VIII. The Procedure of carrying out of employment that organizational structure of employment:

Allocation of points that students can gain:

At a digestion of a subject 2 from the thematic module №1 for educational activity to the student the estimate for 4 marks (traditional) a scale which then are converted in points as follows is exposed:

Estimate{Estimation} Balls

“5” (perfectly) 6 balls

“4” (well) 4 balls

“3” (satisfactorily) 2 balls

“2” (unsatisfactorily) 0 balls

The procedure sheet of employment

№	The Basic stages of employment, their function that the content	The Level of a digestion	The Quality monitoring and learnings	Materials of methodical maintenance	Allocation of time (minutes)
1. 2. 3.	The Preparatory stage Organizational actions The purpose of occupation that motivation The check of a datum level of knowledge, skills, skills 1. Structure of a clean and purulent dressing room. 2. The organization of operation in dressing rooms. 3. Concept about bandages and dressings. 4. Views of bandages. 5. Demands to a dressing material.	ІІ ІІ ІІ ІІ II	Individual interrogation Fathers-in-law II	P.1 "The Urgency those" P.2 "The Training purposes" The table: structure of a dressing room Dressing material (a gauze, bandage of a napkin, Emplastrum, tubular bandage). Videofilm	1-3 5 15
4.	The Basic stage 1. Blanket rules of overlaying bandages. 2. Sample head bandages, a neck, upper that inferior an extremity, a thorax, a gaste. 3. Rules of overlaying scarf, adhesive, glue bandages.	ІІІ ІІІ ІІІ	Professional training in the solution of atypical clinical problems Practical training	Employment to be spent in an educational room Employment to be spent in a clean dressing room Exercises	30 10 15
5. 6. 7.	The Final stage The check that correction of a level of professional skills that of skills Summarizing of employment{occupation} Homework (the basic and additional{padding} literature on a subject)	ІІІ	The individual check of skills Fathers-in-law III.	Fathers-in-law III Exercises III Methodical indicatings for operation on practical employment .	12

Tests and problems for checkout of a datum level of knowledge:

Subject: the Organization of operation in a clean dressing room. A desmurgy, a dressing material. Typical bandages. Head bandages, a neck, a thorax. Care of the patients operated on a head, a neck, a thorax.

1. To the doctor the patient with a purulent wound which is had on a back surface of a neck was converted. What bandage needs to be apply?

1 circular

2 spica

3 protecting cap

4 spiral

5 cruciate

2. At the patient the postoperative wound of epigastric area. What bandage to use for the prevention of a becoming infected of a wound?

1 bandage

2 gauze

3 glue

4 integral

5 circular

3. At the patient extensive bite wounds of a right forearm. What bandage is most convenient?

1 glue

2 emplastic

3 spiral with an inflection

4 circular

5 circular gypseous

4. During prompt walking at the patient the stack has turned up. The applying, what bandage it is possible to facilitate its state?

1 return on a foot

2 eight-figurative

3 spica

4 creeping

5 turtle

5. At the patient the wound of the upper third of left-hand femur, in the field of a major trochanter takes place. What bandage is necessary for him for imposing?

1 T-bandage

2 eight-figurative

3 fourtailed

4 spica

5 turtle

6. The boy has fallen the face to land, and at once there was a bleeding from a nose. What bandage needs to be imposed for first-aid treatment to the victim?

1 any

2 pressing

3 fourtailed

4 special

5 emplastic

7. At the victim five wounds in the field of a pilar part of a head take place. What bandage to him to impose?

1 scarf

2 emplastic

3 glue

4 bridle

5 protecting cap

8. At the victim fracture of a mandible. What bandage is necessary for imposing a bandage at first-aid treatment?

1 protecting cap

2 fourtailed

3 Hippocrates’s cap

4 bridle

5 scarf

9. At the patient the purulent mastitis of a right mamma is opened. What bandage is better to apply?

1 Desanlt’s bandage

2 spiral on a thorax

3 circular on a thorax

4 bolstering on a mamma

5 pressing on a mamma

10. With a dislocation of a brachium it is necessary for patient to render the first medical care. What bandage to him is necessary for imposing?

1 bandage

2 scarf

3 gypseous

4 spica on a brachium

5 special

11. Most an appreciable error at applying a bandage on a field of a neck is:

1 free enough

2 it is not anchored

3 tight bandage

4 the wide bandage is used

5 it is imposed with very lot of rounds

12. What bandage is fixed by a dressing material on a amputation a stump?

1 circular

2 spica

3 recurrent

4 turtle

5 spiral

13. What bandage is used on field of a whirlbone?

1 spiral

2 turtle

3 creeping

4 cruciate

5 circular

14. The dressing material on a thorax is fixed by a bandage:

1 spica

2 turtle

3 Velpeau’s bandage

4 circular

5 spiral

15. The dressing material should meet all demands except for:

1 hygroscopicity

2 elastance

3 opportunity of sterilization without losses of quality

4 stimulating activities on a tissue

5 capillarities

1. The woman with the 10-years boy was converted to you in connection with that the child is disturbed with pains in a right ulnar joint. To the boy 6 hour back, in an ambulatory, on the infected graze of a ulnar joint, after its processing the bandage has been imposed. At survey the protrusion of saphenas is defined easy cyanotic a right forearm and a hand, even at a raising of an arm to up. What's happened? How to help the child?

2. On reception the person of 40 years who disturbs an itch of the left-hand forearm has come. Three days ago has gained thermal combustion I-II of a degree. On a forearm the aseptic bandage has been imposed. At survey it is erected, that the bandage on a dorsum of a medial third of forearm is imbued by yellow-grey eductions. How correctly to take out a bandage?

3. In a reception it is delivered the man of 34 years with cut wound of a palmar surface of a medial third of right forearm. According to the victim, the wound 1,5 hours ago in the street was superimposed a knife by the unknown person. The toilet of a wound is carried, primary junctures are imposed. The nurse on a wound has anchored a dressing material a bandage, having fastened the ends of bandage in unit above a wound. After that she has inlet to him (patient) subcutaneously 0,5 ml a tetanic anatoxin and 3000 МЕ antitetanic Serum. What error is admitted in technique of applying of a bandage?

4. The patient of 68 years, on an interior surface of the inferior third of right anticnemion has a trophic canker in the dimension 1,5 х 2 sm with necrotic fundus, a dermahemia and morbidity around. The canker, is handled by a solution of an antiseptic, exsiccated and covered by a napkin with a salve "Iruxolum". You impose what anchoring bandage?

5. The patient has varicose dilating saphenas in stages of subneutralization is carried a venectomy of a major saphena on a right femur and an anticnemion. Wounds are sewn up, the handled 1% a solution of Iodonatum, occluded by napkins. What bandage should be imposed to put on the inferior extremity for fastening a dressing material?

6. To the patient, 20 years in connection with a trauma of a cervical department of a column and damage of a spinal cord, with the purpose of decompression its carried urgent laminectomy. The wound on a back surface of a neck is sewn up, occluded by gauze napkins. What bandage you impose for fastening a dressing material?

7. You are an ambulance surgeon. You caused to the patient with making penetrating wound of a thorax on the right. A state of the victim hardly. He instinctively covers a wound with a hand, having bent in the right side. At survey of a wound air entrainment through it during the moment of an inspiration is scored, and at an expiration air with hum leaves it. Your activities?

8. To the patient, 28 years, are carried disclosing a purulent ulnar bursitis. The ascus is washed by a solution of an antiseptic, drainage of napkin, moistened by a hypertonic salt solution of sodium of Sodium chloridum, covered by a gauze napkin. How you anchor a dressing material?

9. The patient, 36 years, has suffered during road failure. Are available cut, abundantly bleeding wound in right temporal area and extensive slash - an avulsive wound on an exterior surface of a right shoulder joint. Attributes of fracture of a brachium are not present. What bandages should be imposed to the patient at rendering to him first aid?

10. You the casual witness of accident: the child has burnt boiled water a right hand, shouts from a pain. Blisters appear on a dorsum of dactyls and hand. In the house first-aid set there is a solution of Furacilinum (1:5000) and in packaging sterile bandage. With the purpose of granting of the first aid, what bandage should be imposed to the victim?

11. In rural local hospital the 52-years worker of state farm with contused-cut wound of right parietal field with which the victim himself covers with the combined handkerchief is delivered. What volume of a medical care should be given to the patient?

12. As the local pediatrist you, having examined children's homes, have recommended to impose to her on a right ear warming compress. Mother of the child, referring to inability to execute this procedure, has asked you to help. How to impose warming compress on an ear and by means of what bandage to anchor it?

13. To the doctor of a rural ambulatory the boy of 11 years who about an hour back during game in hockey has gained shock by a stick in about an area left eye. At once first aid in the form of applying on this an eye of a snow has been rendered. The moderate hyperemia of an eyeglobe, erosion of a cornea is visually defined. At a palpation - an eye it is painful. The diagnosis is erected: a blunt trauma left-hand an eye. What volume of the first medical assistance should be given to the child and than to anchor a dressing material?

14. The person of 47 years has fallen from a bicycle complains of pains in the field of a right brachium. The visually mark, strain, morbidity and a crepitation in a projection of a medial third of right clavicle is visually scored. Pulse on a right radial artery is satisfactory. Which you will diagnose also what бинтовую an immovable bandage impose?

15. After diaplasis of a traumatic dislocation of a right brachium at the victim it is necessary immobilization a right upper extremity on the average on 1 week. What бинтовую an immovable bandage you impose?

Відповіді:

1. 5

2. 3

3. 3

4. 2

5. 4

6. 3

7. 5

8. 2

9. 5

10. 2

11. 3

12. 3

13. 2

14. -5

15. 4

1 The answer: The bandage to the child is imposed tightly therefore there was a disturbance of a circulation. It is necessary to attenuate or variate a bandage.

2 The answer: To take out a bandage follows, all over again having slited it far away from a field of damage, or from the opposite of a burn wound. The bandage can be unreeled, agglomerating it in a floc and shifting from one hand in another, on the close distance from a wound. The dried bandage is taken out after wetting of 3 % by hydrogen peroxide.

3 The answer: At fastening a bandage cross-wise with each other the ends cutting bandage, the unit should not overlap on wound surface.

4 The answer: In the given event for bandaging a convenient circular bandage on the inferior third of skin.

5 The answer: in the beginning of bandaging to keeping a dressing material on the appreciable piece of an extremity apply a creeping (coiled) bandage. After that it is necessary to impose an ascending spiral bandage. As a result of the pencil-point shape of an anticnemion for its bandaging the spiral bandage with inflections of bandage is convenient. In similar events it is possible to apply and tendenisc bandaging of the inferior extremity, which short in a combination of several bandages: a figure-of-eight bandage of stack, the turtle bandage of field of a heel, a spiral bandage with inflections on an anticnemion, the turtle bandage on field of a knee joint, a spiral bandage with inflections on a femur, an ascending spica bandage in the field of a hip joint and a basin.

6 The answer: for fastening a dressing material on a back surface of a neck it is necessary to impose a cruciate bandage. Before bandaging with the purpose of the prevention of squeezing of a neck it is desirable to impose its forward surface a stratum of cotton. That the bandage was not moved up, it is expedient to add it courses of bandage of phylum of a cruciate bandage of a back.

7 The answer: it is necessary to impose urgently an occlusive bandage during the moment of an expiration. For this purpose the skin around of a wound is greased with 5% with a solution of an iodine, the wound is occluded a sterile gauze napkin, and from above turtle paste strias of a sticking plaster which come far for edges of a napkin. If you have an individual dressing-room package (IPP) it is possible to use it. In this case a wound occlude a cotton wool-gauze small pillow, a skin around of which for the best potting grease with Vaselinum put on it an interior (sterile) surface rubber packaging of a package and anchor spiral bandage on a breast. For trustier prevention of shift of a bandage it is desirable to bandage and a conforming arm to the damaged side of a thorax. To the patient inlet anesthetizing, under indications - cardiacs and transport in a surgical hospital.

8 The answer: it is possible to impose the turtle bandage on a ulnar joint in bend its standing or to anchor a dressing material by means of tube-elastic bandage.

9 The answer: at presence of a bleeding wound in temporal area it is more rational to impose a so-called nodal bandage. The dressing material on a wound in the field of a shoulder joint can be trusty anchored by a spica bandage. Besides the right upper extremity in this case should be hung by means of a kerchief.

10 The answer: the piece of bandage moistened in a solution of Furacilinum, it is necessary to cover the burnt brush, having indented cords of bandage between the divorced dactyls for the prevention of conglutinating of the burnt fields and a maceration of a skin. After that the retracing bandage on a brush overlaps. In a similar event when near at hand there is no necessary dressing material, it is possible to impose a triangular bandage from the scarf combined on a diagonal.

11 The answer: it is necessary widely cut a hair around of a wound, to handle a skin a solution of iodine, to wash out a wound a solution of an antiseptic, to cover with sterile napkin and to impose anchoring bandage (Hippocrates’s cap, a protecting cap or a bridle).

12 The answer: warming compress on field of an ear plot as follows. Bandage put in 6-8 stratums, at centre of the gained napkin cut out a hole for an auricle. A napkin water in an admixture with alcohol (1:1) or oil (camphoric etc), wring out and impose on a skin around of an auricle. A napkin occlude polyethylene film (oilcloth or a wax paper) so that film on 2-3 sm overlapped it. From the outside impose a stratum of cotton depth of 2-3 sm which overlaps all subjacent. The compress on field of an ear is conveniently anchored by the Neapolitan bandage.

13 The answer: it is necessary to instill in an eye of 5% a solution of Novocainum, intramuscular to inlet Vicasolum, to give inside Analginum, Ascorutinum, to cover eye with a sterile napkin, to impose an easy monocular bandage and urgently to refer the child on reception to the oculist.

14 The answer: at the victim traumatic fracture of a right clavicle. A right upper extremity it is necessary immobilization bandage Desault’s or Velpeau’s.

15 The answer: after diaplasis of a dislocation of a brachium the shown immobilize bandage Desault’s or Velpeau’s.