Îñòàâüòå ññûëêó íà ýòó ñòðàíèöó â ñîöñåòÿõ:

Ïîèñê ïî áàçå äîêóìåíòîâ:

 

ÏÐÀÂÈÒÅËÜÑÒÂÎ ÌÎÑÊÂÛ

ÄÅÏÀÐÒÀÌÅÍÒ ÇÄÐÀÂÎÎÕÐÀÍÅÍÈß

 

ÐÀÑÏÎÐßÆÅÍÈÅ

 

18 èþíÿ 2003 ã.

 

N 249-ð

 

ÎÁ ÓÒÂÅÐÆÄÅÍÈÈ ÑÒÀÍÄÀÐÒÎÂ ÎÊÀÇÀÍÈß ÑÊÎÐÎÉ È ÍÅÎÒËÎÆÍÎÉ

ÌÅÄÈÖÈÍÑÊÎÉ ÏÎÌÎÙÈ ÁÎËÜÍÛÌ È ÏÎÑÒÐÀÄÀÂØÈÌ ÁÐÈÃÀÄÀÌÈ ÑÒÀÍÖÈÈ

ÑÊÎÐÎÉ È ÍÅÎÒËÎÆÍÎÉ ÌÅÄÈÖÈÍÑÊÎÉ ÏÎÌÎÙÈ ÃÎÐÎÄÀ ÌÎÑÊÂÛ

 

 öåëÿõ óëó÷øåíèÿ êà÷åñòâà îêàçàíèÿ ìåäèöèíñêîé ïîìîùè áîëüíûì è ïîñòðàäàâøèì íà äîãîñïèòàëüíîì ýòàïå, ïðèêàçûâàþ:

1. Óòâåðäèòü "Ñòàíäàðòû îêàçàíèÿ ñêîðîé è íåîòëîæíîé ìåäèöèíñêîé ïîìîùè áîëüíûì è ïîñòðàäàâøèì áðèãàäàìè ÑÑèÍÌÏ ãîðîäà Ìîñêâû" (ïðèëîæåíèå).

2. Ãëàâíîìó âðà÷ó ÑÑèÍÌÏ ã. Ìîñêâû Ýëüêèñó Ë.Ñ.

2.1. Îðãàíèçîâàòü èçó÷åíèå "Ñòàíäàðòîâ îêàçàíèÿ ñêîðîé è íåîòëîæíîé ìåäèöèíñêîé ïîìîùè áîëüíûì è ïîñòðàäàâøèì áðèãàäàìè ÑÑèÍÌÏ ãîðîäà Ìîñêâû". Ñðîê: 15.07.2003 ã.

2.2. Ââåñòè â ïðàêòèêó âûåçäíûõ áðèãàä "03" óòâåðæäåííûå "Ñòàíäàðòû îêàçàíèÿ ñêîðîé è íåîòëîæíîé ìåäèöèíñêîé ïîìîùè áîëüíûì è ïîñòðàäàâøèì áðèãàäàìè ÑÑèÍÌÏ ãîðîäà Ìîñêâû". Ñðîê: ñ 15.07.2003 ã.

2.3. Îñóùåñòâëÿòü îêàçàíèå ìåäèöèíñêîé ïîìîùè áîëüíûì è ïîñòðàäàâøèì áðèãàäàìè "03" â ñòðîãîì ñîîòâåòñòâèè ñ óòâåðæäåííûìè Ñòàíäàðòàìè. Ñðîê: - ïîñòîÿííî.

3. Êîíòðîëü çà âûïîëíåíèåì íàñòîÿùåãî ïðèêàçà âîçëîæèòü íà çàìåñòèòåëÿ ðóêîâîäèòåëÿ Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ Ëåøêåâè÷à È.À.

 

Ðóêîâîäèòåëü Äåïàðòàìåíòà

À.Ï.ÑÅËÜÖÎÂÑÊÈÉ

 

 

 

 

 

Ïðèëîæåíèå

ê Ðàñïîðÿæåíèþ Äåïàðòàìåíòà

çäðàâîîõðàíåíèÿ ãîðîäà Ìîñêâû

îò 18.06.2003 ã. N 249-ð

 

ÑÒÀÍÄÀÐÒÛ

ÎÊÀÇÀÍÈß ÑÊÎÐÎÉ È ÍÅÎÒËÎÆÍÎÉ ÌÅÄÈÖÈÍÑÊÎÉ ÏÎÌÎÙÈ

ÁÎËÜÍÛÌ È ÏÎÑÒÐÀÄÀÂØÈÌ ÁÐÈÃÀÄÀÌÈ ÑÒÀÍÖÈÈ ÑÊÎÐÎÉ È

ÍÅÎÒËÎÆÍÎÉ ÌÅÄÈÖÈÍÑÊÎÉ ÏÎÌÎÙÈ ÃÎÐÎÄÀ ÌÎÑÊÂÛ

 

ÐÀÇÄÅË: "ÃÈÍÅÊÎËÎÃÈ×ÅÑÊÈÅ ÇÀÁÎËÅÂÀÍÈß, ÀÊÓØÅÐÑÒÂÎ"

 

ÑÎÃËÀÑÎÂÀÍÎ:

Ãëàâíûé àêóøåð-ãèíåêîëîã

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

Þ.Ì.ÁËÎØÀÍÑÊÈÉ

 

ÃÈÍÅÊÎËÎÃÈ×ÅÑÊÈÅ ÇÀÁÎËÅÂÀÍÈß, ÀÊÓØÅÐÑÒÂÎ

 

┌─────┬─────────────────────────────┬────────────────────────────────┬────────────────┐

│ Êîä │           Äèàãíîç               Îáúåì ìåäèöèíñêîé ïîìîùè       Ðåçóëüòàò   

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│Ñ.91-│Êðîâîòå÷åíèå â                                                              

│Ñ.94 │ãèíåêîëîãè÷åñêîé ïðàêòèêå                                                   

     │1) ïðåðûâàíèå áåðåìåííîñòè â │1. Îñìîòð                       │Ñòàöèîíàðíîå   

     │ðàííèå ñðîêè                 │2. Ãîñïèòàëèçàöèÿ               │ëå÷åíèå        

     │2) øåå÷íàÿ áåðåìåííîñòü      │1. Îñìîòð                       │Ñòàöèîíàðíîå   

                                  │2. Ñðî÷íàÿ ãîñïèòàëèçàöèÿ       │ëå÷åíèå         

     │3) òðàâìû ïîëîâûõ îðãàíîâ    │1. Îñìîòð                       │Ñòàöèîíàðíîå   

                                  │2. Ñðî÷íàÿ ãîñïèòàëèçàöèÿ       │ëå÷åíèå        

                                  │3. Âëàãàëèùíàÿ òàìïîíàäà ïî                     

                                  │ïîêàçàíèÿì                                     

     │4) íàðóøåíèå ìåíñòðóàëüíîãî  │1. Îñìîòð                       │Ñòàöèîíàðíîå   

     │öèêëà                        │2. Ïðè îáèëüíîì êðîâîòå÷åíèè è  │ëå÷åíèå        

                                  │èçìåíåíèè îáùåãî ñîñòîÿíèÿ -                   

                                  │ãîñïèòàëèçàöèÿ.                                

                                  │Ïðè íåçíà÷èòåëüíûõ - ñîâåò,                    

                                  │àêòèâ â æ/ê                                    

     │5) ðàê øåéêè è òåëà ìàòêè    │1. Îñìîòð                       │Ñòàöèîíàðíîå   

                                  │2. Îáåçáîëèâàíèå:               │ëå÷åíèå        

                                  │- àíàëüãèí 50%-2,0                             

                                  │- òðàìàë 2,0 + ðåëàíèóì â/â                    

                                  │3. Ïðè îáèëüíîì êðîâîòå÷åíèè                   

                                  │òàìïîíàäà è ãîñïèòàëèçàöèÿ, ïðè │               

                                  │íåçíà÷èòåëüíîì - àêòèâ â                       

                                  │ïîëèêëèíèêó                                    

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│0.00 │Îñòðûé æèâîò â ãèíåêîëîãèè   │1. Îñìîòð                       │Ñòàöèîíàðíîå   

     │1) âíåìàòî÷íàÿ áåðåìåííîñòü  │2. Ñðî÷íàÿ ãîñïèòàëèçàöèÿ -     │ëå÷åíèå        

                                  │íîñèëêè                                        

│N.83 │2) àïîïëåêñèÿ ÿè÷íèêà        │1. Îñìîòð                       │Ñòàöèîíàðíîå    

                                  │2. Ãîñïèòàëèçàöèÿ - íîñèëêè     │ëå÷åíèå        

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│N.70-│3) âîñïàëèòåëüíûå çàáîëåâàíèÿ│1. Îñìîòð                       │Ñòàöèîíàðíîå   

│N.76 │æåíñêèõ ïîëîâûõ îðãàíîâ      │2. Ãîñïèòàëèçàöèÿ (ïî ïîêàçàíèþ)│ëå÷åíèå        

                                  │3. Àêòèâ â ËÏÓ                                 

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

     │Àêóøåðñêèå êðîâîòå÷åíèÿ:     │1. Îñìîòð                       │Ñòàöèîíàðíîå   

│0.44 │1. Ïðåäëåæàíèå ïëàöåíòû      │2. Èçîòîíè÷åñêèé ð-ð 0,9%-400,0,│ëå÷åíèå        

│0.45 │2. Ïðåæäåâðåìåííàÿ îòñëîéêà  │Âèòàìèí "Ñ" 5,0 -2,0 â/â                       

     │íîðìàëüíî ðàñïîëîæåííîé      │êàïåëüíî, ïðåäíèçîëîí 60 ìã â/â │               

     │ïëàöåíòû                     │ñòðóéíî                                        

                                  │Îáåçáîëèâàíèå: ïðîìåäîë 2%-1,0                 

                                  │â/â                                            

                                  │3. Çàêèñü àçîòà 2:1                            

                                  │4. Ãîñïèòàëèçàöèÿ - íîñèëêè                    

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│0.20 │Îñëîæíåíèÿ, ñâÿçàííûå ñ      │1. Îñìîòð                       │Ñòàöèîíàð      

     │áåðåìåííîñòüþ                │2. Ãîñïèòàëèçàöèÿ                              

     │1. Óãðîæàþùåå ïðåæäåâðåìåííîå│                                               

     │ïðåðûâàíèå áåðåìåííîñòè                                                     

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│0.60 │Ïðåæäåâðåìåííî íà÷àâøååñÿ    │1. Îñìîòð                       │Ñòàöèîíàð      

     │ðîäîðàçðåøåíèå               │2. Ãîñïèòàëèçàöèÿ - íîñèëêè     │ðîäîðàçðåøåíèå 

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│0.21 │1) Èíòîêñèêàöèÿ I ïîëîâèíû   │1. Îñìîòð                       │Ñòàöèîíàðíîå   

     │áåðåìåííîñòè (ðâîòà          │2. Àêòèâ â æåíñêóþ êîíñóëüòàöèþ │ëå÷åíèå        

     │áåðåìåííûõ)                  │3. Ïðè íåóêðîòèìîé ðâîòå -                     

                                  │ãîñïèòàëèçàöèÿ                                 

│0.14 │2) Íåôðîïàòèÿ                │1. Îñìîòð                       │1. Ñíèæåíèå ÀÄ  

                                  │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │2. Ïîëîæèòåëüíûé│

                                  │- ñåðíîêèñëàÿ ìàãíåçèÿ 25%-10,0 │äèóðåç         

                                  │â/ì                             │3. Êóïèðîâàíèå 

                                  │- äèáàçîë 1%-4,0                │ñóäîðîã        

                                  │- ïàïàâåðèí 2%-2,0                             

                                  │- ðåëàíèóì 2,0                                 

                                  │- ëàçèêñ 40 ìã                                 

                                  │3. Ãîñïèòàëèçàöèÿ                              

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│0.14 │3) Ïðåýêëàìïñèÿ ýêëàìïñèÿ    │1. Îñìîòð                       │1. Ñíèæåíèå ÀÄ 

                                  │2. Çàêèñü àçîòà - ÀÍ-8          │2. Ïîëîæèòåëüíûé│

                                  │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │äèóðåç         

                                  │- ðåëàíèóì 2,0 â/â              │3. Êóïèðîâàíèå 

                                  │- äèáàçîë 1%-5,0                │ñóäîðîã        

                                  │- ïàïàâåðèí 2%-2,0              │4. Ñòàáèëèçàöèÿ │

                                  │- ñåðíîêèñëàÿ ìàãíåçèÿ 25%-10,0 │ñîñòîÿíèÿ      

                                  │- ëàçèêñ 60 ìã - â\â            │5. Ýôôåêòèâíàÿ 

                                  │- äðîïåðèäîë 7,5-10 ìã â/â      │ðåàíèìàöèÿ     

                                  │- â/â êàïåëüíî ðåîïîëèãëþêîí                   

                                  │400,0                                          

                                  │4. Ãîñïèòàëèçàöèÿ - íîñèëêè                    

                                  │5. Ðåàíèìàöèîííîå ïîñîáèå                      

                                  │<*> Âñå ìàíèïóëÿöèè ïîä çàêèñüþ │               

                                  │àçîòà                                          

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│0.80 │Íîðìàëüíûå ðîäû              │1. Îñìîòð                       │Ðîäîâñïîìîæåíèå │

                                  │2. Ðîäîâñïîìîæåíèå                             

                                  │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî                  

                                  │ïîêàçàíèÿì (ìåòèëýðãîìåòðèí 1,0)│                

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

│0.83 │Çàòðóäíåííûå ðîäû            │1. Îñìîòð                       │Ðîäîâñïîìîæåíèå │

                                  │2. Ãîñïèòàëèçàöèÿ                               

                                  │3. Ðîäîâñïîìîæåíèå                             

├─────┼─────────────────────────────┼────────────────────────────────┼────────────────┤

     │Îñëîæíåíèÿ ïîñëåðîäîâîãî                                                    

     │ïåðèîäà                                                                     

│0.85 │1) Ïîñëåðîäîâûé ýíäîìåòðèò   │1. Îñìîòð                       │Ñòàöèîíàðíîå   

                                  │2. Ãîñïèòàëèçàöèÿ               │ëå÷åíèå        

│0.91 │2) Ìàñòèò                    │1. Îñìîòð                       │Ñòàöèîíàðíîå   

                                  │2. Ãîñïèòàëèçàöèÿ               │ëå÷åíèå        

│0.72 │3) Àòîíè÷åñêîå êðîâîòå÷åíèå â│1. Îñìîòð                       │Âîññòàíîâëåíèå 

     │ïîçäíåì ïîñëåðîäîâîì ïåðèîäå │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ      │ãåìîäèíàìèêè   

                                  │- îêñèòîöèí 1,0 â/â,            │Ñòàöèîíàðíîå   

                                  │ìåòèëýðãîìåòðèí 1,0             │ëå÷åíèå        

                                  │- ðåîïîëèãëþêèí 400,0 â/â                      

                                  │êàïåëüíî                                       

                                  │3. Ãîñïèòàëèçàöèÿ - ïðè                        

                                  │òðàíñïîðòèðîâêå ïðèæàòèå                       

                                  │áðþøíîãî îòäåëà àîðòû                          

└─────┴─────────────────────────────┴────────────────────────────────┴────────────────┘

 

ÐÀÇÄÅË: "ÒÐÀÂÌÀÒÎËÎÃÈß"

 

ÑÎÃËÀÑÎÂÀÍÎ:

Ãëàâûé òðàâìàòîëîã

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

È.Þ.ÊËÞÊÂÈÍ

 

Ãëàâíûè íåéðîõèðóðã

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

Â.Â.ÊÐÛËÎÂ

 

Ãëàâíûé êîìáóñòèîëîã

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

Ñ.Â.ÑÌÈÐÍÎÂ

 

ÒÐÀÂÌÀÒÈ×ÅÑÊÈÅ ÏÎÂÐÅÆÄÅÍÈß

 

┌─────┬─────────────────────────────┬────────────────────────────────┬─────────────────┐

│ Êîä │           Äèàãíîç               Îáúåì ìåäèöèíñêîé ïîìîùè        Ðåçóëüòàò   

                                             áðèãàäàìè                            

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│S.02 │Ïåðåëîì ÷åðåïà               │1. Îñìîòð                       │1. Îñòàíîâêà    

     │(ñâîä è îñíîâàíèå)           │2. Âðåìåííàÿ îñòàíîâêà          │êðîâîòå÷åíèÿ    

                                  │êðîâîòå÷åíèÿ: (ïî ïîêàçàíèÿì)   │2. Ïîääåðæàíèå  

                                  │- äàâÿùàÿ àñåïòè÷åñêàÿ ïîâÿçêà  │è âîññòàíîâëåíèå │

                                  │ñ ãåìîñòàòè÷åñêîé ãóáêîé        │æèçíåííî âàæíûõ 

                                  │- ïàëüöåâîå ïðèæàòèå ñîñóäà     │ôóíêöèé         

                                  │íàëîæåíèå êðîâîîñòàíàâëèâàþùåãî │                

                                  │çàæèìà (äî íà÷àëà                               

                                  │òðàíñïîðòèðîâêè)                                 

                                  │3. Ïðîôèëàêòèêà ìåõàíè÷åñêîé                    

                                  │àñôèêñèè (ïî ïîêàçàíèÿì):                       

                                  │- ñàíàöèÿ ÂÄÏ                                   

                                  │- ôèêñàöèÿ ÿçûêà                                

                                  │ÿçûêîäåðæàòåëåì                                 

                                  │- âîçäóõîâîä                                    

                                  │- èíòóáàöèÿ òðàõåè (äëÿ ÁÈÒ è                   

                                  │ñïåöáðèãàä)                                     

                                  │- êîíèêîòîìèÿ (ñòðîãî ïî                        

                                  │æèçíåííûì ïîêàçàíèÿì)                           

                                  │4. Ðåàíèìàöèîííîå ïîñîáèå                       

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │5. Òðàíñïîðòèðîâêà íîñèëêè â                    

                                  │ïîëîæåíèè íà ñïèíå ñ ïîâåðíóòîé │                

                                  │íà áîê ãîëîâîé                                  

                                  │6. Ãîñïèòàëèçàöèÿ                               

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│S.02 │Ïåðåëîì ëèöåâûõ êîñòåé       │1. Îñìîòð                       │1. Îñòàíîâêà    

     │(êîñòåé íîñà; ñêóëîâîé êîñòè;│2. Îñòàíîâêà êðîâîòå÷åíèÿ (ïî   │êðîâîòå÷åíèÿ    

     │íèæíåé, âåðõíåé ÷åëþñòè è äð.│ïîêàçàíèÿì):                    │2. Êóïèðîâàíèå  

                                  │- äàâÿùàÿ àñåïòè÷åñêàÿ ïîâÿçêà  │áîëåâîãî ñèíäðîìà│

                                  │ñ ãåìîñòàòè÷åñêîé ãóáêîé                        

                                  │- ïàëüöåâîå ïðèæàòèå ñîñóäà                     

                                  │3. Àñåïòè÷åñêàÿ ïîâÿçêà (ïî                     

                                  │ïîêàçàíèÿì)                                     

                                  │4. Îáåçáîëèâàíèå:                               

                                  │- àíàëüãèí 50% - 2,0 â/ì                        

                                  │5. Ãîñïèòàëèçàöèÿ                               

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│S.12;│Ïåðåëîì ïîçâîíî÷íèêà         │1. Îñìîòð                       │1. Ïîääåðæàíèå  

│S.14;│(íåîñëîæíåííûé, îñëîæíåííûé) │2. Ïðîòèâîøîêîâàÿ òåðàïèÿ:      │æèçíåííî âàæíûõ 

│S.22;│                             │- ïðåäíèçîëîí 180 ìã äîçà       │ôóíêöèé îðãàíèçìà│

│S.24;│                             │óâåëè÷èâàåòñÿ îò ñòåïåíè øîêà                   

│S.32;│                             │- ïîëèãëþêèí èëè äðóãèå                         

│S.34 │                             │ïëàçìîçàìåíèòåëè                                

                                  │- èíãàëÿöèÿ êèñëîðîäîì ïî                       

                                  │ïîêàçàíèÿì                                       

                                  │3. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                   

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │4. Èììîáèëèçàöèÿ øèíû Øàíöà                      

                                  │5. Òðàíñïîðòèðîâêà íà ùèòå (ñ                   

                                  │ôèíêàöèåé ïîñòðàäàâøåãî ê ùèòó) │                

                                  │èëè íà âàêóóìíîì ìàòðàöå                        

                                  │6. Ãîñïèòàëèçàöèÿ                               

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│S.42 │Ïåðåëîì êëþ÷èöû, êëþ÷è÷íî-   │1. Îñìîòð                       │1. Êóïèðîâàíèå  

     │àêðîìèàëüíîãî ñî÷ëåíåíèÿ     │2. Îáåçáîëèâàíèå:               │áîëåâîãî ñèíäðîìà│

                                  │- òðàìàë 2,0 - â/â èëè â/ì;                     

                                  │- ïðîìåäîë 2% - 1,0 èëè îìíîïîí │                

                                  │2% - 1,0 - â/â èëè â/ì;                         

                                  │- (â ñëó÷àÿõ íåýôôåêòèâíîñòè                    

                                  │íåíàðêîòè÷åñêèõ àíàëüãåòèêîâ)                   

                                  │3. Òðàíñïîðòíàÿ èììîáèëèçàöèÿ                   

                                  │4. Ãîñïèòàëèçàöèÿ                               

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│S.22 │Ïåðåëîì ãîðòàíè, òðàõåè,     │1. Îñìîòð                       │1. Êóïèðîâàíèå  

     │ãðóäèíû                      │2. Îñòàíîâêà êðîâîòå÷åíèÿ       │áîëåâîãî ñèíäðîìà│

                                 │(ïî ïîêàçàíèÿì):                │2. Ïîääåðæàíèå  

                                  │- äàâÿùàÿ ïîâÿçêà               │è âîññòàíîâëåíèå │

                                  │3. Ïðîôèëàêòèêà è áîðüáà ñ      │æèçíåííî âàæíûõ  

                                  │ìåõàíè÷åñêîé àñôèêñèåé:         │ôóíêöèé îðãàíèçìà│

                                  │- ñàíàöèÿ ÂÄÏ                                   

                                  │- ââåäåíèå âîçäóõîâîäà                          

                                  │- èíòóáàöèÿ òðàõåè                              

                                  │- êîíèêîòîìèÿ (ñòðîãî ïî                        

                                  │æèçíåííûì ïîêàçàíèÿì)                           

                                  │4. Îáåçáîëèâàíèå - òðàìàë 2,0,                  

                                  │îìíîïîí 2% - 1,0 èëè ïðîìåäîë                   

                                  │2% - 1,0 (ïðè íåýôôåêòèâíîñòè                   

                                  │äåéñòâèÿ íåíàðêîòè÷åñêèõ                        

                                  │àíàëüãåòèêîâ)                                   

                                  │5. Ãîñïèòàëèçàöèÿ                               

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│S.27 │Ïíåâìîòîðàêñ, ãåìîòîðàêñ     │1. Îñìîòð                                       

                                  │2. Ïðîôèëàêòèêà è áîðüáà ñ                      

                                  │ìåõàíè÷åñêîé àñôèêñèåé:                         

                                  │- ñàíàöèÿ ÂÄÏ                                   

                                  │- ââåäåíèå âîçäóõîâîäà                          

                                  │- èíòóáàöèÿ òðàõåè                              

                                  │3. Îêêëþçèîííàÿ ïîâÿçêà (ïðè                    

                                  │îòêðûòîì è êëàïàííîì                            

                                  │ïíåâìîòîðàêñå).                                 

                                  │4. Îáåçáîëèâàíèå - òðàìàë 2,0                    

                                  │èëè îìíîïîí 2% - 1,0                            

                                  │(ïðè íåýôôåêòèâíîñòè            │1. Êóïèðîâàíèå  

                                  │íåíàðêîòè÷åñêèõ àíàëüãåòèêîâ) - │áîëåâîãî        

                                  │â/ì èëè â/â                     │ñèíäðîìà        

                                  │- Íîâîêàèíîâûå áëîêàäû -        │2. Âîññòàíîâëåíèå│

                                  │âàãîñèìïàòè÷åñêàÿ, ìåæðåáåðíàÿ  │äûõàíèÿ         

                                  │(äëÿ ñïåöáðèãàä)                                

                                  │5. Îêñèãåíîòåðàïèÿ                              

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │6. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                   

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │7. Ãîñïèòàëèçàöèÿ                               

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│S.32 │Ïåðåëîì òàçà                 │1. Îñìîòð                                       

                                  │2. Îáåçáîëèâàíèå:                               

                                  │- ôåíòàíèë 0,005% - 2,0 - â/â                   

                                  │- çàêèñü àçîòà ñ êèñëîðîäîì                     

                                  │(â ñîîòíîøåíèè 1:1)                             

                                  │- âíóòðèòàçîâàÿ íîâîêàèíîâàÿ                    

                                  │áëîêàäà (äëÿ ñïåöáðèãàä)                         

                                  │3. Èíôóçèîííàÿ òåðàïèÿ:                         

                                  │- ïîëèãëþêèí èëè äðóãèå ïëàçìî- │1. Êóïèðîâàíèå  

                                  │çàìåíèòåëè âíóòðèâåííî êàïåëüíî │áîëåâîãî        

                                  │- ïðåäíèçàëîí 60-90 ìã èëè      │ñèíäðîìà        

                                  │ãèäðîêîðòèçîí 75-125 ìã â/â     │2. Ñòàáèëèçàöèÿ 

                                  │êàïåëüíî                        │ãåìîäèíàìèêè    

                                  │4. Ãîñïèòàëèçàöèÿ íà ùèòå ñ                     

                                  │âàëèêîì ïîä êîëåííûå ñóñòàâû                    

                                  │(ïîçà "ëÿãóøêè")                                

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│S.42;│Ïåðåëîì: êîñòåé âåðõíåé      │1. Îñìîòð                       │1. Âðåìåííàÿ    

│S.52;│êîíå÷íîñòè áåäðî             │2. Îñòàíîâêà êðîâîòå÷åíèÿ       │îñòàíîâêà       

│S.62;│                             │(ïî ïîêàçàíèÿì)                 │êðîâîòå÷åíèÿ    

│S.72 │                             │- äàâÿùàÿ ïîâÿçêà;              │2. Êóïèðîâàíèå  

                                  │- ïàëüöåâîå ïðèæàòèå ñîñóäà;    │áîëåâîãî        

                                  │- íàëîæåíèå æãóòà               │ñèíäðîìà        

│S.82;│äð. êîñòåé íèæíåé êîíå÷íîñòè │3. Îáåçáîëèâàíèå:               │3. Ñòàáèëèçàöèÿ 

│S.92 │                             │- òðàìàë 50-100 ìã. â/â,        │ãåìîäèíàìèêè    

                                  │ìîðôèí ãèäðîõëîðèä 1% - 1,0 èëè │                

                                  │îìíîïîí 2% - 1,0 â/â (ïðè                        

                                  │ïåðåëîìàõ òðóá÷àòûõ êîñòåé)                     

                                  │4. Èíôóçèîííàÿ òåðàïèÿ (ïðè                     

                                  │ïåðåëîìå áåäðà è ìíîæåñòâåííûõ                   

                                  │ïåðåëîìàõ):                                     

                                  │- ïîëèãëþêèí èëè äð.                            

                                  │ïëàçìîçàìåíèòåëè ñ                              

                                  │ïðåäíèçîëîíîì 60-90 ìã èëè                      

                                  │ãèäðîêîðòèçîíîì 125 ìã - â/â                    

                                  │êàïåëüíî                                        

                                  │5. Òðàíñïîðòíàÿ èììîáèëèçàöèÿ                   

                                  │6. Ãîñïèòàëèçàöèÿ - íîñèëêè                     

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│Ò.00 │Ñî÷åòàííàÿ òðàâìà            │1. Îñìîòð è îïðåäåëåíèå         │1. Âîññòàíîâëåíèå│

                                  │äîìèíèðóþùåãî ïîâðåæäåíèÿ       │è ïîääåðæàíèå   

                                  │2. Îñòàíîâêà íàðóæíîãî          │æèçíåííî âàæíûõ 

                                  │êðîâîòå÷åíèÿ                    │ôóíêöèé         

                                  │3. Îáåçáîëèâàíèå:               │îðãàíèçìà       

                                  │- íåíàðêîòè÷åñêèå èëè           │2. Âðåìåííàÿ    

                                  │íàðêîòè÷åñêèå àíàëüãåòèêè       │îñòàíîâêà       

                                  │- Ïðè ñî÷åòàíèè ñ ÷åðåïíî-      │êðîâîòå÷åíèÿ    

                                 │ìîçãîâîé òðàâìîé                │3. Êóïèðîâàíèå  

                                  │ïðåäïî÷òèòåëüíî                 │áîëåâîãî        

                                  │íåéðîëåïòàíàëüãåçèÿ             │ñèíäðîìà         

                                  │- èíãàëÿöèîííûé íàðêîç                          

                                  │4. Èíôóçèîííàÿ ïðîòèâîøîêîâàÿ                   

                                  │òåðàïèÿ:                                         

                                  │- ïîëèãëþêèí èëè äð.                            

                                  │ïëàçìîçàìåíèòåëè â/â êàïåëüíî                   

                                  │- ïðåäíèçàëîí èëè ãèäðîêîðòèçîí │                

                                  │- â/â êàïåëüíî (äîçà â                          

                                  │çàâèñèìîñòè îò ñòåïåíè øîêà)                    

                                  │- òðèñîëü èëè ð-ð Ðèíãåðà                       

                                  │5. Èíãàëÿöèÿ êèñëîðîäîì                         

                                  │6. Èíòóáàöèÿ òðàõåè è ÈÂË                       

                                  │(ïðè îñòðîé äûõàòåëüíîé                         

                                  │íåäîñòàòî÷íîñòè)                                

                                  │7. Àñåïòè÷åñêàÿ ïîâÿçêà                         

                                  │8. Òðàíñïîðòíàÿ èììîáèëèçàöèÿ                   

                                  │9. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                   

                                  │10. Ãîñïèòàëèçàöèÿ (ýêñòðåííàÿ) │                 

                                  │- íîñèëêè                                       

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│S.03 │Âûâèõè                       │1. Îñìîòð                       │1. Êóïèðîâàíèå  

│S.13 │                             │2. Îáåçáîëèâàíèå:               │áîëåâîãî        

│S.23 │                             │- òðàìàë 50 ìã - â/ì èëè â/â    │ñèíäðîìà        

│S.33 │                             │- ïðîìåäîë 2% - 1,0 èëè îìíîïîí │                

│S.43 │                             │2% - 1% (ïðè íåýôôåêòèâíîñòè                    

│S.53 │                             │íåíàðêîòè÷åñêèõ àíàëüãåòèêîâ)                   

│S.63 │                             │3. Òðàíñïîðòíàÿ èììîáèëèçàöèÿ                   

│S.73 │                             │4. Ãîñïèòàëèçàöèÿ - èëè                         

│S.83 │                             │äîñòàâêà â òðàâìïóíêò                           

│S.93 │                                                                            

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│S.03 │Ðàñòÿæåíèå è ïðåíàïðÿæåíèå   │1. Îñìîòð                       │1. Êóïèðîâàíèå  

│S.13 │êàïñóëüíîñâÿçî÷íîãî àïïàðàòà │2. Îáåçáîëèâàíèå:               │áîëåâîãî        

│S.23 │                             │- àíàëüãèí 50% - 2,0 èëè òðàìàë │ñèíäðîìà        

│S.33 │                             │50 ìã - â/ì                                     

│S.43 │                             │3. Òðàíñïîðòíàÿ èììîáèëèçàöèÿ                   

│S.53 │                             │(ôèêñèðóþùàÿ ïîâÿçêà)                           

│S.63 │                             │4. Ãîñïèòàëèçàöèÿ (ñòàöèîíàð)                    

│S.73 │                             │èëè äîñòàâêà â òðàâìïóíêò                       

│S.83 │                                                                             

│S.93 │                                                                              

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│S.06 │Îòêðûòàÿ ÷åðåïíî-ìîçãîâàÿ    │1. Îñìîòð                       │1. Îñòàíîâêà    

     │òðàâìà (íåïðîíèêàþùàÿ,       │2. Îñòàíîâêà êðîâîòå÷åíèÿ (ïî   │êðîâîòå÷åíèÿ    

     │ïðîíèêàþùàÿ, ñ ïîâðåæäåíèåì è│ïîêàçàíèÿì):                    │2. Âîññòàíîâëåíèå│

     │áåç ïîâðåæäåíèÿ ãîëîâíîãî    │- äàâÿùàÿ àñåïòè÷åñêàÿ ïîâÿçêà  │è ïîääåðæàíèå   

     │ìîçãà)                       │ñ ãåìîñòàòè÷åñêîé ãóáêîé        │æèçíåííî âàæíûõ 

                                  │- ïàëüöåâîå ïðèæàòèå ñîñóäà     │ôóíêöèé îðãàíèçìà│

                                  │- íàëîæåíèå                                     

                                  │êðîâîîñòàíàâëèâàþùåãî çàæèìà äî │                

                                  │íà÷àëà òðàíñïîðòèðîâêè                          

                                  │3. Ïðîôèëàêòèêà ìåõàíè÷åñêîé                    

                                  │àñôèêñèè (ïî ïîêàçàíèÿì):                       

                                  │- ñàíàöèÿ ÂÄÏ                                   

                                  │- ôèêñàöèÿ ÿçûêà                                

                                  │ÿçûêîäåðæàòåëåì;                                

                                  │- âîçäóõîâîä;                                   

                                  │- èíòóáàöèÿ òðàõåè;                             

                                 │- êîíèêîòîìèÿ (ñòðîãî ïî                        

                                  │æèçíåííûì ïîêàçàíèÿì)                           

                                  │4. Ýõî-ýíöåôàëîñêîïèÿ (äëÿ                       

                                  │ñïåöèàëèçèðîâàííûõ áðèãàä)                      

                                  │5. Èíôóçèîííàÿ òåðàïèÿ                          

                                  │(ïî ïîêàçàíèÿì):                                

                                  │6. Îêñèãåíîòåðàïèÿ                              

                                  │7. Ðåàíèìàöèîííîå ïîñîáèå                       

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │8. Òðàíñïîðòèðîâêà íà ñïèíå ñ                   

                                  │ïîâåðíóòîé íà áîê ãîëîâîé                       

                                  │9. Ãîñïèòàëèçàöèÿ                               

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│S.06 │Çàêðûòàÿ ÷åðåïíîìîçãîâàÿ     │1. Îñìîòð                       │1. Âîññòàíîâëåíèå│

     │òðàâìà:                      │2. Ïðîôèëàêòèêà ìåõàíè÷åñêîé    │è ïîääåðæàíèíå  

     │1. ñîòðÿñåíèå ãîëîâíîãî      │àñôèêñèè (ïî ïîêàçàíèÿì):       │æèçíåííî âàæíûõ 

│S.07 │ìîçãà;                       │- ñàíàöèÿ ÂÄÏ;                  │ôóíêöèé îðãàíèçìà│

     │2. óøèá ìîçãà;               │- ôèêñàöèÿ ÿçûêà                                

     │3. ñäàâëåíèå ìîçãà           │ÿçûêîäåðæàòåëè;                                 

                                  │- âîçäóõîâîä;                                   

                                  │- èíòóáàöèÿ òðàõåè;                             

                                  │- êîíèêîòîìèÿ.                                  

                                  │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                     

                                  │- ñåðíîêèñëàÿ ìàãíåçèÿ 25% -                    

                                  │10,0 - â/â (ïðè óøèáå è                         

                                  │ñäàâëåíèè ãîëîâíîãî ìîçãà)                       

                                  │4. Îêñèãåíîòåðàïèÿ                              

                                  │5. Ýõî-ýíöåôàëîãðàôèÿ                           

                                  │(äëÿ ñïåö. áðèãàä)                              

                                  │6. Ðåàíèìàöèîííîå ïîñîáèå                       

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │7. Ãîñïèòàëèçàöèÿ                               

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

     │Êîìáèíèðîâàííàÿ òðàâìà       │Îáúåì ìåäèöèíñêîé ïîìîùè                        

                                  │çàâèñèò îò õàðàêòåðà                            

                                  │òðàâìèðóþùèõ àãåíòîâ è ñîñòîèò                  

                                  │èç îñíîâíûõ ìåäèöèíñêèõ                         

                                  │ìàíèïóëÿöèé ïðè òðàâìàõ                         

                                  │(ìåõàíè÷åñêèõ, òåðìè÷åñêèõ,                     

                                  │õèìè÷åñêèõ è ðàäèîöèîííûõ                       

                                  │ïîðàæåíèÿõ)                                     

                                  │Ãîñïèòàëèçàöèÿ                                  

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

     │Òðàâìà îðãàíîâ ãðóäíîé       │1. Îñìîòð                       │1. Âðåìåííàÿ    

     │êëåòêè:                      │2. Àñåïòè÷åñêàÿ ïîâÿçêà.        │îñòàíîâêà       

│S.26 │- òðàâìà (ðàíåíèå) ñåðäöà    │3. Îáåçáîëèâàíèå:               │êðîâîòå÷åíèÿ    

                                  │- òðàìàë 50-100 ìã - â/â;       │2. Êóïèðîâàíèå  

│S.27 │- òðàâìà ëåãêîãî, áðîíõîâ,   │- ïðîìåäîë 2% - 1,0 ìã, îìíîïîí │áîëåâîãî        

     │òðàõåè, ïëåâðû.              │2% - 1,0 â/â (ïðè ðàíåíèÿõ      │ñèíäðîìà        

                                  │ñåðäöà, ëåãêèõ)                 │3. Âîññòàíîâëåíèå│

                                  │4. Èíôóçèîííàÿ òåðàïèÿ:         │è ïîääåðæêà     

                                  │- ð-ð ïëàçìîçàìåíèòåëÿ ñ        │æèçíåííî âàæíûõ 

                                  │ïðåäíèçîëîíîì 90-120 ìã èëè     │ôóíêöèé îðãàíèçìà│

                                  │ãèäðîêîðòèçîíîì 75 ìã - â/â                     

                                  │êàïåëüíî                                        

                                  │5. Îêñèãåíîòåðàïèÿ                              

                                  │6. Èíòóáàöèÿ òðàõåè - ÈÂË (áåç                  

                                  │ôîðñèðîâàííîãî âäîõà) - ïðè                     

                                  │íàðóøåíèè äûõàíèÿ                               

                                  │7. Ãîñïèòàëèçàöèÿ - íîñèëêè                     

                                  │(ïðè ðàíåíèè ñåðäöà ïî                          

                                  │âèòàëüíûì ïîêàçàíèÿì â                          

                                  │áëèæàéøåå ïðîôèëüíîå ëå÷åáíîå                   

                                  │ó÷ðåæäåíèå)                                     

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│S.36 │Òðàâìà îðãàíîâ áðþøíîé       │1. Îñìîòð                       │1. Ñòàáèëèçàöèÿ 

     │ïîëîñòè (ïå÷åíü, ñåëåçåíêà,  │2. Àñåïòè÷åñêàÿ ïîâÿçêà         │ãåìîäèíàìèêè    

     │ïîäæåëóäî÷íàÿ æåëåçà,        │3. Âûïàâøèå ïåòëè êèøå÷íèêà èëè │                

     │æåëóäîê, êèøå÷íèê)           │îðãàíû â áðþøíóþ ïîëîñòü íå                      

                                  │âïðàâëÿþòñÿ - ïîêðûâàþò                         

│S.37 │Òðàâìà òàçîâûõ îðãàíîâ       │óâëàæíåííîé (ôèçèîëîãè÷åñêèé                    

     │(ïî÷êè, ìî÷åâîé ïóçûðü,      │ð-ð) ñòåðèëüíîé ñàëôåòêîé                       

     │ìî÷åòî÷íèê, ìàòêà è äð.)     │4. Îáåçáîëèâàíèå:                               

                                  │- òðàìàë 50-100 ìã â/â;                         

                                  │- ïðè îòêðûòîé ïðîíèêàþùåé                      

                                  │òðàâìå ïðîìåäîë 2% - 1,0 ìã èëè │                

                                  │îìíîïîí 2% - 1,0 â/â                            

                                  │5. Èíôóçèîííàÿ òåðàïèÿ                          

                                  │- ð-ð ïëàçìîçàìåíèòåëÿ ñ                        

                                  │ïðåäíèçàëîíîì 60-90 ìã èëè                      

                                  │ãèäðîêîðòèçîíîì 125 ìã - â/â                    

                                  │êàïåëüíî                                        

                                  │- àìèíîêàïðîíîâàÿ êèñîðòà 5% -                  

                                  │100,0 èëè õëîðèñòûé êàëüöèé 10% │                

                                  │- 10,0                                          

                                  │6. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                   

                                 │(ïî ïîêàçàíèÿì)                                 

                                  │7. Ãîñïèòàëèçàöèÿ - íîñèëêè                     

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

     │Îòêðûòûå ðàíû:               │1. Îñìîòð                       │1. Îñòàíîâêà    

│S.01;│ãîëîâà                       │2. Îñòàíîâêà êðîâîòå÷åíèÿ:      │êðîâîòå÷åíèÿ    

│S.11;│øåÿ                          │- äàâÿùàÿ ïîâÿçêà               │2. Êóïèðîâàíèå  

│S.21;│òóëîâèùå                     │- íàëîæåíèå æãóòà               │áîëåâîãî        

│S.31;│                             │- íàëîæåíèå çàæèìà íà           │ñèíäðîìà        

│S.41;│âåðõíÿÿ êîíå÷íîñòü           │êðîâîòî÷àùèé ñîñóä -            │3. Ñòàáèëèçàöèÿ 

│S.51;│                             │(âðåìåííî! äî òðàíñïîðòèðîâêè)  │ïîêàçàòåëåé     

│S.61;│                             │- ïðèæàòèå ñîñóäà               │ãåìîäèíàìèêè    

│S.71;│íèæíÿÿ êîíå÷íîñòü            │3. Àñåïòè÷åñêàÿ ïîâÿçêà                         

│S.81;│                             │4. Îáåçáîëèâàíèå (ïî                            

│S.91 │                             │ïîêàçàíèÿì):                                    

                                  │- òðàìàë 50-100 ìã â/ì - â/â                    

                                  │5. Èíôóçèîííàÿ òåðàïèÿ                          

                                  │(ïî ïîêàçàíèÿì):                                

                                  │- ð-ð ïëàçìîçàìåíèòåëÿ ñ                        

                                  │ïðåäíèçîëîíîì 60 ìã èëè                         

                                  │ãèäðîêîðòèçîí 50 ìã                             

                                  │(äîçà ïî ïîêàçàíèÿì)                            

                                  │6. Èììîáèëèçàöèÿ                                

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │7. Ãîñïèòàëèçàöèÿ - íîñèëêè                     

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│S.00 │Ïîâåðõíîñòíûå òðàâìû è óøèáû │1. Îñìîòð                                        

│S.10 │áåç ïîâðåæäåíèÿ êîæíûõ       │2. Ôèêñèðóþùàÿ ïîâÿçêà                          

│S.20 │ïîêðîâîâ                     │(ïî ïîêàçàíèÿì)                                 

│S.30 │                             │3. Ãîñïèòàëèçàöèÿ                               

│S.40 │                             │(ïî ïîêàçàíèÿì)                                 

│S.50 │                                                                             

│S.60 │                                                                             

│S.70 │                                                                             

│S.80 │                                                                             

│S.90 │                                                                             

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│S.07;│Ðàçìîçæåíèÿ è òðàâìàòè÷åñêèå │1. Îñìîòð                       │1. Êóïèðîâàíèå  

│S.08 │àìïóòàöèè                    │2.Îáåçáîëèâàíèå:                │áîëåâîãî        

│S.17;│Ñèíäðîì äëèòåëüíîãî ñäàâëåíèÿ│- îìíîïîí 2% - 1,0 èëè ïðîìåäîë │ñèíäðîìà        

│S.18 │                             │1% - 1,0 - â/â                  │2. Ñòàáèëèçàöèÿ 

│S.28 │                             │- èíãàëÿöèÿ çàêèñüþ àçîòà ñ     │ïîêàçàòåëåé     

│S.38 │                             │êèñëîðîäîì â ñîîòíîøåíèè 1:1    │ãåìîäèíàìèêè    

│S.47;│                             │3. Íàëîæåíèå æãóòà,                             

│S.48 │                             │îñâîáîæäåíèå êîíå÷íîñòè -                       

│S.57;│                             │ñíÿòèå æãóòà, òóãîå áèíòîâàíèå                  

│S.58 │                             │- õîëîä                                          

│S.67;│                             │4. Èíôóçèîííàÿ òåðàïèÿ:                         

│S.68 │                             │- ðåîïîëèãëþêèí 400,0 ìë â/â                    

│S.77;│                             │êàïåëüíî                                        

│S.78 │                             │- ãåìîäåç 200,0 èëè äð.                         

│S.87;│                             │ïëàçìîçàìåíèòåëü - â\â êàïåëüíî │                

│S.88 │                             │5. Èììîáèëèçàöèÿ                                

│S.97;│                             │6. Ãîñïèòàëèçàöèÿ - íîñèëêè.                    

│S.98 │                             │<*> Àìïóòèðîâàííàÿ ÷àñòü òåëà                   

                                  │ïîìåùàåòñÿ â ïîëèýòèëåíîâûé                     

                                  │ïàêåò è äîñòàâëÿåòñÿ â                          

                                  │ñòàöèîíàð                                       

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│T.15-│Ïîñëåäñòâèÿ ïðîíèêíîâåíèÿ    │1. Îñìîòð (âêëþ÷àÿ              │1. Âîññòàíîâëåíèå│

│T.19 │èíîðîäíûõ òåë                │ëàðèíãîñêîïèþ - ùàäÿùàÿ)        │è ïîääåðæàíèå   

                                  │2. Èçâëå÷åíèå èíîðîäíîãî òåëà:  │æèçíåííî âàæíûõ 

                                  │ïðè ñâîáîäíîì äîñòóïå ê         │ôóíêöèé îðãàíèçìà│

                                  │èíîðîäíîìó òåëó - ñïåöèàëèñòàìè │                

                                  │ëå÷åáíûõ ó÷ðåæäåíèé                             

                                  │3. Èíòóáàöèÿ òðàõåè,                            

                                  │êîíèêîòîìèÿ (ïî ïîêàçàíèÿì)                      

                                  │4. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                   

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │5. Ãîñïèòàëèçàöèÿ                                

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│T.20-│Îæîãè                        │Îáúåì ìåäèöèíñêèõ ìåðîïðèÿòèé   │1. Êóïèðîâàíèå  

│T.32 │                             │çàâèñèò îò ïëîùàäè îæîãà è      │áîëåâîãî        

                                  │ñòåïåíè îæîãà                   │ñèíäðîìà        

                                  │1. Îñìîòð                       │2. Ñòàáèëèçàöèÿ 

                                  │2. Îáðàáîòêà îæîãîâ àýðîçîëÿìè  │ïîêàçàòåëÿ      

                                  │òèïà "Ïàíòåíîë"                 │ãåìîäèíàìèêè    

                                  │3. Àñåïòè÷åñêàÿ ïîâÿçêà         │3. Âîññòàíîâëåíèå│

                                  │4. Îáåçáîëèâàíèå:               │è ïîääåðæàíèå   

                                  │- òðàìîë 50-100 ìã - â/â;       │æèçíåííî âàæíûõ 

                                  │- ïðîìåäîë 2% - 1,0 èëè îìíîïîí │ôóíêöèé îðãàíèçìà│

                                  │2% - 1,0 - â/â (ïðè ïîðàæåíèè                   

                                  │áîëåå 60% ïîâåðõíîñòè çàêèñè                    

                                  │àçîòà ñ Î2 (â ñîîòíîøåíèè 1:1)                  

                                  │5. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ                     

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │6. Èíôóçèîííàÿ òåðàïèÿ                          

                                 │(ïî ïîêàçàíèÿì):                                

                                  │- ð-ð ïëàçìîçàìåíèòåëÿ â/â                      

                                  │êàïåëüíî.                                        

                                  │7. Îêñèãåíîòåðàïèÿ                              

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │8. Èíòóáàöèÿ òðàõåè                              

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │9. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                   

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │10. Ãîñïèòàëèçàöèÿ                              

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│Ò.69 │Îáùåå îõëàæäåíèå îðãàíèçìà   │1. Îñìîòð                       │1. Ñòàáèëèçàöèÿ 

     │(ñíèæåíèå òåìïåðàòóðû òåëà   │2. Òåïëîèçîëÿöèÿ áîëüíîãî       │ãåìîäèíàìèêè    

     │íèæå 35 ãðàä.)               │(â ñàëîíå âàòîìàøèíû îòêëþ÷èòü  │2. Ïîääåðæàíèå  

                                  │íàãðåâàòåëüíûå ïðèáîðû)         │æèçíåííî âàæíûõ 

                                  │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ      │ôóíêöèé îðãàíèçìà│

                                  │- ãåïàðèí (êëåêñàí äî 10 òûñ.                   

                                  │åä. â/â                                         

                                  │- ïàïàâåðèí 2% - 2,0 â/ì                        

                                  │- ãëþêîçà 40% - 30,0-40,0 â/â                    

                                  │èëè ãëþêîçà 5%-200,0 â/â                        

                                  │êàïåëüíî                                        

                                  │- ðåîïîëèãëþêèí 400,0 â/â                       

                                  │êàïåëüíî                                        

                                  │4. Ãîñïèòàëèçàöèÿ íà íîñèëêàõ,                  

                                  │â ðåìàíèìàöèîííîå îòäåëåíèå                     

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│Ò.33-│Îòìîðîæåíèå (ïîâåðõíîñòíîå   │1. Îñìîòð                       │1. Ñòàáèëèçàöèÿ 

│Ò.35 │îòìîðîæåíèå, ñ íåêðîçîì      │2. Òåïëîèçîëèðóþùàÿ ïîâÿçêà íà  │ãåìîäèíàìèêè    

     │òêàíè)                       │ïîðÿæåííóþ ïîâåðõíîñòü          │2. Ïîääåðæàíèå  

                                  │3. Îáåçáîëèâàíèå:               │æèçíåííî âàæíûõ 

                                  │- òðàìàë 50-100 ìã â/â èëè â/â  │ôóíêöèé îðãàíèçìà│

                                  │ìåäëåííî èëè íàðêîòè÷åñêèå                      

                                  │àíàëüãåòèêè                                     

                                  │4. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                     

                                  │- ïàïàâåðèí 2% - 2,0 â/ì                        

                                  │- ãåïàðèí 20 òûñ. åä. â/â                       

                                  │- ãëþêîçà 40% - 30,0-40,0 èëè                   

                                  │5% - 200,0 â/â                                  

                                  │- ðåîïîëèãëþêèí 400,0 â/â                        

                                  │êàïåëüíî                                        

                                  │5. Ãîñïèòàëèçàöèÿ                               

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│Ò.67 │Âîçäåéñòâèå âûñîêèõ          │1. Îñìîòð                       │1. Êóïèðîâàíèå  

     │òåìïåðàòóð (òåïëîâîé,        │2. Õîëîä íà ãîëîâó, â ïàõîâûå   │áîëåâîãî ñèíäðîìà│

     │ñîëíå÷íûé óäàð)              │îáëàñòè; îáòèðàíèå õîëîäíîé     │2. Ñòàáèëèçàöèÿ 

                                  │âîäîé                           │ïîêàçàòåëåé     

                                  │3. Ïðîõëàäíîå ïèòüå             │ãåìîäèíàìèêè    

                                  │4. Îáåçáîëèâàíèå: àíàëüãèí 50%  │3. Âîññòàíîâëåíèå│

                                  │- 2,0 èëè}                      │æèçíåííî âàæíûõ 

                                  │òðàìàë 50-100 ìã - â/ì èëè â/â  │ôóíêöèé         

                                  │ìåäëåííî                        │îðãàíèçìà       

                                  │5. Ïðîòèâîøîêîâàÿ òåðàïèÿ: ð-ð                  

                                  │ïëàçìîçàìåíèòåëÿ â/â êàïåëüíî                   

                                  │ïðåäíèçîëîí 30 ìã èëè                           

                                  │ãèäðîêîðòèçîí 25 ìã (äîçà ïî                    

                                  │ïîêàçàíèÿì)                                     

                                  │6. Îêñèãåíîòåðàïèÿ                              

                                  │7. Ðåàíèìàöèîííîå ïîñîáèå                       

                                  │(ïî ïîêàçàíèÿì)                                 

                                 │8. Ãîñïèòàëèçàöèÿ                               

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│Ò.75 │Óòîïëåíèå è ïîãðóæåíèå â âîäó│1. Îñìîòð:                      │1. Âîññòàíîâëåíèå│

                                  │à) ïîñòðàäàâøèé â ñîçíàíèè,     │è ïîääåðæàíèå   

                                  │ñòàáèëüíàÿ ãåìîäèíàìèêà,        │æèçíåííî âàæíûõ 

                                  │îòñóòñòâèå æàëîá:               │ôóíêöèé         

                                  │- ñàíàöèÿ âåðõíèõ äûõàòåëüíûõ   │îðãàíèçìà       

                                  │ïóòåé;                                          

                                  │- ðàñòèðàíèå òåëà ñóõèì                         

                                  │ïîëîòåíöåì;                                     

                                  │- ñîãðåâàíèå;                                   

                                  │- ãîñïèòàëèçàöèÿ                                

                                  │á) ïîñòðàäàâøèé áåç ñîçíàíèÿ,                   

                                  │ñòàáèëüíàÿ ãåìîäèíàìèêà:                        

                                  │ðåàíèìàöèîííîå ïîñîáèå:                         

                                  │- ñàíàöèÿ âåðõíèõ äûõàòåëüíûõ                   

                                  │ïóòåé è ò.ä.;                                   

                                  │- ðàñòèðàíèå ñóõèì ïîëîòåíöåì;                  

                                  │- ñîãðåâàíèå;                                   

                                  │- ãîñïèòàëèçàöèÿ                                

                                  │â) ïîñòðàäàâøèé áåç ñîçíàíèÿ ñ                  

                                  │îòñóòñòâèåì ñàìîñòîÿòåëüíîãî                    

                                  │äûõàíèÿ, íî ñ ñîõðàíåííîé                       

                                  │ñåðäå÷íîé äåÿòåëüíîñòüþ:                        

                                  │1. Ðåàíèìàöèîííîå ïîñîáèå:                      

                                  │- ñàíàöèÿ âåðõíèõ äûõàòåëüíûõ                    

                                  │ïóòåé;                                          

                                  │- âîçäóõîâîä;                                   

                                  │ èíòóáàöèÿ òðàõåè;                              

                                  │- ÈÂË                                           

                                  │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                     

                                  │- ëàçèêñ                                        

                                  │- 80 ìã - â/â                                   

                                  │- ÃÎÌÊ 20% - 10-20 ìë - â/â;                    

                                  │- ãåïàðèí 10000 åä. - â/â.                      

                                  │- Èíôóçèîííàÿ òåðàïèÿ: ð-ð                      

                                  │ïëàçìîçàìåíèòåëÿ â/â êàïåëüíî                   

                                  │3. Ðàñòèðàíèå òåëà ñóõèì                        

                                  │ïîëîòåíöåì                                      

                                  │4. Ñîãðåâàíèå                                   

                                  │5. Ãîñïèòàëèçàöèÿ (ñðî÷íî!)                     

                                  │ã) ïîñòðàäàâøèé áåç ñîçíàíèÿ ñ                  

                                  │îòñóòñòâèåì äûõàíèÿ è ñåðäå÷íîé │                

                                  │äåÿòåëüíîñòè:                                   

                                  │- ñàíàöèÿ âåðõíèõ äûõàòåëüíûõ                   

                                  │ïóòåé;                                           

                                  │- ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                    

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│Ò.71 │Àñôèêñèÿ è ñòðàíãóëÿöèÿ      │1. Îñìîòð                       │1. Âîññòàíîâëåíèå│

                                  │2. Ðåàíèìàöèîííîå ïîñîáèå:      │è ïîääåðæàíèå   

                                  │- ñàíàöèÿ âåðõíèõ äûõàòåëüíûõ   │æèçíåííî âàæíûõ 

                                  │ïóòåé;                          │îðãàíîâ         

                                  │- âîçäóõîâîä;                   │2. Êóïèðîâàíèå  

                                  │- èíòóáàöèÿ òðàõåè              │ñóäîðîæíîãî     

                                  │(ïî ïîêàçàíèÿì);                │ñèíäðîìà        

                                  │- ÈÂË (ïî ïîêàçàíèÿì);                          

                                  │- íåïðÿìîé ìàññàæ ñåðäöà                        

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │3. Èíôóçèîííàÿ òåðàïèÿ                          

                                  │(ïî ïîêàçàíèÿì):                                

                                  │- ð-ð ïëàçìîçàìåíèòåëÿ ñ                        

                                  │íîðàäðåíàëèíîì 0,2% - 1,0 -                     

                                  │â/â êàïåëüíî                                    

                                  │4. Ïðîôèëàêòèêà è                               

                                  │ïðåäóïðåæäåíèå ñóäîðîæíîãî                      

                                  │ñèíäðîìà:                                        

                                  │- ÃÎÌÊ 20% - 10,0-20,0 - â\â                    

                                  │5. Îêñèãåíîòåðàïèÿ                              

                                  │6. Ãîñïèòàëèçàöèÿ                                

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│Ò.75 │Âîçäåéñòâèå ýëåêòðè÷åñêîãî   │1. Óñòðàíåíèÿ âîçäåéñòâèÿ       │1. Êóïèðîâàíèå  

     │òîêà                         │ýëåêòðè÷åñêîãî òîêà (ïðèìåíåíèå │ñóäîðîã         

                                  │ðåçèíîâûõ ïåð÷àòîê, ðàçëè÷íûõ   │Ïðîôèëàêòèêà    

                                  │èçîëèðóþùèõ ïðåäìåòîâ)          │íàðóøåíèÿ       

                                  │2. Îñìîòð                       │ñåðäå÷íîãî      

                                  │3. ÝÊà                         │ðèòìà           

                                  │4. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ:                    

                                  │à) ïðè âîçáóæäåíèè ðåëàíèóì 2,0 │                

                                  │â/ì èëè â/â ìåäëåííî.                           

                                  │á) ïðè ñóäîðîãàõ:                               

                                  │- àìèíàçèí 2,5% - 0,5 ìë -                      

                                  │â/ì;                                            

                                  │- ëàçèêñ 80 ìã - â/â.                           

                                  │â) ïðè ýêñòðàñèñòîëèè -                         

                                  │ëèäîêàèí 80-100 ìã â/â                          

                                  │5. Èíôóçèîííàÿ òåðàïèÿ                          

                                 │(ïî ïîêàçàíèÿì): ð-ð                            

                                  │ïëàçìîçàìåíèòåëÿ â/â êàïåëüíî                   

                                  │6. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                    

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │7. Äåôèáðèëëÿöèÿ                                

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │8. Ãîñïèòàëèçàöèÿ                               

                                  │(îáÿçàòåëüíî!)                                  

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│S.11 │Íîæåâûå ðàíåíèÿ              │1. Îñìîòð                       │1. Ïîääåðæàíèå  

│S.21 │                             │2. Îñòàíîâêà êðîâîòå÷åíèÿ:      │è âîññòàíîâëåíèå │

│S.31 │                             │- äàâÿùàÿ ïîâÿçêà;              │æèçíåííî âàæíûõ 

│S.41 │                             │- ïàëüöåâîå ïðèæàòèå ñîñóäà;    │ôóíêöèé         

│S.51 │                             │- íàëîæåíèå æãóòà ïðè           │îðãàíèçìà       

│S.61 │                             │íåýôôåêòèâíîñòè äð. ñïîñîáîâ                    

│S.71 │                             │3. Àñåïòè÷åñêàÿ ïîâÿçêà.                        

│S.81 │                             │4. Îáåçáîëèâàíèå:                               

│S.91 │                             │- ôåíòàíèë 0,05% - 1,0 - â/â                    

                                  │5. Èììîáèëèçàöèÿ                                

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │6. Èíôóçèîííàÿ òåðàïèÿ                          

                                  │(ïî ïîêàçàíèÿì)                                 

                                  │7. Ãîñïèòàëèçàöèÿ                               

├─────┼─────────────────────────────┼────────────────────────────────┼─────────────────┤

│S.11 │Îãíåñòðåëüíûå ðàíåíèÿ        │1. Îñìîòð                       │1. Ïîääåðæàíèå  

│S.21 │                             │2. Îñòàíîâêà êðîâîòå÷åíèÿ:      │è âîññòàíîâëåíèå │

│S.31 │                             │- äàâÿùàÿ ïîâÿçêà               │æèçíåííî âàæíûõ 

│S.41 │                             │- ïàëüöåâîå ïðèæàòèå ñîñóäà     │ôóíêöèé îðãàíèçìà│

│S.51 │                             │- íàëîæåíèå æãóòà                               

│S.61 │                             │3. Àñåïòè÷åñêàÿ ïîâÿçêà                         

│S.71 │                             │4. Îáåçáîëèâàíèå: íàðêîòè÷åñêèå │                

│S.81 │                             │è íåíàðêîòè÷åñêèå àíàëüãåòèêè                   

│S.91 │                             │5. Èììîáèëèçàöèÿ                                

                                  │6. Èíôóçèîííàÿ òåðàïèÿ                          

                                  │7. Ãîñïèòàëèçàöèÿ                               

└─────┴─────────────────────────────┴────────────────────────────────┴─────────────────┘

 

ÐÀÇÄÅË: "ÒÅÐÀÏÅÂÒÈ×ÅÑÊÈÅ ÇÀÁÎËÅÂÀÍÈß"

 

ÑÎÃËÀÑÎÂÀÍÎ

Ãëàâíûé òåðàïåâò

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

Ë.Á.ËÀÇÅÁÍÈÊ

 

ÒÅÐÀÏÅÂÒÈ×ÅÑÊÈÅ ÇÀÁÎËÅÂÀÍÈß

 

┌───────┬──────────────────────────┬────────────────────────────────┬─────────────────┐

  Êîä           Äèàãíîç              Îáúåì ìåäèöèíñêîé ïîìîùè        Ðåçóëüòàò   

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│Ñ.00-  │Íîâîîáðàçîâàíèÿ           │1.Îñìîòð                                        

│Ñ.95                             │2. Ìåäèêàìåíòîçíî-                              

│Ä.10-                            │ñèìïòîìàòè÷åñêàÿ òåðàïèÿ:                       

│Ä.34   │Áîëåâîé ñèíäðîì           │- àíàëüãèí 50% - 2,0 èëè        │1. Îáåçáîëèâàíèå │

                                 │áàðàëãèí 5,0 èëè ìàêñèãàí 5,0   │Àêòèâ ËÏÓ       

                                 │èëè òðàìàë 2,0 - â/ì            │Äëÿ êîððåêöèè   

                                 │- íàðêîòè÷åñêèå àíàëüãåòèêè     │îáåçáîëèâàþùåãî 

                                 │(ñîãëàñíî ñóùåñòâóþùåé          │ýôôåêòà         

                                 │Èíñòðóêöèè)                     │2.              

                                                                 │Ãîñïèòàëèçàöèÿ  

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│Å.10-  │- Ñàõàðíûé äèàáåò:                                                        

│Å.14   │- ãèïîãëèêåìè÷åñêèå       │1. Îñìîòð                                       

       │ñîñòîÿíèÿ;                │2. Ãëþêîìåòðèÿ èëè ãëþêîòåñò    │Èñ÷åçíîâåíèå    

                                 │(ñîäåðæàíèÿ ãëþêîçû â êðîâè (îò │ñëàáîñòè, ÷óâñòâà│

                                 │2,78 äî 3,33 ììîëü/ë)           │ãîëîäà, òðåâîãè 

                                 │3. Ïðèåì óãëåâîäèñòîé ïèùè                      

                                 │(ñëàäêèé ÷àé, êóñî÷êè ñàõàðà,                   

                                 │áåëûé õëåá)                                     

                                 │4. Ðåêîìåíäàöèÿ (êîíñóëüòàöèÿ                   

                                 │ýíäîêðèíîëîãà)                                  

                                                                 │Âîñòàíîâëåíèå   

       │- ãèïîãëèêåìè÷åñêàÿ êîìà  │1. Îñìîòð                       │ñîçíàíèÿ        

                                 │2. Ãëþêîìåòðèÿ ïðè íàëè÷èè      │Ïîääåðæàíèå     

                                 │ãëþêîìåòðà (ñîäåðæàíèÿ ãëþêîçû â│æèçíåííûõ ôóíêöèé│

                                 │êðîâè 2,0 ììîëü/ë)                              

                                 │3. Ïðîôèëàêòèêà íàðóøåíèÿ                       

                                 │ïðîõîäèìîñòè ÂÄÏ (ñàíàöèÿ ÂÄÏ,                  

                                 │âîçäóõîâîä)                                     

                                 │4. Ìåäèêàìåíòîçíàÿ òåðàïèÿ                      

                                 │- ãëþêîçà 20% - 40% - 40-60 ìë                  

                                 │â/â. Ïðè îòñóòñòâèè ýôôåêòà                     

                                 │ïîâòîðèòü,                                      

                                 │ïðè íèçêîì ÀÄ:                                  

                                 │- äèñîëü 400,0 â/â êàïåëüíî èëè │                

                                 │ÝÊà (ïî ïîêàçàíèÿì áîëüíûì                      

                                 │ñòðàäàþùèì èøåìè÷åñêîé áîëåçíüþ │                

                                 │ñåðäöà è ìîçãà)                                 

                                 │5. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                   

                                 │(ïî ïîêàçàíèÿì):                                 

                                 │6. Ãîñïèòàëèçàöèÿ - íîñèëêè                     

                                                                                 

       │- äèàáåòè÷åñêàÿ êîìà      │1. Îñìîòð                       │Ïîääåðæàíèå     

                                 │2. Ãëþêîìåòðèÿ ïðè íàëè÷èè      │æèçíåííûõ ôóíêöèé│

                                 │ãëþêîìåòðà (ñîäåðæàíèå ñàõàðà â │                

                                 │êðîâè áîëüøå 16 ììîëü/ë)                        

                                 │3. Ïðîôèëàêòèêà íàðóøåíèÿ ÂÄÏ                   

                                 │(ñàíàöèÿ ÂÄÏ, âîçäóõîâîä,                       

                                 │èíòóáàöèÿ òðàõåè)                               

                                 │4. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                     

                                 │(ðåãèäðîòàöèÿ)                                  

                                 │0,9% - 400,0 ðàñòâîð õëîðèñòîãî │                

                                 │íàòðèÿ â/â êàïåëüíî;                            

                                 │- ÝÊÃ (ïî ïîêàçàíèÿì)                           

                                 │Èíãàëÿöèÿ Î2                                    

                                 │5. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ                   

                                 │(ïî ïîêàçàíèÿì)                                 

                                 │6. Ãîñïèòàëèçàöèÿ - íîñèëêè â                   

                                 │ðåàíèìàöèîííîå îòäåëåíèå                        

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│Å.03-  │Áîëåçíè ýíäîêðèííîé       │1. Îñìîòð                       │1. Íîðìàëèçàöèÿ 

│Å.86   │ñèñòåìû ðàñòðîéñòâà       │2. Ìåäèêàìåíòîçíî-              │äåÿòåëüíîñòè    

       │ïèòàíèÿ                   │ñèìïòîìàòè÷åñêàÿ òåðàïèÿ        │ñåðäå÷íî-       

                                 │(ïî ïîêàçàíèÿì)                 │ñîñóäèñòîé      

                                                                 │ñèñòåìû         

       │òèðåîòîêñè÷åñêíé êðèç:    │1. Îñìîòð                       │3. Êîððåêöèÿ    

                                 │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ      │ãàðìîíàëüíîãî,  

                                 │- ãèäðîêîðòèçîí 150-150 ìã â/â  │âîäíî-          

                                 │ñòðóéíî                         │ýëåêòðîëèòíîãî  

                                 │- Áåòà-àäðåíîáëîêàòîðû (îáçèäàí │îáìåíà          

                                 │1-5 ìã â/â ìåäëåííî)                            

                                 │- ñåðäå÷íûå ãëèêîçèäû (êîðãëèêîí│                 

                                 │0,06% - 1 ìë èëè ñòðîôàíòèí                     

                                 │0,05% - 0,3-1 ìë â/â ìåäëåííî)                  

                                 │- Ïðè ïñèõîìîòîðíîì âîçáóæäåíèè,│                

                                 │ñåäàòèâíûå ïðåïàðàòû (ðåëàíèóì                  

                                 │èëè ñåäóêñåí 2 ìë â/ì)                          

                                 │3. Ãîñïèòàëèçàöèÿ               │Êóïèðîâàíèå     

                                                                 │ïñèõèìîòîðíîãî  

                                                                 │âîçáóæäåíèÿ     

                                                                                 

│Ïðè    │ãèïîïàðàòèðåîèäíûé êðèç   │1. Îñìîòð                       │Êóïèðîâàíèå     

│ñîõðà- │(òåòàíèÿ)                 │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ      │ñóäîðîã         

│íåííîì │                          │- õëîðèñòûé êàëüöèé 10% èëè                     

│ñîçíà- │                          │ãëþêîíàò êàëüöèÿ 10% â äîçå 10- │                

│íèè                              │50 ìë (â çàâèñèìîñòè îò ñòåïåíè │                

                                 │òÿæåñòè ïðèñòóïà) - â/â                         

                                 │3. Ãîñïèòàëèçàöèÿ - íîñèëêè                     

                                                                                 

       │íàäïî÷å÷íèêîâûé êðèç      │1. Îñìîòð                       │Êîððåêöèÿ âîäíî- │

       │(àääèñîíè÷åñêèé)          │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ      │ýëåêòðîëèòíîãî, 

                                 │- ãèäðîêîðòèçîí 50 ìã èëè       │óãëåâîäíîãî     

                                 │ïðåäíèçàëîí 30 ìã â/â ñòðóéíî   │îáìåíîâ         

                                 │- ðàñòâîð õëîðèñòîãî íàòðèÿ 0,9%│Ïîäúåì ÀÄ       

                                 │- 500,0 ñ ïðåäíèçîëîíîì 25-30                   

                                 │ìã â/â êàïåëüíî                                 

                                 │- Ðàñòâîð ãëþêîçû 40% - 20-40 ìë│                

                                 │â/â                                              

                                 │- ïðè ñòîéêîé ãèïîòîíèè (äîïàìèí│                

                                 │0,05% - 5,0 èëè íîðàäðåíàëèí                    

                                 │0,2% - 1,0) â/â êàïåëüíî                         

                                 │3. Ãîñïèòàëèçàöèÿ íîñèëêè                       

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│Ä.50-  │Áîëåçíè êðîâè è           │1. Îñìîòð                       │1. Îñòàíîâêà    

│Ä.73   │êðîâåòâîðíûõ îðãàíîâ      │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïðè  │êðîâîòå÷åíèÿ    

                                 │êðîòå÷åíèè:                                     

                                 │- õëîðèñòûé êàëüöèé 10% - 10,0                  

                                 │èëè ãëþêîíàò êàëüöèÿ 10,0% -                    

                                 │10,0 - â/â                                      

                                 │- àñåïòè÷åñêàÿ äàâÿùàÿ ïîâÿçêà                  

                                 │(ïî ïîêàçàíèÿì)                                 

                                 │4. Ðåêîìåíäàöèè (êîíñóëüòàöèÿ                   

                                 │ãåìàòîëîãà)                                     

                                 │5. Àêòèâ â ËÏÓ                                  

                                 │6. Ãîñïèòàëèçàöèÿ ïî ïîêàçàíèÿì │                

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│J.00   │ÎÐÂÈ                      │1. Îñìîòð                       │1. Ñíèæåíèå     

│J.02   │Î. ôàðèíãèò               │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │òåìïåðàòóðû ïðè 

│J.03   │Î. òîíçèëëèò (Àíãèíà)     │- àíàëüãèí 50% - 2,0 (ïðè       │ãèïåðòåðìèè     

│J.04-  │Ëàðèíãèò, Òðàõåèò         │ãèïåðòåðìèè) - â/ì                              

│J.06                             │- äèìåäðîë 1% - 1,0 èëè                         

│J.10   │Ãðèïï                     │ñóïðàñòèí 2% - 1,0 èëè òàâåãèë                  

│J.30-  │äðóãèå áîëåçíè âåðõíèõ    │2,0 â/ì                                         

│J.39   │äûõàòåëüíûõ ïóòåé         │3. Àêòèâ â ËÏÓ                                  

       │(õðîíè÷åñêèé ôàðèíãèò,    │4. Ãîñïèòàëèçàöèÿ (ïðè àíãèíå                   

       │õðîíè÷åñêèé ëàðèíãèò è    │ñòðîãî îáÿçàòåëüíà, ïðè îòêàçå                  

       │ò.ä.)                     │àêòèâ íà "03", ïðè ïîâòîðíîì                     

                                 │îòêàçå àêòèâ â ËÏÓ                              

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│J.18   │Ïíåâìîíèÿ                 │1. Îñìîòð                       │- Óëó÷øåíèå     

                                 │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ (ïî  │ñîñòîÿíèÿ       

                                 │ïîêàçàíèÿì) ïðè áîëÿõ â ãðóäíîé │- íîðìàëèçàöèÿ  

                                 │êëåòêå, ãèïåðòåðìèè             │ãåìîäèíàìèêè    

                                 │- àíàëüãèí 50% - 2,0 â/ì        │- ïîääåðæàíèå   

                                 │- äèìåäðîë 1% - 1,0 â/ì         │æèçíåííî âàæíûõ 

                                 │ïðè ñåðäå÷íî-ñîñóäèñòîé         │ôóíêöèé         

                                 │íåäîñòàòî÷íîñòè                 │îðãàíèçìà       

                                 │- ñåðäå÷íûå ãëèêîçèäû:                          

                                 │êîðãëèêîí 0,06% - 1 ìë èëè                      

                                 │ñòðîôàíòèí 0,05% - 0,3 - 1 ìë                   

                                 │â/â ìåäëåííî                                    

                                 │- êîðäèàìèí 2,0 èëè                             

                                 │ñóëüôîêàìôîêàèí 10% - 2,0 ï/ê                   

                                 │- ïðè òîêñè÷åñêîì îòåêå ëåãêèõ                  

                                 │ïðåäíèçîëîí 60-90 ìã - â/â                      

                                 │- ïðè âîçáóæäåíèè - ñóäîðîãàõ;                  

                                 │ñåäóêñåí èëè ðåëàóíèì 2,0 â/ì                   

                                 │èëè â/â ìåäëåííî; èëè                           

                                 │îêñèáóòèðàò íàòðèÿ 20% - 5-10 ìë│                

                                 │â/â ìåäëåííî                                    

                                 │- ïðè íèçêîì ÀÄ - äîïàìèí - 5 ìë│                

                                 │â/â êàïåëüíî, ðåîïîëèãëþêèí                     

                                 │400,0                                           

                                 │3. Èíôóçèîííàÿ òåðàïèÿ:                         

                                 │- ïîëèãëþêèí 400,0 èëè                          

                                 │ðåîïîëèãëþêèí 400,0 èëè ãëþêîçà │                 

                                 │5% - 400,0 â/â êàïåëüíî                         

                                 │4. Îêñèãåíîòåðàïèÿ                              

                                 │(êèñëîðîä 30-40%)                                

                                 │5. Ãîñïèòàëèçàöèÿ íîñèëêè                       

                                 │6. Àêòèâ â ËÏÓ ïðè îòêàçå îò                    

                                 │ãîñïèòàëèçàöèè                                  

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│J.40-  │Õðîíè÷åñêàÿ îáòóðàöèîííàÿ │1. Îñìîòð                       │1. Óëó÷øåíèå    

│J.47   │(îáñòðóêòèâíàÿ) áîëåçíü   │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │ñîñòîÿíèÿ,      

       │ëåãêèõ                    │- áåðîäóàë 20-40 êàïåëü â 3 ìë  │óìåíüøåíèå èëè  

                                 │ôèçèîëîãè÷åñêîãî ðàñòâîðà ÷åðåç │êóïèðîâàíèå     

                                 │íåáóëàéçåð èëè ñàëüáóòàìîë 2-4  │îäûøêè          

                                 │ìë ÷åðåç íåáóëàéçåð                             

                                 │- ýóôèëëèí 2,4% - 10,0,                         

                                 │êîðãëèêîí 0,06% - 1,0 - â/â                     

                                 │Ïðè òÿæåëîì ïðèñòóïå, à òàêæå                   

                                 │ïðè ïîñòîÿííîì ïðèåìå                           

                                 │òàáëåòèðîâàííûõ ñòåðîèäîâ.                      

                                 │- ïðåäíèçàëîí 120 ìã â/â èëè                    

                                 │ãèäðîêîðòèçîí 250 ìë â/â                        

                                 │3. Àêòèâ â ËÏÓ                                  

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│J.45   │Áðîíõèàëüíàÿ àñòìà        │1. Îñìîòð                                       

                                 │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                     

                                                                                 

       │îáîñòðåíèå, ëåãêàÿ ñòåïåíü│1. Ìåäèêàìåíòîçíàÿ òåðïèÿ       │1. Êóïèðîâàíèå  

       │òÿæåñòè                   │- ñàëüáóòàìîë (âåíòîëèí) 2,5-5  │ïðèñòóïà        

                                 │ìã ÷åðåç íåáóëàéçåð â òå÷åíèå                   

                                 │5-10 ìèí.                                        

                                 │Îöåíèòü òåðàïèþ ÷åðåç 20 ìèí.                   

                                 │Ïðè íåóäâîëåòâîðèòåëüíîì ýôôåêòå│                

                                 │ïîâòîðèòü àíàëîãè÷íóþ èíãàëÿöèþ │                 

                                 │áðîíõîëèòèêà                                    

       │ñðåäíå-òÿæåëàÿ ñòåïåíü    │1. Ìåäèêàìåíòîçíàÿ òåðàïèÿ      │1. Êóïèðîâàíèå  

       │òÿæåñòè                   │- ñàëüáóòàìîë (âåíòîëèí) 2,5-5  │ïðèñòóïà        

                                 │ìã ÷åðåç íåáóëàéçåð â òå÷åíèå 5-│2. Ãîñïèòàëèçàöèÿ│

                                 │10 ìèí.; ïóëüìèêîðò îäíà-äâå    │â ñòàöèîíàð     

                                 │íåáóëû ÷åðåç íåáóëàéçåð èëè                     

│J.46                             │ýóôèëëèí 2,4% - 10,0 ìë íà ôèç. │                

                                 │ðàñòâîðå â/â ìåäëåííî (10 ìèí.),│                

                                 │ïðåäíèçîëîí â/â 60-90 ìã,                       

                                 │Îöåíèòü òåðàïèþ ÷åðåç 20 ìèí.                   

                                 │Ïðè íåóäâîëåòâîðèòåëüíîì ýôôåêòå│                

                                 │ïîâòîðèòü àíàëîãè÷íóþ èíãàëÿöèþ │                

                                 │áðîíõîëèòèêà                                    

       │òÿæåëàÿ ñòåïåíü           │1. Ìåäèêàìåíòîçíàÿ òåðïèÿ       │1. Ãîñïèòàëèçàöèÿ│

                                 │- ñàëüáóòàìîë (âåíòîëèí) 2,5-5  │â ñòàöèîíàð     

                                 │ìã ÷åðåç íåáóëàéçåð â òå÷åíèå 5-│                

                                 │10 ìèí.; ïóëüìèêîðò îäíà-äâå                    

                                 │íåáóëû ÷åðåç íåáóëàéçåð èëè                     

                                 │ýóôèëëèí 2,4% - 10,0 ìë íà ôèç. │                

                                 │ðàñòâîðå â/â ìåäëåííî (10 ìèí.),│                

                                 │ïðåäíèçîëîí â/â 60-90 ìã.,                      

                                 │ïðåäíèçîëîí (èëè                                

                                 │ìåòèëïðåäíèçîëîí) â/â 90-150 ìã.│                

       │óãðîçà îñòàíîâêè äûõàíèÿ  │1. Ìåäèêàìåíòîçíàÿ òåðàïèÿ      │1. Ãîñïèòàëèçàöèÿ│

                                 │- ýóôèëëèí 2,4% - 10,0 ìë íà    │â óñëîâèÿ ÁÈÒ   

                                 │ôèç. ðàñòâîðå â/â ìåäëåííî (10                   

                                 │ìèí.); ïðåäíèçîëîí (èëè                         

                                 │ìåòèëïðåäíèçîëîí) â/â äî 150-180│                

                                 │ìã                                               

                                 │2. Èíòóáàöèÿ òðàõåè                             

                                 │- áåðîäóàë 20-40 êàïåëü â 3 ìë                  

                                 │ôèçèîëîãè÷åñêîãî ðàñòâîðà ÷åðåç │                

                                 │íåáóëàéçåð èëè ñàëüáóòàìîë 2-4                  

                                 │ìë ÷åðåç íåáóëàéçåð                             

                                 │èëè                                             

                                 │- ýóôèëëèí 2,4% - 10,0 â/â                      

                                 │èëè                                             

                                 │- àäðåíàëèí 0,01% - 0,3-0,5                     

                                 │(îäíîêðàòíî áîëüíûì ìîëîäîãî                    

                                 │âîçðàñòà) - â/â                                 

                                 │Ïðè òÿæåëîì ïðèñòóïå, à òàêæå                   

                                 │ïðè ãîðìîíî çàâèñèìîì òå÷åíèè                   

                                 │áðîíõèàëüíîé àñòìû.                             

                                 │- ïðåäíèçîëîí 120 ìã â/â èëè                    

                                 │ãèäðîêîðòèçîí 250 ìë â/â                        

                                 │3. Àêòèâ â ËÏÓ                                  

                                 │4. Ãîñïèòàëèçàöèÿ (ïî                           

                                 │ïîêàçàíèÿì)                                     

                                 │5. Äëÿ ËÝÁ âûçîâ ÁÈÒ ïðè                        

                                 │íåêóïèðóþùèìñÿ ïðèñòóïå                         

       │- àñòìàòè÷åñêèé ñòàòóñ    │1. Îñìîòð                       │Âîññòàíîâëåíèå  

                                 │2. Èíôóçèîííàÿ òåðàïèÿ: â/â,    │äûõàíèÿ,        

                                 │êàïåëüíî                        │ïîääåðæàíèå     

                                 │- ïðåäíèçîëîí 120 ìã èëè        │æèçíåííî âàæíûõ 

                                 │ãèäðîêîðòèçîí 250 ìã            │ôóíêöèé îðãàíèçìà│

                                 │- ýóôèëëèí 2,4% - 10,0                          

                                 │- ãëþêîçà 5% - 500,0                            

                                 │3. Âîçäóøíî-êèñëîðîäíàÿ ñìåñü                    

                                 │(70:30)                                         

                                 │4. Èíòóáàöèÿ òðàõåè, ÈÂË                        

                                 │5. Ãîñïèòàëèçàöèÿ ÁÈÒ                           

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│J.81   │Äðóãèå áîëåçíè ëåãêèõ     │1. Îñìîòð                       │1. Óëó÷øåíèå    

       │(îñòðûé îòåê ëåãêèõ,      │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │ñîñòîÿíèÿ       

       │ëåãî÷íûé çàñòîé è ò.ä.)   │- êîðãëèêîí 0,06% - 1,0 èëè     │- óìåíüøåíèå    

                                 │ñòðîôàíòèí 0,05% - 0,5 - â/â    │îäûøêè          

                                 │- ëàçèêñ äî 60 ìã â/â           │- ñòàáèëèçàöèÿ  

                                 │- èíãàëÿöèÿ óâëàæíåííûì Î ñ     │ãåìîäèíàìèêè    

                                 │ïàðàìè ýòèëîâîãî ñïèðòà                         

                                 │4. Æãóòû íà êîíå÷íîñòè                          

                                 │5. Âûçîâ ÁÈÒ-áðèãàäû äëÿ ËÝÁ                    

                                 │6. Èíòóáàöèÿ òðàõåè, ÈÂË                        

                                 │7. Ãîñïèòàëèçàöèÿ                               

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│J.80   │Äðóãèå áîëåçíè îðãàíîâ    │1. Îñìîòð                       │1. Óëó÷øåíèå    

       │äûõàíèÿ (ïëåâðèò,         │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │ñîñòîÿíèÿ:      

       │ïíåâìîòîðàêñ)             │- àíàëüãèí 50% - 2,0 - â/ì      │- êóïèðîâàíèå   

                                 │- ïðîìåäîë 1% - 1,0 (ïî         │áîëåé           

                                 │ïîêàçàíèÿì) - ï/ê               │- îäûøêè        

                                 │- äèìåäðîë 1% - 1,0 èëè         │- íîðìàëèçàöèÿ  

                                 │ñóïðàñòèí 2% - 1,0 èëè òàâåãèë  │ÀÄ, PS          

                                 │2,0 â/ì                                         

                                 │- êîðäèàìèí èëè ñóëüôîêàìôîêàèí │                

                                 │2,0 - â/ì                                        

                                 │3. ÝÊÃ - äèàãíîñòèêà                            

                                 │(ïî ïîêàçàíèÿì)                                 

                                 │4. Îêêëþçèîííàÿ ïîâÿçêà â                        

                                 │çàâèñèìîñòè îò âèäà                             

                                 │ïíåâìîòîðàêñà                                   

                                 │6. Ãîñïèòàëèçàöèÿ                               

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│N.00-  │Íåôðèò, íåôðîòè÷åñêèé     │1. Îñìîòð                       │1. Âîññòàíîâëåíèå│

│N.03   │ñèíäðîì, îñòðûé è         │2. Ìåäèêàìåíòîçíî-              │è ñîõðàíåíèå    

       │õðîíè÷åñêèé               │ñèìïòîìàòè÷åñêàÿ òåðàïèÿ        │äèóðåçà         

│N.17-  │ãëîìåðóëîíåôðèò, íåôðèò,                                  │2. Êîððåêöèÿ ÀÄ 

│N.19   │ÎÏÍ è ò.ä.                                                                

       │- îñòðàÿ ïî÷å÷íàÿ         │1. Îñìîòð                                       

       │íåäîñòàòî÷íîñòü           │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                     

                                 │- ëàçèêñ 100-200 ìã â/â êàïåëüíî│                

                                 │â ðàçâåäåíèè                                    

                                 │- ýóôèëëèí 2,4% - 5-10 ìë íà                    

                                 │èçîòîíè÷åñêîì ðàñòâîðå                          

                                 │4. Ãîñïèòàëèçàöèÿ íîñèëêè                       

                                                                                 

       │- óðåìè÷åñêàÿ êîìà        │1. Îñìîòð                       │1. Êîððåêöèÿ    

                                 │2. Ïðîìûâàíèå æåëóäêà ñ 2%      │æèçíåííî âàæíûõ 

                                 │ðàñòâîðîì íàòðèÿ ãèäðîêàðáîíàòà │ôóíêöèé îðãàíèçìà│

                                 │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ                      

                                 │- ïðè ðâîòå: àòðîïèí 0,1% - 0,3-│                

                                 │1 ìë ï/ê è õëîðèñòûé íàòðèé 10% │                

                                 │- 10,0 â/â                                      

                                 │- ãëþêîçà 5% - 200,0 â/â                        

                                 │êàïåëüíî                                         

                                 │- ïðè âîçáóæäåíèè:                              

                                 │- ðåëàíèóì èëè ñåäóêñåí 2 ìë â/ì│                

                                 │ïðè âûñîêîì ÀÄ                                   

                                 │- êëîôåëèí 0,01% - 1,0 â/â                      

                                 │ìåäëåííî èëè äèáàçîë 0,5% - 1% -│                

                                 │3-5 ìë â/ì                                      

                                 │3. Ãîñïèòàëèçàöèÿ íîñèëêè                       

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│L.50   │Áîëåçíè êîæè è ïîäêîæíîé  │1. Îñìîòð                       │1. óëó÷øåíèå    

       │êëåò÷àòêè (äåðìàòèò,      │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî   │ñîñòîÿíèÿ,      

       │ýêçåìà, ïñîðèàç,          │ïîêàçàíèÿì:                     │óìåíüøåíèå çóäà 

       │àëëåðãè÷åñêàÿ êðàïèâíèöà è│- äèìåäðîë 1% - 1,0 èëè                         

       │ò.ä.)                     │ñóïðàñòèí 2% - 1,0 èëè òàâåãèë                  

                                 │2,0 â/ì                                         

                                 │3. Àêòèâ â ËÏÓ                                  

                                 │4. Ãîñïèòàëèçàöèÿ (ïî ïîêàçàíèþ)│                

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│Ì.15-  │Áîëåçíè êîñòíî-ìûøå÷íîé   │1. Îñìîòð                       │1. Óìåíüøåíèå   

│Ì.25   │ñèñòåìû è ñîåäèíèòåëüíûõ  │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî   │áîëåé           

       │òêàíåé (àðòðîçû, àðòðèòû è│ïîêàçàíèÿì:                                     

       │ò.ä.)                     │- àíàëüãèí 50% - 2,0 â/ì                        

                                 │- äèìåäðîë 1% - 1,0 â/ì                         

                                 │- ðåîïèðèí 5,0 â/ì                              

                                 │- îðòîôåí 0,025 ã - per os                      

                                 │4. Àêòèâ â ËÏÓ                                  

├───────┼──────────────────────────┼────────────────────────────────┼─────────────────┤

│Ò-78   │Àíàôèëàêòè÷åñêèé øîê,     │1. Îñìîòð (âíèìàíèå íà ñîñòîÿíèå│1. Âîññòàíîâëåíèå│

       │íåóòî÷íåííàÿ,             │ãåìîäèíàìèêè, äûõàíèÿ)          │ïðîõîäèìîñòè ÂÄÏ │

       │íåáëàãîïðèÿòíàÿ ðåàêöèÿ íà│2. Âûçîâ ñïåö. áðèãàäû äëÿ ËÝÁ. │2. Âîññòàíîâëåíèå│

       │ëåêàðñòâåííûå ñðåäñòâà,   │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │ãåìîäèíàìèêè,   

       │ìåäèêàìåíòû, áèîëîãè÷åñêèå│à) äèìåäðîë 1% - 1,0 èëè        │äûõàíèÿ         

       │ïðåïàðàòû, îòåê Êâèíêå    │ñóïðàñòèí 2% - 1,0 N 1 èëè      │3. Ýôôåêòèâíàÿ  

                                 │òàâåãèë 2,0 N 1, õëîðèñòûé      │ðåàíèìàöèÿ      

                                 │êàëüöèé 10% - 10,0 N 1 èëè      │4. Óìåíüøåíèå   

                                 │ãëþêîíàò êàëüöèÿ 10% - 10,0 N 1 │êîæíîãî çóäà    

                                 │à/à                             │5. Ãîñïèòàëèçàöèÿ│

                                 │á) ýóôèëëèíà 2,4% - 10,0 â/â íà │â ïðîôèëüíûé    

                                 │ôèç. ðàñòâîðå (ïðè ÿâëÿíèÿõ     │ñòàöèîíàð       

                                 │áðîíõîñïàçìà)                                   

                                 │â) àäðåíàëèí 1:1000 - 0,5 â/ì                   

                                 │ã) ðåîïîëèêëþêèí 400,0 N 1 èëè                  

                                 │ïîëèãëþêèí 400,0 N 1,                           

                                 │ãèäðîêîðòèçîí 125 ìã                            

                                 │(ïðåäíèçîëîí äî 300 ìã) òðèñàìè │                

                                 │30,0 (ëàêòîñîë)                                 

                                 │4. Êîíèêîòîìèÿ ïðè îòåêå Êâèíêå,│                

                                 │èíòóáàöèÿ òðàõåè, ÈÂË ïî                        

                                 │ïîêàçàíèÿì                                      

                                 │5. Ðåàíèìàöèîííîå ïîñîáèå                       

                                 │6. Ãîñïèòàëèçàöèÿ ïî ïîêàçàíèÿì │                

                                 │èëè àêòèâ â ËÏÓ                                 

└───────┴──────────────────────────┴────────────────────────────────┴─────────────────┘

 

ÐÀÇÄÅË: "ÍÅÂÐÎËÎÃÈß"

 

ÑÎÃËÀÑÎÂÀÍÎ

Ãëàâíûé íåâðîëîã

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

À.Í.ÁÎÉÊÎ

 

 ðàçðàáîòêå ó÷àñòâîâàëè:

Ïðîô. êàô. íåâðîëîãèè è íåéðîõèðóðãèè ÐÃÌÓ Ìàðòûíîâ Ì.Þ.

Çàâ. ÎÌÎ íåâðîëîãè÷åñêîé ïîìîùè ÄÇ ã. Ìîñêâû ê.ì.í. Áàòûøåâà Ò.Ò.

Çàâ. íåâðîëîãè÷åñêèì îòä. ÃÊÁ N 4 Ïðèêàç÷èêîâ Ñ.Â.

Âðà÷ ÎÌÎ íåâðîëîãè÷åñêîé ïîìîùè ÄÇ ã. Ìîñêâû Âèíåöêèé ß.ß.

Ãëàâíûé íåâðîëîã ÑÑ è ÍÌÏ ã. Ìîñêâû Ñèäîðîâ A.M.

 

┌──────┬──────────────────────────┬────────────────────────────────┬──────────────────┐

│ Êîä           Äèàãíîç              Îáúåì ìåäèöèíñêîé ïîìîùè        Ðåçóëüòàò    

├──────┴──────────────────────────┴────────────────────────────────┴──────────────────┤

                      ÁÎËÅÇÍÈ ÍÅÐÂÍÎÉ ÑÈÑÒÅÌÛ È ÎÐÃÀÍΠ×ÓÂÑÒ                      

├──────┬──────────────────────────┬────────────────────────────────┬──────────────────┤

│G.00- │Âîñïàëèòåëüíûå áîëåçíè    │1. Îñìîòð                       │1. Ïîääåðæàíèå   

│G.09  │öåíòðàëüíîé íåðâíîé       │2. Ïåðâè÷íàÿ êîððåêöèÿ íàðóøåíèÿ│æèçíåííî âàæíûõ  

      │ñèñòåìû (áàêòåðèàëüíûé    │äûõàíèÿ: ñàíàöèÿ, ÂÄÏ, ââåäåíèå │ôóíêöèé îðãàíèçìà │

      │ìåíèíãèò; ìåíèíãèò        │âîçäóõîâîäà, èíòóáàöèÿ òðàõåè,  │ïðè ãîñïèòàëèçàöèè│

      │íåóòî÷íåííîé ýòèîëîãèè,   │ÈÂË                                              

      │ýíöåôàëèò, ìèåëèò,        │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî                    

      │ýíöåôàëîìèåëèò, ôëåáèò è  │ïîêàçàíèÿì:                                      

      │òðîìáîôëåáèò              │- íåéðîèíòîêñèêàöèîííûé ñèíäðîì:│                 

      │âíóòðè÷åðåïíûõ âåíîçíûõ   │à) ðåîïîëèãëþêèí 400,0 â/â                       

      │ñèíóñîâ, âíóòðè÷åðåïíîé è │êàïåëüíî                                         

      │âíóòðèïîçâîíî÷íûé àáñöåññ,│á) ïðåäíèçîëîí äî 90 ìã â/â                      

      │îñòðûé èíôåêöèîííûé       │ñòðóéíî èëè äåêñàçîí 8 ìã â\ì                    

      │ïîëèíåâðèò                │â) äîïàìèí 5 ìë â/â êàïåëüíî ïðè│                 

                                │ïàäåíèè ÀÄ (ïî ïîêàçàíèÿì)                       

                                │- Ñèíäðîì âíóòðè÷åðåïíîé                         

                                │ãèïåðòåíçèè:                                     

                                │à) ëàçèêñ äî 60 ìã â/â                           

                                │á) Ìàííèò 15%-200,0 â\â, êàï.                    

                                │ïðè íèçêèõ öèôðàõ ÀÄ (ïî                         

                                │ïîêàçàíèÿì)                                      

                                │- Ñóäîðîæíûé ñèíäðîì:                            

                                │á) ðåëàíèóì 10 ìã â/â                            

                                │4. Îêñèãåíîòåðàïèÿ ïî ïîêàçàíèÿì│                 

                                │5. Ðåàíèìàöèîííîå ïîñîáèå                        

                                │6. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │7. Ãîñïèòàëèçàöèÿ â                              

                                │íåâðîëîãè÷åñêîå îòäåëåíèå îáùåãî│                 

                                │ïðîôèëÿ; ïî ïîêàçàíèÿì:                          

                                │òåðàïåâòè÷åñêîå, ËÎÐ è äð.                       

                                │îòäåëåíèÿ                                        

├──────┼──────────────────────────┼────────────────────────────────┼──────────────────┤

│G.40  │Ýïèëåïñèÿ:                │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │- "ãåíåðàëèçîâàííàÿ       │2. Ìàíèïóëÿöèè, ïðåäîõðàíÿþùèå  │ñóäîðîæíîãî      

      │ñóäîðîæíàÿ ýïèëåïñèÿ,     │ïðèêóñ ÿçûêà                    │ñèíäðîìà         

      │ãåíåðàëèçîâàííàÿ ýïèëåïñèÿ│3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

      │áåç ñóäîðîã, êàðäèàëüíàÿ  │- ðåëàíèóì 10 ìã â/ì èëè â/â èëè│                 

      │ýïèëåïñèÿ"                │äîðìèêóì 2,5-3 ìã â/ì                            

                                │- Ñóëüôàò ìàãíèÿ - 25% - 10,0 íà│                 

                                │10,0 ôèç. ðà-ðà â/â, ìåäëåííî                    

                                │4. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │5. Ãîñïèòàëèçàöèÿ:                               

                                │- èç îáùåñòâåííîãî ìåñòà, óëèöû,│                 

                                │ïðèïàäîê âîçíèêøèé âïåðâûå â                     

                                │æèçíè â íåâðîëîãè÷åñêîå                          

                                │îòäåëåíèå îáùåãî ïðîôèëÿ                         

                                │- â ñëó÷àÿõ ïîëó÷åíèÿ òðàâìû âî │                 

                                │âðåìÿ ïðèïàäêà - â ñòàöèîíàð                     

                                │èìåþùèé íåéðîòðàâìàòîëîãè÷åñêîå │                 

                                │èëè íåéðîõèðóðãè÷åñêîå                           

                                │îòäåëåíèÿ.                                       

                                │- áîëüíîé íà äîìó -                              

                                │ðåêîìåíäàöèè, àêòèâ â ËÏÓ                        

                                                                                 

      │- ñåðèÿ ïðèïàäêîâ         │1. Òî æå, âîçìîæíî ïîâòîðíîå    │1. Êóïèðîâàíèå   

                                │ââåäåíèå ÷åðåç 7-10 ìèí         │ñóäîðîæíîãî      

                                │ðåëàíèóìà 10 ìã â/â èëè äîðìèêóì│ïðèïàäêà         

                                │2,5-3 ìã â\ì (êîíòðîëü çà       │2. Îáåñïå÷åíèå   

                                │äûõàíèåì)                       │àäåêâàòíîé       

                                │2. ïåðâè÷íàÿ êîððåêöèÿ íàðóøåíèÿ│âåíòèëÿöèè ëåãêèõ │

                                │äûõàíèÿ (ñàíàöèÿ ÂÄÏ,           │ïðè               

                                │âîçäóõîâîä, èíòóáàöèÿ òðàõåè,   │òðàíñïîðòèðîâêå  

                                │ÈÂË)                                             

                                │3. Òðàíñïîðòèðîâêà - íîñèëêè.                    

                                │4. Ãîñïèòàëèçàöèÿ - â áîëüíèöó, │                 

                                │èìåþùóþ ðåàíèìàöèîííîå è                         

                                │íåâðîëîãè÷åñêîå îòäåëåíèÿ îáùåãî│                 

                                │ïðîôèëÿ                                          

                                                                                 

│G.41  │Ýïèëåïòè÷åñêèé ñòàòóñ     │1. Îñìîòð                       │1. Êóïèðîâàíèå   

                                │2. Ïåðâè÷íàÿ êîððåêöèÿ íàðóøåíèÿ│ñóäîðîæíîãî      

                                │äûõàíèÿ: (ñàíàöèÿ ÂÄÏ,          │ñèíäðîìà         

                                │âîçäóõîâîä, èíòóáàöèÿ òðàõåè,   │2. Ñòàáèëèçàöèÿ  

                                │ÈÂË)                            │ãåìîäèíàìè÷åñêèõ 

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │ïîêàçàòåëåé      

                                │- ðåëàíèóì 10 ìã â 20 ìë        │3. Îáåñïå÷åíèå   

                                │èçîòîíè÷åñêîãî ð-ðà â/â         │àäåêâàòíîé       

                                │ìåäëåííî, ÷åðåç 5-7 ìèí. ââîäÿò │âåíòèëÿöèè ëåãêèõ │

                                │ïîâòîðíî â òîé æå äîçå; èëè     │ïðè              

                                │äîðìèêóì 3 ìã â/ì               │òðàíñïîðòèðîâêå  

                                │- áàðáèòóðàòû ãåêñåíàë,                          

                                │òèîïåíòàë Na 2 ìã\êã ìàññû òåëà │                 

                                │â\ì (â óñëîâèÿõ ñïåö. Áðèãàäû)                   

                                │- èíãàëÿöèîííûé íàðêîç, çàêèñüþ │                 

                                │àçîòà â ñìåñè ñ êèñëîðîäîì â                     

                                │ñîîòíîøåíèè 3:1 (ïðè                             

                                │íåêóïèðîâàííûõ ïðèïàäêàõ,                        

                                │çàòðóäíÿþùèõ ãîñïèòàëèçàöèþ)                     

                                │- îñìîòè÷åñêèå äèóðåòèêè: ìàííèò│                 

                                │15% - 200,0 â\â, êàï. (ïî                         

                                │ïîêàçàíèÿì)                                      

                                │4. Ðåàíèìàöèîííîå ïîñîáèå                        

                                │5. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │6. Ãîñïèòàëèçàöèÿ - â áîëüíèöó, │                 

                                │èìåþùóþ ðåàíèìàöèîííîå è                         

                                │íåâðîëîãè÷åñêîå îòäåëåíèÿ îáùåãî│                 

                                │ïðîôèëÿ                                          

├──────┼──────────────────────────┼────────────────────────────────┼──────────────────┤

│G.43  │Ìèãðåíü                   │1. Îñìîòð                                        

                                │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

                                │- àíàëüãèí 50% - 2,0                             

                                │- äèìåäðîë 1% - 1,0                              

                                │- êîôåèí 10% - 1,0                               

                                │3. Ðåêîìåíäàöèè, àêòèâ â ËÏÓ                     

                                │4. Íå êóïèðóþùèéñÿ ïðèñòóï                       

                                │ìèãðåíè:                                         

                                │à) âûçîâ ñïåöèàëèçèðîâàííîé                      

                                │íåâðîëîãè÷åñêîé áðèãàäû                          

                                │á) ÍÏÂÏ: äèêëîôåíàê 3,0 â/ì èëè │                 

                                │ìîâàëèñ 1,5 ìë (15 ìã) â/ì                       

                                │5. Ãîñïèòàëèçàöèÿ â                              

                                │íåâðîëîãè÷åñêîå îòäåëåíèå îáùåãî│                 

                                │ïðîôèëÿ (ïî ïîêàçàíèÿì)                          

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      │Äðóãèå ýêñòðàïèðàìèäíûå   │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │è äâèãàòåëüíûå íàðóøåíèÿ: │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ,     │ñèíäðîìîâ        

│G.35  │- ðàññåÿííûé ñêëåðîç      │íàïðàâëåííàÿ íà ëå÷åíèå îñíîâíûõ│                 

│G.80  │- äåòñêèé öåðåáðàëüíûé    │ïàòîëîãè÷åñêèõ ñèíäðîìîâ                         

      │ïàðàëè÷                   │(ñóäîðîæíîãî, ìèàñòåíè÷åñêîãî è │                  

                                │äð.):                                            

│G.20                            │3. Ãîñïèòàëèçàöèÿ:                               

                                │- îáùåñòâåííîå ìåñòî, óëèöà - â │                 

│G.25  │- áîëåçíü Ïàðêèíñîíà      │íåâðîëîãè÷åñêîå îòäåëåíèå                        

      │- õîðåÿ                   │îáùåãî ïðîôèëÿ                                   

                                │- â ñëó÷àÿõ ïîëó÷åíèÿ òðàâìû - â│                 

                                │áîëüíèöû èìåþùèå                                 

                                │íåéðîòðàâìàòîëîãè÷åñêîå è                        

                                │íåéðîõèðóðãè÷åñêîå îòäåëåíèÿ                     

                                │- íà äîìó - ðåêîìåíäàöèÿ, àêòèâ │                 

                                │â ËÏÓ                                            

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│G.90  │Âåãåòàòèâíàÿ äèñòîíèÿ     │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │(âåãåòàòèâíî-ñîñóäèñòûé   │2. ÝÊà (ïî ïîêàçàíèÿì), ÝÊÏ â   │íåâðîòè÷åñêîãî   

      │êðèç)                     │óñëîâèÿõ ËÝÁ                    │ñèíäðîìà, ñíèæåíèå│

                                │3. Ïîñèíäðîìíàÿ ìåäèêàìåíòîçíàÿ │àðòåðèàëüíîé     

                                │òåðàïèÿ:                        │ãèïåðòåíçèè äî   

                                │- ñ àðòåðèàëüíîé ãèïåðòåíçèåé:  │ñóáíîðìàëüíûõ öèôð│

                                │êëîôåëèí 0,01% - 1,0 - â/ì,     │ÀÄ               

                                │ïàïàâåðèí 2% - 2-4 ìë,                           

                                │ïðîêñîäîëîë 2 ìë â\â.                            

                                │- ñ íåâðîòè÷åñêèì ñèíäðîìîì:                     

                                │ðåëàíèóì 10 ìã â\ì, íàñòîéêà                     

                                │âàëåðèàíû 20 ìë, êîðâàëîë 40-60 │                 

                                │êàï.                                             

                                │- ïðè ãîëîâíûõ áîëÿõ: àíàëüãèí                   

                                │50% - 2,0 èëè áàðàëãèí 5,0 -                     

                                │â/ì, íî-øïà 2,0 - â/ì                            

                                │4. Ðåêîìåíäàöèè, àêòèâ â ËÏÓ                      

                                │5. Ãîñïèòàëèçàöèÿ: ïðè ðàçâèòèè │                 

                                │ñòîéêîãî íåêóïèðóþùåãîñÿ                         

                                │âåãåòàòèâíîãî ïàðîêñèçìà - â                     

                                │íåâðîëîãè÷åñêîå îòäåëåíèå îáùåãî│                 

                                │ïðîôèëÿ                                          

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│G.93  │Äðóãèå ïîðàæåíèÿ ãîëîâíîãî│1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │ìîçãà: (ýíöåôàëîïàòèÿ ñ   │2. Ïåðâè÷íàÿ êîððåêöèÿ íàðóøåíèÿ│îñíîâíûõ         

      │âíóòðè÷åðåïíîé            │äûõàíèÿ:                        │ñèíäðîìîâ        

      │ãèïåðòåíçèåé, íåóòî÷íåííûå│- ñàíàöèÿ ÂÄÏ, ââåäåíèå         │2. Ïîääåðæàíèå   

      │ðàññòðîéñòâà íåðâíîé      │âîçäóõîâîäà (èíòóáàöèÿ òðàõåè)  │äûõàíèÿ è        

      │ñèñòåìû)                  │3. Ìåäèêàìåíòîçíîå ëå÷åíèå ïî   │ãåìîäèíàìèêè íà  

                                │ñèíäðîìàì:                      │àäåêâàòíîì óðîâíå │

                                │- äåãèäðàòàöèîííàÿ òåðàïèÿ:     │âî âðåìÿ         

                                │ëàçèêñ 40 ìã â\ì; ìàííèò 15% -  │òðàíñïîðòèðîâêè  

                                │200,0 â\â, êàï., äåêñàçîí 8 ìã                   

                                │â\ì (ïî ïîêàçàíèÿì)                              

                                │4. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │5. Ãîñïèòàëèçàöèÿ: â                             

                                │íåâðîëîãè÷åñêîå îòäåëåíèå îáùåãî│                 

                                │ïðîôèëÿ (ïî ïîêàçàíèÿì)                          

                                                                                 

│G.31  │Î.àëêîãîëüíàÿ             │1. Îñìîòð                                        

      │ýíöåôàëîïàòèÿ.            │2. Ïåðâè÷íàÿ êîððåêöèÿ íàðóøåíèÿ│                 

      │Ýíöåôàëîïàòèÿ Ãàéå-Âåðíèêå│äûõàíèÿ                                          

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî                    

                                │ñèíäðîìàì:                                       

                                │- äåçèíòîêñèêàöèîííàÿ òåðàïèÿ:                   

                                │ð-ð ãëþêîçû 5% - 400,0 â/â                        

                                │êàïåëüíî, èíñóëèí ïðîñòîé 6 ÅÄ, │                 

                                │ïðåäíèçîëîí 60 ìã, âèòàìèí Â-1- │                 

                                │1% - 5,0 ìë, àñêîðáèíîâàÿ êè-òà │                 

                                │5% - 5 ìë                                        

                                │4. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │5. Ãîñïèòàëèçàöèÿ - â                            

                                │òåðàïåâòè÷åñêîå îòäåëåíèå îáùåãî│                 

                                │ïðîôèëÿ; ýíöåôàëîïàòèÿ Ãàéå-                     

                                │Âåðíèêå - â íåâðîëîãè÷åñêîå                      

                                │îòäåëåíèå îáùåãî ïðîôèëÿ, ÎÐÈÒ                   

                                │(ïî ïîêàçàíèÿì)                                  

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│G.45  │Òðàíçèòîðíàÿ èøåìèÿ ìîçãà │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │(ñïàçì öåðåáðàëüíûõ       │2. ÝÊà                         │ïàòîëîãè÷åñêèõ   

      │àðòåðèé, ïðåõîäÿùàÿ èøåìèÿ│3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │ñèíäðîìîâ        

      │ìîçãà)                    │- ãèïîòåíçèâíûå ñðåäñòâà ïî     │2. Âîññòàíîâëåíèå │

                                │ïîêàçàíèÿì:                     │âèòàëüíûõ ôóíêöèé │

                                │- Ïðè ÀÄ âûøå 25% îò            │è ïîääåðæàíèå èõ 

                                │îïòèìàëüíîãî äëÿ äàííîãî        │íà ñòàáèëüíîì    

                                │áîëüíîãî:                       │óðîâíå ïî ïóòè   

                                │- Êîðäàôëåêñ (íèôåäèïèí) 20-30  │ñëåäîâàíèÿ â     

                                │ìã ñóáëèíãâàëüíî, èëè êàïîòåí   │ñòàöèîíàð        

                                │12,5-25 ìã ñóáëèíãâàëüíî.                        

                                │- Íåéðîïðîòåêòîðû:                               

                                │- Ãëèöèí 1 ã ñóáëèíãâàëüíî                       

                                │- ìåêñèäîë 5%-2,0 â/â (äëÿ                       

                                │íåâðîëîãè÷åñêèõ áðèãàä)                          

                                │- ýóôèëëèí 2,4% - 10,0 íà 10,0                   

                                │ôèç. ð-ðà â/â (ïðè îòñóòñòâèè                     

                                │íàðóøåíèé ñåðäå÷íîãî ðèòìà)                      

                                │- ñåðäå÷íûå ãëèêîçèäû                            

                                │(ïî ïîêàçàíèÿì)                                  

                                │4. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │5. Ãîñïèòàëèçàöèÿ - â                            

                                │àíãèîíåâðîëîãè÷åñêîå îòäåëåíèå                   

                                │6. Àêòèâ â ËÏÓ ïðè îòêàçå îò                     

                                │ãîñïèòàëèçàöèè                                   

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│G.50- │Áîëåçíè ïåðèôåðè÷åñêîé    │1. Îñìîòð                       │1. Êóïèðîâàíèå   

│G.59  │íåðâíîé ñèñòåìû è         │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî   │áîëåâîãî ñèíäðîìà │

      │ìåæïîçâîíêîâûõ äèñêîâ     │ñèíäðîìàì è ïîêàçàíèÿì:                          

      │(ñïîíäèëåç, îñòåîõîíäðîç  │- áîëåâîé ñèíäðîì: àíàëüãèí 50% │                 

      │ñ áîëåâûì ñèíäðîìîì,      │- 2,0 â/â èëè òðàìàë 100 ìã                      

      │íåâðîëãèÿ òðîéíè÷íîãî     │â\ì.                                             

      │íåðâà è äðóãèå ëèöåâûå    │- ÍÏÂÏ: äèêëîôåíàê 3,0 â/ì èëè                   

      │áîëè)                     │ìîâàëèñ 1,5 ìë (15 ìã) â/ì                       

                                │3. Ðåêîìåíäàöèè, àêòèâ â ËÏÓ                     

                                │4. Ãîñïèòàëèçàöèÿ                                

                                │à) ïðè ñèìïòîìàõ êîìïðåññèè                      

                                │ñïèííîãî ìîçãà (ñïåö.                            

                                │íåâðîëîãè÷åñêîé áðèãàäîé) â                      

                                │íåéðîõèðóðãè÷åñêîå îòäåëåíèå                     

                                │á) ïðè êîìïðåññèè êîðåøêîâ                       

                                │ñïèííîãî ìîçãà (ñïåö.                            

                                │íåâðîëîãè÷åñêîé áðèãàäîé) - â                    

                                │íåâðîëîãè÷åñêîå îòäåëåíèå îáùåãî│                 

                                │ïðîôèëÿ                                          

                                │5. Òðàíñïîðòèðîâêà - íîñèëêè                      

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│G.70  │Ìèàñòåíèÿ, ìèàñòåíè÷åñêèé │1. Îñìîòð                       │1. Âîññòàíîâëåíèå │

      │êðèç                      │2. Ìåäèêàìåíòîçíîå ëå÷åíèå:     │ñïîíòàííîãî      

                                │- ïðîçåðèí 0,05% - 2,0 ï/ê èëè  │äûõàíèÿ èëè      

                                │â/â ÷åðåç 30 ìèí. ïîâòîðíî â òîé│ïðîâåäåíèå ÈÂË äî │

                                │æå äîçå, ÷åðåç 30 ìèí. ïîâòîðíî │ïåðåäà÷è áîëüíîãî │

                                │â òîé æå äîçå ïðè íåêóïèðîâàíèè │â áëîê ÈÒ        

                                │êðèçà                                            

                                │3. Ñàíàöèÿ ÂÄÏ, èíòóáàöèÿ                        

                                │òðàõåè, ÈÂË                                      

                                │4. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │4. Ãîñïèòàëèçàöèÿ (â óñëîâèÿõ                    

                                │ÁÈÒ, ñïåöáðèãàäû) - â                            

                                │íåâðîëîãè÷åñêîå îòäåëåíèå îáùåãî│                 

                                │ïðîôèëÿ èëè ÎÐÈÒ                                 

                                │(ïî ïîêàçàíèÿì)                                  

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│I 60  │Ñóáàðàõíîèäàëüíîå         │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │êðîâîèçëèÿíèå             │2. Âûçîâ íåâðîëîãè÷åñêîé áðèãàäû│îñíîâíûõ         

                                │äëÿ ëèíåéíîé áðèãàäû            │ïàòîëîãè÷åñêèõ   

                                │3. Ëþìáàëüíàÿ ïóíêöèÿ (òîëüêî   │ñèíäðîìîâ        

                                │äëÿ êîíñóëüòàòèâíîé             │2. Àäåêâàòíûå    

                                │íåâðîëîãè÷åñêîé áðèãàäû â       │ïîêàçàòåëè äûõàíèÿ│

                                │óñëîâèÿõ ñòàöèîíàðà)            │è ãåìîäèíàìèêè è 

                                │4. Ïåðâè÷íàÿ êîððåêöèÿ          │âî âðåìÿ         

                                │äûõàòåëüíûõ íàðóøåíèé (ñàíàöèÿ  │òðàíñïîðòèðîâêè  

                                │ÂÄÏ, ââåäåíèå âîçäóõîâîäà,      │áîëüíîãî â       

                                │èíòóáàöèÿ òðàõåè)               │ñòàöèîíàð        

                                │5. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                       

                                │- ãèïîòåíçèâíàÿ òåðàïèÿ ïî                       

                                │ïîêàçàíèÿì                                       

                                │- Ïðè ÀÄ âûøå 25% îò                             

                                │îïòèìàëüíîãî äëÿ äàííîãî                         

                                │áîëüíîãî                                         

                                │- Êîðäàôëåêñ (íèôåäèïèí) 20-30                   

                                │ìã ñóáëèíãâàëüíî, èëè êàïîòåí                    

                                │12,5-25 ìã ñóáëèíãâàëüíî. Ïðè                    

                                │íåäîñòàòî÷íîì ýôôåêòå -                          

                                │ïðîñîäîëîë 2,0 â\â                               

                                │- ïðîòèâîñóäîðîæíûå,                             

                                │àíàëüãåòè÷åñêèå ñðåäñòâà ïî                      

                                │ïîêàçàíèÿì                                       

                                │6. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │7. Ãîñïèòàëèçàöèÿ - â áîëüíèöó, │                 

                                │èìåþùóþ àíãèîíåâðîëîãè÷åñêîå                     

                                │(íåéðîÏèò) è íåéðîõèðóðãè÷åñêîå │                 

                                │îòäåëåíèå                                        

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│I 61  │Âíóòðèìîçãîâîå            │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │êðîâîèçëèÿíèå (ðàçðûâ     │2. Ýõî-ýíöåôàëîñêîïèÿ (äëÿ      │îñíîâíûõ         

      │êðîâåíîñíîãî ñîñóäà       │íåâðîëîãè÷åñêèõ áðèãàä) äëÿ     │ïàòîëîãè÷åñêèõ   

      │ãîëîâíîãî ìîçãà)          │óòî÷íåíèÿ äèàãíîçà              │ñèíäðîìîâ        

                                │3. Ïåðâè÷íàÿ êîððåêöèÿ          │2. Ïîääåðæàíèå   

                                │äûõàòåëüíûõ íàðóøåíèé (ñàíàöèÿ  │æèçíåííî âàæíûõ  

                                │ÂÄÏ, ââåäåíèå âîçäóõîâîäà,      │ôóíêöèé îðãàíèçìà │

                                │èíòóáàöèÿ òðàõåè)               │âî âðåìÿ         

                                │4. Ìåäèêàìåíòîçíîå ëå÷åíèå:     │òðàíñïîðòèðîâêè  

                                │- ãèïîòåíçèâíûå ñðåäñòâà ïî                       

                                │ïîêàçàíèÿì:                                      

                                │- Ïðè ÀÄ âûøå 25% îò                             

                                │îïòèìàëüíîãî äëÿ äàííîãî                         

                                │áîëüíîãî:                                        

                                │- Êîðäàôëåêñ (íèôåäèïèí) 20-30                   

                                │ìã ñóáëèíãâàëüíî, èëè êàïîòåí                    

                                │12,5-25 ìã ñóáëèíãâàëüíî. Ïðè                    

                                │íåäîñòàòî÷íîì ýôôåêòå -                          

                                │ïðîñîäîëîë 2,0 â\â                               

                                │- Äåãèäðàòàöèîííàÿ òåðàïèÿ ïî                    

                                │ïîêàçàíèÿì: äåêñàçîí 8 ìã â\ì                    

                                │- ìàãíèÿ ñóëüôàò 25% - 20,0 â/â │                 

                                │êàïåëüíî íà 200,0 - 5% ãëþêîçû                   

                                │(äëÿ íåâðîëîãè÷åñêèõ áðèãàä                      

                                │- Àíãèîïðîòåêòîðû: Ýòàìçèëàò                     

                                │12,5% - 2,0 â/ì,â/â (äëÿ                         

                                │íåâðîëîãè÷åñêèõ                                  

                                │áðèãàä)                                          

                                │- Ïðîòèâîñóäîðîæíàÿ òåðàïèÿ,                     

                                │àíàëüãåòè÷åñêèå ñðåäñòâà ïî                      

                                │ïîêàçàíèÿì                                       

                                │5. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │6. Ãîñïèòàëèçàöèÿ - â áîëüíèöó, │                 

                                │èìåþùóþ àíãèîíåâðîëîãè÷åñêîå                     

                                │îòäåëåíèå (íåéðî ÏÈÒ) è                          

                                │íåéðîõèðóðãè÷åñêîå îòäåëåíèå                     

                                │7. Ïðè îòêàçå îò ãîñïèòàëèçàöèè │                 

                                │- äëÿ ËÝÁ âûçîâ ñïåö.                            

                                │íåâðîëîãè÷åñêîé áðèãàäû                           

                                │- äëÿ ñïåö. íåâðîëîãè÷åñêîé                      

                                │áðèãàäû - àêòèâ â ËÏÓ                            

├──────┼──────────────────────────┼────────────────────────────────┼──────────────────┤

│I 63  │Èíôàðêò ìîçãà,            │1. Îñìîòð                       │1. Êóïèðîâàíèå   

                                │2. ÝÊà                         │ïàòîëîãè÷åñêèõ   

│I 66  │Çàêóïîðêà è ñòåíîç        │3. Ýõî-ýíöåôàëîñêîïèÿ (äëÿ      │ñèíäðîìîâ        

      │ìîçãîâûõ àðòåðèé (òðîìáîç,│íåâðîëîãè÷åñêèõ áðèãàä) äëÿ     │2. àäåêâàòíîå    

      │ýìáîëèÿ ìîçãîâûõ àðòåðèé, │óòî÷íåíèÿ äèàãíîçà              │ïîääåðæàíèå      

      │íåóòî÷íåííûé õàðàêòåð     │4. Ïåðâè÷íàÿ êîððåêöèÿ íàðóøåíèÿ│ãåìîäèíàìèêè è   

      │èíñóëüòà)                 │äûõàíèÿ, ñàíàöèÿ ÂÄÏ, âîçäóõîâîä│äûõàíèÿ ïî ïóòè  

                                │(èíòóáàöèÿ òðàõåè)              │ñëåäîâàíèÿ â     

                                │5. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:     │ñòàöèîíàð        

                                │- ãèïîòåíçèâíûå ñðåäñòâà ïî                      

                                │ïîêàçàíèÿì:                                      

                                │Ïðè ÀÄ âûøå 25% îò îïòèìàëüíîãî │                 

                                │äëÿ äàííîãî áîëüíîãî:                            

                                │Êîðäàôëåêñ (íèôåäèïèí) 20-30 ìã │                 

                                │ñóáëèíãâàëüíî, èëè êàïîòåí 12,5-│                 

                                │25 ìã ñóáëèíãâàëüíî                              

                                │- Äåãèäðàòàöèîííàÿ òåðàïèÿ ïî                    

                                │ïîêàçàíèÿì: äåêñàçîí 8 ìã â\ì                    

                                │- Íåéðîïðîòåêòîðû:                               

                                │- Ãëèöèí 1 ã ñóáëèíãâàëüíî;                      

                                │ñåìàêñ 0,1% - 3 ê. â êàæäóþ                      

                                │íîçäðþ (äëÿ ñïåö.                                

                                │íåâðîëîãè÷åñêîé áðèãàäû)                         

                                │- ìåêñèäîë 5% - 2,0 â/â â ïåðâûå│                 

                                │6 ÷àñîâ îò íà÷àëà èíñóëüòà (äëÿ │                 

                                │íåâðîëîãè÷åñêèõ áðèãàä)                          

                                │- òðåíòàë (ïåíòîêñèôèëëèí) 2% - │                 

                                │5,0 (100 ìã) â/â êàïåëüíî,                       

                                │ìåäëåííî íà 250 ìë                                

                                │èçîòîíè÷åñêîãî ðàñòâîðà (äëÿ                     

                                │íåâðîëîãè÷åñêèõ áðèãàä)                          

                                │- ýóôèëëèí â/â 2,4 - 10,0 íà 20 │                  

                                │ìë 40% ð-ðà ãëþêîçû - â/â (ïðè                   

                                │îòñóòñòâèè íàðóøåíèé ñåðäå÷íîãî │                 

                                │ðèòìà)                                           

                                │- Àíãèîïðîòåêòîðû:                               

                                │Ýòàìçèëàò (äèöèíîí) 12,5% - 2,0 │                 

                                │â/ì,â/â (äëÿ íåâðîëîãè÷åñêèõ                     

                                │áðèãàä)                                          

                                │6. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │7. Ãîñïèòàëèçàöèÿ - â                            

                                │àíãèîíåâðîëîãè÷åñêîå îòäåëåíèå                   

                                │(íåéðîÏÈÒ)                                       

                                │8. Ïðè îòêàçå îò ãîñïèòàëèçàöèè │                 

                                │- âûçîâ ñïåö. íåâðîëîãè÷åñêîé                    

                                │áðèãàäû                                          

                                │- äëÿ ñïåö. íåâðîëîãè÷åñêîé                      

                                │áðèãàäû - àêòèâ â ËÏÓ                            

├──────┼──────────────────────────┼────────────────────────────────┼──────────────────┤

│I 64  │Îñòðûå íî íåòî÷íî         │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │îáîçíà÷åííûå              │2. ÝÊà                         │ïàòîëîãè÷åñêèõ   

      │öåðåáðîâàñêóëÿðíûå á-íè   │4. Ïåðâè÷íàÿ êîððåêöèÿ          │ñèíäðîìîâ        

      │(ÎÍÌÊ, áåç óòî÷íåíèÿ åãî  │äûõàòåëüíûõ íàðóøåíèé           │2. Âîññòàíîâëåíèå │

      │õàðàêòåðà è ëîêàëèçàöèè)  │5. Ìåäèêàìåíòîçíàÿ òåðàïèÿ      │âèòàëüíûõ ôóíêöèé │

                                │(íåäèôôåðåíöèðîâàííîå ëå÷åíèå)  │è ïîääåðæàíèå èõ 

                                │ïî ïîêàçàíèÿì:                  │íà ñòàáèëüíîì    

                                │- Ãèïîòåíçèâíûå ñðåäñòâà ïî     │óðîâíå ïî ïóòè   

                                │ïîêàçàíèÿì: Ïðè ÀÄ âûøå 25% îò  │ñëåäîâàíèÿ â     

                                │îïòèìàëüíîãî äëÿ äàííîãî        │ñòàöèîíàð        

                                │áîëüíîãî: Êîðäàôëåêñ (íèôåäèïèí)│                 

                                │20-30 ìã ñóáëèíãâàëüíî, èëè                       

                                │êàïîòåí 12,5-25 ìã                               

                                │ñóáëèíãâàëüíî                                    

                                │- Íåéðîïðîòåêòîðû:                                

                                │- Ãëèöèí 1 ã ñóáëèíãâàëüíî;                      

                                │ñåìàêñ 0,1% - 3 ê. â êàæäóþ                      

                                │íîçäðþ (äëÿ ñïåö.                                

                                │íåâðîëîãè÷åñêîé áðèãàäû)                         

                                │- Ìåêñèäîë 5% - 2,0 â/â â ïåðâûå│                 

                                │6 ÷àñîâ îò íà÷àëà èíñóëüòà (äëÿ │                 

                                │íåâðîëîãè÷åñêèõ áðèãàä)                          

                                │- Ýóôèëëèí â/â 2,4 - 10,0 íà 20 │                 

                                │ìë 40% ð-ðà ãëþêîçû - â/â (ïðè                   

                                │îòñóòñòâèè íàðóøåíèé ñåðäå÷íîãî │                 

                                │ðèòìà)                                           

                                │- Àíãèîïðîòåêòîðû: Ýòàìçèëàò                     

                                │(äèöèíîí) 12,5% - 2,0 â/ì,â/â                    

                                │(äëÿ íåâðîëîãè÷åñêèõ áðèãàä)                     

                                │6. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │7. Ãîñïèòàëèçàöèÿ -                              

                                │àíãèîíåâðîëîãè÷åñêîå îòäåëåíèå                   

                                │(íåéðîÏÈÒ)                                       

                                │8. Ïðè îòêàçå îò ãîñïèòàëèçàöèè │                 

                                │- âûçîâ ñïåö. íåâðîëîãè÷åñêîé                    

                                │áðèãàäû                                          

                                │- äëÿ ñïåö. íåâðîëîãè÷åñêîé                      

                                │áðèãàäû - àêòèâ â ËÏÓ                            

├──────┼──────────────────────────┼────────────────────────────────┼──────────────────┤

│I 67  │Îñòðàÿ ãèïåðòîíè÷åñêàÿ    │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │ýíöåôàëîïàòèÿ             │2. ÝÊà (ïî ïîêàçàíèÿì)          │ïàòîëîãè÷åñêèõ   

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî   │ñèìïòîìîâ        

                                │ïîêàçàíèÿì è ñèíäðîìàì:                          

                                │- Ýóôèëëèí 2,4% - 10,0 â/â                        

                                │- ìàãíèÿ ñóëüôàò 25% - 20,0 íà                   

                                │5% -200,0 ð-ðà ãëþêîçû â/â, êàï.│                 

                                │(äëÿ ñïåö. íåâðîëîãè÷åñêèõ                       

                                │áðèãàä)                                          

                                │- ãèïîòåíçèâíàÿ òåðàïèÿ:                         

                                │- Ïðè ÀÄ âûøå 25% îò                             

                                │îïòèìàëüíîãî äëÿ äàííîãî                         

                                │áîëüíîãî:                                        

                                │- Êîðäàôëåêñ (íèôåäèïèí) 20-30                   

                                │ìã ñóáëèíãâàëüíî, èëè êàïîòåí                    

                                │12,5-25 ìã ñóáëèíãâàëüíî. Ïðè                    

                                │íåäîñòàòî÷íîì ýôôåêòå -                          

                                │ïðîñîäîëîë 2,0 â/â                               

                                │- Äåãèäðàòàöèîííàÿ òåðàïèÿ:                      

                                │ëàçèêñ 20 - 40 ìã â/â; ìàííèò                    

                                │15% - 200,0 â\â, êàï. (äëÿ                       

                                │íåâðîëîãè÷åñêèõ áðèãàä)                          

                                │- Ñåäàòèâíàÿ, ïðîòèâîñóäîðîæíàÿ │                 

                                │òåðàïèÿ ïî ïîêàçàíèÿì:                           

                                │ðåëàíèóì 10 ìã â/ì                               

                                │4. Òðàíñïîðòèðîâêà - íîñèëêè                     

                                │5. Ãîñïèòàëèçàöèÿ - â                            

                                │òåðàïåâòè÷åñêîå îòäåëåíèå îáùåãî│                 

                                │ïðîôèëÿ ñòàöèîíàðà èìåþùåãî                      

                                │íåâðîëîãè÷åñêîå îòäåëåíèå                        

├──────┼──────────────────────────┼────────────────────────────────┼──────────────────┤

│I 69  │Ïîñëåäñòâèÿ               │1. Îñìîòð                       │1. Êóïèðîâàíèå   

      │öåðåáðîâàñêóëÿðíûõ        │2. Íåéðîïðîòåêòîðû: Ïèðàöåòàì   │ïàòîëîãè÷åñêèõ   

      │áîëåçíåé (öåðåáðàëüíûé    │20% - 30 ìë (6 ãð.) â/â.        │ñèíäðîìîâ        

      │àòåðîñêëåðîç)             │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî                    

                                │ïîêàçàíèÿì è ñèíäðîìàì                           

                                │4. Àêòèâ â ËÏÓ                                   

└──────┴──────────────────────────┴────────────────────────────────┴──────────────────┘

 

ÐÀÇÄÅË: "ÒÎÊÑÈÊÎËÎÃÈß"

 

ÑÎÃËÀÑÎÂÀÍÎ

Ãëàâíûé òîêñèêîëîã

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

Þ.Í.ÎÑÒÀÏÅÍÊÎ

 


 

ÒÎÊÑÈÊÎËÎÃÈß

 

Êîä 

Äèàãíîç        

Îáúåì ìåäèöèíñêîé ïîìîùè  

Ðåçóëüòàò      

Ò-39 

Îòðàâëåíèå              
àíàëüãåçèðóþùèìè,       
æàðîïîíèæàþùèìè è       
ïðîòèâîðåâìàòè÷åñêèìè   
ñðåäñòâàìè              

1. Îñìîòð                   
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
ëàêòîñîë 400,0, ãåìîäåç     
400,0 ìë èëè ãëþêîçà 5% -   
400,0, ðåîïîëèãëþêèí 400,0  
(ïî ïîêàçàíèþ) â/â êàïåëüíî 
4. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä, ââåäåíèå              
ýíòåðîñîðáåíòà              
5. Ðåàíèìàöèîííîå ïîñîáèå   
(ïðè ïîêàçàíèÿõ)            
6. Ãîñïèòàëèçàöèÿ           

1. Âîññòàíîâëåíèå    
ãåìîäèíàìè÷åñêèõ     
ïîêàçàòåëåé, äûõàíèÿ 
2. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
3. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
Âíèìàíèå! ïðè        
ïåðåäîçèðîâêå        
ïàðàöåòàìîëîì        
ãîñïèòàëèçàöèÿ       
îáÿçàòåëüíà          
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)

Ò 40.0
-    
Ò-40.4

Îòðàâëåíèå íàðêîòèêàìè  

1. Îñìîòð (âíèìàíèå íà      
çðà÷êè - óçêèå, äûõàíèå     
ðåäêîå)                     
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ââåäåíèå âîçäóõîâîäà     
(èíòóáàöèÿ òðàõåè) -        
àäåêâàòíàÿ ÈÂË ïðè          
íàðóøåíèÿõ äûõàíèÿ, òóàëåò  
ÂÄÏ ñ ïîìîùüþ îòñîñà        
4. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
ââåäåíèå à) àíòèäîòà        
íàëîêñîí (íàðêàíòè)         
âíóòðèâåííî,                
á) òðèñàìèí 400,0 èëè       
ëàêòîñîë, ãëþêîçà 5% -      
400,0, ãåìîäåç 400,0 â/â    
êàïåëüíî                    
â) ïðåäíèçîëîí 30 ìã (äîçà  
ïî ïîêàçàíèÿì)              
ã) êîôåèí 10% - 2,0,        
êîðäèàìèí 2,0 - ýôôåêòèâíû  
ïîñëå àíòèäîòíîé òåðàïèè!   
4. à) Ïðîìûâàíèå æåëóäêà    
÷åðåç çîíä (ó áîëüíûõ â     
êîìàòîçíîì ñîñòîÿíèè ïåðåä  
ïðîìûâàíèåì æåëóäêà -       
èíòóáàöèÿ òðàõåè)           
á) Ââåäåíèå ýíòåðîñîðáåíòà  
÷åðåç çîíä                   
Óêàçàííûå ìàíèïóëÿöèè       
ïðîâîäÿòñÿ ïðè ïåðîðàëüíîì  
èëè íåèçâåñòíîì ñïîñîáå     
ââåäåíèÿ ÿäà!               
5. Ðåàíèìàöèîííîå ïîñîáèå   
6. Ãîñïèòàëèçàöèÿ           
(âîññòàíîâëåíèå äûõàíèÿ     
ïîñëå ââåäåíèÿ íàëîêñîíà íå 
ñíèìàåò ïîêàçàíèÿ ê         
ãîñïèòàëèçàöèè)             

1. Âîññòàíîâëåíèå    
äûõàòåëüíûõ ôóíêöèé  
2. Âîññòàíîâëåíèå    
ñîçíàíèÿ.            
3. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè         
4. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
(Âíèìàíèå!            
Ïðè íàëè÷èè          
àñïèðàöèîííîãî       
ñèíäðîìà, äëèòåëüíîé 
ãèïîêñèè òåðàïèÿ     
íà÷èíàåòñÿ ñ ï. 2    
Ââîäèòü àíòèäîä -    
(íàëîêñîí, íàðêàíòè) 
òîëüêî ïîñëå         
óñòðàíåíèÿ óêàçàííûõ 
îñëîæíåíèé.          
Âîññòàíîâëåíèå äûõàíèÿ
ïîñëå ââåäåíèÿ       
íàëîêñîíà ïðè        
ïåðåäîçèðîâêå        
íàðêîòè÷åñêèìè       
ñðåäñòâàìè íå ñíèìàåò
ïîêàçàíèé ê          
ãîñïèòàëèçàöèè)      

Ò-40.5
-    
Ò 40.9

Îòðàâëåíèå              
ãàëëþöèíîãåíàìè         

1. Îñìîòð (âíèìàíèå íà      
çðà÷êè - øèðîêèå, íàëè÷èå   
ïñèõè÷åñêèõ ðàñòðîéñòâ:     
ãàëëþöèíàöèè, âîçáóæäåíèå)  
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Èçìåðåíèå ÀÄ, ïîäñ÷åò    
ïóëüñà                      
4. Ñåäàòèâíàÿ òåðàïèÿ       
(ðåëàíèóì, àìèíàçèí, ÃÎÌÊ)  
5. à) Ïðîìûâàíèå æåëóäêà    
÷åðåç çîíä (ó áîëüíûõ â     
êîìàòîçíîì ñîñòîÿíèè ïåðåä  
ïðîìûâàíèåì æåëóäêà -       
èíòóáàöèÿ òðàõåè)           
á) Ââåäåíèå ýíòåðîñîðáåíòà  
÷åðåç çîíä                  
Óêàçàííûå ìàíèïóëÿöèè       
ïðîâîäÿòñÿ ïðè ïåðîðàëüíîì  
èëè íåèçâåñòíîì ñïîñîáå     
ââåäåíèÿ ÿäà!               
6. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
òðèñàìèí èëè ëàêòîñîë       
(400,0), ãëþêîçà (5% -      
400,0), ãåìîäåç (400,0) â/â 
êàïåëüíî ïî ïîêàçàíèÿì      
7. Ðåàíèìàöèÿ               
8. Ãîñïèòàëèçàöèÿ           

1. Âîññòàíîâëåíèå    
äûõàòåëüíûõ ôóíêöèé  
2. Âîññòàíîâëåíèå    
ñîçíàíèÿ             
3. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè         
4. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèè ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)

Ò-42-
Ò-43 

Îòðàâëåíèå ïñèõîòðîïíûìè
ñðåäñòâàìè              

1. Îñìîòð (âíèìàíèå íà      
ãëóáèíó êîìû, äûõàíèå,      
õàðàêòåð ïóëüñà)            
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Èíòóáàöèÿ òðàõåè ïðè     
ðàçâèòèè êîìû, ÈÂË ïðè      
óãíåòåíèè äûõàíèÿ, ñàíàöèÿ  
òðàõåî-áðîíõèàëüíîãî äåðåâà 
ïðè àñïèðàöèè; ïðè çàïàäåíèè
ÿçûêà - âîçäóõîâîä          
4. Ìåäèêàìåíòîçíàÿ òåðàïèÿ. 
Ââåäåíèå àíòèäîòîâ:         
à) ïðè ðàçâèòèè             
àíòèõîëèíåðãè÷åñêîãî        
(õîëèíîëèòè÷åñêîãî) ñèíäðîìà
- àìèíîñòèãìèí 0,1% - 2-4 ìë
â/ì èëè ðåëàíèóì 2-4 ìë;    
á) ïðè îòðàâëåíèè           
áåíçîäèàçåïèíàìè (êîìà) -   
àíåêñàò 1 ìã â/â ñòðóéíî    
ìåäëåííî                    
â) ïðè àäðåíåðãè÷åñêîì      
ñèíäðîìå - ðåëàíèóì 2-4 ìë  
èëè àìèíàçèí 2 ìë           
5.                           
à) ãåìîäåç 400,0 èëè ãëþêîçà
(5% - 400,0)                
á) ðåîïîëèãëþêèí 400,0 (â/â 
êàïåëüíî)                   
â) äîïàìèí â/â êàïåëüíî     
(äîçà ïî ïîêàçàíèþ) ïðè     
íèçêîì ÀÄ                   
6. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä, ââåäåíèå ýíòåðîñîð-   
áåíòà èëè ñëàáèòåëüíîãî (ïðè
ãëóáîêîé êîìå ñëàáèòåëüíîå  
íå ââîäèòü!)                
7. Ðåàíèìàöèîííîå ïîñîáèå   
8. Ãîñïèòàëèçàöèÿ           

1. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè, äûõàíèÿ
2. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ            
3. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
4. Ïðè îòðàâëåíèè    
òðèöèêëè÷åñêèìè      
àíòèäåïðåññàíòàìè -  
ñíÿòèå ÝÊà          
5. Âíèìàíèå! ïðè     
ðàçâèòèè             
âíóòðèæåëóäî÷êîâîé   
áëîêàäû (îòðàâëåíèå  
àìèòðèïòèëèíîì)      
ââîäèòü óíèòèîë 10,0 
â/ìûøå÷íî,           
ãèäðîêîðòèçîí 125 ìã 
â/â                  
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)

Ò-51 

Òîêñè÷åñêîå äåéñòâèå    
àëêîãîëÿ                

1. Îñìîòð (âíèìàíèå íà      
ãëóáèíó êîìû, äûõàíèÿ)      
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Èíòóáàöèÿ òðàõåè ïî      
ïîêàçàíèÿì (âîçäóõîâîä),    
òóàëåò ÂÄÏ ñ ïîìîùüþ îòñîñà 
4. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
à) êîôåèí 10% - 1,0 èëè     
êîðäèàìèí 2,0               
á) âèòàìèí Ñ 5%-1,0 N 5,    
âèòàìèí Â äî 3,0, âèòàìèí ÐÐ
1% äî 5,0                   
â) òðèñàìèí 300,0           
(ëàêòîñîë), ãåìîäåç 400,0,  
ãëþêîçà 5% - 400,0,         
ðåîïîëèãëþêèí 400,0, äîïìèí 
0,5% - 5,0 (ïî ïîêàçàíèÿì), 
ïðåäíèçîëîí äî 120 ìã èëè   
ãèäðîêîðòèçîí 125 ìã (ïî    
ïîêàçàíèÿì)                 
5. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä                         
6. Ðåàíèìàöèîííîå ïîñîáèå   
7. Ãîñïèòàëèçàöèÿ           

1. Âîññòàíîâëåíèå    
ãåìîäèíàìè÷åñêèõ     
ïîêàçàòåëåé, äûõàíèÿ 
2. Âîçìîæíîñòü       
óìåíüøåíèÿ ãëóáèíû èëè
âûõîä èç êîìû        
3. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
4. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 

Ò-53 

Òîêñè÷åñêîå äåéñòâèå    
ãàëîãåíïðîèçâîäíûõ      
àëèôàòè÷åñêèõ è         
àðîìàòè÷åñêèõ           
óãëåâîäîðîäîâ           

1. Îñìîòð (âíèìàíèå íà      
ñîçíàíèå, äûõàíèå,          
ãåìîäèíàìèêó)               
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
à) àíòèäîòíàÿ òåðàïèÿ: ð-ð  
óíèòèîëà 5% - 10,0 (ïðè     
îòðàâëåíèè õëîðèðîâàííûìè   
óãëåâîäîðîäàìè), ëèïîåâàÿ   
êèñëîòà 0,2% - 5,0 (äëÿ     
òîêñèêîëîãè÷åñêèõ áðèãàä),  
âèòàìèíîòåðàïèÿ: âèòàìèí Ñ  
5% - 2,0 N 5, Â1 5% - 1,0 N 3
á) äåçèíòîêñèêàöèîííàÿ      
òåðàïèÿ: òðèñàìèí 300,0     
(ëàêòîñîë) â\â êàïåëüíî     
ãëþêîçà 5% - 400,0 èëè      
ãåìîäåç 400,0 èëè           
ðåîïîëèãëþêèí 400,0         
â) ïðè âîçáóæäåíèè,         
ñóäîðîãàõ - ðåëàíèóì 2,0-4,0
â/â ñòðóéíî ìåäëåííî        
4. Èíòóáàöèÿ òðàõåè (ïðè    
ðàçâèòèè êîìû), ÈÂË ïî      
ïîêàçàíèÿì                  
5. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä + ýíòåðîñîðáåíò èëè    
ìàñëÿíîå ñëàáèòåëüíîå       
(âàçåëèíîâîå ìàñëî)         
6. Ðåàíèìàöèîííîå ïîñîáèå   
7. Ãîñïèòàëèçàöèÿ           

1. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè, äûõàíèÿ;
ïðè îòðàâëåíèè       
äèõëîðýòàíîì         
âîññòàíîâëåíèå       
ãåìîäèíàìèêè ìîæåò íå
áûòü                 
2. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
3. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)

Ò-54 

Òîêñè÷åñêîå äåéñòâèå    
ðàçúåäàþùèõ âåùåñòâ:    
êèñëîò, åäêèõ ùåëî÷åé   

1. Îñìîòð (âíèìàíèå íà      
áîëåâîé ñèíäðîì, äûõàíèå,   
ãåìîäèíàìèêó)               
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
à) ìîðôèí 1% - 1,0 èëè      
îìíîïîí 2% - 1,0 èëè        
ïðîìåäîë 2% - 1,0 èëè       
ôåíòàíèë 0,005% - 2,0       
á) ïëàòèôèëëèí 0,2% - 1,0   
èëè àòðîïèí 0,1% - 1,0      
â) ëå÷åíèå øîêà:            
ðåîïîëèãëþêèí 400,0 èëè     
ïîëèãëþêèí 400,0 ñ          
íîâîêàèíîì 0,5% - 20,0,     
ãåìîäåç 400,0 â/â êàïåëüíî, 
ïðåäíèçîëîí 30-120 ìã èëè   
ãèäðîêîðòèçîí 125 ìã (ïî    
ïîêàçàíèÿì)                 
ïðè îòðàâëåíèè êèñëîòàìè -  
òðèñàìèí 300,0 (ëàêòîñîë)   
4. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä õîëîäíîé âîäîé         
5. Ðåàíèìàöèîííîå ïîñîáèå   
6. Ãîñïèòàëèçàöèÿ ïðè îæîãå 
äûõàòåëüíûõ ïóòåé (îñèïëîñòü
ãîëîñà, çàòðóäíåííûé âäîõ) -
âíóòðèâåííî ñòðóéíî         
ãèäðîêîðòèçîí 125 ìã +      
èíãàëÿöèÿ ãèäðîêîðòèçîíà íà 
ôèç. ðàñòâîðå, ïðè          
äåêîìïåíñèðîâàííîì ñòåíîçå  
ãîðòàíè - êîíèêîòîìèÿ       

1. Êóïèðîâàíèå       
áîëåâîãî ñèíäðîìà    
2. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè, äûõàíèÿ
3. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
4. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíîå îòäåëåíèå 
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)

Ò-56 

Òîêñè÷åñêîå äåéñòâèå    
ìåòàëëîâ (ìûøüÿê, ðòóòü è
ò.ä.)                   

1. Îñìîòð (âíèìàíèå íà      
ñîñòîÿíèå ñîçíàíèÿ,         
äûõàíèÿ, ãåìîäèíàìèêó, öâåò 
è ñóõîñòü ñëèçèñòûõ è êîæíûõ
ïîêðîâîâ)                   
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
3.1. Àíòèäîòíàÿ òåðàïèÿ ð-ð 
óíèòèîëà 5% - 5,0-10,0 ìë   
3.2. Äåçèíòîêñèêàöèîííàÿ    
òåðàïèÿ: ãåìîäåç 400,0, èëè 
ðåîïîëèãëþêèí 400,0, èëè    
ãëþêîçà 5% - 400,0, òðèñàìèí
300,0 èëè ëàêòîñîë, äîïìèí  
5% - 5,0 (ïî ïîêàçàíèÿì)    
4. Èíòóáàöèÿ òðàõåè ïðè     
ðàçâèòèè êîìû, ÈÂË ïî       
ïîêàçàíèÿì                  
5. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä + ýíòåðîñîðáåíò (ïðè   
îòðàâëåíèè ñîåäèíåíèÿìè     
ìåòàëëîâ ïåðåä ïðîìûâàíèåì  
æåëóäêà - îáåçáîëèâàíèå,    
ò.ê. âîçìîæåí õèìè÷åñêèé    
îæîã ñëèçèñòîé æåëóäî÷íî-   
êèøå÷íîãî òðàêòà)           
6. Ðåàíèìàöèîííîå ïîñîáèå   
7. Ãîñïèòàëèçàöèÿ           

1. Êóïèðîâàíèå       
ïàòîëîãè÷åñêèõ       
ñèíäðîìîâ            
2. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè, äûõàíèÿ
3. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
4. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)


Ò-58 
Ò-59 

Òîêñè÷åñêîå äåéñòâèå:   
îêèñè óãëåðîäà          
äð. ãàçû, äûìû, ïàðû    

1. Îñìîòð (âíèìàíèå íà      
ñîñòîÿíèå ñîçíàíèÿ, äûõàíèÿ)
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ââåäåíèå âîçäóõîâîäà     
(èíòóáàöèÿ òðàõåè) -        
àäåêâàòíàÿ ÈÂË ïðè          
íàðóøåíèÿõ äûõàíèÿ, òóàëåò  
ÂÄÏ ñ ïîìîùüþ îòñîñà        
4. Èíãàëÿöèÿ êèñëîðîäà      
5. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
à) äåçèíòîêñèêàöèîííàÿ:     
òðèñàìèí èëè ëàêòîñîë 400,0,
ãåìîäåç 400,0 èëè           
ðåîïîëèãëþêèí 400,0 ãëþêîçà 
5% - 400,0 â/â êàïåëüíî     
á) ïðè îòðàâëåíèè ãàçàìè    
ðàçäðàæàþùåãî, óäóøàþùåãî   
äåéñòâèÿ ïðåäíèçîëîí 120 ìã 
èëè ãèäðîêîðòèçîí 250 ìã,   
àòðîïèí 0,1% - 1,0,         
ïëàòèôèëëèí 0,2% - 1,0,     
äèìåäðîë 1,0% - 1,0, âèòàìèí
Ñ 5% - 5,0, âèòàìèí Â1 - 5,0
(ïðè îòðàâëåíèè îêèñüþ      
óãëåðîäà), äîïìèí 0,5% - 5,0
â) ïðè òÿæåëîì îòðàâëåíèè ÑÎ
- ãëþêîçà 40% - 20,0 +      
ýóôèëëèí 2,4% - 10,0 â/â    
ã) ïðè ðàçâèòèò ñóäîðîã -   
ðåëàíèóì 2,0 â/â ïðè        
îòðàâëåíèè îêèñüþ óãëåðîäà  
íà ôîíå àðòåðèàëüíîé        
ãèïåðòåíçèè - ðàñòâîð       
ìàãíåçèè (25% - 10,0)       
â/ìûøå÷íî                   
6. Èíòóáàöèÿ òðàõåè, ÈÂË    
(ïî ïîêàçàíèÿì)             
7. Ðåàíèìàöèîííîå ïîñîáèå   
8. Ãîñïèòàëèçàöèÿ           

1. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè, äûõàíèÿ
2. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
3. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ           
êîíñóëüòàöèè ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)

Ò-60 

Òîêñè÷åñêîå äåéñòâèå    
ïåñòèöèäîâ              
(ôîñôîðîðãàíè÷åñêèå è   
êàðáàìàòíûå èíñåêòèöèäû)

1. Îñìîòð (âíèìàíèå íà      
ñîñòîÿíèå ñîçíàíèÿ, äûõàíèÿ 
öâåò è ñóõîñòü êîæíîãî      
ïîêðîâà, øèðèíà çðà÷êîâ)    
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
3.1. Àíòèäîòíàÿ òåðàïèÿ     
3.1.1. ââåäåíèå àíòèäîòà ð-ð
àòðîïèíà 0,1% - 1,0 îò 5,0  
ïðè ëåãêîì, äî 20-30 ìë ïðè 
òÿæåëîì îòðàâëåíèè          
(ðåàêòèâàòîðû õîëèíýñòåðàçû 
1 äîçà) â/ì èëè â/â         
3.1.2. Äåçèíòîêñèêàöèîííàÿ  
òåðàïèÿ: ãåìîäåç 400,0, èëè 
ðåîïîëèãëþêèí 400,0, èëè    
ãëþêîçà 5% - 400,0, òðèñàìèí
300,0, èëè ëàêòîñîë, äîïìèí 
5% - 5,0 (ïî ïîêàçàíèÿì)    
3.1.3. Èíòóáàöèÿ òðàõåè ïðè 
ðàçâèòèè êîìû, ÈÂË ïî       
ïîêàçàíèÿì                  
4. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä + ýíòåðîñîðáåíò.        
5. Ðåàíèìàöèîííîå ïîñîáèå   
6. Ãîñïèòàëèçàöèÿ           

1. Êóïèðîâàíèå       
ïàòîëîãè÷åñêèõ       
ñèíäðîìîâ (â ò.÷.    
áðîíõîðåè,           
áðàäèêàðäèè)         
2. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè, äûõàíèÿ
3. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
4. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)

Ò-65.0

öèàíèäû                 

1. Îñìîòð (âíèìàíèå íà      
ñîñòîÿíèå ñîçíàíèÿ, äûõàíèÿ,
ãåìîäèíàìèêó, öâåò êîæíûõ   
ïîêðîâîâ)                   
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ: 
3.1. àìèëíèòðèò, èíãàëÿöèÿ  
íà âàòêå, ð-ð ìåòèëåíîâîé   
ñèíè 1% - 20,0 âíóòðèâåííî. 
3.2. Äåçèíòîêñèêàöèîííàÿ    
òåðàïèÿ: ãåìîäåç 400,0 èëè  
ðåîïîëèãëþêèí 400,0, èëè    
ãëþêîçà 5% - 400,0, òðèñàìèí
300,0 èëè ëàêòîñîë, äîïìèí  
5% - 5,0 (ïî ïîêàçàíèÿì)    
4. Èíòóáàöèÿ òðàõåè ïðè     
ðàçâèòèè êîìû, ÈÂË ïî       
ïîêàçàíèÿì                  
5. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä + ýíòåðîñîðáåíò        
6. Îêñèãåíîòåðàïèÿ          
7. Ðåàíèìàöèîííîå ïîñîáèå   
8. Ãîñïèòàëèçàöèÿ           

1. Êóïèðîâàíèå        
ïàòîëîãè÷åñêèõ       
ñèíäðîìîâ            
2. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè, äûõàíèÿ
3. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
4. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)

Ò-65.3

ìåòãåìîãëîáèíîîáðàçîâàòå-
ëè (íèòðèòû, ïðîèçâîäíûå
áåíçîëà)                

1. Îñìîòð (âíèìàíèå íà      
äûõàíèå, ãåìîäèíàìèêó,      
ñòåïåíü íàðóøåíèÿ ñîçíàíèÿ, 
öâåò êîæíûõ ïîêðîâîâ)       
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ  
3.1. àíòèäîòíàÿ òåðàïèÿ: ð-ð
ìåòèëåíîâîé ñèíè 1% - 20,0  
3.2. Äåçèíòîêñèêàöèîííàÿ    
òåðàïèÿ: ãåìîäåç 400,0 èëè  
ðåîïîëèãëþêèí 400,0, èëè    
ãëþêîçà 5% - 400,0, òðèñàìèí
300,0, èëè ëàêòîñîë, äîïìèí 
5% - 5,0 (ïî ïîêàçàíèÿì)    
4. Èíòóáàöèÿ òðàõåè ïðè     
ðàçâèòèè êîìû, ÈÂË ïî       
ïîêàçàíèÿì                  
5. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä + ýíòåðîñîðáåíò        
6. Îêñèãåíîòåðàïèÿ          
7. Ðåàíèìàöèîííîå ïîñîáèå   
8. Ãîñïèòàëèçàöèÿ           

1. Êóïèðîâàíèå       
ïàòîëîãè÷åñêèõ       
ñèíäðîìîâ, öèàíîçà   
2. Âîññòàíîâëåíèå    
ãåìîäèíàìèêè, äûõàíèÿ
3. Ýôôåêòèâíàÿ       
ðåàíèìàöèÿ           
4. Ãîñïèòàëèçàöèÿ â  
ïðîôèëüíûé ñòàöèîíàð 
Ïðè òÿæåëûõ è íåÿñíûõ
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé     
öåíòð òåë. 928-16-87)

Ò-65.9

Îòðàâëåíèÿ íåóòî÷íåííûì 
ÿäîì                    

1. Îñìîòð (âíèìàíèå íà      
ñîñòîÿíèå, ñîçíàíèÿ,        
äûõàíèÿ, ãåìîäèíàìèêè,      
ñóõîñòü, îêðàñêó êîæíûõ     
ïîêðîâîâ, ìèîôèáðèëëÿöèè)   
2. Âûçîâ ñïåöèàëèçèðîâàííîé 
áðèãàäû                     
3. Âûäåëåíèå âåäóùèõ        
ñèíäðîìîâ ñ öåëüþ ïðîâåäåíèÿ
ñèïòîìàòè÷åñêîé òåðàïèè:    
- ëå÷åíèå íàðóøåíèÿ äûõàíèÿ 
- ïðîòèâîøîêîâàÿ,           
âíóòðèâåííàÿ, èíôóçèîííàÿ   
òåðàïèÿ                     
- óñòðàíåíèÿ íàðóøåíèé ðèòìà
ñåðäöà                      
- îáåçáîëèâàíèå,            
ïðîòèâîñóäîðîæíàÿ òåðàïèÿ   
(ïðè ïîêàçàíèÿõ)            
4. Ââåäåíèå àíòèäîòîâ:      
íàëîêñîí, àíåêñàò, Â6,      
àìèíîñòèãìèí - ñ            
äèôôåðåíöèàëüíî-             
äèàãíîñòè÷åñêîé öåëüþ ïðè   
ïîäîçðåíèè íà îòðàâëåíèå    
íàðêîòèêàìè,                
áåíçîäèàçåïèíàìè, òóáàçèäîì,
ïðè õîëèíîëèòè÷åñêîì        
ñèíäðîìå                    
5. Ïðîìûâàíèå æåëóäêà ÷åðåç 
çîíä (ïðè ïîäîçðåíèè íà     
ïåðîðàëüíûé ïðèåì ÿäà) +    
ýíòåðîñîðáåíò               
6. Ðåàíèìàöèîííîå ïîñîáèå   
7. Ãîñïèòàëèçàöèÿ           

Âíèìàíèå ïðè:        
1. òÿæåëûõ è íåÿñíûõ 
îòðàâëåíèÿõ          
êîíñóëüòàöèÿ ñ       
òîêñèêîëîãîì (çâîíèòü
â èíôîðìàöèîííî-     
êîíñóëüòàòèâíûé      
òîêñèêîëîãè÷åñêèé    
öåíòð òåë. 928-16-87)
2.  ñëó÷àå, åñëè íå 
óäàåòñÿ âûÿâèòü      
õàðàêòåðíûå          
êëèíè÷åñêèå ñèìïòîìû 
îïðåäåëåííîãî        
îòðàâëåíèÿ, àíòèäîòû 
íå ââîäèòü           

 


 

ÐÀÇÄÅË: "ÈÍÔÅÊÖÈÎÍÍÛÅ ÇÀÁÎËÅÂÀÍÈß"

 

ÑÎÃËÀÑÎÂÀÍÎ

Ãëàâíûé èíôåêöèîíèñò

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

Í.À.ÌÀËÛØÅÂ

 

ÍÅÊÎÒÎÐÛÅ ÈÍÔÈÊÖÈÎÍÍÛÅ È ÏÀÐÀÇÈÒÀÐÍÛÅ ÁÎËÅÇÍÈ

 

┌───────┬─────────────────────────┬─────────────────────────────┬─────────────────────┐

  Êîä           Äèàãíîç           Îáúåì ìåäèöèíñêîé ïîìîùè         Ðåçóëüòàò     

├───────┼─────────────────────────┼─────────────────────────────┼─────────────────────┤

│À.00   │Õîëåðà                   │1. Îñìîòð                    │1. Êîððåêöèÿ âîäíî- 

                                │2. Èíäèâèäóàëüíàÿ ýêñòðåííàÿ │ýëåêòðîëèòíûõ ïîòåðü │

                                │ïðîôèëàêòèêà ìåä. ïåðñîíàëà  │2. Ïðåäóïðåæäåíèå   

                                │- èñïîëüçîâàíèå ýïèäóêëàäêè  │ðàçâèòèÿ            

                                │- îòêðûòûå ÷àñòè òåëà âûìûòü │ãèïîâîëåìè÷åñêîãî   

                                │âîäîé ñ ìûëîì                │øîêà                

                                │- îáðàáîòàòü ëèöî è ðóêè     │3. Ëîêàëèçàöèÿ ýïèä. │

                                │âàòíûì òàìïîíîì, ñìî÷åííûì   │î÷àãà               

                                │70% ñïèðòîì - íàäåòü ìàñêó,                      

                                │ïåð÷àòêè                                         

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ                       

                                │(ïî ïîêàçàíèÿì) õëîñîëü                          

                                │800,0 èëè äèñîëü 800,0, èëè                      

                                │òðèñîëü 800,0 â/â (ïåðâûå                        

                                │200,0 ñòðóéíî, îñòàâøèåñÿ                        

                                │600,0 êàïåëüíî)                                  

                                │4. Òåêóùàÿ äåçèíôåêöèÿ â                         

                                │î÷àãå                                            

                                │5. Äàëüíåéøàÿ òàêòèêà                            

                                │ñîîòâåòñòâåííî ñ                                 

                                │äîëæíîñòíûìè îáÿçàííîñòÿìè è │                    

                                │ïðèêàçàìè ïî ÎÎÈ                                 

                                │6. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

                                                                                 

│À.01.0 │Áðþøíîé òèô,             │1. Îñìîòð                    │1. Ñòàáèëèçàöèÿ     

│-À.01.4│ïàðàòèô è ò.ä.           │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ   │ãåìîäèíàìèêè        

                                │(ïî ïîêàçàíèÿì):             │2. Ñíèæåíèå ñòåïåíè 

                                │- êîðãëèêîí 0,06% - 1,0 -    │èíòîêñèêàöèè        

                                │â/â                          │3. Ïðåäóïðåæäåíèå   

                                │- ïðåäíèçîëîí 30-60 ìã - â/â │ðàçâèòèÿ èíôåêöèîííî-│

                                │- äèñîëü 400,0 èëè òðèñîëü   │òîêñè÷åñêîãî øîêà   

                                │400,0, èëè ãåìîäåç 400,0 -                       

                                │â/â êàïåëüíî                                     

                                │3. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

├───────┼─────────────────────────┼─────────────────────────────┼─────────────────────┤

│À.02   │Ñàëìîíåëëåç              │1. Îñìîòð.                   │1. Ïðåäóïðåæäåíèå   

                                │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ   │ðàçâèòèÿ èíôåêöèîííî-│

│À.03   │Øèãåëëåç                 │(ïî ïîêàçàíèÿì):             │òîêñè÷åñêîãî        

       │(äèçåíòåðèÿ)             │- ïîëèèîííûå ðàñòâîðû        │ñîñòîÿíèÿ.          

│À.04;  │Äðóãèå áàêòåðèàëüíûå     │(äèñîëü, òðèñîëü, ëàêòîñîëü  │2. Êîððåêöèÿ âîäíî- 

       │êèøå÷íûå èíôåêöèè        │- 400,0 â/â êàïåëüíî)        │ýëåêòðîëèòíûõ ïîòåðü │

       │(âèðóñíûå ýíòåðèòû, äð.  │- ïåðîðàëüíàÿ ðåãèäðàòàöèÿ                       

       │óòî÷íåííûå êèøå÷íûå      │äèñîëü 400,0, õëîñîëü 400,0                      

       │èíôåêöèè, äèàððåÿ è      │- ïðåäíèçîëîí 30-60 ìã - â/â │                    

       │ãàñòðîýíòåðèò)           │ñòðóéíî, ìåäëåííî â                              

                                │ïåðåõîäíèê êàïåëüíèöû                            

                                │3. Àêòèâ â ËÏÓ                                   

                                │4. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

                                │(ïî ïîêàçàíèÿì)                                  

├───────┼─────────────────────────┼─────────────────────────────┼─────────────────────┤

│À.05   │Áîòóëèçì                 │1. Îñìîòð                    │1. Ïðåäóïðåæäåíèå   

                                │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │îñòàíîâêè äûõàíèÿ   

                                │(ïî ïîêàçàíèÿì):                                 

                                │3. Ïðîìûâàíèå æåëóäêà ÷åðåç                      

                                │çîíä íå çàâèñèìî îò ñðîêîâ                       

                                │âîçìîæíîãî çàðàæåíèÿ                              

                                │4. Ìåäèêàìåíòîçíàÿ òåðàïèÿ                       

                                │(ïî ïîêàçàíèÿì)                                  

                                │- òðèñîëü 200,0 èëè õëîñîëü                      

                                │200,0, èëè äèñîëü 200,0, èëè │                    

                                │ëàêòîñîëü 200,0; ãåìîäåç                         

                                │100,0 â/â êàïåëüíî                               

                                │5. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ│                    

                                │(ïî ïîêàçàíèÿì - ïðè                             

                                │íàðàñòàíèè àñôèêñèè):                            

                                │- ïîêàçàíèÿ äëÿ èíòóáàöèè è                      

                                │ïîñëåäóþùåãî ÈÂË: àïíîý,                         

                                │òàõèàíîý áîëåå 40 â 1 ìèí.;                      

                                │- íàðîñòàíèå áóëüáàðíûõ                          

                                │ðàñòðîéñòâ, îñòðàÿ ëåãî÷íî-                      

                                │ñåðäå÷íàÿ íåäîñòàòî÷íîñòü                        

                                │6. Ãîñïèòàëèçàöèÿ - íîñèëêè, │                    

                                │ïîëîæåíèå áîëüíîãî íà ïðàâîì │                    

                                │áîêó                                             

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│À.37   │Êîêëþø                   │1. Îñìîòð. Êèñëîðîäíàÿ                           

│À.38   │Ñêàðëàòèíà               │èíãàëÿöèÿ (ïî ïîêàçàíèÿì)                        

│Â.05   │Êîðü                     │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ                      

│Â.06   │Êðàñíóõà                 │(ïî ïîêàçàíèÿì):                                 

│Â.01   │Âåòðÿííàÿ îñïà           │3. Àêòèâ â ËÏÓ                                   

                                │4. Ãîñïèòàëèçàöèÿ                                

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│À-04.6 │Èåðñèíèîç                │1. Îñìîòð                                        

│À-32.1 │Ïñåâäîòóáåðêóëåç         │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ                      

                                │(ïî ïîêàçàíèÿì)                                   

                                │3. Àêòèâ â ËÏÓ                                   

                                │4. Ãîñïèòàëèçàöèÿ                                

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│À 32   │Ëèñòåðèîç                │1. Îñìîòð                    │1. Âîññòàíîâëåíèå è 

│À 32.1 │- æåëèçèñòàÿ             │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ïîääåðæàíèå æèçíåííûõ│

│À.32.8 │- íåðâíàÿ ôîðìà          │(ïî ïîêàçàíèÿì)              │ôóíêöèé íà          

│À 32.9 │- ñåïòè÷åñêàÿ            │- ïðåäíèçîëîí 30 ìã â/â      │äîãîñïèòàëüíîì ýòàïå │

                                │- ïîëèèîííûå ð-ðû: õëîñîëü   │2. Ñòàáèëèçàöèÿ ÎÖÊ è│

                                │(äèñîëü, ëàêòîñîëü, òðèñîëü  │îáùåãî ñîñòîÿíèÿ    

                                │- 200,0 â/â êàïåëüíî);                           

                                │- ëàçèêñ - 40-60 ìã (â/ì)                        

                                │- ãåìîäåç 100 ìë â/â                             

                                │êàïåëüíî                                         

                                │- îêñèãåíîòåðàïèÿ                                

                                │- êîððåêöèÿ íàðóøåíèé                            

                                │äûõàíèÿ (ñàíàöèè ÂÄÏ,                            

                                │ââåäåíèå âîçäóõîâîäà)                            

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│À.35   │Ñòîëáíÿê                 │1. Îñìîòð                    │1. Êóïèðîâàíèå      

                                │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ñóäîðîã             

                                │(ïî ïîêàçàíèÿì):             │2. Êîððåêöèÿ        

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ   │íàðóøåíèÿ äûõàíèÿ   

                                │(ïî ïîêàçàíèÿì - ïðè                             

                                │ñóäîðîæíîì ñèíäðîìå):                            

                                │- àìèíàçèí 2,5% - 2,0 â/ì                        

                                │- ðåëàíèóì 2,0 èëè ñåäóêñåí                      

                                │2,0 èëè ÃÎÌÊ 20% - 10,0 â/â                      

                                │ìåäëåííî                                         

                                │- çàêèñü àçîòà                                   

                                │4. Îêñèãåíîòåðàïèÿ                               

                                │5. Ðåàíèìàöèîííîå                                

                                │ìåðîïðèÿòèå (ïî ïîêàçàíèÿì)                      

                                │6. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

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│À.80.1 │Ïîëèîìèåëèò              │1. Îñìîòð                    │1. Ïðåäóïðåæäåíèå   

│À 80.9 │Îñòðûå âÿëûå ïàðàëè÷è    │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ðàçâèòèÿ ïðèçíàêîâ  

│A.81.0 │Áîëåçíü Êðåéòöôåëüäà     │(ïî ïîêàçàíèÿì)              │ïàðàëè÷à äûõàíèÿ    

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ                       

                                │(ïî ïîêàçàíèÿì ïðè                               

                                │íàðàñòàíèè îäûøêè, ñåðäå÷íî- │                    

                                │ëåãî÷íîé íåäîñòàòî÷íîñòè,                        

                                │íåâðîëîãè÷åñêîé ñèìïòîìàòèêå │                    

                                │- ïàðàëèòè÷åñêàÿ ôàçà):                          

                                │- òðèñîëü 200,0 èëè õëîñîëü                      

                                │200,0, èëè äèñîëü 200,0, èëè │                    

                                │ãåìîäåç 200,0 â/â êàïåëüíî;                      

                                │- ëàçèêñ - 40 ìã â/ì                             

                                │- ïðåäíèçîëîí 30 ìã â/â                          

                                │- îêñèãåíîòåðàïèÿ                                

                                │4. Ðåàíèìàöèîííûå                                

                                │ìåðîïðèÿòèÿ (ïî ïîêàçàíèÿì)                      

                                │5. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

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│A.36   │Äèôòåðèÿ                 │1. Îñìîòð                    │1. Âîññòàíîâëåíèå   

                                │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ïðîõîäèìîñòè ÂÄÏ    

                                │(ïî ïîêàçàíèÿì)              │2. Ñòàáèëèçàöèÿ     

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ   │ñîñòîÿíèÿ           

                                │(ïî ïîêàçàíèÿì - ïðè         │3. Ïðåäóïðåæäåíèå   

                                │òîêñè÷åñêîé ôîðìå I, II, III │ðàçâèòèÿ èíôåêöèîííî-│

                                │ñò., èëè íàðàñòàíèè ÿâëåíèÿ  │òîêñè÷åñêîãî øîêà   

                                │àñôèêñèè):                                       

                                │- ïðåäíèçîëîí 30-60 ìã èëè                       

                                │ãèäðîêîðòèçîí 125 ìã - â/ì                       

                                │èëè â/â                                          

                                │- ðåîïîëèãëþêèí 200,0 èëè                        

                                │ãåìîäåç 200,0 â/â êàïåëüíî                       

                                │4. Îêñèãåíîòåðàïèÿ                               

                                │5. Êîíèêîòîìèÿ                                   

                                │(ïî æèçíåííûì ïîêàçàíèÿì)                        

                                │6. Ðåàíèìàöèîííîå ïîñîáèå                        

                                │(ïî ïîêàçàíèÿì)                                  

                                │7. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

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│A.34   │Ýíòåðîâèðóñíûå èíôåêöèè  │1. Îñìîòð                    │1. Âîññòàíîâëåíèå è 

       │â ò.÷. ñåðîçíûé ìåíèíãèò │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ïîääåðæàíèå âèòàëüíûõ│

                                │(ïî ïîêàçàíèÿì)              │ôóíêöèé îðãàíèçìà íà │

                                │3. Ñàíàöèÿ âåðõíèõ           │äîãîñïèòàëüíîì ýòàïå │

                                │äûõàòåëüíûõ ïóòåé èëè        │è ýòàïå             

                                │âîçäóõîâîä                   │ãîñïèòàëèçàöèè      

                                │4. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:  │2. Ïðåäóïðåæäåíèå   

                                │- ïðè îòåêå ãîëîâíîãî ìîçãà: │ðàçâèòèÿ ñóäîðîæíîãî │

                                │ëàçèêñ 30 ìã - 40 ìã â/â     │ñèíäðîìà            

                                │ïðåäíèçîëîí 30 ìã - 40 ìã    │3. Ïðåäóïðåæäåíèå   

                                │â\â                          │îòåêà ãîëîâíîãî     

                                │ãåìîäåç 200,0, õëîñîëü 200,0 │ìîçãà               

                                │èëè äèñîëü 200,0, èëè òðèñîëü│                    

                                │200,0, â/â êàïåëüíî                               

                                │- ïðè ñóäîðîæíîì ñèíäðîìå:                       

                                │ÃÎÌÊ 20% - 10,0 èëè ñåäóêñåí │                    

                                │2,0 èëè ðåëàíèóì 2,0 â/â                         

                                │- ñàíàöèÿ âåðõíèõ                                

                                │äûõàòåëüíûõ ïóòåé                                

                                │- âîçäóõîâîä                                     

                                │- èíòóáàöèÿ òðàõåè                               

                                │(ïî ïîêàçàíèÿì)                                  

                                │5. Ðåàíèìàöèîííîå                                

                                │ìåðîïðèÿòèå ïî ïîêàçàíèÿì,                       

                                │âêëþ÷àÿ èíòóáàöèþ òðàõåè                         

                                │6. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

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│À.39   │Ìåíèíãîêîêêîâàÿ èíôåêöèÿ,│1. Îñìîòð                    │1. Âîññòàíîâëåíèå è 

       │ìåíèíãîêîêöåìèÿ, ìåíèíãèò│2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ïîääåðæàíèå âèòàëüíûõ│

                                │(ïî ïîêàçàíèÿì)              │ôóíêöèé âî âðåìÿ    

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:  │òðàíñïîðòèðîâêè     

                                │- ïðè èíôåêöèîííî-           │2. Ïðåäóïðåæäåíèå   

                                │òîêñè÷åñêîì øîêå èëè îòåêå   │ðàçâèòèÿ èíôåêöèîííî-│

                                │ãîëîâíîãî ìîçãà              │òîêñè÷åñêîãî øîêà è 

                                │- ïðåäíèçîëîí 30-60 ìã - â/ì │îòåêà ãîëîâíîãî     

                                │èëè â/â, ãèäðîêîðòèçîí 125   │ìîçãà               

                                │ìã â/â èëè â/ì                                   

                                │- ëàçèêñ 40-60 ìã - â/â èëè                      

                                │â/ì                                              

                                │- ëåâîìèöåòèí ñóêöèíàò 0,5 - │                    

                                │1 ã èëè ïåíèöèëëèí íàòðèåâàÿ │                    

                                │ñîëü 2 ìëí. ÅÄ - â/ì                             

                                │- Èíôóçèîííàÿ òåðàïèÿ:                            

                                  ãåìîäåç 200,0 èëè                              

                                │ðåîïîëèãëþêèí 200,0, èëè                         

                                │õëîñîëü (äèñîëü, òðèñîëü)                        

                                │200,0 â/â êàïåëüíî;                              

                                │4. Îêñèãåíîõåðàïèÿ                               

                                │5. Êîððåêöèÿ íàðóøåíèé                           

                                │äûõàíèÿ (ñàíàöèÿ ÂÄÏ,                            

                                │âîçäóõîâîä)                                      

                                │6. Ðåàíèìàöèîííûå                                

                                │ìåðîïðèÿòèÿ                                      

                                │7. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

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│À.15-  │Òóáåðêóëåç ðàçëè÷íûõ ôîðì│1. Îñìîòð                    │1. Óëó÷øåíèå        

│À.19   │è ëîêàëèçàöèé            │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ñîñòîÿíèÿ:          

                                │(ïî ïîêàçàíèÿì)              │- óìåíüøåíèå îäûøêè 

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ   │- îñòàíîâêà         

                                │(ïî ïîêàçàíèÿì)              │êðîâîòå÷åíèÿ        

                                │- ïðè êðîâîõàðêàíüå,                             

                                │ëåãî÷íîì êðîâîòå÷åíèè:                           

                                │à) ñàíàöèÿ âåðõíèõ                               

                                │äûõàòåëüíûõ ïóòåé -                              

                                │îòñàñûâàíèå êðîâè èç ïîëîñòè │                    

                                │ðòà, ãëîòêè                                      

                                │á) õëîðèñòûé êàëüöèé 10% -                       

                                │10 èëè ãëþêîíàò êàëüöèÿ 10%                      

                                │- 10,0 â/â èëè àìèíîêà-                          

                                │ïðîíîâàÿ êèñëîòà 200,0 â/â                       

                                │êàïåëüíî                                         

                                │- ïðè ëåãî÷íîé                                    

                                │íåäîñòàòî÷íîñòè:                                 

                                │- ýóôèëëèí 2,4% - 10,0 â/â                       

                                │èëè ýóôèëëèí 24% - 1,0 - â\ì │                    

                                │- îêñèãåíîòåðàïèÿ                                

                                │4. Àêòèâ â ËÏÓ                                   

                                │5. Ãîñïèòàëèçàöèÿ ïî                             

                                │ïîêàçàíèÿì - íîñèëêè                             

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│Â.00   │Ãåðïåòè÷åñêàÿ èíôåêöèÿ   │1. Îñìîòð                    │Óëó÷øåíèå ñîñòîÿíèÿ 

│Â.02   │Îïîÿñûâàþùèé ëèøàé       │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ                      

                                │(ïî ïîêàçàíèÿì)                                  

                                │3. Àêòèâ â ËÏÓ                                   

                                │4. Ãîñïèòàëèçàöèÿ                                

                                │(ïî ïîêàçàíèÿì)                                  

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│Â.15-  │Âèðóñíûé ãåïàòèò         │1. Îñìîòð                    │Ïðåäóïðåæäåíèå      

│Â.19                            │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ðàçâèòèÿ            

│Â.26   │Ýïèäåìè÷åñêèé ïàðîòèò    │(ïî ïîêàçàíèÿì)              │èíòîêñèêàöèîííîé    

│Â.27   │Èíôåêöèîííûé ìîíîíóêëåîç │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ   │ýíöåôàëîïàòèè íà    

                                │(ïî ïîêàçàíèÿì - ïðè         │äîãîñïèòàëüíîì ýòàïå │

                                │ÿâëåíèÿõ èíòîêñèêàöèè)                           

                                │- ãëþêîçà 5% - 500,0 â/â                         

                                │êàïåëüíî                                         

                                │- ãåìîäåç 200,0 â/â êàïåëüíî │                    

                                │- ïðåäíèçîëîí 30-60 ìã - â/ì │                    

                                │èëè â/â                                          

                                │4. Àêòèâ â ËÏÓ                                   

                                │5. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

                                                                                  

│À.82   │Áåøåíñòâî                │1. Îñìîòð                    │1. Ïðåäóïðåæäåíèå   

                                │2. Îáèëüíî ïðîìûòü ðàíû,     │ðàçâèòèÿ ïðèçíàêîâ  

                                │öàðàïèíû, ññàäèíû è ìåñòà    │ïàðàëè÷à äûõàíèÿ    

                                │îñëþíåíèÿ ñòðóåé âîäû ñ      │2. Ñòðîãîå íàáëþäåíèå│

                                │ìûëîì                        │çà áîëüíûì â        

                                │3. Îáðàáîòàòü êðàÿ ðàíû 70%  │ñîñòîÿíèè           

                                │ñïèðòîì èëè ð-ðîì éîäà       │âîçáóæäåíèÿ,        

                                │4. Àñåïòè÷åñêàÿ ïîâÿçêà      │ãàëëþöèíàòîðíîãî    

                                │5. Ãîñïèòàëèçàöèÿ            │àôôåêòà, àãðåññèè   

                                                             │3. Êóïèðîâàíèå      

                                                             │ïñèõîìîòîðíîãî      

                                                             │âîçáóæäåíèÿ         

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│Â.12-  │ÂÈ×-èíôåêöèÿ             │1. Îñìîòð                                        

│B.24                            │2. Èíäèâèäóàëüíàÿ                                

                                │ïðîôèëàêòèêà ìåä. ïåðñîíàëà                      

                                │3. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ                      

                                │(ïî ïîêàçàíèÿì)                                  

                                │4. Ãîñïèòàëèçàöèÿ                                

                                │(ïî ïîêàçàíèÿì)                                  

├───────┼─────────────────────────┼─────────────────────────────┼─────────────────────┤

│Â.51   │Ìàëÿðèÿ                  │1. Îñìîòð                    │1. Ïðåäóïðåæäåíèÿ   

                                │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ðàçâèòèÿ îñëîæíåíèé 

                                │(ïî ïîêàçàíèÿì)              │2. Êóïèðîâàíèå      

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:  │ïñèõîìîòîðíîãî      

                                │- ïðè îòåêå ãîëîâíîãî ìîçãà: │âîçáóæäåíèÿ         

                                │ëàçèêñ 40-60 ìã â\â          │3. Ïðåäóïðåæäåíèå   

                                │ïðåäíèçîëîí 90 ìã â\â        │ðàçâèòèÿ ìàëÿðèéíîé 

                                │äåëàãèë 5% - 10,0 â/â        │êîìû                 

                                │êàïåëüíî, ãëþêîçà 5% - 200.0 │                    

                                │â/â êàïåëüíî                                     

                                │Èíôóçèîííàÿ òåðàïèÿ:                             

                                │ïîëèèîííûå ð-ðû:                                 

                                │õëîñîëü 400,0 (èëè òðèñîëü,                      

                                │äèñîëü, ëàêòîñîëü 400,0 â/â                      

                                │êàïåëüíî), ãåìîäåç 100,0 â/â │                    

                                │êàïåëüíî                                         

                                │- ïðè ïñèõîìîòîðíîì                              

                                │âîçáóæäåíèè àìèíàçèí 2,5% -                      

                                │2,0 â/ì                                          

                                │4. Îêñèãåíîòåðàïèÿ                               

                                │5. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

├───────┼─────────────────────────┼─────────────────────────────┼─────────────────────┤

│À.96-  │Âèðóñíûå ãåìîððàãè÷åñêèå │1. Îñìîòð                    │Ëîêàëèçàöèÿ         

│À 98   │ëèõîðàäêè                │2. Èíäèâèäóàëüíàÿ ýêñòðåííàÿ │ýïèäåìèîëîãè÷åñêîãî 

│Â.03   │Íàòóðàëüíàÿ îñïà         │ïðîôèëàêòèêà ìåä. ïåðñîíàëà: │î÷àãà               

│ 04   │Îñïà îáåçüÿí ÊÂÃË        │- èñïîëüçîâàíèå ýïèä.                            

                                │óêëàäêè:                                         

                                │à) îáðàáîòàòü ðóêè, ëèöî                         

                                │âàòíûì òàìïîíîì, ñìî÷åííûì                       

                                │70% ñïèðòîì;                                     

                                │á) ïðîïîëîñêàòü ðîòîâóþ                          

                                │ïîëîñòü è ãîðëî ðàñòâîðîì                        

                                │0,05% ìàðãàíöîâîêèñëîãî                          

                                │êàëèÿ                                            

                                │â) çàêàïàòü â ãëàçà, íîñ ð-ð │                    

                                │0,05% ìàðãàíöîâîêèñëîãî                          

                                │êàëèÿ                                             

                                │ã) íàäåòü âàòíî-ìàðëåâûé                         

                                │ðåñïèðàòîð, ïåð÷àòêè äî                          

                                │ïðèáûòèÿ êîíñóëüòàòèâíîé                         

                                │èíôåêöèîííîé áðèãàäû,                            

                                │äîñòàâèâøåé äîïîëíèòåëüíûé                       

                                │êîìïëåêò êîñòþìîâ "Êâàðö"                        

                                │3. Ïîñèíäðîìíàÿ,                                 

                                │ìåäèêàìåíòîçíàÿ òåðàïèÿ                          

                                │(ïî ïîêàçàíèÿì)                                  

                                │4. Äàëüíåéøàÿ òàêòèêà                            

                                │ñîîòâåòñòâåííî ñ                                 

                                │äîëæíîñòíûìè îáÿçàííîñòÿìè è │                    

                                │ïðèêàçàìè ïî ÎÎÈ                                 

├───────┼─────────────────────────┼─────────────────────────────┼─────────────────────┤

│À.20   │×óìà                     │1. Îñìîòð                    │Ëîêàëèçàöèÿ         

│À.21                            │2. Èíäèâèäóàëüíàÿ ýêñòðåííàÿ │ýïèäåìèîëîãè÷åñêîãî 

                                │ïðîôèëàêòèêà ìåä. ïåðñîíàëà: │î÷àãà               

                                │- èñïîëüçîâàíèå ýïèä.                            

                                │óêëàäêè:                                         

                                │à) îáðàáîòàòü ðóêè, ëèöî                         

                                │âàòíûì òàìïîíîì, ñìî÷åííûì                       

                                │70% ñïèðòîì;                                     

                                │á) ïðîïîëîñêàòü ðîòîâóþ                          

                                │ïîëîñòü è ãîðëî 70% ñïèðòîì                      

                                │â) çàêàïàòü â ãëàçà, ïîëîñòè │                    

                                │íîñà ð-ð ñòðåïòîìèöèíà                           

                                │(ðàñòâîðèòü â 1 ìë                               

                                │äèñòèëëèðîâàííîé âîäû 250000 │                    

                                │åä. ñòðåïòîìèöèíà)                                

                                │ã) íàäåòü âàòíî-ìàðëåâûé                         

                                │ðåñïèðàòîð, ïåð÷àòêè äî                          

                                │ïðèáûòèÿ êîíñóëüòàòèâíîé                         

                                │áðèãàäû, äîñòàâèâøåé                             

                                │äîïîëíèòåëüíûé êîìïëåêò                          

                                │êîñòþìîâ "Êâàðö"                                 

                                │3. Ïîñèíäðîìíàÿ                                  

                                │ìåäèêàìåíòîçíàÿ òåðàïèÿ                          

                                │4. Ïðîâåäåíèå òåêóùåé                            

                                │äåçèíôåêöèè â î÷àãå                              

                                │5. Äàëüíåéøàÿ òàêòèêà                            

                                │ñîîòâåòñòâåííî ñ                                 

                                │äîëæíîñòíûìè îáÿçàííîñòÿìè è │                    

                                │ïðèêàçàìè ïî ÎÎÈ                                 

├───────┼─────────────────────────┼─────────────────────────────┼─────────────────────┤

│A 84   │Êëåùåâîé ýíöåôàëèò       │1. Îñìîòð                    │1. Êóïèðîâàíèå      

│A 96.2 │Áîëåçíü Ëàéìà            │2. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ  │ñèìïòîìîâ îòåêà     

       │(Ëàéì-áîððåëèîç êëåùåâîé)│(ïî ïîêàçàíèÿì)              │ãîëîâíîãî ìîçãà è   

                                │3. Ìåäèêàìåíòîçíàÿ òåðàïèÿ   │ñóäîðîæíîãî ñèíäðîìà │

                                │(ïî ïîêàçàíèÿì):             │2. Ñòàáèëèçàöèÿ     

                                │- ëàçèêñ 40 ìã - â/â         │ñîñòîÿíèÿ           

                                │- ð-ð ãëþêîçû 40% - 20,0                         

                                │- àñêîðáèíîâàÿ êèñëîòà 50% - │                    

                                │5,0 â/â                                          

                                │- ïðåäíèçîëîí 60 ìã                              

                                │- ãåìîäåç - 200,0 â/â                            

                                │êàïåëüíî)                                        

                                │4. Îêñèãåíîòåðàïèÿ                               

└───────┴─────────────────────────┴─────────────────────────────┴─────────────────────┘

 

ÐÀÇÄÅË: "ÕÈÐÓÐÃÈß"

 

ÑÎÃËÀÑÎÂÀÍÎ

Ãëàâíûé õèðóðã

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

À.Ñ.ÅÐÌÎËÎÂ

 

ÕÈÐÓÐÃÈ×ÅÑÊÈÅ ÇÀÁÎËÅÂÀÍÈß

 

┌──────┬──────────────────────────┬──────────────────────────────┬────────────────────┐

│ Êîä           Äèàãíîç             Îáúåì ìåäèöèíñêîé ïîìîùè        Ðåçóëüòàò     

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.25 -│ßçâà æåëóäêà:             │1. Îñìîòð                                        

      │îñòðàÿ ñ ïðîáîäåíèåì èëè ñ│2. Èíôóçèîííàÿ òåðàïèÿ ïðè                       

      │êðîâîòå÷åíèåì; õðîíè÷åñêàÿ│íàðóøåíèÿõ ãåìîäèíàìèêè âî                       

      │ñ ïðîáîäåíèåì èëè         │âðåìÿ òðàíñïîðòèðîâêè: íàòðèé │                    

      │êðîâîòå÷åíèåì             │õëîðèäèÿ 0,9% - 400,0, ãåìîäåç│                   

│Ê.26  │ßçâà 12-ïåðñòíîé êèøêè ñ  │400,0                                            

      │ïðîáîäåíèåì               │3. Ãîñïèòàëèçàöèÿ - íîñèëêè                       

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.35  │Îñòðûé àïïåíäèöèò         │1. Îñìîòð                                        

                                │2. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.40  │Ïàõîâàÿ ãðûæà (ñ          │1. Îñìîòð                                        

      │óïîìèíàíèåì îá óùåìëåíèè),│2. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

│Ê.42  │Ïóïî÷íàÿ ãðûæà (ñ                                                          

      │óïîìèíàíèåì îá óùåìëåíèè) │                                                 

│Ê.43  │Ãðûæà ïåðåäíåé áðþøíîé                                                     

      │ñòåíêè (ñ óïîìèíàíèåì îá                                                   

      │óùåìëåíèè)                                                                 

│Ê.45  │Äðóãèå ãðûæè áðþøíîé                                                       

      │ïîëîñòè (ñ óïîìèíàíèåì îá │                                                 

      │óùåìëåíèè)                                                                 

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.56  │Íåïðîõîäèìîñòü êèøå÷íèêà  │1. Îñìîòð                                        

      │(áåç ãðûæè) - èíâàãèíàöèÿ,│2. Èíôóçèîííàÿ òåðàïèÿ ïðè                        

      │ñïàå÷íàÿ áîëåçíü.         │íàðóøåíèÿõ ãåìîäèíàìèêè âî                       

                                │âðåìÿ òðàíñïîðòèðîâêè:                           

                                │- íàòðèé õëîðèäèÿ 0,9% -                          

                                │400,0, ãåìîäåç 400,0                             

                                │(ïðè îöåíêå òÿæåñòè)                             

                                │4. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.65  │Ïåðèòîíèò                 │1. Îñìîòð                                        

                                │2. Èíôóçèîííàÿ òåðàïèÿ ïðè                       

                                │íàðóøåíèÿõ ãåìîäèíàìèêè âî                       

                                │âðåìÿ òðàíñïîðòèðîâêè:                           

                                │- ãåìîäåç 250,0 èëè                              

                                │ðåîïîëèãëþãèí 400,0 - â/âåííî │                   

                                │êàïåëüíî                                         

                                │3. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.80  │Æåë÷íî-êàìåííàÿ áîëåçíü   │1. Îñìîòð                     │Êóïèðîâàíèå áîëåé  

      │(ïå÷åíî÷íàÿ êîëèêà)       │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

                                │íî-øïà 2,0 èëè àòðîïèí 0,1% - │                   

                                │1,0 èëè ïëàòèôèëëèí 0,2% - 1,0│                   

                                │â/ì                                              

                                │3. Àêòèâ â ËÏÓ                                   

                                │3. Ãîñïèòàëèçàöèÿ (ïî                            

                                │ïîêàçàíèÿì)                                      

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.81  │Îñòðûé õîëåöèñòèò         │1. Îñìîòð                     │1. Êóïèðîâàíèå áîëåé│

                                │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

                                │íî-øïà 2.0 èëè ïëàòèôèëëèí                       

                                │0,2% - 1,0 èëè àòðîïèí 0,1% - │                    

                                │1,0 â/ì                                          

                                │3. Ãîñïèòàëèçàöèÿ                                

                                │4.  ñëó÷àÿõ îòêàçà îò                            

                                │ãîñïèòàëèçàöèè:                                  

                                │- àêòèâ íà "03";                                 

                                │- ïðè ïîâòîðíîì îòêàçå îò                        

                                │ãîñïèòàëèçàöèè àêòèâ â ËÏÓ                       

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.85  │Îñòðûé ïàíêðåàòèò         │1. Îñìîòð                                        

                                │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

                                │- ïëàòèôèëëèí 0,2% - 1,0 èëè                     

                                │íî-øïà 2,0, àòðîïèí 0,1% - 1,0│                   

                                │- â/ì                                            

                                │3. Èíôóçèîííàÿ òåðàïèÿ ïî                        

                                │ïîêàçàíèÿì:                                      

                                │íàòðèé õëîðèäèÿ 0,9% - 400,0, │                   

                                │ãåìîäåç 400,0                                    

                                │5. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.70  │Áîëåçíè ïå÷åíè            │1. Îñìîòð                     │1. Êóïèðîâàíèå áîëåé│

      │(àëêîãîëüíûé öèððîç       │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

      │ïå÷åíè)                   │àòðîïèí 0,1% - 1,0 èëè                           

│Ê.71  │Òîêñè÷åñêîå ïîðàæåíèå     │ïëàòèôèëëèí 0,2% - 1,0 èëè                       

      │ïå÷åíè                    │íî-øïà 2,0 â/ì                                   

│Ê.73  │Õðîíè÷åñêèé ãåïàòèò)      │3. Àêòèâ â ËÏÓ                                   

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.83  │Áîëåçíè æåë÷íûõ ïóòåé     │1. Îñìîòð                     │1. Êóïèðîâàíèå áîëåé│

      │(õîëàíãèò, ïîñòõîëåöèñò-  │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

      │ýêòîìè÷åñêèé ñèíäðîì è    │àòðîïèí 0,1% - 1,0 èëè                            

      │ò.ä.)                     │ïëàòèôèëëèí 0,2% - 1,0 èëè                       

                                │íî-øïà 2,0 â/ì                                   

                                │3. Àêòèâ â ËÏÓ                                    

                                │4. Ãîñïèòàëèçàöèÿ ïî                             

                                │ïîêàçàíèÿì                                       

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.92  │Æåëóäî÷íî-êèøå÷íûå        │1. Îñìîòð                     │1. Ñòàáèëèçàöèÿ    

      │êðîâîòå÷åíèÿ (íåÿçâåííîãî │2. Èíôóçèîííàÿ òåðàïèÿ ïðè    │ãåìîäèíàìèêè       

      │ãåíåçà)                   │íàðóøåíèÿõ ãåìîäèíàìèêè âî                       

                                │âðåìÿ òðàíñïîðòèðîâêè:                           

                                │- ïîëèãëþêèí 400,0,                              

                                │àìèíîêàïðîíîâàÿ êèñëîòà 100,0 │                   

                                │â/â êàïåëüíî                                     

                                │3. Ãîñïèòàëèçàöèÿ - íîñèëêè                      

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.61  │Àáñöåññ çàäíåãî ïðîõîäà è │1. Îñìîòð                                        

      │ðåêòàëüíîé îáëàñòè        │2. Ãîñïèòàëèçàöèÿ                                

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ê.62  │Äðóãèå áîëåçíè çàäíåãî    │1. Îñìîòð                                        

      │ïðîõîäà è ïðÿìîé êèøêè    │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

      │(âûïàäåíèå çàäíåãî        │íî-øïà 2,0 èëè ïëàòèôèëëèí                       

      │ïðîõîäà, êðîâîòå÷åíèå)    │0,2% - 1,0 èëè àòðîïèí 0,1% - │                   

                                │1,0 (ïî ïîêàçàíèÿì) - â/ì                        

                                │3. Àñåïòè÷åñêàÿ ïîâÿçêà                          

                                │(ïî ïîêàçàíèÿì)                                  

                                │4. Àêòèâ â ËÏÓ                                   

                                │5. Ãîñïèòàëèçàöèÿ                                

                                │(ïî ïîêàçàíèÿì)                                  

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│N.10- │Îñòðûé è õðîíè÷åñêîé      │1. Îñìîòð                     │1. Ñòàáèëèçàöèÿ ÀÄ 

│11    │ïèýëîíåôðèò               │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ                       

│N.30  │Öèñòèò                    │â/ì:                                              

│N.34  │Óðåòðèò                   │- äèìåäðîë 1% - 1,0 èëè                          

                                │ñóïðàñòèí 1,0                                    

                                │- íî-øïà 2,0 èëè ïàïàâåðèí                        

                                │2% - 2,0                                         

                                │3. Àêòèâ â ËÏÓ                                   

                                │4. Ãîñïèòàëèçàöèÿ                                

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

      │Áîëåçíè ìóæñêèõ ïîëîâûõ   │1. Îñìîòð                                        

      │îðãàíîâ:                  │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ                       

│N.40  │Àäåíîìà ïðåäñòàòåëüíîé    │â/ì:                                             

      │æåëåçû                    │- àíàëüãèí 50% - 1,0                             

│N.45  │Îðõèò, ýïèäèäèìèò         │- êàòåòåðèçàöèÿ ìî÷åâîãî                         

                                │ïóçûðÿ (ìÿãêèì êàòåòåðîì)                        

                                │ïðè îñòðîé çàäåðæêå ìî÷è                         

                                │3. Àêòèâ â ËÏÓ                                   

                                │4. Ãîñïèòàëèçàöèÿ                                

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│N.20  │Êàìíè ïî÷åê è ìî÷åòî÷íèêîâ│1. Îñìîòð                     │1. Êóïèðîâàíèå     

      │(ïî÷å÷íàÿ êîëèêà)         │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:   │ïðèñòóïà áîëåé     

                                │- áàðàëãèí 5,0 - â/â èëè                         

                                │òðàìàë 2,0 - â/â                                 

                                │- íî-øïà 2,0 â/ì                                 

                                │4. Ãîñïèòàëèçàöèÿ                                

                                │(ïî ïîêàçàíèÿì)                                  

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

      │Áîëåçíè àðòåðèé, àðòåðèîë,│1. Îñìîòð, ÝÊà (ïî ïîêàçàíèÿì)│1. Êóïèðîâàíèå áîëåé│

      │êàïèëëÿðîâ:               │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                      

│l70   │Àòåðîñêëåðîç              │àíàëüãèí 50% - 2,0, áàðàëãèí                     

│l73   │Ýíäàðòåðèèò, îáëèòåðóþùèé │5,0, íî-øïà 2,0, ïàïàâåðèí 2% │                    

      │ñòàð÷åñêèé ýíäàðòåðèèò    │- 2,0 - â/ì                                      

      │êîíå÷íîñòåé               │3. Àêòèâ â ËÏÓ                                   

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

      │Áîëåçíè âåí:              │1. Îñìîòð                     │1. Êóïèðîâàíèå áîëåé│

│l80;  │Ôëåáèò, òðîìáîôëåáèò,     │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:   │2. Îñòàíîâêà       

│l83   │âàðèêîçíîå ðàñøèðåíèå âåí │àíàëüãèí 50% - 2,0, ïàïàâåðèí │êðîâîòå÷åíèÿ       

│l84   │Ãåìîððîé                  │2% - 2,0, íî-øïà 2,0 - ïðè                       

│l85   │Âàðèêîçíîå ðàñøèðåíèå âåí │áîëåâîì ñèíäðîìå - â/ì                           

      │ïèùåâîäà                  │3. Àñåïòè÷åñêàÿ ïîâÿçêà                          

│l86   │Âàðèêîçíîå ðàñøèðåíèå âåí │(äàâÿùàÿ) ïðè êðîâîòå÷åíèè                       

      │ìîøîíêè                   │4. Àêòèâ â ËÏÓ                                   

                                │5. Ãîñïèòàëèçàöèÿ                                

                                │(ïî ïîêàçàíèÿì)                                  

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│l88   │Íåñïåöèôè÷åñêèé ëèìôàäåíèò│1. Îñìîòð                     │1. Êóïèðîâàíèå áîëåé│

│l89   │Ëèìôàíãèò, ëèìôîîòåê      │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ ïî │2. Îñòàíîâêà       

                                │ïîêàçàíèÿì: àíàëüãèí 50% -    │ëèìôîððåè          

                                │2,0, ïàïàâåðèí 2% - 2,0,                         

                                │íî-øïà 2,0 - â/ì                                 

                                │3. Àñåïòè÷åñêàÿ ïîâÿçêà                          

                                │(ïî ïîêàçàíèÿì)                                  

                                │4. Àêòèâ â ËÏÓ                                   

                                │5. Ãîñïèòàëèçàöèÿ                                

                                │(ïî ïîêàçàíèÿì)                                  

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│L.02  │Àáñöåññ êîæè, ôóðóíêóë,   │1. Îñìîòð                                         

      │êàðáóíêóë                 │2. Àñåïòè÷åñêàÿ ïîâÿçêà                          

│L.03  │Ôëåãìîíà                  │(ïî ïîêàçàíèÿì)                                  

                                │3. Ãîñïèòàëèçàöèÿ                                 

                                │(ïðè ëîêàëèçàöèè ïðîöåññà                        

                                │íà ëèöå, ãîëîâå, øåå)                            

                                │4. Àêòèâ â ËÏÓ (ïðè äðóãîé                       

                                │ëîêàëèçàöèè ïðîöåññà)                            

├──────┼──────────────────────────┼──────────────────────────────┼────────────────────┤

│Ì.86  │Îñòåîìèåëèò               │1. Îñìîòð                                        

                                │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ                       

                                │(ïî ïîêàçàíèÿì) àíàëüãèí                         

                                │50% - 2,0 â/ì                                    

                                │3. Àñåïòè÷åñêàÿ ïîâÿçêà                          

                                │(ïî ïîêàçàíèÿì)                                  

                                │4. Àêòèâ â ËÏÓ                                   

└──────┴──────────────────────────┴──────────────────────────────┴────────────────────┘

 

ÐÀÇÄÅË: "ÏÅÄÈÀÒÐÈß"

 

ÑÎÃËÀÑÎÂÀÍÎ

Ãëàâíûé äåòñêèé ïåäèàòð

Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ

ãîðîäà Ìîñêâû

À.Ã.ÐÓÌßÍÖÅÂ

 

┌──────┬─────────────────────────┬──────────────────────────────┬─────────────────────┐

│ Êîä           Äèàãíîç            Îáúåì ìåäèöèíñêîé ïîìîùè         Ðåçóëüòàò     

├──────┼─────────────────────────┼──────────────────────────────┼─────────────────────┤

│R.50  │Ãèïåðòåðìèÿ              │1. Ôèçè÷åñêèå ìåòîäû          │1. Ñíèæåíèå         

      │(ãèïåðòåðìè÷åñêàÿ        │îõëàæäåíèÿ òåëà:              │òåìïåðàòóðû         

      │ðåàêöèÿ)                 │à) îõëàæäåíèå (ëåä) îáëàñòè                        

                               │êðóïíûõ ñîñóäîâ (øåÿ,                             

                               │ïîäìûøå÷íûå, ïàõîâûå îáëàñòè, │                    

                               │ïå÷åíü)                                           

                               │á) ïèòüå îõëàæäåííûõ ðàñòâîðîâ│                    

                               │2. àíàëüãèí 50% - (0,1 íà 1                       

                               │ãîä æèçíè 10 ìã/êã âåñà) èëè                      

                               │ïàðàöåòàìîë ïðè t > 39                            

                               │3. Àêòèâ â ËÏÓ                                    

├──────┼─────────────────────────┼──────────────────────────────┼─────────────────────┤

│R.50  │Ãèïåðòåðìè÷åñêèé ñèíäðîì │Âñå ïðåïàðàòû ââîäèòü â/â     │1. Ñíèæåíèå t       

                               │1. Àíàëüãèí 50% - (0,1 íà 1   │2. Íîðìàëèçàöèÿ     

                               │ãîä æèçíè 10 ìã/êã âåñà) èëè  │æèçíåííî âàæíûõ     

                               │ïàðàöåòàìîë ïðè t > 39        │ôóíêöèé îðãàíèçìà   

                               │2. Ïðè öåíòðàëèçàöèè          │3. Ñíÿòèÿ ñïàçìà    

                               │êðîâîîáðàùåíèÿ:               │ïåðèôåðè÷åñêèõ      

                               │- ïàïàâåðèí 2%                │ñîñóäîâ             

                               │èëè íî-øïà (1 ìã/êã âåñà) - â │                    

                              │2 ìë 2% - 40 ìã                                   

                               │- äèáàçîë (0,5-1, 0 ìã/êã                         

                               │âåñà) - â 2 ìë â                                   

                               │1% - 20 ìã                                        

                               │- íèêîòèíîâàÿ êèñëîòà 1%                          

                               │(1 ìã/êã âåñà)                                     

                               │- ïðè íåýôôåêòèâíîñòè:                            

                               │ïåíòàìèí 5% (â çàâèñèìîñòè                        

                               │îò âîçðàñòà îò 1,0 äî 4,0                         

                               │ìã/êã âåñà) - â 1 ìë 5% -                         

                               │50 ìã                                             

                               │- ïðåäíèçàëîí (1,0-2 ìã/ êã                       

                               │âåñà)                                             

                               │- ïðè ðàçâèòèè øîêà äî                            

                               │6,0-8,0-10,0 ìã/êã âåñà                           

                               │3. Ôèçè÷åñêèå ìåòîäû                              

                               │îõëàæäåíèÿ òåëà (ëåä íà                           

                               │êðóïíûå ñîñóäû, îáòèðàíèå                         

                               │òåëà, ïèòüå îõëàæäåííûõ                           

                               │ðàñòâîðîâ è ò.ä.) - òîëüêî                        

                               │ïîñëå ñíÿòèÿ ñïàçìà                               

                               │ïåðèôåðè÷åñêèõ ñîñóäîâ                            

                               │4. Ãîñïèòàëèçàöèÿ                                 

├──────┼─────────────────────────┼──────────────────────────────┼─────────────────────┤

│R.56  │Ñóäîðîæíûé ñèíäðîì       │1. Êîððåêöèÿ íàðóøåíèé        │Êóïèðîâàíèå ñóäîðîã 

                               │äûõàíèÿ:                                          

                               │- ñàíàöèÿ ïîëîñòè ðòà                             

                               │- ââåäåíèå âîçäóõîâîäà                            

                               │- èíòóáàöèÿ òðàõåè                                

                              │- ÈÂË                                             

                               │2. Ýòèîòðîïíàÿ òåðàïèÿ                            

                               │(ãèïåðòåðìè÷åñêèé ñèíäðîì,                         

                               │îáìåííûå íàðóøåíèÿ è ò.ä.)                        

                               │3. Ïðîòèâîñóäîðîæíàÿ òåðàïèÿ: │                    

                               │- ðåëàíèóì 0,2 - 0,5 ìã/êã                         

                               │âåñà, íî íå áîëåå 10 ìã íà                        

                               │ââåäåíèå - â 2 ìë 10 ìã                           

                               │- ÃÎÌÊ 50-150 ìã/êã âåñà (â 10│                     

                               │ìë â 20% - 2000 ìã)                               

                               │- ñóëüôàò ìàãíèÿ 0,2 ìë/êã                        

                               │âåñà (50 ìã)                                      

                               │- çàêèñü àçîòà ñ êèñëîðîäîì                       

                               │3:1 (äîçû íà ôîíå ðàíåå                           

                               │ââåäåííûõ ïðîòèâîñóäîðîæíûõ                       

                               │ïðåïàðàòîâ óìåíüøàòü â 2 ðàçà)│                    

                               │4. Äåãèäðàòàöèÿ (ïî                               

                               │ïîêàçàíèÿì):                                      

                               │- ëàçèêñ 1-3 ìã/êã âåñà                           

                               │- ìàííèòîë 0,5-1,5 ã ñóõîãî                       

                               │âåù-âà íà êã âåñà                                 

                               │5. Îêñèãåíîòåðàïèÿ                                

                               │6. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ │                    

                               │ïðè íàðóøåíèè æèçíåííî âàæíûõ │                    

                               │ôóíêöèé îðãàíèçìà                                 

                               │7. Ãîñïèòàëèçàöèÿ                                 

├──────┼─────────────────────────┼──────────────────────────────┼─────────────────────┤

│Ó.05  │Áðîíõîîáñòðóêòèâíûé      │1. Ñàíàöèÿ òðàõåè, áðîíõîâ                        

      │ñèíäðîì                  │2. Êóïèðîâàíèå áðîíõîñïàçìà:                      

                              │- â/â, â/ì, per rectum -                          

                               │ñâå÷è, per os                                     

                               │- ýóôèëëèí îò 3,0 äî 7,0 ìã/êã│                     

                               │âåñà (ïîäáîð äîçû                                 

                               │èíäèâèäóàëüíî, çàâèñèò îò                         

                               │òå÷åíèÿ çàáîëåâàíèÿ) â 10 ìë                       

                               │2,4% è â 1 ìë 24% - 240 ìã                        

                               │ïðåïàðàòà                                         

                               │- ñàëüáóòàìîë 0,1 ìã (1 âäîõ) │                     

                               │- â èíãàëÿöèè (ïðèìåíÿòü ñ 3-õ│                    

                               │ëåòíåãî âîçðàñòà)                                 

                               │4. Àíòèãèñòàìèííûå ïðåïàðàòû                      

                               │(ñóïðàñòèí, òàâåãèë) - ñòðîãî │                    

                               │ïî ïîêàçàíèÿì òîëüêî ïðè                          

                               │íàëè÷èè àëëåðãè÷åñêèõ                             

                               │ïðîÿâëåíèé                                        

                               │5. Îêñèãåíîòåðàïèÿ                                

                               │6. Ãîñïèòàëèçàöèÿ                                 

├──────┼─────────────────────────┼──────────────────────────────┼─────────────────────┤

│Ó.46  │Àñòìàòè÷åñêèé ñòàòóñ     │1. Ñàíàöèÿ òðàõåè, áðîíõîâ    │Âîññòàíîâëåíèÿ      

                               │2. Êóïèðîâàíèå áðîíõîñïàçìîâ: │äûõàíèÿ             

                               │- â/â êàïåëüíî ýóôåëëèí                           

                               │(ïîäáîð äîçû èíäèâèäóàëüíî, â │                    

                               │çàâèñèìîñòè îò òÿæåñòè                            

                               │ñîñòîÿíèÿ) îò 1 äî 9 ëåò - 24 │                    

                               │ìã/êã âåñà â ñóòêè îò 9 äî 12 │                    

                               │ëåò - 20 ìã/êã âåñà â ñóòêè                       

                               │îò 12 äî 15 ëåò - 18 ìã/êã                        

                               │âåñà â ñóòêè                                      

                              │3. â\â êàïåëüíî ïðåäíèçîëîí                       

                               │äî 10 ìã/êã âåñà                                  

                               │(â çàâèñèìîñòè îò òÿæåñòè                          

                               │ñîñòîÿíèÿ)                                        

                               │4. Îêñèãåíîòåðàïèÿ                                

                               │5. Ãîñïèòàëèçàöèÿ                                  

├──────┼─────────────────────────┼──────────────────────────────┼─────────────────────┤

│Ó.06  │Ñòåíîç ãîðòàíè           │1. Ñîçäàòü îïòèìàëüíûé        │1. Âîññòàíîâëåíèå   

      │èíôåêöèîííîé ýòèîëîãèè   │ìèêðîêëèìàò - óâëàæíåíèå      │äûõàíèÿ             

                               │âîçäóõà                       │2. Ïîääåðæàíèå      

                               │2. Ãîðÿ÷àÿ íîæíàÿ âàííà èëè äî│æèçíåííî âàæíûõ     

                               │ïîÿñà â òå÷åíèå 5-10 ìèí. (ïðè│ôóíêöèé îðãàíèçìà   

                               │îòñóòñòâèè òåìïåðàòóðû)                           

                               │3. Èíãàëÿöèÿ ñ ïèòüåâîé ñîäîé │                    

                               │4. Ãîðÿ÷åå ïèòüå (÷àé, ìîëîêî │                    

                               │ñ ñîäîé, áîðæîìè)                                 

                               │5. Ïàïàâåðèí 2% èëè íî-øïà -                      

                               │1 ìã/êã âåñà                                      

                               │- ýóôèëëèí 2,4% - 3 ìã/êã âåñà│                    

                               │(òîëüêî ïî ïîêàçàíèÿì ñ ó÷åòîì│                    

                               │âîçìîæíûõ íåæåëàòåëüíûõ                           

                               │ÿâëåíèé)                                          

                               │6. Ñåäàòèâíàÿ òåðàïèÿ:                            

                               │- íàñòîéêà âàëåðèàíû èëè                          

                               │ïóñòûðíèêà - 1 êàïëÿ íà 1                         

                               │÷àéíóþ ëîæêó                                      

                               │7. Íåéðîëåïòèêè - ïî                              

                               │ïîêàçàíèÿì                                        

                               │8. Àíòèãèñòàìèííûå ïðåïàðàòû -│                    

                              │òîëüêî ïðè íàëè÷èè                                

                               │àëëåðãè÷åñêèõ ïðîÿâëåíèé                          

                               │9. Ïðåäíèçàëîí 1,0-2,0 ìã/êã                       

                               │âåñà â/ì, â/â èëè â èíãàëÿöèè │                    

                               │(íà ôèç. ðàñòâîðå) ïðè II, II-│                    

                               │III, III ñòàäèÿõ                                   

                               │10. Îêñèãåíîòåðàïèÿ                               

                               │11. Ïðÿìàÿ ëàðèíãîñêîïèÿ:                         

                               │- èíòóáàöèÿ òðàõåè                                

                               │- ÈÂË ïðè III, III-IV ñòàäèÿõ │                    

                               │12. Ïóíêöèÿ èãëîé ìåæõðÿùåâîãî│                    

                               │ïðîñòðàíñòâà, êîíèêîòîìèÿ,                        

                               │òðàõåîñòîìèÿ ïðè III-IV, IV                       

                               │ñòàäèÿõ                                           

                               │13. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ│                    

                               │ïðè III-IV, IV ñòàäèÿõ                            

                               │14. Ãîñïèòàëèçàöèÿ                                

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│À.39  │Ìåíèíãîêîêêîâàÿ èíôåêöèÿ:│                                                  

      │- ìåíèíãèò               │1. Ïåíèöèëèí 35-80 åä./êã âåñà│                    

                               │èëè ëåâîìèöåòèí 20-25 ìã/êã                       

                               │âåñà (ðàçîâàÿ äîçà - â/ì)                         

                               │2. Ïðåäíèçîëîí 1-2 ìã/êã âåñà │                    

                               │- â\âåííî                                         

                               │3. Äåãèäðàòàöèîííàÿ òåðàïèÿ:                      

                               │â/âåííî                                           

                               │- ëàçèêñ 1-3 ìã/êã âåñà                           

                               │- ìàííèòîë 0,5-1,5 ã ñóõîãî                       

                               │âåùåñòâà íà êã âåñà                               

                               │4. Ïîñèíäðîìíàÿ òåðàïèÿ                           

                               │(ãèïåðòîíè÷åñêèé ñèíäðîì,                         

                               │ñóäîðîæíûé ñèíäðîì, íàðóøåíèÿ │                    

                              │äûõàíèÿ - ïðè íåîáõîäèìîñòè)                      

                                                                                 

      │- ìåíèíãîêîêöåìèÿ        │1. Ëåâîìèöåòèí 20-25 ìã/êã                         

                               │âåñà (ðàçîâàÿ äîçà) - â/ì                         

                               │2. Ïðåäíèçîëîí 1-2 ìã/êã âåñà │                    

                               │- â\âåííî                                          

                               │3. Ïîñèíäðîìíàÿ òåðàïèÿ ïðè                       

                               │íåîáõîäèìîñòè (ãèïåðòîíè÷åñêèé│                    

                               │ñèíäðîì, ñóäîðîæíûé ñèíäðîì è │                     

                               │ò.ä.)                                             

                               │4. Ãîñïèòàëèçàöèÿ                                 

                                                                                 

      │- èíôåêöèîííî-òîêñè÷åñêèé│1. Ëåâîìèöåòèí 20-25 ìã/êã                        

      │øîê                      │âåñà (ðàçîâàÿ äîçà - â/ì)                         

                               │2. Ïðåäíèçîëîí 1-2 ìã/êã âåñà │                    

                               │- â\âåííî                                         

                               │3. Ðåîïîëèãëþêèí 10 ìë/êã âåñà│                    

                               │â/âåííî êàïåëüíî                                  

                               │4. Äîïàìèí 5 ìã/êã âåñà                           

                               │(ñóòî÷íàÿ äîçà) - â/âåííî                         

                               │5. Îêñèãåíîòåðàïèÿ                                

                               │6. Êîððåêöèÿ íàðóøåíèé                            

                               │æèçíåííî âàæíûõ ôóíêöèé                           

                               │(ïðè íåîáõîäèìîñòè)                               

                               │7. Ðåàíèìàöèîííûå ìåðîïðèÿòèÿ │                    

                               │8. Ãîñïèòàëèçàöèÿ                                 

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│À.02  │Ïèùåâàÿ òîêñèêîèíôåêöèÿ  │1. Ïðîìûâàíèå æåëóäêà         │Âûâåäåíèå òîêñèíîâ  

                               │2. Ïðè íàëè÷èè ñèìïòîìîâ      │è ëå÷åíèå            

                               │äåãèäðîòàöèè - èíôóçèîííàÿ    │îáåçâîæèâàíèÿ       

                               │òåðàïèÿ (ïåðîðàëüíî èëè                           

                               │â/âåííî, â çàâèñèìîñòè îò                          

                               │ñîñòîÿíèÿ ðåáåíêà):                               

                               │- òðèñîëü, äèñîëü, ãëþêîçî-                       

                               │ñîëåâûå ðàñòâîðû - 5,0-10,0                       

                               │ìë/êã âåñà (ñóòî÷íàÿ äîçà)                        

                               │3. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ                       

                               │(ãèïåðòåðìèÿ, ñóäîðîãè                            

                               │è ò.ä.)                                           

                               │4. Ãîñïèòàëèçàöèÿ                                 

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│L.50  │Àëëåðãè÷åñêèå ðåàêöèè    │1. Àíòèãèñòàìèííûå ïðåïàðàòû  │1. Ñòàáèëèçàöèÿ     

                               │(ñóïðàñòèí, òàâåãèë) - â/ì,   │ñîñòîÿíèÿ           

                               │ï\ê                           │2. Êóïèðîâàíèå      

                               │2. Ïðåäíèçîëîí 1-2 ìã/êã âåñà │àëëåðãè÷åñêèõ       

                               │- â\â, â/ì - ïðè              │ïðîÿâëåíèé          

                               │àíàôèëàêòè÷åñêîì øîêå äî 10                       

                               │ìã/êã âåñà                                        

                               │3. Ãëþêîíàò êàëüöèÿ 0,5-1                         

                               │ìë/êã âåñà èëè õëîðèñòûé                          

                               │êàëüöèé 0,5 ìë/êã âåñà - â/â -│                    

                               │10%                                               

                               │4. Ìåðîïðèÿòèÿ ïî áûñòðåéøåìó │                    

                               │âûâåäåíèþ àëëåðãåíà                               

                               │(ïðîìûâàíèå æåëóäêà,                              

                               │î÷èñòèòåëüíàÿ êëèçìà, ñâåæèé                      

                               │âîçäóõ; îáêàëûâàíèå ìåñòà                         

                               │èíúåêöèè èëè óêóñà; õîëîä íà                       

                               │ìåñòî óêóñà èëè èíúåêöèè)                         

                               │5. Àêòèâ â ËÏÓ                                    

                               │6. Ãîñïèòàëèçàöèÿ                                  

                               │(ïî ïîêàçàíèÿì)                                   

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│Ò.36- │Îñòðûå ýêçîãåííûå        │1. Óäàëåíèå íåâñîñàâøåãîñÿ                         

      │îòðàâëåíèÿ:              │ÿäà:                                              

│Ò.64  │- èíãàëÿöèîííûå          │- âûâåñòè èç îòðàâëåííîé                          

      │îòðàâëåíèÿ               │àòìîñôåðû ïî ïîêàçàíèÿì                           

                               │àíàëåïòèêè, ÈÂË íåçàâèñèìî îò │                    

                               │ÿäà - êèñëîðîä                                    

                                                                                 

      │- îòðàâëåíèå ÷åðåç êîæó  │- îñâîáîäèòü îò îäåæäû, êîæó                      

                               │ïðîìûòü ïðîòî÷íîé âîäîé                           

                                                                                 

      │- îòðàâëåíèå ÷åðåç       │- ïðîìûòü ëåãêîé ñòðóåé âîäû ñ│                    

      │êîíúþíêòèâó              │ïîìîùüþ øïðèöà, çàêîëîòü 0,25%│                    

                               │ð-ð íîâîêàèíà                                     

                                                                                 

      │- óêóñû çìåé             │- õîëîä íà ìåñòî, èíúåêöèè èëè│                    

                               │óêóñà;                                            

                               │- â ìåñòî óêóñà èëè èíúåêöèè -│                    

                               │0,1-0,3 ìë 0,1% ð-ðà                              

                               │àäðåíàëèíà;                                       

                               │- öèðêóëÿòîðíàÿ íîâîêàèíîâàÿ                      

                               │áëîêàäà âûøå ìåñòà ïîïàäàíèÿ                      

                              │ÿäà;                                              

                               │- íàëîæåíèå æãóòà íà óêóøåííóþ│                    

                               │ïîâåðõíîñòü ïðîòèâîïîêàçàíî                        

                                                                                 

      │- îòðàâëåíèå ÷åðåç ðîò   │- ïðîìûâàíèå æåëóäêà ÷åðåç                        

                               │çîíä ïåòüåâîé âîäîé êîìíàòíîé │                     

                               │òåìïåðàòóðû (íåçàâèñèìî îò                        

                               │âðåìåíè ïîñòóïëåíèÿ ÿäà)                          

                               │- îáúåì îäíîêðàòíî, ââåäåííîé │                     

                               │â æåëóäîê æèäêîñòè íå äîëæåí                      

                               │ïðèâûøàòü âîçðàñòíîé äîçû                         

                               │ðàçîâîãî ïðèåìà ïèùè:                             

                               │íîâîðîæäåííûå 15,0-20,0                           

                               │1 ìåñ. 40,0-50,0                                  

                               │3-4 ìåñ. - 60,0-90,0                              

                               │5-6 ìåñ. - 100,0-110,0                            

                               │7-8 ìåñ. - 110,0-120,0                            

                               │9-12 ìåñ. - 150,0-200,0                           

                               │2-3 ãîäà - 200,0-250,0                            

                               │4-5 ëåò - 300,0-250,0                             

                               │6-7 ëåò - 350,0-400,0                             

                               │8-11 ëåò - 400,0-450,0                            

                               │12-15 ëåò - 450,0-500,0                           

                                                                                 

                               │Ïîëíûé îáúåì æèäêîñòè äëÿ                         

                               │ïðîìûâàíèÿ ñîñòàâëÿåò:                            

                               │íîâîðîæäåííûå - 100,0                             

                               │äî 3 ìåc. - 100,0-200,0                           

                               │äî 6 ìåñ. - 300,0                                 

                              │äî 1 ãîäà - 500,0                                 

                               │1-3 ãîäà - 1 ë                                    

                               │3-5 ëåò - 2-3 ë                                    

                               │5-7 ëåò - 3-5 ë                                   

                               │äî 10 ëåò - 6-8 ë                                 

                               │> 10 ëåò - 8-10 ë                                  

                               │(Ïðèáëèçèòåëüíàÿ ôîðìóëà                          

                               │V = n-2, n - ÷èñëî ëåò)                           

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│Ò.44  │Îòðàâëåíèå êëîôåëèíîì    │1. Èíòóáàöèÿ òðàõåè           │1. Êîððåêöèÿ        

                               │(ïî ïîêàçàíèÿì)               │æèçíåííî âàæíûõ     

                               │2. Ïðîìûâàíèÿ æåëóäêà ÷åðåç   │ôóíêöèé îðãàíèçìà   

                               │çîíä                          │2. Óäàëåíèå ÿäà èç  

                               │3. Àòðîïèí ñóëüôàò 0,1% â     │îðãàíèçìà           

                               │äîçàõ (ïåðâè÷íîå ââåäåíèå)                        

                               │I ñò.                                             

                               │- äî 1 ã. - 0,2-0,4 ìë                            

                               │- äî 4 ëåò. - 0,5-0,6 ìë                          

                               │- îò 4 äî 7 ëåò - 0,6-0,8 ìë                      

                               │- ñò. 10 ëåò - 1,2-2 ìã                           

                               │ïðè íåîáõîäèìîñòè ïîâòîðíîå                       

                               │ââåäåíèå ÷åðåç 30 ìèí. - 0,02 │                    

                               │ìã/êã âåñà                                        

                               │II ñò.                                            

                               │äîçó 1-ãî ââåäåíèÿ óâåëè÷èòü                      

                               │â 2 ðàçà; ïðè íåîáõîäèìîñòè                       

                               │ïîâòîðíîå ââåäåíèå ÷åðåç 15-30│                    

                               │ìèí. â äîçå 0,02 ìã/êã âåñà                       

                               │III ñò.                                           

                              │äîçó 1-ãî ââåäåíèÿ óâåëè÷èòü                      

                               │â 3-4 ðàçà ïðè íåîáõîäèìîñòè                      

                               │ïîâòîðíîå ââåäåíèå ÷åðåç 15-30│                     

                               │ìèí. â äîçå 0,04 ìã/êã âåñà                       

                               │3. Ïðåäíèçîëîí 1-2 ìã/êã âåñà │                    

                               │èëè ãèäðîêîðòèçîí 3-5 ìã/êã                        

                               │âåñà                                              

                               │ïðè ÝØ - äî 7-10 ìã/êã âåñà                       

                               │4. Ðåîïîëèãëþêèí - 10-20 ìë/êã│                     

                               │âåñà ñóòî÷íàÿ äîçà                                

                               │5. Ãîñïèòàëèçàöèÿ â                               

                               │òîêñèêîëîãè÷åñêîå îòäåëåíèå                       

                               │13 ÄÊÁ                                            

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│Ò.48  │Îòðàâëåíèå ïàôòèçèíîì    │1. Ïðîìûâàíèå ïîëîñòè íîñà                        

                               │âîäîé                                             

                               │2. Ìåäèêàìåíòîçíàÿ òåðàïèÿ:                       

                               │- àòðîïèí, ïðåäíèçîëîí                            

                               │(ñì. îòðàâëåíèå êëîôåëèíîì)                       

                               │3. Ãîñïèòàëèçàöèÿ â                               

                               │òîêñèêîëîãè÷åñêîå îòäåëåíèå                       

                               │13 ÄÊÁ                                            

├──────┼─────────────────────────┼──────────────────────────────┼─────────────────────┤

│Ò.49  │Îòðàâëåíèå êðèñòàëàìè    │1. Î÷èùåíèå ñëèçèñòîé ïîëîñòè │                    

      │ÊÌïΠ                    │ðòà îò êðèñòàëëîâ ÊÌïÎ 1%                         

                               │ðàñòâîðîì àñêîðáèíîâîé êèñëîòû│                    

                               │2. Íî-øïà 0,1 èëè àòðîïèí 0,1%│                    

                               │- 0,1 - äî ïðîìûâàíèÿ æåëóäêà │                    

                               │3. Ïðîìûâàíèå æåëóäêà ÷åðåç                       

                              │çîíä, ñìàçàííûé ìàñëîì íà âñåì│                    

                               │ïðîòÿæåíèè õîëîäíîé âîäîé                         

                               │4. Óíèòèîë 5% - 1 ìë/10 êã                         

                               │(ñóòî÷íàÿ äîçà)                                   

                               │5. Ïðè îæîãå äûõàòåëüíûõ                          

                               │ïóòåé:                                             

                               │- èíãàëÿöèÿ ñ ãèäðîêîðòèçîíîì │                    

                               │5-8 ìã/êã âåñà íà                                 

                               │ôèçèîëîãè÷åñêîì ðàñòâîðå                          

                               │6. Ðåîïîëèãëþêèí èëè ãåìîäåç                      

                               │â/âåííî 5-10 ìë/êã âåñà                           

                               │ñóòî÷íàÿ äîçà                                     

                               │7. Ãîñïèòàëèçàöèÿ                                 

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│Ò.46  │Îòðàâëåíèå êàðäèî-                                                         

      │òîêñè÷åñêèìè ÿäàìè:                                                        

      │- ñåðäå÷íûå ãëèêîçèäû    │I. Ïðîôèëàêòèêà èëè ëå÷åíèå                       

      │(äèãèòàëèñ, äèãîêñèí,    │ïåðâè÷íîãî êàðäèîòîêñè÷åñêîãî │                    

      │ëàíòîçèä) è ò.ä.         │ýôôåêòà:                                          

      │Îáçèäàí, èìèçèí,         │1. óíèòèîë 5% ïî 1,0 íà êàæäûå│                    

      │àìèòðèïòèëèí, àçàôåí     │10 êã âåñà ñ öåëüþ                                

                               │ïðîôèëàêòèêè - â/ì, ïðè                           

                               │âûðàæåííîì êàðäèîòîêñè÷åñêîì                      

                               │ýôôåêòå - â/â êàïåëüíî                            

                               │2. ãèäðîêîðòèçîí - â/â: äëÿ                       

                               │ïðîôèëàêòèêè - 3-5 ìã/êã                          

                               │3. L-òîêîôåðîë 10% - 0,5-1,0                      

                               │â/ì                                               

                               │II. ×åðåç 10 ìèíóò íà÷èíàþò                       

                              │çîíäîâîå ïðîìûâàíèå æåëóäêà                       

                               │Èíòóáàöèÿ òðàõåè                                  

                               │(ïî ïîêàçàíèÿì)                                    

                               │3. Ñèìïòîìàòè÷åñêàÿ òåðàïèÿ:                      

                               │- ïðè áðàäèêàðäèè: àòðîïèí                        

                               │0,1% - ï/ê                                         

                               │äî 1 ãîäà - 0,2-0,4 ìë                            

                               │äî 4 ëåò - 0,5-0,6 ìë                             

                               │îò 4 äî 7 ëåò - 0,6-0,8 ìë                        

                               │ñò. 10 ëåò - 1,2-2 ìë                             

                               │- ïðè ïàäåíèè ÀÄ:                                 

                               │ãèäðîêîðòèçîí - â/â 7-10 ìã/êã│                    

                               │- ïðè ñóäîðîãàõ: ÃÎÌÊ 20% -                       

                               │â/â 50-150 ìã/êã                                  

                               │4. Ãîñïèòàëèçàöèÿ                                 

└──────┴─────────────────────────┴──────────────────────────────┴─────────────────────┘

 

 



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