{"id":389,"date":"2019-06-07T04:04:18","date_gmt":"2019-10-07T04:04:18","guid":{"rendered":"http:\/\/pnt.badt.vn\/bantin\/?p=389"},"modified":"2019-10-07T04:04:20","modified_gmt":"2019-10-07T04:04:20","slug":"quan-ly-nguy-co-va-cac-bien-co-y-khoa-khong-y-muon","status":"publish","type":"post","link":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/?p=389","title":{"rendered":"qu\u1ea3n l\u00fd nguy c\u01a1 v\u00e0 c\u00e1c bi\u1ebfn c\u1ed1 y khoa kh\u00f4ng \u00fd mu\u1ed1n"},"content":{"rendered":"\n<p>Y khoa l\u00e0 l\u0129nh v\u1ef1c khoa h\u1ecdc bi\u1ec7n ch\u1ee9ng trong \u0111\u00f3 ki\u1ebfn th\u1ee9c y h\u1ecdc thay \u0111\u1ed5i theo tr\u00ecnh \u0111\u1ed9 c\u1ee7a khoa h\u1ecdc v\u00e0 m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng c\u1ee7a th\u1eddi \u0111i\u1ec3m hi\u1ec7n t\u1ea1i. H\u1ec7 qu\u1ea3 t\u1ea5t y\u1ebfu l\u00e0 trong y h\u1ecdc lu\u00f4n t\u1ed3n t\u1ea1i nh\u1eefng gi\u1edbi h\u1ea1n chuy\u00ean m\u00f4n. C\u00f3 nh\u1eefng b\u1ec7nh l\u00fd, nh\u1eefng tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh v\u01b0\u1ee3t qu\u00e1 kh\u1ea3 n\u0103ng ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u1ee7a y h\u1ecdc. Do v\u1eady, \u0111i\u1ec1u \u0111\u1ea7u ti\u00ean m\u00e0 nh\u00e2n vi\u00ean y t\u1ebf ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o v\u00e0 ph\u1ea3i n\u1eafm v\u1eefng trong ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n l\u00e0: \u201ckh\u00f4ng l\u00e0m cho b\u1ec7nh n\u1eb7ng th\u00eam\u201d (First, do no harm). <br> An to\u00e0n ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 tr\u1edf th\u00e0nh m\u1ed9t trong nh\u1eefng th\u00e1ch th\u1ee9c l\u1edbn nh\u1ea5t trong l\u0129nh v\u1ef1c y t\u1ebf[5]. T\u1ea7n su\u1ea5t v\u00e0 m\u1ee9c \u0111\u1ed9 t\u00e1c \u0111\u1ed9ng c\u1ee7a tai bi\u1ebfn \u0111i\u1ec1u tr\u1ecb tr\u00ean th\u1ebf gi\u1edbi kh\u00f4ng \u0111\u01b0\u1ee3c bi\u1ebft r\u00f5 cho \u0111\u1ebfn nh\u1eefng n\u0103m th\u1eadp k\u1ef7 90, khi m\u00e0 nhi\u1ec1u qu\u1ed1c gia tr\u00ean th\u1ebf gi\u1edbi c\u00f4ng b\u1ed1 s\u1ed1 l\u01b0\u1ee3ng l\u1edbn b\u1ec7nh nh\u00e2n b\u1ecb nguy hi\u1ec3m do c\u00e1c tai bi\u1ebfn \u0111i\u1ec1u tr\u1ecb g\u00e2y ra, \u01b0\u1edbc t\u00ednh c\u1ee9 10 b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n th\u00ec c\u00f3 1 b\u1ec7nh nh\u00e2n b\u1ecb tai bi\u1ebfn \u0111i\u1ec1u tr\u1ecb[5]. G\u00e1nh n\u1eb7ng v\u1ec1 m\u1eb7t kinh t\u1ebf c\u1ee7a vi\u1ec7c ch\u0103m s\u00f3c y khoa kh\u00f4ng an to\u00e0n c\u0169ng r\u1ea5t \u0111\u00e1ng b\u00e1o \u0111\u1ed9ng. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y chi ph\u00ed ph\u1ee5 tr\u1ed9i g\u00e2y ra do c\u00e1c tai bi\u1ebfn y khoa bao g\u1ed3m chi ph\u00ed n\u1eb1m vi\u1ec7n l\u00e2u h\u01a1n, m\u1ea5t thu nh\u1eadp, m\u1ea5t s\u1ee9c lao \u0111\u1ed9ng\u2026 v\u00e0o kho\u1ea3ng 6 \u0111\u1ebfn 29 t\u1ec9 \u0111\u00f4 la M\u1ef9 m\u1ed7i n\u0103m [5]<br> Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, ng\u00e0y c\u00e0ng nhi\u1ec1u b\u00e1o c\u00e1o nghi\u00ean c\u1ee9u t\u1eadp trung m\u00f4 t\u1ea3, ph\u00e2n t\u00edch v\u00e0 t\u00ecm h\u01b0\u1edbng can thi\u1ec7p nh\u1eb1m gi\u1ea3m thi\u1ec3u sai s\u00f3t kh\u00f4ng \u0111\u00e1ng c\u00f3 trong th\u1ef1c h\u00e0nh y khoa. C\u00f3 nh\u1eefng sai s\u00f3t c\u00f3 th\u1ec3 kh\u00f4ng g\u00e2y \u1ea3nh h\u01b0\u1edfng quan tr\u1ecdng, kh\u00f4ng \u0111\u01b0\u1ee3c ch\u00fa \u00fd; m\u1ed9t s\u1ed1 kh\u00e1c c\u00f3 th\u1ec3 g\u00e2y nh\u1eefng h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng th\u1eadm ch\u00ed \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ti\u00ean l\u01b0\u1ee3ng s\u1ed1ng c\u00f2n c\u1ee7a ng\u01b0\u1eddi \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c (v\u00ed d\u1ee5 nh\u01b0 d\u00f9ng thu\u1ed1c c\u1ea3n quang trong ch\u1ee5p CT n\u00e3o, ho\u1eb7c ch\u1ec9 \u0111\u1ecbnh g\u00e2y m\u00ea tr\u00ean b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng v\u1edbi thu\u1ed1c g\u00e2y m\u00ea, suy th\u1eadn sau ch\u1ee5p c\u1ea3n quang \u0111\u1ed9ng m\u1ea1ch v\u00e0nh). Vi\u1ec7c can thi\u1ec7p ph\u00f2ng ng\u1eeba bi\u1ebfn ch\u1ee9ng y khoa hi\u1ec7n nay \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u trong m\u1ed9t ph\u1ea1m tr\u00f9 m\u1edbi, \u0111\u00f3 l\u00e0 \u201cd\u1ef1 ph\u00f2ng c\u1ea5p IV\u201d. C\u00f3 th\u1ec3 n\u00f3i, v\u1edbi vai tr\u00f2 l\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c v\u00e0 b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, b\u00e1c s\u0129 gia \u0111\u00ecnh l\u00e0 ng\u01b0\u1eddi tham gia tr\u1ef1c ti\u1ebfp v\u00e0 th\u01b0\u1eddng tr\u1ef1c trong d\u1ef1 ph\u00f2ng c\u1ea5p IV nhi\u1ec1u h\u01a1n so v\u1edbi c\u00e1c chuy\u00ean ng\u00e0nh chuy\u00ean s\u00e2u kh\u00e1c.<br> Theo t\u00e1c gi\u1ea3 Kohn LT trong b\u00e0i t\u1ed5ng quan v\u1ec1 c\u00e1c nguy c\u01a1 tai bi\u1ebfn l\u00e2m s\u00e0ng: sai s\u00f3t k\u1ef9 thu\u1eadt (technical incompetence) chi\u1ebfm 44%, sai s\u00f3t v\u1ec1 ch\u1ea9n \u0111o\u00e1n chi\u1ebfm 14%, th\u1ea5t b\u1ea1i trong vi\u1ec7c ph\u00f2ng ng\u1eeba bi\u1ebfn ch\u1ee9ng  chi\u1ebfm 12% v\u00e0 sai s\u00f3t trong k\u00ea toa chi\u1ebfm 10%[2],[4].<\/p>\n\n\n\n<p><strong> Ph\u00e2n lo\u1ea1i bi\u1ebfn c\u1ed1 y khoa kh\u00f4ng mong mu\u1ed1n<\/strong><\/p>\n\n\n\n<p> Th\u00f4ng th\u01b0\u1eddng, khi \u0111\u1ee9ng tr\u01b0\u1edbc m\u1ed9t di\u1ec5n bi\u1ebfn l\u00e2m s\u00e0ng b\u1ea5t th\u01b0\u1eddng, ch\u00fang ta c\u1ea7n ph\u00e2n bi\u1ec7t c\u00e1c lo\u1ea1i tai bi\u1ebfn y khoa:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Di\u1ec5n bi\u1ebfn c\u1ee7a b\u1ec7nh: v\u00ed d\u1ee5 nh\u01b0 tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n s\u1ed1t xu\u1ea5t huy\u1ebft c\u00f3 th\u1ec3 s\u1ebd di\u1ec5n ti\u1ebfn s\u1ed1c v\u00e0o ng\u00e0y th\u1ee9 4-5 c\u1ee7a b\u1ec7nh. N\u1ebfu s\u1ed1c c\u00f3 x\u1ea3y ra, di\u1ec5n ti\u1ebfn n\u00e0y kh\u00f4ng th\u1ec3 d\u1ef1 \u0111o\u00e1n, v\u00e0 h\u1ea7u nh\u01b0 kh\u00f4ng li\u00ean \u0111\u1edbi tr\u1ef1c ti\u1ebfp \u0111\u1ebfn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3. V\u00ed d\u1ee5 kh\u00e1c nh\u01b0 trong di\u1ec5n ti\u1ebfn \u0111i\u1ec1u tr\u1ecb c\u1ee7a vi\u00eam nhi\u1ec5m c\u1ea5p h\u00f4 h\u1ea5p tr\u00ean c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n vi\u00eam tai gi\u1eefa. Ho\u1eb7c trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u tr\u1ecb COPD \u1ed5n \u0111\u1ecbnh t\u1ea1i c\u1ed9ng \u0111\u1ed3ng th\u00ec xu\u1ea5t hi\u1ec7n \u0111\u1ee3t b\u1ec7nh vi\u00eam ph\u1ed5i g\u00e2y suy h\u00f4 h\u1ea5p c\u1ea5p. <\/li><li>T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a b\u1ea3n th\u00e2n ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb: bao g\u1ed3m t\u1ea5t c\u1ea3 c\u00e1c h\u1eadu qu\u1ea3 li\u00ean \u0111\u1edbi \u0111\u1ebfn can thi\u1ec7p li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n: nhi\u1ec5m tr\u00f9ng b\u1ec7nh vi\u1ec7n \u0111\u1ed1i v\u1edbi quy\u1ebft \u0111\u1ecbnh ch\u1ec9 \u0111\u1ecbnh nh\u1eadp vi\u1ec7n trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u1ea7n thi\u1ebft; d\u1ecb \u1ee9ng thu\u1ed1c c\u1ea3n quang trong ch\u1ee5p CT (c\u1eadn l\u00e2m s\u00e0ng); nguy c\u01a1 d\u00ednh ru\u1ed9t sau ph\u1eabu thu\u1eadt v\u00f9ng b\u1ee5ng (can thi\u1ec7p ngo\u1ea1i khoa); t\u00e1c d\u1ee5ng t\u0103ng nh\u1ecbp tim c\u1ee7a thu\u1ed1c Nifedipine (can thi\u1ec7p n\u1ed9i khoa). <\/li><li>Sai s\u00f3t trong \u0111i\u1ec1u tr\u1ecb: c\u00e1c tr\u01b0\u1eddng h\u1ee3p ch\u1ea9n \u0111o\u00e1n kh\u00f4ng ch\u00ednh x\u00e1c, t\u1ea7m so\u00e1t kh\u00f4ng ra b\u1ec7nh, \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u00f9 h\u1ee3p v\u1edbi b\u1ec7nh c\u1ea3nh, di\u1ec5n ti\u1ebfn n\u1eb7ng trong \u0111i\u1ec1u tr\u1ecb l\u00e0 nh\u1eefng t\u00ecnh hu\u1ed1ng n\u1eb1m trong nh\u00f3m n\u00e0y. Ch\u1ec9 nh\u1eefng sai s\u00f3t l\u00e0 kh\u00f4ng ch\u1ee7 \u00fd, mang t\u00ednh kh\u00e1ch quan m\u1edbi \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o nh\u00f3m n\u00e0y. <\/li><li>Sai ph\u1ea1m (t\u1ea5t tr\u00e1ch): \u0111i\u1ec1u n\u00e0y li\u00ean quan t\u1ea5t tr\u00e1ch, thi\u1ebfu tr\u00e1ch nhi\u1ec7m trong c\u00f4ng vi\u1ec7c d\u1eabn \u0111\u1ebfn vi\u1ec7c \u1ea3nh h\u01b0\u1edfng s\u1ee9c kh\u1ecfe b\u1ec7nh nh\u00e2n. \u0110\u1eb7c \u0111i\u1ec3m gi\u00fap ph\u00e2n bi\u1ec7t nh\u00f3m sai ph\u1ea1m so v\u1edbi nh\u00f3m sai s\u00f3t \u0111i\u1ec1u tr\u1ecb l\u00e0 \u1edf kh\u00eda c\u1ea1nh c\u1ed1 \u00fd l\u00e0m sai, l\u00e0m tr\u00e1i c\u00e1c qui \u0111\u1ecbnh \u2013h\u01b0\u1edbng d\u1eabn \u2013 khuy\u1ebfn c\u00e1o \u0111\u00e3 c\u00f3,  mang t\u00ednh ch\u1ee7 quan t\u1eeb ph\u00eda nh\u00e2n vi\u00ean y t\u1ebf.<br>\nM\u1ed9t tai bi\u1ebfn y khoa c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o nh\u00f3m n\u00e0y hay nh\u00f3m kh\u00e1c t\u00f9y thu\u1ed9c v\u00e0o b\u1ea3n ch\u1ea5t nguy\u00ean nh\u00e2n g\u00e2y ra tai bi\u1ebfn. V\u00ed d\u1ee5 trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng \u0111\u1ea7u v\u00e0 c\u00f3 ch\u1ec9 \u0111\u1ecbnh ch\u1ee5p c\u1eaft l\u1edbp \u0111i\u1ec7n to\u00e1n (CT scan) v\u00f9ng \u0111\u1ea7u v\u1edbi ch\u1ea5t c\u1ea3n quang (\u0111\u1ec3 ph\u00e1t hi\u1ec7n kh\u1ed1i m\u00e1u t\u1ee5 xu\u1ea5t huy\u1ebft). <\/li><li>N\u1ebfu b\u1ec7nh nh\u00e2n di\u1ec5n ti\u1ebfn \u0111i v\u00e0o s\u1ed1c v\u1edbi huy\u1ebft \u00e1p th\u1ea5p do nguy\u00ean nh\u00e2n b\u1ec7nh n\u1ec1n c\u00f3 s\u1eb5n m\u00e0 kh\u00f4ng li\u00ean quan \u0111\u1ebfn ch\u1ea5t c\u1ea3n quang th\u00ec \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o nh\u00f3m I (do di\u1ec5n ti\u1ebfn c\u1ee7a b\u1ec7nh xu\u1ea5t huy\u1ebft n\u00e3o n\u1eb7ng). <\/li><li>N\u1ebfu t\u00ecnh tr\u1ea1ng t\u1ee5t huy\u1ebft \u00e1p n\u00e0y li\u00ean quan \u0111\u1ebfn thu\u1ed1c c\u1ea3n quang m\u00e0 b\u1ec7nh nh\u00e2n ch\u01b0a h\u1ec1 ghi nh\u1eadn ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng thu\u1ed1c, qui tr\u00ecnh \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ed1t c\u00e1c b\u01b0\u1edbc th\u00ec \u0111\u00e2y l\u00e0 tai bi\u1ebfn nh\u00f3m II (do t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb).<\/li><li>N\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u00e3 c\u00f3 ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng v\u1edbi thu\u1ed1c, nh\u00e2n vi\u00ean y t\u1ebf \u0111\u00e3 test thu\u1ed1c ra k\u1ebft qu\u1ea3 \u00e2m t\u00ednh nh\u01b0ng th\u1ef1c t\u1ebf khi ti\u1ebfn h\u00e0nh ti\u00eam thu\u1ed1c th\u1eadt s\u1ef1 th\u00ec b\u1ecb s\u1ed1c li\u00ean quan \u0111\u1ebfn ch\u1ea5t c\u1ea3n quang th\u00ec \u0111\u00e2y l\u00e0 tai bi\u1ebfn nh\u00f3m III (sai s\u00f3t trong \u0111i\u1ec1u tr\u1ecb). <\/li><li>Trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n m\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 ti\u1ec1n c\u0103n s\u1ed1c thu\u1ed1c trong qu\u00e1 kh\u1ee9, \u0111\u00e3 b\u00e1o cho nh\u00e2n vi\u00ean y t\u1ebf, b\u1ec7nh nh\u00e2n v\u1eabn kh\u00f4ng \u0111\u01b0\u1ee3c th\u1eed test da thu\u1ed1c c\u1ea3n quang tr\u01b0\u1edbc khi ti\u00eam do nh\u00e2n vi\u00ean y t\u1ebf kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u00fang qui tr\u00ecnh, b\u00e1c s\u0129 kh\u00f4ng \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c v\u1ec1 nguy c\u01a1 d\u1ecb \u1ee9ng v\u1edbi thu\u1ed1c, b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c k\u00fd cam k\u1ebft tr\u01b0\u1edbc khi ti\u00eam thu\u1ed1c c\u1ea3n quang th\u00ec l\u1ed7i n\u00e0y l\u1ea1i n\u1eb1m trong nh\u00f3m IV (sai ph\u1ea1m). <br>\n\u0110\u1ed1i v\u1edbi nh\u00f3m di\u1ec5n ti\u1ebfn c\u1ee7a b\u1ec7nh v\u00e0 nh\u00f3m t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a \u0111i\u1ec1u tr\u1ecb, vi\u1ec7c ph\u00f2ng ng\u1eeba tai bi\u1ebfn kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng d\u1ec5 d\u00e0ng tr\u00e1nh kh\u1ecfi. L\u00fd do l\u00e0 v\u00ec n\u00f3 thu\u1ed9c t\u00ednh kh\u00e1ch quan c\u1ee7a ch\u00ednh hi\u1ec7n t\u01b0\u1ee3ng (di\u1ec5n ti\u1ebfn c\u1ee7a b\u1ec7nh t\u1eadt, vai tr\u00f2 t\u01b0\u01a1ng \u0111\u1ed1i c\u1ee7a \u0111i\u1ec1u tr\u1ecb). Ch\u00ednh do v\u1eady, 2 nh\u00f3m n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c xem l\u00e0 sai s\u00f3t y khoa. \u0110\u1ec3 gi\u1ea3m thi\u1ec3u c\u00e1c nguy c\u01a1 tai bi\u1ebfn n\u00e0y, c\u00e1c gi\u1ea3i ph\u00e1p \u0111\u01b0a ra bao g\u1ed3m: nghi\u00ean c\u1ee9u s\u00e2u v\u1ec1 c\u01a1 ch\u1ebf b\u1ec7nh sinh \u2013 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3; can thi\u1ec7p \u0111i\u1ec1u tr\u1ecb ngay t\u1eeb giai \u0111o\u1ea1n s\u1edbm \u0111\u1ec3 tr\u00e1nh b\u1ec7nh di\u1ec5n ti\u1ebfn n\u1eb7ng; ph\u00f2ng ng\u1eeba c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1; c\u1ea7n c\u1eadp nh\u1eadt ki\u1ebfn th\u1ee9c y khoa li\u00ean t\u1ee5c; \u00e1p d\u1ee5ng c\u00e1c ti\u1ebfn b\u1ed9 m\u1edbi nh\u1ea5t trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u1ee7a y h\u1ecdc; v\u1eadn d\u1ee5ng y h\u1ecdc th\u1ef1c ch\u1ee9ng; \u01b0u ti\u00ean s\u1eed d\u1ee5ng nh\u1eefng bi\u1ec7n ph\u00e1p hi\u1ec7u qu\u1ea3, mang l\u1ea1i gi\u00e1 tr\u1ecb th\u1ef1c cho ng\u01b0\u1eddi b\u1ec7nh. <br>\n\u0110\u1ed1i v\u1edbi nh\u00f3m nguy\u00ean nh\u00e2n sai s\u00f3t v\u00e0 t\u1ea5t tr\u00e1ch, tai bi\u1ebfn c\u00f3 li\u00ean quan \u0111\u1ebfn ph\u1ea1m tr\u00f9 ch\u1ee7 quan t\u1eeb ph\u00eda ng\u01b0\u1eddi nh\u00e2n vi\u00ean y t\u1ebf. \u0110\u00e2y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem l\u00e0 d\u1ea1ng sai s\u00f3t trong chuy\u00ean m\u00f4n m\u00e0 ch\u00fang ta c\u1ea7n ph\u1ea3i gi\u1ea3m thi\u1ec3u t\u1ed1i \u0111a. Vi\u1ec7c n\u00e0y \u0111\u00f2i h\u1ecfi \u1edf nh\u00e2n vi\u00ean y t\u1ebf m\u1ed9t tinh th\u1ea7n khoa h\u1ecdc, c\u1ea7u ti\u1ebfn, c\u00f3 tr\u00e1ch nhi\u1ec7m \u0111\u1ed1i v\u1edbi b\u1ea3n th\u00e2n, b\u1ec7nh nh\u00e2n v\u00e0 c\u00f4ng vi\u1ec7c. Vai tr\u00f2 c\u1ee7a t\u1ed5 ch\u1ee9c y t\u1ebf (\u0111\u01a1n v\u1ecb y t\u1ebf nh\u01b0 b\u1ec7nh vi\u1ec7n, ph\u00f2ng kh\u00e1m..) gi\u1eef vai tr\u00f2, tr\u00e1ch nhi\u1ec7m nh\u1ea5t \u0111\u1ecbnh trong tri\u1ec3n khai m\u00f4i tr\u01b0\u1eddng l\u00e0m vi\u1ec7c sao cho h\u1ea1n ch\u1ebf c\u00e1c bi\u1ebfn c\u1ed1 kh\u00f4ng mong mu\u1ed1n n\u00e0y. <br>\nQua v\u00ed d\u1ee5 tr\u00ean, ch\u00fang ta c\u00f3 th\u1ec3 nh\u1eadn th\u1ea5y t\u00ednh ch\u1ea5t ph\u1ee9c t\u1ea1p khi \u0111\u00e1nh gi\u00e1 m\u1ed9t tai bi\u1ebfn y khoa. T\u00f9y theo b\u1ed1i c\u1ea3nh di\u1ec5n ra tai bi\u1ebfn m\u00e0 k\u1ebft lu\u1eadn c\u00f3 th\u1ec3 r\u1ea5t kh\u00e1c nhau, v\u00e0 h\u1ec7 qu\u1ea3 l\u00e0 m\u1ee9c \u0111\u1ed9 tr\u00e1ch nhi\u1ec7m c\u1ee7a nh\u00e2n vi\u00ean y t\u1ebf c\u0169ng kh\u00e1c nhau. Do v\u1eady, khi \u0111\u1ee9ng tr\u01b0\u1edbc m\u1ed9t tai bi\u1ebfn y khoa, \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 ch\u00fang ta c\u1ea7n gi\u1eef th\u00e1i \u0111\u1ed9 kh\u00e1ch quan, c\u1ea7n xem x\u00e9t hi\u1ec7n t\u01b0\u1ee3ng nh\u01b0 l\u00e0 m\u1ed9t kinh nghi\u1ec7m c\u1ea7n h\u1ecdc t\u1eadp, l\u00e0m c\u01a1 s\u1edf \u0111\u1ec3 hi\u1ec7u ch\u1ec9nh v\u00e0 c\u1ea3i thi\u1ec7n trong t\u01b0\u01a1ng lai.<br>\nTuy nhi\u00ean, trong th\u1ef1c t\u1ebf, c\u00e1c sai s\u00f3t y khoa th\u01b0\u1eddng b\u1ecb qui tr\u00e1ch nhi\u1ec7m cho c\u00e1 nh\u00e2n. H\u1eadu qu\u1ea3 d\u1eabn \u0111\u1ebfn s\u1ef1 vi\u1ec7c kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 ph\u00f9 h\u1ee3p \u2013 kh\u00f4ng \u0111\u01b0\u1ee3c t\u00ecm hi\u1ec3u th\u1ea5u \u0111\u00e1o; c\u00e1c kh\u00eda c\u1ea1nh c\u1ee7a v\u1ea5n \u0111\u1ec1 kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u01b0a ra ph\u00e2n t\u00edch. Do v\u1eady, kh\u00f3 c\u00f3 th\u1ec3 hi\u1ec3u \u0111\u00fang v\u00e0 kh\u00f4ng \u0111\u01b0a ra gi\u1ea3i ph\u00e1p ch\u00ednh x\u00e1c, kh\u1eafc ph\u1ee5c h\u1eadu qu\u1ea3 c\u0103n c\u01a1, kh\u00f4ng g\u00f3p ph\u1ea7n ph\u00f2ng tr\u00e1nh bi\u1ebfn c\u1ed1 m\u1edbi trong t\u01b0\u01a1ng lai. <br>\nCh\u00ednh t\u1eeb th\u1ef1c t\u1ebf \u0111\u00f3, c\u1ea7n c\u00f3 c\u00e1ch nh\u00ecn m\u1edbi \u0111\u1ed1i c\u00e1c bi\u1ebfn c\u1ed1 kh\u00f4ng mong mu\u1ed1n trong y khoa. C\u1ea7n t\u00e1ch b\u1ea1ch gi\u1eefa c\u00e1c nh\u00f3m t\u00ecnh hu\u1ed1ng. C\u1ea7n n\u1eafm b\u1eaft \u0111\u01b0\u1ee3c m\u1ea5u ch\u1ed1t v\u1ea5n \u0111\u1ec1 \u0111\u00e3 g\u00e2y n\u1ea3y sinh bi\u1ebfn c\u1ed1.<br>\nTrong \u0111a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p, cho d\u00f9 m\u1ed9t c\u00e1 nh\u00e2n hay m\u1ed9t nh\u00f3m ng\u01b0\u1eddi ph\u1ea1m l\u1ed7i th\u00ec nguy\u00ean nh\u00e2n c\u01a1 b\u1ea3n th\u01b0\u1eddng l\u00e0 do qui tr\u00ecnh ho\u1ea1t \u0111\u1ed9ng c\u1ee7a \u0111\u01a1n v\u1ecb. Theo y v\u0103n, sai s\u00f3t y khoa x\u1ea3y ra do b\u1ea5t c\u1ea9n c\u00e1 nh\u00e2n \u00edt h\u01a1n l\u00e0 do c\u00e1ch t\u1ed5 ch\u1ee9c c\u1ee7a h\u1ec7 th\u1ed1ng y t\u1ebf[2]. \u0110\u1ec3 gi\u1ea3i quy\u1ebft v\u1ea5n \u0111\u1ec1 n\u00e0y, ch\u00fang ta c\u1ea7n x\u00e2y d\u1ef1ng m\u1ed9t h\u1ec7 th\u1ed1ng y t\u1ebf, qui tr\u00ecnh ho\u1ea1t \u0111\u1ed9ng trong \u0111\u00f3 \u201cl\u00e0m \u0111\u00fang\u201d th\u00ec d\u1ec5 h\u01a1n l\u00e0 \u201cl\u00e0m sai\u201d.   <\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Y khoa l\u00e0 l\u0129nh v\u1ef1c khoa h\u1ecdc bi\u1ec7n ch\u1ee9ng trong \u0111\u00f3 ki\u1ebfn th\u1ee9c y h\u1ecdc thay \u0111\u1ed5i theo tr\u00ecnh \u0111\u1ed9 c\u1ee7a khoa h\u1ecdc v\u00e0 m\u1ee9c <a class=\"mh-excerpt-more\" href=\"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/?p=389\" title=\"qu\u1ea3n l\u00fd nguy c\u01a1 v\u00e0 c\u00e1c bi\u1ebfn c\u1ed1 y khoa kh\u00f4ng \u00fd mu\u1ed1n\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,6,9],"tags":[],"class_list":["post-389","post","type-post","status-publish","format-standard","hentry","category-ban-tin-noi-bo","category-ban-tin-y-te","category-dao-tao"],"_links":{"self":[{"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/posts\/389","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=389"}],"version-history":[{"count":1,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/posts\/389\/revisions"}],"predecessor-version":[{"id":390,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/posts\/389\/revisions\/390"}],"wp:attachment":[{"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=389"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=389"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=389"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}