practical lesson № 1

Topic № 1: Types of medical aid.
Health care of India
The organization of the treatment-andprophylactic institution. Admission
department. Structure and function.
First aid
A) self-help
B) the mutual
B) help paramedics
(Police, fireman, stewardess, etc.)
2. pre-medical care (pre-doctor care). Рre-medical care provides the nursing personnel:
doctor’s assistant or nurse.
3. The first medical aid. Simple medical manipulations, prophylactic and sanitary-andhygienic measure.
4. Qualified medical aid. Сomplex medical manipulation surgical and therapeutic
profile are performed by a physician, a surgeon, pediatrist, etc.
5. Specialized medical aid. This is aid of narrowly focused specialist: cardiologist,
arrhythmologist, endocrinologist, etc., in specialized treatment institutions.
Health care of India
The system of the delivery of health care to the population in India is
represented by two types of medical institutions: it is public and private
hospitals. There are also private clinics.
The public (state) hospital provides inexpensive medical treatment, and
sometimes free.
In private hospitals, all fully paid for by the patient.
First aid in extreme situation is provided in public hospitals.
Later, the patient chooses the type of medical assistance.
Doctors in India are responsible for their decisions and medical manipulations
in accordance with the law. Complaints will be reviewed by the people's court.
An important problem of the Indian state is a significant level of poverty in the
country and the inaccessibility of quality health care for all segments of the
India spends only 1% of national income on health care.
Other developing countries spend 3%.
But economy and health care is growing at a rapid pace lately.
Health сare India demonstrates success in different directions.
Indian doctors performs surgical operations of varying complexity at a high level.
Basic surgical directions - cardiac surgery, оncology, bone marrow transplant, the
transplant kidney. The efficiency of treatment of stenocardia in India is 99%. In the
United States of 97%.
In India is rapidly developing the medical insurance. Now 100% of India's
population have the health insurance and can get free the medical care.
5.Производство медицинского
оборудования быстро развивается. В
настоящее время 35% медицинского
оборудования делают в стране.
Совместные предприятия создаются
для производства медицинского
Израильская компания «Elbit Medical
Imaging» намерена осуществить в
Индии ряд проектов:
• строительство больницы и центра
исследований в Калькутте.
• строительство в Индии научно–
производственного центра по
исследованию стволовых клеток.
• проект по изучению возможности
уничтожения фиброзных
опухолей при помощи
ультразвука без хирургического
• открытие медицинского колледжа
и школы медсестер.
Сегодня Индия является лидером в
производстве медицинских
препаратов (на втором месте
находится Китай, на третьем Бразилия).
Production of medical equipment is evolving
rapidly. Now 35% of medical equipment are doing in
the country.
Joint ventures are created for the production of
medical equipment, such as «Siemens», «GE»,
«Philips Medical Systems», «Toshiba», «Hitachi»,
«Boston Scientific» and other.
The Israeli company «Elbit Medical Imaging» plans
to make in India the several projects together with
Indian experts:
• the construction of the hospital and the centre for
biotechnology research in Kolkata;
• the construction scientific-production centre for
stem cell research in India;
• the study of the treatment of fibrous tumors
without surgery (using ultrasound);
• the opening of the medical College and the school
of nursing.
Today, India is a leader in the manufacture of a
medical preparations (in second place is China, the
third - Brazil).
Main directions of the delivery of health care in Russia treatment-and-prophylactic.
Types of the treatment-and-prophylactic institution: Ambulatory
(out-patient clinics) and Hospitals (in-patient clinics)
1.Policlinic. Patients served by the policlinic and at home (without
hospitalization), located in the city.
2.Ambulatory. Patients served in the ambulatory and at home (without
hospitalization), located in a small town.
3.Medico-sanitary department. Task - service workers of industrial enterprises,
consists of a policlinic, hospital, health center, preventorium.
4. Dispensary - specialized institutions in which receive treatment patients with
certain pathology (tuberculosis, skin and venereal diseases, cancer etc.)
5.Station of Ambulance - provides emergency specialized medical aid around
the clock.
6. Women's Consultation – carry out control and treatment of women with
gynecological diseases, and prenatal service.
7. Hospital – carry out dynamic control and treatment of patients around the
8. Clinic - the hospital, which is composed of the Chair of Medical school.
9. Military hospital - a hospital for sick soldiers and disabled veterans.
10. Sanatorium - a hospital in the resort zone, where carry out therapy by natural
and physical methods.
The structure of the hospital:
admission department;
inpatient departments
diagnostic department;
pharmaceutical department.
administration rooms.
Types of hospitalization:
• planned hospitalization. The patient comes to the hospital in the
direction of a doctor from the policlinic or comes to the hospital by
• emergency hospitalization. The patient is admitted to a hospital in
an emergency (acute illness, trauma, injury and other)
• transfer from another medical hospital
Admission department
This department, where provide registration, the initial examination of
patients, sanitary and hygienic processing, providing qualified
emergency aid.
Functions of the admission department:
1. Reception and registration of patients.
2. The medical examination of the patient.
3. Emergency medical aid.
4. Оfficial registration of medical papers.
5. Determination department for hospitalization.
6. Sanitary and hygienic processing of patients.
7. Transportation of patients.
The structure of admissions department:
1. The waiting room - a room for patients and relatives, which should be plenty
of chairs, an information board.
2. Registry - special сabinet where is executed medical records (case history).
3. Examination rooms.
4. Sanitary inspection room is consisting of several rooms: a room for
undressing patients , bathroom or shower room, dressing room.
5. Diagnostic room
6. Isolator
7. The treatment room .
8. Operating room (bandaging room)
9. X-ray room
10. laboratory
11. Room of duty doctor
12. Room of head of department
13. Toilet room (WC)
14. Warehouse for the storage patient’s clothes
The principle of operation of the admissions Department
Принцип работы приемного отделения
registration of patients
medical examination
sanitary and hygienic processing
transportation of patients
• the nurse records the patient data in medical documentation,
• the nurse measures the body temperature
• invites of the doctor of admissions department;
of admission department
Journal of registration of patients and refusal of hospitalization
Medical hospital card (medical history)
Journal of examination for pediculosis
Journal of notifiable infectious diseases
Emergency notification in sanitation and epidemiological institutions
Journal of telephone messages, etc.
• The physician examines the patient in the exam room
• The doctor determines the indications for hospitalization in
• The doctor prescribes the minimum examination in accordance
with the disease.
• The physician provides first aid if the patient's condition is severe
(seriously ill).
• The patient is directly hospitalized in the intensive care unit, if
the patient's condition is critical.
• The doctor determines the volume of sanitization.
Types of sanitary and hygienic processing:
• complete processing
• partial processing.
The algorithm complete sanitary and hygienic processing:
examination of the hair and skin (detection pediculosis);
grooming of nails and hair (if needed);
shaving (if needed);
take a shower or hygienic bath.
Partial sanitary and hygienic processing is partial wash and wiping the skin.
Partial processing is performed if the patient in critical condition.
The structure of sanitary
inspection room
a room for undressing patients where patients undress and are inspected.
Shower or bathroom, where patients take a shower or bath.
Dressing room where patients dress in clean clothes.
Clothes of patients is delivered in a warehouse.
If the patient revealed an infection, his clothes is delivered in the disinfection chamber.
The patient is placed in isolator or hospitalized to the infectious diseases hospital.
Examination of the skin and hair of the patient is carried out with the purpose of case
detection pediculosis.
Pediculosis - a specific parasitism of lice on human, which feed on its blood. Louse vectors of typhus and relapsing fever and other rickettsial diseases.
Types of lice:
A) Head louse
B) Body louse (louse on clothing)
С) pubic louse (epidemiological do not matter)
1. Спецодежда для медсестры(
дополнительный халат,
косынка, медицинские
перчатки, клеёнчатый фартук.
2. Педикулицид( «Ниттифор»,
«Медифокс» и др.)
3. Столовый уксус( 6 % раствор
уксусной кислоты)
4. Расчёска
5. Клеёнка
6. Косынка
7. Шампунь
8. Полотенце
9. Мешок для грязного белья
10. Контейнер с дезинфицирующим
Processing hair of the head with
1. Protective clothes for nurses (medical
gown, additional medical gown,
medical cap, oilcloth apron, gloves)
2. The solution against lice. For example Pedikulitsid ("Nittifor" "Medifoks",
3. Vinegar (6% acetic acid solution)
4. Comb
5. Oilcloth
6. Kerchief
7. Shampoo
8. Towel
9. Laundry bag
10. A container with a disinfectant solution
1. Надеть спецодежду.
2. Расстелить клеёнку, усадить
пациента на стул или кушетку.
3. Нанести препарат на волосы
4. Повязать на голову косынку и
выдержать необходимое время,
методическим указаниям на данный
5. Смыть препарат тёплой водой с
6. Ополоснуть волосы 6% тёплым
раствором столового уксуса
7. Тщательно вычесать вши и гниды
частой расчёской.
8. Произвести дезинфекцию
предметов ухода и спец одежды.
9. Внести запись в медицинскую карту
пациента( на титульном листе обозначение « P»)
10. Обработать помещение.
Algorithm of actions:
1. Wear protective clothes.
2 . Spread out oilcloth, seat the patient on a
chair or couch.
3 . Apply the medication to the patient's hair .
4 . Wear a kerchief on head and sustain the
necessary time, according to methodical
instructions on the medication.
5 . Wash off medication with warm water and
with shampoo.
6. Rinse hair with warm water and 6% vinegar.
7. Carefully comb out lice and nits louse with
8. Disinfect object of care and protective
9. Make an entry in the patient's medical
document. Marking «P» on the title page of
Medical hospital card (medical history)
10 . Process the room.
1. На носилках
2. На кресле-каталке
3. Пешком (в сопровождении
медперсонала – санитарки
и , или медсестры)
Необходимо учитывать
состояние пациента.
The doctor determines the method of
transportation of the patient in the
1. On a stretcher (gurney)
2. A wheelchair
3. On foot (accompanied by medical
personnel - nurse)
Necessary take into account the patient's
22/Транспортировка пациента на
1. Поставить каталку
кушетке(кровати), головной
конец каталки
к ножному концу кушетки.
2. Поднять пациента, повернуться
на 90° в сторону каталки.
3. Уложить пациента на каталку,
укрыть его.
4. Везти по отделению головой
вперёд, чтобы оценивать
возможные изменения
состояния пациента.
5. Приставить в палате головной
конец каталки к ножному концу
6. Поднять пациента, повернуться
на 90° ,положить его на
7. Обработать каталку.
8. Сбросить ветошь и перчатки в
Transportation a patient on a
1. Wear gloves.
2. Put the stretcher perpendicularly couch (bed),
put the head end of stretcher to the foot end
of the couch (bed).
3. Raise the patient, turn in the direction of
stretcher on 90 ° .
4. Place the patient on a stretcher, cover him.
5. Carry the stretcher (roll the gurney) in the
department by head forward to evaluate
possible changes patient’s condition.
6. In the ward put the head end of the stretcher
to the foot end of the bed.
7. Raise the patient, turn on 90 °, put him on the
7. Process the stretcher.
8. Put rags and gloves in disinfectant.
Способы перекладывания
При участи трёх медработников
• Первый подводит руки под
голову и лопатки пациента;
• Второй подводит руки под таз
и верхнюю часть бёдер;
• Третий подводит руки под
середину бёдер и голеней.
При участии двух медработников
Первый подводит руки под
голову и туловище пациента;
Второй подводит руки под таз
и середину бёдер.
Methods for shifting the patient:
With the assistance of the three medical
personnel of department:
• The first nurse supports the head and sсapula
of patient;
• The second nurse supports the pelvis and the
upper thighs;
• The third nurse supports the center of the
thighs and lower legs.
With the assistance of two medical personnel of
• The first nurse supports the patient's head and
• The second nurse supports the pelvis and the
center of the thighs.
24/Транспортировка пациента
на кресле-каталке:
1. Обеспечить безопасную
транспортировку зафиксировать тормоз.
2. Поддерживая пациента,
усадить его на креслокаталку.
3. Поместить руки пациента на
4. Ноги пациента поставить
на подставку для ног.
5. Снять каталку с тормоза и
транспортировать пациента
в отделение.
6. Обработать кресло.
7. Поместить ветошь и
перчатки в дезраствор.
Transportation the patient on a wheelchair:
1. Ensure safe transportation - fix brake.
2. Supporting the patient sit him to a
3. Put patient’s hands on the armrest.
4. The patient's legs put on a footrest.
5. Remove the wheelchair with brakes and
transport the patient to the department.
6. Process wheelchair.
7. Put rags and gloves in disinfectant solution.