Medical organization should " Get first and examine first " " seriously ill preferably " ?

Medical organization should " Get first and examine first " " seriously ill preferably " ?
Stood in front of the lawyer, Deputy Director of Yan Chai Hospital emergency department Chen Yi felt wronged. They are confronting each other for the medical dispute of the emergency call: A big 19 -year-old child gets myocarditis, though get to the emergency ward and see a doctor in time, but because wait too long, has not seen the doctor yet, has closed eyes forever.
The lawyer asks: "Why keep heavy patient wait so long? " Chen Yi is extremely awkward: " We want, deal with 1600 emergency call quantity of people every day, really too busy to do it.
A large number of patients must wait for 2- 3 hours and see the doctor at least. "

This scene took place one year ago. At last, emergency call that ferment for a long time divide, examine 2 month before the system helping the intersection of emergency call and internal medicine department implemented in benevolence quietly - -No longer only foundation " First come, first served " Let the patient wait sequentially, begin to give consideration to " order of importance and emergency " of the condition . The reporter knows in the interview, the emergency wards of more hospitals want to divide and examine the emergency call too, for the moment eager to hope, divide, examine system, can have " The legal identity " ,And make a set of unified standards in the whole Shanghai.
It is not the emergency case that packs the emergency ward
Emergency call doctor yellow to draft the intersection of emergency call and internal medicine department divide for Yan Chai Hospital into and examine the standard first draft while being joyous. He says: "We have consulted Unite States Standard. " The standard divide patient into moderate breeze is critical urgent.
To emergency call doctor, perhaps the one most difficult to judge is in " urgently " With " ordinary " During patient. That big 19 -year-old child was exactly this kind of situation at that time. So-called " ordinary " Grade, mean, have the intersection of emergency call and situation but the intersection of condition and stable, physical sign steady life, can let patient until " first come, first served " Line up to go to a doctor; And " urgent " The patient of grade, have more life dangers, need treating and curing preferably.
In the 80s and 90s of last century, only by having a fever and is higher than 38.5 can it register for the emergency call; But in more than ten years later, " old rules and regulations " Broken, should register for emergency case to make, the emergency ward of the large hospital of the result is huger and huger, full everyday the huger emergency ward is.
6 hospitals such as Xinhua, one city, Zhongshan have united and done an investigation to the emergency call situation, inquire patient's why " Choose the emergency call but not clinic " ,52.6% of the people answer " (because really) " Come down with acute disease " ,And 37.7% of the people say because " the emergency call is checked fast " , 30.1% people say because " whether emergency call waiting time short " ,27.7% people say because " have no time to see the doctor in the daytime " . The investigation of Yan Chai Hospital reveals, in 1100 persons' patient of internal medicine department of emergency call every day, 90% are not actually emergency calls, should advise them to see the clinic.
Distinguish the condition and guarantee to wait safely
"Investigation result explain the intersection of emergency call and overstaffed reason, but we can not what the patient refused outside the door of emergency ward. " Xinhua the intersection of hospital and emergency call Pan ShuMing, director of in the center say, " pursue the emergency call to divide examining the system under this kind of background, in order to guarantee the patient waits safely. " Wait safely, it is in " first come, first served " Wait on the foundation of the system, set up the condition " order of importance and emergency " Sieve check procedure.
Pursue, divide, examine system to be different in the intersection of emergency call and internal medicine department only still with Yan Chai Hospital, Xinhua hospital divide wider coverages that examine, the patient that all 120 ambulances are sent to must too be assigned and examined, the heavy patient sends into and rescues the room directly, the light patient belongs to the ordinary emergency call.
Two fen of hospital examine the standards, fully consider the disease table of today: Old patient's quantity rises year by year now, a lot of old men suffer from several kinds of diseases at the same time, ; Meanwhile, there is more and more acute disease brought out by all kinds of chronic disease, require the hospital to possess stronger rescue ability.
Pan ShuMing says: "Can't already judge the order of importance and emergency of the condition by 38.5 body temperature thread now, should monitored the physical sign of the life. " For this reason, two hospital examine platform allocate " the modern weapon " in fen, emergency call of internal medicine department --The portable heart electricity guards the appearance: So long as grip patient's finger, can obtain data such as intimate dancing, blood pressure, blood and oxygen saturation lever,etc. in half a minute. In general cases, so long as these data are in stabilizing the range, the patient will have no supposition of the life. In the emergency ward of Xinhua hospital, each patient makes the electricity of heart to monitor free. "So long as find the physical sign of the life unstable, the nurse on duty will let the patient go to a doctor preferably, or change over to and rescue the room directly. "
The skillful one is, Yan Chai Hospital assigned to and examined for less than one month the emergency call, ran into the myocarditis patient again, it is a teenager. This time, the life guards the situation that the appearance has found patient's blood and oxygen saturation lever low in time, change it over to rescuing the room at once.
Need making and dividing and examining the standard in unison badly
However, fen implemented for the moment examine the system, the basis is still the standard which the hospital makes by oneself, have " The legal identity " . Chen Yi and Pan ShuMing both say: "We hope urgently the responsible department of the goverment or medical association make one and seek unity of standard, help us to advance this job. " Chief of Shanghai Municipal Health Bureau Xu Jian only says: "It is very important that the emergency call divides examining, it's time to need promoting badly already now. "
The investigation regarding the emergency call divide and examine the system of 6 hospitals reveals, 75.5% of the medical personnel thinks the task of top priority is the standardization, secondly divide the accuracy examined. Reporter investigation find Shanghai every the intersection of hospital and mode of emergency call differ, because medical personnel divide, examine the standard, disagree to emergency call too. The medical association General Board of the emergency call of Shanghai, Rui Jin hospital emergency call, a ring professor in the land of head of the department, say to this: "The medical association has already planned to start and make the emergency call to divide and examine the standard, the present doubt is afraid the patient does not cooperate. "
Pan ShuMing finds, divides and examines the standard, need to assigning and examining personnel to specially train. He encourages fen that the nurse participated in American nurse's test subject to examine the examination, improve and divide the ability to examine accurately. He believes, with having " legal identities " to examine the system to divide , assign, examine personnel, have enough qualification, cooperation of patient degree sure to raise while being corresponding.
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