First aid and nursing

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Theme 1. Organization of work of medical institutions.

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The structure, equipment and work mode of emergency

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room (admission department).

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Alexey Alexandrovich Frolov
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PhD, physician
 Healthcare: definition
• Healthcare – combination of social, economic and medical

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measures undertaken by society and the state with the aim of

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organizing, maintaining and improving medical care of individual

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and population health level.

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 Healthcare: the components
1. Medical and preventive care.

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2. Provision of sanitary and epidemiological well-being of the country:

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questions of prevention of epidemics of infectious diseases, sanitary

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supervision over the quality of drinking water, food, air and others.

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3. Improving the health of the population: the formation of a healthy
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lifestyle, improvement of working and living conditions of people.
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 Healthcare: the principles
• Prevention – a system of socio-economic, socio-hygienic and specific

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medical measures aimed at preventing morbidity and prolonging

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people's lives;

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• Respect for human rights in the field of health.

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 Prevention methods
• disease prevention;

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• elimination of the causes of diseases;

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• sanitary and hygienic control (compliance with hygiene standards,

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compliance with sanitary legislation);

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• health education, education of a healthy lifestyle;

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medical examination of the population;

• principle of responsibility areas in the work of medical institutions;

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• implementation of preventive activities by general practitioners.

 Prevention types
• Primary prevention is a set of medical and non-medical

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measures aimed at preventing the deterioration of human health,

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the appearance of diseases and the identification of early and latent

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forms of diseases.

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• Secondary prevention is set of medical measures aimed at

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preventing exacerbations of already identified diseases.

• Tertiary prevention is aimed at preventing the progression of

diseases and the development of their complications.
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Respect for human rights: components and methods
• rights of citizens;

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• duties and rights of medical workers;

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• liability for harm to health;

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• accessibility of medical care;

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• social security (the system of compulsory medical insurance - the Law of
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the Russian Federation "On medical insurance of citizens in the Russian
Federation" (1994);
• responsibility of state authorities and officials for ensuring the rights of
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citizens in the field of health protection.

 Types of medical care
1. First aid: self-help, mutual aid, help from policeman, firefighter, stewardess,

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etc.

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2. Pre-medical (paramedic) care: is provided by paramedical personnel.

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3. First medical (doctor) care: simplest medical treatment, prophylactic and

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sanitary-hygienic measures.

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4. Qualified medical care: complex medical manipulations of a therapeutic or
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surgical profile performed by a general doctor (therapist, surgeon, pediatrician,
etc).

5. Specialized medical care: assistance of specialists (cardiologist,

arrhythmologist, pulmonologist, endocrinologist, etc.) in medical institutions
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specially designed for these purposes.

 Classification of medical institutions
Direction Type Examples
Medical (therapeutic) Outpatient (ambulatory and polyclinic, ambulant clinic, health center

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and preventive polyclinic)

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Stationary hospital, clinic, medical-sanitary unit

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Dispensary oncology сenter
Maternal and child welfare women's consultation

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institutions

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Emergency ambulance station

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Sanitary and Sanatorium-resort sanatorium
preventive
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Sanitary and epidemiological state sanitary and epidemiological
surveillance centers
Health education medical prevention center
Forensic and medical Bureau of forensic medicine bureau of forensic medicine
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Pharmaceutical and Pharmacy pharmacy

medical technology
Medical technology medical equipment store
 Classification of medical (therapeutic) and
preventive institutions

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• outpatient / inpatient

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• monoprofile / multidisciplinary

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 The goals and objectives of the outpatient units
• Qualified medical care in the polyclinic and at home.

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• Medical examination.

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• Preventive measures (reduction in morbidity, disability and

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mortality).

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• Examination of temporary disability.
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• Sanitary education of the population.
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• Promotion of healthy lifestyles.

 Main types of the outpatient units
• polyclinic

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• ambulant clinic

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• health center

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• women's consultation

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• ambulance station ba Al
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 The goals and objectives of the inpatient units
• Diagnosis and treatment of diseases.

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• Urgent care.

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• Rehabilitation of patients.

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• Disease prevention.

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• Educational activities (training of medical personnel).
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 Main types of the inpatient units
• hospital

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• clinic

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• medical-sanitary unit

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• dispensary

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• sanatorium ba Al
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 Nursing (patient care)
• Nursing (patient care) – a system of medical, preventive and

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sanitary-hygienic measures aimed at alleviating the patient’s

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condition, correct timely execution of medical appointments,

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preparation and conduct of some diagnostic procedures, competent

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monitoring of the patients condition, first aid and preparation of

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relevant medical documentation .
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 Types of patient care
• General care. It does not depend on the type of disease. General

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examination, measurement of body temperature, change of linen,

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etc.

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• Special care. Depending on the diagnosis (for example, preparing

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a patient for cholecystography, catheterization of the bladder, etc).

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 Responsibilities of nurses and medical orderlies
• Medical orderly – no or primary medical education.

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• Nurse – secondary medical education (after medical college).

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• Doctor – higher medical education (after higher school).

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 General responsibilities of medical orderlies
1. Regular wet cleaning: woods, corridors, public spaces and others.

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2. Assisting a nurse in caring for patients: changing bed linens,

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feeding seriously ill patients, hygienic support of seriously ill

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patients (cleaning and washing bedpans, matrasses, etc).

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3. Sanitary and hygienic treatment of patients.
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4. Escort of patients for diagnostic and treatment procedures.

5. Transportation of patients.
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 General responsibilities of nurses
1. Implementation of doctor's appointments: injections, dispensing of drugs, enemas, etc.
2. Nursing examination - the initial examination of the patient, measuring body temperature, counting the
frequency of respiratory movements and heart rate, measuring blood pressure, monitoring daily

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diuresis, etc.

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3. Collection of material for analysis (blood, sputum, urine and feces).

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4. Providing care for patients - care for the skin, eyes, ears, oral cavity.

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5. Control of changing bed linens.

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6. Organization of proper and timely patients feeding.

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7. The provision of first aid and pre-medical care.
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Providing transportation of patients.
Reception of patients and organization of discharge of patients.
10. Implementation of control over the sanitary condition of the departments.
11. Monitoring of compliance by patients with the internal rules of medical institutions and their
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compliance with personal hygiene rules.

12. Maintaining medical documents.
 Positions of nurses
• The head nurse of the hospital.

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• Senior nurse of the department.

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• Ward nurse.

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• Procedural nurse.

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• Operating nurse.

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• District nurse.
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• Nurses working with specialist (optometrist, ENT specialist, neuropathologist,
etc.).
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• Dietary nurse.
 Fundamentals of medical ethics (deontology)
• Medical ethics (deontology) – a set of ethical standards and

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principles of behavior of medical workers in the performance of

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their professional duties.

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• Medical ethics investigate and identifies the relationship:

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– medical worker - patient

– medical worker - patient relatives

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– medical worker - a medical worker

The basic principle of medicine

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NON NOCERE (Latin) – DO NO HARM!

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 Fundamentals of medical ethics (deontology)
• Traits of a medical worker: compassion, kindness, sensitivity,

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responsiveness, caring, respect, attention, interest

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• Neat appearance.

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• Availability of necessary medical knowledge.

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• Observance medical confidentiality (except for situations that pose a
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threat to other people).
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 Mistakes and medical offenses
• Medic is responsible for evading or unprofessional performance of

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their duties

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• Mistakes are caused by misconception.

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• Medical offenses are caused by inadequate performance of their

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professional duties.
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• Refusal to provide medical care is also an offense.

• Depending on the seriousness of the offense, the healthcare provider

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may receive administrative or criminal penalties.

 Personal hygiene of medics

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• daily shower

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• wash medical gown, cap and personal clothes regularly

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• medical gown should cover personal clothing

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• medical cap should cover hair

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• use washable shoes

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do not wear work clothes outdoor
• do not use harsh perfume
• nails should be trimmed
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• cleaning without jewelry and watches

 Medical uniform

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• medical gown / surgical suit

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• medical cap

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• indoor shoes

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• medical gloves
• medical mask
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Lo
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City Clinical Hospital #13
 City Clinical Hospital #13:
clinical departments

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1088 patients

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• gastroenterological department • department of vascular surgery

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• gynecological department • department of medical rehabilitation

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• dermatological department • therapeutic department no. 1

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• department of cardiology no. 1 • therapeutic department no. 2
• department of cardiology no. 2 • traumatology and orthopedic department

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• ophthalmology department • neurosurgical department
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coloproctology department
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neurological department for stroke patients
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urology department
surgical department
• neurological department • endocrinology department
• ENT department • department of anesthesiology and resuscitation
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• pulmonology department • intensive care unit

• rheumatology department • intensive care unit for patients with stoke
 City Clinical Hospital #13:
auxiliary departments

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• hospital pharmacy

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• clinical diagnostic laboratory

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• x-ray department

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• operating unit (10 operating rooms)

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• department of radioactive iodine therapy

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• department of x-ray diagnostic methods and treatment
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department of medical rehabilitation
department of endoscopy
• department of physiotherapy
• department of ultrasound diagnostics
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• department of functional diagnostics

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General hospital scheme
 Emergency room (admission department):
the functions
• reception of patients

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• registration of patients

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• initial examination

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• anthropometry

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• sanitary treatment

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• emergency medical care

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preparation of medical documentation

• sorting of patients
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• transportation to other departments

 Emergency room (admission department):
sequence
1. registration of patients;

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2. medical examination;

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3. sanitary treatment.

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 Emergency room (admission department):
scheme
1. Waiting room 8. Operating room

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2. Registry 9. X-ray room

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3. Viewing room 10. Laboratory

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4. Sanitary inspection room with 11. Doctor's office

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shower or bath

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12. The office of the head of the
5. Diagnostic room ba Al department.
6. Insulator 13. Toilet
7. Treatment room 14. A room for storing clothes
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received patients
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Thanks for attention!