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Íèæå — ñòðóêòóðèðîâàííàÿ êàðòà ýêñòðåííîãî âûåçäà. Îíà ïîìîãàåò ïàöèåíòó è ñåìüå ïîíèìàòü, ÷òî ïðîèñõîäèò â êàæäûé îòðåçîê âðåìåíè, êàêèå öåëè ìû ïðåñëåäóåì è ïî êàêèì êðèòåðèÿì äâèãàåìñÿ äàëüøå.
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Ð˜®Ñ€˜¸˜¼˜¹˜¼˜±˜¶Ñ‡˜³Ñ˜¸˜®Ñ ˜¸˜¹˜¶˜»˜¶˜¸˜® ‘©Ð ˜³Ðœ˜³˜² Ðš˜®Ñ€˜³˜¹˜¶Ñ‘¹ â€” ÑÑ‚˜¼ ˜¸Ñ€Ñƒ˜±˜¹˜¼ÑÑƒÑ‚˜¼Ñ‡˜»˜®Ñ ˜º˜³˜²˜¶Ñ†˜¶˜»Ñ˜¸˜®Ñ ˜½˜¼˜º˜¼Ñ‰ÑŒ, ˜½˜¼ÑÑ‚Ñ€˜¼˜³˜»˜»˜®Ñ ˜»˜® ˜½Ñ€˜¶˜»Ñ†˜¶˜½˜³ ˜¸˜¹˜¶˜»˜¶Ñ‡˜³Ñ˜¸˜¼˜· Ñ‚˜¼Ñ‡˜»˜¼ÑÑ‚˜¶: ˜¸˜®˜´˜²˜®Ñ ˜½Ñ€˜¼Ñ†˜³˜²ÑƒÑ€˜® ˜¶˜º˜³˜³Ñ‚ Ñ†˜³˜¹ÑŒ, ˜½Ñ€˜¼˜°˜³Ñ€Ñ˜³˜ºÑ‹˜³ ˜º˜®Ñ€˜¸˜³Ñ€Ñ‹ ˜¶ ˜»˜®˜µ˜»˜®Ñ‡˜³˜»˜»˜¼˜³ ˜¼˜¸˜»˜¼ ˜½˜³Ñ€˜³˜¼Ñ†˜³˜»˜¸˜¶. ÐœÑ‹ ˜¶Ñ˜½˜¼˜¹ÑŒ˜µÑƒ˜³˜º Ñ˜¼˜°Ñ€˜³˜º˜³˜»˜»Ñ‹˜³ ˜º˜³Ñ‚˜¼˜²Ñ‹ ˜²˜³Ñ‚˜¼˜¸Ñ˜¶˜¸˜®Ñ†˜¶˜¶ ˜¶ ˜½˜¼ÑÑ‚˜®˜¯ÑÑ‚˜¶˜»˜³˜»Ñ‚˜»˜¼˜· ÑÑ‚˜®˜¯˜¶˜¹˜¶˜µ˜®Ñ†˜¶˜¶, ˜»˜³ ˜½˜³Ñ€˜³˜±Ñ€Ñƒ˜´˜®Ñ Ñ‚˜³Ñ€˜®˜½˜¶ÑŽ ‘©˜»˜® ˜°ÑÑ˜¸˜¶˜· Ñ˜¹ÑƒÑ‡˜®˜·‘¹ ˜¶ ˜»˜³ ˜½˜¼˜¹˜®˜±˜®ÑÑÑŒ ˜»˜® Ñƒ˜»˜¶˜°˜³Ñ€Ñ˜®˜¹ÑŒ˜»Ñ‹˜³ ‘©Ñ˜¶˜¹ÑŒ˜»Ñ‹˜³ ˜¸˜®˜½˜³˜¹ÑŒ˜»˜¶Ñ†Ñ‹‘¹. Ð’˜º˜³ÑÑ‚˜¼ ÑÑ‚˜¼˜±˜¼ â€” ˜º˜¼˜²Ñƒ˜¹ÑŒ˜»Ñ‹˜³ ÑÑ…˜³˜ºÑ‹, ˜¸˜¼Ñ€Ñ€˜³˜¸Ñ‚˜¶Ñ€˜¼˜°˜¸˜® ˜¼˜²˜»˜¼˜±˜¼ ˜½˜®Ñ€˜®˜º˜³Ñ‚Ñ€˜® ˜µ˜® Ñ€˜®˜µ ˜¶ ˜¼˜¯Ñ˜µ˜®Ñ‚˜³˜¹ÑŒ˜»˜®Ñ ˜¼Ñ†˜³˜»˜¸˜® Ñ€˜³˜µÑƒ˜¹ÑŒÑ‚˜®Ñ‚˜®. ˜ ˜®˜¸˜¼˜· ˜½˜¼˜²Ñ…˜¼˜² Ñ˜»˜¶˜´˜®˜³Ñ‚ Ñ„˜®Ñ€˜º˜®˜¸˜¼˜»˜®˜±Ñ€Ñƒ˜µ˜¸Ñƒ, ÑƒÑ˜¸˜¼Ñ€Ñ˜³Ñ‚ ˜°˜¼ÑÑÑ‚˜®˜»˜¼˜°˜¹˜³˜»˜¶˜³ Ñ˜»˜® ˜¶ ˜®˜½˜½˜³Ñ‚˜¶Ñ‚˜® ˜¶ ˜²˜³˜¹˜®˜³Ñ‚ ˜¹˜³Ñ‡˜³˜»˜¶˜³ ˜½Ñ€˜³˜²Ñ˜¸˜®˜µÑƒ˜³˜ºÑ‹˜º ˜²˜¹Ñ ˜½˜®Ñ†˜¶˜³˜»Ñ‚˜® ˜¶ ˜³˜±˜¼ Ñ˜³˜ºÑŒ˜¶. Ð˜»˜¼˜»˜¶˜º˜»˜¼ÑÑ‚ÑŒ ˜°ÑÑ‚Ñ€˜¼˜³˜»˜® ˜° ˜½Ñ€˜¼Ñ†˜³ÑÑÑ‹: ˜»˜³˜º˜®Ñ€˜¸˜¶Ñ€˜¼˜°˜®˜»˜»Ñ‹˜³ ˜°Ñ…˜¼˜²Ñ‹, ˜±Ñ€˜®˜´˜²˜®˜»Ñ˜¸˜®Ñ Ñ„˜¼Ñ€˜º˜® ˜½˜³Ñ€Ñ˜¼˜»˜®˜¹˜®, ˜»˜³˜·Ñ‚Ñ€˜®˜¹ÑŒ˜»Ñ‹˜³ Ñ„˜¼Ñ€˜ºÑƒ˜¹˜¶Ñ€˜¼˜°˜¸˜¶ ˜° ˜²˜¼˜¸Ñƒ˜º˜³˜»Ñ‚˜®Ñ…, ‘©Ñ‚˜¶Ñ…˜¶˜³‘¹ Ñƒ˜°˜³˜²˜¼˜º˜¹˜³˜»˜¶Ñ ˜¶ Ñ€˜®˜µ˜±Ñ€˜®˜»˜¶Ñ‡˜³˜»˜»Ñ‹˜· ˜²˜¼ÑÑ‚Ñƒ˜½ ˜¸ ˜¸˜®Ñ€Ñ‚˜³ ˜»˜®˜¯˜¹ÑÐŠÎ‹ooŒÏ.
ÐŸ˜¼˜²Ñ€˜¼˜¯˜»˜³˜³ Ñ‚ÑƒÑ‚ - ˜»˜®Ñ€˜¸˜¼˜¹˜¼˜±˜¶Ñ‡˜³Ñ˜¸˜®Ñ ˜¸˜¹˜¶˜»˜¶˜¸˜® ˜° ˜½˜³Ñ‚Ñ€˜¼˜µ˜®˜°˜¼˜²Ñ˜¸˜³
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Ìóðìàíñê — ãîðîä ñ äëèííûìè ñóìåðêàìè è âëàæíûì âåòðîì îò Êîëüñêîãî çàëèâà, ÷òî ñêàçûâàåòñÿ íà ñíó è âå÷åðíåé êàðäèîëàáèëüíîñòè. Ïîýòîìó ìû àäàïòèðóåì ìàðøðóòû: âûåçäíûå áðèãàäû ðàáîòàþò â ãðàæäàíñêîé îäåæäå, çàõîäÿò áûñòðî è òèõî, à â ïàëàòàõ êëèíèêè èñïîëüçóåòñÿ ò¸ïëàÿ ïîäñâåòêà è àêóñòè÷åñêîå ïîãëîùåíèå. Äëÿ íî÷íûõ ïîñòóïëåíèé äåéñòâóåò ïðîòîêîë «ìÿãêîé ïîñàäêè»: ìèíèìèçèðîâàííûå êîíòàêòû, ò¸ïëàÿ âîäà ìàëûìè ãëîòêàìè, çàòåì — äèàãíîñòèêà è ñòàðò èíôóçèè ïðè îòñóòñòâèè «êðàñíûõ ôëàãîâ». Ýòî ñíèæàåò ñåíñîðíóþ íàãðóçêó è ïîçâîëÿåò îðãàíèçìó äàòü ÷åñòíûé êëèíè÷åñêèé îòâåò áåç ëèøíèõ ðàçäðàæèòåëåé.
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Åñëè ïðè òåëåôîííîì òðèàæå âûÿâëÿþòñÿ «êðàñíûå ôëàãè» (äûõàíèå, ðèòì, ñîçíàíèå), ìàðøðóò íàñòðàèâàåòñÿ ñðàçó ïîä ñòàöèîíàð: òå æå öåëè, òîò æå îòâåòñòâåííûé êóðàòîð, òîëüêî íåïðåðûâíûé ìîíèòîðèíã âèòàëüíûõ è íî÷íîé ïîñò. À êîãäà ðèñêè íåâûñîêè, ìû íà÷èíàåì äîìà èëè àìáóëàòîðíî è óäåðæèâàåì òåìï êîíòðîëüíûìè âêëþ÷åíèÿìè — ýòî ÷àùå âñåãî äà¸ò ñïîêîéíóþ ïåðâóþ íî÷ü è ëåã÷å ïåðåíîñèìûé âòîðîé äåíü.
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˜¥Ñ‚˜¼˜¯Ñ‹ Ñƒ ˜½˜®Ñ†˜¶˜³˜»Ñ‚˜® ˜¶ ˜¯˜¹˜¶˜µ˜¸˜¶Ñ… ˜»˜³ ˜°˜¼˜µ˜»˜¶˜¸˜®˜¹ ˜°˜¼˜½Ñ€˜¼Ñ ‘©Ñ‡Ñ‚˜¼ ˜²˜®˜¹ÑŒÑˆ˜³‘¹, ˜ºÑ‹ ˜¶Ñ˜½˜¼˜¹ÑŒ˜µÑƒ˜³˜º ˜¸˜®Ñ€Ñ‚Ñƒ ˜½˜³Ñ€˜°Ñ‹Ñ… Ñ‡˜®Ñ˜¼˜°. Ðž˜»˜® ˜µ˜®˜²˜®Ñ‘Ñ‚ Ñ†˜³˜¹˜¶, ˜²˜³˜·ÑÑ‚˜°˜¶Ñ, ˜¸˜¼˜»Ñ‚Ñ€˜¼˜¹ÑŒ ˜¶ ˜¸Ñ€˜¶Ñ‚˜³Ñ€˜¶˜¶ ˜½˜³Ñ€˜³Ñ…˜¼˜²˜® ˜º˜³˜´˜²Ñƒ ÑÑ‚˜®˜½˜®˜º˜¶. ˜ ˜®˜¸˜¼˜· ˜½˜¼˜²Ñ…˜¼˜² Ñ˜¸˜¼˜»˜¼˜º˜¶Ñ‚ ˜º˜¶˜»ÑƒÑ‚Ñ‹ ˜¶ ˜¶Ñ˜¸˜¹ÑÑ‡˜®˜³Ñ‚ ˜¶˜º˜½Ñ€˜¼˜°˜¶˜µ˜®Ñ†˜¶˜¶ ‘©Ñ€˜®˜²˜¶ Ñƒ˜°˜³Ñ€˜³˜»˜»˜¼ÑÑ‚˜¶‘¹.
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Åñëè íà òåëåôîííîì ýòàïå âûÿâëÿþòñÿ «êðàñíûå ôëàãè» — ñïóòàííîñòü, âûðàæåííàÿ îäûøêà, «ñêà÷óùèé» ðèòì, íåóêðîòèìàÿ ðâîòà, — ìû ðåêîìåíäóåì êîðîòêîå îêíî ñòàöèîíàðíîãî íàáëþäåíèÿ. Ïðè íèçêîì ðèñêå öåëåñîîáðàçíî íà÷àòü äîìà: ïðèâû÷íàÿ ñðåäà ñíèæàåò ñåíñîðíóþ íàãðóçêó, à òåëåìåäèöèíñêèå âêëþ÷åíèÿ âå÷åðîì ïî 15–20 ìèíóò ïîìîãàþò ïðîéòè «òðóäíûé ÷àñ» áåç ïîåçäîê.
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