Today, one of the most sought-after professions in medicine is a doctor. general practice... Almost every resident of the countryside knows who he is. The fact is that it is in the villages that doctors of this specialty work most often.
General practitioner: who is he?
The main difference between doctors of this specialty from others is that they have basic knowledge in each of the branches of medicine. Moreover, they are not required to provide specialized medical care.
Siberian State Medical University
Practical equipment manuals related to health and safety may be made available through national and local jurisdictions. In exceptional circumstances where the practice's physical space is limited and a height-adjustable bed cannot be accommodated, the practitioner should be able to demonstrate why she cannot accommodate a height-adjustable bed, and how the practice safely manages examinations of patients with mobility impairment and protects health and safety personnel.
They should be able to solve relatively simple health problems and deal with the prevention of diseases of a therapeutic, surgical and gynecological profile in both adults and children.
Why are general practitioners prevalent in rural areas?
It is in the villages that you can most often find such a specialist as a general practitioner. All the villagers know who he is. It is in this area that general practitioners are most widespread due to the economic inefficiency of the construction of full-fledged medical and preventive institutions in each settlement and providing work in it for a large number of doctors. From this point of view, it would be much more expedient to create small outpatient clinics in which a general practitioner (family doctor), a nurse and a nurse will work. Such a recruitment of employees will allow the outpatient clinic to provide full medical care to residents of the region attached to it.
In the disability sector, experts reviewed the height-adjustable beds currently available on the market to ensure that the needs of people with disabilities are met. Standard 1 Services and Access Our practice provides a safe and efficient environment for our practice team and patients.
Our practices are suitable for a safe and efficient environment for patients and practice teams
Head of Health Service Reception staff Clinical staff. ... Table 1 explains each of the indicators for this criterion. The following is a description of the ways in which Aboriginal controlled public administration can provide tools that are appropriate for a safe and efficient environment for patients and staff.
For rural areas far from large centers, a general practitioner becomes a real salvation. All residents of agricultural regions know who it is, because it is to him that they go first. He is able to carry out the simplest surgical and gynecological manipulations, he is familiar with the therapeutic pathologies of both adults and children.
The service complies with the recruitment guidelines for clinical laboratories and the availability of consultation rooms, so each of its clinical staff has access to a separate, appropriately equipped consultation room when needed.
As its community expands and the number of patients increases, the service is already finding that consultation space is limited. It is currently developing plans to expand its services, including adding at least one more consultation room to continue to provide one fully equipped conference room for each clinician at any time.
How is general practitioner trained?
After graduating from a higher medical institution, this specialist must undergo an internship at one or more clinics. He needs to acquire the skills of a therapeutic, surgical, pediatric and gynecological profile. As a result of such training, he becomes a specialist with general skills in the diagnosis and treatment of diseases in any medical field.
Every time he plans to introduce new or additional services or programs, the service thinks about what space and equipment will be needed to ensure that existing clinical equipment or facilities are not adversely affected.
Each of the conference rooms has control lamps and examination tables. The service has a fully equipped mobile caravan to visit remote areas and provide medical assistance to patients who find it difficult to visit this service.
The service has at least one height-adjustable bed in all of its locations, including the caravan. Because of the many people of childbearing age in their community, the service has opted for a side rail model that can be moved up and down and with stirrups for gynecological examinations when needed.
How is the work of a general practitioner structured?
Prevention, diagnosis and treatment are all the main areas within which a general practitioner conducts his professional activity. His work is based primarily on identifying the risks of developing certain serious diseases in the population living in the area under his control, as well as systematic activities aimed at countering their formation.
Waiting areas at all service locations provide items for children, such as interactive play panels on the wall and children's tables and chairs for children. These include videos and coloring books that feature various pages about promoting children's health, or health quizzes. Waiting areas also include both an internal and external waiting area for patients who prefer to wait outdoors.
This service has male and female patient toilets, including a disabled toilet located in the waiting room, to serve a variety of disabled patients. All toilets have access to hand washing facilities. Inside the building, there are separate hand-washed staff toilets that patients cannot access.
What is required for a specialist to work?
A general practitioner's office should be equipped with a range of tools that aid in the initial diagnosis. We are talking about a phonendoscope, tonometer, glucometer, thermometers, spatulas, laryngoscopes, otoscopes, rhinoscopes, ophthalmological and gynecological equipment. In addition, a general practitioner's outpatient clinic should have the simplest surgical instruments.
The service has its own electrical equipment, which is inspected annually by an independent contractor. All firefighting equipment is inspected and labeled annually by an independent contractor. Ensure that the physical layout of the service includes counseling rooms, toilets and hand cleaners. Provide baby furniture and play equipment.
- Maintain a heating and cooling system.
- Have adequate signage.
- Maintain at least one height-adjustable bed.
Ideally, an outpatient clinic can be equipped with a mini-laboratory. It greatly simplifies the work of a general practitioner. Those from specialists in this field who do not try to equip their outpatient clinic have to constantly refer patients to the district medical institutions for carrying out the simplest laboratory tests (general blood test, general urinalysis, biochemical blood test, and others).
Emergency management is an integral part of primary health care. As the first contact physicians, general practitioners can face any type of emergency. Updated knowledge, communication and procedural skills, trained paramedical staff, necessary equipment and medication and appropriate organization of practice are vital to provide optimal care, which can even save patients' lives. The wide range of problems and the rarity of problems make renewal and the competence of primary health care physicians in the provision of emergency care difficult.
What services does a general practitioner provide to the public?
The work of this specialist is of great importance for the entire population served. Thanks to him, medical care becomes noticeably closer to people. In outpatient clinics, the simplest surgical procedures are performed. In addition, all conditions for injection (including in the form of droppers) administration of drugs have been created here. There is necessarily a small bed fund that allows you to place patients in. That is, the patient can go to the doctor and, if he sees fit, be treated without going to the hospital.
General practitioner: who is he?
Some of emergencies can be completely controlled in general practice, while others should be referred to hospital after initial administration. The extent to which a patient should be managed may be determined by the severity of the condition, the experience of the physician, and the distance to the nearest hospital. In addition to pharmacological management, explanations of the condition and need for admission and appropriate advice on pre-admission care are also important components of management. Writing a relevant referral, organization vehicleInforming the hospital of referrals are also important steps in this process, as these measures can prevent critical delays.
In large outpatient clinics, in addition to the usual specialist, a general dentist can also work.
In the event that a person becomes very ill, and he cannot visit a doctor on his own, he has the opportunity to call him at home. Moreover, most often a specialist of this profile serves such calls after lunch, and the appointment at the outpatient clinic leads before him.
How is general practitioner trained?
Emergency care is the responsibility of primary care physicians, and they must have the knowledge and experience and organize their practice to ensure prompt and effective management when the need arises.
Key words: emergency care, primary health care, general practice. A health emergency is an injury or illness that is acute and poses an immediate risk to a person's life or long-term health, and it is imperative to monitor these patients immediately. Early detection of emergency care and subsequent management will be beneficial in saving the patient's life and preventing irreversible consequences. Exposure to airway, breathing, circulation, disability and exposure, which is widely accepted by emergency medicine professionals, is applicable in primary health care and for the immediate assessment and treatment of critically ill patients.
Economic feasibility of outpatient clinics
Such institutions and the position of "general practitioner" (who is who, we have already found out) were introduced not only to bring medical care closer to the population of rural areas. The point is that it is beneficial from an economic point of view. Firstly, there is no need to send separately a therapist, gynecologist, surgeon, ophthalmologist, otorhinolaryngologist and others. All relatively simple problems can be dealt with by a general practitioner. Those who present more serious complaints, or whose state of health causes concern in this doctor, are sent to higher level healthcare facilities.
What is required for a specialist to work?
As the first contact physicians, primary care physicians could face any type of emergency at any time. Community-level accessibility and accessibility makes them the ideal first point of contact for emergency assistance.
The greatest requirement for emergency management is updated physician knowledge that assists in early diagnosis and management. The challenge for the primary care physician is to be updated and competent in any emergency they may face. One reason is the wide range of problems, and another reason is the rarity of some emergency situations... They should be able to suspect or diagnose that the patient is having serious problems and they can perform at least the initial prehospital treatment.
Prospects for the development of the profession in the future
Currently, the general practitioner (who is who, it was mentioned above) is not the most common, but at the same time a very necessary profession. This specialist is in demand in rural areas. At the same time, such a doctor saves the state significant funds, because there is no need to maintain a large health care institution in each settlement, in which a large number of doctors work. The general practitioner will cope with many problems on his own. If, in order to combat this or that pathology, the intervention of narrow specialists is required, then the patient will be referred to a medical center of the corresponding profile.
They should be competent in therapeutic and diagnostic procedures such as nebulization and electrocardiography. Influencing emergency care through curricula, ongoing medical education sessions, and discussions with colleagues can help them increase their knowledge, competence, and confidence.
They must have excellent interpersonal and communication skills that lead to the exchange of information, as well as to connect with patients, family members, and healthcare staff. It is imperative to be calm in these situations and to get staff to do what is expected. They need to understand that these are situations where patients and families are very concerned and worried. Direct attention, explanation, and confidence would help ease their fears and concerns and the confidence of the patient and caregivers.
In the future, a general practitioner may be re-registered as a so-called family doctor. This specialist is a doctor who cares for multiple families. He knows each of his patients very well. A small number of them allows him to delve deeply into the problems of all charges. Family doctors are very effective method to preserve the health of the population, however, the activity of such specialists is possible only in a sufficiently developed economy. The fact is that the salary of such an employee will consist of deductions from his immediate patients. So the family doctor, if we talk about the widespread activities of such specialists, still remains a prospect for the future. In many European countries, the institution of family doctors has existed for a long time and has proven its effectiveness. At the same time, the basis of the activities of such specialists is precisely the prevention and early diagnosis of any diseases.
Trained medical personnel are also essential to respond quickly to emergencies. Reception staff should be educated about health emergencies and should be encouraged to give priority to patients who provide medical care. Staff should also be trained to identify patients requiring rapid attention, such as wheezing, instability, and pain when entering a facility. Some patients are unaware that they have a life-threatening condition despite having these symptoms, and some patients are reluctant to break queues and harass staff and doctors.
In addition, the profession of the general practitioner himself is promising. Nowadays, mobile complexes are being created that allow to significantly expand the capabilities of this doctor in the field of diagnosing certain diseases. We are talking about the so-called specialized vehicles general practitioner. This complex includes a small laboratory, as well as a set for carrying out the most important instrumental studies.
Paramedical personnel in practice should be competent in basic procedures such as obtaining intravenous access, stabilizing and maintaining the airway, breathing and circulation, and nebulization. They need proper preparation, regular knowledge renewal, encouragement and admiration.
The location and location of the medical center play an important role in the provision of emergency care. It should ideally be located in the center of the community, with easy access to it by any means of transport; therefore, care should be taken when choosing a site for general practice. It should be spacious and have electricity, water, telephone and toilet facilities, and ample parking. It should have a wide entrance and wheelchair access so that the patient can be transported or rolled if the need arises.
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SIBERIAN STATE MEDICAL UNIVERSITY
Test
on "Family Medicine"
"Equipping the workplace for a family doctor and nurse"
Performed
student of ZFVMSO
groups 59-04
Slesareva S.V.
1. Equipping the workplace of a family doctor and a nurse
The work of a family doctor has some peculiarities. Firstly, during the appointment, the doctor must serve patients of various ages and with various diseases in nature, since no scheduling of appointments will eliminate their possible accumulation in the waiting room. Secondly, the admission of patients is often disrupted by the emergence of unscheduled patients seeking emergency help or delivered as a result of accidents. Providing assistance to such victims is associated with a significant investment of time and delays the admission of the next planned patients. In this regard, the working rooms of the family doctor should be located in a separate block, and if there is no elevator, on the first or second floor of the building, which facilitates the reception of patients and helps to maintain order and cleanliness in it.
By order of the Ministry of Health of the Russian Federation No. 230 of August 26, 1992, it is recommended to deploy the following offices for the full-fledged work of a family doctor: a waiting room, a doctor's office, dressing room, a procedure room, an operating room with a preoperative room, a physiotherapy room, a utility room, a nurse's room with a bathroom and a sanitary room ... family doctor medical equipment
At the same time, the walls in all working rooms should be smooth and painted with oil paint to a height of 2 m. The walls of the dressing room, treatment room, preoperative and operating room are tiled or painted with light-colored oil paint. The ceiling is covered with enamel or paint only in the operating room. It is desirable that the floor be covered with metlakh tiles or linoleum. All work rooms should be equipped with sinks. It is very good if in the dressing room, treatment room, preoperative and operating room, the taps of the washbasins are adapted to be opened or closed with the elbow. All rooms should be provided with good ventilation and adequate lighting, both natural and artificial. For the dressing room and the operating room, in addition to electric light coming from several points on the ceiling of the room, you need to have portable lamps, preferably shadowless. Emergency lighting is absolutely essential, the reliability of which is ensured by constant monitoring. In the operating room, the air temperature is maintained at 21 - 24 ° C. To regulate the temperature in the hot season, window household air conditioners BK-1500 or BK-2500 are used, which are installed in window openings. For steam heating, radiators should be smooth on the outer surface in the form of flat heaters or thick smooth pipes. It is better to install electric heaters with automatic temperature control in the walls. In the dressing room, manipulation room, operating room and physiotherapy room, plug sockets are required to turn on electrical appliances (boiler, lamp, quartz, etc.).
When patients visit a family doctor, they initially go to a waiting room. This room is at least 20 m 2, well lit and ventilated. On the walls of the room, it is advisable to place indoor climbing plants, paintings, as well as stands with the necessary medical information. The waiting room should have a TV, soft comfortable chairs, medical sofas and coffee tables with medical and fiction, various information materials in the form of albums, tablets and showcases. It is assumed that there should be no queue to the family doctor in his waiting room, but still there may be several people, for example, the patient's relatives who came with him, or a patient resting after a manipulation or treatment procedure. The nurse registers the patients who have applied, appoints the sequence of admission depending on the patient's age and the severity of his illness.
It is advisable to equip the doctor's office in a well-lit room with an area of \u200b\u200b15-18 m 2, which is connected with the dressing and manipulation room. In the doctor's office there should be a writing table convenient for work, several chairs, a medical sofa or couch for examining patients in a lying position, a screen and a clothes hanger for the patient and a wardrobe, preferably in-wall, for a doctor. It is advisable to have a telephone and a computer in the doctor's office with data on the state of health of all observed patients.
The dressing room and the treatment room should contain a dressing table, tool tables with a metal coating, medical couches with a headrest, screens, a hard chair with armrests, several chairs, tables for sterile instruments, sterile dressing material and sterile linen, as well as for medicines used in dressings. It is better to cover tables with synthetic safety glass. The most convenient in-wall cabinets with glass doors are for the most frequently used instruments and for the daily supply of medicines. They also need cupboards for storing bandages of different sizes, hand reflectors with a long cord, table lamps, pedal buckets with a lid for used dressings, sterilizers with boiled brushes for washing hands, soap dishes, bottles with disinfectant solutions, trays. Spare tools, medicine, spare dressings, splints, crutches, plaster and cleaning supplies should be kept in the utility room.
The operating room should be equipped with a light-weight operating table, small tables for performing hand operations, instrument tables, medical stools, and a stationary shadowless lamp. It is absolutely necessary to have a small support with which the patient climbs onto the operating table. The same stand is needed in the dressing room. Approximate equipment of the operating room and dressing equipment and medical instruments is stipulated by the order of the Ministry of Health of the Russian Federation No. 230 dated August 26, 1992.
The physiotherapy room should have a nurse's table, comfortable chairs for patients and cabins for physiotherapy procedures, in which there are medical couches. In the office, you must have a UHF therapy apparatus, devices for electrophoresis and ultrasound, inhalers, baths for paraffin and ozokerite therapy, quartz and sollux.
In addition to the above, in the working rooms of the family doctor, it is necessary to have household electrical appliances such as refrigerators, electric stoves, kettles, etc. Standard list the equipment of the family doctor's working premises depends on many factors: the presence of the premises themselves, their comfort, location; the number of people in the field of family doctor services; the nature of the allocations for payment of the expenses of the family doctor service, the source of their funding, their volume and stability However, one thing is certain - the better the family doctor's workplace is equipped, the more optimal his working conditions will be.
2 ... Kits of medications and tools for family doctor home care
Quite often, in the practice of a family doctor, situations arise when medical care, including emergency, has to be provided to the patient at home. Some of the acute illnesses or injuries observed by a family doctor are common, others rare, some occur suddenly, others gradually. Therefore, the family doctor has to take with him quite a lot of medicines and instruments to be called. Medical support a doctor also depends on his field of activity. A city family doctor, who has the ability to quickly deliver a patient to a hospital, has to take much less for a call than a rural doctor, who, in addition, must take into account weather conditions.
The list below cannot be considered exhaustive, although it provides care for the vast majority of diseases that cause the patient to be treated at home by a family doctor. There are many medicines that are similar to those recommended by us, but the family doctor should use those with which he is most familiar. Most family doctors primarily use the "general kit", which contains the necessary diagnostics and medicines for the most common diseases. It is also desirable to have “ additional kit»For more rare pathological conditions. Often a special "surgical kit" is required, which contains everything you need to apply and remove stitches, as well as for dressings, which sometimes have to be done at home.
Family physicians should also have a separate “obstetric kit”. Cases of home births are now very rare, nevertheless, despite all the efforts of obstetricians, “home” births still occur sometimes, in addition, there are emergencies associated with abortion, miscarriage and ectopic pregnancy. Finally, the family doctor should have a separate standard “resuscitation kit”. The family doctor needs to regularly check the expiration dates of medicines and replace expired packages.
2.1 "General set" of drugs and medical instruments
The following drugs are for home emergency services.
Analeptics
Bemegrid (amp. 0.5% 10.0)
Camphor (amp. 20% 1.0 and 2.0)
Cordiamine (fl. 15.0; amp. 25% 1.0 and 2.0)
Lobelia (amp. 1% 1.0)
Sulfocamfocaine (amp. 10% 2.0)
Cititon (amp. 1.0)
Antiplatelet agents
Curantil (amp. 0.5% 2.0; tables 0.025 and 0.075)
Caffeine (amp. 10% and 20% 1.0 and 2.0; table 0.075)
Trentap (amp. 2% 5.0; table 0.1)
Euphyllin (amp. 2.4% 10.0 and 24% 1.0; table 0.15)
Antiallergic agents
Gridrocortisone (amp. 0.025 and 0.1)
Diazolin (others 0.05 and 0.1)
Diphenhydramine (amp. 1% 1.0; tables 0.02, 0.03 and 0.05)
Calcium gluconate (amp. 10% 10.0; tables 0.25 and 0.5)
Calcium chloride (amp. 10% 5.0 and 10.0)
Pipolfen (amp. 2.5% 2.0; tables 0.025, 0.005 and 0.01)
Suprastin (amp. 2% 1.0; table 0.025)
Tavegil (amp. 2.0, tab. 0.001)
Antiarrhythmic drugs
Verapamil (finoptin) (amp 0.25% 2.0; tables 0.04 and 0.08)
Kordaron (amp. 5% 3.0; tab. 0.2)
Novocainamide (amp. 10% 5.0; tables 0.25 and 0.5)
Propranolol (inderal, anaprilin) \u200b\u200b(amp 0.1% 1.0 and 5.0; tab.
Antidotes, adsorbing and complexing agent
Almagel (fl. 170 ml)
Amyl nitrite (amp. 1.0)
Bemegrid (amp. 0.5% 10.0)
Nalorphine (amp. 0.5% 1.0 and 0.05% 0.5)
Unitiol (amp. 5% 5.0)
Activated carbon (table 0.5)
Anticoagulants
Heparin (vial 5.0)
Neodicumarin (table 0.05 and 0.1)
Phenylin (table 0.03)
Antiseptics for external use
Boric acid (por.)
Brilliant green (por; solution 1 - U / o)
Potassium permanganate (solutions 0.01-0.1%)
Methylene blue (por; amp. 1% 20.0 and 50.0)
Synthomycin liniment (5% and 10% 25.0)
Streptocide ointment (5% and 10% 30.0)
Furacilin (table 0.1; ointment 0.2% 25.0; solution 1: 50,000)
Antienzyme and enzyme agents
Gordox (amp. 10.0 - 100,000 U)
Contrikal (trasilol) (fl. 10,000 U, 30,000 U and 50,000 U)
Crystalline trypsin (amp. And vial 0.005 and 0.01)
Pain reliever
Amidopyrine (table 0.25)
Analgin (amp. 25% and 50% 1.0 and 2.0; Table 0.5)
Acetylsalicylic acid (tables 0.25 and 0.5)
Baralgin (amp. 5.0)
Bronchodilators
Antastman (table 0.5)
Izadrin (novodrin) (vial 1% 100.0; amp. 0.5% 1.0; table 0.005)
Theofedrine (Table 0.5)
Ephedrine (amp. 5% 1.0; tables 0.025 and 0.003; 0.002 and 0.001)
Hemostatic agents
Aminocaproic acid (fl. 5% 100.0)
Vikasol (amp. 1% 1.0; table 0.015)
Dicinone (amp. 12.5% \u200b\u200b2.0; Table 0.25)
Protamine sulfate (amp. 1% 2.0 and 5.0)
Fibrinogen (fl. 250.0 and 500.0)
Antihypertensive drugs
Arfonad (amp. 0.25)
Dibazol (amp.0.5% and 1% 1.0.2.0 and 5.0; Table 0.02 and 0.002.0.003
Clonidine (amp. 0.01% 1.0; tables 0.075 and 0.15)
Tropafen (amp. 20.0)
Local anesthetics
Lidocaine (amp. 1% 10.0 and 20.0; 2% 2.0 and 10.0)
Novocaine (amp. 0.5% 1.0 and 5.0, 10.0 and 20.0; 1% and 2% 1.0 and 2.0,
5.0 & 10.0; fl. 0.25% and 0.5% 200.0 and 400.0)
Diuretics
Hypothiazide (tables 0.025 and 0.1)
Glycerin (vial 100.0)
Lasix (furosemide) (amp. 1% 2.0; table 0.04)
Mannitol (amp. 15% 200.0, 400.0 and 500.0; vial 500.0)
Narcotic drugs
Morphine (norphine) (amp. 1% 1.0; table. 0.01)
Omnopon (pantopon) (amp. 1% and 2% 1.0)
Promedol (amp. 1% and 2% 1.0; table 0.025)
Antianemic agents
Ferrum Lek (amp. 2.0 and 5.0)
Anti-inflammatory drugs
Butadion (tables 0.03, 0.05 and 0.15)
Vipraxin (amp. 1.0)
Ibuprofen (Table 0.2)
Indomethacin (caps. 0.025)
Reopyrin (amp. 5.0; tab. 0.125)
Anti-infectious agents (antibiotics, sulfonamides, etc.)
Ampicillin (vials 0.25 and 0.5; table 0.25)
Gentamicin (amp. 4% 1.0 and 2.0; vial 0.08)
Kanamycin (vials 0.5 and 1.0; amp. 5% 5.0 and 10.0)
Nitroxoline (5-NOK) (table 0.05)
Sulfadimethoxine (tables 0.2 and 0.5).
Tetracycline (tables 0.05, 0.1 and 0.25)
Furadonin (table 0.03, 0.05 and 0.1)
Cefamizin (vials 0.25, 0.5 and 1.0, 2.0 and 4.0)
Erythromycin (tables 0.1 and 0.25)
Etazole (tables 0.25 and 0.5)
Anticonvulsants
Barbamil (por. 0.1 and 0.2; vial 5% 10.0)
Hexenal (vial 1.0)
Diphenin (table 0.117)
Phenobarbital (table 0.005, 0.05 and 0.1)
Finlepsin (table 0.2)
Sedatives and antipsychotics, tranquilizers
Mazheptil (amp. 1% 1.0; tables 0.001 and 0.01)
Meprotan (andaxin, meprobamate) (table 0.2)
Seduxen (amp. 0.5% 2.0; table 0.005)
Tazepam (table 0.01)
Trioxazine (Table 0.3)
Phenozepan (table 0.005, 0.001 and 0.0025)
Elenium (table 0.005)
Drugs that improve heart function
Digoxin (amp. 0.025% 1.0; tab.0.00025)
Dopamine (amp. 0.5% and 4% 5.0)
Corazol (amp. 10% 1.0; table 0.1)
Korglikon (amp. 0.06% 1.0)
Strofantin (amp. 0.05% 1.0)
Antispasmodics
Atropine (amp. 0.1% 1.0)
Complamin (amp. 15% 2.0 and 10.0; table 0.15)
Nitroglycerin (vial 1% 5.0; table 0.005)
No-shpa (amp. 2% 2.0; table 0.04)
Papaverine (amp. 2% 2.0; table 0.4)
Platyphyllin (amp. 0.2% 1.0; table 0.005)
Trental (amp. 2% 5.0; table 0.1)
Serum preparations
Tetanus toxoid
Gamma globulin against tick-borne encephalitis
Anti-botulinum serum
Anti-gangrenous serum
Anti-snake serum
Anti-tetanus serum
Remember that serum preparations must be stored in the refrigerator.
2.2 Medical instruments
A family doctor in a "general kit" should have: a phonendoscope, a sphygmomanometer, an otoscope, an ophthalmoscope, a flashlight, thermometers, a neurological hammer, a hand-held magnifier, disposable gloves, lubricating cream, a measuring tape, a tongue spatula, a vaginal speculum, a rectoscope, fingertips , hemostatic tourniquet, ophthalmic scapula.
It is desirable to have in the "general set" a portable electrocardiograph, sterile Nelaton catheters, No. 6, 10, 14 with anesthetic ointment, Faley catheter No. 12, gastric tube with funnel, oilcloth apron, disposable syringes of 1.2, 5, 10 and 20 ml with needles, alcohol balls.
Various collection containers are also required: blood tubes - clean and preservative, sterile urine jars, stool boxes, smear slides, culture medium and swabs for swabs.
Surgical kit. It is difficult for a family doctor to manage his work without a dressing kit, which he needs to prepare in advance, in the amount of 5-6 units. It is advisable to prepare sterile kits for dressing, catheterization, vaginal examination, etc.
The dressing kit includes: cotton wool, bandages of various sizes, gauze napkins, oilcloth, adhesive plaster, sterile gloves, plaster bandages, cleol. Of the instruments, it is necessary to have sterile scissors, a needle holder, surgical and anatomical tweezers, a scalpel, clamps, bulbous and grooved probes, forceps, as well as sterile suture material of various numbers with atraumatic needles.
The kit should also include medications, different kinds antiseptics (see "general set"), ointments, ampoules of novocaine, lidocaine and chloroethyl, disposable syringes of various sizes, needles, a set of transport tires.
Obstetric kit. This kit includes a sterile dressing material (gauze balls and napkins, diapers, oilcloth, vaginal tampons), sterile instrumentation (tweezers, clamps, sharp-pointed scissors, scalpel, gutted probe, needle holder, forceps, bullet forceps, metal urinary catheter, gastric tube soft urinary catheters), oilcloth apron, sterile gowns, masks, sterile gloves, forceps at the doctor's choice, obstetric stethoscope, suture set, as in a surgical kit, but with the addition of a vaginal speculum and a lift, sterile suture material (lavsan, nylon and catgut) with round and cutting atraumatic needles; ampoules of novocaine and lidocaine, disposable syringes and needles for injection.
The kit should include a kit for a newborn, which includes scissors, clamps and ligatures for the umbilical cord, a thin catheter for evacuating mucus from the pharynx, a pediatric laryngoscope, endotracheal tubes, a breathing bag and oxygen apparatus, a suction device to remove mucus.
Medicines included in the obstetric kit are divided into 2 groups: for the mother (methylergomentrin, oxytocin, pituitrin, progesterone, ergotal in ampoules and bisecurin, non-ovlon, norkolut, ergotamine in tablets) and for the newborn, (antiseptic solution for mouth , Bactrim suspension, 4% sodium bicarbonate solution, naloxone and ampiox in ampoules).
In addition, the kit must have disposable systems for transfusing liquids, isotonic sodium chloride solution, polyglucin, 5% glucose, hemodez, as well as test tubes for samples from the umbilical cord, a brush for washing hands, and soap.
Resuscitation kit. In some cases, the family doctor has to provide emergency care both in your office and at home. In such cases, he always needs to have a resuscitation kit prepared for work, which should include: a manual breathing apparatus (ADR-2 or DP-10) with a set of masks for children and adults, usually an oxygen source can be connected to the apparatus; suction apparatus (AN-1 or ONPT), powered by a foot drive; air ducts of various sizes; oxygen inhaler (KI-ZM or KI-4); a folding rack for drip infusions with a supply of sterile solutions (0.9% sodium chloride solution, 5% glucose solution, 1.4% sodium bicarbonate solution, polyglucin, Ringer's solution); laryngoscope for adults and children with a set of endotracheal tubes; mouth dilator, tongue holder, suction catheter; disposable systems for blood transfusion and blood substitutes.
The rational minimum of medical instruments required by a family doctor includes the following necessary sets:
Tracheotomy kit consists of a scalpel, 4 hemostatic clamps, 2 single-tooth and 2 three-tooth hooks, 2 surgical forceps, anatomical forceps, scissors, a Trousseau expander needle holder, 3 tracheotomy tubes, 3 surgical needles, 2- x ampoules with silk, sterile towels, sterile gauze wipes and balls, 2 sterile bandages.
IN set for venesection includes: scalpel, scissors, 2 surgical forceps, anatomical forceps, needle holder, 3 atraumatic surgical needles, Deschamp's needle, 2 ampoules with silk, sterile towel, kidney basin, sterile gauze napkins, balls, 2 sterile bandages.
Set for catheterization of great vessels includes: a needle for puncture of the subclavian vein, a needle for intramuscular injection, a disposable syringe of 10 ml, a kidney basin, disposable catheters, a sterile towel, sterile gauze pads, balls and bandages.
This kit should be in the doctor's office, always at hand. When visiting a patient at home, the doctor usually uses a briefcase-type case with drawers or light plastic boxes, where medicines and instruments included in the general and surgical kits are placed, but the capacity of these cases is limited. Obstetric and resuscitation kits are usually placed in large bags with a common compartment and a bottom box for devices, forceps and medical instruments, an apron, etc.
The following literature was used to write the work
1. General practice and family medicine / Ed. Kochena M.M.
2. General practice (family medicine) / Ed. S.A. Simbirtseva, N.N. Gurin. vol. 1
3. Family medicine: A guide in 2 volumes / Ed. Krasnov A.F .. v.1
4. Family medical reference book / L.N. Khakhalin
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