Таллиннские роддома экономят на эпидуральной анестезии. Миф или правда?



Роды редко проходят безболезненно, однако, если боль становится невыносимой, роженице могут предложить обезболивающие средства. Обезболивающие препараты применяют в том случае, если схватки идут слишком часто или порог болевой чувствительности у роженицы слишком низкий, и она испытывает очень сильные боли.

Самой действенной и безопасной на сегодняшний день является эпидуральная анестезия. При этом анестезирующий укол делают в поясницу, тем самым, блокируя нервы нижней части тела. Боль проходит, но ясность сознания сохраняется.

spinalnaya-anesteziya-pri-kesarevom-sechenii1

Проводить эту процедуру может только врач-анестезиолог, так как необходимо очень точно рассчитать дозу препарата, чтобы действие анальгетика прекратилось к потугам, иначе возможно замедление родовой деятельности и увеличение риска эпизиотомии. Поэтому эпидуральная анестезия может быть не в каждом родильном доме. Что касается Таллинна, то и в Центральном и в Пельгулинна роддомах применяют эпидуральную анестезию.

В последнее время на различных местных форумах роженицы все чаще стали жаловаться на то, что в наших роддомах им было отказано в обезболивающим средстве, не смотря на то, что они испытывали очень сильные боли. Врачи не хотят делать эпидуральную анестезию и ставить капельницы с гормонами, если нет прогресса в родовой деятельности. Многие высказали предположение, что скорее всего, таким образом роддома пытаются экономить, так как процедура эта довольно дорогая.

Мы связались с роддомом Пельгулинна и решили выяснить так ли это на самом деле? И по какой причине роженицам порой отказывают в эпидуральной анестезии?

«Для каждого медикаментозного вмешательства в родовую деятельность есть строгие правила и предписания, в рамках которых мед персонал принимает решения на родах. Например эпидуральную анестезию можно ставить когда соблюдены 2 условия:

- хорошая родовая деятельность (схватки с определенной частотой и силой) и

- раскрытие минимум 3 сантиметра.

Если например нет хорошей родовой деятельности тогда эпидуральная анестезия может ослабить ее совсем. Мы не знаем, что конкретно происходило в каждом случае о котором пишут роженицы, каждые роды надо рассматривать отдельно и внимательно.

Утверждение о том что «дорого очень, экономят все больницы» очень далеко от правды, поскольку всех застрахованных пациентов и все процедуры связанные с родами Haigekassa больнице оплачивает (за каждую процедуру больница выставляет Haigekassa счет). Поэтому следуя логике, больнице было бы выгоднее ставить как можно больше эпидуралок. К счастью, все наши врачи действуют в рамках медицинских предписаний и руководствуются ими и интересами пациента, а не выгодой!»

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  85. If you’re still on the fence: grab your favorite earphones, head down to a Best Buy and ask to plug them into a Zune then an iPod and see which one sounds better to you, and which interface makes you smile more. Then you’ll know which is right for you.

  86. This is getting a bit more subjective, but I much prefer the Zune Marketplace. The interface is colorful, has more flair, and some cool features like ‘Mixview’ that let you quickly see related albums, songs, or other users related to what you’re listening to. Clicking on one of those will center on that item, and another set of «neighbors» will come into view, allowing you to navigate around exploring by similar artists, songs, or users. Speaking of users, the Zune «Social» is also great fun, letting you find others with shared tastes and becoming friends with them. You then can listen to a playlist created based on an amalgamation of what all your friends are listening to, which is also enjoyable. Those concerned with privacy will be relieved to know you can prevent the public from seeing your personal listening habits if you so choose.

  87. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

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  90. Hands down, Apple’s app store wins by a mile. It’s a huge selection of all sorts of apps vs a rather sad selection of a handful for Zune. Microsoft has plans, especially in the realm of games, but I’m not sure I’d want to bet on the future if this aspect is important to you. The iPod is a much better choice in that case.

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  102. The new Zune browser is surprisingly good, but not as good as the iPod’s. It works well, but isn’t as fast as Safari, and has a clunkier interface. If you occasionally plan on using the web browser that’s not an issue, but if you’re planning to browse the web alot from your PMP then the iPod’s larger screen and better browser may be important.

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