Source / Live Broadcast Hainan, Grassroots Physician Commune
Finishing / Xiaolin
The 7-year-old boy died after infusion, and the village doctor involved was fined 90,000 yuan! In the next step, the official will carry out industry rectification throughout the county.
Yesterday (February 26), the hainan radio and television station's column "Live Hainan" released a message about the boy's infusion death, which aroused concern in the primary medical field.
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A boy died after an infusion in the village clinic!
Prescription exposure
On January 7, Xiao An, a 7-year-old boy from Lingao County, Hainan Province, went to a nearby village clinic for abdominal pain. After the infusion, Xiao'an abdominal pain was relieved.
For the next few days, Xiao An continued to infuse and developed headache symptoms on January 10. On January 13, after Xiaoan finished infusion, there were abnormal conditions such as convulsions.
The village doctor involved injected Xiao An with adrenaline and other first aid, and then called a car to send him to the big hospital, but Xiao An eventually died after the rescue was ineffective.
The village doctor revealed to the Hainan reporter that he played amika star, dexamethasone and ribavirin for the boy.
No cases, no prescriptions, no medical practice in the place of incorporation...
The village doctor involved was fined 90,000 yuan
In the end, the village doctor involved was confiscated of drugs and illegal gains, and fined 90,000 yuan.
The grassroots doctors' commune found that there were more violations in the entire medical malpractice of this village doctor, and everyone should take it as a warning.
Behavior 1: No allergy history, no prescription
The boy's family was not informed of the prescription for the infusion and the boy's allergy history was not asked. As for the boy's prescription information, it was only revealed after the reporter asked questions.
Local residents also said that when they went to the village clinic for treatment, the village doctor did not prescribe medical records and prescriptions, and many times people did not know what kind of injection they were taking.
Behavior 2: Not practicing medicine at the place of registration
On the wall of the village clinic involved hangs a "Medical Institution Practice Permit" issued by the health department, but the location marked is another village clinic, not the current location for practicing medicine.
Behavior 3: Unable to provide drug purchase receipts
Law enforcement officers found that the village doctor could not provide a purchase receipt for ribavirin injection. Law enforcement officers temporarily detained 7 boxes and sent them for inspection, waiting for the inspection results before taking the next step.
Official: Industry remediation will be carried out throughout the county
Infusion pay attention to these 8 points
The relevant staff of the market supervision administrative law enforcement brigade of the Lingao County Comprehensive Administrative Law Enforcement Bureau said that this incident is now in the bureau, and the party group and the director of the bureau attach great importance to it. In the next step, according to this situation, a county-wide mapping and overall industry rectification will be carried out.
Every time a medical accident occurs, it is a wake-up call for everyone. According to past cases, the grassroots doctors' commune has sorted out 8 places to pay attention to in the infusion service for everyone, and quickly collected them.
1. The infusion should be approved by the county-level health and family planning department
At present, many places are strengthening the clinical application management of antibacterial drugs in grass-roots medical institutions, coupled with the normalization of the epidemic management, we can not carry out infusion services without authorization.
The use of antibacterial drugs in village clinics, clinics and community health service stations to carry out intravenous infusion activities shall be approved by the county-level health and family planning administrative departments.
Second, it is necessary to prescribe according to the level of antibacterial drugs
This year, the Shanxi Provincial Health Commission issued the "Notice on Printing and Distributing the Catalogue of Graded Management of Clinical Application of Antibacterial Drugs (2021 Edition)" to adjust the use level of antibacterial drugs (see the end of the article).
And make stricter regulations: township health centers, community health service centers (stations), village clinics, outpatient departments, clinics and other grass-roots medical institutions, in principle, the use of non-restricted use grade antibacterial drugs, and can only use national essential drugs.
Third, prepare rescue drugs and equipment
The list of rescue drugs and rescue equipment is as follows:
1. Rescue drugs
Respiratory stimulants: nicosamide needles, lobelin needles;
Dehydrating agent: 20% mannitol, etc.;
Vasopressors: dopamine needles, etc.;
Antihypertensive drugs: nitroglycerin needles, etc.;
Cardiopulmonary resuscitation drugs: epinephrine injections, etc.;
Antiarrhythmic drugs: sidilan needles, etc.;
Anticholinergic drugs: atropine needles, etc.;
Antiasthmatic drugs: aminophylline needles, etc.;
Anti-allergic drugs: 10% calcium gluconate needles, atropine needles, etc.;
Glucocorticoid drugs: dexamethasone needles, etc.
2. Rescue equipment
Breathing sacs, oxygen concentrators or oxygen cylinders, stretchers, etc
4. Ask the patient about his or her past history and allergy history
Before infusion, patients should be carefully asked about allergy history, past history and other disease conditions, if the questioning is not careful, it is easy to occur allergic reactions during the infusion process, aggravate underlying diseases and other conditions that endanger the patient's life and health.
There are three main antibacterial drugs that generally require skin testing: cephalosporins, penicillins, and penicillin plus enzyme inhibitors:
Cephalosporins
Ceftezole sodium, cefotaphene, cefoteam, cefotaxime, ceftame, ceftriaxone sodium
Penicillins
Penicillin sodium, benzylcin penicillin, benzoxicillin sodium, amoxicillin sodium, ampicillin sodium, amoxicillin, piperacillin, sulfobexicillin sodium, aloxacillin sodium, melocillin sodium
Zithromycin + enzyme inhibitors
Amoxicillin clavulanate potassium, ticarcillin clavulanate potassium, piperacillin tazobactam sodium
Fifth, keep the drug purchase and sales bills
When the drug is accepted, it should be checked and accepted according to the contents listed in the tax invoice, and the acceptance record of the purchased drug should be established according to the contents listed in the tax invoice, and the acceptance record of the purchased drug should be established so that the ticket, account and goods are consistent.
Key inspection: generic name, dosage form, specification, batch number, expiration date, manufacturer, purchase unit, outbound quantity, sales date, outbound date and sales amount.
The tax invoice and list should correspond to the relevant contents of the sales order, the amount should match, and the acceptance record and distribution list should be kept until one year after the expiration date of the drug.
Sixth, the practice of medicine should be consistent with the place of registration
Where the registered practice address is, it should be practiced wherever it is, and it should be reminded that the practice place cannot be set at home.
Recently, the Jiangsu Provincial Health Commission replied to the question about the division of medical areas in the living areas of village-level clinics, clarifying:
According to the Notice on Printing and Distributing the Measures for the Management of Village Clinics (Trial Implementation), the construction scale of village clinic houses is not less than 60 square meters, and the village clinics are at least equipped with consultation rooms, treatment rooms, public health rooms and pharmacies.
With the approval of the county-level health and family planning administrative department, an additional observation room is added to carry out intravenous drug administration service projects, a duty room is set up as needed, and a rehabilitation room is encouraged to be set up if conditions permit.
There is no mention of the possibility of setting up living areas, only the possibility of setting up a duty room, especially during the current epidemic period, it is not recommended to live in a medical service institution.
Seventh, try to avoid infusion
It is best to prescribe medicines where to prescribe, where to inject, and not to put yourself at risk by making dozens of dollars more.
If the dissuasion is ineffective and the patient strongly requests the injection, then the patient is required to provide the medical records, the original invoice for the hospital dispensing, and then the patient is required to sign a notice of the endorsement after confirming the above materials, informing the patient of the risks of the substitution, in duplicate, one for the patient and the medical institution.
Think more about whether the patient really needs infusions
Rural doctors should follow the principle of taking medicine without intramuscular injection, and intramuscular injection without infusion to minimize the occurrence of medical accidents.
Income can be increased by developing appropriate TCM techniques, such as acupuncture, massage, external treatment and internal administration.
Attached: Shanxi Province"Antimicrobial Clinical Application Graded Management Catalogue (2021 Edition)"
Note: In principle, antibacterial drugs with *added before the name are only available in tertiary medical institutions and secondary medical institutions with intensive care departments
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