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Ukunciphisa abatyeleli abandlongondlongo okanye abantu abakhathazekileyo kukhathalelo lwempilo kunye neenkonzo

Emergency numbers differ by country. This page uses 911, the number for the United States and Canada. Many other countries use 112, 999, or another number. Find the number for your country.

Abasebenzi bokhathalelo lwempilo, abo bamkela iikliniki, abasebenzi basekhemesti, oonontlalontle, abasebenzi bevenkile, kunye nabo babukeleyo kumagumbi okulinda esibhedlele bajongana nawona mazinga aphezulu ohlaselo emsebenzini ehlabathini. Nokuba ukuxhalaba komntu kuqhutywa kukoyika ngenxa yemeko engxamisekileyo yezonyango, i-acute metabolic delirium (efana neswekile ephantsi kakhulu okanye i-hypoxia), ukunxila, ingxaki yempilo yengqondo, okanye umsindo wokulinda ixesha elide kunye neengxabano zokuhlawula, imizuzwana yokuqala engama-90 yokuma kwakho ngokomzimba kunye nethoni yomlomo imisela ukuba ungquzulwano luyaphola okanye lube lugonyamelo. Eyona njongo yakho iphambili ayikokuba "uphumelele" ingxabano, kukwehlisa ukuvuseleleka komzimba womntu ngelixa ugcina indlela engathintelwanga ukuya kumnyango okhuselekileyo wokuphuma.

Yenza oku ngoku

  1. Soloko uzimise phakathi komntu okruqukileyo nomnyango wokuphuma wegumbi: Ungaze uvumele isigulana esinomsindo, undwendwe, okanye umthengi eme phakathi kwakho nomnyango wegumbi leemviwo, i-ofisi yokubonisana, okanye ialkove esemva kwekhawuntara. Ukuba sele beluvalile ucango, sebenzisa isingxengxezo esizolileyo ("Mandiphume ndiye edesikeni ndikujongele itshathi ngoku") ukubadlulela kwipaseji evulekileyo ngaphambi kokuba uqhubeke nencoko.
  2. Gcina ubuncinane iingalo ezi-2 ubude (i-1.5 ukuya kwi-2.5 yeemitha / 5 ukuya kwi-8 iinyawo) zomgama wokuphendula: Xa umntu efakwe i-adrenalized okanye i-pacing, imfuno yakhe yendawo yobuqu iyanda ukuya kubukhulu obuphindwe kane obuqhelekileyo. Ukusondela ukubamba igxalaba okanye ukuthetha ngokuzolileyo kuchazwa yingqondo ephazamisekile njengohlaselo lomzimba; buya umva ukuze ubanike igumbi lokuphefumla elibonakalayo kwaye ume kwi-45-degree angle kune-square-up esifubeni ukuya esifubeni.
  3. ** Gcina izandla zakho zibonakala, zivule, kwaye zikhululekile phambi kwesinqe sakho (ungaze unqumle iingalo zakho okanye ukhombe ngomnwe)**: Ungaze ufake izandla zakho epokothweni yakho, ubambe amanqindi, ubeke izandla zakho esinqeni sakho, okanye uphakamise umnwe wakho kumntu onomsindo. Bamba izandla zakho zivuleke ngeentende ezijonge phezulu zijonge phezulu ngaphantsi kwenqanaba lesifuba, imo yendalo yonke engoyikiyo ekwashiya izandla zakho kwindawo yokukhusela intloko yakho ukuba into iphosiwe.
  4. Yehlisa izwi lakho, ucothise isantya sokuthetha ngesiqingatha, kwaye ungaze uthi "Yehlisa umoya": Ukuxelela umntu onomsindo okanye owothukileyo ukuba "Yehlisa umoya" okanye "Relax" phantse isoloko ixhokonxa umsindo okhawulezileyo ngenxa yokuba iyayichitha ingxaki yabo. Endaweni yoko, yehlisa ilizwi lakho iinotshi ezimbini ezizolileyo nezicothayo kunezabo, qinisekisa iimvakalelo zabo ngaphandle kokuvuma ukuziphatha okungakhuselekanga ("Ndiyayibona indlela ekukhathaza ngayo ukulinda iiyure ezimbini ngelixa umntwana wakho esezintlungwini"), kwaye ubuze ukuba unganceda njani ukusombulula ingxaki ekhawulezileyo.
  5. Khupha kwaye uphume ngokukhawuleza ukuba ubona izikhombisi zokuhlaselwa komzimba okanye isixhobo: Ukunciphisa ngomlomo kusebenza kuphela ngelixa umntu eseva kwaye eqhuba ulwimi. Ukuba umntu ufingqe amanqindi, akhuphe ibhatyi, ajonge kuwe "ngeeyadi eziliwaka," abambe into enzima (isitulo, i-IV pole, imonitha), okanye abonise / akhankanye isixhobo, **yeka ukuthetha kwaye uhambe ngokukhawuleza uphume kwindawo ngokukhawuleza ** ungene kwigumbi elikhuselekileyo lebheji okanye ngaphandle kwesakhiwo.
  6. Qalisa isixhobo sakho sothuso esithuleyo, ikhowudi yokhuseleko, okanye utsalele umnxeba kwinombolo yakho yexesha likaxakeka: Ukuba usebenza ekliniki okanye evenkileni, cofa iqhosha eliphantsi kwedesika okanye ubhengeze ikhowudi yokhuseleko engaphezulu kweziko lakho (elifana ne "Code Grey" okanye "Dr. Strong to Triage"). Ukuba kukho isisongelo esikhawulezileyo ebomini okanye kwisixhobo, tsalela umnxeba kwinombolo yakho yexesha likaxakeka (911 eUnited States naseKhanada, 112 kwiEuropean Union, 999 eUnited Kingdom, okanye 000 eOstreliya) okanye ujonge amanani kaxakeka ulawulo.

Uvavanyo lomntu oluphazamisekileyo kunye nokuhamba kwesigqibo esikhuselekileyo

Sebenzisa lo mthi wesigqibo seklinikhi kunye nokhuseleko loluntu xa undwendwe, isigulana, okanye umthengi eqala ukuphakamisa ilizwi, isantya, okanye ukwenza izoyikiso.

flowchart TD
    Start["Isigulana esikhathazekileyo, undwendwe, okanye uMthengi oPhakamisayo ilizwi okanye iPacing"] --> WeaponCheck{"Ngaba Isixhobo Siyabonakala, Ngaba Impahla Iyatyunyuzwa, OKANYE Ngaba Amanqindi Ayaphakanyiswa?"}
    WeaponCheck -->|YES: Immediate Physical Danger| EgressNow["1. YIMA I-Verbal De-scalation Ngokukhawuleza: Phuma kwindawo, tsala ababukeleyo emva kweengcango zomlilo / iibheji ezitshixwayo, kwaye ufowunele 911 / 112 / 999"]
    WeaponCheck -->|NO: Verbal Anger, Pacing, or Demanding Behavior| ExitPosition{"Ngaba Ume Ngokukufutshane Nomnyango Wokuphuma KunoMntu Okhathazekileyo?"}
    ExitPosition -->|No: Cornered in Room or Alcove| ExcuseMove["1. MUSA ukujongana ngelixa ukwikona; yithi ngokuzolileyo: 'Mandibambe umphathi/ifayile kanye ngaphandle' kwaye ndiye emnyango kuqala"]
    ExitPosition -->|Yes: Clear Path to Open Doorway| StanceSet["1. Thatha iSimo sokuXhasa: ubude beengalo ezi-2 (iimitha ezi-2) ngasemva, umzimba uneengile ezingama-45 degrees, izandla zivulekile phambi kwesinqe."]
    ExcuseMove --> StanceSet
    StanceSet --> MedicalScreen{"Ngaba i-Acute Medical Delirium Inokuba Iqhuba Ukuphazamiseka (I-Hypoxia, Iswekile Yegazi Eliphantsi, Ukwenzakala Entloko, Istroke)?"}
    MedicalScreen -->|Yes: Sudden Confusion, Sweating, Cyanosis, or Slurred Speech| ClinicalCall["2. Biza iQela leeMpendulo zezoNyango + Ukhuseleko kunye kumgama okhuselekileyo; ungaze ujike"]
    MedicalScreen -->|No: Situational Anger, Grief, Wait Time, or Intoxication| VerbalLoop["2. Sebenzisa i-4-Step Verbal Loop: Mamela ngaphandle kokuphazamisa -> Qinisekisa imvakalelo -> Nika ukhetho olu-2 oluzolileyo -> Misela imida ecacileyo"]
    VerbalLoop --> EscalateCheck{"Ngaba ilizwi loMntu/uMzimba uyaphumla OKANYE uyaqhubeka nokunyuka?"}
    EscalateCheck -->|Relaxing: Shoulders Drop, Breathing Slows| SolveIssue["3. Yiya kwindawo ezolileyo esembi-yabucala enemigca ecacileyo kwaye usombulule ingxaki ebambekayo"]
    EscalateCheck -->|Escalating: Clenched Jaw, Pacing Faster, Threats| StepOut["3. Zikhuphe ngokukhuselekileyo: Ngena emnyango, vula ukhuseleko / impendulo yamapolisa, kwaye ukhusele igumbi lokulinda"]

Inyathelo 1: Ukuqaphela izigaba ezi-5 zefiziyoloji zomjikelo wohlaselo

Kwiikliniki zonyango, amasebe angxamisekileyo, iikhemesti, kunye needesksi zenkonzo yabathengi, ubundlobongela bunqabile ukuqhuma ukusuka kwi-zero ngaphandle kokudlula ngokulandelelana okuqikelelwayo kokunyuka kokuziphatha (okuqhelekileyo kufanekiselwa kuqeqesho lweklinikhi njenge-**Assault / Aggression Escalation Curve **). Ukuthelekisa impendulo yakho kunye nenqanaba elichanekileyo umntu akulo ngoku kukuthintela ukuba ungagaleli amafutha emlilweni ngempazamo.

Inqanaba lokunyuka Iimpawu ezibonakalayo zoMzimba kunye nezaMazwi Kwenzeka Ntoni Engqondweni Yomntu Abasebenzi abachanekileyo / impendulo yombukele
1. Isiseko / iNqanaba lokuxhalaba Ukubetha, ukubetha izandla, ukuncwina ngokuvakalayo, ukujonga ngokuphindaphindiweyo iwotshi okanye ifowuni, ukujonga kumnyango wetriage, ukubuza umbuzo ofanayo ngokuphindaphindiweyo ngelizwi eliphakamileyo, eliphakamileyo. Uloyiko, intlungu, ukungaqiniseki, okanye ukungabi nakuzinceda kuyakha; i-prefrontal cortex (ingqondo enengqondo) isasebenza, kodwa iihomoni zoxinzelelo ziyenyuka. I-Early Empathic Intervention: Bavume ngokukhawuleza ngokudibana kwamehlo kunye nohlaziyo lwexesha lekhonkrithi ("Ndiyakubona ulindile; kukho abantu ababini phambi kwakho kwaye ndiza kukujonga kwimizuzu eyi-10"). Ukungaqiniseki kubangela ixhala; ulwazi luyayikhulula.
2. Inqanaba loKhuselo / lokuNyusa ngamazwi Ilizwi liba phezulu, likhawuleze, okanye libe nempoxo; ukuhamba ngasemva naphambili phambi kwedesika; ubuso obupholileyo; ukuthuka "inkqubo"; ukwala ukuhlala phantsi; efuna ukubonana nomphathi okanye ugqirha ngokukhawuleza. I-amygdala (iziko le-alam "lokulwa-okanye-lokubhabha") liye laphanga ingqondo, likhukula igazi nge-adrenaline kunye ne-cortisol. Umntu uziva engahlonelwa, engaviwa, okanye evalelwe. I-Active Verbal De-Escalation: Buyela umva ngeemitha ezi-2 (iinyawo ezi-6), ujike umzimba wakho ube zii-degrees ezingama-45, yehlisa ilizwi lakho, qinisekisa ukuphoxeka kwabo ngaphandle kwezibakala eziphikisanayo, kwaye unikeze iindlela ezimbini zokukhetha ezixhobisayo ("Ngaba ungathanda ukuhlala apha namanzi, okanye utsibele kwifestile ezolileyo ngelixa ndikhuphela umongikazi ohlawulayo?").
3. Uhlaselo lwangaphambili / iSigaba seSilumkiso seNgxaki ekufuphi Ukutshintsha ngesiquphe ukusuka kwingxolo engxolayo ukuya ekujongeni okothusayo okanye okusisigxina ("ukukhangela kwiwaka leyadi"); idyasi yokulahla, umnqwazi, okanye ubhaka; amanqindi aqhinayo nangawacolisiyo; ukudumba isifuba; ukuxhuzula kwemisipha yomhlathi; ukungena kwindawo yakho yemitha e-1 (iinyawo ezi-3); ukuskena ikhawuntara kwizinto ezilahlwayo. Ukulahlwa kwe-Adrenaline kugqityiwe: Umntu uyekile ukuzama ukunxibelelana ngomlomo kwaye ngokomzimba ulungiselela ukubetha okanye ukutyumza into. YEKA uThethathethwano Ngomlomo kwaye udale umgama: Musa ukumisela imithetho engqongqo okanye uphikise ngoku. Thatha amanyathelo amathathu okuzola ubuyela umva ngomnyango wokuphuma okanye emva komqobo obonakalayo, yenza i-alarm yakho ethe cwaka, kwaye uxelele abantu osebenza nabo ukuba bacoce abo babukeleyo.
4. ISigaba sokuSebenza / sokuNdloba ngokwaseMzimbeni Ukujula iibhodi eziqhotyoshwayo, iimonitha, okanye izitulo; ukubethelela imiqobo ye-plexiglass; imiphunga, ukutshica, ukubamba impahla, okanye ukukhupha isixhobo. Ukulahlekelwa ngokupheleleyo kolawulo lokuziphatha. **I-Egress kunye ne-Physical Barrier Isolation **: Phuma kwigumbi kunye nendawo yokulinda ngokukhawuleza, tshixa iingcango ezilawulwa ngebheji phakathi komhlaseli kunye nezigulane / abasebenzi, kwaye ufowunele ukhuseleko kunye namapolisa (911 / 112 / 999). Ungaze uzame ukuzibamba wedwa ngaphandle kokuba uqeqeshwe kwiqela lezonyango kwaye ubomi bomntu busengozini kwangoko.
5. Ukunciphisa iTension / Ukwehla emva kweNgxaki Ukuwa kwamandla; ukulila, ukungcangcazela, ukucela uxolo, okanye ukuwela esitulweni udinwe udiniwe njengoko iadrenaline iphela (nangona ukugqabhuka okwesibini kunokuvuswa ngokulula ukuba uyangxoliswa). Ukubetha kwentliziyo kunye noxinzelelo lwegazi luyehla; ihlazo, ukoyika ukubanjwa, okanye ukubhideka kuqala. Gcina Umgama oKhuselekileyo kwaye Uphephe ukufundisa: Gcina isithinteli sakho seemitha ezi-2 (ezi-6-fithi), thetha ngokuzolileyo, ungabafundisi okanye ubangxolise ngokugqabhuka kwabo ngoku (oku kutshisa kwakhona iNqanaba lesi-3), kwaye uvumele ukhuseleko okanye abezonyango bagqibezele isandla esikhuselekileyo.

Inyathelo lesi-2: Iiflegi ezibomvu zezonyango (Xa "ugonyamelo" luyimeko engxamisekileyo yonyango ebeka ubomi esichengeni)

Esibhedlele, iklinikhi yokhathalelo olungxamisekileyo, iofisi yamazinyo, i-ambulensi bay, okanye indawo kawonke-wonke, kukho ulwahlulo olubalulekileyo lweklinikhi phakathi **kokuziphatha/umsindo wemeko ** kunye ne-acute organic delirium. Iimeko ezingxamisekileyo zonyango ezibeka ubomi esichengeni zilambisa ingqondo yomntu yeoksijini okanye iswekile, nto leyo ebangela ukuba umntu oqhelekileyo, othobekileyo abe nomsindo ngequbuliso, axakeke, abhule, aze axhaphaze.

Phambi kokuba ucinge ukuba isigulana esikhathazekileyo okanye umntu obukeleyo "uyinto nje ebhudayo" okanye enxilile, skena ngokubonakalayo kumgama okhuselekileyo oziimitha ezi-2 (iinyawo ezi-6) ukwenzela AEIOU-TIPS zonyango ezibangela idelirium:

  • I-Hypoglycemia (Iswekile yegazi ephantsi kakhulu): Enye yezona zinto zixhaphakileyo zokulinganisa umsindo wokunxila. Xa umntu onesifo seswekile uneswekile yeswekile yegazi ngaphantsi kwe \(3.0\text{mmol/L} (54\text{ mg/dL})\), ingqondo ibangela uqhaqho olukhulu lweadrenaline ukunyanzela isibindi ukuba sikhuphe iswekile. Umntu ubonakala ebile kakhulu, ephaphatheka, engcangcazela, ebhidekile, kwaye esilwa ngokumasikizi okanye engenangqiqo. Khangela i-bracelet ye-alert bracelet okanye impompo ye-insulin, kwaye ukuba ikhuselekile kwaye umntu unokuginya, ukunika indebe yejusi yeziqhamo okanye i-glucose gel inokusombulula "ubundlongondlongo" kwimizuzu emi-5. Bona wethu iimeko ezingxamisekileyo zesifo seswekile isikhokelo.
  • Acute Hypoxia (Ukunqongophala kweOxygen eBuchotsheni): Isigulana esineoksijini esegazini yehla ngokukhawuleza (isuka kuhlaselo oluqatha lwesifuba, i-pulmonary embolism, inyumoniya, ityhefu yecarbon monoxide, okanye ukusilela kwentliziyo) siziva ngathi sifuthaniselwa phantsi kwamanzi. Izigulana ezine-Hypoxic zihlala zikrazula iimaski zeoksijini, zizame ukunyuka ebhedini, kwaye zijiwule kuye nabani na omi phezu kwazo ngenxa yokuba ingqondo yabo elambileyo ioksijini ikwimeko yokoyika ukusinda. Jonga imilebe eblu luhlaza okanye iinzipho (cyanosis), ukuphefumla okunganzulwanga, okanye ukugqabhuka kweempumlo.
  • ** I-Head Trauma (i-Intracranial Bleeding / Concussion) okanye i-Post-Ictal Seizure State **: Umntu osandul 'kuwa, wayekwingozi yemoto, okanye nje waba ne-tonic-clonic seizure ngokubanzi ehlala evuka kwi- ** post-ictal confusional state ** apho abaqapheli i-paramedics okanye abongikazi kunye nokulwa nobundlobongela babo nabani na. Ungaze ubambe isigulana se-post-ictal phantsi; banike indawo, bathethele phantsi, kwaye bakhusele intloko yabo ekubetheni iindonga eziqinileyo ngelixa ingqondo yabo iqala kwakhona kwi-10 ukuya kwimizuzu engama-20. Bona wethu ukuxhuzula kwaye ukwenzakala entloko izikhokelo.
  • I-Encephalitis, i-Sepsis, i-Heat Stroke, okanye i-Acute Drug/Alcohol Withdrawal (i-Delirium Tremens): Ubushushu bomzimba obuphezulu, usulelo lwenkqubo kubantu abadala, okanye ukurhoxa ngesiquphe etywaleni okanye kwizithomalalisi kubangela ukubonwa okucacileyo kunye noloyiko.

Warning

Nangona ukulwa komntu kubangelwa yishukela ephantsi yegazi, i-hypoxia, i-dementia, okanye ukwenzakala entloko, oku kuthetha ukuba banenjongo ekhohlakeleyo, ** i-punch, i-kick, okanye isitulo esiphoswe kwisigulana esibuhlungu sophula amathambo kanye njengokuba umntu ovela kumhlaseli wolwaphulo-mthetho **. Ungaze uncame umgama oziimitha ezi-2 (iinyawo ezi-6) okanye uzivumele ukuba ubekwe ekoneni kwigumbi lovavanyo ngenxa yokuba umntu egula; biza i-backup yeklinikhi kunye nokhuseleko ngaphambi kokuba usondele.

Inyathelo lesi-3: Ukuma ngokwasemzimbeni, ulawulo lokusingqongileyo, kunye ne "Supportive Stance"

Ngaphezulu kwe-70 pesenti yombono woloyiko lwabantu ngexesha lentlekele ayithethi. Xa ingqondo yomntu izele yiadrenaline, akakwazi ukwenza izivakalisi ezintsonkothileyo, kodwa amehlo akhe afunda ngoko nangoko ukuma kwakho, indawo omi kuyo isandla, kunye nomgama.

1. Imithetho emi-4 yokumiswa komzimba okungasongeli

  1. Umthetho wokuPhuma kuNxantathu wokuQala: Ungaze ungene kwigumbi leemviwo, icubicle yokubonisana, okanye igumbi lokulala lesigulana kwaye uvumele undwendwe ukuba lume kufutshane nomnyango kunawe. Yima ngaphakathi kwemitha e-1 (iinyawo ezi-3) zomnyango ovulekileyo nocango luvulekile ngokupheleleyo (ungaze uvumele isivalo socango sivaleke emva kwakho xa kukho umntu ophazamisekileyo).
  2. Ubude beengalo ezimbini zomgama (iimitha ezi-1.8 ukuya kwi-2.4 / 6 ukuya kwi-8 iinyawo): Hlala umva ngokwaneleyo ukuba umntu uthe ngequbuliso waphamba okanye wajiwuzisa ngenqindi okanye ibhegi yesandla, kufuneka athathe inyathelo elinye elipheleleyo phambi kokuba afike kuwe, enika ingqondo yakho imizuzwana eyi-0.5 yexesha lokusabela elifunekayo ukuze uphume ngomnyango.
  3. I-45-Degree "iNqanaba / iSimo esixhasayo":
  4. Ukuma ngokulinganayo esifubeni ukuya esifubeni (0 degrees) kunye neenyawo zakho ezinxuseneyo kukhangeleka ngathi ngumceli mngeni ongena kwiringi yamanqindi, kwaye kukushiya ukwi-balance xa utyhiliwe.
  5. Endaweni yoko, jika i-torso kunye neenyawo zakho kwi-*-45-degree angle ** emntwini, kunye nonyawo lwakho lwangasemva lubuyele umva kancinci. Oku kujongeka kungenakuphikisana kwaye kunentlonipho, ikhusela amalungu akho asembindini, kwaye ikuvumela ukuba ujikeleze kwaye uphume ngomnyango ngoko nangoko ngaphandle kokukhubeka ezinyaweni zakho.
  6. Vula Izandla "kwiNdawo yoKhuseleko oluNgephakathi": Beka izandla zakho ngokukhululekileyo phambi kwesifuba sakho esisezantsi okanye esinqeni neentende ezivulekileyo. Ungaze ufihle izandla zakho ngasemva okanye kwiipokotho zangaphakathi (umntu okhathazekileyo okanye ophambanayo unokoyika ukuba ubambe isirinji, isitshizi sepepile, okanye isixhobo), kwaye ungaze usonge iingalo zakho esifubeni sakho (efundeka njengokubandayo, ukwala okugunyazisiweyo).

2. Ukucoca izixhobo zendawo yokusebenza kunye neengozi zokukrwitshwa

Jonga kufutshane nedesika yakho ekufutshane, i-triage bay, okanye igumbi leemviwo ngoku kwaye ushenxise izinto zemihla ngemihla ezithi zibe zizixhobo okanye ii-ligatures ngexesha logqabhuko-dubulo:

  • Ungaze unxibe i-stethoscope egqunywe entanyeni yakho okanye intambo engaqhawukiyo/iqhina lomqala: Esibhedlele okanye ekliniki, isitethoskopu esijikelezwe ngasemva kwentamo yakho okanye intambo ye-ID yenayiloni eqhelekileyo sisiphatho sokukrwitsha ngoko nangoko esivumela isigulana esiphazamisekileyo ukuba sitsale intloko yakho phantsi kugwayimbo. Nxiba i-stethoscope yakho ngaphakathi kwepokotho yedyasi okanye isiholi esinqenqemeni, unamathisele ibheji yesazisi sakho kwikhola/epokothweni yakho, okanye sebenzisa kuphela amanqaku ama-3 agqabhukileyo amalanya agqabhuka phakathi kweekhilogram ezi-2 (iikhilogram ezi-5) zokutsalwa.
  • Sula ikhawuntara yeeprojekti ezinzima okanye ezibukhali: Musa ukushiya iistaplers zentsimbi ezinzima, iivazi zeentyatyambo zeglasi, iibhodi eziqhotyoshwayo zetshati yentsimbi, izikere, iimagi zekofu ezenziwe ngeceramic, okanye izikhongozeli zeenaliti ezibukhali ezihlala ngaphambili kwikhawuntara yolwamkelo apho undwendwe olunomsindo lunokutshayela okanye luziphose ebusweni bakho.
  • Gcina isithethi esizolileyo sibe sinye kuphela sithetha (“Umthetho Owodwa”): Ukuba abasebenzi abathathu okanye oonogada bangqonge umntu ophazamisekileyo baze bobathathu baqalise ukukhwaza imiyalelo eyahlukileyo ngaxeshanye (“Hlala phantsi” / “Buyisa umva” / “Zola”), ingqondo yomntu ezaliswe ngokugqithiseleyo iya kuphakuzela ize igqabhuke. Chonga umntu omnye (oyena mntu unobudlelwane obuhle) ukuba enze i-100 lepesenti yokuthetha ngelizwi elizolileyo ngelixa abanye abasebenzi behlala bethe cwaka kwaye bebukele umjikelezo.

Inyathelo lesi-4: Izikripthi ezichanekileyo zokususwa kwe-escalation (Into omawuyithethe kwaye ungaze uyithethe)

Xa undwendwe olunomsindo okanye isigulana sikukhwaza, ithuku lakho lendalo kukuzikhusela, ukucaphula umgaqo-nkqubo wesibhedlele/wenkampani, okanye ulungise iinyani zabo. Ukuchasa umnqweno wokuphikisa iinyani kwimizuzu emibini yokuqala yimfihlelo yokwehla kwamazwi. Kufuneka uzolise ingqondo yeemvakalelo (amygdala) phambi kokuba ingqondo ebambekayo (i-prefrontal cortex) ive imithetho okanye iingcaciso.

Amabinzana anetyhefu anyusa ubundlobongela ngokuchasene nokhuseleko lokunyuka kwescript

Ungaze Uthethe Oku (Escalation Triggers) Isizathu Sokuba Isilele Thetha Oku Endaweni
"Yehlisa umoya." / "Kufuneka uphumle ngoku." Uxelela umntu ukuba ukubandezeleka kwakhe akusebenzi kwaye akhuphe umyalelo othe ngqo, phantse amqinisekise ukuba uya kukhwaza esithi "UNGATHI NDIZOHLE" kwaye banyukele kwiNqanaba lesi-3. "Ndiyakuva indlela okhathazeke ngayo/udanile ngayo ngoku. Masikhe siphefumle sobabini ukuze undixelele kakuhle ukuba kwenzeke ntoni ndikuncede."
"Yipolisi yethu leyo, akhonto ndingayenza." Yenza umntu azive engenamandla ngokupheleleyo kwaye evaleleke eludongeni olungakhathaliyo, eshiya ukoyikiswa njengesixhobo esibonwayo kuphela. "Nantsi into endinokukwenzela yona ngoku: Ndingaya kuthetha ngqo nonesi ohlawulayo, okanye ndingakufunela igqwetha lesigulana emnxebeni ngemizuzu emibini. Ungathanda yeyiphi?"
*"Ukuba awuyeki ukungxola, ndibiza isecurity ukuba ikukhuphele ngaphandle." Ukukhupha isiphelo okanye isoyikiso kucel’ umngeni ukuzingca komntu phambi kwababukeli, kubanyanzele ukuba “basindise ubuso” ngokuhlasela ngaphambi kokuba ukhuseleko lufike. *"Inene ndifuna ukuyilungisa lento kumamakho, kwaye kunzima kum ukuva zonke iinkcukacha xa uphakamisile ilizwi lakho. Ukuba sinokuthothisa amazwi ethu, ndingaluthoba ngoku olu lwazi."
*"Uyaphosisa, ulinde imizuzu engama-45 kuphela, hayi iiyure ezimbini." Ukuxoxa ngeenkcukacha ezingenamsebenzi xa umntu esoyika okanye esentlungwini ijika incoko ibe yidabi lokulawula. "Ukulinda ndisezintlungwini xa ungazi ukuba kwenzekani akunasiphelo. Mandijonge i-tracking board kwangoku ndikunike uhlaziyo oluchanekileyo."
"Ndiyayazi kakuhle indlela oziva ngayo." Izandi ezingento zanto kwaye zinceda umntu okwingxaki enkulu yezonyango okanye intlekele yobuqu. *"Andiyicingi indlela olunzima ngayo usuku olunje namhlanje kwintsapho yakho. Ndixelele eyona nto ikuxhalabisayo ngalo mzuzwana."

Inyathelo lesi-4 elithi "LEAP" kwilophu yokususa ukwehla kwamazwi

Xa uthetha nomntu okhathazekileyo kwindawo ekhuselekileyo yomnyango oziimitha ezi-2 (iinyawo ezi-6), jikela kula manyathelo mane ngelizwi elicothayo, eliphantsi, nkqu:

  1. L, Mamela ngenkuthalo imizuzwana engama-30 ukuya kuma-45 ngaphandle kokuphazamisa: Bavumele bakhuphe umsindo wabo kwimiphunga yabo (ukuba nje bengasondeli kuwe ngokwasemzimbeni). Gxininisa kancinci ukubonisa ukuba uhoyile. Uninzi lwabantu abanomsindo balindele ukuba ubanqumle emva kwemizuzwana emi-5; xa ubavumela bagqibe isivakalisi sabo bethule, ngokwemvelo baphelelwa ngumphunga kwaye kufuneka banqumame ukuze baphefumle.
  2. E, Yiba novelwano ngeemvakalelo (kungekhona ukuziphatha kakubi): Hlaziya iimvakalelo ezisisiseko eziqhuba ukugqabhuka kwabo, ngokuqhelekileyo uloyiko, ukungakwazi ukuzinceda, intlungu, okanye ukungabi nantlonipho.
  3. Script: *"Uyoyika nyani ngoba utatakho iyure yonke esemva akhomntu uphumileyo uzokuxelela ukuba uyaphila.
  4. A, Buza imibuzo ecacileyo yokucacisa okanye unikeze ukhetho olu-2 olulula: Ukubuza umbuzo okanye ukunika ukhetho kunyanzela ingqondo yomntu ukuba itshintshe ukusuka kwimvakalelo amygdala ibuyele kuhlalutyo i-prefrontal cortex.
  5. Script: "Ukuze uqiniseke ukuba ndikufumanela umntu okulungeleyo apha kuwe, utheni kuwe lo wetriage nurse xa kuqala ukungena utatakho?" OKANYE "Ungakhetha ukuhlala kwezi zitulo zithuleyo zisecaleni kwe-water cooler ndijonge, okanye ulinde kwalapha ngasefestileni?"
  6. ** P, Umlingane kwaye ubeke imilinganiselo yokuziphatha ethobekileyo, ehloniphekileyo **: Xa ubadinga ukuba bayeke ukuthuka, ukubuya umva kwidesika, okanye ukubeka into phantsi, isakhelo isicelo malunga ne-*indlela ebanceda ngayo ukuba bafumane oko bafuna **, kunokuba njengomyalelo ogunyazisiweyo.
  7. Script: *"Mnumzana Davis, ndisecaleni lakho kwaye ndifuna ukugcwalisa i-prescription yakho ngoku. Ndicela ubuye umva kwi-counter window ukuze ndizive ndikhuselekile xa ndigqibezela iodolo yakho kunye nosokhemesti wam."

Inyathelo lesi-5: Ukwehla ngexesha lotyelelo lwezempilo ekhaya, unontlalontle ohambahambayo, kunye neshifti yokwamkela umntu yedwa

Ngelixa isebe elikhulu lesibhedlele likaxakeka linamagosa okhuseleko anxibe iyunifomu kunye neengcango zomlilo ezivaliweyo kwiimitha ezili-10 (iinyawo ezingama-33) kude, abongikazi bokhathalelo lwempilo yasekhaya, abanyangi bomzimba, oonontlalontle, kunye nabamkeli bebodwa kwiikliniki zamazinyo ezincinci okanye zezilwanyana bahlala besebenza ngaphandle kokhuseleko lwendawo. Sebenzisa ezi prothokholi zikhethekileyo xa usebenza kwikhaya lesigulana okanye kwiofisi encinci ezimeleyo:

1. Impilo yasekhaya, ihospice, kunye notyelelo loonontlalontle kwindawo yokuhlala

  • Paka esitratweni okanye uphume umva kwindlela yokungena (ungaze uvalwe): Ungaze uyitsale imoto yakho yonke indlela emxinwa yendlela enye apho imoto yelungu losapho inokutsalela emva kwakho kwaye ivale ukuphuma kwakho. Paka esitratweni ujonge kwicala lendlela yokusuka izitshixo zemoto yakho zikrwelelwe esinqeni sakho okanye ngaphakathi kwipokotho yakho yangaphambili (awuzange ungcwatywe ngaphakathi kwengxowa yezonyango enzima ekunokufuneka uyishiye).
  • Yenza i-10 yemizuzwana yeveranda kunye nesango lokungena phambi kokuba ungene ngaphakathi: Mamela kucango lwangaphambili phambi kokuba unkqonkqoze izandi zokukhwaza, zokuqhekeza, okanye izinja ezindlongondlongo. Xa ungena, qaphela indlela i-adadbolt yangaphambili ivula ngayo ngaphakathi (umzekelo, qinisekisa ukuba ayifuni isitshixo se-cylinder ephindwe kabini ukuvula ngaphakathi), cela ukuba naziphi izilwanyana ezinkulu okanye eziphazamisekileyo zigcinwe kwigumbi lokulala elivaliweyo ngaphambi kokuba uvule ikiti yakho, kwaye uhlale uhlala kwindawo yokutyela eqinile okanye isihlalo segumbi lokuhlala esinomgca othe ngqo, ongathintekiyo ukuya kumnyango onzulu, umgcini wosapho onomsindo ophakathi okanye umgcini wentsapho onomsindo. phakathi kwakho nepaseji).
  • Sebenzisa umbhalo wokuphuma othi "Isixhobo Esilityelweyo Esiqwini": Ukuba isigulana okanye ilungu losapho ngaphakathi ekhaya lithuka, linxilile, okanye ligrogrise, ungaze ubhengeze "Ndiyaluphelisa olu tyelelo ngenxa yokuba uyandoyikisa." Endaweni yoko, jonga phantsi kwibhegi yakho yezonyango, phatha iipokotho zakho, kwaye uthi nje kancinci kwithemometha, thatha iqondo lobushushu ekunene: "Oh umqolo wemoto yam, hlala apho, ndiza kubuya emva kwemizuzwana engama-30." Hamba uzolile uphume ngomnyango wangaphambili ushiya ibhodi eqhotyoshwayo yexabiso eliphantsi ngasemva ukuba kuyimfuneko, ngena ngqo emotweni yakho etshixiweyo, qhuba ibhloko ezintathu, kwaye ufowunele umphathi we-arhente yakho kunye no-911 / 112 / 999.

2. Abantu abazamkela iidesika eyedwa kunye nabasebenzi abancinci bekliniki

  • ** Inkqubo yangaphambili ibinzana lekhowudi ethuleyo kunye nabasebenzi abasebenza emva kwe-ofisi **: Kwiofisi encinci yezonyango, yamazinyo, okanye yenkonzo ngaphandle konogada ozinikeleyo, misela ibinzana lekhowudi yomlomo engathathi hlangothi ebonisa abasebenzi base-ofisini ukuba bafowunele 911 / 112 / 999 okanye bahambe baye kwidesika engaphambili ngokukhawuleza, umzekelo: *"Ngaba umntu unokukhangela indawo yokugcina ngasemva kwifolda yeMiller?
  • Gcina ucango lwe counter counter luvaliwe ngalo lonke ixesha: Ungaze uwushiye ucango lwamaDatshi olujingayo olukwisiqingatha sobude okanye ucango lwepaseji ecaleni kwefestile yolwamkelo ungaqhathwanga. Ucango oluluqilima olutshixwayo phakathi kwendawo yokulinda yoluntu kunye nepaseji yonyango yangaphakathi ithintela undwendwe olunomsindo ukuba lungahambi emva kwedesika kwaye ikunika indawo ekhuselekileyo ngoko nangoko yokubuyela kuyo.

Xa ukususwa kwe-escalation kusilela: Ukukhutshwa okukhuselekileyo kunye noluhlu lokujonga ukhuseleko lomntu obukeleyo

I-Verbal de-escalation sisixhobo esinamandla, kodwa **ayinakuze i-100 iphumelele ipesenti **, ngakumbi xa umntu ephantsi kweempembelelo zeziyobisi ezikhuthazayo (ezifana ne-methamphetamine okanye i-phencyclidine / PCP), ujongene ne-psychosis enzima, okanye uzinikele kubundlobongela. Landela olu luhlu lungqongqo lokungathotyelwa kwemida yokhuseleko olukhawulezileyo iyawelwa:

  • Themba ithumbu lakho ("Isipho Soloyiko") ngokukhawuleza: Ukuba iinwele ezisemva kwentamo yakho ziphakama okanye uziva uloyiko olungachazwanga xa uthetha nomntu, yeka ukuzikhathaza ngokujonga "krwada" okanye "ongenamsebenzi". Imeko yentlalo ehloniphekileyo ifumana ukhathalelo lwezempilo kunye nabasebenzi benkonzo benzakala; zixolele kwaye ungene kucango lwebheji etshixwayo kwangoko.
  • Ungaze umjike umva umntu okhathazekileyo ngelixa ubuya umva: Hamba umva okanye ecaleni nge-engile ye-45-degree ngelixa ubeke amehlo akho ezandleni nasemagxeni abo de uphume ngokupheleleyo emnyango kwaye uvale/ubambe ucango phakathi kwakho.
  • Khusela ezinye izigulana, abantwana, kunye nababukele kwigumbi lokulinda: Ukuba umntu uqalisa ukutyumza izinto okanye ukujula izitulo kwigumbi lokulinda okanye kwigumbi lokulinda, ngokuzolileyo nangokungqongqo uqondise abantu abakufutshane ukuba baphume kwindlela yesibini yokuphuma (*"Wonke umntu ndilandele ngoku ngomnyango wepaseji"), kwaye ubethe ukukhutshwa kocango lwemagnethi ukwahlula igumbi lokulinda kwiipaseji zekliniki.
  • Sibhale ngesehlo ngokucokisekileyo uze ucele ukudibana kwezonyango/zokhuseleko emva koko: Nje ukuba amapolisa okanye abokhuseleko besibhedlele bayisombulule imeko kaxakeka, bhala ingxelo yesiganeko esinenjongo echaza ngokuthe ngqo izinto ezibangele, izoyikiso zomlomo ezenziweyo, kunye namanyathelo athathiweyo, kwaye ugqirha axilonge nawuphi na umsebenzi otshiceweyo, owoyikiweyo, okanye ubethiwe. (Ukuba ulwelo lomzimba lunxibelelane namehlo okanye ulusu olwaphukileyo, bona wethu intonga yenaliti kunye ne-pathogen enegazi le-PEP Isikhokelo sokuhlamba kwangoko kunye ne-post-exposure prophylaxis.)

Tip

Ukuba usebenza kukhathalelo lwempilo, imfundo, iinkonzo zentlalontle, okanye ukwamkela iindwendwe, yongeza ikhosi yoncedo lokuqala oluvunyiweyo lwe-Red Cross okanye i-St John Ambulance kunye nenkqubo esemthethweni yokunciphisa indawo yokusebenza (njengeCrisis Prevention Institute CPI Nonviolent Crisis Intervention, TEAM, okanye i-OSHA yoqeqesho lokuthintela ubundlobongela emsebenzini).

Imibuzo edla ngokubuzwa

Why should you never tell an angry or agitated person to "calm down" during an emergency?

When a person is in an acute state of fear, grief, or rage, their brain is flooded with adrenaline and they feel unheard or helpless. Telling them to "calm down" or "relax" is perceived as a dismissive command that invalidates their crisis and challenges their autonomy, which almost always causes them to shout louder to prove how serious their problem is; instead, lower your own voice, keep two arm's lengths of distance, and validate their emotion by saying, "I can see how frustrating and scary this situation is, tell me how I can help."

Where is the safest place to stand when speaking with an agitated patient, visitor, or customer?

Always position yourself closer to the room's exit door than the agitated person so you can never be trapped or cornered inside an exam room, office, or behind a counter. Stand at least two full arm's lengths (1.5 to 2.5 meters or 5 to 8 feet) back to give them personal space and give yourself reaction time, turn your body at a non-confrontational 45-degree angle rather than squared up chest-to-chest, and keep your hands open and visible in front of your waist.

What medical emergencies can make a normal person suddenly act violent or combative?

Several life-threatening medical conditions starve the brain of sugar or oxygen and cause acute organic delirium that looks identical to drunken rage or hostility. The most common culprits are severe hypoglycemia (low blood sugar in diabetics), acute hypoxia (dangerously low blood oxygen from asthma, heart failure, or lung clots), head injuries with brain bleeding, the post-ictal confusion phase right after a seizure, and severe infections (sepsis) in older adults; always check from a safe distance for profuse sweating, bluish lips, medical alert bracelets, or sudden slurred speech.

How can you tell when verbal de-escalation is no longer working and a physical attack is imminent?

Watch for the transition from loud verbal venting to physical pre-attack indicators: if the person suddenly stops talking and stares right through you ("thousand-yard stare"), clenches their fists, tightens their jaw, takes off their jacket or backpack, steps repeatedly inside your 1.5-meter (5-foot) safety buffer after being asked to step back, or scans the counter for heavy objects to throw, verbal negotiation has failed. Stop talking immediately, step backward through a locked exit door without turning your back, and call security or 911 / 112 / 999.

Imithombo ijongiwe

  • UKhuseleko lwezeMisebenzi kunye noLawulo lwezeMpilo (OSHA, eUnited States): *Izikhokelo zokuThintela uBundlobongela eMsebenzini kuNonophelo lwezeMpilo kunye nabaSebenzi beNkonzo yeNtlalo (OSHA 3148) *.
  • Iziko leSizwe leMpilo kunye neNkathalelo yokuGqwesa (i-NICE) kunye neNkonzo yeSizwe yezeMpilo (i-NHS, e-United Kingdom): * Ubundlobongela kunye noBundlobongela: Ulawulo lwexesha elifutshane kwiMpilo yengqondo, iMpilo kunye neZilungiselelo zoLuntu (NG10) *.
  • Umbutho waseMelika we-Emergency Psychiatry (AAEP): * I-BETA yeProjekthi (iZenzo ezigqwesileyo zoVavanyo kunye noNyango loNyango): Ingxelo yeMvumelwano kwi-Verbal De-Escalation ye-Agitated Patient *.
  • UMbutho wezeMpilo weHlabathi (i-WHO) kunye noMbutho waBasebenzi baMazwe ngaMazwe (ILO): Izikhokelo zeNkqubo-sikhokelo yokuJongana noBundlobongela baseMsebenzini kwiCandelo lezeMpilo.
  • I-Crisis Prevention Institute (CPI) kunye neKomishoni eHlangeneyo (eUnited States): Ii-Support Stance Mechanics, i-Assault Escalation Curve, kunye ne-Sentinel Event Alert kwi-Physical and Verbal Violence against Health Care Workers.

Izikhokelo ezinxulumeneyo