E-United States, ii-ambulensi zisebenza ngamagosa e- paramedics , ochwepheshe bezonyango eziphuthumayo ( EMT s ), okanye ukudibana kokubili. Akunabo bonke i-ambulensi abasabela kwiifowuni eziphuthumayo ze-911 kwaye kumaxesha amaninzi, ii-ambulensi ezingekho ngezoxakeka zisebenza nge-EMTs ezimbini kwaye akukho zixhobo eziphuculweyo.
Ii-EMTs kunye nee-paramedics ziyizona zimbini ezihlukeneyo zomboneleli wezempilo.
Ii-EMTs zifunda isiseko sezixhobo kunye nezakhono zokuqeqeshwa kwee-paramedic ziya kwakha emva koko. Kodwa musa ukuvumela ukuba ukuqhubela phambili kukukhohlise. Izakhono ze-EMT zibaluleke kakhulu njengalezo ze-paramedic. Enyanisweni, i-paramedic ephumelelayo yinto engazange ikhohlwe ukwenza izinto ezisiseko.
Inkxaso yoBomi yoBomi
Ochwepheshe bezonyango eziphuthumayo baqeqeshelwa ukubonelela ngenkxaso yokuphila ngokusisiseko. Ixesha elibi ngenxa yokuba isiseko asikwenzeki ngokuqinisekileyo izakhono zokugcina ubomi ezifunekayo kwi-EMTs. Ngokuqhelekileyo, kunyango lwengxamisekileyo, uqeqesho oluphambili lubaluleke kakhulu ekusindiseni ubomi. I-CPR, njengomzekelo, yinkqubo yezogqirha yonyango eyona nto ingayithatha, kodwa ngokuqinisekileyo isakhono esibaluleke kakhulu kunoma yimuphi umboneleli wezempilo.
Inkxaso-siseko yobomi yinqanaba eliphambili kuwo onke ama-ambulensi e-US Ukuba i-ambulensi isithutha isigulane, kukho umlindi emva kwe-ambulensi kunye nesigulane esinikeza inkxaso esisezantsi okanye ephakamileyo.
Imbango yodwa kulo mgaqo yinkcazo engavumelekanga yokuthuthwa kwezinto eziphambili zokunakekelwa kwezothutho (i-CCT) okanye iinqununu zokunakekelwa kwezothutho (SCT). Ngaphantsi kwepesenti enye yee-ambulensi kwindlela yokusebenzisa amaqela akhethekileyo ukunyamekela izigulane ezisuka kwenye indawo yokunakekelwa kwezempilo ukuya kwelinye. La maqela angabandakanya abahlengikazi, oogqirha, abaphefumli be-respiratory therapists, okanye intlangano yazo zonke ezi kunye ne-EMTs okanye i-paramedics.
Ukwahlula phakathi kokuxhasa ngokusisiseko kunye nenkqubela phambili yobomi (ALS) ngokutshintsha rhoqo, ngoko kunzima ukuchaza ngokufanelekileyo i-BLS. Umgaqo owodwa wezothuthi kukuba ukuba inqubo ibandakanya inaliti okanye ukuba ityhubhu idlula emqaleni, akusiyo inkxaso yokuphila ngokuyisiseko. Kukho ezinye izixhobo zokuhlola eziphambili eziphuma ngaphandle kwe-BLS yokusebenza, njenge-electrocardiograms (ECGs).
Ziziphi ii-EMTs zokuFunda
Ukuqonda kangcono ukuba yeyiphi inkxaso yokuphila ebalulekileyo (i-BLS), makhe sijonge ukujonga ngokubanzi izakhono ezifundiswa yi-EMT:
- Uvavanyo lweMonde : I-EMT kufuneka ifunde ukuvavanya izigulane kunye nokuqonda iimpawu kunye neempawu zentsholongwane ebungozi. Ii-EMTs zifunda ukufumana imbali kwaye zenze uvavanyo lomzimba. Oku kuba sisiseko sovavanyo lwe-EMT kunye nokuhlolwa kwee-paramedic kulawo ma-EMTs abaya kuba ngama-paramedics.
- Ulawulo lwe-Airway : Enye yeenkqubo ezibaluleke kakhulu ukugcina ubomi yindlela yokuphefumula . Ii-EMTs zifunda ukugcina isigulane somoya ngokusebenzisa izixhobo zokuhamba ngeendlela (izixhobo ezikunceda ukugcina ulwimi luvule ngendlela yokuvula umlenze, apho umoya ungena kwi-trachea) kunye nokutshatyalaliswa ukususa iimfihlo kunye nezinto zangaphandle ezisuka emqaleni. Bafunda nokuphatha ukuphefumula okufutshane nokusebenzisa i-oksijini kwaye ngamanye amayeza amayeza aerosolized. Ukusetyenziswa kwamachiza afana ne-albuterol kuxhomekeke kummandla okanye kumasipala apho i-EMT isebenza khona.
- Ukuqhafaza : Isiqinisekiso se-EMT senziwa iminyaka ngaphambi kokuba uphuhliso lwee-paramedics luphuhliswe. Ukuphazamiseka kokudala ii-EMTs kwavela kwindlela yokuqhuma kweemoto ezinzima ngexesha lee-halcyon iintsuku zeemoto ezinama-1960. Ixinzelelo lwezinto ezibangelwa ukuphazamiseka kweemoto zanceda ukuphuhlisa uqeqesho lwaloo nto yayingumqhubi wee-ambulance nje. Ukuchithwa kwezinto ezingenakuqhelaniswa kwaba yinxalenye enkulu yekharityhulam.
- Ukubambisana : Kuza kunye nokuqhaqhaqhaqhaqhaqhaqhaqhaqhaqhaza ukuza kubetha amanxeba . Iindlela ezifanayo zokulimala eziphule amathambo zikhupha isikhumba kunye nemisipha evulekile. Ii-EMTs kufuneka zikwazi ukusingatha kokubili kakuhle.
- Ukukhulula iintsana : Ukugqithiswa kwinto elula yokuba ii-ambulensi zibizwa ngokuba ngabafazi abasemsebenzini, kubalulekile ukuba bayazi ukuba benzani xa befika khona. Xa kuziwa kwizakhono ze-paramedic malunga nokubeleka, kuninzi kakhulu ukuba bafunda ngaphaya kwezinto ezisiseko zoqeqesho lwe-EMT.
Ezi zizakhono ezisisiseko kwaye azikatshintshanga ukususela ngo-EMTs. Ngo-1996, ikharityhulam yezoqeqesho zezonyango eziphuthumayo (ngexesha elibizwa ngokuba yi-technician-basic base-technician) lishicilelwe yi-National Highway Traffic Safety Administration (NHTSA), eyenza ingqiqo xa ukhumbula ubudlelwane phakathi kwe-EMTs kunye nemoto iingozi.
Kukho izinto ezimbalwa ezongeziweyo kwiminyaka (iicandelo elitsha lweemfuno zonyango lweenkonzo zonyango zongxamisekileyo zanyatheliswa phakathi kuka-2005-2009), kuquka imithi efana ne-albuterol, i-epinephrine, i-naloxone, ne-nitroglycerin. Uluhlu olukhulu kwi "akukho masingele" umthetho wesigxina esingaphezulu kukusetyenziswa kwe-epinephrine kunye ne-naloxone. Zombini zala mayeza anikezwa ngejoza. Kwiimeko ezininzi, i-EMTs isebenzisa i-auto-injection eyenzelwe ukusetyenziswa kwamacandelo ukulawula la mayeza. Ukusetyenziswa kwamachiza ngaphandle kwe-oksijini kunye ne-glucose yomlomo (ishukela elula kakhulu enikezelwa kwizigulane ezine-hypoglycemia) ayikho yonke indawo. Ulwahlulo lwengingqi olukhoyo lukhoyo kwii-EMT kunye nehlabathi leepedimic.
Ukuba yi-EMT eqinisekisiweyo
Wonke urhulumente unemithetho yakhe kunye nemimiselo elawula ukuqeqeshwa kunye nesatifikethi sezonyango zonyango. Uninzi lu landela iMigangatho yeNkonzo yezoNyango yeNkonzo yezoNyango epapashwe yi-NHTSA. Imilinganiselo iqikelela ukuba uqeqesho lwe-EMT luza kuthatha iiyure eziyi-150-190. Amaninzi amaninzi aneeyure ezisezantsi zichazwe ngokomthetho. I-California, ngokomzekelo, idinga ubude obuncinane bekhosi kwiiyure ezili-120 ze-EMT isitifiketi, ngaphantsi kwe-standard estimation. Iinkqubo zinokuthatha ixesha elide kunokuba ubuncinci, kunjalo.
Emva kokuba ikhosi yoqeqesho igqityiwe ngempumelelo, umfaki-sicelo we-EMT kufuneka adlulise iimviwo zeemviwo. Kuzo zonke izinto ezine (eNew York, Wyoming, Illinois, naseNorth Carolina), umfaki-sicelo uya kuthatha uvavanyo oluphuhliswe kwaye lulawulwa yiRejista kaZwelonke yeeNgcali zezoLimo eziPhezulu (i-NREMT). Kuloo mazwe, uvavanyo luya kulawulwa nguRhulumente kwaye imithetho iya kuhlukile kunokuba ichazwe apha.
Xa uviwo lugqityiwe, umfaki sicelo uya kuqinisekiswa yi-NREMT. Kwenzeka ntoni ngokulandelayo kuxhomekeke kwilizwe, kodwa ngokuqhelekileyo i-EMT eqinisekisiweyo i-NREMT izakufaka isatifikethi sayo se-NREMT kwi-ofisi ye-EMS yelizwe kwilayisenisi yelizwe (asiyi kungena kwingxoxo malunga nelayisenisi ngokuchasene nesiqinisekiso apha). Ilayisenisi yelizwe kunye nesitifiketi se-NREMT zilungile iminyaka emibini. Ukuhlaziywa kubhekiselele kummandla, kwaye kuya kufuneka ukuba ifune ixesha eliqhubekayo lemfundo. Ininzi amazwe ayenzi i-EMT igcine isatifikethi sayo se-NREMT emva kokuba ilayisenisi yokuqala ikhutshwe.
I-EMTs Ukusuka kwi-State ukuya kuRhulumente
Ukuba unesatifikethi seNREMT sangoku, unesabelo esibaluleke kakhulu sokuhambisa ilayisenisi ukusuka kwelinye ilizwe ukuya kwelinye. Ngokuqhelekileyo, nangona kunjalo, akwanele. Ininzi yezizwe zinemfuneko eyongezelelweyo yokugqiba phambi kokuba unikwe ilayisenisi, nangona usuqinisekisiweyo ngokuqinisekileyo wesizwe.
Kunzima kwaye akukho ndlela yokufihla zonke iziseko. Iingcebiso ezilungileyo kukubiza umnxeba we-EMS kwilizwe apho uhamba khona. Fumana uluhlu lwezinto ofuna ukuyenza kwaye uqinisekise ukuba ukhawule zonke iibhokisi.
Ziziphi ii-EMTs ezingafundanga esikolweni (ngokuqhelekileyo)
Ochwepheshe bezonyango eziphuthumayo bafundiswa ukuphatha izigulane kwizinto ezilingana nomhla obi kakhulu (mhlawumbi owokugqibela) wobomi bomguli. Kodwa oko akuyiyo eyona nto i-EMTs eya kuyenza xa ekugqibeleni igqityiwe inkqubo kwaye inyuke kwi-ambulensi okokuqala. Uninzi lwe-EMTs aluyi kubaleka kwizitrato ezisetyenziselwa ukulila kunye nezibane zikhawuleza, kuphela ukuhlutha isigulane esichengeni kwisifo se-jaw of death nje ngexesha lokutya.
Uninzi lwe-EMTs luya kuqhuba isiguli esifanayo emva kweentsuku ezimbini emva kwesibhedlele apho athethwa khona ngexesha loxakeka esibhedlele apho uya kugqiba ukubuyiswa kwakhe. Leyo yinyaniso yokuthutha i-ambulensi: ezininzi ii-ambulensi zisetyenziselwa ukukhawuleza.
Iiprogram zoqeqesho ze-EMT zichitha ixesha elincinane. ukuba zikhona, ukufundisa abaviwa be-EMT izakhono zangempela eziza kubabenza baphumelele kakhulu kwiminyaka yokuqala yemisebenzi yabo: inceba, ukunyamezela, kunye noqhagamshelwano olunxulumene nabanye, nje ukubiza ezimbalwa.
Izakhono zongxamiseko ziyimfuneko kakhulu, kungakhathaliseki ukuba i-EMT iqhubela phambili kwiifowuni ezili-911 okanye ukuphathwa kwee-interfacility transfers. Enyanisweni, izigulane ezigula kakhulu i-EMT entsha iya kuba yinyameko yilezo ezithutha esibhedlele esibhedlele. Ukuba kukho into eyenzeka ngexesha lothutho, i-EMT kulindeleke ukuba iqaphele kwaye isabele.
Izakhono zokuphinda zihloliswe ngexesha lento edlalwa ngokuba yinto "yokuqhelanisa" ayinakuqiniswa kwiinkqubo zokuqeqeshwa eziqhelekileyo. Ii-EMTs zifundiswa ukufika, ukuvavanya, ukuphatha, ukuthutha, ukuhlamba, nokuphinda. Ngokuqhelekileyo abafumani naluphi na izikhokelo malunga nendlela yokuphatha izigulane ezifuna ukubeka iliso rhoqo, ngamanye amaxesha ngeeyure ngexesha lothutho.
Ukulungiselela ngokupheleleyo i-EMTs yelizwe lenene, kuyimfuneko ukuba sibanike izixhobo zomsebenzi abaya kwenzayo ngokwenene. Njengomqhubi kwinqwelo lomgibeli, kufuneka bahlale bekulungele ukungalindelekanga, kodwa kufuneka baqonde nendlela yokuphatha i-mundane ngaphandle kokubanjwa.
> Imithombo:
> Davis CS, Southwell JK, Niehaus VR, Walley AY, Dailey MW. Iinkonzo zonyango ezinxamisekileyo ze-naloxone ukufikelela: ukuhlaziywa komthetho ngokusemthethweni. Acad Emerg Med . 2014 Oct; 21 (10): 1173-7. i-doi: 10.1111 / acem.12485.
> Isebe leSebe lezothutho / iNational Highway Traffic Administration. (2009). IMigangatho yeeNkonzo zeZiko leMpilo yezoNyango. EWashington, DC.
> Isebe leSebe lezothutho / iNational Highway Traffic Administration. (2009). Imigangatho yeNqanaba leMfundo lezeNzango zeZingxamisekileyo . EWashington, DC.
> Isebe leSebe lezothutho / iNational Highway Traffic Administration. (2005). Umxholo weSizwe we-EMS. EWashington, DC.
> Isebe leSebe lezothutho / iNational Highway Traffic Administration. (2007). UMgangatho weSizwe we-EMS woLuhlu lweZenzo. EWashington, DC.