu kana kuvhiyiwa kwekuporesa. Emergency or unscheduled procedures inobatanidza nemamiriro akaoma akafanana neappendicitis kana kushungurudzika zvinoponeswa kuzvipatara zvine maitiro ezvimwe zvetsika kana zvimwe zvezvipatara zvakasiyana.
Kune ikozvino zvipatara zvakatsaurirwa kuvakadzi nevana, matambudziko epfungwa, zvirwere zvepachiviri, zvipatara zvipatara, kenza nzvimbo; kunyange septicemia. Chimwe nechimwe chinogona kuiswa pasi pechipatara kana mune imwe nzvimbo nezvose zvinotarisirwa navanachiremba kutarisa pane imwe nhengo yevarwere.
Nzira Yokufamba Nzvimbo Nzvimbo
Iyi maitiro ehutano inokosha kune hutano hwakakura hwehutano hwakasiyana nevarwere vakasiyana-siyana.
Kuti vashumire varwere, masangano aya anofanira kuva nezvipatara zvakasiyana-siyana apo varwere vanogona kutsvaka rubatsiro, asiwo kukwanisa kuendesa varwere ivavo kumutero wakakodzera wekutarisira munzira isingatengesi kutarisirwa kwevarwere. Chipatara chinotungamira sei varwere kubva munzvimbo kuenda kune imwe nzvimbo?
Ambulance.
Nhoroondo yemamulensi inotarisa kushandiswa kwavo sekufambisa kwakakurumidza kwevanorwara nekukuvara kwekukurumidza. Ambulance haisati yatanga kupindura zvinenge zvangoerekana zvaitika pasina. Vaiwanzoendeswa kundounganidza avo vane zvirwere (maperembudzi uye denda, somuenzaniso) uye vanovatora mukurwisa kwavo kuda kwekurapa uye kuparadzana.
Apo ambulensi yakashandiswa pakukurumidza, iyo yaiwanzoshandiswa nezvipatara sekushumira kune varwere vakapfuma. Kushandiswa kwema ambulensi kwekufambisa kwekukurumidzira kwakachinja mune zvehondo. Nyaya inonyanya kuwanikwa yakabva kune yekuvandudzwa kwema ambulensi mumauto aNapoleon.
Mukushandiswa kwema ambulensi yakatanga muhondo, avo vakakuvadzwa kakawanda vakamirira kusvikira hondo ikamira kuti ma ambulensi iuye kuzotora. Chiremba Mukuru weNapoleon Mukuru akaziva kuti kana ambulensi dzakatumirwa kare, dzaigona kuchengetedza hupenyu huzhinji, nokudaro kuderedza kurasikirwa kubva muhondo. Kuvandudza kupona pakati pemasoja kwakanga kusiri kuedza kwevanhu; chaiva chekudzivirira.
Kwete Nokuda Kwokukurumidza
Kubva kutanga, ambulensi haisati iri kungoerekana yaitika. Kutora murwere kumutora kuchipatara ndeimwe yemashandisirwo emu ambulensi. Ambulance inogonawo kufamba-uye yakagara ichifambisa-varwere kubva pane imwe nzvimbo kuenda kune imwe nzvimbo mumamiriro ezvinhu asina kuitika.
Zvimwe zvekare kare maambulensi mazano nhasi akawana kutanga kwavo kuita chimwe chinhu kunze kwekupindura kune kukumbira rubatsiro. Vakawanda vakanga vakagara mune chimwe chipatara uye vaishandiswa kutamisa varwere kuenda kune dzimwe uye kubva mune dzimwe zvipatara, izvo zvichiri kushandiswa zvakanyanya kwema ambulensi. Nhasi, rudzi urwu rwokufambisa runonzi "inter-facility transfer" (IFT). Nokufamba kwenguva, mamwe ma ambulensi akazoshandurwa kuti ape ruzivo rwakazvimirira ivo pachavo.
Kune ambulensi yevanorwara vanorwara vanoshandisa mukoti pane (kana kuti kuwedzera) kune remedicic. Kune maambumba ekurera vana vakagadzirirwa kutakura vana vasati vasvika. Mamwe ma ambulensi ane masangano evanotarisira vanobatanidza vanamukoti, vanachiremba, mapfupa ekufema, vanachiremba, varapi vemapurisa, nyanzvi dzezvehutano dzekukurumidzira, kana dzose idzi.
Continuum of Care
Panzvimbo yekupindura kune zvinokurumidza, ambulensi dzinoita IFTs dzinopa kuenderera kwekutarisira kubva kune imwe nzvimbo kuenda pane imwe. Panguva yekutakura, murwere anoongororwa kuti ave nechokwadi chokuti mamiriro ake ezvinhu haachinje.
Izvozvo hazvirevi kuti dzimwe nzvimbo-yekufambisa nzvimbo haina kukosha zvakanyanya. Mune zviitiko zvakawanda, murwere ari kutamirwa kubva kune imwe nzvimbo isingagoni kugovera kutarisirwa kwekudiwa kune imwe nzvimbo inogona. Mune zvimwe zviitiko, kurapwa kwakakosha kunoenderera mberi munguva dzose dzekutakura kunova nechokwadi chokuti murwere anoita kuti ive yakachengeteka uye akagadzirira kugamuchira kutarisirwa kuchipatara chitsva.
Vashandi veICTT ambulensi inokosha chikamu chekurapa kwevarwere. Ivo vari chikamu cheboka rehutano sezvinoitwa nevashandi vezvipatara. Pasina basa iri rinokosha, varwere muhutano hwemazuva ano havangatori kurapa kwavanoda kubva kune vanyori vanogona kupa.
Kudzidzira kukanganisa
Pasinei nokuti ma ambulensi ari kubata zvose zvehutano pamwe chete munyika umo vatapi vehutano vakagadzirirwa muzvikoro zvezvidimbu; uye pasinei nokuti maAgt ambulensi haatopfuura ma ambulensi ari kutaridza nhamba dze 911 (kana kuti kupindura maitiro maviri ezvokukumbira), dzidzo uye mapurogiramu ekudzidzira vezvechiremba vezvehutano nekukurumidzira vanenge vachiri kungotarisa pamusoro pezvinhu zvakangoerekana zvaitika.
Emergency medical technicians vanodzidziswa kubwinya, kuchenesa ropa , CPR , kuponesa kupemha, uye nzira yekugadzirisa varwere kubva mumotokari mushure mekuitika kwechiitiko. Paramedic education inotarisa mukurapa mwoyo nekurwisa varwere. Munhu wese anodzidza kutarisa mamiriro ezvinhu munguva yakawanda yezviitiko zvinouraya (MCI). Zvose izvi zvakakosha kudzidziswa izvo zvisingagoni kuderedzwa, asi muItT setting, haina kushandura.
Zvechokwadi, EMT kana chirwere chepamuviri chinokwanisa kukwanisa kugadzirisa zvakakodzera murwere ane mamiriro ezvinhu anowedzera kamwe kamwe panguva yekuendesa, pasinei kana kutakura ikoko kwakatanga kubva kuchipatara kana kubva kumurwere achidana 911. Sezvo mutyairi wengarairi akadzidziswa kwete kubhururuka paaimirira, asi nokuda kwekuti kana munhu anopindira achipera uye ndege iri mudambudziko, varayiriki uye EMTs vanofanira kunge vakagadzirira zvisingatarisirwi.
Asi mutyairi wacho anodzidziswawo kubhururuka nemunhu anozvipira. Anonyatsoziva pane zvinotarisirwa zvakawanda sezvisingatarisirwi. IEEM haina kumbowana kurovedzwa uku-kunyanya kwete sechikamu chehurumende yepamusoro purogiramu. IEEM haidzidziswe nzira yekuita nayo chaiyo yaachazoshandisa makore mashoma ekutanga kwebasa rake.
Kuchinja Kutarisira
Kuwanda kwema ambulensi inonzi inotungamirirwa nevarwere kubva mune imwe nzvimbo kuenda kune imwe, varwere vanofanira kuda kuti vashandi vanofamba vachida kuita basa. Kana chimwe chinhu chichienda zvakashata, EMT yakagadzirira kupindira mukati, asi zvakadini nekutarisira kuti kutarisira kubva kune imwe nzvimbo yekugadzirira kunoenderera mberi kusingagumi kune yechipiri?
EMTs vanobuda pakudzidzira kwavo kwokutanga vakagadzirira kuchengetedza hupenyu uye kubvisa chirwere ichi. Ndivo mavheti akadzidziswa-mukumirira. Ivo vakagadzirira kumhanya apo vamwe vari kubuda. Asi iyo haisi iyo yavanoita-kwete pakutanga. IEEMT itsva ichaita IFT, kwete nokuti haina kukosha. Vachazoita IFT nokuti zvinotyisa. Haisi kutya "kupisa" nemagetsi achibhururuka uye anodzivirira kubhururuka kuti atore munhu anorwa kubva mumotokari inopisa.
IFT haisi sexy; kunyanya kwete kune EMT itsva.
Izvozvo zvinogona kuchinjwa. Nekudzidziswa kwakanaka kunotarisa kukosha uye maitiro eFTT, EMTs uye varapi vezvematongerwe enyika vachagamuchira basa idzva. Vachazviita uye vanozviita zvakanaka chero bedzi vachiziva zvavanotarisira uye vane zvigadzirwa zvekuita basa.
Varwere vachabatsirwa nehutano hwakasimba hwehutano hwehutano, uko vashandi veku ambulance zvechokwadi chikamu chinokosha cheboka uye kubva kune imwe nzvimbo kuenda kune imwe nzvimbo hakuiti nzvimbo isina simba mukutarisira kwevarwere.
> Sources:
> History of Hospitals and Wards . (2016). Healthcaredesignmagazine.com .
> Kufurirwa kwaDominique Jean Larrey pane unyanzvi uye nesayenzi yekununurwa. (2016). Sciencedirect.com .
> Kulshrestha, A. & Singh, J. (2016). Inter-chipatara uye intra-kuchipatara ichiendesa kurwara. Indian Journal Of Anesthesia , 60 (7), 451. ini: 10.4103 / 0019-5049.186012
> Samuels, David J, et al. Emergency Medical Technician-Basic: National Standard Curriculum. (1997) . US Department of Transportation.