RU203743U1 - INFORMATION CARD OF THE WOUNDER - Google Patents

Abstract

The utility model refers to printed materials of a special format and can be used in military medicine to record data on the nature of the injury and the medical care performed, in order to ensure continuity in the provision of medical care at the stages of the medical and evacuation system. The information card of the wounded is made on a flat paper medium of a round shape and contains a central and three peripheral visual-readable fields with an internal segmental structure, on which standardized medical signs of the first and second order in text and schematic design are applied in a certain order, with the possibility of their differentiated selection. Provides the universality of the information card of the wounded and the ability to record data in the field. f-ly, 1 dwg.

Description

The utility model refers to printed materials of a special format and / or purpose, which are of an informational nature and can be used in military medicine to record data on the nature of the injury and the medical treatment performed in order to ensure continuity in the provision of medical care at the stages of the medical and evacuation system. ...

The provision of assistance begins from the place of injury and continues until the hospitalization of the victim with a combat surgical injury to the hospital. In the conditions of multi-stage assistance to the wounded during armed conflicts of varying intensity, the movement of the wounded along the evacuation routes and the provision of assistance to them by different persons is inevitable. In this regard, monitoring the dynamics of the condition of the wounded at each stage of medical care, especially when they are massively admitted, is difficult without the availability of initial data on the nature of the injuries. It is also important to have information about the medical measures carried out at the previous stage of the evacuation, especially for the wounded who are in an unconscious state. The lack of this information can lead to inadequate assistance at subsequent stages (for example: overdose or insufficient dosage of medications, etc.), which can lead to the development of various complications, including death.

For registration of primary and subsequent data on the state of the wounded and injured, as well as the medical measures performed by him at the pre-hospital stage of medical care, various forms of accounting documentation have been proposed.

Known accounting form No. 114 / y, which includes an accompanying sheet of the station (department) of emergency medical care and a coupon to it [1]. This form, made on a flat rectangular paper, is a personal medical record intended to ensure continuity and consistency in the provision of medical care to patients and victims. The accompanying sheet of the station (department) of emergency medical care is a form with the front and back sides. On the front side of the accompanying sheet of the emergency medical station (department), free columns are sequentially applied from top to bottom for entering information into it on the following sections:

1. passport data (name of the applicant, age, gender, information about the identity document, place of residence);

2. place of rendering emergency medical care (street, apartment, workplace, medical organization, public place (underline if necessary), other (specify));

3. diagnosis of the doctor (paramedic) of the ambulance brigade; referral of a polyclinic, other medical organization (underline the necessary and enter the diagnosis);

4. date and time of receiving the call, delivery to the medical organization, the name of the medical organization;

5. signature, full name of the doctor (paramedic) of the ambulance brigade.

On the reverse side of the accompanying sheet of the emergency medical station (department), free columns are sequentially applied from top to bottom for entering information on the following sections:

1. features associated with the transportation and provision of emergency medical care to the patient;

2. other comments.

The coupon to the accompanying sheet on the front side includes the following columns for entering information signs into them:

1. passport data (name of the applicant, age, gender, information about the identity document, place of residence);

2. place of rendering emergency medical care (street, apartment, workplace, medical organization, public place (underline if necessary), other (specify));

3. circumstances of the accident, date and time of injury;

4. medical assistance rendered;

5. way of transportation: on a stretcher, on hands, on foot (underline the necessary);

6. date and time of receiving the call, delivery to the medical organization, the name of the medical organization;

5. signature, full name of the doctor (paramedic) of the ambulance brigade.

On the reverse side of the coupon to the accompanying sheet, there are columns in which information is entered that is filled in when the patient is in inpatient treatment: diagnosis of an emergency doctor (paramedic), emergency department (point), polyclinic; the diagnosis of the doctor of the admission department; final clinical diagnosis (postmortem report); information about the performed surgical interventions; terms of staying in hospital; hospitalization outcomes; comments of the medical organization to the work of the ambulance team.

This form has the following disadvantages, which exclude the possibility of using it for registering primary data in the wounded in an armed conflict at the prehospital stage:

- non-adaptation of the registration form to the military contingent - the presence of an extensive passport part, data on the patient's place of residence, data on the place of care;

- duplication of information in the two-component structure of the registration form No. 114 / y (accompanying sheet and coupon to it) increases the filling time and makes it difficult to use it at the site of injury and at the stages of medical evacuation, especially in an unfavorable medical-tactical situation, as well as in mass the arrival of the wounded;

- the complexity of filling out the form, associated with the need for handwritten entry of additional data into the existing columns;

- the impossibility of using this form by personnel without medical education (sanitary instructors);

- dependence of visual recognition of information entered in free columns on the individual characteristics of the person's handwriting filling out the form No. 114 / y.

Known primary medical card (form 100), which is a document of personal medical records, designed to ensure continuity and consistency in the provision of medical care to the wounded and sick at the advanced stages of medical evacuation [2]. A primary medical card, made on a flat paper, rectangular, is entered on all wounded and sick people who are out of action due to injury or illness for a period of at least one day, when they are first provided with medical assistance. In the structure of the primary medical card, the front and back sides are distinguished, and the main part and the tear-off spine can also be distinguished in it (it contains information in an abbreviated form that is fixed on the main part). On the sides of the main part of the primary medical card there are colored signal stripes (red, yellow, black, blue), designed to inform the next stage of medical evacuation about special urgent measures that the wounded (patient) needs. The red stripe is left after filling out Form 100 in cases where the wounded (patient) needs emergency medical care at the next stage of the evacuation. The yellow bar indicates the need for sanitization. The black bar indicates the need to isolate the wounded (patient) at the next stage of evacuation due to an infectious disease, reactive state, defeat by bacteriological weapons. The blue stripe indicates the need for special measures in case of damage from penetrating radiation. If there is no need for one or another type of assistance at the next stage of medical evacuation, then the corresponding strips are torn off when filling out the card. If the wounded (patient) needs several medical measures at the same time, two, three or four stripes can be left on the card. The internal structure of the front side of the primary medical card is represented by the following horizontally oriented elements:

1.free columns for entering the following information in them: general data (names of the stage of assistance provided; time of issue of the card; full name, military rank, number of the military unit, identity card, individual badge of the wounded (patient); time, date of onset of the disease or injury ), diagnosis, data on the fact and time of application of the tourniquet, sanitization;

2. a table with free cells for entering data on measures for the provision of medical care: the introduction of antibiotics, toxoid, serum PSS, PGS, anesthetic drugs, transfusion of blood products, blood substitutes, immobilization and dressing;

3. pictorial signs - conventional symbols characterizing the etiological factor of the lesion; type of evacuation transport, evacuation method (sitting, lying), locally evacuation destination;

4. a schematic representation of a person - front and back views (to inform about the localization of the injury).

On the reverse side of the primary medical card there are free columns for entering information on the evacuation of the specified diagnosis, on the medical measures taken at the subsequent stages, on the methods and destination of the evacuation, the outcome of the injury (disease).

This form has the following disadvantages:

- the use of this form only from the stage of first medical aid creates a shortage of information on the provision of first and first aid, in connection with which there is no continuity in these links of the medical and evacuation system;

- the complexity of filling out the form, associated with the need to enter additional data into the existing free columns;

- the possibility of using this form only by the medical staff;

- the absence in the form 100 of data on the clinical signs of injury and the severity of the condition of the wounded, except for the localization of damage;

- dependence of the visual recognition of information entered in free columns on the individual characteristics of the handwriting of the person filling out the primary medical card.

Known map for the provision of tactical assistance to the wounded [3]. This map, printed on flat, rectangular paper, is used by US Special Operations Forces to document and treat casualties from where they were injured. The Tactical Wounded Aid card has both front and back sides. On the front side, the following elements are consistently applied from top to bottom:

1. free columns for entering general data on the injured person, the date and time of the injury;

2. graphic elements - a schematic representation of a human figure: front and back views (to inform about the localization of the injury, the area of the lesion);

3. a table with free cells for entering data on the condition of the wounded in the following sections - level of consciousness, pulse, respiratory rate, blood pressure.

On the reverse side of the tactical assistance card, the following elements characterizing the provision of medical assistance to the wounded are plotted in sequential order from top to bottom:

- textual information about the imposition of hemostatic tourniquets, pressure bandages, the use of local hemostatic agents, with free fields located opposite them for marking the implementation of these measures;

- a table characterizing the ongoing infusion therapy, with empty cells for entering data on the type and volume of the solution;

- a table characterizing the ongoing drug therapy, with empty cells for entering data on the name of the drug, dosage and time of administration;

- free columns for entering information not categorized in the previous sections;

- signature and data of the person who provided assistance.

This map for providing tactical assistance to the wounded has the following disadvantages:

- the complexity of filling out the form, associated with the need to enter additional data into the existing free columns;

- dependence of the visual recognition of information entered in free columns on the individual characteristics of the handwriting of the person filling out the primary medical card.

The primary medical card (Form 100) and the Tactical Combat Casualty Care Card are taken as prototypes.

The task to be solved by the implementation of the proposed utility model is to eliminate the shortcomings of prototypes by creating a universal map with standardized internal information saturation, which allows to optimize the solution of the range of problems associated with both the registration of injury data and the provision of medical care in primary health care units. evacuation system.

The technical results of the implementation of the assigned task include:

- the universality of the information card of the wounded, which allows it to be used for registering data to all persons involved in the provision of medical benefits to the wounded at the prehospital stage (at the site of injury, during evacuation), regardless of whether they have medical education and their knowledge of special terminology;

- no need for additional data entry due to the optimal internal information saturation of the card;

- ergonomics of filling out the card and the ability to register data in the field in the absence of writing materials.

The essence of the utility model is the information card of the wounded (Fig. 1), is that on the front side of the card, made on a flat paper medium of a round shape and including a central (1) and three peripheral visually readable fields (2, 3, 4) with the internal segmental structure, in a certain order, applied standardized medical signs of the first and second order in text and schematic execution, with the possibility of their differentiated selection in accordance with the received combat surgical trauma and the amount of assistance provided. The visually readable fields of the utility model follow the shape of the carrier and are arranged sequentially from the center to the periphery. Each visually readable field is divided by radial lines (5) into segments (6, 7), which together form the segmentary structure of the utility model. The number of segments in each visually readable field corresponds to the number of applied information signs. The central visual-readable field (1) is divided into two equal segments, on which a schematic representation of a person is applied - front and back view (8), to indicate the localization of the wound. Along the periphery of the central one (1), there is a visually readable field (2), divided by radial lines (5) into segments (7), on which standardized medical signs of the first order are applied along the circumference (9): type of injury, life-threatening consequences, invasiveness, form of severity conditions, stopping bleeding, ensuring airway patency, cardiopulmonary resuscitation, stabilization of external respiration, immobilization, manipulations, analgesic, infusion, hemostatic. Along the periphery of each standardized medical sign of the first order (9), in the segments (6) of the visually readable field (3), the corresponding groups of detailing standardized medical signs of the second order are plotted (10). The standardized medical sign of the first order (9) "type of injury" corresponds to a group of standardized medical signs of the second order (10) - bullet, fragmentation, mine-explosive, explosive injury, thermal injury, mechanical injury; the sign of "life-threatening consequences" - external bleeding, internal bleeding, asphyxia, compression of the brain, open pneumothorax, tension pneumothorax, costal valve; the sign of "invasiveness" - penetrating, non-penetrating; the sign "the form of the severity of the condition" - traumatic shock, terminal state, traumatic coma, acute respiratory failure, acute heart failure; the sign of "stopping bleeding" - a pressure bandage, wound tamponade, local hemostatics, hemostatic tourniquet; the sign "ensuring the patency of the airways" - setting the air duct, conicotomy, atypical tracheostomy, tracheal intubation; the sign "cardiopulmonary resuscitation" - carried out, not carried out; the sign of "stabilization of external respiration" - the imposition of an occlusive dressing, fixation of the costal valve, decompression of the pleural cavity; the sign of "immobilization" - carried out, not carried out; the sign "analgesic" - was introduced, not administered; the sign of "infusion" - carried out, not carried out; the sign of "hemostatic" - was introduced, not introduced. On the periphery of the standardized medical signs of the second order (10), a visually readable field (4) is applied, divided into segments (6) and containing, opposite each detailing feature (10), a round-shaped mark (11), previously prepared for extraction by microperforations along the circumference. The possibility of a differentiated choice is realized by means of a breakdown or by another method of extracting a round mark (11) previously prepared by microperforations opposite the required standardized medical sign of the second order (10).

A distinctive feature of the information card of the wounded is that its segmental internal structure and information saturation formed by standardized medical signs of the first and second order eliminates the need to enter additional data and medical terms, which makes it possible, due to visual reading of the available information, to use it by persons without medical education who participate in providing assistance in the primary links of the medical and evacuation system.

The circular shape of the utility model and the circular peripheral arrangement of medical features, in contrast to the rectangular shape and sequential entry of data into free graphs and prototype tables, implements the possibility of easy access to each feature for its differentiated selection.

The presence on the periphery of the information card opposite each standardized medical sign of the second order of marks, previously prepared by microperforations around the circumference, allows, in comparison with prototypes, to select the desired sign by mechanical action on the mark, without the use of writing instruments, which in turn gives an advantage when registering data on the nature of the injury and the amount of assistance provided in the field.

Literature

1. Order of the Ministry of Health and Social Development of the Russian Federation of December 2, 2009 N 942 "On approval of the statistical instruments of the station (department), emergency hospital". [Electronic resource]. URL: https://base.garant.ru/12171975/ (date of access 05.05.2020).

2. Small Medical Encyclopedia in 6 volumes / ch. ed. IN AND. Pokrovsky. - M .: Medicine, 1996. - T. 4. Nephrotomy - Renal failure. - S. 280-281.

3. The Tactical Combat Casualty Care Casualty Card TCCC Guidelines? Proposed Change 1301. [Electronic resource] / Kotwal, Russ S. et al. // Journal of special operations medicine: a peer reviewed journal for SOF medical professionals. - 2013. - Vol. 13 (2) - P. 82-87. - URL: https://docplaver.net/21361355-The-tactical-combat-casualtv-care-casualtv-card-tccc-guidelines-proposed-change-1301.html (date of access 05/05/2020).

Claims (3)

1. Information card of the wounded, containing a flat paper carrier, on which text and schematic information is applied, characterized in that it is made of a circular shape and contains a central and three peripheral visually readable fields with an internal segmental structure formed by the separation of visually readable fields by radial lines into segments in which textual and schematic information is applied in a given order in the form of standardized medical signs of the first and second order, while the visually readable fields are made in the shape of the carrier and are sequentially located from the center to the periphery, and the number of segments in each visually readable field corresponds to the number of applied standardized medical signs, and the visually readable field on the periphery of the carrier contains rounded marks in the form of microperforations located around the circumference, located opposite each standardized medical sign and made They are removable by breakdown for a differentiated selection of a standardized medical feature, and the central visual-readable field is divided into two equal segments, on which a schematic image of a person is applied, displaying his front and back views and intended to indicate the localization of the wound. 2. Information card according to claim 1, characterized in that the standardized medical signs of the first order are plotted in a circle on a visually readable field located along the periphery of the central one, and contain information indicating the type of injury, life-threatening consequences, the ratio of the injury to the cavities, the form of severity conditions, stopping bleeding, ensuring airway patency, cardiopulmonary resuscitation, stabilization of external respiration, immobilization, manipulations, analgesic, infusion. 3. Information card according to claim 2, characterized in that the standardized medical signs of the second order are plotted in a circle on the visually readable field located along the periphery of the visually readable field with the indicated medical signs of the first order, and contain information detailing the nature of the wound and elements providing assistance.

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