Physical offices. Types of physiotherapeutic procedures
A physiotherapeutic office is a structural unit of a medical and health resort institution that provides physiotherapeutic procedures to the population. It can function independently (in low-power institutions) or be part of a physiotherapy or rehabilitation (restoration) department. Depending on the capacity of the institution, it can use either individual devices, or groups of devices, or the whole complex devices and equipment for the operation of which several physiotherapy rooms can be organized. However, regardless of the number and type of physiotherapeutic devices, they can be used for prevention and treatment only if safety precautions are ensured in accordance with current regulations. regulatory documents and if there is at least a mid-level medical worker who has passed special training and having a document authorizing him to work with physiotherapeutic equipment.
Physiotherapy rooms are located in specially equipped premises that fully meet the requirements of the “Rules for the design, operation and safety of physiotherapy departments (offices)”, approved by the Ministry of Health. When setting up and equipping a physiotherapy room, the following must be provided: 1) safety precautions; 2) convenience for patients; 3) normal conditions for staff work. When constructing new or reconstructing existing physiotherapy rooms (departments), an approved standard design is required, which indicates the placement of equipment, electricity, water, heat supply, and ventilation. Commissioning of the cabinet is formalized by a special act with a conclusion on the possibility of operating the adopted cabinets. One copy of the act must be kept by the head physician of the institution, the second - by the head of the office (department). Special attention addresses the placement of equipment and the nurse's workplace. It depends on the correct placement of the equipment. rational use and convenience during procedures.
Separate rooms must be equipped for carrying out procedures for each or similar types of treatment. Electrotherapy and light therapy may be placed in the same room. Every specialized office has some features in its design and equipment. In electric light therapy rooms, according to the number of stationary devices, cabins for carrying out procedures are equipped.
The area of the office is determined at the rate of at least 6 m2 per treatment couch, including the area for aisles and staff workplaces. The sister's workplace should be equipped close to the entrance to the office. Each office must have an adjacent utility room with an area of at least 6-8 m2 for preliminary preparation medical procedures. A room located no lower than the first floor is allocated for the physiotherapy room (and department). The office space should be warm, dry, bright and spacious enough. For systematic ventilation, transoms and supply and exhaust ventilation with air heating are installed in the physiotherapy room. A washbasin with a mixer is installed in the office, to which hot and cold water is supplied. The floor of the offices should be wood, oil-painted, parquet or covered with linoleum. The walls of the offices to a height of 2 m are painted with light-colored oil paint. Central heating radiators, water supply and sewer pipes must be covered with wooden casings painted with oil paint. A group electrical panel with a common switch is installed in the office, and switchboards are installed to connect individual devices. An emergency first aid kit should be available in the office medical care.
The management of the work of a physiotherapy room is entrusted to a physiotherapist, and in his absence, to a doctor trained in physiotherapy. The physiotherapy room is equipped in accordance with the current report card. Preventive surveillance and repair of physiotherapeutic equipment is carried out by the relevant institutions (representatives) of the Medtekhnika system.
For each physical therapy room, safety instructions must be developed, approved by the administration of the institution. Instructions must be posted in a visible place. Every office should have detailed instructions, defining the action of personnel to provide first aid in case of electrical injury, overdose of factors, as well as instructions and an evacuation plan in the event of a fire, approved by the administration medical institution. Each office must have a technical passport containing a list of premises, their equipment and protective devices. An inventory of the technical equipment of the office, a list of measures for routine maintenance and repair of equipment must be contained in the technical maintenance log.
The official document of the patient in the physiotherapy room is the registration card in form No. 44/U, in which the prescription of the physiotherapy procedure is specified by the physiotherapist or another doctor and signed by him.
A record of the procedures, indicating the actual dosages and duration of the procedures, is carried out when each procedure is performed by the nurse.
At the end of treatment, the card in form No. 044/U is stored in the department for a year or pasted into the medical history (outpatient card) of the patient.
The activities and scope of work of a physiotherapy room are determined depending on the profile of the medical institution by the relevant regulatory documents. To take them into account, by order of the Ministry of Health, standard units for the performance of physiotherapeutic procedures are approved.
To conduct a quantitative and qualitative analysis of the office’s activities, journals are usually kept in it containing diaries of the work of the physiotherapy office of a hospital or clinic.
The main tasks of the staff of the physiotherapy room are: carrying out therapeutic, restorative and preventive measures using physical factors; introduction into practice of new methods of physiotherapy and physioprophylaxis; organizing the promotion of physiotherapy methods among medical workers and patients; accounting of the work of the office in accordance with the approved accounting and reporting documentation, etc.
Physiotherapy is today a very popular and popular method of treatment for many diseases. This is due to its high efficiency combined with maximum safety for the patient’s body. Medicinal methods of treatment, despite their effectiveness, tend to have negative side effect on the body. At the same time, physiotherapy in some cases can completely replace other treatment methods or significantly reduce, for example, the need for medicinal drugs. In addition, physiotherapeutic treatment is an integral component of rehabilitation programs prescribed in the post-traumatic and postoperative periods. Thus, physiotherapy can act independent method treatment and prevention, or be a component of complex treatment.
Physiotherapeutic treatment allows the use of a wide variety of methods, which are based on the use of natural and artificially created physical effects on the body’s tissues. In particular, heat and cold, electric current, magnetic fields and ultrasound can be used, laser radiation etc.
Physiotherapy methods
The choice of physiotherapeutic treatment method depends on many factors and is carried out exclusively individually in each case. Firstly, the indications of the underlying disease and the stage of the underlying disease against which this treatment will be carried out are taken into account. Secondly, a complete medical examination patient to determine the general condition of the patient’s body, other chronic diseases and pathologies, the presence of hereditary factors, etc.
Thirdly, the doctor also takes into account other external factors that can influence the course of treatment - age, gender, working and living conditions, climate zone accommodation, etc. Thus, despite the prevalence and versatility, and most importantly the safety of physiotherapeutic treatment this direction clinical medicine has a serious scientific basis and applies an individual approach to each individual case.
As for the methods directly used in physiotherapy, their list is quite extensive and includes not only traditional ones (massage and exercise therapy), but also modern ones using the latest technology and equipment. Modern physiotherapy room has a wide offer and we will look at some of the treatments:
Cryotherapy. This method is based on the effect on the patient’s body low temperatures. For this purpose it is used a liquid nitrogen. Cryotherapy provides a general activating effect on processes in the body. In particular, it promotes pain relief, stimulates the endocrine and immune system, helps relieve swelling and spasms, helps saturate the blood with active biological components, etc. This method can be used not only to treat a number of diseases, but also to prevent them.Laser therapy. Today, lasers are widely used in clinical medicine and the areas of this use are very diverse - from physiotherapeutic treatment to surgery. Laser therapy is the effect on tissue of a directed light flux (radiation). In this case, the degree of impact will depend on the type of radiation (red and infrared) and its wavelength. What does this light effect give? Active saturation of cells with light leads to activation of enzymes responsible for basic biochemical processes at the cellular level. As a result, cells are renewed, normalized and restored their vital functions, natural processes of self-regulation of vital functions and mobilization of the body’s internal reserves are launched. In addition, laser exposure helps improve blood microcirculation, which also has positive impact on restoration processes in the body.
Magnetotherapy. Magnetic fields- This is another way of influencing the body and its tissues, actively used in physiotherapy. In this case, each tissue cell acts as the final “reception point” of sent electromagnetic signals, which activate all compensatory and adaptive functions of the body at the cellular level, thus including internal recovery reserves. Magnetotherapy is prescribed for a wide variety of diseases. In particular, it provides beneficial effect on cerebral blood supply, promotes oxygen saturation of the myocardium, which in turn helps to improve the general condition of the patient, and also normalizes blood pressure, reduces blood sugar levels, improves immunity, etc.
UV blood irradiation - ultraviolet irradiation blood, also called photohemotherapy or photomodification of blood. This method allows you to influence the blood with a light flux by one-time insertion of a special light-guide catheter into a vein using a needle. Therapeutic effect this method based on the fact that such direct light exposure helps to activate the antioxidant system of the blood and increases the amount of hemoglobin. Ultraviolet irradiation of the blood undoubtedly stimulates and improves immunity, improves tissue nutrition, which has great importance for various diseases of internal organs.
Contact physiotherapy room Our medical center guarantees patients the appointment of individually selected comprehensive physiotherapeutic treatment. In this case, doctors conduct a preliminary examination and the choice of treatment methods is carried out taking into account all existing indications for a specific disease and the general condition of the patient. In addition, do not forget that physiotherapy is also an excellent preventive method to prevent large quantity a wide variety of diseases. Therefore, contacting our center may well be of a preventive nature. Indeed, in addition to the hardware physiotherapeutic methods discussed above, there are massage courses and exercise therapy programs ( therapeutic exercises), inhalation procedures, visiting a halochamber (effect salt caves) etc. Physiotherapeutic procedures are also indispensable during rehabilitation period after injuries or surgery.
Thus, we can confidently say that contacting our medical center will be useful both for people who have certain health problems and for those who seek to maintain their health and prevent the occurrence of serious illnesses in future.
Offers a full range of Ems devices for physiotherapy and rehabilitation, health and beauty centers, and spa salons.
Our partners are the world's leading manufacturers of physiotherapeutic equipment for rehabilitation treatment, hydrotherapy, massage, fitness and massage training. Based on the assortment, our specialists select equipment that corresponds to the specifics of medical institutions, taking into account all the wishes of clients.
Modern equipment of rehabilitation and physiotherapy departments
The main activity of the Tech-Med company is the comprehensive equipment of clinics and departments of exercise therapy, massage, manual therapy, physiotherapy rooms, balneology, spa salons and health centers. We supply quality products.
The devices are multifunctional and will help you save money when creating a new institution or office. They have a wide range of adjustments and a large range of additional accessories. Among the advantages, we note modern design, light weight, convenient accessories, and a large database of methodological recommendations.
All equipment has GOST certificates and registration certificates from the Ministry of Health of the Russian Federation.
Medical equipment for physiotherapy and rehabilitation Eme and BTL
Our company is a reliable and proven partner of leading European manufacturers. Over the years successful work we have sold hundreds of types rehabilitation equipment and furniture. Having assessed the quality of services, our new clients become regulars. We respect every customer equally.
Our research department never stands still. We keep our finger on the pulse of new technologies and strive to bring new products to the warehouse as quickly as possible. This means we offer the most modern medical equipment for rehabilitation, including Eme and BTL.
Each device and accessory has a specific function, affecting different systems. human body, thereby facilitating accelerated healing or maintaining and strengthening the patient’s health.
Multifunctionality of physiotherapy equipment for rehabilitation
A lot depends on technology. Naturally, more complex and modern devices provide more opportunities, and, accordingly, the doctors of this clinic can prescribe more effective procedures.
A multifunctional physiotherapy device is suitable for:
for electrotherapy,UHF-,
DMV-,
SMV-,
EHF-,
TES therapy,
wave,
magnetic therapy,
amplipulse therapy.
This is not the entire list. Thus, the system can be equipped with devices for magnetic laser therapy, inhalers, ionizers, humidifiers, air purifiers, and so on.
We offer only certified plus medical equipment from the best European manufacturers.
Why is physical therapy effective?
Modern technologies and techniques give excellent results without side effects. After undergoing a course of physical therapy, the patient gets rid of the consequences of the disease, addiction, allergies, and recovers faster.
This procedure can be combined with other treatment methods: from “traditional” medicine in the form of mustard plasters, cupping, massage, foot parks, baths to a course potent drugs and surgery. Physiotherapy sessions are safe and can be done without the help of a doctor. They are prescribed individually, taking into account age, severity of the condition, chronic and acute diseases.
Our company sells therapeutic equipment of any configuration. We have a large warehouse, and if necessary we can deliver goods to order.
Physiotherapeutic equipment. Areas of use
This medical equipment is used in many areas of medicine. They are simply irreplaceable in surgery, dentistry, neurology, obstetrics, gynecology, urology, and cosmetology. Procedures are prescribed to prepare the body for the upcoming main treatment and for recovery after. They are also necessary for general strengthening health, relapse prevention.
It is worth buying devices for surgery, therapeutic, neurological, and ENT departments. They will help the body recover after surgery.
Medical equipment for physical cabinets are complex, expensive equipment, and it must be operated according to the rules. Regular maintenance and timely repairs will help increase its service life.
We offer reliable, durable, easy to maintain and operate, repairable devices. We take full responsibility for product quality. By purchasing it from us, you will open up new perspectives for yourself.
Where is the best place to buy physiotherapy equipment?
Therapeutic equipment is necessary in medical institutions for effective treatment and prevention various diseases. The Tech-Med company offers advanced devices and instruments from the world's leading manufacturers and guarantees the most favorable purchasing conditions.
A physiotherapeutic office is a structural unit of a medical and preventive institution; a set of premises, equipment and auxiliary equipment intended for performing physiotherapeutic procedures. It is necessary to distinguish between a physiotherapy department, where all the main types are presented (electrical, light, water, heat therapy), and a physiotherapeutic office, which has only a part of the devices. In the latter case, one or two or three rooms (usually adjacent) can be allocated for a physiotherapy room.
The organization of a physiotherapy room (department) provides for the rational placement and arrangement of equipment, taking into account the ease of its operation and safety during procedures. The opening and operation of a physiotherapy department (office) is permitted only if it complies with the safety and sanitation rules approved by the USSR Ministry of Health and the Central Committee of the Health Workers' Trade Union.
The height of the premises of the physiotherapy room must be at least 3 m. The area of the premises for the physiotherapy room is determined at the rate of at least 6 m 2 per treatment couch. The area of the combined electric light therapy room must be at least 24 m2; if there are 4 or more low-power generators, a separate room with an area of also 24 m2 is allocated for them. The ratio of window area to floor area is at least 1: 6. The lowest artificial illumination at the level of 0.8 m from the floor with incandescent lamps is 75 lux, with fluorescent lamps - 150 lux.
The floor should be wooden. Walls to a height of 2 m are painted with light oil paint; the rest of the walls and ceiling are adhesive. Wall cladding with ceramic tiles is not permitted.
The physiotherapy room must have supply and exhaust ventilation with air heating, as well as transoms; the air temperature in the room should not be lower than 20°. The physiotherapy room must be equipped with a washbasin. Treatment areas (cabins) are separated from each other by curtains on a metal, plastic or polished wooden frame, attached to the ceiling at a height of 2 m. The metal structures of the cabins are insulated from the stone walls by placing 40 mm thick wooden socket boxes under the flanges, impregnated with paraffin and painted with oil paint.
Dimensions of cabins for electrolight therapy procedures: length 2-2.2 m, width (for all floor-standing and ultrasonic devices) - 2 m, for others - 1.6 m. Only one floor-standing device is installed in each cabin. To the physiotherapy room, where there are devices for, medicinal substances, treatment with low frequency currents and devices for, a special insulated box (8 m2) is allocated for work on the preparation of the treatment procedure (boiling electrode pads, drying them, wetting with solutions of medicinal substances, etc.) with a drying cabinet and exhaust ventilation.
The electrical equipment of the physiotherapy room must be carried out in accordance with the “Rules for the design, operation and physiotherapy departments (offices)”. Each office must have an independent electrical input from the main switchboard, laid with copper wire with a cross-section of at least 6 mm 2, and a group switchboard with a common switch or starter that has clearly marked “on” and “off” positions. The switch is installed at a height of 1.6 m from the floor level. A mains voltmeter with a phase switch is mounted on the switchboard. The group board is mounted from fuses or maximum current circuit breakers of 15 I with the number of groups corresponding to the number of installed devices, also taking into account sterilizers and electric stoves. In the booths for connecting devices, starter shields made of insulating material are installed at a height of 1.5 m from the floor level. A three-pole switch (starter) for 15-25 A is mounted on them, clearly marked “on”, “off”, four terminals in an insulating frame, of which two left ones are for connecting devices, the rest are for protective grounding of the device, one plug socket with self-catering.
Only portable equipment may be connected to the socket outlets. The line from the group to the starting panels is laid with copper wire with a cross-section of at least 2.5 mm 2. All starting devices are installed only in a protected form.
It is prohibited for personnel to remain in the direct radiation zone in front of the remotely located emitter of devices for microwave or decimeter wave therapy. The operation of such devices is carried out in specially designated rooms or in common rooms, subject to shielding using a metal mesh or chambers made of metal mesh, shields covered with absorbent electromagnetic vibrations substances, booths or screens made of cotton fabric with microwire.
Introduction
Conclusion
Bibliography
Introduction
A physiotherapy room is one of the structural divisions of a medical and preventive institution, which is a complex of auxiliary equipment and equipment that are designed to perform physiotherapeutic procedures.
Organization of a physiotherapy department (office) includes the process rational placement and placement of equipment for subsequent ease of operation and safety of procedures.
It is permitted to open a physical therapy office subject to compliance with safety and sanitary standards.
The purpose of the work is to explore all aspects of the organization of a physiotherapy room, regulatory framework, basic rights and responsibilities of personnel, sanitary standards.
Job objectives:
Chapter 1. Department of Physiotherapy. General questions of the organization, as well as a list of documents and regulations of the physiotherapy department (office)
The physiotherapeutic department is a structural unit of an institution for treatment and prevention of inpatient, rehabilitation or outpatient clinic type.
In the physiotherapy department, electric current treatment is carried out with low, ultra-high and high frequencies; electrosleep and ultrasound; laser therapy; microwave therapy, magnetotherapy; as well as heat therapy, hydrotherapy and inhalation.
The necessary premises are provided for all types of treatment.
Physiotherapeutic departments must comply with hygienic and sanitary standards, as well as radiation and fire safety requirements.
The following persons should be allowed to work in the physiotherapy room:
· With high relevant professional qualifications, in accordance with current regulations;
· Those who have undergone instruction and training in the appropriate manner, as well as a knowledge test regarding labor protection requirements
· Past medical checkup
· No medical contraindications
In each treatment and prevention institution, if there is a physiotherapy room, there must be a passport of the physiotherapy department. The following documents are also attached to the passport:
· Permission from the Sanitary and Epidemiological Service (SES) to open a physiotherapy office (department) in the institution
· Diagram showing the placement of equipment
· Diagram showing grounding, indicating the depth of grounding, cross-section of wires and material, as well as soldering of joints; including a certificate of testing the effectiveness of grounding, submitted once a year
· Order from the management of the medical institution, indicating positions and professions, hazardous working conditions, additional payment for persons working in harmful conditions, in the amount of 15%
· A journal in which a note is made about the current repairs and routine inspection of the physiotherapy room equipment
· Briefing log
· List of nurses
· Instructions for actions in case of fire
· Periodic personnel inspection log
· Procedure log
· Register of primary patients
· List of staff of the medical institution, indicating telephone numbers and addresses
· Nurses' work schedule
· Office work plan
· Job Descriptions nurses and doctors in the physical room
Copies of the following documents are required:
· Copy of the certificate and attachment of the accreditation and licensing commission
· License and protocol
· Act on checking the hygienic and sanitary condition of the department premises
· Annual and monthly reports on the work of nurses and doctors in the physical therapy office
physiotherapy room sanitary standards
The working hours of the physiotherapy room are set from 07.00 to 18.00.
The doctors' workload is five patients per hour, forty per day.
Regulations
· Federal Law "On Compulsory Medical Insurance in the Russian Federation";
· Decree of the Government of the Russian Federation of October 4, 2012 No. 1006 “On approval of the Rules for the provision of paid medical services by medical organizations”;
· Decree of the Government of the Russian Federation of November 28, 2014 No. 1273 “On the program of state guarantees free provision citizens of medical assistance for 2015 and for planning period 2016 and 2017";
· Decree of the Government of the Russian Federation of March 6, 2013 No. 186 “On approval of the Rules for the provision of medical care foreign citizens on the territory of the Russian Federation";
Chapter 2. Responsibilities of the doctor and nurse in the physiotherapy room
Responsibilities of a physical nurse:
.The need to follow all doctor's orders
2.Prepare equipment in a timely manner and workplace to receive patients
3. Maintain order and cleanliness in the office/department
Monitor the patient's well-being during the procedure
Monitor the operation of the equipment, as well as the time during the procedure
If a deterioration in the patient’s condition is detected, provide first aid if necessary, as well as immediately inform the doctor and make a note about what happened in the patient’s procedural record.
It is necessary to keep records of work and monitor the condition of patients throughout the entire treatment phase.
Maintain accounting documentation approved by the Ministry healthcare.
You must be at your workplace during the procedure.
Process medical equipment in a timely manner.
At the end of the working day, it is necessary to turn off all equipment. Heating and heating devices, as well as comply with safety regulations
Improve your skills
Observe the principles of deontology.
Responsibilities of a physiotherapist
· Providing qualified medical care, using modern diagnostic and preventive methods
· Purpose of treatment
· Providing consulting assistance to other doctors
· Supervising the work of junior medical personnel, assisting them in fulfilling their duties job responsibilities
· Control of prescribed treatment
· Monitoring the correctness of treatment procedures and the consumption of materials
· Monitoring compliance with labor safety
· Participation in advanced training of junior and nursing staff
· Planning and analysis of your activities
· As well as systematic improvement of your qualifications
Working hours for physiotherapy room staff
The standard working week for physical therapy room staff is 33 hours; this duration is established for full-time physical therapists conducting outpatient visits.
The duration of additional leave is 6 days for doctors in physiotherapy rooms and junior medical personnel.
Chapter 3. Sanitary standards for physiotherapy departments
All newly built, reconstructed and existing medical institutions, including day hospitals, must be equipped with water supply, sewerage, and centralized hot water supply.
The quality of water for domestic and drinking purposes must comply with the requirements of SANPIN 2.1.3.1375-03.
The buildings of medical institutions in which medical treatment facilities are located must be equipped with supply and exhaust ventilation systems with mechanical drive and natural exhaust without mechanical drive.
FTO premises may only be used for their intended purpose. Carrying out any other work in them that is not related to the operation of physiotherapeutic equipment is prohibited. All treatment rooms and doctors' offices must be equipped with washbasins with hot and cold water.
In addition to treatment rooms, the physical technical department must have the following premises: the office of the head of the physical technical department (12 m 2), physiotherapist's office (12 m 2), head nurse's office (12 m 2), storage room for storing portable medical equipment and consumable medical equipment (6 m 2), equipment maintenance room (18 m 2), linen room for storing clean linen (6 m 2), pantry for storing cleaning items and dirty linen (4 m 2), storage room for storing carbon dioxide cylinders (8 m 2), a compressor room (according to SNiP standards), bathrooms with washbasins in the airlocks for men and women for patients and staff (according to SNiP standards).
The surface of the walls, floors and ceilings of the premises must be smooth, easily accessible for wet cleaning and stable when using detergents and disinfectants permitted for use in accordance with the established procedure.
Each room must have an alarm system to invite patients to a procedure and call medical personnel into the treatment room to assist the patient.
Cabinets electro- and phototherapy. The composition and area of newly built and reconstructed electro- and phototherapy rooms, the requirements for ventilation, heating, air conditioning, and lighting of premises must comply with the current SNiP.
The walls of rooms in offices to a height of 2 m should be painted with light-colored oil paint, the rest of the walls and ceilings should be painted with adhesive paint. Wall cladding with ceramic tiles is prohibited. The floor should be wood without potholes or covered with linoleum, which does not generate static electricity. It is prohibited to use synthetic materials that can create static electric charges.
The area of electro- and phototherapy rooms must be planned at the rate of 6 m 2per couch, and if there is one couch - at least 12 m 2. A separate room for intracavitary procedures with an area of 18 m should be equipped 2for one gynecological chair.
To carry out medical procedures, treatment cabins should be equipped, the frame of which is made of plastic or well-polished wooden racks, or metal (nickel-plated or oil-painted) pipes.
Metal structures of cabins must be insulated from stone walls and floors by installing flanges on pads made of non-conductive material 40-50 mm thick (wood pads, pre-boiled in paraffin and painted with oil paint). Flange mounting screws (bolts) should not be longer than the height of the gasket. The dimensions of the cabins should not be less than 2 m in height and 2.2 m in length. The width of the cabins is calculated depending on the type of device: for HF and microwave therapy devices, powerful UHF generators, devices for general galvanization with baths for limbs and stationary for light therapy devices - 2 m, for other devices - 1.8 m. Each cabin must have a wooden couch with a lifting headrest (chair with a headrest), a chair, a hanger, a device for local lighting, one stationary or two portable physiotherapy devices placed on movable tables.
In laser therapy rooms, the walls and ceiling should have a matte finish. In this case, the walls are painted with oil paint in a color that promotes maximum absorption of reflected rays (green, light green). In the office next to the laser (0.7 m from it), it is necessary to place a couch for the patient, as well as provide free access for service personnel to the control panel and for the patient to pass to the couch.
The distance between the installation and the wall of the office (the wall of the treatment cabin, another apparatus) must be at least 1 m. The doors of the premises must be equipped with internal locks and have a sign “No unauthorized entry!” and a laser danger sign.
In rooms for electro- and phototherapy there should be supply and exhaust ventilation with a supply of heated air, providing 3-4 times air exchange per hour, and window transoms. In UHF therapy rooms, fotaria with DTR dumps (PRK), the supply and exhaust ventilation performance should provide 4-5 air exchanges per hour. The air temperature in the premises must be at least 20°C.
Each room must have an independent power supply line coming from the distribution board, laid with wires of the required cross-section according to calculation. To distribute the load across current phases, the inputs should be laid with a voltage rating of 380/110 or 220/127 V four-wire. Connecting household electrical equipment to this line is prohibited.
In each room it is necessary to equip a group switchboard (for example, AP-50, A-3114/7) with a common switch, and at a height of 1.6 m from the floor, trigger panels (type A-50) or NVD buttons with a plug socket are placed on the walls and terminals in an insulating frame.
The group board should be mounted with U-27 fuses or 16 A maximum current circuit breakers with the number of groups corresponding to the number of devices (the number of devices also includes sterilizers and other devices). The distribution voltage for powering the devices is 127 or 220 V.
Grounding wires and grounding strips in the physiotherapy room are fixed to the walls at a distance of 5-10 cm from the floor. The cross-section of the grounding line inside the building is 24 mm 2(with a tire thickness of 3 mm), outside the building - 48 mm 2(tire thickness 4 mm).
Inhalation therapy rooms. The area of the room, temperature and humidity conditions and ventilation must comply with sanitary standards: 4 m 2per seat, air temperature within 20°C, supply and exhaust ventilation with 8-10 air exchanges per hour. It is prohibited to carry out inhalation therapy in light therapy rooms.
To connect portable inhalation devices, ultrasonic aerosol and electro-aerosol devices, it is necessary to provide plug sockets with protective (grounding) contacts.
Thermotherapy room. For heat treatment (paraffin and ozokerite treatment), it is necessary to allocate an isolated room at the rate of 6 m 2for one couch, but not less than 12 m 2if there is one couch, equipped with supply and exhaust ventilation, providing 4-5 air exchanges per hour. To heat paraffin (ozokerite), a special room (kitchen) with an area of at least 8 m2 must be provided .
The floors of the premises should be covered with linoleum, the kitchen walls should be tiled to a height of 2.5 m with glazed tiles. Tables for heaters and pouring paraffin (ozokerite) into cuvettes must be covered with heat-resistant material. Heating of paraffin (ozokerite) should only be done in special heaters or in a water bath.
Hydrogen sulfide hospital.
Treatment hydrogen sulfide baths must be carried out in a separate room or dead-end section of the hydropathic clinic, isolated from other treatment rooms.
The block of premises should consist of: a hall with an area of 8 m2 2for one bath, the minimum area of the hall with one bath is not less than 12 m 2; laboratories for the preparation of solutions with an area of at least 10 m 2one place with a fume hood; premises for storing solutions with an area of at least 8 m2 ;
The walls in the bathroom and laboratory should be tiled with glazed tiles or painted with oil paint on zinc white. Baths must be made of corrosion-resistant materials. A hydrogen sulfide hospital must have a ventilation system isolated from other rooms with air exchange in the bathroom + 3-5, in the airlocks + 3-4, in the locker room + 3-3. The exhaust pipe for air exhaust must be higher than the ridge of the building's roof.
Pipes supplying hydrogen sulfide water, as well as highly concentrated brine or sea water, must be made of materials resistant to aggressive environments. Fittings (taps, handles, etc.) must be made of corrosion-resistant materials. Wooden parts and objects should be coated with oil paint on zinc white. Coating with oil paint on white lead is prohibited.
Chapter 4. Safety precautions
The physiotherapy room (department) is organized on the above-ground floors of the medical institution.
The basement can be used for mud storage, boiler room, compressor room. The air temperature in the rooms is maintained within +20°C with humidity up to 70%. Therefore, all offices must have supply and exhaust ventilation.
Pipes, water heating radiators and all metal objects connected to the ground must be covered with protective grilles and other devices that would prevent even accidental contact of the patient with them. For this purpose, electrical fittings (panels, sockets, switches, etc.) are covered with insulating, non-conducting material.
To connect devices, the electric light therapy room is equipped with starting panels "PNV-30" and "PV-30" at a height of 1.6 m, which have a fuse, a switch, terminals for connecting stationary devices, a white terminal for grounding, 1-2 sockets for portable devices. The distance from the socket to the device should not exceed 2 m. The starting panels are connected to the cabinet's main 100 A switchboard, which has a common switch, voltmeter, E-27 fuses or circuit breakers. For most offices, a cabin system for placing equipment is acceptable. In addition to the apparatus, a wooden couch, a chair, and a hanger are installed in the cabin, which is 2 m high and long and 1.6 m wide. The office outside the cubicles houses the nurse's desk, which contains log books, procedure charts, and an electric procedure clock.
In dental institutions, taking into account the specifics of procedures in the oral cavity, in the physiotherapy room, equipment can be placed on the walls or bedside tables, without dividing into booths, since constant visual monitoring of the patient during the procedure is required. Estimated area per device in such conditions: 3-4 m2 .
When working with laser installations, the main source of danger, except electric current high (3-5 kV) and low (200 V) voltage is laser radiation (direct, reflected and scattered). The best way to organize laser therapy is a separate room with an area of 20-25 m 2, the ceiling and walls of which are painted with matte blue-green paint that absorbs red light. There is a sign on the outside of the office door: “Caution! Laser radiation!” In difficult circumstances, you can allocate a booth in the light therapy room. The office should not have devices with a shiny reflective surface. The lighting should be bright (300-500-1000 lux), which causes constriction of the pupils and reduces the likelihood of damage to the retina due to accidental exposure to scattered-reflected laser light. A laser hazard sign with the inscription “Caution! Do not look along the beam” is placed next to the laser device. During the procedure, the nurse (doctor) wears Sunglasses"ZN62-OZH", and the patient wears glasses with blue-green lenses ("SZS-18", "SZS-22"), which are included with the device.
When aiming the beam at the source of the disease, you must not look towards or along laser beam, since with unprotected eyes there is a danger of damage to the retina by direct or reflected light. It is prohibited to bring shiny objects into the area of exposure to the beam (rings, watches, mirrors, etc.), which cause reflection of light and increase the possibility of it entering the eye structures.
To protect the skin of service personnel, a regular long-sleeved medical gown is sufficient. Laser devices are operated in intermittent mode (50-60 minutes of operation, 30 minutes break). The HeNe laser tube should be kept on at all times to prolong its service life. The Ministry of Labor and Social Protection of the Russian Federation, by resolution of June 8, 1992, No. 17, section 2, paragraph 24, determined for personnel (doctors, nurses) working with laser systems of any class a 15% increase in official salary.
The preparation of a concentrated radon solution is carried out in special laboratories with appropriate equipment. Medical personnel working with radon are provided with special clothing and are required to follow all safety regulations. Ventilation in the office should work throughout the day.
The paraffin-ozokerite treatment room is equipped with a room with a fume hood for preparing the coolant mass. Heating of paraffin (ozokerite) is carried out in special paraffin heaters or a water bath, which is boiled on a closed electric stove in a fume hood.
Since these substances are easily flammable, the cabinet table must be covered with fire-resistant material and the cabinet must be equipped with a fire extinguisher. Due to the increased fire hazard, open fires, open electric stoves and electric boilers should not be used in the office.
Special rooms are equipped for inhalation and electromud therapy, since these procedures lead to an increase in air humidity. This can negatively affect electrical wiring and devices in ordinary offices where there is no hermetically sealed insulation. In physiotherapy rooms, equipment is arranged according to a diagram approved by the head of the department so that it and the trigger panels are easily accessible.
All changes can be made only with appropriate permission. Passports of devices in operation must be kept by the head nurse of the department.
All devices with electrical safety class 01 and I are subject to mandatory grounding to the building circuit.
Daily monitoring of the condition of the equipment is carried out by a nurse before starting work shift.
For normal and long-term operation, it is necessary to systematically care for the equipment. Therefore, every day at the beginning and end of the working day, the nurse removes dust from the switched off devices with a slightly damp cloth. Dust from the internal parts of the device is removed with a vacuum cleaner by a technician during preventive examinations. To reduce dust, when not in use, devices are covered with sheets or special covers. To prevent the effects of dampness, physiotherapy rooms are located in a dry, bright, ventilated room, where the equipment is placed away from windows.
When bringing the device in from a frosty street, keep it inoperative at room temperature for 24 hours. This time is usually indicated in the technical instructions for the device. It is necessary to protect the devices from impacts and shocks. Therefore, it is best to move them in wheelchairs with good shock absorption. To avoid overheating, it is necessary to operate intermittently, which will extend their service life.
A special hanger is equipped for the wires, where they hang along their entire length, which eliminates kinks and extends their service life. Twisting and bending wires during storage leads to rapid damage not only to the insulation, but also to the wire itself. The metal plates of the electrodes are stacked and periodically remove lead oxide from the surface with sandpaper. The plates are straightened on a solid base with a special roller.
Rice. 1. Laser hazard sign according to GOST R 50723-94
The finishing of premises should be made only from non-combustible materials. Premises must comply with fire safety requirements and have necessary funds fire prevention and fire protection.
Chapter 5. Hardware organization of the physiotherapy room
The physiotherapy room is designed to carry out therapeutic rehabilitation procedures due to the influence of such physical factors as light, heat, water, eclectic and magnetic fields, ultrasonic waves, laser radiation. Depending on the size and scale of the activity, it is possible to use one type of treatment or several at once.
When choosing equipment and furniture for your office, you should pay attention to three most important criteria:
patient safety and comfort;
convenience, ergonomic conditions for normal operation personnel;
equipment compliance the latest developments in the field of physiotherapy, high clinical effectiveness.
Standard option equipment - several regular or massage couches, separated by screens. Nearby there are cabinets for equipment<#"justify">Among various health services, physiotherapy occupies one of the leading places in terms of the number of visits and treatment procedures provided. In the late 1980s, the physiotherapy service Russian Federation was characterized by the following statistical indicators (approximate estimates are given):
Over the past decade, the qualitative and quantitative equipment of physiotherapy rooms in medical institutions of the Ministry of Health of the Russian Federation has remained virtually unchanged. However, there remains a steady need to provide physiotherapeutic equipment (PTA) that implements the classic set therapeutic techniques.
The persistence of this need is determined by the following factors:
· Commissioning of new facilities.
· The need for a planned replacement of the FTA, which has reached material and moral wear and tear.
· Replenishment of physical therapy service strategic reserves.
The optimal solution to the problem of meeting the annual healthcare need for FTA is A complex approach. At the same time, the basis of such equipment should be the idea of a multivariate hardware complex.
This diversity is explained by the fact that the physiotherapy service is part of most medical and preventive institutions various levels and profile: from a district clinic to a regional multidisciplinary hospital, from a factory dispensary to a large specialized sanatorium.
In each medical institution, the physiotherapy service solves its own range of tasks, determined by the specifics of a particular institution. This circumstance gives rise to a variety of qualitative and quantitative requirements for the hardware of physiotherapy departments (PTD).
The optimal solution to the problem of hardware equipping medical and treatment-and-prophylactic departments of various profiles can be found on the basis of a systemic variable approach to the formation of hardware complexes. As a basic equipment option (BVO), a hardware complex has been formed that provides physiotherapeutic procedures in all medical specialties of a general hospital.
The structure of such a BVO physiotherapy department is given below. Based on the BVO, you can easily form special options equipment expanded in comparison with the BVI both in the range and in the number of physiotherapeutic devices, taking into account the profile and level of a particular medical institution or some local healthcare system.
This expansion is carried out on the basis of a formed and regularly updated database of physiotherapeutic equipment.
As an example, below is an expanded version for equipping the FTO, built on the basis of the BVO.
The formation of the BVO was carried out taking into account the following criteria:
· Preservation of the classic office structure of the FTO.
· Minimizing the range of devices that implement the required set of techniques for each office.
· Minimizing the number of devices in each office.
· Priority activation of devices with the following parameters:
o With high rate ratio " quality/price;
o backed by guaranteed delivery and service.
o designed and manufactured by the supplier.
Equipment for the physiotherapy department. Basic and advanced options are presented in Appendix B.
Conclusion
During the writing of the work, all aspects of the organization of the physiotherapy room, the regulatory framework, the basic rights and responsibilities of personnel, and sanitary standards were examined.
The main tasks of the work were solved
.Consider the regulatory framework and basic sanitary standards for organizing a physiotherapy room
2.Consider the main responsibilities of a doctor and junior medical staff
.Consider the basic requirements for organizing a physiotherapy room, including footage, location of equipment and safety precautions
Bibliography
1.Ulashchik, V.S. Physiotherapy. Universal medical encyclopedia/ V.S. Ulashik. - M: Book House, 2012. - 640 p.
2.Klyachkin, L.M. Physiotherapy / L.M. Klyachkin. - M: Medicine, 1988. - 270 p.
.Bogolyubov, V.M. Physiotherapy and balneology / V.M. Bogolyubov. - M: Binom, 2015. - 312 p.
.Sokolova, N.G. Physiotherapy / N.G. Sokolova. - M: Phoenix, 2014. - 352 p.
.Obrosov, A.N. Handbook of physiotherapy / A.N. Obrosov. - M: Medicine, 1976. - 344 p.
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