X An loan giao ihdng - An. ninh hdng hdi .
KY NANG SONG SOT hrotiQ nacc ann
AHGTlfiP J
aiip theo S i thing 6/2013)
OiSu tri ngudl bl nan khi dnac vAt lintddUAIntfAclanli
Kiem tra diu hieu song: Ngdfli bj nan cfln thd khong? Hg cfl bi bat tlnh khflng (khflng phln flng) hay tlnh tlo?
Thde hien sd cflu nhd mfl t l dUdi day v l tham khIo phic do trong phan cuii.
Lufln lufln tham vin nhln viin y te d n g sdm d n g tot, tham chl c l khi ngdfli bj nan fl trong nuflc lanh chda llu va dang tinh tao Cac Ifli khuyen cfl the nhan dUde mien phi thong qua dich vu y t l tfl xa (Telemedical Assistance Service - TMAS), cfl the liin lac qua Trung tam Phoi hdp tim kiem cflu nan (RCC).
NgUdi bj nan b^ tinh
Thfla nhan d e quy trinh sd cflu chuan.
Niu khong thd:
-)- Kilm tra/llm thflng ddflng thfl, niu van chda thfl thflng du hai dddng thd.
+ Bit diu i p tim (cardiopulmonary resuscitation - CPR) theo cleh thflc dupe huin luyin trong sd cflu.
-1- Trong khi chd tu van y t i , tilp tyc i p tim vfli mflc dp 100 lin/phflt v l thflng dddng thfl m i i 30 lin i p .
-I- Tilp tuc tfli khi bet sflc (niu l l m mpt minh); miu d sd trd giflp thi doi nhau 2 phut mflt lin trinh bj hit hdi.
-I- Niu khflng cfl diu bleu ngflng tim (cardiac arrest): niu khong eo td vin y te, khflng vin d l gi nguy hilm trdflc m i t v l khong cfln dau hiiu sing sau 30 phut, ngdng bflp tim nhung xfl ly ngUdi bj nan theo nhflng kiin nghi fl phan "chit lam dng".
Niu thd nhung bat tinh:
+ Chuyin tfli vi tri an toln.
+ Kilm tra thUdng tich.
-t- Oat nguyin tai vi tri vdt iin -I- Chu y vipe nfln mfla thudng gap khi bj duoi nudc,
-«- Xiny kiin td v i n y t i .
5 8 IIA^GHAnTETNAM , So 7/2013
BUI HOANG
+ Theo doi v l ghi chip hdi thfl, nhjp tim (nhjp co/dflng maeh d n h ) . Nhjp tim v l nhjp thd tang cfl the II diu higu bien chflng manh cfla duii nude v l vdi ngufli bj m i t nhiet, tim cfl t h i bj ngflng bit cfl Iflc nlo.
+ Cung c i p oxy qua m i t na thfl neu d .
-(- Tim d c h sdfll i m ngddi nan nhan ehing m i t nhiit thim. O l trinh mit nhigt, bgc ngddi bj nan bang chin hay till gifl nhiet.
Ngirdibj nan tinh tdo
Tiep xuc trong thdi gian ngan (dUdi 30 phut): ngddi g$p n^n bj run
- Ngudl bj nan tinh tlo, sang suit v l ke lai chi tiet nhflng gi trli qua, cho dfl van cfln run ray s i phuc hii holn t d n nlu thay quan ao ddt v l phu i m bang chan. N I U ngudi bj nan ehi tilp xflc vfli ndflc lanh tnDng vflng 30 phflt, eP the llm i m lai bang d c h ngam nudc i m hole t l m vfli hoa sen fl nhiit dp khoing 39- 41°C (niu nhipt di? thip hdn, ngUdi bi nan cd the tiep tuc bi l^nh, tham chi ci khi cim thay nudc am. Niu khong c6 nhi$t ke thi cd the nhung khuyu tay xuong nudc: nhi$t d^ sai lich cho phep nhUng khong cao hdn) - nhdng niu chl run v l phai theo dpi sflm nlu d diu hiiu cholng vIng hole dpt quy do q u i nhiit.
NgUdc lai, neu ngfldi bj nan chi mn v l tinh tlo, tap the dye cfl the day nhanh q u i trinh lam i m cd t h i trd lai.
- Tham khIo y kiln td van y te.
Tiip xuc trong thdi gian dai (tren 30 phdt) va/hoac ngudi bi nan khdng run
-I- 0 i m tranh mat nhiet do bay hdi hole do gifl.
-1- Trinh khiing vie - bpc bang chan
. An toan giao thong - An ninh hang hdi
z
hoac bao nylon, c l d i u (trii mat), c6 va j^nchan.
' -f- Dl ehuyen vio ch6 i m , eho dude che chan.
+ Dat ngudi bj nan fl td t h i nfla nim, ilia ngii (chfl khi bj cholng vang thi nam Ta tit nhat).
I + Thfl oxy nlu d thi.
+ Neu hit phli ndflc, dflng viin hp thfl sau hole ho.
+ Theo dfli v l ghi nhjp tim, nh|p thfl (nhjp ci/dpng m?ch d n h ) 5 phfll/lin ' trong 15 phut dau va niu khflng thay doi thi 15 phul/lin (Tang nhjp thd ho^c nhjp Sm la bien chflng efla ngat nddc - v l d n nhcl II dii vdi ngddi bj m i t nhiit nghiem trong, tim d the ngdng dap b i t cfl luc nao).
+ Tham khIo tfl van y te.
+ Khi da tinh t l o v l am khflng nhat thiet phli duy tri td t h i nfla nlm hoac nam
+ Cho uong nddc ngpt i m - khflng eo con.
Neu tinh trang eua ngdfli bj nan xiu Si, tham khIo quy tnnh xfl ly ngdfli bat tlnh fl phan tren.
filiu tri ngudi duoc dua len tCr piwiang ben cum sinh
- Nhflng ngddi khong dUde ehe chin va kho rao trong khoang thfli gian ngan va tinh tao cfl the dupe dieu trj nhd la rgufli bi mit nhiit nhe (ddpc mP t l trong ph^n ngufli bj nan bj ngam nude nhung tinh tao).
- Nhifng ngufli bj nan bi Uflt, lanh v l it Hnh tlo d n dUde dua len theo tu t h i gin ngang va flUdc cfilu tri nhu II ngdfli bi ngam trong nuflc fl cflng mflc dp tinh tao.
I ' -Cho uing nufle nggt am.
- Tham khIo tu vin y te. Cle Idi khuyen co the nhln miin phi qua djch vu y t i tfl xa (TMAS), co the lien lae qua RCC.
Ch^t ldm Sdng
Xfl \'i ngufli dupe vflt lin da chit llm sang, khflng cfl dau hiiu song, sd vio da lanh la mpt viec kho.
Trong mpi khi nang hg s i chet thuc
% dac biit khi nhflng ngdfli nhin thiy hp
^a trong tinh tr^ng nhu vay nhiiu gifl. Tuy fihien, nlu khflng cfl d e blo d o nhu vay, thi van phli cho II hp con song nhung bl mat nhiit nghiem trgng: tim van ePn dap
nhdng r i t yiu v l khPng d m nhan dUde mach, ding tfl da gian.
Lufln lufln tham khIo ;/ kien tfl van d n g s6m d n g tot. CIc Idi khuyin efl t h i nhan miin phi qua djch vu y t l tfl xa (TMAS), cfl t h i liin lae qua RCC.
NgUdi chit llm sing cin ddpc:
+ Dda lin theo phddng ngang v l thao t i e nhu vfli ngdfli binh ngng.
+ Thin t h i phli ddde dat nhp nhIng tai vj tri dda len fl khoang dupe ehe chin v l am Ip.
+ N I U vSn cfln sing, efl t h i llm i m lai cd the tfl tfl fl mpt mflc dp t i i Uu cho phip.
+ Theo dfli v l ghi ehep kich thuflc ding tfl v l iiy nhiet dp trdc tring hlng gifl trong 12 gid. Niu khPng thay d i i v l vln khPng efl diu hi^u sing thi cfl t h i eoi nhu ngudi bj nan da chit.
-I- Tuy nhien, neu dp dan ding tfl gilm, thi cfl khi nang ngddi bi nan con song: bat d i u theo dfli v l ghi chip 15 phflVlan, ding thfli theo dfli nhip tim va nhip thfl.
+ Neu cfl diu hiiu song, dieu tri nhd II ngufli bj nglm trong nuflc bit tlnh fl phin trin.
Torn tat
Huflng din nay gili thich vln t i t d c h cd t h i con ngdfli phan flng vfli d i lanh;
biin phap giup phflng ngfla tae dflng xiu va phUdng phap xfl ly doi vdi ngdfli dflfle vflt len td dufli ndflc hole tfl phddng tien cflu sinh.
Tom t i t nhflng dilm quan trgng cin nhfl de song sot. Hay l l m theo nfl, bfli vi cupe song cua ban mgt ngly nao dfl se phy thupc vio nfl.
- L i p k i hoach hlnh dong khin cap ttf trdflc. Tu hfli minh phli lam gi niu tinh buing khan c i p xly ra. Lii ra gin nhit din cho tholt hilm? Bfl quin ao ehong mat nhiit, ao phao, bp phln xa radar, tieu djnh vj khan c i p v l phUdng tiin cflu sinh gin nhit fl dau? Llm d c h nlo tiep can vfli d c thiet bi sfl dyng trong thdi tiit xiu nhu quin ao each nhiet, gang tay...?
- Bilt di/dc cic thiet bj CLTU sinh hoat dong t h i nlo. Lue khan c i p khflng phli II luc de hpc.
-I- Tham chi fl vung nhiet dfli, trdflc khi bfl t l u , m^c d n g nhiiu Idp quin ao de chong lanh, Mac bo quan ao giu' nhiit
neu cfl the.
+ Mae l o phao ngay khi eo tinh huong khan cip xly ra - dilu chinh dung quy d c h .
+ Khi bfl t l u , c i gang len phddng tiin ciAi sinh trong trang t h l i khfl rlo m l khong phli xuong nddc.
-I- u i n g thuoc ching say song d n g sflm d n g tot.
+ Neu ein phli xuing nuflc, co gang xuing ni/flc m^t d c h tit tfl.
+ Phln iirng ban d i u khi bi nglm trong nuflc lanh se chi xly ra trong vdng v l i phut: gifl binh tmh cho tfli khi ban dilu ehinh lai ddpc hdi thfl (phln flng ban diu nly khong phli luon xly ra, nhung chic chin xly ra khi nhiit do thip v l It dupe blovi).
+ Co gang nlng cing nhilu phin cd the lin khfli mat ndflc cing tot.
-I- Bdi se lam tang sd m i t nhiet. Chl bdi khi cfl cho tru an gan ben neu khong chac chan dupe cflu sflm va tu tin II minh cfl the tiep can dUde. Neu khong t h i bdi tfli cho tru an, e i gang gilm thieu sd mat nhiet: noi trin mat ni/flc vcfi hai chan song song khep lai, kep khuyu tay vio ngddi v l hai d n h tay vat cheo trddc ngifc. Bdi ngifa va dung chin niu d thi.
-I- Neu CO gang tiip can d c vat noi, bdi xuong dddi gifl vat do, d l gio dda nfl tfli vfli ban.
-H Neu khong mac l o phao, di/ng vay de keu gpi sd chu j?. Ban se mat dfl nil neu khflng mac l o phao.
-i- I d thijc day y chi sing sot. Diiu nly se tao sU khlc biet gifla sU song v l d l chit. Giif cho diu fle ban rpn va tap trung vio d e muc tieu ngin ban.
-i- Difng qua td nfl life trong qua trinh CLfU nan hay de nhln viin cflu nan lam viec eua hg - hp dang trong tinh trang tot hdn ban. Thlm ehi khi dang dUdc edu, di/ng tha Iflng qua sflm.
Chuan bi, lap k l hoaeh v l nam bat tfl truflc va suy tinh bin than cfl the II nhflng yeu to cfl ^ nghla nhit cho sd song con cua ban - hoac trong diiu tri nhflng ngUfli bj nhiim lanh.
TU lam quen vfli d c npi dung eua hdflng dan nly.
Cae chl dan efl the catva dan fl nhdng nfli eong cpng d c vj tri tap trung de tham khIo khi can t h i i t i £
HANG HAI VIETNAM • So 7/201 3 '