Township hospitals: At present, the problem of unreasonable infusion in some primary medical institutions in our county is more prominent, which leads to the increase of medical hidden dangers and risks. In order to standardize medical behavior, strengthen the management of intravenous infusion in primary medical institutions, and ensure the safety and effectiveness of patients' medical treatment, the following requirements are put forward to strengthen the management of intravenous infusion in primary medical institutions, please implement them conscientiously. First, to carry out intravenous infusion in township hospitals, the personnel engaged in clinical medical services must have the qualification of practicing doctors or practicing assistant doctors, and the nursing staff must obtain the qualification of practical nurse; Village doctors in village clinics must obtain the practicing certificate of village doctors. Second, the hospital should train the medical staff in the hospital and village clinics on the professional knowledge of infusion business and the emergency handling skills of infusion adverse reactions. Through training, master the incompatibility of commonly used drugs, the application of rescue equipment and drugs, the principles and methods of infusion reaction and rescue, and ensure the safety of infusion. Three, the hospital to participate in the training of the object of infusion business professional knowledge and skills operation assessment, after passing the examination, can carry out infusion business. Training and assessment will be included in the annual performance appraisal, and relevant information must be filed for future reference. Four, to carry out intravenous infusion must be equipped with corresponding rescue equipment, drugs and oxygen supply device, and ensure the equipment intact rate 100%. Drugs and disposable infusion sets used must comply with the provisions of the Drug Administration Law and the Management Standard for Hospital Infection, and be purchased from formal channels. Disposable infusion sets after use should be disinfected and deformed in time, and classified in strict accordance with the Regulations on Medical Waste Management. Five, strictly grasp the indications of infusion, strictly follow the principle of "oral injection, intramuscular injection and intravenous injection". The application of antibiotics should conform to the Guiding Principles for Clinical Application of Antibiotics. It is forbidden to abuse antibiotics and strictly control the indications of hormones. In addition to rescue, the use of glucocorticoids is prohibited in village clinics, and the scope of drug use should be in the list of essential drugs. Six, standardize the writing of medical documents, infusion patients must issue infusion prescriptions, write outpatient medical records and outpatient logs, village clinics must use outpatient registration, detailed, accurate and objective records of clinical symptoms and positive signs, prescription content must be consistent with outpatient medical records (outpatient registration). Seven, strictly implement the infusion operation specification, strictly carry out aseptic operation and three checks and seven pairs, there should be a special person in charge of the patrol during the infusion process, closely observe the general situation of patients, and deal with infusion reactions in time (Annex: Principles for Handling Common Infusion Reactions). Eight, the hospitals should conduct an inspection of the infusion business in the village clinic, and the key points of the inspection are: whether the employees meet the qualifications; Whether the use of medical documents and drugs is standardized; Sterilization and isolation, whether the medical room meets the requirements, etc. Blood transfusion institutions that do not meet the requirements should be rectified within a time limit. If the problem is outstanding and the rectification is ineffective, the intravenous infusion business of the institution will be cancelled. Nine, increase publicity to correct the bad drug habits of doctors and patients. All primary medical institutions should focus on a period of time to carry out various and easy-to-understand health education, telling patients that intravenous infusion is the most unsafe way to use drugs, and that continuous infusion will reduce their own immune ability and other scientific knowledge to help patients make reasonable choices. Attachment: Principles for Handling Common Infusion Reactions reported on March 6, 20 1 February: Attachment of Municipal Health Bureau: Principles for Handling Common Infusion Reactions (1) Anaphylactic Shock1. Stop taking medicine immediately, carry out on-site rescue, take off your pillow and lie flat, and pay attention to keep warm. 2. Immediately inject 0. 1% epinephrine hydrochloride 0.5- 1ml subcutaneously, and reduce the dosage in children. If the symptoms are not relieved, 0.5ml can be injected subcutaneously or intravenously with an interval of 20 ~ 30 minutes until it is out of danger. 3. Improve the symptoms of hypoxia: loosen the collar, open the airway, remove secretions or vomit, keep the airway unobstructed, and give oxygen. When breathing is inhibited, immediately carry out mouth-to-mouth artificial respiration or simple respirator assisted breathing, and intramuscular injection of respiratory stimulants such as Nikethamide or Lobelin. When laryngeal edema affects breathing, you should immediately prepare tracheal intubation or cooperate with tracheotomy. 4. Establish venous access to maintain arterial blood pressure. If blood pressure continues to drop, antihypertensive drugs such as dopamine should be used in time. 5. Application of adrenocortical hormone: intravenous injection of dexamethasone 5- 10mg or intravenous drip of hydrocortisone 200-400mg and 5%- 10% glucose solution 500ml as soon as possible. 6. If the heart stops, immediately perform chest compressions and artificial respiration. 7. Closely observe the patient's consciousness, temperature, pulse, breathing, blood pressure, urine volume and other clinical changes, and make a dynamic record of the condition. Call 120 emergency center as soon as possible when the condition is serious. (2) Causes of fever reaction: imported pyrogen, impure solution or medicine, and poor disinfection and preservation. Clinical manifestations: it usually occurs from a few minutes to 1 hour after infusion, showing chills, chills and then fever. Mild body temperature is about 38℃, and it will return to normal within a few hours after stopping infusion; In severe cases, chills begin, and then the body temperature can reach above 40℃, accompanied by nausea, vomiting, headache, rapid pulse and other symptoms. Treatment: 1. Slow down the dripping speed or stop infusion, and give anti-allergic drugs or hormone treatment according to the doctor's advice. 2. Appropriate quilt cover shall be added during chills, and physical cooling shall be carried out during high fever. 3. Report to the doctor for symptomatic treatment. 4. Keep the residual liquid and infusion set and send them to the Institute for Drug Control for testing. (3) Causes of acute pulmonary edema: The infusion speed is too fast, and too much liquid is input in a short time, so that the circulating blood volume increases sharply and the heart load is too heavy. Clinical manifestations: The patient suddenly developed dyspnea, shortness of breath, cough and pink foam sputum. In severe cases, sputum is ejected from the nose and mouth, and wet rales can be heard in both lungs. Treatment: 1. Stop infusion immediately, arrange the patient's sitting position, and droop his legs to reduce venous reflux and reduce the burden on his heart. 2. Pressurized oxygen supply and humidified oxygen inhalation with 20-30% alcohol can reduce the surface tension of foam in alveoli, make the foam rupture and dissipate, improve the gas exchange in the lungs, and quickly relieve the symptoms of hypoxia. 3. Give sedatives, vasodilators and cardiotonic drugs according to the condition. 4. If necessary, bind the limbs with tourniquet and call the emergency center as soon as possible 120. (4) Causes of air embolism: the air was not exhausted during infusion, the infusion tube was not tightly connected, and the bottle was not connected in time. Clinical manifestations: abnormal chest discomfort, followed by dyspnea and severe cyanosis, and a large and lasting "bubbling sound" can be heard in the precordial area of auscultation. Treatment: 1. Immediately lower your left head and raise your feet. 2. Take oxygen and call 120 emergency center at the same time.