The resuscitator is the same doctor whose competence is to save human life in emergency situations. Thanks to his experience, knowledge and appropriate tools, in a matter of seconds he can orient himself in life-threatening situations and restore the work of his body.
Typically, such specialists are called resuscitators-anesthesiologists, since their range of duties always includes the ability to conduct anesthesia. It is believed that both of these professions are interchangeable. Because of this, upon graduation from a medical university with a specialization in General Medicine, those who wish to take a place in intensive care receive the status of an intensive care anesthetist and can get a job in any of these areas.
But the chief of the department almost always combines both positions. The same goes for doctors in small medical institutions, such as hospitals in small towns. There is also no significant difference between these specialists in terms of the age of the wards they will be entrusted with. Separately, they do not teach doctors for children or adults, which is why almost always a pediatric and adult specialist is one and the same person.
Those experts who work in specialized children’s centers simply have more skills in working with newborns, developed in the process of practice.
Today, such workers form their own professional communities. They even have an official website that provides up-to-date information regarding world achievements in their native medical field. In the same place, the Federation of Physicians publishes news regarding upcoming seminars, congresses and other options for advanced training courses. The latter have to be taken on a mandatory basis approximately once every five years.
Some yesterday’s medical students choose this specialization solely because the salary here is somewhat higher than that of other narrow specialists. But due to the fact that an anesthesiologist with the duties of a resuscitator is listed as one of the most stressful professions in clinical practice, not everyone can withstand it. Therefore, a future professional applying for vacancies must have good theoretical knowledge, practical skills, but also be distinguished by quick response and stress resistance.
Reason for applying
In almost all cases of contacting a resuscitator, a person does not get to see him on his own. He is transferred from other departments of the hospital, intensive care units or after the arrival of an ambulance.
The main reason for attracting help is considered a state of shock. It can be the result of various deviations in the functioning of the body. The first victims of such a response of the body are:
- respiratory system;
- cardiac activity;
- metabolism;
- nervous system;
- endocrine system.
They can fail either one at a time or all together. This process and the degree of damage to internal organs are influenced by many factors, among which there is not always a pain syndrome with an off-scale threshold.
Often the shock can wear other variations:
- traumatic;
- emotional;
- toxic;
- bacterial.
The doctor’s job is to immediately alleviate the condition of the victim admitted to the hospital and transfer him to a team of narrow doctors.
Outwardly, shock can manifest itself in different ways. Some people will be in an inexplicably agitated state, while others will seem very depressed. The skin at first sharply turns pale, and then begins to be covered with sweat. If clinical measurements are made at the same time, then the victim will be able to see:
- reduced pressure;
- rapid pulse;
- shallow breathing.
Together, this indicates the onset of the terminal state. They have to save lives and those who are in a state of clinical death. Moreover, society still confuses these two concepts.
The terminal state is the situation when the patient can still be brought back to life with a high degree of probability, and at the same time in the future this will not seriously affect the functionality of his internal organs. The resuscitator, upon detection of a similar condition in the victim, is obliged to resume the work of all vital body systems.
With clinical death, everything is much more complicated. Although the conditions are similar, in the second scenario, the brain turns off, which leads to a complete cessation of breathing and blood supply. Only exchange processes remain active.
In this state, a person can be only about five minutes and during this time the expert will have to bring him back to life with the help of artificial respiration and heart massage. Moreover, in some particularly acute situations, the doctor will start the heart muscle manually, using the principle of its stimulation with an open sternum. This applies to situations where the victim becomes a victim of clinical death during major operations.
In order to bring the patient to his senses in the allotted few minutes, the pros must use the knowledge and skills of intensive care. To increase efficiency, they use all available auxiliary methods of assistance, such as:
- artificial lung ventilation;
- dialysis;
- pacing;
- intravenous infusions.
Against this background, it becomes clear that the responsibility of the resuscitator-anesthesiologist does not include the treatment of any specific list of diseases. Its main task is to save a person through the restoration of vitality.
Diagnostic secrets
For such responsible work, people have to study not just all the years at the university, but in general every day. Only those who have received a higher medical education and confirmed their qualifications are allowed to this activity.
The development of the list of tasks involves the study of the features of the extinction of the main functions of the body and the corresponding effective methods for their restoration. To do this, the ace must be well versed in physiology and anatomy.
On the basis of all this, in a critical situation, he will be able to set a chain of priorities for carrying out diagnostic measures in relation to each specific victim. Moreover, almost always the first type of diagnosis for describing the current clinical picture is electrocardiography. After that, he will pay attention to the results of urine and blood tests in order to familiarize himself in detail with the following important indicators:
- ALT and AST levels;
- urea;
- total protein;
- glucose;
- bilirubin;
- potassium;
- sodium;
- of creatinine.
One of the first tests is done to see if the victim suffers from some serious infectious or other disease. These are analyzes for:
- HIV;
- hepatitis type B or C;
- syphilis.
Separately, the patient determines the blood type, his Rh factor and the time of blood clotting. This will be required if you cannot do without a blood transfusion, plasma.
After the worst is over, it will be possible to monitor the important vital signs of the ward through a special bedside monitor. It can be found in almost every hospital, even outdated models. Also, the patient will periodically do other tests to compare them with previous results and determine the vector of the dynamics of recovery.
Range of duties
Regardless of which particular department the resuscitator and part-time anesthesiologist works in, whether it be obstetric wards or the cardiology department, the range of his duties remains almost identical. It is based on:
- conducting anesthesia;
- providing emergency assistance;
- diagnostics;
- changing the previously approved plan due to circumstances.
The last aspect of the list indicates that the initially prescribed type of pain relief and its dosage can be changed. Therefore, one should always be prepared for the fact that the state of the victim standing on the verge of death can change dramatically. You will have to adjust to this variable variable and at the same time adapt the treatment to the individual characteristics of his body, since some allergy sufferers have intolerance to popular types of anesthesia.
If any complications were recorded, then the issue of alternative treatment should be immediately agreed with the head of the department. After the crisis has passed, the doctor will need to continue to monitor the condition of his ward. To do this, he conducts diagnostic and therapeutic procedures according to a previously established and approved scheme. Also on his shoulders lies the connection of special equipment that helps in the functioning of the internal organs of the patient and reads his vital signs.
The responsibilities also include the use of modernized diagnostic techniques, which is designed to improve the quality of service.
The job description of this doctor clearly spells out all the requirements for a person who has assumed the responsibility of saving others’ lives. In the event of serious consequences not only for health, but for life in general, the doctor will be obliged to bear severe responsibility. In some cases, as a response for their actions or inaction, the expert may be subject to disciplinary and administrative liability. In the worst case scenario, he can be held accountable to the letter of the law in accordance with criminal law.
Planned and emergency patients
Anesthesiologists and resuscitation as sciences always go together. They were even brought into a separate medical industry together around the fifties of the last century.
Since in small towns the services of a resuscitator are not needed on a permanent basis, he often works in the operating room also as an anesthesiologist. In this situation, he monitors the condition of planned patients. This is the name of patients who, before the start of the operation, passed all the necessary tests for compatibility with drugs, current health, and others.
It is quite another thing when the victim is brought literally from the street. In this situation, the resuscitator must take up the performance of his direct duties. The transition to the use of anesthetic skills should be carried out only if emergency admission to the intensive care unit is necessary.
Especially often this happens to those who came in with polytrauma, in shock or unconscious, or even in a state of intoxication, when an already terrible clinical picture is smeared with alcohol and drugs.
In a matter of minutes, specialists must make a decision regarding the drugs chosen for treatment and their dosage, even without having the results of primary blood tests on hand.
To simplify the task, the resuscitator, together with the anesthetist nurse, creates a so-called anesthesia card. It records data about when the operation itself began, and how anesthesia was performed.
This may not be the usual regimen with an intravenous principle of drug administration, because sometimes such patients arrive who require tracheal incubation. All stages of the operation are entered into the card, and this should be done as detailed as possible, up to the description of the incision made.
Also, in order to later be able to restore the sequence, information is entered regarding the dosage and the order of the administered drugs. It does not do without the parameters of blood pressure, pulse and oxygen saturation of the blood.
Many other data are also entered there, focusing on the protocol, and at the end they note the point on extubation. The card records whether the patient is already conscious, whether his muscle tone is sufficient, and whether breathing can be called adequate.
Success at this stage is considered to be the established mark that the victim was transferred to the ward, which means a successfully completed set of operational measures.