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Ãëàâíàÿ Îáðàòíàÿ ñâÿçü Äèñöèïëèíû:
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Ïàöèåíò ÍÅ ÄÎËÆÅÍ íè íà ìèíóòó âûïàäàòü èç ïîëÿ çðåíèÿ ðåàíèìàòîëîãîâ
ÅÑËÈ ÍÀ ÏÐÎÒßÆÅÍÈÈ 30-40 ÌÈÍÓÒ ÇÐÀ×ÊÈ ÎÑÒÀÞÒÑß ØÈÐÎÊÈÌÈ. ÑÀÌÎÑÒÎßÒÅËÜÍÀß ÑÅÐÄÅ×ÍÀß ÄÅßÒÅËÜÍÎÑÒÜ È ÄÛÕÀÍÈÅ ÍÅ ÂÎÑÑÒÀÍÀÂËÈÂÀÞÒÑß, ìîæíî êîíñòàòèðîâàòü ÁÈÎËÎÃÈ×ÅÑÊÓÞ ÑÌÅÐÒÜ. Çàêàí÷èâàÿ ðàçäåë, ïîñâÿùåííûé ÄÎÂÐÀ×ÅÁÍÎÉ ÐÅÀÍÈÌÀÖÈÈ, íåîáõîäèìî îáðàòèòü âíèìàíèå íà îäíî âàæíîå îáñòîÿòåëüñòâî. Ïðîâåäåíèå íàðóæíîãî ìàññàæà ñåðäöà äîñòàòî÷íî ÷àñòî ñîïðîâîæäàåòñÿ ÏÅÐÅËÎÌÀÌÈ ÐÅÁÅÐ ïàöèåíòà, ðåæå âåäåò ê ïîâðåæäåíèþ ëåãî÷íîé òêàíè ñ âûõîäîì âîçäóõà â ïëåâðàëüíóþ ïîëîñòü (ïíåâìîòîðàêñ), ðàçðûâàìè ñîñóäîâ è èçëèÿíèåì â ïëåâðàëüíóþ ïîëîñòü êðîâè (ãåìîòîðàêñ). Îäíàêî îïàñåíèå âûçâàòü îñëîæíåíèÿ íè â êîåì ñëó÷àå ÍÅ ÄÎËÆÍÎ ÏÐÈÂÎÄÈÒÜ Ê ÎÒÊÀÇÓ îò ðåàíèìàöèè èëè ïðîâåäåíèþ åå â íåïîëíîì îáúåìå èëè íåäîñòàòî÷íî ýíåðãè÷íî. ÓÂÀÆÀÅÌÛÅ ÊÎËËÅÃÈ ÏÐÅÏÎÄÀÂÀÒÅËÈ È ÃËÀÂÍÛÅ ÌÅÄÑÅÑÒÐÛ!  ÑÂÎÅÉ ÐÀÁÎÒÅ ÂÀÌ ÍÅÎÁÕÎÄÈÌÎ ÐÓÊÎÂÎÄÑÒÂÎÂÀÒÜÑß ÑËÅÄÓÞÙÈÌÈ ÄÎÊÓ-ÌÅÍÒÀÌÈ. ÈÍÑÒÐÓÊÒÈÂÍÎ-ÌÅÒÎÄÈ×ÅÑÊÈÅ ÄÎÊÓÌÅÍÒÛ ÏÎ ÄÅÇÈÍÔÅÊÖÈÎÍÍÎ-ÑÒÅÐÈËÈÇÀÖÈÎÍÍÎÌÓ ÐÅÆÈÌÓ Â ËÏÓ. 1. ÃÎÑÒ 25375-82. "Ìåòîäû, ñðåäñòâà è ðåæèìû ñòåðèëèçàöèè è äåçèíôåêöèè èçäåëèé ìåäèöèíñêîãî íàçíà÷åíèÿ. Òåðìèíû è îïðåäåëåíèÿ". Óòâåðæäåíû Ãîñóäàðñòâåííûì Êîìèòåòîì ïî ñòàíäàðòàì ñ 1.07.83ã. 2. ÎÑÒ 42-21-2-85. "Ñòåðèëèçàöèÿ è äåçèíôåêöèÿ èçäåëèé ìåäèöèíñêîãî íàçíà÷åíèÿ. Ìåòîäû, ñðåäñòâà, ðåæèìû". 3. Ïðèêàç ÌÇ ÑÑÑÐ ¹ 408 îò 12.07.89 ã. "Î ìåðàõ ïî ñíèæåíèþ çàáîëåâàåìîñòè âèðóñíûìè ãåïàòèòàìè â ñòðàíå*. 4. Ìåòîäè÷åñêèå ðåêîìåíäàöèè ïî îðãàíèçàöèè öåíòðàëèçîâàííûõ ñòåðèëèçàöèîííûõ â ëå÷åáíî-ïðîôèëàêòè÷åñêèõ ó÷ðåæäåíèÿõ. Óòâ. ÌÇ ÑÑÑÐ ¹ 15-6/8 îò 01.02.90 ã. 5. Ìåòîäè÷åñêèå óêàçàíèÿ ïî êîíòðîëþ ðàáîòû ïàðîâûõ è âîçäóøíûõ ñòåðèëèçàòîðîâ. Óòâ. ÌÇ ÑÑÑÐ Ìâ 15/6-5 îò 28.02.91 ã. 6. Ìåòîäè÷åñêèå ðåêîìåíäàöèè ïî ïîâûøåíèþ íàäåæíîñòè ñòåðèëèçàöèîííûõ ìåðîïðèÿòèé â ëå÷åáíî-ïðîôèëàêòè÷åñêèõ ó÷ðåæäåíèÿõ ïî ñèñòåìå "÷èñòûé èíñòðóìåíò". Óòâ. ÌÇ ÐÔ ¹ 11-16/03-03 îò 31.01.94ã. 7. Ïðèêàç ÌÇ ÑÑÑÐ ¹ 691 îò 28.12.89 ã. "Î ïðîôèëàêòèêå âíóò-ðèáîëüíè÷íûõ èíôåêöèé â àêóøåðñêèõ ñòàöèîíàðàõ". 8. Ìåòîäè÷åñêèå ðåêîìåíäàöèè. Ïðîôèëàêòèêà âíóòðèáîëüíè÷-íûõ èíôåêöèé ó íîâîðîæäåííûõ è äåòåé ðàííåãî âîçðàñòà â äåòñêèõ ñòàöèîíàðàõ. Óòâ. ÌÇ ÑÑÑÐ ¹ 15/6-20 îò 28.09.89 ã. 9. Ïðèêàç ÌÇ ÑÑÑÐ ¹ 440 îò 20.04.83 ã. Ïðèëîæåíèå "Èíñòðóêöèÿ ïî îðãàíèçàöèè è ïðîâåäåíèþ êîìïëåêñà ñàíèòàðíî-ïðîòèâîýïèäåìè÷åñêèõ ìåðîïðèÿòèé â îòäåëåíèÿõ äëÿ íîâîðîæäåííûõ è íåäîíîøåííûõ äåòåé äåòñêèõ áîëüíèö". Ïðèëîæåíèå ¹ 7 "Ìåòîäè÷åñêèå óêàçàíèÿ ïî äåçèíôåêöèè êóâåçîâ äëÿ íåäîíîøåííûõ äåòåé". 10. Ïðèêàç ÌÇ ÑÑÑÐ ¹ 720 îò 31.07.78 ã. "Îá óëó÷øåíèè ìåäèöèíñêîé ïîìîùè áîëüíûì ñ ãíîéíûìè õèðóðãè÷åñêèìè çàáîëåâàíèÿìè è óñèëåíèè ìåðîïðèÿòèé ïî áîðüáå ñ âíóòðèáîëüíè÷íîé èíôåêöèåé". 11. Ìåòîäè÷åñêèå óêàçàíèÿ. Êîíòðîëü êà÷åñòâà ïðåäñòåðèëèçàöè-îííîé î÷èñòêè èçäåëèé ìåäèöèíñêîãî íàçíà÷åíèÿ ñ ïîìîùüþ ðåàêòèâà Àçîïèðàì. Óòâ. ÌÇ ÑÑÑÐ ¹ 28-6/13 îò 26.05.88 ã. 12. Èíñòðóêöèÿ ïî ïðîòèâîýïèäåìè÷åñêîìó ðåæèìó â ëàáîðàòîðèÿõ äèàãíîñòèêè ÑÏÈÄà. Óòâ. ÌÇ ÑÑÑÐ ¹ 42-28/38-90 îò 05.07.90 ã. 13. Ïðèêàç ÃÓÇÌ ¹ 538/104-90 îò 17.12.90 ã. "Î äîïîëíèòåëüíûõ ìåðàõ ïî ïðåäóïðåæäåíèþ ðàñïðîñòðàíåíèÿ ÑÏÈÄà â ã. Ìîñêâå". 14. Ïðèêàç ÌÇ ÑÑÑÐ ¹ 916 îò 04.08.83 ã. "Îá óòâåðæäåíèè Èíñòðóêöèè ïî ñàíèòàðíî-ïðîòèâîýïèäåìè÷åñêîìó ðåæèìó è îõðàíå òðóäà ïåðñîíàëà èíôåêöèîííûõ áîëüíèö (îòäåëåíèé)". 15. Ïðèêàç ÌÇ ÑÑÑÐ ¹ 320 îò 05.03.87 ã. "Îðãàíèçàöèÿ è ïðîâåäåíèå ìåðîïðèÿòèé ïî áîðüáå ñ ïåäèêóëåçîì". 16. Ïðèêàç ÌÇ ÑÑÑÐ ¹ 288 îò 23.03.76 ã. "Îá óòâåðæäåíèè Èíñòðóêöèè î ñàíèòàðíî-ïðîòèâîýïèäåìè÷åñêîì ðåæèìå áîëüíèö è î ïîðÿäêå îñóùåñòâëåíèÿ îðãàíàìè è ó÷ðåæäåíèÿìè ñàíèòàðíî-ïðîòèâî-ýïèäåìè÷åñêîé ñëóæáû Ãîñóäàðñòâåííîãî ñàíèòàðíîãî íàäçîðà çà ñàíèòàðíûì ñîñòîÿíèåì ëå÷åáíî-ïðîôèëàêòè÷åñêèõ ó÷ðåæäåíèé". 17. Ìåòîäè÷åñêèå ðåêîìåíäàöèè ïî ïðåäñòåðèëèçàöèîííîé î÷èñòêå è ñòåðèëèçàöèè ìåäèöèíñêèõ èíñòðóìåíòîâ ê ãèáêèì ýíäîñêîïàì. Óòâ. ÌÇ ÑÑÑÐ ¹ 28-6/3 îò 09.02.88 ã. 18. Ìåòîäè÷åñêèå ðåêîìåíäàöèè ïî î÷èñòêå, äåçèíôåêöèè è ñòåðèëèçàöèè ýíäîñêîïîâ. Óòâ. ÌÇ ÑÑÑÐ ¹ 15-6/33 îò 17.07.90 ã. 19. Ìåòîäè÷åñêèå ðåêîìåíäàöèè ïî ñòåðèëèçàöèè ëèãàòóðíîãî øîâíîãî ìàòåðèàëà â ëå÷åáíî-ïðîôèëàêòè÷åñêèõ ó÷ðåæäåíèÿõ. Óòâ. ÌÇ ÑÑÑÐ ¹ 15-6/34 îò 19.07.90 ã. 20. Âðåìåííûå ìåòîäè÷åñêèå óêàçàíèÿ ïî ãàçîâîé ñòåðèëèçàöèè êåòãóòà. Óòâ. ÌÇ ÑÑÑÐ ¹ 866-70 îò 28.05.70 ã.  ó÷åáíèêå èñïîëüçîâàíû íàçâàíèÿ äåçèíôèöèðóþùèõ è àíòèñåïòè÷åñêèõ ñðåäñòâ, ðàçðåøåííûõ Ñàíýïèäíàäçîðîì ã. Ìîñêâû íà ÿíâàðü 1997 ãîäà. ÁÈÁËÈÎÃÐÀÔÈß 1. Â.À. Ìèíÿåâ, "Îðãàíèçàöèÿ ðàáîòû ñðåäíåãî ìåäèöèíñêîãî ïåðñîíàëà â ËÏÓ, èýä-âî "Ìåäèöèíà", 1982 ã. 2. Ì.Ê. Öåðåõ, "Óõîä çà áîëüíûìè â êëèíèêå âíóòðåííèõ áîëåçíåé", ÌÇ ÑÑÑÐ, ã.Ìèíñê, 1985 ã. 3. Å.Â. Þðêîâà, "Êóðñ ëåêöèé ïî äåçèíôåêöèîííî-ñòåðèëèçàöèîí-íîìó ðåæèìó â ËÏÓ", ã. Ìîñêâà, 1996 ã. 4. Ìàòåðèàëû öèêëà ïåðâè÷íîé ñïåöèàëèçàöèè ìåäèöèíñêèõ ñåñòåð-àíåñòåçèñòîê ïî àíåñòåçèè è ðåàíèìàöèè. Öåíòðàëüíûé ãîñïèòàëü âîåííî-êîñìè÷åñêèõ ñèë, ã'Ãàëèöûíî-2, 1995 ã. 5. Ìåòîäè÷åñêèå ðåêîìåíäàöèè Öåíòðàëüíîãî íàó÷íî-èññëåäîâàòåëüñêîãî èíñòèòóòà ãåìàòîëîãèè è ïåðåëèâàíèÿ êðîâè ÌÇ ÑÑÑÐ. Óòâåðæäåíû Íà÷àëüíèêîì Ãëàâíîãî óïðàâëåíèÿ ëå÷åáíî-ïðîôèëàêòè÷åñêîé ïîìîùè ÌÇ ÑÑÑÐ Â.È. Ôèëàòîâûì 03.03.87 ã. 6. "Ñïðàâî÷íèê ìåäñåñòðû ïî óõîäó". Ïîä ðåäàêöèåé àêàäåìèêà Í.Ð. Ïàëååâà, èçä.2-å, ã. Ìîñêâà, 1994 ã. 7. "Îñíîâíûå ïðèíöèïû è ìåòîäû ðåàíèìàöèè". Êëèíèêà àíåñòåçèîëîãèè è ðåàíèìàòîëîãèè ÖÍÈË, àêàäåìèê ÀÌÍ ÑÑÑÐ Ã.À. Ðÿáîâ è ÄÐ. 1989 ã.. 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