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8/20/2019 2016-6 DESC MU Le Patient "Main" Aux Urgences
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@giux nk`prijcri dh prkodç`htgqui cu phtgijthc`gs hux urmijnis
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Di ngrnugt ehogtuid vgh dis urmijnis
Nkjstht< piu oçjçqui pkur di phtgijt «`hgj²
Q k u r q u k g ;
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Di phtgijt « `hgj ² hux urmijnis
! Jkj prkmrh``ç, ij pdus it ij « surpdus ²chjs d‗hntgvgtç ci dh lkurjçi ... pgri dh jugt !
! ^kuvijt vu «ijtri ciux² ... ijtri ? urmijnis, ijtri ? pkrtis, ijtri ? odkns ...
! Nkjnipt ci ohsi ku fhthdgtç ; Gd ist «jkr`hd² c‗httijcri hux urmijnis
! Kr, trås piu c‗urmijnis g``çcghtis á dh `hgj
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Di phtgijt `hgj hux urmijnis
Ni « qu‗KJ cgt ²< qui oihunkup ci phtgijts vgijjijt pkur«_GIJ² hux urmijnis !
H ridhtgvgsir …
Yrmijnis « `hgj ² skuvijt quhdgçis ci «pitgtis urmijnis² ku ci « okokdkmgi ² …
Ji phs kuodgir<
Di vçnu cu phtgijt, dh ckudiur, dh jktgkj «c‗urmijni rissijtgi², dh `çnkjjhgsshjni
`çcgnhdi, d‗gjqugçtuci quhjt hux sçquiddis, á d‗i`pdkg, á dh prhtgqui ci dkgsgrs ...
Jktgkj ci mrhvgtç, jktgkj c‗urmijni á cçjgr ku ri-cçjgr
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Jktgkj c‗Yrmijni
Cçjgtgkj cu Dhrkussi
Cçjgtgkj ci d‗Gjstgtut YQ^H ci dh ckudiur
Hpphrgtgkj ci dh jktgkj ci prçlucgni
D ‗h p p r ç n gh t g k
j c i d ‗ u rm i j n i
i s t
g j s th j th j ç i i t h p ph r t g i j
t h u th j t á dh
v g n t g ̀i q u ‗h u s
k gm jh j t.
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Di ngrnugt cis «urmijnis²< uj phrnkurs cu nk`ohtthjt ....
! Di pdus skuvijt gjhchptç pkur dis «pitgtis² urmijnisnegrurmgnhdis trås spçnghdgsçis, tiddis qui dis « `hgjs ²
! Di phtgijt «`hgj² ist SKYLKY_^ `kgjs mrhvi qui dis hutris .... hux urmijnis!
! Httijti phrfkgs trås dkjmui it gjnk`prgsi cis
phtgijts
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Ngrnugt «urmijnis²
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Ngrnugt «urmijnis²<Qri`gir nkjthnt hvin uj `çcingj
! Gjtirrkmhtkgri «`hgj² skuvijt gjnk`pdit
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Qkurqukg d‗ixh`ij ndgjgqui ist-gd sg piuhodi it sg piu pirtgjijt ;
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Nkjnirjhjt dis tijckjs<- >9% shvijt ni qu‗ist uj ckgmt ij `hgddit
- 5% nkjjhgssijt di ripåri hjhtk`gqui cu Qhd`hrgs Dkjmus
- 69% nkjjhgssijt dh fkjntgkj cu FCQ ...
Nkjnirjhjt dis jirfs<
- >9% nkjjhgssijt dh fkjntgkj `ktrgni cu jirf udjhgri á dh `hgj ...
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Ixh`ij rhcgkdkmgqui
! _x phrfkgs jkj prisnrgtis (gjfintgkjs, dçsgkjs ujmuçhdis, trhu`htgs`ishpphri``ijt `gjiurs ...)
! Ndgneçs rhri`ijt nijtrçs, trås rhri`ijt ri-ci`hjcçis
! Qirtgjijni cis gjngcijnis ;
! Qiu ci jissi chjs d‗hjhdysi cis g`hmis
- ^kuvijt< «Gd j‗y h rgij !² - Frhnturis `hd cçnrgtis
- ^gmjis gjcgrints ci dçsgkjs trås piu ku phs cçnrgts
Irriurs rçnurrijtis, frçquijni cis dçsgkjs qug phssijt gjhpiríuis<Duxhtgkj cu dujhtu`, frhnturi cu snhpekëci
Frhnturis GQQ, ohsi cis `çths, gjsthogdgtç it suo-duxhtgkj (GQC)...
Lirsiy jmir, sintgkjs ci tijckj ...
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Ixh`ij rhcgkdkmgqui
Ndgneç ci fhni sthjchrc Ndgneç ij prkjhtgkj ci 89±
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Cg`ijsgkj psynekdkmgquiit mistgkj ci dh ckudiur
! ^kuvijt `giux prgsi ij nehrmi hu ^HY qu‗ijsirvgni spçnghdgsçi Qrgkrgtç ci tkuti urmijni
! Mçjçrhtrgni c‗hjxgçtç, ci `çnkjtijti`ijt, itc‗gjnk`prçeijsgkj Qdhgjti pdus fhngdi
! Sç`kgmji ci d‗hosijni ci nkjsgcçrhtgkj cu
trhu`htgs`i psynekdkmgqui Qhrfkgs dkurc! Dh `hgj 0 «krmhji á phrt it á phrt ijtgåri²
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H d k r s q u i .
...
Dh `hgj knnupi uji pdhni prçpkjcçrhjti chjs jktri
nirvihu
• 8791 «Sei niriorhd nkrtix kf `hj², ek`kjnudi `ktiur it sijskrgid
• Qir`it c‗çthodgr uji «nhrti² cid‗hjhtk`gi fkjntgkjjiddi cu nirvihu eu`hgj
D‗ek`kjnudus ci Qijidc
]gdcir Qijidc
8578-87=6
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Dh surfhni riprçsijtçi ist c‗huthjt pdus mrhjci qui dh phrtgi cu nkrps nkjsgcçrçi ist nk`pdixi
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• Nk``ijt ixh`gjir dh `hgj ;
• Fhut-gd fhgri cis rhcgks ; Xuiddis gjngcijnis ;
• Xuhjc ckgt-kj hppidir di negrurmgij ;
• Xui piut-kj rçphrir hux urmijnis ;
• Nk``ijt fhgri d‗hjisteçsgi ;
• Xuiddis gjfkr`htgkjs hux phtgijts ;
_gsquis, nkjsçquijnis fkjntgkjjiddis, sçquiddis prçvgsgodis ;
• Xuid sugvg ; Chjs nk`ogij ci ti`ps ; Qhr qug ;
• Xuiddi curçi c‗hrrìt ci trhvhgd ; .....
D‗ u rm i j t gs t i is t p h r f k gs i j
p r k g i á u j n i r t h g j c çs h r r k g
Y r m i jtgsti
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Dh rçpkjsi spçnghdgsçi
! Qhrfkgs dkjmui`ijthttijcui ...
! Qhr qug ;
! Qhrfkgs jkj pirtgjijti, phsci vrhgi rçpkjsi
! Qhrfkgs `huvhgsi quhdgtç ci
dh rçpkjsi! Gjtçrìt ci dh quhdgtç
ridhtgkjjiddi ijtri discgffçrijts gjtirvijhjts
Gjtirji
krtek
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Ixpdgnhtgkjs ckjjçs hu phtgijt cis urmijnis
! Di pdus skuvijt
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Hjisteçsgis cgsthdis ij okx c‗urmijni
! @çnkjjhgsshjni cis HD_ á dh `hgj (urmijtgstis itnegrurmgijs)
! _hri`ijt c‗ixpdgnhtgkj ckjjç hu phtgijtDgiu c‗gjlintgkj, iffit rissijtg, tirrgtkgri hjisteçsgç, curçi ci d‗hjisteçsgi, IG
ku sçquiddis pktijtgiddis .....
! Cçfhut ci `htçrgid hchptç, nkjtixti piu fhvkrhodi
FN_
QD
FNY
Qkgjt ci pkjntgkj
Krgijthtgkj hgmugddi
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Mistis ci « pitgti ² negrurmgi ij okx c‗urmijni
! Gjsthddhtgkj cu phtgijt +/-
! @htçrgid< bgt ci suturi lithodi - it ds
!
^nghdytgqui +++! Dkupis mrkssgsshjtis +/-
! Xugc cu phrhmi ;
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Mistis ci « pitgti ² negrurmgi ij okx c‗urmijni
Cis rçsudthtsskuvijt
hdçhtkgris ...
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G``kogdgshtgkjs
! Xuhdgtç cis g``kogdgshtgkjs< mrhjci cgsphrgtç dgç hu `htçrgid cgspkjgodi it `çcingj cçpijchjt +++
!
^kuvijt ci `çcgknri quhdgtç ... tkut piut si vkgr
Ckgmt ci pkrti hvin frhnturi ci Q>
Frhnturi hrtgnudhgri
ohsi Vå`i `çth
Frhnturis GG it
GGG å`is `çths
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G``kogdgshtgkjs
Frhnturi cghpeyshgri spgrkëci cuGV å`i `çth
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G``kogdgshtgkjs
Ckgmt ci pkrti hvin frhnturi ci Q>
Ijtkrsi Q?_> hvin hrrhnei`ijt
ohsi ci Q?
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G``kogdgshtgkjs
Frhnturi cu pkgmjit á L81
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G``kogdgshtgkjs
Qrkohodi rçphrhtgkj hpphrigd ixtijsiur ij zkji Vckrshdi cu ?å`i rhykj
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Ckssgir phtgijt Cknu`ijts
hc`gjgstrhtgfs
Cgfnudtçs ci dinturi / nk`prçeijsgkj !
HS jkj `ijtgkjjç_ijsigmji`ijts chjs di cçskrcri
Qhs ci prçngsgkj nkjnirjhjt d‗hpphrigd ujmuçhd, `hgs gd y h iu uji suturi ! ci
qukg ;Itht cu dgt ujmuçhd ;
Qrisnrgptgkjs ci skrtgi ;Curçi HS ;
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Ckssgir phtgijt
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Nkurrgir c‗uj nkjfråri
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Cçndhrhtgkj c‗HS
Xugc ci dh pirtgjijni cid‗gjfkr`htgkj ;
_hturhmi qug gjvhdgcidi cknu`ijt
Qhs c‗hutkrgshtgkjci skrtgis !
_ijsigmji`ijts quggjnk`oijt
hu `çcingj qug prijc ijnehrmi di phtgijt
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^ugtis it sugvg
! Di sugvg muri rhri`ijt chjs di ckssgir !
! Di pdus skuvijt< hosijni c‗gjfkr`htgkj nkjnirjhjtdis sçquiddis prçvgsgodis, dh curçi cis skgjs, dh curçi
c‗uj HS (fkjntgkj cu `çtgir it phs cis dçsgkjs !)! Ci `ì`i< hosijni frçquijti c‗ixpdgnhtgkjs
nkrrintis nkjnirjhjt di sugvg, dh curçi cis phjsi`ijts, dh curçi ci dh ngnhtrgshtgkj ci dh pihu,
cis strunturis skus-lhnijtis .....
D h pr kuissi n egr ur m gnh di ji su f t ph s !
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Dkrsqui di skgj ist rçhdgsç hux urmijnis
! Yj nirthgj jk`ori c‗çdç`ijts jiskjt phs tkulkurs fhvkrhodis
! Vkgri< dis çdç`ijts skjt tkulkurs
cçfhvkrhodis
Gjtçrìt< rççnegr pkur cçjgr cis hxis c‗h`çdgkrhtgkjFkr`htgkj cis urmijtgstis
Qhrtijhrght hvin uji çqugpi spçnghdgsçi cgspkjgodi …
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_i-pijsir d‗hnnuigd cis urmijnis ci dh `hgj it dh mistgkj cu sugvg
! Xuhdgtç ci dh prgsi ij nehrmi gjgtghdi fkjch`ijthdi
! Nkddhokrhtgkj urmijtgstis +/- spçnghdgsçs hvin çqugpi
negrurmgnhdi cgspkjgodi! Fhngdgtç c‗hnnås hu odkn
Mdkohdi`ijt<Yrmijnis « `hgj ² 0
81% ci d‗ijsi`odi cis urmijnis negrurmgnhdis
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Yji krmhjgshtgkj kptg`hdi cås d‗hnnuigdcivrhgt pir`ittri<
! Yji cg`gjutgkj +++ ci d‗httijti
! Yji cg`gjutgkj cu jk`ori cis gjtirvijhjts
! Yj nkjthnt rhpgci hvin uj `çcingj
! Yj trhgti`ijt hchptç ci dh ckudiur
! Yj cçohddhmi, jittkyhmi it pri`gir ogdhj rhpgcis
! Yj ixh`ij ndgjgqui pirtgjijt hvin prisnrgptgkj ci _x utgdis
! Cis cçngsgkjs rhpgcis, sg oiskgj ij nkjnirthtgkj hvind‗çqugpi negrurmgnhdi
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Kodgmhtgkj ci `kyijs itKodgmhtgkj ci si ckjjir dis `kyijs
Ci ogij fhgri
Qkur tkus dis phtgijts hyhjt ujidçsgkj urmijti á dh `hgj
Xuid qui skgt d‗gjtirvijhjt it dis
nkjtgjmijnis dkmgstgquis
@ g c t tt tg
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