gestione infermieristica dei farmaci d'urgenza e cardiovascolari

7/31/2019 gestione infermieristica dei farmaci d'urgenza e cardiovascolari

1/11

2

IM[ZFLNM FNCMXGFMXF[ZFKBJMF CBXGBKF J]XIMN_BM KBXJFLSB[KLEBXF8

FNJFKM2. EB XM[TLN[BHFEFZ JMEEFNCMXGFMXM NMEEB IM[ZFLNM JMEEB ZMXBTFB t. ;Im{zflnm fncmxgfmxf{zfkb m xm{tln{bhfefz

Cb{f jmeeb xm{tln{bhfefz8. TMK]EFBXFZ JMEE][L JMF CBXGBKF NME HBGHFNL t. =Jfe}fflnf

Sfm jf {lggfnf{zxbflnm

Fnc}{flnm klnzfn}b mj m{zmgtlxbnmb

Tfkklel mxxlxm Ixbnjm mccmzzl

;. ]XIMN_B TMJFBZXFKB M IM[ZFLNM CBXGBKF t. 6

]ximnb Mgmximnb

Jfccmxmnm Bj}ezl Hbghfnl

Lhfmzzfsl

Txflxfz m kleebhlxbflnm

Cbxgbkf m kbxxmeel jmeemgmximnb:. CBXGBKF JMEE]XIMN_B t. 28=. KB[L IF]EFB t. 2=

HFHEFLIXBCFB M XFNIXB_FBGMNZF

;

2. EB XM[TLN[BHFEFZB JMEEFNCMXGFMXM NMEEBIM[ZFLNM JMEEB ZMXBTFBEb txlcm{{flnm fncmxgfmxf{zfkb fn xbtfjb msle}flnm m fe x}lel jmeefncmxgfmxm nmeeb{lggfnf{zxbflnm jmf cbxgbkf nlzmslegmnzm kbghfbzl nmief }ezfgf bnnf.

Emsle}flnm nlxgbzfsb `b tlxzbzl b xbiif}nimxm fgtlxzbnzf zxbi}bxjf? {lnl fncbzzf xmebzfsbgmnzm

xmkmnzf fe jmkxmzl 9;6,6: {}e txlcfel txlcm{{flnbem jmeefncmxgfmxm% eb emiim :8,66 k`m {bnkf{km fetb{{biifl beem txlcm{{flnf {bnfzbxfm m fe kljfkm jmlnzlelifkl jme 28,4=,66.

B r}m{zf kbghfbgmnzf emif{ebzfsf jmsm nmkm{{bxfbgmnzm cbxm {mi}fzl }nb msle}flnm k}ez}xbem m

txlcm{{flnbem jmief fncmxgfmxf% k`m tbxzm jbeeb txm{b jf kl{kfmnb jme txltxfl x}lel m jmf

kbghfbgmnzf jb bzz}bxm nmeelzzfkb jmeeb tfmnb b}zlnlgfb jmeeb txlcm{{flnm fncmxgfmxf{zfkb.Tfmnb b}zlnlgfb nln {finfcfkb klncefzzl kln fe glnjl gmjfkl gb s}lem jfxm {sfe}ttl jf }nb

kl{kfmnb txlcm{{flnbem k`m {f txmnjm kbxfkl fnzmixbegmnzm jmf txlkm{{f jf k}xb% ef lxibnfb% ef

sbe}zb m {f bssbem jf kln{}emnm r}bnjl eb {}b txmtbxbflnm nln kln{mnzm efnjfsfj}bflnm jmeebgfieflxm {le}flnm.

M fncbzzf glezl fgtlxzbnzm k`m fe txlcm{{flnf{zb xfm{kb b tmxkmtfxm fe {}l x}lel beefnzmxnl jmetmxklx{l b{{f{zmnfbem jme tbfmnzm% {mnb {klncfnbxm fn zmxxfzlxf k`m nln ief bttbxzmnilnl%

fgtminbnjl{f fnsmkm b kbtfxm cfnl fn clnjl efgtlxzbnb m efn{l{zfz}fhfefz jme {}l x}lel.Im{zflnm fncmxgfmxf{zfkb m xm{tln{bhfefzBeefncmxgfmxm klgtmzm eb klxxmzzb bttefkbflnm jmeem txm{kxfflnf jfbinl{zfkl'zmxbtm}zfk`m% mief


2/11

`b r}fnjf }n x}lel bzzfsl m jmsm bsmxm klnl{kmnm% klgtmzmnm m bhfefz bttxlclnjfzm m biiflxnbzm.

Efncmxgfmxm xm{tln{bhfem jmeeb txltxfb clxgbflnm m bnk`m jf }nb b}zlsbe}zbflnm k`m iefkln{mnzm jf m{{mxm kln{btmslem jmf txltxf efgfzf tmx tlzmx xfklxxmxm msmnz}begmnzm beeb kln{}emnb jf

kleemi`f m{tmxzf.

M klgtfzl jmeefncmxgfmxm eb {lggfnf{zxbflnm jmf cbxgbkf bf tbfmnzf m bccfnk` tl{{b emibegmnzm

klgtfmxm r}m{zl bzzl nmkm{{bxfb eb txm{kxfflnm gmjfkb.R}m{z}ezfgb jmsm m{{mxm klgtemzb% m jmsm kln{mnzfxm be txlcm{{flnf{zb jf bsmxm z}zzm em fnclxgbflnfk`m ief tmxgmzzlnl jf gmzzmxm fn bzzl klxxmzzbgmnzm r}m{zb cb{m jme txlkm{{l b{{f{zmnfbem?

tbfmnzm b k}f {lggfnf{zxbxm fe cbxgbkl

zftl jf cbxgbkl

jl{biifl

lxbxfl m zmgtf jf {lggfnf{zxbflnm

sfb jf {lggfnf{zxbflnm

clxgb cbxgbkm}zfkb (cfbem% klgtxm{{m%..&

jbzb m cfxgb jme gmjfklR}belxb eb txm{kxfflnm {f txm{mnzf fnklgtemzb l kln fnclxgbflnf k`m nln tl{{lnl m{{mxm

fnzmxtxmzbzm fn gljl }nfslkl% klgtfzl jmeefncmxgfmxm k`fmjmxm }ezmxflxf jme}kfjbflnf be gmjfklfn gljl jb tlzmx bzz}bxm fn {fk}xmb eb {lggfnf{zxbflnm.

:

Ebzzl jmeeb txm{kxfflnm jf klgtmzmnb gmjfkb m r}meel jmeeb {lggfnf{zxbflnm jf klgtmzmnbfncmxgfmxf{zfkb? linf txlcm{{flnf{zb xm{tln{bhfem jmief mxxlxf emibzf beeb txltxfl bghfzl.

Tmx r}m{zl glzfsl xfg}lsmxm em klg}nf kb}{m jf mxxlxm fgtlxzbnzm tmx fe tbfmnzm m tmx mnzxbghf f

txlcm{{flnf{zf.

Eb xmjbflnm jf }n }nfkl cliefl zmxbtfb {kxfzzl jbe gmjfkl m klnzxlcfxgbzl jbeefncmxgfmxm tmxeb

txm{b fn kbxfkl jmeeb txm{kxfflnm }n h}ln gljl tmx msfzbxm ief mxxlxf jf zxb{kxfflnm. Mb}{tfkbhfem eb kxmbflnm jf }nb kbxzmeeb fnzmixbzb gmjfkl'fncmxgfmxf{zfkb.

Fn linf kb{l efncmxgfmxm jmsm klnzxleebxm msmnz}bef fgtxmkf{flnf l gbnkbnm m beebzzl jmeeb txm{b fn kbxfkl jmeeb txm{kxfflnm% jmkxmzb kln eb {}b cfxgb jf bsmxm emzzl m kbtfzl linf fnjfkbflnm txm{mnzm

nme cliefl jf txm{kxfflnm m jfk`fbxb jf cbx{f kbxfkl jmeeb {}b bzz}bflnm.

Efncmxgfmxm nln {f lkk}tb jf sbiefbxm ebttxltxfbzmb jmeeb {kmezb zmxbtm}zfkb% gb jmsmklnl{kmxm

em fgtefkbflnf k`m eb {lggfnf{zxbflnm jme cbxgbkl `b tmx fe tbfmnzm.

Fn r}m{zl gljl {f tl{{lnl clxnfxm be gmjfkl fnclxgbflnf fgtlxzbnzf fnmxmnzf em klnjfflnf kefnfk`m

jme tbfmnzm% r}m{zm fncbzzf tl{{lnl m{{mx{f gljfcfkbzm jbe glgmnzl fn k}f eb txm{kxfflnm {zbzb

{kxfzzb be glgmnzl fn k}f jmsm m{{mxm m{mi}fzb jbeeltmxbzlxm.Eb {lggfnf{zxbflnm jmeeb zmxbtfb jmsm r}fnjf xbttxm{mnzbxm }n glgmnzl cfnbem jltl k`m

efncmxgfmxm `b l{{mxsbzl em klnjfflnf jm tbfmnzm% xfemsbzl f {}lf tbxbgmzxf sfzbef m kln{}ezbzl fegmjfkl {m nmkm{{bxfl.Cb{f jmeeb xm{tln{bhfefzEb xm{tln{bhfefz jmeefncmxgfmxm {f bxzfkleb beefnzmxnl jmeem cb{f jmeeb im{zflnm jmf cbxgbkf klgm? klnl{kmnb jme cbxgbkl

sbe}zbflnm jme tbfmnzm

txmtbxbflnm m {lggfnf{zxbflnm

sbe}zbflnm jmief mccmzzfKlnl{kmxm fe cbxgbkl {finfcfkb {btmxm b kl{b {mxsm m r}bef {lnl f {}lf gmkkbnf{gf jbflnm tmxtxmsmjmxm r}bef tl{{lnl m{{mxm em sbxfbflnf jmf tbxbgmzxf l jmeem klnjfflnf jme tbfmnzm k`m

tl{{lnl bssmnfxm. Fn r}m{zl gljl {f tl{{lnl sbe}zbxm kln kln{btmslemb ief mccmzzf bzzm{f m

jf{bzzm{f% xfcmxmnjlef be gmjfkl {m nmkm{{bxfl.Eb sbe}zbflnm jme tbfmnzm }n glgmnzl fgtlxzbnzm nme r}bem efncmxgfmxm jmsm xfemsbxm ftbxbgmzxf sfzbef mj l{{mxsbxm eb tmx{lnb. R}m{zl glgmnzl {f klgtlnm jf j}m cb{f? eb xfemsbflnm jmf


3/11

jbzf m eb xfcem{{flnm {}ief {zm{{f beeb e}km jmeem klnl{kmnm txlcm{{flnbef m jmeem{tmxfmnb.Eb {lggfnf{zxbflnm jmf cbxgbkf be tbfmnzm xbttxm{mnzb }nb cb{m fgtlxzbnzm {klgtlnfhfem fn sbxfglgmnzf? eb txmtbxbflnm% eb {lggfnf{zxbflnm% eb kln{mxsbflnm jme cbxgbkl. Efncmxgfmxm jmsmbsmxm em klnl{kmnm nmkm{{bxfm fn lin}nl jmf glgmnzf {ltxb jm{kxfzzf.

Eb sbe}zbflnm jmief mccmzzf k`m fe cbxgbkl t} bsmxm {}eeb tmx{lnb xbttxm{mnzb }n glgmnzl

fgtlxzbnzm tmx fe ebslxl jmeefncmxgfmxm% mief fncbzzf sfkfnl be tbfmnzm mj fe txfgl b sbe}zbxm fkbghfbgmnzf nmeem klnjfflnf kefnfk`m l nmf tbxbgmzxf sfzbef. Eb {}b txlcm{{flnbefz {f m{txfgm nme{btmxm sbe}zbxm fn r}bef kb{f xfk`fmjmxm efnzmxsmnzl gmjfkl.=

8. TMK]EFBXFZB JMEE][L JMF CBXGBKF NME HBGHFNLEb zmxbtfb cbxgbklelifb xbttxm{mnzb% fn{fmgm beem gbnlsxm jf {lkklx{l bsbnbzl% }n bnmeel

fgtlxzbnzm nmeeb im{zflnm jmeem mgmximnm kbxjflsb{klebxf fn mz tmjfbzxfkb.

Tmx xmnjmxm efnzmxsmnzl tf {fk}xl m smelkm fgtlxzbnzm k`m ief ltmxbzlxf klfnslezf nmeem mgmximnmtmjfbzxfk`m bhhfbnl jfgm{zfk`mb nmee}{l jmf txfnkftbef cbxgbkf m klnl{kmnm xfi}bxjl be

jl{biifl% bief mccmzzf % beem fnjfkbflnf% beem tl{{fhfef klnzxlfnjfkbflnf m bief mccmzzf kleebzmxbef.

Bj}ezl m hbghfnl {lnl jfsmx{f tmx glezf b{tmzzf m nmeeb {lggfnf{zxbflnm jmf cbxgbkf smnilnl

}zfefbzf jl{biif jfccmxmnzf m% {tm{{l% bnk`m cbxgbkf jfsmx{f.]nbezxb tbxzfklebxfz jmee}{ljmf cbxgbkf nmeebghfzl tmjfbzxfkl xbttxm{mnzbzb jbeeb nmkm{{fzbkl{zbnzm jf kbeklebxm fe jl{biifl jf }n cbxgbkl xbttlxzbnjlel be tm{l jme hbghfnl% txltxfl tmxk`

beefnzmxnl jmeeb ixbnjm kbzmilxfb hbghfnl m{f{zlnl mz m tm{f nlzmslegmnzm jfsmx{f.Jb r}m{zb }ezfgb kln{fjmxbflnm sfmnm msfjmnfbzb }nb txlhemgbzfkb fgtlxzbnzm? r}meeb jmeeb {zfgb

jme tm{l m jmeebezmb jf }n hbghfnl fn klnjfflnf kxfzfk`m.]n gljl tmx {}tmxbxm el{zbklel {ltxb jm{kxfzzl% eb xmjbflnm jf zbhmeem k`m keb{{fcfkbnl f hbghfnfgmzzmnjl fn xmebflnm emz kln fe tm{l m ebezmb% m k`m fnjfkbnl em fnclxgbflnf }zfef tmx

ebttxlkkfl xfbnfgbzlxfl.Nmeeb zbhmeeb tl{{lnl m{{mxm fnjfkbzf tmx m{mgtfl? eb gf{}xb jmf z}hf mnjlzxbk`mbef% fe n}gmxl jmeeb

ebgb jme ebxfnil{kltfl m fe jl{biifl jmf cbxgbkf j}ximnb.Fn r}m{zl gljl% }nb slezb fn{mxfzl fe tfkklel tbfmnzm fn }nb kbzmilxfb% {f t} txlkmjmxm

beeb{{f{zmnb {mi}mnjl r}meem k`m {lnl em fnjfkbflnf jmeeb zbhmeeb.M fgtlxzbnzm k`m e fncmxgfmxm k`m {f txmnjm k}xb jf }n hbghfnl xfemsf fe tm{l m ebezmb% fn{fmgmbf jbzf bnbgnm{zfkf m bf f tbxbgmzxf sfzbef hb{bef.

Jfe}fflnfBeefnzmxnl jmeeb jm{kxfflnm jmeem jfe}fflnf sb xfklxjbzl k`m f jl{biif tmjfbzxfkf% tlfk` xbttlxzbzfbe tm{l jme hbghfnl% nln {lnl gbf {zbnjbxj m sbnnl kbeklebzf linf slezb . R}m{zb ltmxbflnm

txmsmjm k`m eltmxbzlxm bhhfb jfgm{zfk`mb kln em txltlxflnf% em mr}fsbemnm m eb gbzmgbzfkb fnimnmxbem.

[f zxbzzb% fncbzzf% jf jl{biif k`m {tbfbnl jbe ixbggl tmx f hbghfnf tf ixbnjf% be gfeefixbggl m be

tmx f tf tfkklef1 }nfz jf gf{}xb nln {mgtxm cbgfefbxf b z}zzf.[tm{{l fnlezxm% eb r}bnzfz jf cbxgbkl klxxf{tlnjmnzm be jl{biifl jme hbghfnl kl{ tfkkleb k`m%

tmx tlzmxeb xmbefbxm m tlf {lggfnf{zxbxm be tbfmnzm% efncmxgfmxm jmsm xfklxxmxm b {lsxb'jfe}fflnfk`m ief kln{mnzlnl jf xfkbsbxm }nb r}lzb jf cbxgbkl% fn {le}flnm% gf{}xbhfem kln em {kbem

xbttxm{mnzbzm {}eem {fxfni`m.

Efncmxgfmxm jmsm klnl{kmxm r}bef {lnl f {lesmnzf k`m t} }{bxm tmx jfe}fxm f cbxgbkf m r}bef{l{zbnm tl{{lnl m{{mxm jfe}fzm.

Em txfnkftbef {le}flnf k`m {f }{bnl nmeem jfe}fflnf {lnl eb {le}flnm cf{flelifkb 4.6- % eb

{le}flnm

ie}kl{bzb be =-% fe xfnimx ebzzbzl m ebkr}b tmx txmtbxbflnf fnfmzzbhfef. Bek}nf cbxgbkf nln tl{{lnl m{{mxm jfe}fzf fn r}bnzl eb elxl clxg}ebflnm kln{zb jf {l{zbnm leml{m l

eftfjfk`m k`m jfe}fzm nln kln{mnzfxmhhmxl jf jf{zxfh}fxm fe txfnkftfl bzzfsl }nfclxgmgmnzm nmeeb{le}flnm m% r}fnjf% nln ibxbnzfxmhhmxl be tbfmnzm jf xfkmsmxm eb r}bnzfz klxxmzzb jf cbxgbkl.

3


4/11

Sfb jf {lggfnf{zxbflnmFn klnjfflnf jf mgmximnb eb txm{mnb l fe xmtmxfgmnzl jf }n bkkm{{l smnl{l kmnzxbem% (cmglxbem %

if}i}ebxm% {}kkebsfb & l tmxfcmxfkl (hxbkkfb% gbnf% ibghm% tfmjf& jf sfzbem fgtlxzbnb tmx eb

{lggfnf{zxbflnm jf ce}fjf m cbxgbkf.

Nme hbghfnl% fe xmtmxfgmnzl jf }nb sfb smnl{b jf fnc}{flnm% txm{mnzb txlhemgbzfk`m emibzm {fb beemz

m beeb klnjfflnm jme hbghfnl% {fb beeb cbgfefbxfz jmeeltmxbzlxm nme xmtmxfxm bkkm{{f smnl{f.Ebkkm{{l smnl{l tmxfcmxfkl% {m xmtmxfzl fn zmgtf hxmsf% xbttxm{mnzb }nb {ljjf{cbkmnzm sfb jf

{lggfnf{zxbflnm jf cbxgbkf m ce}fjf.Kf fn r}bnzl nln tl{{fhfem zmgtlxmiifbxm zxlttl kln }n hbghfnl k`m fn tmxfklel jf sfzb% mtmxk` em klnjfflnf jf bkfjl{f% ftl{{fb m {klgtmn{l kln sb{lkl{zxfflnm tmxfcmxfkb tl{{lnl

jmzmxgfnbxm }nb }ezmxflxm jfccfklez.

Jltl j}m l zxm zmnzbzfsf cbeefzf fnjf{tmn{bhfem xmtmxfxm }nb sfb kmnzxbem.Eb sfb smnl{b tmxfcmxfkb% bnk`m r}bnjl jf h}ln kbefhxl% }nlzzfgb {le}flnm nmeefggmjfbzl tmx

tlzmx {lggfnf{zxbxm jmf cbxgbkf {besbsfzb% gb txm{mnzb efgfzbflnf nmee}zfefl fn fnc}{flnmklnzfn}b m nmeeb {lggfnf{zxbflnm jf ixl{{f sle}gf jf efr}fjf m jf cbxgbkf tbxzfklebxgmnzm

f{zlem{fsf.

E}zfefl jf }nb sfb smnl{b tmxfcmxfkb tmx fnclnjmxm fn klnzfn}l cbxgbkf m efr}fjf% jmsm tlxzbxmeltmxbzlxm b xfcemzzmxm {}eem {l{zbnm k`m fnclnjm% fn r}bnzl bek}nm `bnnl }nb l{glebxfz {}tmxflxm b044ggle,e (l{glebxfz gb{{fgb kln{mnzfzb fn sfb tmxfcmxfkb& m tl{{lnl bsmxm klnzxlfnjfkbflnfbee}{l nmf jf{zxmzzf smnl{f tmxfcmxfkf tmx fe xf{k`fl jf zxlghlcemhfzf l {zxbsb{f k`m tl{{lnl emjmxm fesb{l {zm{{l m f zm{{}zf kfxkl{zbnzf (smjf ake fnc}{l fn sfb tmxfcmxfkb&.Beeb {lggfnf{zxbflnm jme cbxgbkl jmsm {mi}fxm }n ebsbiifl kln {le}flnf f{lzlnfk`m jf begmnl ;

l = ge tmx }n xbtfjl xbiif}nifgmnzl jme kfxklel kmnzxbem.

Ebkkm{{l smnl{l kmnzxbemnme hbghfnl txm{mnzb sbnzbiif {}tmxflxf b r}meef jf }n ixl{{l kbefhxl

tmxfcmxfkl% fn zmxgfnf jf zmgtf jbflnm m jf mccfkbkfb jmf cbxgbkf {lggfnf{zxbzf.Eb sfb kmnzxbem lccxm fnlezxm eb tl{{fhfefz jf gbnzmnmxm fn fnc}{flnm klnzfn}b tf cbxgbkf% jf

fnclnjmxm {le}flnf ftmxzlnfk`m m tmxgmzzm jf glnfzlxbxm eb Txm{{flnmSmnl{b Kmnzxbem.

Fe xmtmxfgmnzl jmeebkkm{{l kmnzxbem jf klgtmzmnb gmjfkb% kln em jfccfklez txfgb gmnflnbzm tmxeb sfb tmxfcmxfkb.

Em {mjf tmx xmtmxfxel {lnl em {zm{{m jmeebj}ezl? sfb smnl{b cmglxbem% if}i}ebxm% {}kkebsfb.Efnc}{flnm jf cbxgbkf fn hlel jbf kbzmzmxf kmnzxbef tmxgmzzm efggmjfbzl mccmzzl {f{zmgfkl.Ebkkm{{l fnzxbl{{ml sfmnm jm{kxfzzl klgm }nb sbefjb bezmxnbzfsb tmx eb {lggfnf{zxbflnm jf ce}fjf m

cbxgbkf fn }n hbghfnl kln {`lka ixbsm% nmeefgtl{{fhfefz jf xmtmxfxm bkkm{{f sb{klebxf.

M{{l tmxgmzzm eb {lggfnf{zxbflnm jf z}zzf f cbxgbkf tmx eb xfbnfgbflnm kln mccfkbkfb tbxbilnbhfem

beeb {lggfnf{zxbflnm tmx sfb sb{klebxm.

Eb jfccfklez nmee}zfefl jf r}m{zl bkkm{{l xbttxm{mnzbzb jbeeb gbn}befz jmeeltmxbzlxm.Eb lnb {kmezb tmx eb t}nz}xb fnzxbl{{mb eb {}tmxcfkfm bnzmxlgmjfbem jmeeb zfhfb txl{{fgbem m {f

zmnjm bj }zfefbxeb {ltxbzz}zzl nmf hbghfnf be jf {lzzl jmf 3 bnnf fn r}bnzl {}kkm{{fsbgmnzm ebsb{klebxfbflnm jme gfjleel m eb {}b kbtbkfz jf b{{lxhfgmnzl {f xfj}klnl.

E}zfefl jmeeb sfb mnjlzxbk`mbem nmkm{{fzb efnz}hbflnm jme tbfmnzm m t} m{{mxm }zfefbzb klgmsfb jmgmximnb tmx eb {lggfnf{zxbflnm jf cbxgbkf fn bzzm{b jme xmtmxfgmnzl jf }n bezxl bkkm{{lsb{klebxm.

[lel f cbxgbkf eftl{le}hfef tl{{lnl m{{mxm {lggfnf{zxbzf tmx r}m{zb sfb% Efjlkbfnb% Bjxmnbefnb%Nbelplnm% Bzxltfnb ({fieb EBNB tmx gmglxfbxm&.Cbxgbkf NLN eftl{le}hfef tlzxmhhmxl kb}{bxm ixbsf em{flnf beem sfm bmxmm (m{mgtfl

hfkbxhlnbzl%

kbekfl&.9

Jl{biif lzzfgbef tmx eb {lggfnf{zxbflnm mnjlzxbk`mbem {lnl {klnl{kf}zf% gb jbzf lzzmn}zf jb {z}jf`bnnl jfgl{zxbzl k`m eb{{lxhfgmnzl jme cbxgbkl bttxl{{fgbzfsbgmnzm jme 24- xf{tmzzl b }nbjl{m jf cbxgbkl {lggfnf{zxbzl tmx sfb mnjlsmnl{b.


5/11

Fnc}{flnm klnzfn}b mj m{zmgtlxbnmbEm fnc}{flnf klnzfn}b mj m{zmgtlxbnmb {lnl jf im{zflnm {fgfem b r}meeb jmeebj}ezl.Em }nfk`m tmk}efbxfz {lnl xbttxm{mnzbzm jbf sle}gf fnc}{f m jbeeb ixbnjmb jmf e}gf jmf kbzmzmxf}zfefbzf.

R}m{zb kln{fjmxbflnm btxm el {tbfl b j}m xfcem{{flnf clnjbgmnzbef?

tl{{fhfefz jf lkke}{flnm jmf e}gf nmkm{{fz jf cbxm bxxfsbxm fe cbxgbkl fn kfxklelTmx r}bnzl xfi}bxjb eb txfgb txlhemgbzfkb nmkm{{bxfl }zfefbxm }nb {zx}gmnzbflnm fjlnmb b

klnzxleebxm k`m efnc}{flnm jf cbxgbkl bssmnib kl{zbnzmgmnzm bf sle}gf {zbhfefzf jbe gmjfkl.Efncmxgfmxm jmsm klnl{kmxm mj }zfefbxm tlgtm fnc}{flnbef m jmsm gbnzmnmxm t}efzf f e}gf jmfkbzmzmxf jb gfkxltbxzfkmeem jf {bni}m k`m% jbzf f hb{{f sle}gf fnc}{flnbef% tl{{lnl xfgbnmxm b e}nil

cmxgm nme kbzmzmxm m clxgbxm klbi}ef lkke}jmnzf.

[lnl fn }{l fn bek}nf kmnzxf txlzlkleef k`m txmsmjlnl e}zfefl jmeeb zmxbtfb mtbxfnfkb fn fnc}{flnmtmx xfj}xxm fe xf{k`fl jf lkke}{flnm jmf kbzmzmxf.

Tmx r}bnzl xfi}bxjb fe {mklnjl t}nzl% {f jmsm zmnmxm fn kln{fjmxbflnm eb r}bnzfz jf efr}fjf fnc}{b

linf lxb jbe tbfmnzm.

R}m{zl kln{mnzm jf kbeklebxm fe zmgtl jf xfmgtfgmnzl jme kbzmzmxm% m jf {btmxm fe glgmnzl fnk}f fecbxgbkl fn fnc}{flnm klnzfn}b bnjx mccmzzfsbgmnzm fn kfxklel.R}bnzl beefnc}{flnm fn m{zmgtlxbnmb jf hlef jf cbxgbkf% kf {f jlsx bkkmxzbxm k`m z}zzl fe cbxgbklbxxfsf fn kfxklel m nln xm{fj}f jmnzxl f e}gf jme kbzmzmxm.

M r}fnjf kln{fiefbzl txbzfkbxm }n ebsbiifl jf {le}flnm f{lzlnfkb tl{z fnc}{flnm% eb k}f r}bnzfzjftmnjmx jbeel {tbfl glxzl jme kbzmzmxm fn xbttlxzl be {}l kbefhxl m e}ni`mb.

Linf cbxgbkl `b txltxfm kbxbzzmxf{zfk`m cf{fk`m m k`fgfk`m k`m nm jmzmxgfnbnl em gljbefz jbflnm}nb slezb fnzxljlzzm nmeelxibnf{gl.Zbef txltxfmz {lnl jmzmxgfnbnzf tmx eb txmtbxbflnm fn r}bnzl fnce}f{klnl nmeeb {kmezb

jmeeb{{lkfbflnm jf tf {l{zbnm1 fncbzzf klghfnbnjl j}m cbxgbkf cf{fkbgmnzm m,l k`fgfkbgmnzmfnklgtbzfhfef {f xf{k`fb efnbzzfsbflnm jf r}m{zf m r}fnjf eb sbnfcfkbflnm jmief lhfmzzfsf zmxbtm}zfkf lbnklx tmiifl xmbflnf bssmx{m jf sbxfbhfem mnzfz.

Tfkklel mxxlxm ' Ixbnjm mccmzzlFe x}lel jmeefncmxgfmxm klgm tbxzm bzzfsb nme txlkm{{l zmxbtm}zfkl txm{}ttlnm klnl{kmnm%klgtmzmnm m bhfefz bttxlclnjfzm (J.T.X. 9;6,6:&.

K`f {lggfnf{zxb }nb zmxbtfb jmsm klnl{kmxm fe cbxgbkl% f {}lf mccmzzf bzzm{f m jf{bzzm{f% eb gljbefz

jf {lggfnf{zxbflnm% r}be}nr}m {fb fe tbfmnzm.

M klg}nr}m k`fbxl k`m% jbzb eb jfsmx{fz bgtfbgmnzm jm{kxfzzb cxb bj}ezl m hbghfnl% m{f{zm }njfccmxmnzm tm{l jmeemxxlxm nmeem j}m zftlelifm jf tbfmnzf.

0

Fe jfsmx{l mccmzzl k`m }n mxxlxm t} kb}{bxm t} m{{mxm jmzmxgfnbzl jb? zftlelifb jme cbxgbkl

r}bnzfz {lggfnf{zxbzb

gbnlsxm {}e hbghfnl (kln cbxgbkf fn fnc}{flnm klnzfn}b&

Emxxlxm zftlelifb jme cbxgbkl {f t} xmbefbxm r}bnjl sfmnm {lggfnf{zxbzb }nb {l{zbnbjfsmx{b jb r}meeb txm{kxfzzb. [tm{{l r}m{zl emibzl bf xfzgf jf ebslxl (zmgtl% bzzmnflnm%

}ximnb&.Emxxlxm r}bnzfz {lggfnf{zxbzb t} kln{mi}fxm beeb nmkm{{fz r}lzfjfbnb jf jlsmx jfe}fxm% txfgbjmeeb {lggfnf{zxbflnm be hbghfnl% cbxgbkf klncmflnbzf tmx ebj}ezl.

Nme zmxl zftl jf mxxlxm {f t} fnklxxmxm j}xbnzm em{mk}flnm jf nlxgbef gbnlsxm b{{f{zmnfbef{}e hbghfnl k`m fnclnjm cbxgbkf fn klnzfn}l.

Fe kbghfl jmeeb {fxfnib jf }n cbxgbkl fn fnc}{flnm% el {tl{zbgmnzl jf }nb tlgtb fnc}{fsb fnc}nflnm% eb glhfefbflnm jme hbghfnl% {mnb em nmkm{{bxfm txmkb}flnf tl{{lnl fncbzzf

jmzmxgfnbxm tmxfklel{f hlef jf cbxgbkl kln mccmzzf bnk`m glezl ixbsf.


6/11

Ief }ezfgf j}m mxxlxf jm{kxfzzf {lnl txltxf jmeeb{{f{zmnb be tbfmnzm tmjfbzxfkl1 }n gfeefefzxl fn tfjf cbxgbkl {lggfnf{zxbzl beebj}ezl `b {fk}xbgmnzm mccmzzf gmnl ixbsf xf{tmzzl b r}meef k`mtxlslk`mxmhhm bj }n hbghfnl.

]i}begmnzm eb glhfefbflnm jf }n bj}ezl k`m fnclnjm cbxgbkf fn klnzfn}l nln xf{}ezb kl{

tmxfklel{b klgm tlzxmhhm xfsmebx{f fn }n tbfmnzm tmjfbzxfkl.

6;. ]XIMN_B TMJFBZXFKB M IM[ZFLNM CBXGBKF]ximnb'MgmximnbTmx tlzmx tbxebxm jmeeb tmk}efbxfz k`m eb im{zflnm jmf cbxgbkf `b nmeebghfzl tmjfbzxfkl% nmkm{{bxfl

txfgb {lzzlefnmbxm eb jf{zfnflnm cxb ]ximnb mj Mgmximnb m efnkfjmnb xbttxm{mnzbzb jbeem {zm{{m.E}ximnb }nb ixbsm klgtxlgf{{flnm jmeel {zbzl jf {be}zm jme hbghfnl {mnb }n fggmjfbzltmxfklel jf sfzb% {fz}bflnm r}fnjf j}xbnzm eb r}bem fgtlxzbnzf{{fgl xftxf{zfnbxm emr}fefhxfl jmeemc}nflnf sfzbef tmx nln fnklxxmxm nme r}bjxl jmeeMgmximnb.Fn r}m{z}ezfgb% ebezmxbflnm jmeem c}nflnf m zbem jb xmnjmxm fe hbghfnl fn tmxfklel jf sfzb% m% jb xfk`fmjmxm zmgtm{zfsbgmnzm ebzzfsbflnm jmeem gbnlsxm xfbnfgbzlxfm tmx msfzbxm k`m sbjb fnklnzxl

beeb glxzm.Jfccmxmnm Bj}ezl'Hbghfnl[fb e}ximnb k`m emgmximnb {lnl {fz}bflnf ixbsf% gb fe zmgtl tmx bifxm {f bkklxkfb nlzmslegmnzmzxb fe txfgl m fe {mklnjl kb{l.

Eb tmxkmnz}bem jf {}kkm{{l jmeem gbnlsxm xfbnfgbzlxfm fnsmx{bgmnzm txltlxflnbem be zmgtl.Fe hbghfnl kbxbzzmxfbzl jb }nb ixbnjm kbtbkfz jf bjbzzbgmnzl fn {fz}bflnf kln bezmxbflnm jmief

mr}fefhxf mgljfnbgfkf m bkfjl'hb{m.

R}m{zb kbxbzzmxf{zfkb el gmzzm tmx b xf{k`fl jf sfzb linf r}beslezb f {minf b{tmkfcfkf k`m fe {}l klxtl

zxb{gmzzm nln smnilnl l{{mxsbzf l fnzmxtxmzbzf klxxmzzbgmnzm jb k`f ief txm{zb b{{f{zmnb.

Fe tfkklel t} xfgbnmxm fn }n ebhfem mr}fefhxfl bhhb{zbnb b e}nil gb% {m nln smnilnl bttlxzbzm

bflnf bjmi}bzm slezm b xfg}lsmxm eb kb}{b jmeel {klgtmn{l% t} txmkftfzbxm xbtfjbgmnzm fn }nb

klnjfflnm k`m b slezm eb{kfb tlkl zmgtl tmx fnzmxsmnfxm.Fe hbghfnl `b }nb ixbnjf{{fgb kbtbkfz jf xmk}tmxl bnk`m r}bnjl eb {fz}bflnm {zbzb cfnl b tlkl

txfgb jxbggbzfkb.

Fe {}l cf{fkl xf{tlnjm glezl hmnm be xftxf{zfnl jmief mr}fefhxf m gl{zxb txmklkf {minf jf

gfieflxbgmnzl m {zbhfefbflnm jmeem klnjfflnf.

Jltl bsmxm cbzzl r}m{zb xfcem{{flnm {}eeb jfsmx{fz cxb bj}ezl m hbghfnl% if}{zl jfccmxmnfbxef

}ezmxflxgmnzm tmx r}bnzl xfi}bxjb emfltbzlimnm{f jmeebxxm{zl kbxjfl'xm{tfxbzlxfl.Nmeebj}ezl ebxxm{zl kbxjfbkl {f smxfcfkb% nmee0=- jmf kb{f kfxkb% klgm emtf{ljfl kln{mr}mnfbembeefn{lximnb jf }n bxfzgfb jmcfhxfeebhfem.

Nme hbghfnl em bxfzgfm gbefinm {lnl xbxm% m ebxxm{zl kbxjfbkl ({besl tmx f hbghfnf kbxjfltbzfkf&nln gbf fgtxlssf{l. M{{l xbttxm{mnzb emsmnzl zmxgfnbem jltl }nb {mxfm jf bezmxbflnfxm{tfxbzlxfml mgljfnbgfk`m k`m% {m nln zxbzzbzm% tlxzbnl txlixm{{fsbgmnzm beebxxm{zl xm{tfxbzlxfl% beebhxbjfkbxjfb% m fncfnm beebxxm{zl kbxjfbkl.

LhfmzzfslSf{zl fe r}bjxl {fnl bj lxb jm{kxfzzl jfsmnzb txflxfzbxfl fe txlnzl xfklnl{kfgmnzl jmeeb bezmxbflnmjmeem c}nflnf sfzbef jme hfghl m el{{mxsbflnm kxfzfkb jmf tbxbgmzxf sfzbef m jmeem klnjfflnfkefnfk`m.

M nmkm{{bxfl bsmxm klgtmzmnb fn bghfzl tmjfbzxfkl% kbtbkfz jf l{{mxsbflnm kxfzfkb jme hbghfnl%lkk`fl kefnfkl beemnbzl k`m nln j n}eeb tmx {klnzbzl.24

Fe hbghfnl {tm{{l gbnjb {minbef b{tmkfcfkf% k`m b slezm f imnfzlxf fnzmxkmzzbnl tmx txfgf {mnb{btmxef {tfmibxm m ef xbkklnzbnl bief ltmxbzlxf.

R}m{zf }ezfgf jmslnl {btmxm fnzmxtxmzbxm em fnclxgbflnf xbkklezm jf{kxfgfnbnjlem fn txmfl{f fnjff


7/11

l {mgtefkf jbzf.

Fe glnjl jme hbghfnl klg}nfkb bzzxbsmx{l efni}biif jfsmx{f jb r}meef zxbjfflnbef% mj nmkm{{bxfl%tmx k`f ebslxb fn bghfzl tmjfbzxfkl% fgtbxbxef tmx tlzmxm bsmxm }nb h}lnb fnzmxbflnm kln fe hbghfnl

m fe imnfzlxm.

Txflxfz m kleebhlxbflnm

Fe xfklnl{kfgmnzl xmtmnzfnl jmf {minf m {fnzlgf k`m fnjfkbnl ebezmxbflnm jmeem c}nflnf sfzbef clnjbgmnzbem m tmxgmzzm jf gmzzmxm fn bzzl r}mf klgtlxzbgmnzf k`m kln{mnzlnl jf klgtmn{bxm l

xfg}lsmxm f cbzzlxf jf xf{k`fl fn gljl jb txmsmnfxm fe txlixm{{fsl jmzmxflxbgmnzl jmief mr}fefhxf.

M fncbzzf jf sfzbem fgtlxzbnb nme tbfmnzm tmjfbzxfkl eb txmsmnflnm fnzm{b klgm txlnzl xftxf{zfnljf smnzfebflnm% l{{fimnbflnm% slemgfb% mr}fefhxfl bkfjl hb{m% fn gljl jb fnzmxxlgtmxm eb

kbzmnb jfmsmnzf k`m tlxzb beebxxm{zl kbxjfbkl.M nmkm{{bxfl r}fnjf clkbefbxm fe txlhemgb m% jltl bsmxm cbzzl }nb sbe}zbflnm jmeeb {fz}bflnm%txlkmjmxm kln }nb l tf bflnf slezm b xf{lesmxel.Bsmxm k`fbxb eb {mr}mnb jf sbe}zbflnf m bflnf jb klgtfmxm kln{mnzm jf bzzfsbx{f fn gljl mccfkbkm

mj mccfkfmnzm. Ebeilxfzgl jmee}ximnb tmjfbzxfkb clxnfzl jbeem efnmm i}fjb jmeeM}xltmbnXm{}{kfzbzfln Kl}nkfe nmf klx{f jf THE[ bf}zb bj bsmxm }n klgtlxzbgmnzl klxxmzzl m {zbnjbxjfbzl.

Nbz}xbegmnzm r}m{zb kln{fjmxbflnm sbem bnk`m tmx eb{{f{zmnb beebj}ezl.Eb im{zflnm jmeemgmximnb tmjfbzxfkb xfk`fmjm }n ixl{{l fgtminl mglzfsl jb tbxzm jmief ltmxbzlxf%m fe cbzzl jf {btmxm kl{b {f jmsm cbxm fgtminb eb gmnzm m eb jf{zliefm zmgtlxbnmbgmnzm jbeemglzfsfzk`m kbxbzzmxfb emsmnzl.J}xbnzm emgmximnb {lnl clnjbgmnzbef f zxm {mi}mnzf b{tmzzf?2. eb jfsf{flnm jmf x}lefBeefnzmxnl jme ix}ttl jf ebslxl sfmnm nbz}xbegmnzm fnjfsfj}bzl }n embjmx k`m xbttxm{mnzb fekllxjfnbzlxm jmeem ltmxbflnf.

Mief jmsm m{{mxm kln{btmslem jme x}lel bzzxfh}fzlief% m jmsm klgtlxzbx{f fn gljl jb tlzmx jfxfimxmief ltmxbzlxf k`m kleebhlxbnl kln e}f.

Gmnl tmx{lnm jbnnl lxjfnf gmnl kbl{ m zmn{flnm {f kxmbnl.

8. eb kllxjfnbflnm jmief ltmxbzlxf

Fn }n }ximnb kf {bx k`f {f lkk}tb jmexm{tfxl% k`f jme k}lxm% k`f jmf cbxgbkf% k`f jmief

bkkm{{fsb{klebxf% k`f jf beemxzbxm em cfi}xm jme {lkklx{l bsbnbzl (bnm{zm{f{zb,xfbnfgbzlxm% kbxjflelil m

kbxjflk`fx}xil% mkk..&.Fe embjmx {f jmsm lkk}tbxm jmeeb elif{zfkb? jmsm {}jjfsfjmxm f x}lef f gljl k`m lin}nl jmief

ltmxbzlxf {fb fgtminbzl fnzmixbegmnzm fn }nb cb{m jme txlkm{{l jf k}xb% {mnb l{zbklebxm fe ebslxl

jmief bezxf.

R}m{zl kln{mnzm jf lzzfgfbxm f zmgtf m f xf{}ezbzf% jf nln kxmbxm klnc}{flnm% m tmxgmzzm be zmbg jf

txlkmjmxm klgm }n)}nfkb tmx{lnb kln tf gbnf.M txltxfl jb r}m{zl bzzmiifbgmnzl k`m {kbz}xf{km }n klgtlxzbgmnzl kllxjfnbzl jmeem sbxfm cfi}xmk`m ebslxbnl fn }nb {fz}bflnm jf mgmximnb l }ximnb.

;. elxibnfbflnm jmeel {tbfl cf{fkl

Jf }i}bem fgtlxzbnb elxibnfbflnm jmeel {tbfl cf{fkl jlsm {f ebslxb% b gbiiflx xbiflnmr}bnjl fe tbfmnzm tmjfbzxfkl.

22

Eb {tfmibflnm sb jb { fggbifnbnjl em gf{}xm jf }n hbghfnl m klncxlnzbnjlem kln r}meem jf }n

bj}ezl.

M fgtlxzbnzm eb {}jjfsf{flnm cf{fkb jmeel {tbfl? el {tbfl jmeeb zm{zb tmx r}bnzl klnkmxnm ebsmnzfebflnm1el {tbfl jme zxlnkl tmx glnfzlxfbflnm% gb{{biifl kbxjfbklm emsmnz}bem

jmcfhxfeebflnm1 el {tbfl jmeebkkm{{l smnl{l tmx eb txmtbxbflnm m eb {lggfnf{zxbflnm jmfcbxgbkf.

Eb {}jjfsf{flnm jmf x}lef m jmief {tbf kln{mnzm bj linf ltmxbzlxm jf tlzmx{f klnkmnzxbxm {}eebnmeel


8/11

jmeeb kbzmnb jmeeb {ltxbssfsmnb jf {}b klgtmzmnb {mnb fnzxbekfbxm ief bezxf.

Cbxgbkf m kbxxmeel jmeemgmximnzbJbe glgmnzl k`m fgtlxzbnzm eb k`fbxmb jmf klgtfzf m k`m jmslnl m{{mxm jbzf tlk`f klgbnjf gb

k`fbxf% kf lkk}tmxmgl lxb jf r}meef k`m xfi}bxjbnl eb txm{kxfflnm jmf cbxgbkf.Fn imnmxm j}xbnzm }n}ximnb em txm{kxfflnf smnilnl jbzm smxhbegmnzm% m em xfk`fm{zm smnilnl cbzzm

fn gljl smelkm m klnkfzbzl.Z}zzl kf t} imnmxbxm bn{fb m zmn{flnm nmief ltmxbzlxf k`m {f lkk}tbnl jmeeb txmtbxbflnm m

{lggfnf{zxbflnm jmf cbxgbkf.

Em jfe}fflnf jmf cbxgbkf fn bghfzl tmjfbzxfkl {lnl {mgtxm kbxbzzmxfbzm jb }nfz jf gf{}xbtfkklem

k`m jmslnl m{{mxm xfkbsbzm jbe txfnkftfl bzzfsl fn hb{m b txmkf{f kbeklef.

]nb slezb fnjfsfj}bzb eb sfb jf {lggfnf{zxbflnm% eltmxbzlxm k`m {f lkk}tb jmf cbxgbkf jmsm m{{mxmsmelkm% txmkf{l% m jmsm fnzmxbifxm kln ief bezxf ltmxbzlxf fn gljl k`m z}zzf {fbnl txlnzf b cxlnzmiifbxm

{fb mccmzzf bzzm{f jbf cbxgbkf k`m msmnz}bef xmbflnf bssmx{m.

Txltlxflnf mj mr}fsbemnm jmslnl m{{mxm im{zfzf kln glezb jfgm{zfk`mb m bhfefz.

B r}m{zl txltl{fzl lttlxz}nl kfzbxm eb kln{}mz}jfnm fn }{l fn bek}nf kmnzxf jf txmtbxbxm iflxnl tmx

iflxnl jmzmxgfnbzf cbxgbkf jmgmximnb txm'jfe}fzf% kl{ klgm e}zfefbflnm jf zbhmeemtxmkbeklebzmnmeem r}bef {f jmsm {lel fn{mxfxm fe tm{l jme tbfmnzm.Xfgbnm klg}nr}m c}lxf j}hhfl k`m% tmx xfkbsbxm smelkmgmnzm eb r}bnzfz jf cbxgbkl jb

{lggfnf{zxbxm% {lnl nmkm{{bxfm? eb klnl{kmnb jmf txfnkftbef cbxgbkf j}ximnb fn }{l fn xmtbxzl m emelxl txfnkftbef jfe}fflnf% xfkbsbnjl eb klxxf{tlnjmnb jf }n jl{biifl fn gfeefixbggf l kln

}nb }nfz jf gf{}xb fn gfeefefzxf Eltmxbzlxm jmsm klnl{kmxm fnlezxm f cbxgbkf txmjfe}fzf% fn gljl jbtlzmxef }zfefbxm kln eb if}{zb

jfgm{zfk`mb.

Linf xmtbxzl `b }nb txltxfb lxibnfbflnm jf kbxxmeef% sb{{lf l kb{{mzzf b zmgb fn hb{m beeb zftlelifb

jf tbfmnzm k`m bkkliefm.

Fe kbxxmeel jmeemgmximnb sbxfb fn hb{m bee}nfz ltmxbzfsb fn k}f {f zxlsb? zmxbtfb fnzmn{fsb% {bebltmxbzlxfb l xmtbxzl jf jmimnb.

Fn }nb nlxgbem }nfz jf jmimnb jlsxmhhm m{{mxm txm{mnzm }n kbxxmeel jmgmximnb txbzfkl%m{{mnfbem% }nfsmx{begmnzm klnl{kf}zl jbeem cfi}xm k`m kleebhlxbnl nme xmtbxzl% klnzxleebzl kln

xmilebxfz% m kln }n fjlnml {f{zmgb jf {fk}xmb b {fifeel.Fe kbxxmeel jmsm m{{mxm txbzfkl% fn gljl jb tlzmx m{{mxm gbnmiifbzl bimslegmnzm beefnzmxnl jf }nb}nfz ltmxbzfsb1 eb {}b klgtl{fflnm jmsm m{{mxm m{{mnfbem% slezb b klnj}xxm fe tbfmnzm {fnl beeb

{zbhfefbflnm1 ief ltmxbzlxf jmslnl m{{mxm b klnl{kmnb jf kf k`m klnzfmnm fn gljl jb tlzmx

zxlsbxm cbkfegmnzm fe gbzmxfbem.

Fncfnm fe kbxxmeel jmsm m{{mxm klnzxleebzl m {fifeebzl xmilebxgmnzm% b ibxbnfb k`m z}zzl {fb be txltxfl

tl{zl.[}e kbxxmeel jlsxmhhm m{{mxm tl{zl }n jmcfhxfeebzlxm {mgfb}zlgbzfkl,gbn}bem kln c}nflnm jftbkfni k`m z}zzf ief ltmxbzlxf jmslnl m{{mxm bjjm{zxbzf bj }{bxm.

Fe jmcfhxfeebzlxm jmsm m{{mxm klnzxleebzl kln kbjmnm txm{zbhfefzm (begmnl }nb slezb be iflxnl& jb

cfi}xm fnjfsfj}bzm kln k`fbxmb.

28

:. CBXGBKF JMEE]XIMN_BEb zmxbtfb cbxgbklelifkb nmeeb xfbnfgbflnm kbxjfltleglnbxm {mxsm b {zfglebxm m {}ttlxzbxm eb

c}nflnbefz kbxjflkfxklebzlxfb mj b}gmnzbxm eb txm{{flnm bxzmxfl{b gfieflxbnjl eb tmxc}{flnm m

el{{fimnbflnm b efsmeel jme gflkbxjfl% jmeemnkmcbel jmf xmnf mj bezxf lxibnf sfzbef.B r}m{zl {kltl f cbxgbkf txfgbxf fgtfmibzf nmeeb xfbnfgbflnm {lnl?

BJXMNBEFNBM[TBN[LXF JF SLE]GM

BZXLTFNB


9/11

HFKBXHLNBZL JF [LJFL

CBXGBKF BNZFBXFZGFKF bjmnl{fnb% efjlkbfnb% bgfljbxlnmSf {lnl tlf f cbxgbkf jf {}ttlxzl kbxjflsb{klebxm tl{z xfbnfgbflnm kbxjfltleglnbxm?

Jltbgfnb

Jlh}zbgfnb

Bjxmnbefnb

Mj bezxf cbxgbkf }zfef nme {}ttlxzl xfbnfgbzlxfl bsbnbzl?

Kbekfl

Ie}kl{fl

Gbinm{fl

BJXMNBEFNBM }nb kbzmklebgfnb mnjlimnb fe k}f mccmzzl m r}meel jf b}gmnzbxm eb cxmr}mnb kbxjfbkb

b}gmnzbxm eb clxb jf klnzxbflnm jme gflkbxjfl

b}gmnzbxm eb txm{{flnm {f{zmgfkb

b}gmnzbxm eb txm{{flnm jfb{zlefkb blxzfkb m r}fnjf fe ce}{{l klxlnbxfkl

jmzmxgfnb hxlnkljfebzbflnm

kln{mnzm }nb gbiiflxm mccfkbkfb jmeeb jmcfhxfeebflnm% txmtbxbnjl em kmee}em gflkbxjfk`m beeb

jmtlebxfbflnm

TXMTBXB_FLNM

2 ge 7 2 gi(2?2444&

Eb {lggfnf{zxbflnm jmeebjxmnbefnb t} m{{mxm xftmz}zb linf ;% = gfn}zf kln el {zm{{l jl{biifl.R}m{zl cbxgbkl fnbzzfsbzl jbf hfkbxhlnbzl% tmxzbnzl nln sb gm{klebzb bj m{{f nmeeb sfb jf

fnc}{flnm. [m {f jmsm }zfefbxm eb {zm{{b sfb% b{{fk}xbx{f }n h}ln ebsbiifl zxb }n cbxgbkl m ebezxl.Sfmnm }{bzb bnk`m fn fnc}{flnm klnzfn}b.

CE]FJF TMX EM[TBN[FLNM JF SLE]GMSmnilnl }{bzf fn z}zzf f zftf jf {`lka? ftlslemgfkl% mglxxbifkl% {mzzfkl% bnbcfebzzfkl m nmeebxxm{zlkbxjfbkl. F elxl mccmzzf {lnl glezmtefkf?

xftxf{zfnl sle}gm kfxklebnzm

klxxmflnm jmeebkfjl{f gmzbhlefkb2;

gbnzmnfgmnzl jf }nbjmi}bzb txm{{flnm jf tmxc}{flnm j}xbnzm em klgtxm{{flnf kbxjfbk`m {zfglel klnzxbzzfefz gflkbxjfkb mj b}gmnzl jmeeb cxmr}mnb kbxjfbkb

klxxmflnm jmief {r}fefhxf gmzbhlefkf

ZFTL JF CE]FJF

Kxf{zbeelfjf? {le}flnf f{lzlnfk`m r}bef cf{flelifkb (NbKe 4%6-& l Xfnimx ebzzbzl

Tlefgmxf {fnzmzfkf? (m{.Mgbime&BZXLTFNBM }n cbxgbkl tbxb{fgtbzfklefzfkl k`m bnzbilnfb ief mccmzzf jmeebkmzfeklefnb% b}gmnzbnjl ebcxmr}mnb kbxjfbkb m eb klnj}flnm bzxfl'smnzxfklebxm.

Sfmnm }zfefbzl nmeem hxbjfkbxjfm kb}{bzm jb helkkl bzxfl'smnzxfklebxm l b}gmnzbzl zlnl sbibem m

nmief bssmemnbgmnzf jb lxibnlcl{clxfkf.

TXMTBXB_FLNM

Cfbeb jb 4%= gi,ge?biif}nimxm beeb cfbeb : ge jf {le}flnm cf{flelifkb

Cfbeb jb 2 gi,ge?biif}nimxm beeb cfeb 6ge jf {le}flnm cf{flelifb

Fn r}m{zl gljl {f lzzfmnm k`m 2 ge 7 4.2 gi.

M xftmzfhfem }nb {leb slezb mj `b emccmzzl gb{{fgl jltl 28'2= gfn}zf kln }nb j}xbzb jbflnm zxb em8'3 lxm.

HFKBXHLNBZL JF [LJFL[f }{b nmeebkfjl{f gmzbhlefkb m nmeeftmxtlzb{{fmgfb.


10/11

TXMTBXB_FLNM

Nb@KL; 0%:- 7 2gMr,ai

M }zfem jfe}fxm eb {le}flnm kln }n mi}bem sle}gm jf {le}flnm hfjf{zfeebzb fn gljl k`m 2 geklxxf{tlnjb b 4.= gMr.

R}m{zl cbxgbkl m{{mnjl }nb {le}flnm bekbefnb% {m fnc}{l nmeeb {zm{{b sfb smnl{b jmeem kbzmklebgfnm

nm jf{bzzfsb emccmzzl% m b{{lkfbzl fn fnc}{flnm kln txmtbxbzf k`m klnzmnilnl kbekfl t} clxgbxmtxmkftfzbzf.BJMNL[FNBM }n nm}xlzxb{gmzzfzlxm jme {f{zmgb nmxsl{l kmnzxbem k`m% b efsmeel kbxjfbkl %xbeemnzb eb klnj}flnmbzzxbsmx{l fe nljl bzxfl'smnzxfklebxm. R}m{zl gmkkbnf{gl jbflnm xf{}ezb mccfkbkm nmeefnzmxxlgtmxm}nb zbk`fkbxjfb tbxl{{f{zfkb {ltxbsmnzxfklebxm.

TXMTBXB_FLNM

Axmnl{fn ce ;gi,ge

Nln txmsf{zb eb jfe}fflnm {f }{b fn hlel xbtfjl {mi}fzl jb }nb ebsbiifl jf ;,= ge jf {le}flnm

cf{flelifkb. Fe cbxgbkl sfmnm fnc}{l xbtfjbgmnzm tmxk` fe {}l mccmzzl jmeeb j}xbzb jf kfxkb 24

{mklnjf fn r}bnzl sfmnm gmzbhlefbzl {}hfzl jbf ielh}ef xl{{f .

Fggmjfbzbgmnzm jltl eb {lggfnf{zxbflnm {f t} bsmxm }n tmxfljl zxbn{fzlxfl jf b{f{zlefb lhxbjfbxfzgfb. Fe tbfmnzm sb {mgtxm glnfzlxbzl kln mki j}xbnzm z}zzb eb txlkmj}xb .[f t} bsmxm

zxbn{fzlxfbgmnzm fnlezxm jf{tnmb% jlelxm zlxbkfkl% ceb{` k}zbnmf m hxlnklkl{zxfflnm.

2:

BGFLJBXLNMM }n cbxgbkl bnzfbxfzgfkl% klgtmzfzfsl kln f xmkmzzlxf becb m hmzb bjxmnmxifkf. F {}lf mccmzzf {lnl? sb{ljfebzbflnm

xbeemnzbgmnzl jmeeb klnj}flnm bzzxbsmx{l fe nljl B'S

txle}nibgmnzl jmeefnzmxsbeel RZ xbeemnzbgmnzl jmeeb klnj}flnm jmeefgt}e{l bzzxbsmx{l fe gflkbxjfl kln fe helkkl jmf kbnbef

kmee}ebxf jme {ljflTXMTBXB_FLNM

Cfbem jb =4 gi,ge.

EFJLKBFNBM }n cbxgbkl bnzfbxfzgfkl% k`m helkkb f kbnbef jf {ljfl xfj}kmnjl eb cb{m jfb{zlefkb jfxftlebxfbflnm% helkkbnjl eb txlixm{{flnm jf msmnz}bef fgt}e{f bnlgbef.

TXMTBXB_FLNM

Cfbem jb 24 gi,ge (2-& m jb 84 gi,ge (8-&.

JLTBGFNBM }nb kbzmklebgfnb mnjlimnb% bilnf{zb bjxmnmxifkl% b}gmnzb eb cxmr}mnb kbxjfbkb% eb ifzzbzb m ebtxm{{flnm {f{zlefkb% txlk}xbnjl }nb sb{lkl{zxfflnm tmxfcmxfkb.

B jl{f hb{{m `b zmlxfkbgmnzm }n mccmzzl jf sb{ljfebzbflnm jme jf{zxmzzl kmxmhxbem m xmnbem.[f }{b fn fnc}{flnm klnzfn}b.

TXMTBXB_FLNM

M{f{zlnl cfbem jb :4 gi,ge m jb 04 gi,ge.

Eb jl{m jf cbxgbkl jb gmzzmxm fn {le}flnm sfmnm kbeklebzb bzzxbsmx{l sbxfm clxg}em gbzmgbzfk`m zxb

k}f eb tf nlzb r}meeb jmeeb xmileb jme {mf.

Fe efgfzm jf r}m{zb xmileb emibzl be sfnklel jf b}gmnzbxm glezl f efr}fjf fnc}{f fn }n lxb tmx

b}gmnzbxm fe jl{biifl jme cbxgbkl% r}fnjf r}bnjl nmkm{{bxfl gbnzmnmxm xf{zxmzzmm nmf sle}gf

fnc}{f {f tl{{lnl bttefkbxm bezxm xmilem gbzmgbzfk`m.

JLH]ZBGFNB

M }nb kbzmklebgfnb k`m b}gmnzb eb klnzxbzzfefz kbxjfbkb xfj}kmnjl fe zlnl sb{klebxm tmxfcmxfklkb}{bnjl r}fnjf }nb efmsm jfebzbflnm. [f }{b fn fnc}{flnm klnzfn}b.TXMTBXB_FLNM


11/11

Eb txmtbxbflnm fn cfbem jb 28.= gi,ge% m eb jl{m jf cbxgbkl jb gmzzmxm fn fnc}{flnm sfmnm

kbeklebzb klgm tmx eb jltbgfnb.

2=

=. KB[L KEFNFKLTxltlnfbgl lxb }n kb{l kefnfkl nme r}bem {f s}lem gl{zxbxm klgm gmzzmxm fn txbzfkb em

fnjfkbflnf txltl{zm nmf kbtfzlef txmkmjmnzf jf cxlnzm bj }nb {fz}bflnm jf mgmximnb.Fe kb{l tbxeb jmeeb tfkkleb If}efb.% }nb hbghfnb jf 0 iflxnf bccmzzb jb }nb klbxzbflnm blxzfkb

m xfklsmxbzb fn zmxbtfb {mgf'fnzmn{fsb. Tmx emf {zbzb jfbinl{zfkbzb }nb kbxjfltbzfb klnimnfzb fn

mtlkb txmnbzbem m fe tbxzl {zbzl txlixbggbzl txm{{l fe [. Lx{leb jf Hlelinb tmx smelkfbxm

ebkkm{{l be xmtbxzl jf kbxjflelifb m kbxjflk`fx}xifb tmjfbzxfkb.Beeb nb{kfzb% r}fnjf% eb hbghfnb {zbzb {}hfzl zxb{cmxfzb nmeeb nl{zxb }nfz ltmxbzfsb.

Beebxxfsl em {zbzl tl{fflnbzl }n kbzmzmxm smnl{l kmnzxbem fn smnb lghmefkbem b j}m e}gf m {lnl{zbzm gm{{m fn fnc}{flnm klnzfn}b }nb ie}kl{bzb be =- m em txl{zbiebnjfnm tmx gbnzmnmxm tmxsfl fe

jlzzl jf Hlzbeel cfnl be glgmnzl jmeefnzmxsmnzl kbxjflk`fx}xifkl.Fgtxlssf{bgmnzm% eb tfkkleb `b txm{mnzbzl }nb hx}{kb jm{bz}xbflnm b {mi}fzl jf }nb btnmb

({fz}bflnm jf ]XIMN_B&. M {zbzb {zfglebzb gb fe xm{tfxl nln {f xftxm{l nmggmnl bssfkfnbnjlemel{{fimnl be sf{l? xmtmnzfnbgmnzm {f hxbjfkbxjfbzb ({fz}bflnm jf MGMXIMN_B&.CB[F?

Fe txfgl ltmxbzlxm% k`m mxb txm{mnzm bf cbzzf% {f lkk}tbzl jf b{{f{zmxm eb hbghfnb jbet}nzl jf sf{zb xm{tfxbzlxfl% ibxbnzmnjl eb tmxsfmz jmeem sfm bmxmm m smnzfebnjleb kln fe

tbeelnm b}zlm{tbn{fhfem m el{{fimnl be 244-. Fe {mklnjl ltmxbzlxm `b {}lnbzl ebeebxgm tmx xfk`fbgbxm ief bezxf fncmxgfmxf nmeeb{zbnb1 {f tl{fflnbzl sfkfnl be zlxbkm jmeeb tfkkleb g}nfzl jmf cbxgbkf jf

mgmximnb txmjfe}fzf m {f txmtbxbzl bj b{{f{zmxeb kln fe gb{{biifl kbxjfbkl.

Fe zmxl ltmxbzlxm% {ltxbiif}nzl fn{fmgm be gmjfkl% {f lkk}tbzl jf xmk}tmxbxm fe

kbxxmeel jmeemgmximnb. Jbzl k`m eb cxmr}mnb kbxjfbkb mxb {km{b {lzzl f 34 h,gfn% fe

gmjfkl `b fnffbzl fe gb{{biifl kbxjfbkl m{zmxnl m ief `b k`fm{zl jf beemxzbxmebnm{zm{f{zb m jf txmtbxbxm ebjxmnbefnb m ebzxltfnb txmjfe}fzm. B r}m{zl t}nzl efncmxgfmxm jmsm sbe}zbxm bzzmnzbgmnzm eb sfb jfnc}{flnm jb k}f {ft} bkkmjmxm tmx {lggfnf{zxbxm f cbxgbkf jmgmximnb% sbe}zbnjl bzzmnzbgmnzm emfnc}{flnf fn klx{l. Nme kb{l {tmkfcfkl smxx {kmezl fe e}gm jb k}f {f {zb fnclnjmnjl eb

ie}kl{bzb be =-.

Clxz}nbzbgmnzm% em gbnlsxm jf xfbnfgbflnm `bnnl {lxzfzl }n h}ln mccmzzl {mnb xfklxxmxm

bee}zfefl jmf cbxgbkf m If}efb {f xftxm{b.Bkr}f{fxm }nl {k`mgb gmnzbem m txbzfkl mccfkbkm tmx tlzmx bccxlnzbxm em }ximnm m em

mgmximnm jlsxmhhm m{{mxm }n lhfmzzfsl txflxfzbxfl tmx linf mr}ftm.

23

HFHEFLIXBCFB FXK [FGM]T% Tmjfbzxfk Bjsbnkm{ Efcm [}ttlxz% Gb{{ln 844:1

FXK [FGM]T% Tmjfbzxfk Hb{fk Efcm [}ttlxz% Gljmxnb 84481

Bgmxfkbn @mbxz B{{lkfbzfln%Mgmximnm Kbxjflsb{klebxf% Kmnzxl [kfmnzfcfkl mjfzlxm 844:1

Hmzz E.Ib`bxz% Bjxfmnnm X. Nbbxmnl%Fnzxbsmnl}{ Gmjfkbzfln{% Gl{hv 26661

@l{tfzbe clx [fka K`fejxmn%Jx}i @bnjhlla bnj Clxg}ebxv% Befkm Alybekva% H.[.T`bxg%

T`bxg.J.1

G. Gb}xf% G.Hx}{zfb% Im{zflnm fncmxgfmxf{zfkb jmf cbxgbkf kbxjflsb{klebxf% IFZFK 844=

Ftb{sf Mgfefb Xlgbinb%B}zlnlgfb% Klgtmzmnb% Xm{tln{bhfefz fncmxgfmxf{zfkb% 844;.

gestione infermieristica dei farmaci d'urgenza e cardiovascolari

Documents

Transcript of gestione infermieristica dei farmaci d'urgenza e cardiovascolari