The renal sinus pyelolithotomy surgery treatment of 18 cases of giant staghorn calculi Beijing: People’s Health Publishing House, 1995.4l3. [3] Huang Zhiqiang, Li Ao, Zhang Zhaoxiang. Surgical operation [M]. Beijing: People’s Medical Publishing House, 1997.1161. [4] Yu Tianlin, gold tin Imperial Operative Surgery Complete Works of Urology Volume [M]. Beijing: People’s Medical Publishing House, l994.1lO. [5] Yuanli Rong, Zhang Dahong, Nguyen Lei. Laparoscopic renal sinus and renal pelvis cut the lithotomy efficacy analysis. Journal of Urology, 2006,27:455. Received date :2006-08-28 critically ill patients to hospital, first aid standard procedure to investigate Xu Ke. Zhang Xin (first-aid center in Wuxi City, Jiangsu Wuxi 214002) :1009-5519 ((2007) the 02-0234-02 circle words: R5-: B pre-hospital emergency medical treatment of patients. A small number of risk patients, such as sudden death, shock, acute myocardial infarction, choking, bleeding, unconscious patients, we judge that critically ill patients, accounting for about 10% to 15% of all first-aid total number of patients, the ratio is not large, but exactly what we pre-hospital first aid in the important and difficult. accurate, timely and effective pre-hospital first aid maintained on the patient’s life play a key role for a time for dying patients and lay a good foundation for the hospital to further rescue a location pre-hospital the positioning of the first aid: the original prevention of secondary injury, reduce disability and mortality, quickly and safely transferred to the injured person. 2 admissions 2.1 quickly reach the patient’s side, by understanding the history, simple and focused physical examination, blood pressure, consciousness, pupil detection, if necessary, the ECG, blood sugar, pulse oximetry measurement, a preliminary understanding of the disease. determine whether critically ill patients. 2.2 judgment of critically ill patients: etiology and symptoms must be between one or more of: (1) myocardial infarction, angina pain, cardiogenic shock, heart failure, cerebrovascular accidents, seizures, hypertensive crisis, severe respiratory disease, acute pulmonary edema, pneumothorax, allergic reactions, poisoning, severe acute abdomen, severe trauma, brain injury, heat stroke , drowning, electric shock, advanced tumors (2) symptoms of which: T> 39 ℃, P 24, minutes, BP IS0mmHg , confusion, loss, irritability, pale skin, cyanosis, bleeding> 500ml, difficulty breathing, convulsions, pain 2.3 Note the seemingly mild critically ill patients: such as heart failure patients can move around by car accident caused by visceral bleeding, the patient indifferent expression, of few words. 3 scene 3.1 The principles of treatment: symptomatic treatment based. priority to endanger the life of a patient’s disease. 3.2 emphasis on first aid treatment, active rescue after transshipment. be sure to change the so-called scene Aid is quickly the patient to the hospital to carry out the stereotypes of the treatment, first aid Practice has proved that the original hope to save the patient lost rescue opportunity, the key is to ignore the importance of first aid, using the first , rather than insist on patients must cardiopulmonary resuscitation to the patients have hope of salvation. my first-aid center requirements: when critically ill patients to call 120 emergency ambulance arrives. medical measures must be sent to the patient side, and immediately began to deal effectively with and then escorted to safety nearby, rescue capabilities of the hospital for further diagnosis and treatment. 3.3 site treatment time to complete first aid practices is limited. as quickly, generally not more than 30 minutes and obtain the cooperation of family members, and then rescue side edge transporter. 3.4 critically ill patients require open venous channels, one fluid or administration, and second, once the condition changes can be intravenous drug based on the actual condition, two venous channels can be opened or more qualified persons venous catheter 3.5 to select drugs and devices, priority I, IIa, class, emphasizing the first-line treatment, such as bleeding, hemorrhagic shock, the generation of plasma and rapid rehydration, rather than consider hemostatic. 3.6 of medication can be a variety of ways: with medication tablets, intramuscular, intravenous, intratracheal administration, intravenous maintenance therapy, according to the actual, to take one or several at the same time, such as hypertensive crisis with sublingual nifedipine. muscle injection of reserpine, intravenous nitroglycerin