quy trinhcap cuu

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  • 1. QUY TRNH CP CU BAN U

2. I. QUY NH CHUNG

  • Quy trnh ny c son tho ph hp vi lut bo v sc kho nhn dn, bo h lao ng, Nhng qui nh c bn v t chc cng tc bo h lao ng trong XNLDVSP, cp nht vi kin thc, k thut cp cu ban u vi y khoa th gii c tnh n hon cnh thc t ca XNLD VSP.
  • Qui trnh ny km theo Bn ph lc, l ti liu chnh thc dng cho vic hun luyn trong chng trnhtrin khai HSE. MS ti XNLD VSP .

3. II.NGUYN TCCP CU BAN U 4. II. NGUYN TC CP CU BAN U

  • Mc tiu ca Cp cu ban u:
  • Duy tr s sng.
  • Ngn nga tn thng din tin v hn ch sc chn thng.
  • Gip nn nhn bt lo s, bt au.
  • To iu kin tt cho tr liu chuyn mn tip theo.

II.1.KHI NIM CHUNG 5. II. NGUYN TC CP CU BAN U Khi phi ng x trc mt tai nn khn cp - cp cu vin (CCV) phi bnh tnh, khn trng, thao tc chnh xc, hiu qu. Tun theo cc bc c bn sau: II.2. TIP CN NN NHN CHN THNG TRONG TAI NN 6. II. NGUYN TC CP CU BAN U

  • Trc ht, CCV phi c an ton khng bin mnh tr thnh nn nhn. Xem xt hin trng xc nh cn tn ti yu t gy tai nn khng
  • Nu hin trng khng an ton phi gi ng cu, CCV phi dng phng tin bo h hoc chuyn gp nn nhn ra ni an ton khi cn thit.

II.2.1. Xem xt hin trng:II.2. TIP CN NN NHN CHN THNG TRONG TAI NN 7. II. NGUYN TC CP CU BAN U

      • Nhanh chng gi to: Cu! Cu! Cu! C ngi b nn.
      • Xc nh nn nhn cn tnh khng?
      • Xem xt nhanh nn nhn theo th t u tin A-B-C(ng th - H hp Tim mch).
      • A: Airway -ng thc b tc nghn khng.
      • B: Breathing H hpc b ngng khng.
  • C: Circulation Timc b ngng hocmuc chy t khng

II.2.2. Xem xt nhanh nn nhn k u:II.2. TIP CN NN NHN CHN THNG TRONG TAI NN 8. II. NGUYN TC CP CU BAN U II.2.3.a. Tc nghn ng th II.2.3.b. Ngng h hp M v tai ca CCV khng cm thy hi th ra ca nn nhn, khng thy ngc nn nhn php phng: h hp nhn to mimg qua ming: thi 2 hi y II.2.3. Cp cu ban u: theo th t u tin A-B-C nu:II.2.3.c. Ngng tim, chy mu t Khi mch c ca nn nhn khng cn, lp tc p tim ngoi lng ngc kt hp vi thi trc tip ming qua ming. Nu chy mu ngoi t phi lm ngng chy mu ngay II.2. TIP CN NN NHN CHN THNG TRONG TAI NN 9. II. NGUYN TC CP CU BAN U Cu !, Cu !, co ngi b nan 10. II. NGUYN T C C P C U BAN U Anh c sao khng ? 11. II. NGUYN TC CP CU BAN U 12. II. NGUYN TC CP CU BAN U 13. II. NGUYN TC CP CU BAN U 14. II. NGUYN TC CP CU BAN U 15. II. NGUYN TC CP CU BAN U 16. II. NGUYN TC CP CU BAN U II.2. TIP CN NN NHN CHN THNG TRONG TAI NN II.2.4. Xem xt nn nhn k hai Khng di chuyn hoc xoay tr nn nhn nu khng cn thit, khi cha xc nh cc tn thng. Nu cng lc c nhiu nn nhn, u tin cp cu nn nhn nng trc theo th t A-B-C. Bo c quan y t gn nht cng sm cng tt Ch : 17. III.CP CU NGT TH,NGNG TH 18. III. CP CU NGT TH, NGNG TH Ngt th, ngng th l tnh trng cp cu ti khn v cc t bo no s cht sau 5 pht do thiu oxy Mt s tai nn c th gy nn ngng th, ngt th: in git, ngp nc, nhim hi kh c, bng, rn cn.III.1.KHI NIM CHUNG 19.

  • Th rt yu hoc ngng th khi p m hoc tai st mu nn nhn, m khng cm nhn c c lung hi th ra va khng thy ngc php phng.

III.2. Xc nh ngng th, ngt th III. CP CU NGT TH, NGNG TH 20.

  • Gi h tr cp cu.
  • t nn nhn nm nga trn mt phng cng
  • Khai thng ng th
  • Mt tay nga u, bp mi nn nhn; tay kia nng cm nn nhn, thi hai hi y trc tip vo ming nnnhn (trong khi thi, mt quan st lng ngc nn nhn).

III.3. K thut cp cu h hp nhn to (ming - ming) III. CP CU NGT TH, NGNG TH III.4. nh gi hiu qu, theo di 21. III. CP CU NGT TH, NGNG TH 22. III. CP CU NGT TH, NGNG TH 23. III. CP CU NGT TH, NGNG TH Ch : Thi gian thiming - mingphi lin tc cho n khi bn giao nn nhn cho nhn vin y t. 24. IV.CP CU NGHN NG TH DO SC THC NHOC D VT 25.

  • Nghn ng th do sc thc n hay d vt l tai nn ti khn cp, thng xy ra trong cc tnh hung sau:
  • Va n va ni chuyn, ci a.
  • n khng nhai k, nut vi.
  • Ngm vt trong ming khi chy nhy, chi a.
  • p tr n ung thuc khi tr ang khc.

II.1.KHI NIM CHUNG IV. CP CU NGHN NG TH DO SC THC N HOC D VT 26. IV.2.Xc nh nn nhn b ngn ng th IV. CP CU NGHN NG TH DO SC THC N HOC D VT

  • T th ng:
  • T th ngi:
  • T th nm:

IV.3.K thut cp cu 27. IV. C P C UNG N NG TH DO S C T H C N HO C D V T 28. V.CP CU NGNG TIM 29.

  • Khi xem xt nhanh nn nhn k u pht hin nn nhn khng c mch c p, lp tc phi tin hnh p tim ngoi lng ngc kt hp v thi ming qua ming.
  • Ngoi cc nguyn nhn bnh v tim, trong chn thng, ngng tim thng gp cc tai nn sau:
    • in git.
    • Ngp nc.
    • Nhim c, kh c, rn cn.

V.1. Khi nim chung V. CP CU NGNG TIM 30.

  • Sc mt tm ti, ng t gin to c th bt tnh hn m. Nhng xc nh nn nhn b ngng tim th:
  • Khng cm nhn c mch c, mch bn, mch c tay.
  • Khng nghe c ting tim vng ngc tri.

V.2. Xc nh nn nhn b ngng tim V. CP CU NGNG TIM 31.

  • Khi pht hin tim ngng p, cp cu vin m mnh 2 ci trc ngc nn nhn, thi ming qua ming 2 ln; nu mch c vn khng bt c, bt u tin hnh p tim ngoa lng ngc.
  • p tim ngoi lng ngc cn thc hin u n, nhp khong 60-80 ln/ pht, vi p lc ph hp tim y c mu n cc c quan trong c th. Tng bc thao tc:

V.3. K thut p tim ngoi lng ngc v h hp nhn to V.3.1. p tim ngoi lng ngc V. CP CU NGNG TIM 32. 33. 34.

  • Nu c 2 cp cu vin: 5 ln p tim 1 ln thiming - ming .
  • Nu c 1 cp cu vin: 15 ln p tim 2 ln thiming - ming .

V.3. K thut p tim ngoi lng ngc v h hp nhn to V.3.1. p tim ngoi lng ngc V.3.2. Kt hp h hp nhn to V. CP CU NGNG TIM 35. 5 ln p tim 1 ln thiming - ming . 36. 15 ln p tim2 ln thiming - ming . 37. V.4. Theo di nh gi V. CP CU NGNG TIM 38. Ch : p tim ngoi lng ngc kt hp thi ming-ming lin tc trn ng chuyn n bnh vin V. CP CU NGNG TIM 39. VI.CP CU CHY MU 40.

  • Ngi ta phn bit hai loi chy mu: chy mu trong v chy mu ngoi.
  • Chy mu trong:kh nhn bit, d b b qua .

VI.1. CHY MU TRONG VI.1.1. Quan nim chung VI. CP CU CHY MU VI.1.2. X tr

  • Hn ch, phng nga SC chn thng.

41.

  • Chy mu ngai c th biu hin theo 3 dng:
    • Chy mu ng mch
    • Chy mu tnh mch
    • Chy mu mao mch
  • Mc tiu cp cu chy mu ngoi:
    • Ngng chy mu
    • Phng v hn ch Sc chn thng.
    • Phng v hn ch nhim trng

VI.2.CHY MU NGOI ( S CU VT THNG PHN MM) VI.2.1. Quan nim chung VI. CP CU CHY MU VI.2.2. X tr 42. 43. 44. Ch nh lm Garo rt him ! Gilm Gar ..... Ngi lm ..... 45.

  • Khng nn c ra , st trng vt thng ang chy mu t, vt thng h rng.
  • Khng t vo vt thng si thuc l hoc c nhai dp.
  • Khng c rt d vt ra khi vt thng nu c.
  • Gar c ch dnh x dng rt hn ch!
  • Khi t garo phi tun th qui tc an tan

Ch : VI. CP CU CHY MU 46. VII. D PHNG V HN CH SC CHN THNG 47.

  • Sc l mt bin chng nng thng xy ra sau chn thng nng gy au n, mtnhiu mu hoc bng nng, mt nc, ng c
  • Nguyn nhn thng do ng c cp, rn cn, cc bnh ni khoa cp tnh.... trong chn thng sc thng xy ra khi b a chn thng, vt thng mt nhiu mu, bng nng, gy xng.

VII.1. Khi nim chung VII. D PHNG V HN CH SC CHN THNG 48.

  • Nn nhn nm nga chn k cao hn u khong 40 cm.
  • T th khi nghi ng chn thng u, gy xng chn, ct sng
  • T th khi nn nhn b nn
  • T th khi nn kh th, nghi ng chn thng vng ngc, gy xng sn

VII.4. Mt s t th hn ch sc VII. D PHNG V HN CH SC CHN THNG VII.2. Xc nh sm sc chn thng VII.3. X tr 49. VII. D PHNG V HN CH SC CHN THNG 50. VII. D PHNG V HN CH SC CHN THNG 51.

  • Lm ngng chy mu t.
  • Gi m, cho nn nhn, c th cho ung nc m.
  • Cc ng tc cp cu phi nh nhng thn trng trnh gy au n cho nn nhn.
  • Trnh di di nn nhn khi khng tht cn thit

VII.5. Ch : VII. D PHNG V HN CH SC CHN THNG 52. VIII. CP CU IN GIT 53.

  • in git thng lm tim ngng p, d a n t vong. Khi b in git nn nhn c th b tn thng thm nu ng t trn cao xung. Nn cp cu in git phi:
    • Cp cu ngay lp tc.
    • Cp cu ti ch
    • Cp cu kin tr lin tc.

VIII.1. Khi nim chung VIII. CP CU IN GIT Tch nn nhn ra khi ngun in l vic u tin VIII.2. K thut cp cu: p dng II, III v V 54. IX. NGP NC 55.

  • IX.1. Khi nim chung
  • Nn nhn b ngp nc thng trong tnh trng bt tnh, ngng th, ngng tim, h thn nhit do lnh.
  • IX.2. X tr: tham kho II, III v V
  • nh gi v tin hnh cp cu nn nhn theo A-B-C ng thi m cho nn nhn
  • Ch :
  • Khng mt thi gian cho cng vic lm nc ra khi phi

IX. NGP NC 56. X.BNG 57.

  • Bng l mt loi tn thng rt phc tp do cc tc nhn khc nhau gy nn ,c th dn n nhiu bin chng nghim trng, thm ch t vong.
  • Cc yu t gy bng:
    • Do nhit.
    • Do lnh.
    • Do ho cht