Vіii. The method of conducting of employment is that organizational structure of employment

Distributing of Points, which are appropriated to the students:

At mastering of the given theme for educational activity to the student the estimation is proposed after; 4-points (traditional) scale which is after converted in marks (points) as follows:

Estimation	Points
“5” (fine)	6 Points
“4” (well)	4 Points
“3” (satisfactorily)	2 Points
“2” (unsatisfactorily)	0 Points

Technological card of employment

№ p/p	Basic stages of employment, their functions and maintenance	Level of mastering	Methods of control and teaching	Materials of the methodical providing	Distributing of time (min.)
1. 2. 3.	Preparatory stage Organizational measures. Raising of educational purposes is that motivation. Control of initial level of knowledges, skills, abilities: 1.Структура surgical service of policlinic 2.Обов’язки doctor and middle medical personnel of policlinic 3. Volume of work of surgeon, operating block and bandaging	ІІ ІІ ІІ	The Individual questioning, tests ІІ of	П.1 Actuality of theme П.2 Educational purposes Table: Plan-chart of surgical cabinet of policlinic	1-2 3 15
4.	Basic stage 1.Make registration of patient, that gets to the surgical cabinet 2.Make question and to execute the inspection of patient in the conditions of surgical policlinic reception 3.Take participation in bandaging and surgical manipulations in an operating-room and bandaging surgical cabinet of policlinic	ІІІ ІІІ ІІІ	Practical training	Patients in a surgical cabinet and bandaging policlinics	15 15 20
5. 6. 7.	Final stage Control and correction of level of professional abilities and skills Work out the totals of employment Domestic task (basic and additional literature after a theme)	ІІІ	Individual control of skills, tests and tasks ІІІ	Tests and tasks ІІІ of “Short methodical pointing” to work on practical employment.	20

Practical employment №30.

Theme: Employment in a policlinic

Tests and tasks for verification of initial level of knowledges

1. Dispansarysation – it is the system of measures, directed on the active exposure, diagnostics, medical treatment and prophylaxis of diseases. Which with words is key in this formulation?

а) diagnostics;

b) exposure

c) medical treatment;

d) prophylaxis

2. Which from transferred felons more frequent all is complicated pandactilitis?

а) hypodermic (subcutaneous felon)

b) tendon

c) skin;

d) paronychiya (bolster fingers);

e) joint (articulate) felon.

3. What operative interferences can be executed by the surgeon of policlinic?

а) Cholecystectomy;

b) Deleting of atheroma

c) Liquidation of intestinal impassability;

d) Opening and drainage of furuncle (boil)

e) herniotomy and plastic of a ventral hernia.

4. Which from the transferred subsections of surgical separation of policlinic is obligatory?

а) Bandaging

b) Vent;

c) Cabinet of doctor-surgeon

d) Cabinet of the main trained nurse of policlinic;

e) Endoscopic cabinet.

5. After the term of implementation operative interferences in surgical cabinet of policlinic are:

a). in time operation

b). express operation

c).urgent operation

g).radical operation

d).palliative operation

6. After the term of implementation operative interferences in surgical cabinet of policlinic are:

a).two steps operation

b). urgent operation

c).very quickly operation

d). one operation

e). express operation

7. at preparation of patient to urgent operative interference at the hypodermic whitlow (felon) of brush, for anaesthetizing, you will use:

a).blockade (block) for Lucashevich-Oberst

b). it is not needed in anaesthetizing

c).intravenous anesthesia

g).endotracheal anesthesia

d).psychotherapy

8. At preparation of patient to operative interference at the skin whitlow (felon) of brush, for anaesthetizing, you will use:

a).blockade (block) for Lucashevich-Oberst

b). it is not needed in anaesthetizing

c).intravenous anesthesia

g).endotracheal anesthesia

d).psychotherapy

9. Sick S. asked the medical sister (nurse) of cabinet of policlinic of date him for the acquaintance his ambulatory card and to account for him some medical setting. How is a medical sister in the given situation to act?

а). to give a card to the patient

b).a card not to give and explain not the medical setting

c) to suggest to appeal to treating a doctor

d). to give to familiarize with a card in its presence

e) to give to the patient a card after working hours at doctors

10. What medical documents are designed in the surgical cabinet of policlinic?

а). Sheets of disabled

b). Hospital charts

c). Stationary magazine

d). Magazine of duties

e). Ambulatory cards

Situation tasks.

1. A patient 54 years, sicking with a diabetes mellitus during 10 years. Three days ago hard sickly infiltration appeared on the back of head. Temperature of body – a 38,5⁰ C. After review the skin in the area of the back of head is hyperemia, in a center its sickly infiltration 4х3 cm, on which 3 small festering blisters. Ground your diagnosis? Tactic and medical treatment..

2. A patient, 30 years, appealed for the help in a surgical cabinet with complaints about sharp pain in the area of the second finger of the left brush, violation of function of finger, general weakness, and rise of temperature. Became ill 3 days ago since injured a finger. Objective: the a condition of the patient is satisfactory. Pulse a 90 per minute, AP 120/80 mm. hydr. col., temperature of body – 37,5⁰С. The middle phalanx of the second finger of the left brush is sharply enlarged in the sizes, deformed. Skin is tense with cyanosis. Active motions not in complete to the volume. At palpation in the center of phalanx infiltrate on the middle of which a skin is softened is determined. Diagnosis? Medical treatment. At a necessity operative interference which is needed anaesthetizing?

3. A sick women of 51 years old, on the surgical reception complained about a new formation on a parietal area, which grows gradually, prevents to comb a hair. It is ill near 10 years. The last 2-2,5 years of a new formation are multiplied. Objectively in the parietal area of the form rounded off the tumor of 4x5cm, mobile, is dense, painless, unconnected with a bone. Regional lymphatic nodules are not enlarged. Diagnosis? Medical treatment.

4. Patient., 29 years of old, working in a workshop, by a chance dashed a glass old tub with sulfuric acid. The two-bit of liquid pleased on a right thigh. The victim at once appealed to the policlinic with complaints about the smart sharp turn of skin red, spoiled dressed. What plan of actions?

5. A sick women of 69 years old, suffers a diabetes mellitus within 10 years. It is exposed on the reception, that all fingers of right foot – black-brown color, foot – dark-purple color with bubbles and with an unpleasant smell. What previous diagnosis and which must be tactic of surgeon of policlinic?

6. Electrician Michael, 22 years, executing repair of illumination in the cabinet of surgeon, by a chance fell down from a chair, has hit about a table and cut the left eyebrow. Bleeding began. A surgeon instantly transported a patient in bandaging, processed a wound, did primary surgical treatment and imposed primary stitches with an aseptic bandage. What method of stop of bleeding was executed?

Answers:

1. d,b, 2 a,b 3 b,d 4 a,c 5 b,c 6 b,e 7 a,c 8 a,b,d 9 b,c 10 a,e

1 Answer: Carbuncle of neck (large infiltrate, 3 festering bubbles (blisters), high temperature, typical localization for a carbuncle. A patient needs operative medical treatment in the conditions of surgical permanent establishment.

2 Answer: Hypodermic (subcutaneous) whitlow (felon) of 2nd finger of the left brush. It is necessary to conduct operative medical treatment (opening and drainage). It is possible to use local anesthesia – blockade for Lucashevich- Oberst.

3 Answer: Atheroma of parietal area. Surgical medical treatment is recommended (deleting of atheroma).

4 Answer: For neutralization, immediately it is necessary to process the site of damage by a 1-2% solution by hydro carbonate of sodium (solution of soda), to enter anesthetic and send the victim to the burn center, or in the surgical department.

5 Answer: Previous diagnosis - a diabetes mellitus. Gangrene of right foot. Sick it is necessary quickly to send in the surgical department for stationary medical treatment.

6 Answer: The mechanical method of eventual stop of bleeding was used.