Sivil havac\u0131l\u0131\u011f\u0131m\u0131z\u0131n \u00f6rt\u00fcl\u00fc zafiyet unsurlar\u0131ndan birisi de u\u00e7u\u015f hekimlerinin sisteme yeterince entegre olmamas\u0131d\u0131r. En son s\u00f6yleyece\u011fimizi ba\u015ftan s\u00f6yleyelim: U\u00e7u\u015f hekimleri;<\/span><\/p>\n– pilotaj muayenelerinin yap\u0131ld\u0131\u011f\u0131 yetkili hastanelerde,<\/p>\n
– u\u00e7u\u015f okullar\u0131n\u0131n dershanelerinde,<\/p>\n
– havaalanlar\u0131ndaki sa\u011fl\u0131k birimlerinde,<\/p>\n
– havadaki u\u00e7aklara sa\u011fl\u0131k deste\u011fi vermek \u00fczere 24 saat telsiz ba\u015f\u0131nda, ve<\/p>\n
– hava ambulanslarda hastan\u0131n yan\u0131nda aktif bi\u00e7imde bulunmal\u0131d\u0131rlar.<\/p>\n
U\u00e7u\u015f ekiplerini fizyolojik ve psikolojik konularda bilgilendirmenin, t\u0131bbi nedenli u\u00e7u\u015f kazalar\u0131n\u0131 en aza indirmenin ve hasta yolcular\u0131n emniyetle seyahat etmelerinin tek \u00e7aresi budur. U\u00e7u\u015f hekimlerinin g\u00f6rev alanlar\u0131n\u0131 ve buralardaki i\u015flevlerini a\u015fa\u011f\u0131daki ba\u015fl\u0131klar alt\u0131nda g\u00f6zden ge\u00e7irelim:<\/p>\n
1. Pilotaj muayeneleri:<\/strong>\u00a02003 y\u0131l\u0131 \u00f6ncesinde pilotaj muayenelerinin yap\u0131ld\u0131\u011f\u0131 yetkilendirilmi\u015f hastanelerin say\u0131s\u0131 47 idi. Sadece PPL sahibi amat\u00f6r pilotlar\u0131n de\u011fil, k\u0131talararas\u0131 u\u00e7u\u015flar yapan b\u00fcy\u00fck yolcu u\u00e7aklar\u0131n\u0131n kaptan pilotlar\u0131 da bu 47 hastaneden hangisini can\u0131 \u00e7ekerse oraya ba\u015fvurabiliyor, ald\u0131\u011f\u0131 \u2018sa\u011flam\u2019 karar\u0131 d\u00fcnyan\u0131n her yerinde ge\u00e7erli oluyordu. \u0130stinye ve Eski\u015fehir Devlet Hastaneleri de, Erzurum ve Adana Numune Hastaneleri de, Abant \u0130. Baysal Hastanesi de yetkilendirilmi\u015fti. Havac\u0131l\u0131k t\u0131bb\u0131 alan\u0131nda e\u011fitimli hi\u00e7bir hekim bulundurmayan bu hastaneler ICAO ve JAA gereklilikleri do\u011frultusunda t\u0131bbi sertifikasyon verme yetkisine sahipti… O zamanki yetkili hastanelerin en prestijlisi olan Cerrahpa\u015fa T\u0131p Fak\u00fcltesinde bir n\u00f6roloji hocas\u0131n\u0131n bir pilotta epilepsi hastal\u0131\u011f\u0131 tespit etti\u011fi, bunun i\u00e7in re\u00e7ete yaz\u0131p sonra da u\u00e7u\u015fa elveri\u015flilik karar\u0131n\u0131 imzalad\u0131\u011f\u0131 (!) gibi anekdotlar vard\u0131\u2026 Neyse ki 2003 y\u0131l\u0131nda SHGM ile Hava K.K. aras\u0131nda bir protokol yap\u0131ld\u0131 ve bug\u00fcne kadar 80\u2019den fazla sivil u\u00e7u\u015f hekimi yeti\u015ftirilerek sisteme kazand\u0131r\u0131ld\u0131. 2004 y\u0131l\u0131ndan itibaren b\u00fcnyesinde en az 2 u\u00e7u\u015f doktoru bulunan tam donan\u0131ml\u0131 hastaneler yetkilendirilmeye ba\u015fland\u0131. Olmas\u0131 gereken budur; hatta FAA ve EASA kriterlerinin de \u00fcst\u00fcnde titiz bir uygulama yap\u0131lmakta oldu\u011fu i\u00e7in SHGM\u2019yi takdir etmekteyiz.<\/p>\n2. U\u00e7u\u015f okullar\u0131:\u00a0<\/strong>\u00dclkemizde pilotaj e\u011fitimi %99 a\u011f\u0131rl\u0131kta teknik konulara y\u00f6neliktir. Halbuki u\u00e7a\u011f\u0131 u\u00e7uran insand\u0131r ve insano\u011flu t\u00fcrl\u00fc \u00e7e\u015fitli fizyolojik ve psikolojik zafiyetlerle mal\u00fbl oldu\u011fu i\u00e7in, teknik-d\u0131\u015f\u0131 konular (NOTECHS) \u00e7ok daha \u00f6nemli g\u00f6r\u00fclmektedir. Kaza nedenleri s\u0131ralamas\u0131nda insan fakt\u00f6r\u00fcn\u00fcn %70-80\u2019lerde bir paya sahip olmas\u0131 y\u00fcz\u00fcnden u\u00e7u\u015f okullar\u0131 m\u00fcfredat\u0131na \u201c\u0130nsan performans\u0131 ve limitleri\u201d dersleri konulmu\u015ftur. Peki bu dersler konunun uzmanlar\u0131 taraf\u0131ndan m\u0131, yoksa \u2018kim m\u00fcsaitse\u2019 onlar taraf\u0131ndan m\u0131 verilmektedir? \u0130nsan fakt\u00f6rleri \u00fcst ba\u015fl\u0131\u011f\u0131 alt\u0131nda CRM, SA, stres ve yorgunluk y\u00f6netimi, u\u00e7u\u015f fizyolojisi, ekip \u00e7al\u0131\u015fmas\u0131, karar verme, liderlik ve psikolojik konular, sadece pilot adaylar\u0131 i\u00e7in de\u011fil yeti\u015fmi\u015f u\u00e7u\u015f ve yer ekipleri i\u00e7in de \u00e7ok \u00f6nemlidir. Bu konular\u0131n e\u011fitiminde u\u00e7u\u015f hekimleri de g\u00f6rev almal\u0131d\u0131r; ama maalesef sistem u\u00e7u\u015f hekimlerini bu alanda \u201ckullanmay\u0131\u201d d\u00fc\u015f\u00fcnmemektedir\u2026<\/p>\n3. Havaalan\u0131 sa\u011fl\u0131k deste\u011fi:<\/strong>\u00a0U\u00e7u\u015fa haz\u0131rlanan u\u00e7u\u015f ekipleri ile yolcular\u0131n havaalanlar\u0131nda sa\u011fl\u0131k sorunlar\u0131 ya\u015famas\u0131 olas\u0131d\u0131r. Bu sorunlar\u0131n u\u00e7u\u015fla ba\u011fda\u015f\u0131p ba\u011fda\u015fmad\u0131\u011f\u0131 sorusu, ancak havac\u0131l\u0131k t\u0131bb\u0131 e\u011fitimi olan bir hekim taraf\u0131ndan yan\u0131tlanabilir. Bu nedenle havaalanlar\u0131nda g\u00f6revli DHM\u0130 ve \u00f6zel \u015firket doktorlar\u0131n\u0131n mutlaka havac\u0131l\u0131k t\u0131bb\u0131 e\u011fitimi alm\u0131\u015f (u\u00e7u\u015f hekimleri) olmas\u0131 gerekir. DHM\u0130 kadrolar\u0131nda belirli say\u0131da u\u00e7u\u015f hekimleri var ise de, \u00f6zel \u015firketin (PortClinic) s\u00f6zle\u015fmesinin iptali nedeniyle t\u00fcm sorumluluk DHM\u0130\u2019ye ge\u00e7ti\u011fi i\u00e7in \u00e7ok say\u0131da u\u00e7u\u015f hekimi ihtiyac\u0131 do\u011fmu\u015ftur. Bu eksiklik h\u0131zla tel\u00e2fi edilmelidir.<\/p>\n4. U\u00e7ak i\u00e7inde sa\u011fl\u0131k deste\u011fi:<\/strong>\u00a0U\u00e7u\u015f ekipleriyle yolcular\u0131n u\u00e7u\u015fta t\u0131bbi inkapasitasyona u\u011framalar\u0131 (kalp krizi, bay\u0131lma, beyin kanamas\u0131, ast\u0131m, panik, alerji, zehirlenme, vs.) m\u00fcmk\u00fcnd\u00fcr. \u00d6zellikle pilotlar\u0131n u\u00e7u\u015fta hastalanmas\u0131 u\u00e7aktaki t\u00fcm insanlar\u0131n ya\u015famlar\u0131na mal olabilir. U\u00e7akta yolcu olarak bulunan hekimlerin anons edilerek yard\u0131ma \u00e7a\u011fr\u0131lmas\u0131 y\u00f6ntemi her zaman i\u015fe yaramamaktad\u0131r; baz\u0131 hekimler rahat\u0131n\u0131 ka\u00e7\u0131rmamak, baz\u0131lar\u0131 da bran\u015f\u0131 uygun olmad\u0131\u011f\u0131 i\u00e7in bu t\u00fcr anonslarda sessiz kalmay\u0131 tercih etmekte; sonu\u00e7ta hasta yolcular ma\u011fdur olmaktad\u0131r. THY, hekimlerin motive edilmesi amac\u0131yla c\u00fczi mil puan\u0131 vaad eden ve bize g\u00f6re yetersiz olan bir uygulama\u00a0(Smiling Doctors)<\/em>\u00a0ba\u015flatm\u0131\u015ft\u0131r.\u00a0Catering<\/em>\u00a0hizmetleri i\u00e7in b\u00fcy\u00fck mebl\u00e2\u011flar \u00f6demeyi makul g\u00f6ren havayolu \u015firketlerinin, sa\u011fl\u0131k deste\u011fi s\u00f6z konusu oldu\u011funda bunu ucuza halletmek pe\u015finde olduklar\u0131 anla\u015f\u0131lmaktad\u0131r. D\u00fcnyada da T\u00fcrkiye\u2019de de u\u00e7ak yolcusu hekimleri daha tatmink\u00e2r bi\u00e7imde motive edilmesi ya da ER u\u00e7u\u015flar\u0131nda doktor g\u00f6revlendirilmesi gibi usuller d\u00fc\u015f\u00fcn\u00fclmelidir. Ba\u015fka bir \u00f6nerimiz; acil t\u0131bbi durumlarda u\u00e7ak i\u00e7indeki hekimlere yerden telsizle t\u0131bbi kons\u00fcltasyon deste\u011fi sa\u011flayacak bir sistem kurulmas\u0131, bu amaca hizmet edecek bir yetkili hastane ile anla\u015fma yap\u0131lmas\u0131d\u0131r. Bunun d\u00fcnyadaki \u00f6rne\u011fi MedAire\u2019dir.<\/p>\n5. Hava ambulanslarda sa\u011fl\u0131k deste\u011fi:<\/strong>\u00a0Bir ba\u015fka \u00f6nemli ihtiya\u00e7, hava ambulans sa\u011fl\u0131k ekiplerinin havac\u0131l\u0131k t\u0131bb\u0131 e\u011fitimi alm\u0131\u015f olmalar\u0131d\u0131r. Binlerce a\u011f\u0131r hasta ve yaral\u0131y\u0131 zor ko\u015fullarda yerinden al\u0131p hastanelere ba\u015far\u0131yla g\u00f6t\u00fcrmekte olan hava ambulans hekimlerine mutlaka u\u00e7u\u015f hekimi stat\u00fcs\u00fc kazand\u0131r\u0131lmal\u0131d\u0131r. A\u011f\u0131r yaral\u0131, kanamal\u0131, solunum zorlu\u011fu vs. \u00e7eken hastalar bazen hastal\u0131klar\u0131ndan de\u011fil, u\u00e7u\u015f ko\u015fullar\u0131n\u0131n t\u0131bbi durumlar\u0131n\u0131 bozmas\u0131 y\u00fcz\u00fcnden nakil s\u0131ras\u0131nda ya\u015famlar\u0131n\u0131 yitirebilirler. Bu riski minimize etmek i\u00e7in, gerek havayoluyla nakil karar\u0131n\u0131 veren ve gerekse hava ambulans\u0131 i\u00e7inde m\u00fcdahalede bulunacak hekimlerin havac\u0131l\u0131k t\u0131bb\u0131 temel bilgilerine sahip olmalar\u0131 gerekir. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Hava Ambulans Sisteminde g\u00f6revli hekim, hem\u015fire, sa\u011fl\u0131k teknisyeni ve paramedikler 1-2 g\u00fcnl\u00fck k\u0131sa kurslardan ge\u00e7irilmi\u015f olmakla birlikte, bu yeterli say\u0131lamaz\u2026 Bakanl\u0131k d\u0131\u015f\u0131nda ayn\u0131 i\u015fi yapan \u00f6zel hava ambulans \u015firketleri i\u00e7in de bir e\u011fitim standard\u0131 olmal\u0131d\u0131r.<\/p>\n\u00d6nerimiz:<\/strong>\u00a0Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Ambulans Hizmetleri Y\u00f6netmeli\u011fi\u2019nde B\u00f6l\u00fcm 4- Md.14 ve B\u00f6l\u00fcm 5- Md.18\u2019e yap\u0131lacak birer sat\u0131rl\u0131k ilavedir: \u201cHava ambulans hekimleri u\u00e7u\u015f hekimi stat\u00fcs\u00fcnde olacaklard\u0131r.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Yazar : Prof. Dr. Muzaffer \u00c7eting\u00fc\u00e7 Yay\u0131nlanma tarihi : 26 Ocak 2015 https:\/\/www.airkule.com\/yazar\/UCUS-HEKIMLERININ-SISTEME-GIRME-ZAMANI\/990\/ Sivil havac\u0131l\u0131\u011f\u0131m\u0131z\u0131n \u00f6rt\u00fcl\u00fc zafiyet unsurlar\u0131ndan birisi de u\u00e7u\u015f hekimlerinin sisteme yeterince entegre olmamas\u0131d\u0131r. En son s\u00f6yleyece\u011fimizi ba\u015ftan s\u00f6yleyelim: U\u00e7u\u015f hekimleri; – pilotaj muayenelerinin yap\u0131ld\u0131\u011f\u0131 yetkili hastanelerde, – u\u00e7u\u015f okullar\u0131n\u0131n dershanelerinde, – havaalanlar\u0131ndaki sa\u011fl\u0131k birimlerinde, – havadaki u\u00e7aklara sa\u011fl\u0131k deste\u011fi vermek \u00fczere 24 saat telsiz ba\u015f\u0131nda, ve – […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-3698","post","type-post","status-publish","format-standard","hentry","category-bulten"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/3698","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3698"}],"version-history":[{"count":1,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/3698\/revisions"}],"predecessor-version":[{"id":3699,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/3698\/revisions\/3699"}],"wp:attachment":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3698"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3698"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3698"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}