WORKING OUT OF SCHEMES OF DECISION-MAKING
AT THE PREHOSPITAL STAGE OF RENDERING OF THE FIRST HELP
Ass. prof. Dubitskiy
A.A.
Medical university
Astana, Kazakhstan
The research urgency is caused by necessity of perfection of
medical-diagnostic actions at rendering of the first help [1].
Formation of system of standardization in public health services passes
now to qualitatively new level focused on rationalization of a control system
by quality of medical aid [2].
The extremely important link is the pre-hospital stage which in some
cases predetermines outcomes and consequences of diseases and traumas, terms of
time invalidity, physical inability reception and a lethality of patients and
victims.
Research objective is working out of interdisciplinary logic schemes of
decision-making at a pre-hospital stage of rendering of medical aid which
allows unifying and standardizing approaches to performance of diagnostic and
medical actions, to define their rational sequence on importance degree.
Realization of structurally functional construction of schemes of
decision-making is based on performance of following consecutive problems:
- Formation of groups of experts and complexes of methods of research at
a pre-hospital stage of performance of medical-diagnostic actions at patients
and victims with allocation of a dominating syndrome;
- Use of uniform methodological approaches in the clinical diagnostics,
the unified and standardized criteria of an estimation of severity level of a
condition of the patient;
- Application of the formalized documentation (registration of all
circumstances of an acute disease or a trauma, possibility of carrying out of
monitoring);
- Use of a mark estimation of severity level of a condition of the
patient and prognostic algorithms;
- Formation of the regional-departmental register of the
treatment-and-prophylactic organizations of pre-hospital and hospital stages
(configuration of specialized branches, technical equipment, an operating mode,
etc.);
- Introduction of geoinformation technology (a territorial arrangement
of the treatment-and-prophylactic organizations, a transport infrastructure,
etc.);
- Maintenance with mobile communication channels of subjects of medical
activity;
- Use of the regulated standards of actions of the doctor of "the
first echelon» (the off taker of medical-diagnostic process) at a pre-hospital
stage (an estimation of conditions menacing to life and carrying out of
corresponding emergency actions, carrying out possible at the given stage of a
medical-diagnostic complex, formation of the clinical diagnosis,
decision-making on rational medical-diagnostic "route" and
hospitalization of the victim in specialized branch).
Thus, stage-by-stage realization of tasks in view and use of schemes of
decision-making at a pre-hospital stage it is directed on a regulation and
standardization of performance of an adequate medical-diagnostic complex with
minimization of time intervals, optimization of functional interactions of
subjects of medical activity and perfection of medical aid by the patient and
the victim with the account stage its performance and real-life structure of
the treatment-and-prophylactic organizations.
The literature:
1. Blohin A.B., Fialko V. A, Vaisov F.D., Kirichenko M. A. A role of
priority methods and forms in maintenance of efficiency of functioning systems
of rendering first help//Sb. Works - «Innovative technologies in the
organization and public health services economy, NPTS of problems,
Ekaterinburg, 2009. – 164 with.
2. Panteleeva O.T. Basis of the organization first ïîìîùè.//the Manual -
SPb.: SPb. - 2001. - 31 with.