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CNG HO X HI CH NGHA VIT NAM c lp-T do-Hnh phc . NI DUNG THC T TT NGHIP TI TRM Y T PHNG THU LNG Thi gian: 04/07/2011 n 16/07/2011

I. YU CU: 1. Tm hiu cch s dng v qun l thuc Trm Y T ( An ton, hp l, hn dng ca thuc). 2. Tm hiu v chm sc vng thuc nam ti trm. 3.iu tra Y T cng ng( tham gia vi trm).

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S PHN CNG NHIM V TI TRM Y T PHNG THU LNG

BS:NGUYN TIN (Trng trm) -Ph trch chung -Khm bnh-iu tr -Ngha v qun s -Chng trnh phng chng dinh dng tr em (Thn Lung Hu)

YS:NG THNG (Ph trm) -Ph trch: -Khm bnh-iu tr -5 chuyn khoa x hi -Chng trnh v sinh mi trng - iu hnh y t thn -Phng chng dch cm (Thn Lng M)

DSTH: V Th M Cc -Ph trch Dc (Thn Lng Hu)

.DTH: Mai a Ngha -Ph trch -Chng trnh tim chng m rng -CT: St xut huyt -CT: Phng chng ti nn thng tch -CT:Phc hi chc nng -CT: ARI -CT:V sinh

YS YHCT: Hong Th L Th Hng -Ph trch: Duyn -Ph trch: -CT:Dn s -CT: C.D.D KHHG -(Thn -CT: Vitamin Lng -CT: YHCT Xun) (Thn Lng Hu)

NHS:Hong Th H -Ph trch: -CT:Bo v BMVTE CT:KHHG -CT:Thiu nhi dinh dng -Th qu (Thn Lng ng)

CNG TC DC TI TRM Y T X, PHNG.

Trm Y T x, phng l n v k thut Y t

u tin tip xc vi ngi dn, nm trong h thng Y t nh nc, c nhim v thc hin cc nhim v, k thut chm sc sc kho ban u cho nhn dn trn a bn. lm tt
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nhim v th cng tc qun l thuc, thit b v dng c Y t(cng tc dc) x, phng gi mt v tr quan trng v c nh hng trc tip hiu qu hot ng khm, cha bnh ca trm Y t. Do cng tc dc l mt trong nhng nhim v trng tm trong hot ng ca trm Y t x, phng v phi c thc hin theo cc quy nh chung ca ngnh Y t.

I. Chc trch, nhim v ca cn b Dc ( Dc S Trung Hc ) phng, x :

1. Cn c nhu cu v k hoch c giao, lp d tr mua, nhp thuc, dng c Y t cn thit cho hot ng ca Trm Y t. 2. T chc quy thuc ti trm, bo m thuc thit yu theo quy nh, bo ton v pht trin ngun vn quay vng c cp (nu c). 3. Qun l mi ngun thuc v s dng dng c Y t tai Trm: -M cc loi s sch ghi chp, theo di. -T chc kim k, nh k, hay nhp xut khi cn thit. -Lp s sch theo di thu, chi tin li trong hot ng ca quy thuc. 4. Hng dn ngi bnh s dng thuc, tuyn truyn cho nhn dn s dng thuc an ton, hp l, vn ng trng v s dng thuc nam ti vn nh. 5. Vi cn b Dc, do kim nhim Trm Y t phi b tr thi gian ph hp cho hot ng ca cn b Dc.

II. Cng tc qun l thuc :

1. Lp k hoch d tr mua, nhp thuc, ho cht, dng c: -Xy dng danh mc thuc. -Cn c danh mc thuc thit ca s Y t ban hnh (danh mc bt but) ca trm Y t x, phng. - Cn c m hnh bnh tt ca a phng, hng dn ca Trung tm Y t, S Y t xy dng danh mc, trch nhim ca Trng Trm Y t. -Danh mc thuc c la chn trn nguyn tc: +Thuc m bo c hiu lc v an ton. +Ph hp vi m hnh bnh tt, trnh chuyn mn ca Trm Y t. +Sn c vi s lng m bo yu cu, dng bo ch ph hp vi yu cu s dng, ph hp vi yu cu bo qun, iu kin cung ng.
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+Gi c hp l. -Xc nh nhu cu cn mua, nhn cn c xch nh nhu cu. +Thng k tnh hnh bnh tt hng nm, bnh tt theo ma. +Thng k s dng thuc, dng c hng nm, nhm loi s dng nhiu, nhm loi s dng t. +iu kin kinh t tng a phng 2. T chc hot ng quy thuc quay vng vn: 2. 1. Huy ng ngun vn, c th l thuc, tin mt. Huy ng vn c th l do: -Vn vin tr ca cc t chc, cc nh t thin. -Ngn sch cp(X, Huyn, Tnh). -Nhn dn ng gp -Nhn dn Y t cng gp vn. -Do lm i l cc hiu thuc cc doanh nghip. 2. 2. Qun l ngun vn c cc chng t hp l, lu tng thi k: -C s theo di qu quay vng vn, s thu chi tin li. -Bin lai, phiu thu, phiu chi. -Bn kim k quyt ton hng qu. 2. 3. T chc mua bn thuc. -Cn b trc tip nhn thuc hng thng, cn c danh mc thuc c la chn v xy dng ca Trm y t x. -Ch mua thuc c s kinh doanh hp php, c ho n, chng t hp l, thuc ph hp vi nhu cu, gi c hp l. -Khi mua bn, giao nhn cn ch cc ni dung sau: +Thuc phi ng tn, chng loi ghi trong n t hng v ho n xut hng. +Bao gi phi c nhn ng quy ch, ghi r tn thuc, nng hm lng, hn dng, s ng k, s kim sot, tn c s sn xut, nhng ch cn thit khc. +Kim tra cht lng thuc v cm quan, mu sc, trong, hn dng. +Khng mua thuc khi khng cn nguyn vn bao b, hay nghi ng. 2. 4. Cng tc bo qun tn tr thuc: -Thuc trong kho, quy phi c sp xp gn gng, ngn np sao cho d thy, d ly, d kim tra, c th sp xp theo nhm, vn A-B-C hoc theo nhm bnh. Thc hin hn dng ngn xut trc, hn dng di xut sau.

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-Phi c phng tin, quy t thch hp bo qun thuc, khng thuc trc tip xung sn nh, ch cc yu cu bo qun c bit. 2. 5. Qun l v s lng m y s sch theo di u nm. Kim k thanh quyt ton theo nh k. 2. 6. Qun l cc thit b, Dng c hn c: -M s sch theo di, xut nhp, bn giao cc thit b dng c Y t, tu tng loi dng c thc hin ch bo qun thch hp. -Cui nm t chc kim k nh gi theo quy ch hin hnh.

III. Danh mc thuc thit yu ti Trm Y t phng, v so snh vi danh mc thuc thit yu do B Y t quy nh: A. Danh mc thuc thit yu ti trm Y t
1. ST T 1. 2. Lidocaine. Lidocaine+ epinerphine(xylocain) 2 . Thuc tin m. 3. Atropine sulfate. 0, 25-1mg/ml. ng. 1-2% 1, 8-2ml. ng. ng. Thuc gy t m v Oxygen. Tn thuc. Hm Lng Dng Dng Ghi Ch

3. Thuc gim au, h st, nhm chng vim khng streroid, thuc iu tr gt v cc bnh xng khp. a.Thuc gim au khng c opi:thuc h st, chng vim khng streroid. 4. Acetylsalicylic acid. 100-500mg. Vin, gi, bt
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5. 6. 7. 8. 9. 10.

Diclophenac. Meloxicam. Paracetamol. Paracetamol+ chlorpheniramine. Paracetamol+ Ibuprofen. Pirocicam.

25-100mg. 7, 5-15mg;30g. 80-1000mg. 325mg+4mg. 325mg+200mg 10-20mg.

Vin. ng,

vin,

tup l, gi, vin. Vin. Vin. ng, vin.

b. Thuc chng vim gim ph n. 11. Alpha chymotrypsin. 1-5mg. ng, vin.

4.Thuc chng d ng v dng trong cc trng hp qu mn. 12. 13. 14. 15. Alimemazin. Chlorpheniramine. Cinnarizine. Promethazine. 2, 5-5mg. 4mg. 25mg. 5-50mg/ml. Vin, xiro. Vin. Vin. Xiro, vin.

5.Thuc hng thn. 16. 17. 18. 19. Diazepam. Mekoduxen Phenolbarbital Phenolbarbital 5mg. 5mg 0,1g 0,01g Vin. Vin Vin Vin

6.Thuc tr giun sn. 20. 21. Mebendazol. Albendazol. 100-500mg. 200-400mg. Vin. Vin.

7. Thuc chng nhim khun: 22. 23. 24. Amoxicillin. Cefalexin. Oxacilin. 250-500mg. 250-500mg. 250mg-2g. Vin. gi. Vin, gi. Vin, l.
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25. 26. 27. 28. 29. 30. 31. 32. 33.

Gentamicine. Chloramphenicol. Metronidazole. Ciprofloxacin. Nalidixic acid. Sulfamethoxazol+ Trimethoprim. Doxycyline. Acyclovir. Diloxanide.

40-80mg. 250mg. 250-500mg. 200-500mg. 250-500mg. 400+80mg800+160mg. 100mg. 25-800mg. 250-500mg.

ng. Vin. Vin. Vin. Vin. Vin. Vin. Vin. Vin.

8.Thuc tc dng i vi mu. 34. 35. 36. Folic acide. St sunfute+filic acid. St sunfute+folic acid. 1-5mg. 60-250mg. 350mg-1, 5g. Vin. Vin. Vin.

9.Thuc tim mch, tng huyt p. 37. 38. 39. 40. 41. Furosemid. Nifedipine. Captopril. Piracetam. Propranolon. 10. Thuc ng tiu ho. a. Thuc chng lot d dy. 42. 43. 44. 45. 46. Aluminum. Bismuth. Cimetidine. Omeprazole. Sucrafate. 16g. 120mg. 100-400mg. 200mg. 1g. Gi. Vin. Vin. Vin. Vin, gi. 40mg. 5-20mg. 25-50ml. 400-800mg. 40mg. Vin. Vin. Vin. Vin. Vin.

b.Thuc chng co tht. 47. 48. 49. Alverine(citrate). Papaverine Hydrochloride. Hyoscine butybromide. 15-60mg. 40mg. 10-20mg. Vin. Vin. Vin.

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c.Thuc nhun trng, ty. 50. 51. 52. 53. Bisacodyl. Glycerin. Lactulose. Magnesi(sulfate). d. Thuc tiu chy. 54. 55. 56. 57. 58. Oresol. Bacilus subtilis. Diosmeetile. Lactobacills acidophilus. Berberin. e. Thuc iu tr tr. 59. 60. Diosmine. Diosmine+ Hesperidine 11.Hocmon, ni tit t. 61 62 63 64 65 Dexamethasone. Prednisolone acetate. Glibenlamide. Glielazide. Metfomin. 4mg/ml; 5-1mg. 1-5mg/vin; 0, 5-1% 2, 5-5mg. 30-80mg. 500-1000mg. 0, Vin. Vin. Vin. Vin. Vin. 150-300mg. 450-500mg. Vin. Vin. 1g. 3g. 75mg-1g. 10-20-50mg. Gi. Vin, gi. Gi. Gi. Vin. 5-10mg. 3-5ml. 10/15ml. 5g. Vin. Tut(dng tht). Gi. Gi.

12.Thuc tai, mi, hng. 66 67 68 69 Naphazoline. Xylometazolin. Dexamethasone phosphate+neomycin. Chloramphenicol+ 0, 05%. 0. 05-1%. 0, 10%. 20mg+5mg. L. L. L. L. Nh mi Nh mi Nh mi Nh
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70

Dexamethasone Ciprofloxacin.

0, 30%.

L.

tai. Nh tai

13.Thuc tc dng trn ng h hp. 71 72 73 74 75 Terbutaline. Salbutamol. Theophyline. Terpin codein. N-acetyleysteine. 0, 3-5mg. 2-4mg. 100mg. 0, 1g+0, 015g. 100-200mg. Xiro, vin. Vin. Vin. Vin. Vin, gi.

14.Dung dch iu chnh nc in gii v cn bng acid. 76 DD glucose. Chai 250-500DD truyn. DD tim tim

1000ml. DD 577 78 DD Ringer lactat. DD Natri chlorua. 30%. Chai 250-5001000ml. Chai 9%. 15. Vitamin v cc khong cht. 79 80 81 82 83 84 85 86 87 88 89 VitaminA. Vitamin B1. Vitamin B2. Vitamin B6. Vitamin B12. Vitamin C. Vitamin E. Vitamin PP. Vitamin D2. Vitamin A+D. Vitamin C+rutin. 5000UI. 10-100mg. 5mg. 25-100mg. 500-5000mg. 50-500mg. 100-400UI. 50-500mg. 500-1000UI. 5000UI+500UI 50mg+50mg. 500-

truyn. DD tim truyn.

1000ml. DD 0,

Vin. Vin Vin. Vin. Vin. Vin, ng. Vin. Vin. Vin. Vin. Vin

16. Cc thuc dng ngoi. 90 91 Cn ASA. Cn BSI. 15ml. 15ml. L. L.

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92 93 94 95 96 97 98 99 100 101 102 103

Benzoic

acid

3-6%. 95%. 70%. 10%. 10g. 3%. 100mg. 4%. 30g. 30g. 2-12g. 2%.

Tut. Tut, l. L. L. Tut. L. L. Tut. Tut. Tut. Tut. Tut.

+Salicylicacid. Di Ethyl Phtalat(DEP). Cn. Cn Iod. Flucin-gel. Nc Oxy gi. Xanh methylen+ umgelatin. Erythromycin. Metronidasone. Meloxicam. Methylisalicylate. Promethazine.

17.Cc thuc nh mt v tra mt. 104 105 106 107 108 109 Gentamicin. Neomycin. Chloramphenicol. Tetracyclin. Argyrol. Dexamethasone. 0, 30%. 2%. 0, 40%. 1%. 1-2%. 0, 10%. L. L. L. Tut. L. L.

18.Cc thuc t dng trong sn khoa. 110 111 112 113 114 Clotrimazole. Ketoconazole. Nystatin. Griseofulvin. Povidine lodine. 19. Thuc trnh thai. 112 Evluton. 0, 5mg. Vin. 50-100ml. 200mg;2%. 250-500. 000UI 250-500mg; 5%. 200mg. Vin. Vin, kem Vin. Vi n, tut. Vin. tut,

B. So snh vi danh mc thuc thit yu do B Y t quy nh:

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Nhn chung, vi danh mc thuc thit yu do B Y t quy nh ti tuyn Y t x, phng th danh mc thuc thit yu ti Trm Y T Thu Lng vn cha y , cn thiu. Nhng i vi yu cu chung ca nhn dn th s thuc tr cc bnh thng thng tng i y p ng nhu cu s dng thuc ca nhn dn. IV. Tm hiu v nhu cu v tnh hnh cung ng thuc phc v, chm sc sc kho ti cng ng: -Qua chuyn thc t tt nghip ti Trm Y T Thu Lng cho thy rng, nhu cu v thuc ca nhn dn l rt ng k. Hu nh tt c mi ngi u c thc rng c bnh phi cha v c th phi dng thuc iu tr. V th tt c mi ngi c bnh th h li n Trm Y t. Tt c nhn dn ti Phng Thu Lng ai cng c lng tin vo Trm y t. Thuc phc v nhu cu ca nhn dn rt a dng v phong ph. Bn cnh tnh hnh cung ng thuc phc v chm sc sc kho ti cng ng ca cn b Y t Trm rt nhit tnh vi tm lng Lng y nh t mu, cn b Y t lm vic vi nhn dn rt tnh cm v thn thin, ra sc phc v chm sc sc kho cho ngi dn. Thi gian lm vic v trc lun m bo 24/24h vi mc ch phc v, chm sc sc kho cho ngi dn mi lc v lc no c th. Vi tinh thn trch nhim cao c.Cn b Trm Y t lun gip nhn dn trong vic nhn thc thc hnh cc chng trnh v sc kho cng ng. c bit vi t cch l cn b Dc, h lun ra sc hng dn cch dng, ch nhng iu hn ch cho nhn dn vi tinh thn rt thn thin v nhit tnh. Trm c 3 ngun thuc: 1. Ngun quy Pamaco: Bn thuc phc v nhn dn. 2. Ngun thuc cp pht cho cc bnh x hi. 3. Ngun thuc cp pht cho tr em di 6 tui. Ngoi ra Trm c ngun thuc t pht cp t xut cho nhng ngi gi yu.

V. Tm hiu v c cu m hnh, bnh tt ti a phng v xch nh nhu cu thuc ca mt x, phng: -Nhn chung ti cc Trm Y t x, phng c c cu m hnh bnh tt thng l cc bnh thng thng. Trm Y T Thu Lng cng nm trong phm vi ny. C cu m hnh bnh tt ch yu l cc bnh nh: +ng tiu ho nh: tiu chy, l +ng h hp nh:vim hng, ho, s mi.
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+cc bnh ngoi da nh: vim nhim, try xt, gh, nm +Cm cm, nhc u, vim nhim ng sinh dc, giun sn. . . +ngoi ra cng c mt s bnh c bit nh lao, thn kinh. -Cc bnh mc trong 6 thng u nm : Bnh
STT

Trn 5 tui. Mc 14 32 148 90 110 42 10 8 12 Cht 0 0 0 0 0 0 0 0 0

Tr em di 5 tui Mc 6 8 101 60 91 0 2 0 2 Cht 0 0 0 0 0 0 0 0 0

1 2 3 4 5 6 7 8 9

Hi chng l Cc bnh a chy. Nhim khun h hp trn cp. Vim ph qun. Vim phi. Cm. Tai nn giao thng. Tai nn lao ng. Tai nn, ng c, chn thng khc.

-V nhu cu thuc ti Trm th lng thuc bn ra ch yu l phc v cho ngi ln v tr em trn 6 tui. a s ngi dn y iu tham gia bo him nn lng thuc trm ch yu phc v cho chng trnh bo him.Ring lng thuc bn ra cho tr em di 6 tui th rt t v hin nay c chng trnh cp thuc cho tr di 6 tui, nn hu ht s tr em di 6 tui u i khm v ung thuc min ph, nhng nhu cu thuc ti Trm tng i cao do ngi dn rt tin tng Trm Y t. Trong qu trnh i thc t ti y em thy tnh hnh v nhu cu s dng thuc v cung ng thuc phc v sc kho ti cng ng Trm Y T Thu Lng l tng i tt v y . VI. Trc tip tham gia cng tc chuyn mn ca Trm nh: sp xp, bo qun, cp pht: c s cho php v hng dn, gip ca cn b Y t ti Trm, chng em ln lt tham gia tm hiu cng tc chuyn mn nh Sp xp, bo qun, cp pht v bn thuc qua chng em hiu c ngha v mc ch ca cng tc chuyn mn ny. Trong t thuc u c cc danh mc d ly trong cng tc cp pht. Thng xuyn lau chi v sp xp. Khi bn thuc phi vui v, ho nh vi ngi bnh, hng dn cch dng thuc cho ngi bnh VII. Tham gia cc hot ng ca chng trnh Y t quc gia ti a phng :

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Trong thi gian i thc t ti Trm Y t do thi gian c hn nhng chng em cng c tham gia vo mt vi cng tc nh :cp pht thuc bo him, tr em di 6 tui , v lm mt s vic ca cn b dc ti trm. Tai Trm chng em cung c To iu kin tm hiu thm v cng tc cha bnh theo phng php ng Y. Chng em c hng dn tm hiu v cch dng thuc, phi hp thuc nam ch bnh v cc phng php khc.V cng nhau tham gia trng, chm sc vn thuc nam ca trm.Vn thuc nam ca Trm Do kinh ph u t cha y nn vn cha hon thin lm nhng cn b ti trm vn c gng chm sc v t su tm, tm kim cc cy thuc c ti a phng em v trng ti trm tuyn truyn cho ngi dn bit cc cy thuc c trong dn gian phc v cho cng tc cha bnh bng thuc nam ngy cng tt hn.

****DANH MC THUC TI VN THUC NAM****

-

Mt s cy thuc ti vn thuc Nam:

-Da cn -Lc tin -Cy du -Si t -Ru mo -Cy gai -Kim ngn -C gai mo -Kim tin tho -Ta t - Cy i -Cy qut -Hng nhu ta -Hng nhu ta

Sn dy a lin d Rau sam K u nga Rau m B cng anh R qut Sm i hnh Mch mn C tranh S M

- Mung tru

IX. Thc hnh ghi chp s sch, bo co v thuc v trang thit b Y t theo quy nh: Qua thi gian thc t chng em c cn b Y t Trm hng dn ghi s sch, bo co v thuc v trang thit b Y t rt c th. Cc s sch ca Trm gm c: -S kim k quay vng vn.
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-S kim sot thuc. -S theo di thu chi. -S theo di bo co quyt ton quay vng vn. -S nhp thuc. -S xut thuc. -S cp thuc cho tr di 6 tui. -S theo di thuc hng tm thn. -S cp thuc cho cc bnh x hi. -S qun l thuc Lao tuyn x. -S kim nhp thuc ti Trm Y t. -S theo di thuc hng ngy. Ngoi ra cn c cc bo co nh: -Bo co s tn thuc mi qu. -Bo co quyt ton thnh tin. -Bo co chi ph KCB cho tr di 6 tui. -Bo co tn kho thuc hng tm thn. -Bo co s dng thuc. -Bo co tnh hnh xut, nhp thuc VTTHKCB cho tr di 6 tui. -Bo co tnh hnh s dng thuc Lao. *Mt s biu mu s sch v bo co ca Trm Y t nh sau:

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