Who knows the emergency management system of obstetrics and gynecology? go off into

I can refer to this document, hehe ... I need extra marks. ...

Management system of obstetric emergency center

I. Management and guardianship system for critically ill pregnant women

1. In case of critical patients, members of the obstetric rescue team, the competent doctor and the attending doctor must arrive at the scene immediately, under the unified command of the department director, and organize intensive and orderly rescue. And report to the first aid team leader of the emergency center.

2, the head nurse led the nurse, closely cooperate with the doctor to rescue, ready for all rescue drugs and equipment.

3, by the nurse specialist closely observe the patient's vital signs and all kinds of monitoring data changes, accurate records, report to the doctor at any time, timely treatment.

4. The doctor in charge (or the doctor on duty) is responsible for recording the changes of illness in detail at any time, prescribing medical advice and checking related items.

5, strictly implement the doctor's advice, careful nursing, to prevent cross infection.

6. Keep the intensive care unit quiet and tidy.

7, doctors and nurses do a good job in succession, in addition to the succession records, but also must do a good job in bed succession.

Second, the maternal transport emergency system

1, with all kinds of dystocia diagnosis and treatment technology, obstetrics and neonatal critical rescue, anesthesia and other technologies and corresponding equipment and first-aid drugs, first-aid items are in a functional state at any time.

2. Announce the emergency number to the whole society, implement the 24-hour duty system and receive pregnant women free of charge. Leave the car within 5 minutes after answering the phone, and dispose of critically ill pregnant women within 5 minutes after arriving at the hospital.

3. In remote areas or areas with inconvenient transportation, it is necessary to mobilize community forces to solve the transportation and manpower needed for the transfer clinic. When necessary, the parturient is transported by manpower, and the hospital also sends an ambulance. These two methods should be combined to shorten the transmission time as much as possible.

4, referral, medical staff on the way to pre-hospital first aid. And keep in touch with the hospital according to the needs of the illness in order to better prepare for the rescue.

3. Referral process requirements: In case of particularly critical pregnant women or pregnant women with serious complications, if the hospital has technical or equipment difficulties, it should be transferred in time. Patients transferred from lower-level hospitals must be carefully received, and information such as diagnosis, treatment and treatment results should be fed back in time.

Third, the high-risk pregnancy management system

1, the doctor should inquire about the medical history and delivery history in detail, check carefully and find out the high-risk factors in time. According to the high-risk scoring standard, pregnant women are regularly screened for high-risk factors, scoring registration and high-risk marking are done well, high-risk pregnancy is recorded in a special notebook, and project management is implemented to achieve early detection, early diagnosis, early treatment and strict follow-up.

2, strictly implement the routine diagnosis and treatment of high-risk outpatient service, when difficult and critical patients are difficult to deal with, they should take the initiative to consult their superiors in time.

3. High-risk pregnant women who are transferred to the grassroots level must register and feedback their illness; After the high-risk ending, it will still return to the original unit for exchange management.

4. High-risk pregnant women must ask for hospital delivery. After admission, medical staff must know the medical history in detail, carry out relevant examinations, do a good job in explaining and appeasing the patient's condition, relieve the patient's fears and concerns, closely observe the patient's condition, find problems as soon as possible and deal with them in time.

5, under the condition of conditional, critically ill patients and moaning patients should be placed separately, when the condition is serious, should keep calm, be careful not to affect other patients.

6, keep the ward quiet, ensure the patient rest, reasonable arrangement of working hours, try not to check and treat patients during the break.

7. Keep the air circulation in the ward, open the window for ventilation once every morning, flush the urinal at any time, handle the sputum and garbage in time, and keep it clean and hygienic.

8. Do a good job in collecting, sorting, analyzing and reporting relevant information.

Fourth, the consultation system

1, in case of difficult cases, you should apply for consultation in time.

2. Cross-departmental consultation: proposed by the attending physician, with the consent of the superior physician, fill in the consultation form. The invited doctor should generally finish it within the same day and write the consultation record. For mild patients who need specialist consultation, they can go to a specialist for examination.

3. Emergency consultation: Invited personnel must be on call.

4. Intra-department consultation: proposed by the attending physician or attending physician, and the director of the department calls relevant medical personnel to participate.

5. In-hospital consultation: proposed by the director of the department, agreed by the medical department, determined the consultation time, and informed relevant personnel to attend. Generally presided over by the director of the application department, the medical department should participate.

6. Out-of-hospital consultation: Difficult cases that cannot be diagnosed and treated in our hospital at the moment shall be proposed by the department director, agreed by the medical department, and contacted with relevant units to determine the consultation time. Please ask the hospital to appoint a department director or attending physician for consultation. The consultation will be presided over by the director of the application department. If necessary, bring medical records and accompany patients to consult outside the hospital. Medical records can also be sent to relevant units for written consultation.

7. In-department, in-hospital and out-of-hospital group consultation: The attending physician should introduce the medical history in detail, make preparations before consultation and make consultation records. In the process of consultation, it is necessary to conduct a detailed inspection, carry forward technical democracy, and clearly put forward consultation opinions. The host should make a summary and seriously organize the implementation.

Five, neonatal asphyxia resuscitation, obstetrics and pediatrics cooperation system

1. All high-risk pregnant women or pregnant women who are estimated to be harmful to the newborn during delivery should inform the pediatrician to be present in advance and make all preparations for neonatal asphyxia and resuscitation.

2, obstetricians or midwives should closely cooperate with pediatricians to do a good job of neonatal asphyxia resuscitation.

3. When the newborn is born and discharged, the pediatrician should have a physical examination. Do a good job in neonatal medical care in the same room as mother and baby, and make rounds at least twice a day. Find problems and deal with them in time. If necessary, transfer to pediatric treatment.

4, health care, obstetrics, pediatricians should cooperate closely, from pregnancy, delivery to puerperium * * * with the management of high-risk perinatal children.

5. The pediatrician should explain the situation of the newborn to the parents, and guide and educate the mother on the knowledge of newborn care.

6, health care and pediatrics * * * do a good job of follow-up of high-risk newborns.

Five, critical illness and death case discussion system

1. seminar on acute and critical cases: the discussion on acute and critical cases should be organized immediately, presided over by the department director or attending physician and attended by relevant personnel. We should discuss it carefully, make a diagnosis as soon as possible and put forward a treatment plan. The discussion is recorded in the medical record.

2. Preoperative case discussion: Preoperative discussion must be carried out for major, difficult and secondary surgical cases. Presided over by the department director or attending physician, attended by surgeons, anesthesiologists, head nurses, nurses and related personnel. Put forward the operation plan, postoperative observation items and nursing requirements. For cases that need a second operation, the reason for the operation must be put forward. The discussion is recorded in the medical record.

3. Discussion on death cases: All death cases should generally be held within one week after death, and special cases should be discussed in time. Autopsy cases should be carried out after the pathological report, but not later than two weeks. Presided over by the director of the department, attended by medical staff and related personnel. When necessary, invite the medical department to send someone to attend. The discussion is recorded in the medical record.

Seven, critically ill patients rescue reporting system

1, strengthen the organization and leadership of the rescue work for critically ill patients, actively, timely and effectively carry out the rescue, and implement the organization, system and measures.

2, in case of critically ill patients, should immediately report to the first aid group leader to organize rescue, and report to the dean and the administrative department of health.

3, who was rescued critically ill patients, should regularly fill in the "critically ill notice" in triplicate, respectively, reported to the medical department, family members or units, leave a copy into the medical record. Explain the development and prognosis of his illness in detail and do a good job in ideological work.

4, all patients after the rescue, it is necessary to record the changes of the condition and the treatment process and effect in detail, timely summarize and analyze the situation, in order to supplement, modify or adjust the treatment plan. Emergency consultation should be requested when necessary.

Eight, first-aid drugs and equipment management system

1. Strengthen the management of first-aid drugs in the emergency room (delivery room), and implement four definitions: personal management, regular storage (timely replenishment after use), fixed storage and regular inspection. If expired or deteriorated drugs are found, they should be cleaned up and supplemented in time to ensure that first-aid drugs are available at any time. Managers check once a day, the head nurse supervises once a week and the nursing department supervises once a month. The competent leader shall conduct spot checks at any time.

2, the configuration of all instruments and equipment, in strict accordance with the operating procedures, are not allowed to borrow and move the location at will (such as special circumstances must be borrowed should be approved by the relevant leaders),

3, keep the equipment clean, all equipment must be cleaned and disinfected in time after use, if there is any damage, should promptly report to the relevant departments or personnel for maintenance, keep the rescue equipment functional state.

4, obstetric medical staff must master the use of intensive care equipment.

Nine, rescue blood management system

1, blood matching and transfusion staff should have a high sense of responsibility and skilled operation technology to ensure the safety of patients' blood transfusion.

2, strictly grasp the indications of blood transfusion, perform the examination and approval procedures.

3, before blood transfusion to talk with patients or their families and sign it.

4. Before blood transfusion, the blood type is usually specified and the correct cross matching method is used.

5, to ensure that the input blood and the patient's blood are not mutually exclusive, there must be two people at the same time to check, confirm the blood or blood components of the blood transfusion and the patient and sign it.

8. Strictly implement the "three investigations and eight pairs". Check the expiration date and container (bag) of blood, check the quality of blood and check the blood transfusion device; For the patient's name, bed number, hospitalization number, blood bag number, blood volume, blood type, blood type, cross-matching test sheet, it also includes the name, blood type, number and cross-matching test sheet of the blood donor.

7. Drugs cannot be added to blood or blood components for infusion.

8, depending on the situation to determine the speed of blood transfusion. In principle, the startup speed should be slow, 5ml/ min. After observing 10 ~ 15 minutes, the speed should be increased appropriately, and those with acute hemorrhagic shock or poor cardiac function should accelerate or decelerate as appropriate.

9, strict implementation of aseptic technology and operating procedures, one needle and one tube,

10, the transfusion reaction record card should be sent back to the blood bank within 24 hours after blood transfusion, and the remaining blood in the bottle should be kept for 24 hours to prevent transfusion reaction.

Ten, accept the referral patient feedback system

1. Establish a green channel for maternal and infant safety to ensure the smooth referral of high-risk pregnant women within the jurisdiction for 24 hours.

2 referral units should fill in the high-risk referral notice in duplicate according to the requirements of superiors (one for deposit and transfer unit and one for receiving unit).

3, accepts the doctor should know the condition and medication in detail, do a good job of succession, when necessary, to participate in the rescue, and do a good job in pre-hospital first aid records and admissions related registration.

4, patients after discharge, diagnosis, treatment, treatment, prognosis and other information by telephone feedback to the referral unit of obstetrics and gynecology. If the high-risk pregnant woman sent by the doctor has been diagnosed at that time, she should immediately feedback the situation to the doctor and ask the referral doctor to participate in the treatment and improve the professional and technical level.

5. Report the number of high-risk pregnant women in the last month to the health care department before 4th of each month, and report the annual high-risk pregnant women roster to the health care department before 4th of June every year. 10.

Eleven, maternal work flow chart system

Twelve. Business training system

1, managed by the hospital continuing education leading group. The medical department and the nursing department are responsible for daily work and plans and their concrete implementation.

2. Training time: First-aid team members should train and practice at least twice a year.

3. Training content: professional ethics, various rescue routines, use of first-aid instruments, artificial resuscitation techniques for cardiac arrest, rescue of acute heart failure and hemorrhagic shock, rational use of blood, use of first-aid drugs, etc.

Thirteen, the ambulance service work system

1, rescue team members must have a high sense of responsibility, ensure smooth communication, be on call, and rescue patients with personnel in place, agile and orderly, and every minute counts.

2. During the rescue, be clear about the division of labor, cooperate closely, obey the command and stick to the post.

3, to participate in the rescue personnel must master all kinds of rescue techniques and rescue routine, to ensure the smooth progress of the rescue.

4, closely observe the condition changes, carefully and timely write relevant records. The record content is complete and accurate. The recording time should be accurate to the minute. Failing to record in time, the relevant medical personnel shall truthfully make up the record within 6 hours after the rescue and explain it.

5, strict succession system and inspection system, in the process of rescuing patients, correctly implement the doctor's advice. Oral orders should be accurate and clear, and nurses must repeat them before execution, and then execute them after confirmation; Keep the ampoule for future inspection.

6, after the rescue, timely clean up all kinds of items and make preliminary processing and registration.

7, conscientiously do a good job in the basic nursing and life care of patients. For those who are fidgety, delirious and delirious, add bed bars and take protective restraints to ensure the safety of patients. Prevent and reduce complications.

8, daily check rescue items, succession, do account content. All kinds of first-aid drugs, equipment and articles should be "five fixed": fixed variety quantity, fixed placement, designated personnel management, regular disinfection and sterilization, and regular inspection and maintenance. Relief items are not allowed to be arbitrarily misappropriated or borrowed, and must be in a state of emergency. Sterile articles must be marked with sterilization date to ensure their use within the validity period.