{"id":29179,"date":"2023-05-13T17:07:02","date_gmt":"2023-05-13T10:07:02","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29179"},"modified":"2023-05-13T17:07:02","modified_gmt":"2023-05-13T10:07:02","slug":"quy-trinh-gioi-thieu-chuyen-tuyen-chan-thuong-so-nao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/13\/quy-trinh-gioi-thieu-chuyen-tuyen-chan-thuong-so-nao\/","title":{"rendered":"Quy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o"},"content":{"rendered":"

Quy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o (CTSN) l\u00e0 m\u1ed9t quy tr\u00ecnh quan tr\u1ecdng \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o b\u1ec7nh nh\u00e2n nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 ch\u0103m s\u00f3c v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p nh\u1ea5t trong tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o. Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o<\/a> l\u00e0 m\u1ed9t lo\u1ea1i ch\u1ea5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng \u0111\u1ed1i v\u1edbi h\u1ec7 th\u1ed1ng th\u1ea7n kinh v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u1ee9c n\u0103ng v\u00e0 s\u1ee9c kh\u1ecfe. Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o th\u01b0\u1eddng x\u1ea3y ra khi \u0111\u1ea7u b\u1ecb t\u00e1c \u0111\u1ed9ng m\u1ea1nh ho\u1eb7c va ch\u1ea1m v\u00e0o m\u1ed9t v\u1eadt c\u1ee9ng, g\u00e2y ra s\u1ef1 ch\u1ea5n \u0111\u1ed9ng cho n\u00e3o b\u00ean trong s\u1ecd.<\/p>\n

1. Giai \u0111o\u1ea1n c\u1ea5p va\u0300 quy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n<\/strong><\/h2>\n

Quy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n cho ng\u01b0\u1eddi b\u1ec7nh CTSN t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ed9t qu\u1ef5:<\/p>\n

\"Quy
Quy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o \u01a1\u0309 Vi\u00ea\u0323t Nam<\/figcaption><\/figure>\n

2. Chuy\u1ec3n \u0111\u1ebfn Khoa C\u1ea5p c\u1ee9u \u1edf B\u1ec7nh vi\u1ec7n trong quy tri\u0300nh chuy\u00ea\u0309n tuy\u00ea\u0301n<\/h2>\n

C\u00e1c d\u1ecbch v\u1ee5 y t\u1ebf t\u1ea1i c\u1ed9ng \u0111\u1ed3ng, nh\u01b0 l\u00e0 c\u00e1c b\u00e1c s\u1ef9 \u0111a khoa, c\u1ea7n gi\u1edbi thi\u1ec7u chuy\u1ec3n nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh b\u1ecb th\u01b0\u01a1ng v\u00f9ng \u0111\u1ea7u \u0111\u1ebfn khoa c\u1ea5p c\u1ee9u \u1edf b\u1ec7nh vi\u1ec7n, n\u1ebfu c\u00f3 m\u1ed9t trong nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m sau (NICE, 2014, SIGN, 2008):<\/span><\/p>\n

    \n
  • Thang \u0111i\u1ec3m h\u00f4n m\u00ea Glasgow <15 v\u00e0o l\u00fac \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u<\/li>\n
  • M\u1ea5t \u00fd th\u1ee9c do ch\u1ea5n th\u01b0\u01a1ng<\/li>\n
  • C\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa t\u1eeb l\u00fac b\u1ecb ch\u1ea5n th\u01b0\u01a1ng<\/li>\n
  • Nghi ng\u1edd v\u1ee1 x\u01b0\u01a1ng s\u1ecd ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng \u0111\u00e2m xuy\u00ean \u1edf \u0111\u1ea7u t\u1eeb l\u00fac b\u1ecb ch\u1ea5n th\u01b0\u01a1ng<\/li>\n
  • Qu\u00ean c\u00e1c s\u1ef1 ki\u1ec7n tr\u01b0\u1edbc ho\u1eb7c sau khi b\u1ecb ch\u1ea5n th\u01b0\u01a1ng<\/li>\n
  • Nh\u1ee9c \u0111\u1ea7u dai d\u1eb3ng k\u1ec3 t\u1eeb l\u00fac b\u1ecb ch\u1ea5n th\u01b0\u01a1ng<\/li>\n
  • B\u1ecb n\u00f4n m\u1eeda t\u1eeb l\u00fac b\u1ecb ch\u1ea5n th\u01b0\u01a1ng<\/li>\n
  • B\u1ecb \u0111\u1ed9ng kinh t\u1eeb l\u00fac b\u1ecb ch\u1ea5n th\u01b0\u01a1ng<\/li>\n
  • \u0110\u00e3 \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt n\u00e3o tr\u01b0\u1edbc \u0111\u00e2y<\/li>\n
  • B\u1ecb ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u v\u1edbi l\u1ef1c t\u00e1c \u0111\u1ed9ng l\u1edbn<\/li>\n
  • C\u00f3 ti\u1ec1n s\u1eed b\u1ecb ch\u1ea3y m\u00e1u ho\u1eb7c r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u<\/li>\n
  • \u0110ang \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u nh\u01b0 l\u00e0 warfarin<\/li>\n
  • Nghi\u1ec7n r\u01b0\u1ee3u ho\u1eb7c ma t\u00fay<\/li>\n<\/ul>\n

    3.\u00a0\u00a0 Khoa C\u1ea5p c\u1ee9u trong quy tri\u0300nh chuy\u00ea\u0309n tuy\u00ea\u0301n<\/h2>\n

    3.1. S\u00e0ng l\u1ecdc v\u00e0 L\u01b0\u1ee3ng gi\u00e1<\/strong><\/h3>\n

    C\u00f3 b\u1ed1n l\u00fd do quan tr\u1ecdng \u0111\u1ec3 th\u1ef1c hi\u1ec7n l\u01b0\u1ee3ng gi\u00e1 \u1edf Khoa C\u1ea5p c\u1ee9u (Nh\u00f3m c\u00e1c H\u01b0\u1edbng d\u1eabn New Zealand, 2006) :<\/p>\n

      \n
    1. X\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng h\u1ea1 huy\u1ebft \u00e1p v\u00e0\/ho\u1eb7c t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy \u0111ang x\u1ea3y ra ho\u1eb7c ti\u1ec1m \u1ea9n, v\u00ec n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb s\u1ebd l\u00e0m CTSN n\u1eb7ng h\u01a1n.<\/li>\n
    2. X\u00e1c \u0111\u1ecbnh c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ea5p t\u00ednh c\u1ee7a CTSN c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i can thi\u1ec7p, \u0111\u1eb7c bi\u1ec7t l\u00e0 ch\u1ea3y m\u00e1u trong s\u1ecd v\u00e0\/ho\u1eb7c n\u00e3o.<\/li>\n
    3. X\u00e1c \u0111\u1ecbnh c\u00e1c ch\u1ea5n th\u01b0\u01a1ng kh\u00e1c c\u00f3 th\u1ec3 c\u1ea7n x\u1eed l\u00fd kh\u1ea9n c\u1ea5p, bao g\u1ed3m ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng c\u1ed5.<\/li>\n
    4. \u01af\u1edbc t\u00ednh \u0111\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng n\u00e3o \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn vi\u1ec7c x\u1eed l\u00fd v\u00e0 theo d\u00f5i ti\u1ebfp theo.<\/li>\n<\/ol>\n

      \u0110\u1ed1i v\u1edbi l\u00fd do th\u1ee9 3. \u1ede giai \u0111o\u1ea1n \u0111\u1ea7u kh\u00f4ng ch\u1eafc ch\u1eafn ch\u1ea5n th\u01b0\u01a1ng c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u1ed9t s\u1ed1ng c\u1ed5 hay kh\u00f4ng v\u00ec th\u1ebf c\u1ea7n ph\u1ea3i c\u1ed1 \u0111\u1ecbnh v\u1eefng c\u1ed9t s\u1ed1ng c\u1ed5 cho nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh b\u1ecb ch\u1ea5n th\u01b0\u01a1ng \u1edf \u0111\u1ea7u v\u00e0 bi\u1ec3u hi\u1ec7n b\u1ea5t k\u1ef3 y\u1ebfu t\u1ed1 nguy c\u01a1 n\u00e0o sau \u0111\u00e2y tr\u1eeb khi nh\u1eefng y\u1ebfu t\u1ed1 kh\u00e1c ng\u0103n c\u1ea3n \u0111i\u1ec1u n\u00e0y:<\/p>\n

        \n
      • GCS <15 v\u00e0o l\u00fac \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u (b\u1edfi nh\u00e2n vi\u00ean y t\u1ebf).<\/li>\n
      • \u0110au c\u1ed5.<\/li>\n
      • C\u00f3 tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh khu tr\u00fa.<\/li>\n
      • D\u1ecb c\u1ea3m \u1edf c\u00e1c<\/li>\n
      • B\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng kh\u00e1c nghi ng\u1edd ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng c\u1ed5.<\/li>\n<\/ul>\n

        M\u1ed9t nh\u00e2n vi\u00ean y t\u1ebf \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o c\u1ea7n l\u01b0\u1ee3ng gi\u00e1 t\u1ea5t c\u1ea3 c\u00e1c ng\u01b0\u1eddi b\u1ec7nh b\u1ecb ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u \u0111\u1ebfn khoa c\u1ea5p c\u1ee9u trong v\u00f2ng t\u1ed1i \u0111a 15 ph\u00fat t\u1eeb l\u00fac b\u1ec7nh vi\u1ec7n.<\/p>\n

        M\u1ed9t ph\u1ea7n c\u1ee7a l\u01b0\u1ee3ng gi\u00e1 n\u00e0y l\u00e0 x\u00e1c \u0111\u1ecbnh xem nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng n\u00e3o v\u00e0\/ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng c\u1ed5 v\u1ec1 l\u00e2m s\u00e0ng l\u00e0 cao hay th\u1ea5p<\/p>\n

        V\u1ec1 l\u00fd do th\u1ee9 4. \u01af\u1edbc t\u00ednh m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng t\u1ed5n th\u01b0\u01a1ng n\u00e3o \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn vi\u1ec7c x\u1eed l\u00fd v\u00e0 theo d\u00f5i ti\u1ebfp theo.<\/p>\n

        Ti\u00eau chu\u1ea9n ph\u1ed5 bi\u1ebfn nh\u1ea5t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e2n lo\u1ea1i m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng l\u00e0 Thang \u0111i\u1ec3m H\u00f4n m\u00ea Glasgow (GCS). Thang \u0111i\u1ec3m n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 khi m\u1ed9t ng\u01b0\u1eddi b\u1ec7nh nghi ng\u1edd b\u1ecb CTSN \u0111\u1ebfn kh\u00e1m \u1edf Khoa C\u1ea5p c\u1ee9u ho\u1eb7c b\u00e1c s\u0129 \u0111a khoa. Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 nh\u1eb9, trung b\u00ecnh ho\u1eb7c n\u1eb7ng theo \u0111i\u1ec3m GCS.<\/p>\n

        M\u1ed9t ch\u1ec9 s\u1ed1 h\u1eefu \u00edch kh\u00e1c v\u1ec1 m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ee7a CTSN l\u00e0 qu\u00ean sau ch\u1ea5n th\u01b0\u01a1ng (post- traumatic amnesia, PTA), v\u00ec n\u00f3 li\u00ean quan m\u1eadt thi\u1ebft \u0111\u1ebfn k\u1ebft qu\u1ea3. M\u1ed9t ch\u1ec9 s\u1ed1 kh\u00e1c c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0 th\u1eddi gian m\u1ea5t \u00fd th\u1ee9c (loss of consciousness, LOC).<\/p>\n\n\n\n\n\n\n
        \u0110\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ee7a<\/strong><\/p>\n

        Ch\u1ea5n th\u01b0\u01a1ng<\/strong><\/td>\n

        		\u0110i\u1ec3m GCS<\/strong><\/td>\nTh\u1eddi gian Qu\u00ean Sau<\/strong><\/p>\n

        Ch\u1ea5n th\u01b0\u01a1ng (PTA)<\/strong><\/td>\n

        		Th\u1eddi gian m\u1ea5t \u00fd<\/strong><\/p>\n

        th\u1ee9c (LOC)<\/strong><\/td>\n<\/tr>\n

        Nh\u1eb9<\/td>\n13-15<\/td>\n< 1 ng\u00e0y<\/td>\n< 30 ph\u00fat<\/td>\n<\/tr>\n
        V\u1eeba<\/td>\n9-12<\/td>\n1 – 6 ng\u00e0y<\/td>\n30 ph\u00fat \u2013 24 gi\u1edd<\/td>\n<\/tr>\n
        N\u1eb7ng<\/td>\n3-8<\/td>\n>=7ng\u00e0y<\/td>\n>\u00a0 24 gi\u1edd<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        M\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ee7a CTSN (Rao v\u00e0 c\u1ed9ng s\u1ef1, 2000)<\/em><\/p>\n

        Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 \u0111i\u1ec3m H\u00f4n m\u00ea Glasgow t\u1eeb 8 tr\u1edf xu\u1ed1ng c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c ti\u1ebfp c\u1eadn s\u1edbm b\u1edfi b\u00e1c s\u1ef9 g\u00e2y m\u00ea, b\u00e1c s\u0129 c\u1ea5p c\u1ee9u ho\u1eb7c b\u00e1c s\u0129 ch\u0103m s\u00f3c \u0111\u1eb7c bi\u1ec7t \u0111\u1ec3 x\u1eed l\u00fd \u0111\u01b0\u1eddng d\u1eabn kh\u00ed th\u00edch h\u1ee3p v\u00e0 tr\u1ee3 gi\u00fap h\u1ed3i s\u1ee9c.<\/p>\n

        T\u1ea5t c\u1ea3 \u0111\u1ed9i ng\u0169 y t\u1ebf v\u00e0 \u0111i\u1ec1u d\u01b0\u1ee1ng tham gia ch\u0103m s\u00f3c ng\u01b0\u1eddi b\u1ec7nh b\u1ecb ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u \u0111\u1ec1u ph\u1ea3i \u0111\u01b0\u1ee3c hu\u1ea5n luy\u1ec7n v\u00e0 th\u00e0nh th\u1ea1o vi\u1ec7c s\u1eed d\u1ee5ng v\u00e0 ghi ch\u00e9p GCS.<\/p>\n

        Kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng GCS \u0111\u01a1n \u0111\u1ed9c v\u00e0 c\u1ea7n k\u1ebft h\u1ee3p xem x\u00e9t c\u00e1c th\u00f4ng s\u1ed1 kh\u00e1c, ch\u1eb3ng h\u1ea1n nh\u01b0:<\/p>\n

          \n
        • K\u00edch th\u01b0\u1edbc v\u00e0 ph\u1ea3n \u1ee9ng c\u1ee7a \u0111\u1ed3ng t\u1eed<\/li>\n
        • C\u00e1c v\u1eadn \u0111\u1ed9ng \u1edf tay ch\u00e2n<\/li>\n
        • Nh\u1ecbp th\u1edf v\u00e0 \u0111\u1ed9 b\u00e3o h\u00f2a oxy<\/li>\n
        • Nh\u1ecbp tim<\/li>\n
        • Huy\u1ebft \u00e1p<\/li>\n
        • Nhi\u1ec7t \u0111\u1ed9<\/li>\n
        • H\u00e0nh vi ho\u1eb7c t\u00ednh kh\u00ed b\u1ea5t th\u01b0\u1eddng ho\u1eb7c khi\u1ebfm khuy\u1ebft l\u1eddi n\u00f3i.<\/li>\n<\/ul>\n

          C\u1ea7n ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c th\u00e0nh vi\u00ean trong gia \u0111\u00ecnh v\u00e0 b\u1ea1n b\u00e8 nh\u01b0 l\u00e0 m\u1ed9t ngu\u1ed3n cung c\u1ea5p\u00a0 th\u00f4ng tin (SIGN, 2008).<\/p>\n

          N\u1ebfu t\u00ecnh tr\u1ea1ng x\u1ea5u \u0111i (NICE, 2014) – B\u1ea5t k\u1ef3 t\u00ecnh hu\u1ed1ng n\u00e0o sau \u0111\u00e2y v\u1ec1 t\u00ecnh tr\u1ea1ng th\u1ea7n kinh x\u1ea5u \u0111i c\u1ea7n ph\u1ea3i c\u00f3 b\u00e1c s\u0129 ch\u1ecbu tr\u00e1ch nhi\u1ec7m gi\u00e1m s\u00e1t nhanh ch\u00f3ng \u0111\u00e1nh gi\u00e1 l\u1ea1i :<\/p>\n

            \n
          • Xu\u1ea5t hi\u1ec7n k\u00edch \u0111\u1ed9ng ho\u1eb7c h\u00e0nh vi b\u1ea5t th\u01b0\u1eddng.<\/li>\n
          • Gi\u1ea3m 1 \u0111i\u1ec3m GCS k\u00e9o d\u00e0i (ngh\u0129a l\u00e0, \u00edt nh\u1ea5t 30 ph\u00fat) (\u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111i\u1ec3m \u0111\u00e1p \u1ee9ng v\u1eadn \u0111\u1ed9ng).<\/li>\n
          • Gi\u1ea3m t\u1eeb 3 \u0111i\u1ec3m tr\u1edf l\u00ean trong \u0111i\u1ec3m m\u1edf m\u1eaft ho\u1eb7c \u0111i\u1ec3m \u0111\u00e1p \u1ee9ng l\u1eddi n\u00f3i c\u1ee7a GCS, ho\u1eb7c t\u1eeb 2 \u0111i\u1ec3m tr\u1edf l\u00ean trong \u0111i\u1ec3m \u0111\u00e1p \u1ee9ng v\u1eadn \u0111\u1ed9ng.<\/li>\n
          • \u0110au \u0111\u1ea7u n\u1eb7ng ho\u1eb7c \u0111au \u0111\u1ea7u t\u0103ng l\u00ean ho\u1eb7c n\u00f4n m\u1eeda k\u00e9o d\u00e0i.<\/li>\n
          • C\u00e1c tri\u1ec7u ch\u1ee9ng ho\u1eb7c d\u1ea5u hi\u1ec7u th\u1ea7n kinh m\u1edbi ho\u1eb7c t\u0103ng ti\u1ebfn nh\u01b0 l\u00e0 \u0111\u1ed3ng t\u1eed kh\u00f4ng \u0111\u1ec1u ho\u1eb7c b\u1ea5t \u0111\u1ed1i x\u1ee9ng trong v\u1eadn \u0111\u1ed9ng c\u1ee7a m\u1eb7t ho\u1eb7c tay ch\u00e2n.<\/li>\n<\/ul>\n

            3.2. \u0110i\u1ec1u tr\u1ecb ban \u0111\u1ea7u\u00a0<\/strong><\/h3>\n

            \u0110\u1ea7u ti\u00ean, c\u1ea7n \u1ed5n \u0111\u1ecbnh \u0111\u01b0\u1eddng d\u1eabn kh\u00ed, h\u00f4 h\u1ea5p v\u00e0 tu\u1ea7n ho\u00e0n (ABC) tr\u01b0\u1edbc khi ch\u00fa \u00fd \u0111\u1ebfn c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c. Th\u0103m d\u00f2 ch\u1ecdn l\u1ef1a \u0111\u1ea7u ti\u00ean \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ea5p t\u00ednh c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng v\u1edbi ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o l\u00e0 ch\u1ee5p CT \u0111\u1ea7u. \u0110\u1ed1i v\u1edbi c\u00e1c b\u00e1c s\u1ef9 \u1edf c\u00e1c trung t\u00e2m y t\u1ebf \u1edf v\u00f9ng n\u00f4ng th\u00f4n \u00edt kh\u1ea3 n\u0103ng ti\u1ebfp c\u1eadn v\u1edbi CT, c\u00f3 th\u1ec3 r\u1ea5t kh\u00f3 \u0111\u1ec3 c\u00e2n nh\u1eafc \u01b0u v\u00e0 nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a vi\u1ec7c chuy\u1ec3n b\u1ec7nh \u0111\u1ec3 ch\u1ee5p CT, khi nguy c\u01a1 bi\u1ebfn ch\u1ee9ng c\u1ee7a CTSN kh\u00e1 th\u1ea5p so v\u1edbi nh\u1eefng kh\u00f3 kh\u0103n trong x\u1eed l\u00fd c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 v\u1eady \u1edf m\u1ed9t n\u01a1i xa trung t\u00e2m ph\u1eabu thu\u1eadt th\u1ea7n kinh. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, theo d\u00f5i s\u00e1t trong 24 gi\u1edd thay v\u00ec chuy\u1ec3n \u0111i \u0111\u1ec3 ch\u1ee5p CT l\u00e0 m\u1ed9t gi\u1ea3i ph\u00e1p h\u1ee3p l\u00fd. (Nh\u00f3m C\u00e1c H\u01b0\u1edbng d\u1eabn New Zealand, 2006).<\/p>\n

            C\u00e1c ghi ch\u00e9p theo d\u00f5i v\u1ec1 th\u1ea7n kinh t\u1ed1i thi\u1ec3u ph\u1ea3i g\u1ed3m:<\/p>\n

              \n
            • Thang \u0111i\u1ec3m H\u00f4n m\u00ea Glasgow<\/li>\n
            • K\u00edch th\u01b0\u1edbc v\u00e0 ph\u1ea3n \u1ee9ng c\u1ee7a \u0111\u1ed3ng t\u1eed<\/li>\n
            • V\u1eadn \u0111\u1ed9ng c\u1ee7a tay ch\u00e2n<\/li>\n
            • Nh\u1ecbp th\u1edf<\/li>\n
            • Nh\u1ecbp tim<\/li>\n
            • Huy\u1ebft \u00e1p<\/li>\n
            • Nhi\u1ec7t \u0111\u1ed9.<\/li>\n<\/ul>\n

              C\u1ea7n theo d\u00f5i v\u00e0 ghi l\u1ea1i m\u1ed7i 15 ph\u00fat, ho\u1eb7c th\u01b0\u1eddng xuy\u00ean h\u01a1n trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, cho \u0111\u1ebfn khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ea1t \u0111i\u1ec3m 15 v\u1edbi thang \u0111i\u1ec3m h\u00f4n m\u00ea Glasgow trong hai l\u1ea7n li\u00ean ti\u1ebfp.<\/p>\n

              Can thi\u1ec7p PHCN s\u1edbm c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 v\u1edbi CTSN n\u1eb7ng v\u1ec1 l\u00e2m s\u00e0ng. Do \u0111\u00f3, PHCN c\u1ea7n b\u1eaft \u0111\u1ea7u c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t (Nh\u00f3m C\u00e1c H\u01b0\u1edbng d\u1eabn New Zealand, 2006).<\/p>\n

              Nhi\u1ec1u tri\u1ec7u ch\u1ee9ng c\u1ee7a CTSN tr\u00f9ng l\u1eb7p v\u1edbi c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c (th\u1ec3 ch\u1ea5t, t\u00e2m l\u00fd v\u00e0 t\u00e2m th\u1ea7n). \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 x\u00e1c \u0111\u1ecbnh \u0111\u00fang c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y l\u00e0 do CTSN ho\u1eb7c do c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c v\u00e0 nh\u1eadn bi\u1ebft v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo \u0111\u1ec3 x\u00e2y d\u1ef1ng m\u1ed9t k\u1ebf ho\u1ea1ch PHCN CTSN c\u00f3 hi\u1ec7u qu\u1ea3.<\/p>\n

              V\u1edbi CTSN k\u00e9o d\u00e0i \u1edf tr\u1ebb em, c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i l\u1eb7p l\u1ea1i nhi\u1ec1u l\u1ea7n c\u00e1c l\u01b0\u1ee3ng gi\u00e1 v\u1ec1 th\u1ea7n kinh t\u00e2m l\u00fd v\u00e0 c\u00e1c l\u01b0\u1ee3ng gi\u00e1 kh\u00e1c \u0111\u1ebfn khi tr\u1ebb chuy\u1ec3n sang tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh.<\/p>\n

              C\u00e1c h\u01b0\u1edbng d\u1eabn n\u00e0y s\u1ebd kh\u00f4ng \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 sau:<\/p>\n

                \n
              • C\u00e1c ti\u00eau chu\u1ea9n v\u1ec1 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh<\/li>\n
              • Can thi\u1ec7p y h\u1ecdc trong Khoa C\u1ea5p c\u1ee9u bao g\u1ed3m \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n v\u00e0 th\u1edf m\u00e1y<\/li>\n
              • Gi\u1edbi thi\u1ec7u \u0111\u1ebfn v\u00e0 can thi\u1ec7p \u1edf Ph\u1eabu Thu\u1eadt Th\u1ea7n Kinh<\/li>\n
              • Can thi\u1ec7p CTSN cho tr\u1ebb em \u1edf giai \u0111o\u1ea1n b\u00e1n c\u1ea5p<\/li>\n<\/ul>\n

                \u0110\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin, h\u00e3y tham kh\u1ea3o t\u00e0i li\u1ec7u y khoa li\u00ean quan.<\/p>\n

                4. PHCN \u1edf giai \u0111o\u1ea1n c\u1ea5p\/Khoa Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng<\/h2>\n

                Sau khi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u1edf Khoa C\u1ea5p C\u1ee9u, c\u00f3 nhi\u1ec1u lo\u1ea1i h\u00ecnh d\u1ecbch v\u1ee5 kh\u00e1c nhau c\u00f3 th\u1ec3 gi\u1edbi thi\u1ec7u cho ng\u01b0\u1eddi b\u1ec7nh b\u1ecb CTSN \u0111\u1ec3 \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng:<\/p>\n

                  \n
                • Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng n\u1ed9i tr\u00fa t\u1ea1i b\u1ec7nh vi\u1ec7n<\/li>\n
                • M\u1ed9t c\u01a1 s\u1edf \u0111i\u1ec1u d\u01b0\u1ee1ng m\u00f4 ph\u1ecfng m\u1ed9t m\u00f4i tr\u01b0\u1eddng th\u00f4ng th\u01b0\u1eddng: nh\u1eb1m th\u00fac \u0111\u1ea9y PHCN, nh\u01b0 l\u00e0 ch\u0103m s\u00f3c theo y\u00eau c\u1ea7u, ngh\u0129a l\u00e0 h\u1ed7 tr\u1ee3 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng \u0111i\u1ec1u h\u00e0nh v\u1edbi \u00e1nh s\u00e1ng, ti\u1ebfng \u1ed3n, ng\u01b0\u1eddi th\u0103m v\u00e0 giao ti\u1ebfp, h\u1ed7 tr\u1ee3 \u0111\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c c\u00f4ng vi\u1ec7c h\u00e0ng ng\u00e0y v\u00e0 thi\u1ebft l\u1eadp, duy tr\u00ec c\u00e1c vi\u1ec7c th\u01b0\u1eddng nh\u1eadt, v\u00e0 gi\u1ea3m d\u1ea7n tr\u1ee3 gi\u00fap \u0111\u1ec3 h\u01b0\u1edbng \u0111\u1ebfn \u0111\u1ed9c l\u1eadp<\/li>\n
                • Nhu c\u1ea7u chu\u1ea9n b\u1ecb cho cu\u1ed9c s\u1ed1ng \u0111\u1ed9c l\u1eadp, bao g\u1ed3m h\u1ed7 tr\u1ee3 d\u1ea7n \u0111\u1ec3 ti\u1ebfp qu\u1ea3n t\u1ea5t c\u1ea3 c\u00e1c nhi\u1ec7m v\u1ee5 \u0111\u1ec3 \u0111\u1ea1t s\u1ef1 \u0111\u1ed9c l\u1eadp<\/li>\n
                • Khi c\u00f3 y\u00eau c\u1ea7u c\u00e1c d\u1ecbch v\u1ee5 kh\u00f4ng s\u1eb5n c\u00f3 \u1edf m\u1ed9t m\u00f4i tr\u01b0\u1eddng th\u00f4ng th\u01b0\u1eddng (nh\u01b0 l\u00e0 m\u1edf th\u00f4ng d\u1ea1 d\u00e0y b\u1eb1ng n\u1ed9i soi qua da, ti\u1ebfp c\u1eadn xe l\u0103n, chu\u1ea9n b\u1ecb b\u1eefa \u0103n, tr\u1ee3 gi\u00fap th\u01b0\u1eddng xuy\u00ean v\u1edbi c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y).<\/li>\n<\/ul>\n

                  5.\u00a0\u00a0 Xu\u1ea5t vi\u1ec7n (Quy tri\u0300nh chuy\u00ea\u0309n tuy\u00ea\u0301n)<\/strong><\/h2>\n
                    \n
                  • Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh b\u1ecb ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u t\u1ed1t nh\u1ea5t s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n cho \u0111\u1ebfn khi h\u1ecd \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111i\u1ec3m GCS b\u1eb1ng 15, ho\u1eb7c \u00fd th\u1ee9c b\u00ecnh th\u01b0\u1eddng \u1edf tr\u1ebb em khi \u0111\u01b0\u1ee3c l\u01b0\u1ee3ng gi\u00e1 b\u1eb1ng phi\u00ean b\u1ea3n nhi khoa c\u1ee7a Thang \u0111i\u1ec3m H\u00f4n m\u00ea<\/li>\n
                  • T\u1ea5t c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c chuy\u1ec3n t\u1eeb b\u1ec7nh vi\u1ec7n v\u1ec1 nh\u00e0 n\u1ebfu c\u00f3 c\u00e1c h\u1ed7 tr\u1ee3 ph\u00f9 h\u1ee3p \u0111\u1ec3 di chuy\u1ec3n an to\u00e0n v\u00e0 ch\u0103m s\u00f3c ti\u1ebfp t\u1ee5c v\u00e0 n\u1ebfu ch\u1eafc ch\u1eafn r\u1eb1ng c\u00f3 m\u1ed9t ng\u01b0\u1eddi n\u00e0o \u0111\u00f3 ph\u00f9 h\u1ee3p \u1edf nh\u00e0 \u0111\u1ec3 gi\u00e1m s\u00e1t ng\u01b0\u1eddi b\u1ec7nh .<\/li>\n
                  • V\u1edbi c\u00e1c ng\u01b0\u1eddi b\u1ec7nh b\u1ecb CTSN (ho\u1eb7c nghi ng\u1edd b\u1ecb CTSN) m\u00e0 kh\u00f4ng c\u00f3 ng\u01b0\u1eddi ch\u0103m s\u00f3c \u1edf nh\u00e0, ch\u1ec9 n\u00ean cho h\u1ecd xu\u1ea5t vi\u1ec7n khi kh\u00f4ng c\u00f3 nguy c\u01a1 \u0111\u00e1ng k\u1ec3 g\u00e2y c\u00e1c bi\u1ebfn ch\u1ee9ng mu\u1ed9n, ho\u1eb7c khi \u0111\u00e3 thu x\u1ebfp s\u1ef1 gi\u00e1m s\u00e1t ph\u00f9 h\u1ee3p.<\/li>\n
                  • T\u1ea5t c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n sau khi b\u1ecb CTSN c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c m\u1ed9t b\u00e1c s\u0129 th\u00f4ng b\u00e1o tr\u01b0\u1edbc ho\u1eb7c t\u1ea1i th\u1eddi \u0111i\u1ec3m xu\u1ea5t vi\u1ec7n, m\u1ed9t c\u00e1ch c\u1ee5 th\u1ec3 chi ti\u1ebft v\u1ec1 nh\u1eefng v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe c\u00f2n t\u1ed3n t\u1ea1i v\u00e0 c\u00e1c chi ti\u1ebft v\u1ec1 k\u1ebf ho\u1ea1ch theo d\u00f5i.<\/li>\n
                  • Tr\u01b0\u1edbc khi xem x\u00e9t xu\u1ea5t vi\u1ec7n cho ng\u01b0\u1eddi b\u1ec7nh b\u1ecb CTSN n\u1eb7ng v\u1ec1 l\u00e2m s\u00e0ng, c\u1ea7n ti\u1ebfn h\u00e0nh l\u01b0\u1ee3ng gi\u00e1 nhu c\u1ea7u PHCN n\u1ed9i tr\u00fa ho\u1eb7c ngo\u1ea1i tr\u00fa ngay sau xu\u1ea5t vi\u1ec7n. Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c n\u1ed9i tr\u00fa sau giai \u0111o\u1ea1n c\u1ea5p c\u1ea7n \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn \u0111\u01a1n v\u1ecb chuy\u00ean v\u1ec1 PHCN ngay khi h\u1ecd \u1ed5n \u0111\u1ecbnh n\u1ed9i khoa v\u00e0 c\u00f3 th\u1ec3 tham gia v\u00e0o PHCN (Nh\u00f3m C\u00e1c H\u01b0\u1edbng d\u1eabn New Zealand, 2006).<\/li>\n
                  • C\u00e1c d\u1ecbch v\u1ee5 y t\u1ebf \u1edf b\u1ec7nh vi\u1ec7n c\u1ea7n c\u00f3 m\u1ed9t quy tr\u00ecnh th\u1ed1ng nh\u1ea5t v\u1edbi \u0111\u1ecba ph\u01b0\u01a1ng, \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o r\u1eb1ng tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n:\n
                      \n
                    • Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb, v\u00e0 \u0111\u00e3 tham gia \u0111\u1ea7y \u0111\u1ee7 v\u00e0o l\u1eadp k\u1ebf ho\u1ea1ch xu\u1ea5t vi\u1ec7n<\/li>\n
                    • Nh\u00e2n vi\u00ean y t\u1ebf tuy\u1ebfn c\u01a1 s\u1edf, c\u00e1c nh\u00f3m ch\u0103m s\u00f3c s\u1ee9c kho\u1ebb ban \u0111\u1ea7u v\u00e0 c\u00e1c ph\u00f2ng d\u1ecbch v\u1ee5 x\u00e3 h\u1ed9i (c\u00e1c d\u1ecbch v\u1ee5 d\u00e0nh cho ng\u01b0\u1eddi l\u1edbn) \u0111\u1ec1u \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o tr\u01b0\u1edbc ho\u1eb7c v\u00e0o th\u1eddi \u0111i\u1ec3m xu\u1ea5t vi\u1ec7n<\/li>\n
                    • T\u1ea5t c\u1ea3 c\u00e1c trang b\u1ecb v\u00e0 c\u00e1c d\u1ecbch v\u1ee5 h\u1ed7 tr\u1ee3 c\u1ea7n thi\u1ebft cho xu\u1ea5t vi\u1ec7n an to\u00e0n \u0111\u00e3 c\u00f3 s\u1eb5n[c]<\/sup><\/li>\n
                    • C\u00f3 nh\u00f3m \u0111a chuy\u00ean ng\u00e0nh cung c\u1ea5p d\u1ecbch v\u1ee5 \u0111i\u1ec1u tr\u1ecb chuy\u00ean khoa li\u00ean t\u1ee5c m\u1ed9t c\u00e1ch ph\u00f9 h\u1ee3p.<\/li>\n
                    • Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c \u0111\u01b0\u1ee3c cung c\u1ea5p th\u00f4ng tin v\u00e0 li\u00ean l\u1ea1c v\u1edbi c\u00e1c c\u01a1 s\u1edf t\u00ecnh nguy\u1ec7n v\u00e0 ph\u00e1p lu\u1eadt ph\u00f9 h\u1ee3p.<\/li>\n
                    • C\u00e1c ng\u01b0\u1eddi b\u1ec7nh s\u1eafp \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n nh\u01b0ng v\u1eabn c\u00f2n ph\u1ee5 thu\u1ed9c trong m\u1ed9t s\u1ed1 ho\u1ea1t \u0111\u1ed9ng c\u00e1 nh\u00e2n (nh\u01b0 m\u1eb7c qu\u1ea7n \u00e1o, \u0111i v\u1ec7 sinh) c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c ti\u1ebfp c\u1eadn, n\u1ebfu ph\u00f9 h\u1ee3p, v\u1edbi m\u1ed9t g\u00f3i ch\u0103m s\u00f3c chuy\u1ec3n ti\u1ebfp g\u1ed3m: th\u0103m nh\u00e0 tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n (v\u00ed d\u1ee5 v\u00e0o cu\u1ed1i tu\u1ea7n), t\u1eadp hu\u1ea5n cho ng\u01b0\u1eddi b\u1ec7nh v\u00e0 gi\u00e1o d\u1ee5c cho ng\u01b0\u1eddi ch\u0103m s\u00f3c c\u1ee7a h\u1ecd, h\u1ed7 tr\u1ee3 t\u01b0 v\u1ea5n qua \u0111i\u1ec7n tho\u1ea1i trong 3 th\u00e1ng.<\/li>\n<\/ul>\n<\/li>\n
                    • Tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n cho m\u1ed9t ng\u01b0\u1eddi b\u1ec7nh v\u1eabn c\u00f2n ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ed9t s\u1ed1 ho\u1ea1t \u0111\u1ed9ng, c\u1ea7n l\u01b0\u1ee3ng gi\u00e1 v\u00e0 \u0111i\u1ec1u ch\u1ec9nh th\u00edch h\u1ee3p m\u00f4i tr\u01b0\u1eddng t\u1ea1i nh\u00e0 c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, th\u01b0\u1eddng th\u00f4ng qua m\u1ed9t bu\u1ed5i th\u0103m nh\u00e0 do m\u1ed9t k\u1ef9 thu\u1eadt vi\u00ean ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u th\u1ef1c hi\u1ec7n.<\/li>\n
                    • C\u00e1c b\u1ec7nh vi\u1ec7n c\u1ea7n ph\u1ea3i s\u1eed d\u1ee5ng c\u00e1c h\u1ec7 th\u1ed1ng r\u00f5 r\u00e0ng \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o r\u1eb1ng:\n
                        \n
                      • Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 gia \u0111\u00ecnh tham gia v\u00e0o qu\u00e1 tr\u00ecnh l\u1eadp k\u1ebf ho\u1ea1ch xu\u1ea5t vi\u1ec7n v\u00e0 ng\u01b0\u1eddi nh\u00e0 ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c t\u1eadp hu\u1ea5n v\u1ec1 c\u00e1ch ch\u0103m s\u00f3c, ch\u1eb3ng h\u1ea1n c\u00e1ch di chuy\u1ec3n, thao t\u00e1c v\u1edbi ng\u01b0\u1eddi b\u1ec7nh, m\u1eb7c \u00e1o qu\u1ea7n.<\/li>\n
                      • Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c c\u1ea3m th\u1ea5y \u0111\u00e3 \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb v\u00e0 h\u1ed7 tr\u1ee3 \u0111\u1ea7y \u0111\u1ee7 \u0111\u1ec3 th\u1ef1c hi\u1ec7n ch\u0103m s\u00f3c<\/li>\n
                      • C\u00e1c c\u01a1 s\u1edf y t\u1ebf ph\u00f9 h\u1ee3p (bao g\u1ed3m c\u00e1c b\u00e1c s\u0129 t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng, b\u1ec7nh vi\u1ec7n khu v\u1ef1c) \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o tr\u01b0\u1edbc khi ng\u01b0\u1eddi b\u1ec7nh xu\u1ea5t vi\u1ec7n v\u00e0 c\u00f3 m\u1ed9t k\u1ebf ho\u1ea1ch ch\u0103m s\u00f3c y t\u1ebf v\u00e0 x\u00e3 h\u1ed9i th\u1ed1ng nh\u1ea5t.<\/li>\n
                      • C\u00e1c trang b\u1ecb thi\u1ebft y\u1ebfu \u0111\u00e3 \u0111\u01b0\u1ee3c cung c\u1ea5p (bao g\u1ed3m xe l\u0103n n\u1ebfu c\u1ea7n thi\u1ebft), v\u00e0 ng\u01b0\u1eddi b\u1ec7nh bi\u1ebft c\u1ea7n \u0111\u01b0\u1ee3c bi\u1ebft ph\u1ea3i li\u00ean h\u1ec7 v\u1edbi ai n\u1ebfu g\u1eb7p kh\u00f3 kh\u0103n.<\/li>\n<\/ul>\n<\/li>\n
                      • C\u1ea7n hu\u1ea5n luy\u1ec7n cho ng\u01b0\u1eddi ch\u0103m s\u00f3c c\u1ee7a nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng th\u1ec3 di chuy\u1ec3n \u0111\u1ed9c l\u1eadp v\u1ec1 c\u00e1ch di chuy\u1ec3n v\u00e0 thao t\u00e1c v\u1edbi ng\u01b0\u1eddi b\u1ec7nh v\u00e0 s\u1eed d\u1ee5ng c\u00e1c d\u1ee5ng c\u1ee5 \u0111\u01b0\u1ee3c cung c\u1ea5p cho \u0111\u1ebfn khi h\u1ecd c\u00f3 th\u1ec3 di chuy\u1ec3n v\u00e0 \u0111\u1eb7t t\u01b0 th\u1ebf ng\u01b0\u1eddi b\u1ec7nh m\u1ed9t c\u00e1ch an to\u00e0n \u1edf nh\u00e0.<\/li>\n
                      • T\u1ea5t c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n ti\u1ebfp t\u1ee5c ti\u1ebfp c\u1eadn c\u00e1c d\u1ecbch v\u1ee5 PHCN sau khi xu\u1ea5t vi\u1ec7n, v\u00e0 c\u1ea7n bi\u1ebft c\u00e1ch li\u00ean l\u1ea1c v\u1edbi c\u00e1c d\u1ecbch v\u1ee5 n\u00e0y.<\/li>\n
                      • Gia \u0111\u00ecnh\/Ng\u01b0\u1eddi ch\u0103m s\u00f3c nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN c\u1ea7n \u0111\u01b0\u1ee3c cung c\u1ea5p:\n
                          \n
                        • M\u1ed9t \u0111i\u1ec3m li\u00ean l\u1ea1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh tr\u01b0\u1edbc \u0111\u1ec3 bi\u1ebft th\u00f4ng tin v\u1ec1 CTSN<\/li>\n
                        • Th\u00f4ng tin b\u1eb1ng v\u0103n b\u1ea3n v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 k\u1ebf ho\u1ea1ch x\u1eed l\u00fd c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh<\/li>\n
                        • Hu\u1ea5n luy\u1ec7n th\u1ef1c h\u00e0nh \u0111\u1ea7y \u0111\u1ee7 \u0111\u1ec3 gi\u00fap h\u1ecd ch\u0103m s\u00f3c an to\u00e0n.<\/li>\n<\/ul>\n<\/li>\n
                        • C\u00e1c t\u1ed5 ch\u1ee9c d\u1ecbch v\u1ee5 y t\u1ebf v\u00e0 x\u00e3 h\u1ed9i n\u00ean cung c\u1ea5p m\u1ed9t \u0111i\u1ec3m ti\u1ebfp c\u1eadn duy nh\u1ea5t cho t\u1ea5t c\u1ea3 c\u00e1c d\u1ecbch v\u1ee5 h\u1ed7 tr\u1ee3 v\u00e0 t\u01b0 v\u1ea5n d\u00e0nh cho ng\u01b0\u1eddi khuy\u1ebft t\u1eadt.<\/li>\n<\/ul>\n

                          6.\u00a0\u00a0 H\u00ecnh th\u1ee9c ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng t\u1ea1i nh\u00e0\/c\u1ed9ng \u0111\u1ed3ng (Theo d\u00f5i y t\u1ebf v\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau xu\u1ea5t vi\u1ec7n)<\/h2>\n

                          B\u00ean c\u1ea1nh theo d\u00f5i y t\u1ebf, nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN s\u1ebd c\u1ea7n \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb PHCN khi xu\u1ea5t vi\u1ec7n sau t\u00ecnh tr\u1ea1ng c\u1ea5p t\u00ednh.<\/p>\n

                          Sau khi xu\u1ea5t vi\u1ec7n, c\u00e1c ng\u01b0\u1eddi b\u1ec7nh CTSN c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i trong v\u00f2ng 72 gi\u1edd b\u1edfi Nh\u00f3m \u0111a chuy\u00ean ng\u00e0nh \u0111\u1ec3 l\u01b0\u1ee3ng gi\u00e1 c\u00e1c nhu c\u1ea7u c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ph\u1ed1i h\u1ee3p x\u00e2y d\u1ef1ng c\u00e1c k\u1ebf ho\u1ea1ch can thi\u1ec7p (bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb) [NICE, 2013].<\/p>\n

                          C\u1ea7n gi\u1ea3i th\u00edch v\u00e0 khuy\u1ebfn c\u00e1o v\u1ec1 c\u00e1ch th\u1ee9c v\u00e0 \u0111\u1ecba \u0111i\u1ec3m \u0111\u1ec3 ti\u1ebfp c\u1eadn c\u00e1c d\u1ecbch v\u1ee5 PHCN cho ng\u01b0\u1eddi b\u1ec7nh CTSN v\u00e0 gia \u0111\u00ecnh\/ng\u01b0\u1eddi ch\u0103m s\u00f3c tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n (xem g\u00f3i th\u00f4ng tin v\u1ec1 xu\u1ea5t vi\u1ec7n sau giai \u0111o\u1ea1n c\u1ea5p). N\u1ebfu c\u00f3 th\u1ec3, c\u1ea7n th\u00f4ng b\u00e1o cho m\u1ed9t c\u01a1 s\u1edf PHCN c\u1ee5 th\u1ec3 v\u1ec1 t\u00ecnh tr\u1ea1ng s\u1eafp xu\u1ea5t vi\u1ec7n \u0111\u1ec3 h\u1ed7 tr\u1ee3 theo d\u00f5i ng\u01b0\u1eddi b\u1ec7nh CTSN.<\/p>\n

                          PHCN sau khi xu\u1ea5t vi\u1ec7n giai \u0111o\u1ea1n c\u1ea5p c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c cung c\u1ea5p b\u1edfi c\u00e1c k\u1ef9 thu\u1eadt vi\u00ean PHCN c\u00f3 tr\u00ecnh \u0111\u1ed9 v\u1edbi m\u1ed9t trong 2 h\u00ecnh th\u1ee9c sau:<\/p>\n

                          6.1. PHCN t\u1ea1i b\u1ec7nh vi\u1ec7n\/trung t\u00e2m PHCN<\/h3>\n
                            \n
                          • PHCN t\u1ea1i b\u1ec7nh vi\u1ec7n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i khoa \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa c\u1ee7a m\u1ed9t b\u1ec7nh vi\u1ec7n \u0111\u1ecba ph\u01b0\u01a1ng (nh\u01b0 l\u00e0 B\u1ec7nh vi\u1ec7n Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng, Khoa PHCN) ho\u1eb7c c\u01a1 s\u1edf y t\u1ebf \u1edf c\u1ed9ng \u0111\u1ed3ng (nh\u01b0 l\u00e0 ph\u00f2ng kh\u00e1m t\u01b0 nh\u00e2n ho\u1eb7c ph\u00f2ng kh\u00e1m phi ch\u00ednh ph\u1ee7 \u1edf \u0111\u1ecba ph\u01b0\u01a1ng).<\/li>\n
                          • PHCN c\u00f3 th\u1ec3 l\u00e0 n\u1ed9i tr\u00fa ho\u1eb7c ngo\u1ea1i tr\u00fa t\u00f9y thu\u1ed9c v\u00e0o kh\u1ea3 n\u0103ng ti\u1ebfp c\u1eadn (nh\u01b0 t\u00e0i ch\u00ednh, \u0111\u1ecba l\u00fd) v\u00e0 kh\u1ea3 n\u0103ng cung c\u1ea5p d\u1ecbch v\u1ee5.<\/li>\n
                          • PHCN c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi m\u1ed9t nh\u00f3m c\u00e1c k\u1ef9 thu\u1eadt vi\u00ean c\u00f3 tr\u00ecnh \u0111\u1ed9. Khuy\u1ebfn kh\u00edch ng\u01b0\u1eddi b\u1ec7nh CTSN ph\u1ea3i ch\u1ee7 \u0111\u1ed9ng trong PHCN \u0111\u1ec3 t\u0103ng c\u01b0\u1eddng s\u1ef1 h\u1ed3i ph\u1ee5c v\u00e0 ch\u1ee9c n\u0103ng. S\u1ef1 tham gia c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh CTSN v\u00e0 gia \u0111\u00ecnh\/ng\u01b0\u1eddi ch\u0103m s\u00f3c l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o r\u1eb1ng c\u00e1c b\u00e0i t\u1eadp c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c th\u1ef1c hi\u1ec7n t\u1ea1i nh\u00e0 v\u00e0 s\u1eed d\u1ee5ng t\u1ed1i \u0111a c\u00e1c chi\u1ebfn l\u01b0\u1ee3c ch\u1ee9c n\u0103ng nh\u1eb1m t\u1ea1o thu\u1eadn \u0111\u1ed9c l\u1eadp t\u1ea1i nh\u00e0 v\u00e0 c\u1ed9ng \u0111\u1ed3ng.<\/li>\n<\/ul>\n

                            6.2. PHCN t\u1ea1i nh\u00e0<\/h3>\n
                              \n
                            • PHCN t\u1ea1i nh\u00e0 cho ph\u00e9p can thi\u1ec7p PHCN h\u01b0\u1edbng \u0111\u1ebfn m\u1ee5c \u0111\u00edch h\u01a1n v\u1edbi ng\u01b0\u1eddi b\u1ec7nh CTSN, nh\u1ea5n m\u1ea1nh v\u00e0 gi\u1ea3i quy\u1ebft c\u00e1c v\u1ea5n \u0111\u1ec1 th\u1ef1c ti\u1ec5n v\u00e0 ch\u1ee9c n\u0103ng m\u00e0 ng\u01b0\u1eddi b\u1ec7nh CTSN v\u00e0 gia \u0111\u00ecnh\/ng\u01b0\u1eddi ch\u0103m s\u00f3c g\u1eb7p ph\u1ea3i \u1edf nh\u00e0 v\u00e0 c\u1ed9ng \u0111\u1ed3ng.<\/li>\n
                            • C\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n c\u00e1c chi\u1ebfn l\u01b0\u1ee3c PHCN t\u1ea1i nh\u00e0 s\u1eed d\u1ee5ng nh\u1eefng ngu\u1ed3n l\u1ef1c s\u1eb5n c\u00f3 \u1edf \u0111\u1ecba ph\u01b0\u01a1ng v\u00e0 thay \u0111\u1ed5i th\u00edch \u1ee9ng nh\u00e0 n\u1ebfu c\u1ea7n thi\u1ebft.<\/li>\n
                            • N\u1ebfu \u0111\u01b0\u1ee3c, m\u1ed9t nh\u00e2n vi\u00ean x\u00e3 h\u1ed9i \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o s\u01a1 b\u1ed9\/Tr\u1ee3 l\u00fd PHCN c\u0169ng c\u00f3 th\u1ec3 \u0111i k\u00e8m v\u1edbi k\u1ef9 thu\u1eadt vi\u00ean \u0111\u1ec3 gi\u00fap ti\u1ebfp t\u1ee5c th\u1ef1c hi\u1ec7n v\u00e0 theo d\u00f5i c\u00e1c b\u00e0i t\u1eadp khi k\u1ef9 thu\u1eadt vi\u00ean kh\u00f4ng th\u1ec3 tr\u1ef1c ti\u1ebfp \u0111i\u1ec1u tr\u1ecb cho ng\u01b0\u1eddi b\u1ec7nh<\/li>\n<\/ul>\n

                              7.\u00a0 Khi kh\u00f4ng c\u00f3 c\u00e1c d\u1ecbch v\u1ee5 PHCN<\/h2>\n

                              V\u00ec c\u00e1c l\u00fd do di chuy\u1ec3n, \u0111\u1ecba l\u00fd v\u00e0 c\u00e1 nh\u00e2n, PHCN t\u1ea1i b\u1ec7nh vi\u1ec7n v\u00e0 t\u1ea1i nh\u00e0 c\u00f3 th\u1ec3 kh\u00f4ng th\u1ef1c t\u1ebf. Do \u0111\u00f3 \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 cung c\u1ea5p m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh t\u1eadp luy\u1ec7n t\u1ea1i nh\u00e0 cho t\u1eebng ng\u01b0\u1eddi b\u1ec7nh (v\u1edbi th\u00f4ng tin \u0111\u01b0\u1ee3c vi\u1ebft ra\/h\u00ecnh v\u1ebd) li\u00ean quan \u0111\u1ebfn c\u00e1c khi\u1ebfm khuy\u1ebft v\u1ec1 th\u1ec3 ch\u1ea5t, ch\u1ee9c n\u0103ng, nh\u1eadn th\u1ee9c v\u00e0 ng\u00f4n ng\u1eef c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh CTSN tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n c\u0169ng nh\u01b0 nh\u1eefng khuy\u1ebfn c\u00e1o v\u1ec1 vi\u1ec7c tr\u1edf l\u1ea1i c\u00e1c ho\u1ea1t \u0111\u1ed9ng x\u00e3 h\u1ed9i v\u00e0 c\u1ed9ng \u0111\u1ed3ng.<\/p>\n

                              Nh\u1eefng ho\u1ea1t \u0111\u1ed9ng n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c theo d\u00f5i b\u1edfi c\u00e1c nh\u00e2n vi\u00ean x\u00e3 h\u1ed9i \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o s\u01a1 b\u1ed9, nh\u1eb1m gi\u00e1m s\u00e1t v\u00e0 gi\u1edbi thi\u1ec7u trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 bi\u1ebfn ch\u1ee9ng th\u1ee9 ph\u00e1t x\u1ea3y ra.<\/p>\n","protected":false},"excerpt":{"rendered":"

                              Quy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o (CTSN) l\u00e0 m\u1ed9t quy tr\u00ecnh quan tr\u1ecdng \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o b\u1ec7nh nh\u00e2n nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 ch\u0103m s\u00f3c v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p nh\u1ea5t trong tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o. Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o l\u00e0 m\u1ed9t lo\u1ea1i ch\u1ea5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng \u0111\u1ed1i v\u1edbi h\u1ec7 th\u1ed1ng […]<\/p>\n","protected":false},"author":42,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nQuy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o - Vinmec<\/title>\n<meta name=\"description\" content=\"Quy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n \u0111\u1ea3m b\u1ea3o b\u1ec7nh nh\u00e2n nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 ch\u0103m s\u00f3c v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p nh\u1ea5t trong tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Quy tri\u0300nh gi\u01a1\u0301i thi\u00ea\u0323u chuy\u00ea\u0309n tuy\u00ea\u0301n ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o - 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