Emergency surgical care
Author: Surgeon Yurevich V.V.
Of all the areas of modern medicine, one can hardly find a more exciting, dramatic and more extreme area than surgery. The word surgery from the ancient Greek language is literally translated as needlework. But, unlike handicraft specialties, the surgeon can literally with his own hands pry the patient out of the hands of death at the right moment. In the same way, with the same hands, the surgeon can destroy a person, in the case of his own inconsistency with this great profession.
The extreme of the surgical specialty, as well as of surgical diseases in general, lies in the fact that both the surgeon and the potential patient cannot know what awaits him in the next minute. Indeed, at any moment there can be such a situation, when the surgeon, having left everything, after a few moments, finds himself in the operating room near the patient lying before him, and no one but him can at this moment help the unfortunate.
And if before surgery was a luxury available only in the largest cities, today, thanks to a carefully thought-out and planned set of organizational measures, surgical assistance, especially emergency and urgent, is available to almost every citizen of our country. Due to this, at present practically in every hospital, every city and regional center there is a specialized surgical department, and in every major clinic there is a surgeon reception.
Surgery is a special area of medicine. When rendering surgical assistance in the overwhelming majority of cases, therapeutic and diagnostic procedures are connected to one degree or another with penetration into the human body, which is why surgery requires huge material and moral costs for its successful and full functioning. But the importance of surgery does not end there.
In general, surgical care for the population is divided into two main categories:
1. Routine surgical care
2. Emergency surgical care
With regard to planned surgical care, it includes the implementation of any surgical intervention, which, regardless of the timing of its implementation, does not have any serious negative impact on the human body and does not lead to potentially dangerous and life-threatening complications for the patient. Planned operations include operations for uncomplicated hernias (some people have hernia all their lives), various benign soft tissue tumors (adhesives, fibromas, etc.), all cosmetic and plastic surgery, and much more. Before performing planned operations, patients are thoroughly examined and carefully prepared. This is necessary in order to minimize any complication of a planned operation.
Features of emergency surgical care
Emergency surgical care is very different from planned surgery. Its main differences are as follows:
- for the provision of surgical care in all hospitals provided round the clock duty of one or more surgeons
- emergency surgical care is provided to patients of any age, gender, nationality and place of residence at any time of the day, on holidays and weekends for free.
- in view of the fact that the time of development of an emergency surgical disease is impossible to predict, and the time for rendering assistance is usually limited, most patients undergo the most rapid preoperative preparation. As a result, complications and mortality after emergency surgeries are much higher than after planned ones.
- if planned surgery is usually the lot of “big” “venerable” surgeons with extensive experience, then everyone, even a beginning surgeon, should own the technique of performing urgent surgical interventions, regardless of whether he works in a small district hospital or in a huge research the institute.
- in emergency surgical situations, the surgeon is usually limited to time. Often, in emergency surgery, there is enough time just to gather your thoughts and immediately rush into battle with a serious illness.
Emergency surgical care is divided into two main sections:
1. Emergency surgical care.
2. Urgent surgical care
Emergency surgical care is the borderline part of emergency surgery in which an acute illness occurs, which, if the surgery is not performed promptly, will inevitably or with a high degree of probability lead to the death of the patient. Emergency surgical diseases include peritonitis (purulent inflammation in the abdomen), acute appendicitis, perforated gastric ulcer, various penetrating injuries of the abdomen and chest, all internal bleeding, strangulated hernia, damage to internal organs and so on. That is why there is an iron rule in emergency surgery - any emergency surgery should be performed no later than two hours after the delivery of the diagnosis.
Urgent surgical care is a section of emergency surgery in which a surgical operation must be performed without fail, because its non-fulfillment can lead to serious consequences. But its performance is not as urgent as during emergency operations and often the surgeon has a lot of time for a full examination and preparation of the patient for the upcoming surgery. An example of urgent operations are all operations for malignant tumors, purulent processes, acute inflammation of the gallbladder, various forms of gangrene, organ transplantation, vascular prosthetics and much more.
Also, emergency surgical care is divided according to the location of its provision.
- outpatient (assistance is provided by a surgeon in the clinic).
- inpatient (it turns out to be a specialized surgical team, including one or more surgeons, an operating nurse, an anesthesiologist, a nurse-anesthetist).
Thanks to this approach to the organization of surgical care for patients in need over the past few decades, it has been possible to reduce the mortality rate and the percentage of serious complications dozens of times. Diseases that were previously considered an estimated sentence are now successfully treated in every corner of our homeland.