Каслинская районная больница готовится к оказанию плановой медицинской помощи

Мы продолжаем рассказывать о работе Каслинской районной больницы в условиях борьбы с COVID-19.

В середине мая в медучреждении для долечивания пациентов, не имеющих клинической картины и симптоматики заболевания, выделены 110 коек. По состоянию на 3 июня, занято 9, но цифры постоянно меняются: люди выздоравливают и выписываются.

Уточним, что под долечиванием понимается перевод пациентов с диагнозом пневмония (не обязательно коронавирусная) или другими инфекционными заболеваниями, которые пролечены на основной госпитальной базе, получили два отрицательных анализа на COVID-19, но все ещё должны находиться под наблюдением врачей, потому что выписывать их по состоянию здоровья пока рано.

При этом, заместитель главного врача по медицинской работе Владислав Сергеевич Логинов отметил, что в больнице пациенту обязательно делают компьютерную томографию, смотрят, как легкие восстанавливаются, при необходимости проводят повторное обследование. И только после того, как пневмония полностью рассосалась, а все анализы пришли в норму, пациента выписывают.

Приказом Министерства здравоохранения Челябинской области, определено 5 баз для стационарного долечивания: в Каслях, п. Увельском, в Магнитогорске, в Миассе и Челябинске.

Почему Касли? Во-первых, это важно с территориальной точки зрения. Город расположен рядом с госпитальной базой (г. Кыштым), что уменьшает время перевозки пациентов и положительно влияет на состояние их здоровья.

Во-вторых, в соответствии с рекомендациями Роспотребнадзора РФ — здание районной больницы имеет чёткое зонирование на «зеленую» и «красную» зону, раздельные въезды и выезды, больницы полностью соответствует требованиям СанПИНов и временным методическим рекомендациям «Профилактика, диагностика и лечение новой коронавирусной инфекции».

И в-третьих, есть понимание, что все объёмы медпомощи пациентам рассчитаны и будут оказаны в полном объёме. Как на долечивании, так и всем обратившимся жителям.

На данный момент с ковидными пациентами работают 17 сотрудников районной больницы, из которых сформировано три бригады, каждую возглавляет врач, работают сутки через трое.

Одна из задач, которая стоит перед администрацией больницы — недопущение случаев инфицирования сотрудников. В связи с этим детально проработана стратегия защиты медицинских работников, которые еженедельно проходят плановое обследование на коронавирусную инфекцию — положительных результатов не выявлено. 

По словам главного врача Владимира Викторовича Мельникова, персонал работает всю рабочую смену в полной экипировке (включая защитный комбинезон, бахилы, две пары перчаток, шапочку, экран, респиратор) и не покидает пределы отделения, что создает дополнительную психофизическую нагрузку.

– Это тяжелая работа, которая связана не с количеством пациентов, а с теми мероприятиями, которые сотрудник проводит перед тем, как заступить на смену, – поясняет Владимир Викторович. – При работе с инфекцией очень важно, прежде всего, соблюдать меры безопасности, санэпидрежим, правильно применять спецодежду, чтобы не допустить внутрибольничного инфицирования.

Сложный труд медицинских работников не остался незамеченным. Они начали получать расчетные листки с новыми суммами, которые включают надбавки, предусмотренные Указом президента. Выплаты производятся по мере поступления средств на счет медицинского учреждения. 

Всё это время в районной больнице оказывалась экстренная хирургическая и акушерско-гинекологическая помощь, работала поликлиника.

Более того, медучреждение готово для того, чтобы возобновить обычный плановый режим работы с соблюдением санитарных и противоэпидемических мероприятий.

– В ближайшее время будет открыто 23 хирургические койки для планового лечения хирургических больных, – сообщил главврач больницы Владимир Мельников. – С гинекологическими заболеваниями женщины также будут поступать к нам в больницу. Мы будем доводить состояние больного до стабилизации и затем по маршрутизации направлять в Кыштым для оказания дальнейшей специализированной медицинской помощи. При необходимости мы можем проводить хирургические операции, у нас имеется 6 реанимационных палат. Надо сказать, что хирургическое и акушерско-гинекологическое отделения экстренной и плановой помощи находятся в чистой зоне, имеют отдельный приемный покой, помещения закрыты, пересечение с пациентами, которые переболели ковидом, исключено. Выписка пациентов будет проходить по второму запасному пути. Мы готовы к работе уже с ближайшего понедельника. Ждем только согласования с Министерством здравоохранения, – подчеркнул Владимир Викторович.

Хирургическая зона полностью готова для приема пациентов
Хирургическая зона полностью готова для приема пациентов

Главврач также отметил, что на территории Каслинского района с положительным диагнозом COVID – 13 человек. Те, кто имеет положительный анализ ПЦР (полимеразная цепная реакция) на коронавирус без клинических проявлений, находятся на самоизоляции. Ежедневно врачи-терапевты или фельдшеры проводят с ними необходимые санитарно-эпидемические мероприятия. Кроме этого, сотрудники полиции также контролируют соблюдение режима самоизоляции: проверяют местонахождение граждан, которым предписано соблюдать необходимые ограничительные меры.

Пациенты, прошедшие обследование с помощью компьютерной томографии легких с выявленными изменениями, говорящие о наличии пневмонии, находятся на лечении в госпитальной базе города Кыштыма.

По информации, предоставленной специалистами районной больницы, у одной из сотрудниц Черкаскульского психоневрологического интерната выявлен положительный результат на COVID-19. Под особое медицинское наблюдение взято 56 сотрудников и 423 клиента данного интерната. Проведен осмотр и лабораторное обследование 72 сотрудников, заступающих на смену 5 июня.

– В очередной раз напоминаем жителям района о соблюдении режима самоизоляции и мерах профилактики,  чтобы не допускать распространения коронавирусной инфекции. Тогда и дополнительный коечный фонд нам не понадобится, если не будет заболевших, – подчеркнул главный врач больницы Владимир Мельников.

Людмила НИЧКОВА

Для справки

Перевод пациентов на базу по долечиванию осуществляется по решению врачебной комиссии.

При улучшении клинической картины заболевания: пациент чувствует себя лучше, у него нет одышки, температура тела не превышает 37,5°С в течение двух суток, у пациента хорошие результаты при диагностическом прослушивании, положительная динамика результатов лабораторных исследований, улучшение результатов рентгенологической диагностики, достаточное насыщение крови кислородом.

При отсутствии тяжелых сопутствующих заболеваний (ХОБЛ, бронхиальная астма, сахарный диабет, сердечно-сосудистые заболевания в стадии декомпенсации, злокачественные новообразования в терминальной стадии, иммунодефицитные состояния), а также беременности и родов.

При возможности продолжения схем антибактериальной терапии, назначенной на первом этапе.

При возрасте не старше 65 лет.

При переводе пациента на долечивание его транспортировка осуществляется санитарным транспортом до приемного отделения принимающей медицинской организации в соответствии с действующими противоэпидемическими правилами.

Плюс, если диагноз Covid-19 лабораторно не подтвержден или получены два отрицательных результата.

Вопрос — ответ

– Почему убрали аптечный пункт в поликлинике?

– Аптечный пункт работал в поликлинике от областного аптечного склада на условиях договора. В силу того, что деятельность больницы последние два месяца проходит в режиме карантинных мероприятий, он временно перенесен в головную аптеку. После снятия всех ограничительных мер для аптечного пункта снова будет предоставлена площадь в поликлинике. А пока пожилые люди и те, кому трудно добираться до основных аптек, могут воспользоваться услугами социальной службы.

– Как получить справку для водительского удостоверения в условиях коронавируса?

– Медицинское обследование и получение справок для водительского удостоверения, а также предрейсовые и послерейсовые медосмотры, по-прежнему, проводятся в районной больнице. Весь процесс проходит в штатном режиме, согласно законодательству РФ.

– Не секрет, что каслинское здравоохранение нуждается в обновление автопарка. Как с этим обстоят дела?

– С начала текущего года больница получила три автомобиля «скорой помощи». Один получен еще зимой и направлен в Тюбукскую амбулаторию, остальные два будут также  распределены учреждениям здравоохранения, расположенным в районе.

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