Nemocnice České Budějovice - Gynekologicko-porodnické oddělení
Na oddělení jsou vyšetřovány, léčeny a eventuelně hospitalizovány ženy od 15 let. Mladší pacientky jsou vyšetřovány konziliárně ve specializované ambulanci, přičemž další léčba je realizována buďto prostřednictvím našeho oddělení, nebo na spolupracujících specializovaných pracovištích. Ve své ambulantní části poskytuje oddělení služby gynekologické ambulance s nepřetržitým provozem a dále specializovaných ambulancí – krajské indikační ambulance, ambulance dětské gynekologie, urogynekologie, onkogynekologie, ambulance pro léčbu sterilit a endokrinologii, ambulance závodního gynekologa, porodnické ambulance a poradny pro riziková a patologická těhotenství. Součástí ambulantního traktu je také specializované ultrazvukové pracoviště. Na ambulantní část navazuje lůžková péče jak konzervativní, tak operační a jednotky intenzivní péče (pooperační a porodnické). Kromě běžné gynekologické operativy včetně širokého spektra endoskopických metod je oddělení specializováno na rozsáhlé onkogynekologické výkony, které centralizuje z celého regionu. Je totiž jedním z akreditovaných onkogynekologických center. Oddělení také získalo certifikát pro provádění nejmodernějších metod léčby močové inkontinence. Ve spektru činnosti oddělení nechybí ani takzvané menší gynekologické výkony – hysteroskopie, konizace, kyretáže, interrupce, a další. Porodnická část je součástí dalšího akreditovaného centra Nemocnice České Budějovice a.s. - Perinatologického centra Jihočeského kraje. Zde se koncentrují nejzávažnější případy těhotenských patologií a péče o porody od 24. týdne těhotenství. Kromě této superspecializované péče oddělení zajišťuje veškeré porodnické služby a kompletní porodnickou operativu. Samozřejmostí je rooming in na maximálně třílůžkových pokojích, nechybí ani možnost pobytu maminek po porodu na nadstandardních jednolůžkových pokojích. Mezi neopomenutelné součásti činnosti patří také oblast prenatální diagnostiky, a to jak neinvazivní (superkonziliární ultravzukové vyšetření zaměřené na diagnostiku možných vývojových vad plodu), tak invazivní (odběr plodové vody - amniocentéza). Oddělení zajišťuje odběr pupečníkové krve při porodu dítěte. Gynekologicko – porodnické oddělení stejně jako celá nemocnice úzce spolupracuje se Zdravotně-sociální fakultou Jihočeské Univerzity v Českých Budějovicích a se středními a vyššími zdravotnickými školami. Proto se mohou klientky se studenty a studentkami těchto škol při pobytu na našem oddělení setkat. Jde především o nastávající porodní asistentky.
Kontakty:
Telefon: 387874401
Email: zenske@nemcb.cz
Web: http://www.nemcb.cz/oddeleni/gynekologicko-porodnicke-oddeleni-2/
Charakteristika oddělení:
Porodnická část oddělení je součástí Perinatologického centra Jihočeského kraje. Koncentruje těhotné se závažnými těhotenskými patologiemi od 24. týdne těhotenství. Již několik let se počet porodů pohybuje nad 2000 porody za rok. Porodní sál disponuje celkem třemi předporodními lůžky na dvou čekacích pokojích a pěti porodními boxy. Jeho součástí je také jednotka intenzivní porodnické péče K dispozici jsou pomůcky k porodu jako například porodnické balóny, stoličky, masážní pomůcky atd. K dispozici je také hydromasážní vana. Přítomnost tatínka či jiného člena rodiny u porodu je možná. Při fyziologickém porodu dbáme na to, aby miminko bylo již od prvních okamžiků po porodu v těsném kontaktu s maminkou a následně po jeho krátkém ošetření a po ošetření eventuelních porodních poranění je novorozenec přikládán k prsu. Po porodu zůstává maminka eventuelně i s tatínkem na porodním boxe a pokud je její stav stabilizován, je po dvou hodinách od porodu přeložena na oddělení šestinedělí. Maminkám v průběhu porodu můžeme poskytnout tlumení bolestí formou tzv. epidurální analgesie, která je dostupná po celých 24 hodin, provádí ji lékař ARO (podrobněji viz Epidurální analgesie při porodu), nejedná se o nadstandardní hrazenou službu. Porodnice je také součástí projektu Banka pupečníkové krve (www.bpk.cz), v rámci kterého se při přání rodičky provádí nekomerční odběry pupečníkové krve. Realizovány však mohou být i odběry komerční. Je velmi vhodné, pokud toto rodička avizuje již při přijetí na naše oddělení. V rámci předporodní přípravy probíhají pro nastávající rodiče prohlídky porodního sálu (každé úterý od 14 hodin). Je však vhodné se nejprve telefonicky informovat, protože v případě obsazených porodních boxů se termín prohlídek posouvá.
Co potřebuji s sebou do porodnice
- Doklady: občanský průkaz, těhotenskou legitimaci (s přílohami dalších vyšetření), průkaz zdravotní pojišťovny. Vdané ženy oddací list (nejlépe kopii). Neprovdané ženy souhlasné prohlášení rodičů o otcovství a jménu dítěte, což je předem nutné učinit na matrice.
- Toaletní potřeby: 2 ručníky, pantofle (nejlépe vhodné i do sprchy), ponožky, podprsenku pro kojící matky, spodní kalhotky, vložky, ev. noční košili.
- Kartu do telefonního automatu.
Porodnice v případě potřeby poskytuje noční košili a župan ( je možné vzít si i vlastní).
Během prvního dne pobytu může žena projít různými místnostmi (předpokoj, porodní sál, šestinedělí) a všechny své věci musí stěhovat s sebou. Také kapacita nočních stolků na oddělení je omezena, proto doporučujeme přiměřenou velikost příručního zavazadla.
Doprovodu u porodu neposkytuje nemocnice občerstvení, proto by měl mít s sebou svačinu a pití. Porodnice poskytuje oblečení a přezůvky. Osobní věci a cennosti si doprovod může uzamknout do vlastní skříňky, přičemž klíč má po celou dobu pobytu na porodním sále u sebe.
Nemocnice neručí za částky peněz nad 200,-Kč. Proto nedoporučujeme brát s sebou vkladní knížky, platební karty, šeky, předměty z drahých kovů, elektrotechniku, mobilní telefony a jiné cennosti.
Co mne čeká při porodu
Příprava k porodu
Pokud je porod je v běhu, bývá nastávající mamince navržena "příprava". Ta tradičně spočívá v oholení zevních rodidel v místě, kde lze případně očekávat provedení nástřihu (epiziotomie), vyprázdnění konečníku očistným klyzmatem a v očistné koupeli osprchováním. Je nutné zdůraznit, že žádná s těchto procedur není povinná a je otázkou domluvy mezi personálem porodního sálu a rodičkou.
Alternativou klasického klyzmatu může být podání přípravku Yal®. Ten je vydáván v lékárně na recept a rodička si ho musí s sebou do porodnice přivézt.
Po přípravě obvykle následuje 20 minutový kardiotokografický záznam.
Metody sledování stavu plodu při porodu
1. Kardiotokografie (monitor, CTG, KTG)
Kardiotokografie je základní přístrojovou metodou používanou při sledování stavu plodu při porodu. Umožňuje sledovat srdeční ozvy plodu a zároveň i děložní kontrakce. Při normálně probíhajícím porodu je vyšetření opakováno zhruba ve 2 až 3 hodinových intervalech, a to vždy v délce asi 20 minut. Existují však i situace, kdy je záznam natáčen trvale a je tak sledován celý porod.
2. IFPO (Intrapartální fetální pulzní oxymetrie)
IFPO (Intrapartální fetální pulsní oxymetrie) je metoda hodnotící nasycení krve plodu kyslíkem. Používá se ve spojení s kardiotokografií jako doplňková metoda v situacích, kdy je třeba upřesnit, zda je plod v děloze ohrožen nedostatkem kyslíku (hypoxií) či nikoli. Vyšetřovací plastová sonda se zavede přes pochvu do dělohy tak, aby byla vedle hlavičky plodu. Na základě výsledku vyšetření je pak rozhodnuto o dalším vedení porodu.
3. ST analyzátor (STAN)
Jde o jednu z nejnovějších metod, která má přispět k rozhodování, zda je plod v děloze ohrožen nedostatkem kyslíku (hypoxií), či nikoli. Principem je hodnocení EKG křivky plodu. Signál je získáván skalpovou elektrodou zavedenou na hlavičšku plodu a hodnocení probíhá, stejně jako u IFPO, v návaznosti na kardiotokografické vyšetření.
Zdroj: nemcb.cz
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<a href=https://vibromera.es/equilibrado-de-piezas/>Equilibrado de piezas</a>
El equilibrado constituye un proceso fundamental en las tareas de mantenimiento de maquinaria agricola, asi como en la fabricacion de ejes, volantes, rotores y armaduras de motores electricos. Un desequilibrio provoca vibraciones que incrementan el desgaste de los rodamientos, provocan sobrecalentamiento e incluso llegan a causar la rotura de componentes. Para evitar fallos mecanicos, resulta esencial identificar y corregir el desequilibrio de forma temprana utilizando tecnicas modernas de diagnostico.
Metodos principales de equilibrado
Existen varias tecnicas para corregir el desequilibrio, dependiendo del tipo de pieza y la magnitud de las vibraciones:
Equilibrado dinamico – Se aplica en elementos rotativos (rotores, ejes) y se lleva a cabo mediante maquinas equilibradoras especializadas.
Equilibrado estatico – Se usa en volantes, ruedas y otras piezas donde es suficiente compensar el peso en un unico plano.
Correccion del desequilibrio – Se lleva a cabo mediante:
Perforado (eliminacion de material en la zona mas pesada),
Instalacion de contrapesos (en ruedas, aros de volantes),
Ajuste de masas de equilibrado (como en el caso de los ciguenales).
Diagnostico del desequilibrio: ?que equipos se utilizan?
Para identificar con precision las vibraciones y el desequilibrio, se emplean:
Equipos equilibradores – Miden el nivel de vibracion y determinan con exactitud los puntos de correccion.
Analizadores de vibraciones – Registran el espectro de oscilaciones, identificando no solo el desequilibrio, sino tambien otros defectos (por ejemplo, el desgaste de rodamientos).
Sistemas de medicion laser – Se emplean para mediciones de alta precision en componentes criticos.
Las velocidades criticas de rotacion requieren especial atencion – condiciones en las que la vibracion se incrementa de forma significativa debido a la resonancia. Un equilibrado adecuado evita danos en el equipo en estas condiciones de funcionamiento.
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Начните свой путь к финансовой свободе уже сегодня! <u>Регистрируйтесь по моей ссылке, получайте бонус и пробуйте мою стратегию.?</u>
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