Urgent surgical care
Author: surgeon Yurevich VV
Of all the fields of modern medicine, it is hardly possible to find an area more exciting, dramatic and extreme than surgery. The word surgery with the ancient Greek language is translated literally as needlework. But only, unlike craft specialties, the surgeon can literally pull the patient out of the hands of death at the right moment. Similarly, with the same hands, the surgeon can ruin a person, in case of a disparity of this great profession.
Extreme surgical specialty, as well as surgical diseases in general, lies in the fact that both the surgeon and the potential patient can not know what is waiting for him in the next minute. After all, at any moment, a situation may arise where the surgeon, having thrown everything, after a few moments, finds himself in the operating room next to the patient lying in front of 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 carefully planned and planned complex of organizational measures, surgical care, especially urgent and urgent is available to almost every citizen of our country. Thanks to this, at present practically every hospital, every city and district center has a specialized surgical department, and a surgeon is taking a reception at each large polyclinic.
Surgery is a special area of medicine. When surgical care is provided in the overwhelming majority of cases, the treatment and diagnostic procedures are associated, to varying degrees, with penetration into the human body, which is why surgery for a successful and full functioning requires enormous material and moral costs. But on this the importance of surgery does not end.
In general, surgical care for the population is divided into two main categories:
1. Routine surgical care
2. Urgent surgical care
With regard to planned surgical care, it includes the performance of any surgical intervention, which, regardless of the timing of its implementation, does not have any serious adverse effects on the human body and does not lead to potentially life-threatening and life-threatening complications. Planned operations include surgery for uncomplicated hernias (some people wear a hernia all their lives), various benign soft tissue tumors (adipose, fibromas, etc.), all cosmetic and plastic surgery, and much more. Before the scheduled operations, the patients are thoroughly examined and carefully prepared. This is necessary in order to minimize any complication of the planned operation.
Features of emergency surgical care
Emergency surgical care is very different from planned surgery. Its main differences are as follows:
- to provide surgical care in all hospitals, one or more surgeon's doctors are on duty around the clock
- urgent surgical care is provided to patients of any age, sex, 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 urgent surgical disease can not be predicted, and the time for care is usually limited, most patients undergo the fastest preoperative preparation. Because of this, complications and lethality after urgent surgical operations are much higher than after the planned ones.
- If planned surgery is a lot of "big" "venerable" surgeons with a lot of experience, then the technique of performing urgent surgical interventions is the responsibility of everyone, even the beginning surgeon, regardless of whether he works in a small district hospital or in a huge research institute.
- in urgent surgical situations, the surgeon, as a rule, is limited by time. Often, in urgent surgery, time is enough only to collect 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 disease, if surgery is not performed in time, will inevitably or with great probability lead to the death of the patient. To urgent surgical diseases include peritonitis (purulent inflammation in the abdomen), acute appendicitis, perforated stomach ulcer, various penetrating wounds 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 carried out necessarily, because its failure can lead to serious consequences. But its implementation is not as urgent as in emergency operations and often for a full examination and preparation of the patient for the forthcoming surgery, the surgeon has plenty of time. An example of urgent operations are all operations for malignant tumors, purulent processes, acute inflammation of the gallbladder, various forms of gangrene, organ transplantation, prosthetics of vessels and much more.
Also, urgent surgical care, depending on the place of its delivery, is divided
- outpatient (assistance is provided by a surgeon in a polyclinic).
- stationary (it turns out to be a specialized surgical team, including one or more surgeons, an operating nurse, an anesthesiologist, an anesthetist nurse).
It is thanks to this approach to the organization of surgical care for those who need it that in the last few decades it has been possible to reduce the death rate and the percentage of serious complications tens of times. Diseases, previously considered an estimate sentence, are now successfully treated in every corner of our country.