erTi generalizebuli krunCxviTi gulyris SemTxvevaSi eqimis gamoZaxeba saWiro ar aris.

gadaudebeli samedicino daxmareba aucilebelia, Tu:

• gulyra ar mTavrdeba 5 wuTis Semdegac;

• erT gulyras maSinve meore mosdevs;
• bavSvi gonze ar modis 20 wuTis gasvlis Semdeg;
• bavSvs aqvs gaxangrZlivebuli pirRebineba;

Tema:
Tema: triaJi sagangebo situaciebSi

statistikuri monacemebi mowmobs, rom msoflioSi yovelwliurad registrirdeba aTobiT

stiqiuri ubedureba da katastrofebi, romlebSic iRupeba 100-ze meti adamiani, xolo naklebi
raodenobis msxverplTa da materialuri danakargebis SemTxvevebi did saxelmwifoebSi
aRiniSneba TiTqmis yoveldRiurad. izrdeba teqnogenuri katastrofebis albaTobac, romelic
dakavSirebulia mosaxleobis raodenobis zrdasTan, urbanizaciasa da warmoebis
koncentraciasTan. am movlenebis samedicino Sedegebs, aseve politikuri, ekonomikuri,
eTnikuri, religiuri, teritoriuli winaaRmdegobebis geografiis da erovnebaTaSoris
warmoqmnil konfliqtur situaciebis zrdas, teroristul aqtebs da a.S. mivyavarT adamianTa
danakargebTan, rac, rogorc wesi, moiTxovs saswrafo samedicino daxmarebis aRmoCenas.
me-20 saukuneSi da gansakuTrebiT bolo aTeul wlebSi msoflioSi momxdari samxedro
konfliqtebis, bunebrivi da teqnologiuri katastrofebis analizi, samedicino Sedegebis
likvidaciis gamocdileba, gviCvenebs, rom katastrofebis Sedegad warmoqmnili tragediebis
masStabebi gamovida teritoriul-geografiuli cnebebis gareT. SeiZines ra zogadsakacobrio
faseuloba, maT mniSvnelovnad daaCqares katastrofebis dros dazianebuli adamianebisaTvis
samedicino daxmarebis aRmoCenis Sina- arsisa da moculobis axleburad Camoyalibebis
sakiTxi.
sadReisod am sakiTxis aqtualobas adasturebs aseve: Cveni qveynis midrekileba amgvari
movlenebis mimarT, satranzito qveynis statusis SeZena da misi Semdgomi ganviTareba, mZlavri
navTob da gazsadenis mSenebloba,somxeTis atomuri eleqtrosadguris siaxlove da a.S.
katastrofebis medicinis fuZemdeblebis profesorebis r.freis da p.safaris katastrofebis
gamocdilebis Seswavlis safuZvelze gamovlenili samwuxaro kanonzomiereba: sicocxlis
SesanarCunebeli sareanimacio RonisZiebebi da Tanamedrove intensiuri Terapiis saSualebebi
katastrofebis dros rogorc wesi gamoiyeneboda Zalian gvian, SemTxvevidan 12-24 saaTis
Semdeg.
sxvadasxva saxeobis sagangebo situaciebis SemTxvevebis gaxSirebis Sedegad sagangebo
situaciebis warmoqmnis da Sedegebis likvidaciis saWiroebidan gamomdinare msoflios
saxelmwifoebSi mosaxle- obisaTvis gadaudebeli samkurnalo-profilaqtikuri da sanitarul-
epidemiologiuri daxmarebis aRmoCenis mizniT Seiqmna katastrofebis medicinis samsaxurebi.
sagangebo situaciebSi adamianTa janmrTelobis da sicocxlis SenarCunebis rTulma da
mravalferovanma problemebma ganapiroba jandacvis saministros dawesebulebebis da
formirebebis mier drouli maRalkvalificiuri samedicino daxmarebiT uzrun- velyofis
saWiroeba.
Mmsxvili avariebis da katastrofebis dros samedicino evakuaciis etapebze warmoiSveba
mravlobiTi, kombinirebuli da Serwymuli dazianebebiT dazianebulTa didi raodenobis
koncentrireba. amgvar SemTxvevebSi katastrofebis medicinis ZiriTadi amocanebia
dazianebulTa (avadmyofTa) dazianebis (daavadebis) tipebad da simZimis xarisxiT daxarisxeba,
degazaciis, dezaqtivaciis Catareba, dazianebulTa izolacia, dazianebulTaTvis maRali
donis samedicino daxmarebis aRmoCena da maTi samedicino evakuaciis Semdgom etapze
transportireba.
Tanamedrove samkurnalo_saevakuacio RonisZiebebis sistemis mniSvnelovani organizaciuli
elementi aris samedicino daxarisxeba.
samedicino daxarisxeba aris samedicino CvenebebiT da konkretuli viTarebis pirobebis
gaTvaliswinebiT dazianebulTa jgufebad ganawilebis meTodi, romelic gvWirdeba
erTgvarovani samkurnalo_profilaqtikuri da saevakuacio RonisZiebebeis Casatareblad.
aRniSnuli RonisZiebebis Sinaarsi dgindeba samedicino Cvenebebis da samedicino daxmarebis
dadgenili moculobis Sesabamisad, romelic SeiZleba AaRmouCndes samedicino evakuaciis
aRniSnul etapze viTarebis konkretul pirobebSi.
sityva daxarisxeba (triage) warmoiSva franguli sityva trier-idan, romelic niSnavs SerCevas,
amorCevas.
daxarisxeba SemogvTavaza dominik Jan lareim, napoleonis armiis cnobilma qirurgma,
romelic iyenebda am meTods brZolaSi daWrilTa mdgomareobis swrafi SefasebisTvis da
kategoriis dasadgenad, agreTve Semdgomi evakuaciis sqemis SemuSavebisTvis. is axorcielebda
daxarisxebas brZolis ganmavlobaSi da mniSvnelobas ar aqcevda daWrilTa wodebas.
daxarisxeba SeiZleba aixsnas rogorc samedicino procesi, romelic ganapirobebs evakuaciis
da mkurnalobis prioritetebis Tanmimdevrobas daWrilTa reanimaciis, stabilizaciis da
transportirebis maqsimalurad optimaluri resursebis gamoyenebiT da avadmyofTa
Cveulebrivi cxovrebis riTmisadmi rac SeiZleba swrafad dabrunebas.
daxarisxebis procesi unda iyos:
1.Lprogresuli
progresuli – pirveladi daxarisxeba unda gaZlierdes daxarisxebisaTvis Semofarglur
teritoriaze evakuaciis jaWvSi;
2. gaxangrZlivebuli – grZeldebodes sanam arsebobs disproporcia avadmyofebsa da
samedicino saSualebebis Soris.
3. dinamiuri – radgan yuradReba unda mivaqciod ara marto Wrilobis zomasa da simZimes,
aramed Wrilobebis kombinacias, daWris meqanizms, prognozs, dazaralebulis saerTo
mdgomareobas, mkurnalobis Sedegs, asaks, dazaralebulTa raodenobas, kulturul da
religiur faqtorebs.
daxarisxebis tradiciuli kategoriebi:

gadaudebeli
es jgufi moicavs dazianebulebs, romelTac esaWiroebaT qirurgiuli daxmareba
sicocxlis da kidurebis gadasarCenad. Ees yvelaze maRali prioritetis kategoriaa, romelic
yvelaze metad amarTlebs samedicino Carevebis ganxorcielbaze daxarjul dros da saxsrebs.
qirurgiuli daxmareba unda aRmouCinon dazaralebulebs, romelTac gadarCenis maRali Sansi
aqvT da ara imaT, viszec tyuilad daixarjeba dro. masobrivi dazianebebisas Wrilobebis
yvela SemTxvevebis miaxloebiT 20% ganekuTvneba aRniSnul kategorias.
gadaudebeli T11

• travmuli Soki
• sunTqvis ukmarisoba
• Zlieri sisxldena (1 litrze meti)
• ugono mdgomareoba
• penetrirebuli gulmkerdis Wriloba an muclis Rrma Wriloba
• Ria, daWimuli da masiuri pnevmoToraqsi;
• menjis, gulmkerdis, xerxemalis, kidurebis motexilobebi;
• Tavis Ria travma;
• damwvroba;
• Termuli inhalacia;
• CO-Ti intoqsikacia;

gadavadebuli

jgufi moicavs dazaralebulebs, romlebic saWiroeben qirurgiul daxmarebas, magram maTi

saerTo mdgomareobidan gamomdinare daxmarebis gadadeba mcire droiT sicocxlisaTvis
safrTxes ar warmoedgens.
Mmocemuli kategoria Seadgens dazianebulTa miaxloebiT 40%-s;

gadavadebuli – T2
gadavadebuli 2
• meore xarisxis damwvroba – sxeulis 30% meti;
• mesame xarisxis damwvroba – xxeulis 10%;
• mesame xarisxis damwvroba xelebze, fexebze, saxeze, sunTqvis garTulebis
gareSe;
• damwvrobebi rbili qsovilebis dazianebiT an mcire motexilobebiT;
• sisxldena (500-1000 ml);
• xerxemlis dazianebebi;
• Tavis travma;
 • kolafsi;
• ugono mdgomareoba;
• mravlobiTi motexilobebi;
• muclis Rrus gamWoli Wrilobebi Sokis gareSe;

msubuqi

am dazaralebulebs aqvT mcire dazianebebi. martivi TviT da urTierT daxmarebis aRmCenis

Semdeg SeuZliaT daubrundnen TavianT saqmianobas. mocemuli kategoria Seadgens
dazianebulTa miaxloebiT 40%-s
M msubuqi - T33
• TiTebisa da kbilebis motexilobebi;
• kontuzia, minimaluri WrilobiT;
• mcire damwvrobebi;
• II xarisxis damwvroba, sxeulis 15%;
• III xarisxis damwvroba, sxeulis 2%;
• zedapiruli damwvrobebi (I xarisxis), sxeulis 20%;
• mcire sisxldenebi;
• martivi motexilobebi;
• rbili qsovilebis zedapiruli dazianebebi;
• stresuli reaqciebis msubuqi formebi;

agoniuri

daWrilebi, romelTac miRebuli aqvT imdenad mZime dazianebebi romlebic naklebad

sarwmunos xdian maTTvis sicocxlis SenarCunebas, im SemTxvevaSic ki Tu amisaTvis
gamoyenebuli iqneba yvela arsebuli saSualebebi. isini calke unda iyvnen gadayvanili sxva
dazianebulebisagan, magram ar SeiZleba maTi upatronod mitoveba, saWiroa maTi simptomuri
mkurnaloba. Mmocemuli kategoria Seadgens dazianebulTa mcire ricxvs.

• II da III xarisxis damwvrobebi, sxeulis 40%;

• II da III xarisxis damwvrobebi, sxeulis 40%, asocirebuli:
• mniSvnelovan motexilobebTan;
• Tavis da zurgis dazianebasTan;
• gulmkerdis dazianebasTan;
• Tavis Ria WrilobebTan;
• zurgis tvinis dazianebasTan;
• dazianebebTan adamianebSi 60-65 wlis zeviT;

dazianebulTa kategoriebi evakuaciis Catarebis saswrafoobis

saswrafoobis mixedviT :
kategoria I – saswrafo.
moicavs dazianebulebs, romlebic pirveli SesaZleblobisTanave unda iyvnen evakuirebuli,
magram araugvianes ori saaTis ganmavlobaSi maTi sicocxlis, kidurebis an mxedvelobis
SenarCunebis, garTulebebis an myari invalidobis Tavidan acilebis mizniT.
kategoria Ia – saswrafo-qirurgiuli.
mas miekuTvnebian dazianebulebi, romlebic saWiroeben sasicocxlo CvenebebiT an maTi
mdgomareobis stabilizaciis mizniT gadaudebel qirurgiul Carevas, romelic maTi Semdgomi
evakuaciis SesaZleblobas uzrunvelyofs.
kategoria II – prioritetuli.
masSi Sedian dazianebulebi, romlebic moiTxoven SesaZlo umokles vadebSi samedicino
daxmarebis aRmoCenas. isini unda iyvnen evakuirebuli uaxloesi 4 saaTis ganmavlobaSi.
winaaRmdeg SemTxvevaSi isini SesaZloa gadavidnen saswrafo kategoriaSi. am kategorias
miekuTvnebian dazianebulebi, romlebsac mocemul etapze ver aRmouCenen mkurnalobas, aseve
pirebi mZime travmuli Sokis an invalidobis ganviTarebis riskiT.
kategoria III – Cveulebrivii.
masSi Sedian dazianebulebi, romelTa evakuaciis vada SeiZleba gadaiwios 24 saaTiT maTi
zogadi mdgomareobis arsebiTad gauaresebis gareSe.
kategoria IV – ar saWiroeben specialur transports.
 am kategoriaSi Sedian pacientebi, romelTa evakuacia sanitaruli transportis ar
arsebobis gamo SesaZloa nebismieri arasamedicino transportiT.
samedicino daxarisxebis mizania
• mokle droSi dazianebulTa udidesi nawilisaTvis
samedicino daxmarebis aRmoCena.
• masobrivi dazianebis keridan dazianebulTa raciona-
luri evakuaciis uzrunvelyofa.

samedicino daxarisxebas safuZvlad udevs:

• dazianebis diagnostikis saswrafooba.
• dazianebulis sicocxlis prognozis gansazRvra.

samedicino daxarisxeba tardeba samedicino evakuaciis yovel etapze da mis yovel

funqcionalur ganyofilebaSi. daxarisxebis Sinaarsi damokideblia im amocanebze, romlebic
dakisrebulia ama Tu im funqcionalur qvedanayofze, samedicino evakuaciis etapze da
samedicino pirobebze.
samedicino daxarisxeba aris uwyveti da konkretuli procesi, romelic efuZneba
eqstremalur pirobebSi dazianebulTa diagnostikis da mkurnalobis erTian koncefcias.
unda gvaxsovdes is WeSmariteba, rom Tu swori diagnozis gareSe SeuZlebelia konkretuli
dazianebulis efeqturi samedicino daxmareba da mkurnaloba, aseve SeuZlebelia samedicino
evakuaciis etapebis muSaobis organizaciis mkveTri gaumjobeseba swori samedicino
daxarisxebis gareSe.

samedicino daxarisxebis principebi

uwyvetoba _ samedicino daxarisxeba unda tardebodes samedicino evakuaciis yvela etapze da
samedicino dawesebulebebis da formirebebis yvela ganyofilebebSi;

Tanmimdevroba _ samedicino daxarisxeba mocemul dawesebulebaSi /etapze /unda tardebodes

Semdgomi etapis an ganyofilebis amocanebis gaTvaliswinebiT.

konkretuloba
konkretulob _samedicino daxarisxeba niSnavs imas, rom igi unda Seexebodes yovel
konkretul dazianebuls da dazianebulTa jgufebi unda Seesabameboden samuSao pirobebs.
samkurnalo dawesebulebebSi samedicino daxarisxebis organizeba evalebaT yvelaze
gamocdil eqimebs_klinicistebs, romelTac SeuZliaT uzrunvelyon dazianebulTa da
daavadebulTa swori diagnostika, diagnostikis ubralo da xelmisawvdomi meTodebis
gamoyenebiT gansazRvron maTi diagnostikuri daniSnuleba.

samedicino dasxarisxebis
dasxarisxebis Catarebis dros gaTvaliswinebuli unda iyos 3 daxarisxebis
niSani:
• garSemomyofTa saSiSroeba
• samkurnalo niSani
• saevakuacio niSani

garSemomyofTaTvis safrTxes warmoadgens:

_ infeqciuri avadmyofebi /infeqciuri daavadebebze saeWvoebi/

_ dazianebulebi reaqtiuli fsiqoziT
_ dazianebulebi radioaqtiuli da momwamlavi nibTierebebiT
_ dazianebulebi baqterialuri saSualebebiT

samkurnalo niSani

gansazRvravs dazianebulebisaTvis samedicino daxmarebis aRmoCenis saWiroebis xarisxs,

rigiTobas da aRmoCenis adgils. saWiroebis xarisxis mixedviT samedicino daxmarebaSi
gamoiyofa Semdegi jgufebi:
_ dazianebulebi, romlebic saWiroeben gadaudebel samedicino
daxmarebas mocemul etapze;
_ dazianebulebi, romelTac daxmareba aRmoCenli eqnebaT Semdeg
etapze da saWiroeben evakuacias;
 _ dazianebulebi, romlebic saWiroeben simptomatur daxmarebas da movlas / agoniaSi
myofni /.

saevakuacio niSani
avadmyofebi, romlebic saWiroeben samedicino daxmarebas samedicino evakuaciis aRniSnul
etapze, nawildebian misi aRmoCenis adgiliT da rigiTobiT(“Sesaxvevi 1 rigSi”, ”saoperacio 2
rigSi”da a.S.). gansakuTrebuli sifrTxile unda gamovavlinoT im pirTa mimarT, romelTac
gaaCniaT mZime, sicocxlisaTvis SeuTavsebeli Wrilobebi da daavadebebi da saWiroeben
upirveles yovlisa im RonisZiebebis Catarebas, romelic Seumsubuqebs maT mdgomareobas.

damxarisxebeli brigada unda Sedgebodes :

sakaciani dazianebulebis daxarisxebisaTvis_ 1 eqimi, 2- medda, 2_ registratori, snitar-

mzidavebis rgoli ;
mosiarule dazianebulebis daxarisxebisaTvis_ 1 –eqimi, 1- medda, 1– registratori;

Tavi V.
Tema: saerTo- sajariso brZolis safuZvlebi
G gegma-konspeqti
saswavlo mizani: Seswavlili iqnas saerTo-sajariso brZolis safuZvlebi da motoqveiTi
qvedanayofebis Semadgenloba, organizacia da brZolaSi moqmedebis taqtika
saswavlo sakiTxebi:
I.Tanamedrove saerTo-sajariso brZolis arsi
II. saerTo-sajariso brZolis ZiriTadi saxeebi
III. motoqveiTi qvedanayofebis Semadgenloba, organizacia da brZolaSi moqmedebis taqtiqa
IV. samxedro topografia
saswavlo dro: 1 saaTi
Catarebis adgili: auditoria
gamoyenebuli literatura:
saxmeleTo wesdeba. FM-100-5
saswavlo-meToduri saxelmZRvanelo taqtikur momzadebaSi
samxedro topografia. Tbilisi 2001 w.
saswavlo rukebi

I. Tanamedrove saerTo-sajariso brZolis arsi

samxedro xelovneba Seicavs strategiul , operatiul da taqtikur doneebs
strategia – aris samxedro xelovnebis umaRlesi done, romelic Seicavs qveynis samxedro
Zalebis omisaTvis momzadebis Teorias da praqtikas, aseve omis dagegmvis warmoebas da
strategiul operaciebs
operatiuli done – Seicavs samxedro gaerTianebebis momzadebis Teorias da praqtikas,
operaciebis momzadebas da warmoebas
taqtikuri done – aris samxedro nawilebisa da SenaerTebis, sxvadasxva saxis SeiaraRebuli
Zalebis omis warmoebisaTvis momzadebis Teoria da taqtika
Tanamedrove pirobebSi didi mniSvneloba eniWeba pirvel operaciebs da sabrZolo moqmedebebs
omis dasawyisSi, raTa mogeriebul iqnes mowinaaRmdegis agresia
operacia- aris saerTo-sajariso gaerTianebis miznis, drois, adgilisa da amocanebis mixedviT
urTierT dakavSirebuli da SeTanxmebuli brZolebis, dartymebis da manevrebis erToblioba,
romlebic tardeba erTiani CanafiqriT, operatiuli da operatiul-taqtikuri amocanebis
gadasawyvetad operatiuli mimarTulebiT an gankuTvnili drois periodSi romelime did
raionSi
sabrZolo moqmedebebi - operaciis Semadgeneli nawilia, romelic warmoadgens ramodenime
mniSvnelovani da daZabuli dartymisa da brZolis erTobliobas
brZola – aris jarebis taqtikuri moqmedebebis ZiriTadi forma, romelic warmoadgens
SenaerTebis, nawilebis da qvedanayofebis organizebul da SeTanxmebul drois, adgilis da
miznis mixedviT dartymas, cecxlsa da manevrs raTa mogeriebuli iqnes mowinaaRmdegis
Semoteva da ganxorcielebuli iqnes sxva amocanebi, garkveul raionSi mokle vadaSi
brZola SeiZleba iyos: saerTo-sajariso, sahaeri Tavdacvis, sahaero da sazRvao