Medical intensive care unit

8/14/2019 Medical intensive care unit

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Hdukdvh|k Fbsk

[dhu


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Hdukdvh|k Fbsk [dhu hv b mgvphub` lbfh`hux lgs fbsk glfshuhfb``x h`` pbuhkduv bu b igsk hdukdvh|k `k|k` umbd hvdkkeke cx gumks pbuhkduv$ Vubllke cx vpkfhb`hqkepksvgddk`$

HF[ fbsk skr{hskv b i{`uhehvfhp`hdbsx ukbi umbu fgdvhvuvgl c{u hv dgu `hihuke ug hdukdvh|hvuv -f`hdhfhbdv ~mgvpkfhb`hqk hd fshuhfb` h``dkvv fbsk$ Umkx ~h`` psg|hekuskbuikdu ibdbnkikdu, ehbndgvhv, hduks|kduhgdv, bdehdeh|he{b`hqke fbsk lgs kbfm pbuhkdu skfg|kshdn lsgi

vk|ksk h``dkvv$


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6/120

_{spgvk gl HF[


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Umk p{spgvk gl umk hdukdvh|k fbsk {dhu -HF[( hv vhip`k k|kdumg{nm umk psbfuhfk hv fgip`k}$ Mkb`umfbsk psglkvvhgdb`v~mg ~gsj hd umk HF[ gs sgubuk umsg{nm hu e{shdn umkhsusbhdhdn psg|hek bsg{de)umk)f`gfj hdukdvh|k igdhugshdn bdeuskbuikdu gl pbuhkduv vk|kd ebxv b ~kkj$

^mkd pbuhkduv bsk usbdvlksske ug umk HF[ lsgi bdgumksmgvphub` ekpbsuikdu, uskbuikdu gseksv bde p`bddhdn i{vuck sk|hk~ke bde dk~ uskbuikdu p`bdv ~shuukd lgs umkpbuhkdu.v f{sskdu vubu{v$ Lgs k}bip`k, b fmsgdhfb``x h``hdpbuhkdu ibx nsg~ ibsjke`x ~gsvk ~humhd b lk~ mg{sv bdeibx ck usbdvlksske ug umk HF[, ~mksk umk vubll i{vuskk|b`{buk gseksv lgs mhv gs mks fbsk$


8/120

Ekvfshpuhgd gl

HF[


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HF[v bsk mhnm`x skn{`buke ekpbsuikduv, uxphfb``x `hihuhdnumk d{icks gl |hvhugsv ug umk pbuhkdu.v hiikehbuk lbih`xk|kd e{shdn |hvhuhdn mg{sv$

Hd beehuhgd ug umk hdukdvh|hvu.v sg`k hd ehskfu pbuhkdu fbsk,mk gs vmk hv {v{b``x umk `kbe pmxvhfhbd ~mkd i{ùhp`k

fgdv{ùbduv bsk hd|g`|ke hd bd hdukdvh|k fbsk psgnsbi$Umk hdukdvh|hvu fggsehdbukv umk fbsk psg|heke cx umkfgdv{ùbduv, ~mhfm b``g~v lgs bd hduknsbuke uskbuikdubppsgbfm ug umk pbuhkdu$

Umk d{svk.v sg`k {v{b``x hdf`{ekv f`hdhfb` bvvkvvikdu,

ehbndgvhv, bde bd hdeh|he{b`hqke p`bd gl k}pkfukeuskbuikdu g{ufgikv lgs kbfm pbuhkdu


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Umk pbuhkdu {v{b``x mbv vk|ksb`

igdhugsv buubfmke ug |bshg{v pbsuv

gl mhv gs mks cgex lgs skb`)uhikk|b`{buhgd gl ikehfb` vubch`hux$


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Umk hdukdvh|hvu ~h`` ibjk pkshgehfbvvkvvikduv gl umk pbuhkdu.v fbsehbfvubu{v, cskbumhdn sbuk, {shdbsx g{up{u,bde c`gge `k|k`v lgs d{ushuhgdb` bde

mgsigdb` psgc`kiv umbu ibx bshvk bdeskr{hsk {snkdu buukduhgd gs uskbuikdu$


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Mhvugsx gl HF[


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Hd 2=;5, L`gskdfk Dhnmuhdnb`k `klu lgs umk Fshikbd ^bs, ~mksk umkdkfkvvhux ug vkpbsbuk vkshg{v`x ~g{deke vg`ehksv lsgi `kvv)vkshg{v`x

~g{deke ~bv gcvks|ke$ Dhnmuhdnb`k ske{fke igsub`hux lsgi 5?+ ug 3+gd umk cbuu`klhk`e, fskbuhdn umk fgdfkpu gl hdukdvh|k fbsk$

Hd 28;?, bdkvumkvhg`gnhvu _kuks Vblbs kvubc`hvmke umk fgdfkpu gl#Be|bdfke V{ppgsu gl @hlk,# jkkphdn pbuhkduv vkebuke bde |kduh`buke hdbd hdukdvh|k fbsk kd|hsgdikdu$ Vblbs hv fgdvhekske umk lhsvu hdukdvh|hvu$

Hd skvpgdvk ug b pg`hg kphekihf -~mksk ibdx pbuhkduv skr{hske fgdvubdu|kduh`buhgd bde v{s|kh``bdfk(, Casd Hcvkd kvubc`hvmke umk lhsvu hdukdvh|kfbsk {dhu hd Fgpkdmbnkd hd 28;6$Umk lhsvu bpp`hfbuhgd gl umhv hekb hd umk[dhuke Vubukv ~bv phgdkkske cx Es$ ^h``hbi Igvkdumb`, b v{snkgd bu umkEbsuig{um)Mhufmfgfj Ikehfb` Fkduks$ Hd umk 28


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_BUHKDUV HD UMK HF[


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UX_KV GL _BUHKDUV _buhkduv fgik hdug umk IHF[ lsgi b |bshkux gl p`bfkv1 umk

l`ggsv, umk KS, bv usbdvlksv lsgi gumks mgvphub`v, bvpgvugpv, bv cgbseksv lsgi gumks vks|hfkv, bde vgikuhikvbv ehskfu beihuv, cxpbvvhdn umk KS$ Umk hdukskvuhdn umhdnbcg{u umk IHF[ hv umbu ~k `huksb``x vkk b chu gl bcvg`{uk`x

k|ksxumhdn, {d`hjk umk vpkfhbùx HF[v$ Hl xg{ ~gsj mksk`gdn kdg{nm, xg{`` vkk pbuhkduv umbu ~g{è dgsib``x ck hdk|ksx gumks HF[ kd|hsgdikdu -k}fkpu ibxck lskvm pgvugpfbsehgumgsbfhf pbuhkduv umbu HF[ ~h`` c{ip igsk vubc`kpbuhkduv g{u ug ibjk sggi($ ^k vkk fbsehbf pbuhkduv,vgikuhikv ~hum hdusb)bgsuhf cb``ggd p{ipv: ~k vkk dk{sg

pbuhkduv, gffbvhgdb``x ~hum igdhugske cgùv hd p`bfk, ~k|kegdk be{ù KFIG b lk~ uhikv, bde ~k k|kd vgikuhikvnku nkdksb`)v{sn pgvugp fbvkv$$


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IHF[ Kr{hpikduv


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2$( Ikfmbdhfb`\kduh`bugs


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Eklhdhuhgdhv b ikumge ug ikfmbdhfb``x bvvhvu gs

skp`bfk vpgdubdkg{v cskbumhdn$

fhsf{ivubdfkv lgs ~mhfm |kduh`buhgd hvskr{hske umkd beehuhgdb` ikbv{skv bsk

glukd skr{hske ug #vkf{sk# umk bhs~bxe{shdn pgvhuh|k pskvv{sk |kduh`buhgd ug b``g~{dhipkeke pbvvbnk gl bhs hdug umk usbfmkbbde b|ghe bhs pbvvhdn hdug umk kvgpmbn{v

bde vugibfm$


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umsg{nm bd bsuhlhfhb` gpkdhdn hdumk dkfj$


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Hdehfbuhgdv1Ikfmbdhfb` |kduh`buhgd hv hdehfbuke ~mkd

umk pbuhkdu.v vpgdubdkg{v |kduh`buhgd hvhdbekr{buk ug ibhdubhd `hlk$

b`vg hdehfbuke bv psgpmx`b}hv lgs hiihdkdu

fg``bpvk gl gumks pmxvhg`gnhf l{dfuhgdv, gshdkllkfuh|k nbv k}fmbdnk hd umk `{dnv


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Fgiigd ikehfb` hdehfbuhgdv lgs{vk hdf`{ek1

Bf{uk `{dn hda{sx -hdf`{ehdn BSEV, usb{ib(Bpdkb ~hum skvphsbugsx bsskvu, hdf`{ehdn fbvkv lsgi hdug}hfbuhgdFmsgdhf gcvus{fuh|k p{`igdbsx ehvkbvk -FG_E(

Bf{uk skvphsbugsx bfhegvhv ~hum pbsuhb` pskvv{sk gl fbscgd ehg}hek -pFG3( 4;? iiMn bde pM 0 >$3;, ~mhfm ibx ck e{k ug pbsb`xvhv gl umk ehbpmsbnie{k ug N{h``bhd)Cbss vxdesgik, Ixbvumkdhb Nsb|hv, vphdb` fgse hda{sx, gsumk kllkfu gl bdbkvumkuhf bde i{vf`k sk`b}bdu es{nv

Hdfskbvke ~gsj gl cskbumhdn bv k|hekdfke cx vhndhlhfbdu ubfmxpdkb,skusbfuhgdv, bde gumks pmxvhfb` vhndv gl skvphsbugsx ehvuskvv

Mxpg}kihb ~hum bsukshb` pbsuhb` pskvv{sk gl g}xnkd -_bG3( ~humv{pp`kikdub` lsbfuhgd gl hdvphske g}xnkd -LhG3( 0 ;;ii Mn

Mxpgukdvhgd hdf`{ehdn vkpvhv, vmgfj, fgdnkvuh|k mkbsu lbh`{skDk{sg`gnhfb` ehvkbvkv v{fm bv I{vf{`bs Exvusgpmx Bixgusgpmhf @buksb`

Vf`ksgvhv


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Ckfb{vk ikfmbdhfb` |kduh`buhgd gd`x vks|kvug psg|hek bvvhvubdfk lgs cskbumhdn bdeegkv dgu f{sk b ehvkbvk, umk pbuhkdu.v{deks`xhdn fgdehuhgd vmg{`e ck fgsskfubc`k

bde vmg{`e skvg`|k g|ks uhik$


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3$( KFN


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K`kfusgfbsehgnsbpmx -KFN gs KJN( hv b

usbdvumgsbfhf hdukspskubuhgd gl umk k`kfushfb`bfuh|hux gl umk mkbsu g|ks uhik fbpu{ske bdek}uksdb``x skfgseke cx vjhd k`kfusgekv$

Hu hv b dgdhd|bvh|k skfgsehdn psge{fke cx bd

k`kfusgfbsehgnsbpmhf ek|hfk$Umk kuxig`gnx gl umk ~gse hv eksh|ke lsgik`kfusg, ckfb{vk hu hv sk`buke ug k`kfushfb`bfuh|hux, fbsehg, Nskkj lgs mkbsu, bde nsbpm,

b Nskkj sggu ikbdhdn #ug ~shuk#$


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hv umk igvu fgiigd`x pkslgsike fbsehbfukvu

Umhv hv ckfb{vk umk KFN hv b {vkl{`vfskkdhdn ugg` lgs b |bshkux gl fbsehbf

bcdgsib`huhkv$KFN ibfmhdkv bsk skbeh`x b|bh`bc`k hd igvu

ikehfb` lbfh`huhkv: bde umk ukvu hv vhip`k ugpkslgsi, shvj)lskk bde hdk}pkdvh|k$


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^mbu hdlgsibuhgd fbd cknbhdke lsgi umk KFN7

umk mkbsu sbukumk mkbsu smxumi

~mkumks umksk bsk fgde{fuhgd bcdgsib`huhkv-bcdgsib`huhkv hd mg~ umk k`kfushfb` hip{`vk

vpskbev bfsgvv umk mkbsu(~mkumks umksk mbv ckkd b pshgs mkbsu buubfj

~mkumks umksk ibx ck fgsgdbsx bsuksx ehvkbvk

~mkumks umk mkbsu i{vf`k mbv ckfgik

bcdgsib``x umhfjkdke


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Mg~ hv umk KFN pkslgsike7

Xg{ ~h`` `hk gd bd k}bihdbuhgd ubc`k, bde 2?k`kfusgekv -gs `kbev( bsk buubfmke ug xg{sbsiv, `knv, bde fmkvu$

Umk k`kfusgekv ekukfu umk k`kfushfb` hip{`vkv

nkdksbuke cx xg{s mkbsu, bde usbdvihu umkiug umk KFN ibfmhdk$

Umk KFN ibfmhdk psge{fkv b nsbpm -umk KFNusbfhdn( gl umgvk fbsehbf k`kfushfb` hip{`vkv$

Umk k`kfusgekv bsk umkd skig|ke$ Umk ukvuubjkv `kvv umbd ; ihd{ukv ug pkslgsi$


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SB gd umk shnmu bsi, b|ghehdn cgdxpsgihdkdfkv$

@B hd umk vbik `gfbuhgd umbu SB ~bv p`bfke,

c{u gd umk `klu bsi umhv uhik$S@gd umk shnmu `kn, b|ghehdn cgdx

psgihdkdfkv$

@@ hd umk vbik `gfbuhgd umbu S@ ~bv p`bfke,c{u gd umk `klu `kn umhv uhik$

23 K`kfusgek _`bfkikdu


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\2hd umk lg{sum hduksfgvub` vpbfk -cku~kkd shcv 5 ;(a{vu ug umk shnmugl umk vuksd{i -cskbvucgdk($\3hd umk lg{sum hduksfgvub` vpbfk -cku~kkd shcv 5 ;(

a{vu ug umk `klugl umk vuksd{i$\6 cku~kkd `kbev \3 bde \5$\5hd umk lhlum hduksfgvub` vpbfk -cku~kkd shcv ;


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6$( Dkc{`hqks


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ek|hfk {vke ug beihdhvuks ikehfbuhgd ug

pkgp`k hd umk lgsi gl b ihvu hdmb`ke hdugumk `{dnv$ Hu hv fgiigd`x {vke hd uskbuhdnfxvuhf lhcsgvhv, bvumib, bde gumksskvphsbugsx ehvkbvkv$

Dkc{`hqksv bffkpu umkhs ikehfhdk hd umklgsi gl b `hr{he vg`{uhgd, ~mhfm hv glukd`gbeke hdug umk ek|hfk {pgd {vk


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Umk skbvgd umkx bsk hdmb`ke hdvukbe glhdnkvuke hv {v{b``x ug ubsnku umkhs kllkfu ugumk skvphsbugsx usbfu, ~mhfm vpkkev gdvku glbfuhgd gl umk ikehfhdk bde ske{fkv vhek

kllkfuv fgipbske ug gumks ikbdv glek`h|kshdn umkvk ikehfhdkv$


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ikehfhdk hv hdmb`ke umsg{nm b u{ck)`hjk

ig{umphkfk, vhih`bs ug umbu gl bd hdmb`ks$


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mg~k|ks, hv vgikuhikv skp`bfke ~hum b lbfk

ibvj, vhih`bs ug umbu {vke lgs hdmb`kebdbkvumkvhb, lgs kbvk gl {vk ~hum xg{dnfmh`eskd gs umk k`eks`x


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5$( Eklhcsh``bugs


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uskbuikdu lgs umk `hlk)umskbukdhdn fbsehbfbssmxumihbv, |kdushf{`bs lhcsh``buhgd bdep{`vk`kvv |kdushf{`bs ubfmxfbsehb$ Eklhcsh``buhgdfgdvhvuv gl ek`h|kshdn b umksbpk{uhf egvk glk`kfushfb` kdksnx ug umk bllkfuke mkbsu

Umhv ekpg`bshqkv b fshuhfb` ibvv gl umk mkbsu

i{vf`k, uksihdbukv umk bssmxumihb, bde b``g~vdgsib` vhd{v smxumi ug ck skkvubc`hvmke cx umkcgex.v dbu{sb` pbfkibjks, hd umk vhdgbushb`dgek gl umk mkbsu$


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Ibd{b` k}uksdb` eklhcsh``bugs

{vke hd fgda{dfuhgd ~hum -gs igsk glukdmb|k hdc{h`u( k`kfusgfbsehgnsbi skbeksv,~mhfm umk mkb`umfbsk psg|heks {vkv ugehbndgvk b fbsehbf fgdehuhgd


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Umk mkb`umfbsk psg|heks ~h`` umkd ekfhek~mbu fmbsnk -hd ag{`kv( ug {vk, cbvke gdpsg|kd n{hek`hdkv bde k}pkshkdfk, bde~h`` ek`h|ks umk vmgfj umsg{nm pbee`kv gspbev gd umk pbuhkdu.vfmkvu$


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;$( _{`vk G}hikuks


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Hu hv b ikehfb` ek|hfk umbu hdehskfu`xikbv{skv umk g}xnkd vbu{sbuhgd gl b

pbuhkdu.v c`gge bde fmbdnkv hd c`gge|g`{ik hd umk vjhd, psge{fhdn bpmgugp`kumxvignsbpm

Hu hv b ikehfb` ek|hfk umbu hdehskfu`x

ikbv{skv umk g}xnkd vbu{sbuhgd gl bpbuhkdu.v c`gge bde fmbdnkv hd c`gge|g`{ik hd umk vjhd, psge{fhdn bpmgugp`kumxvignsbpm

Hu hv b ikehfb` ek|hfk umbu hdehskfu`xikbv{skv umk g}xnkd vbu{sbuhgd gl bpbuhkdu.v c`gge bde fmbdnkv hd c`gge|g`{ik hd umk vjhd, psge{fhdn b

pmgugp`kumxvignsbpm


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L{dfuhgdEhvp`bxv umk pksfkdubnk gl bsukshb` mkign`gchd hd

umk g}xmkign`gchd fgdlhn{sbuhgd$ Bffkpubc`kdgsib` sbdnkv bsk lsgi 8; ug 2?? pksfkdu,

b`umg{nm |b`{kv eg~d ug 8?+ bsk fgiigd


46/120

Uxphfb``x hu mbv b pbhs gl vib`` `hnmu)kihuuhdnehgekv -@KEv( lbfhdn b pmgugehgek umsg{nm busbdv`{fkdu pbsu gl umk pbuhkdu.v cgex, {v{b``x b

lhdnksuhp gs bd kbs`gck$ Gdk @KE hv ske, ~hum~b|k`kdnum gl


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Be|bdubnkvp{`vk g}hikuks hv {vkl{` hd bdx

vkuuhdn ~mksk b pbuhkdu.vg}xnkdbuhgd hv {dvubc`k, hdf`{ehdn

hdukdvh|k fbsk, gpksbuhdn, skfg|ksx,kiksnkdfx bde mgvphub` ~bsevkuuhdnv, ph`guv hd {dpskvv{shqkebhsfsblu, lgs bvvkvvikdu gl bdx

pbuhkdu.v g}xnkdbuhgd, bdeekuksihdhdn umk kllkfuh|kdkvv gl gsdkke lgs v{pp`kikdub` g}xnkd$


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@hihubuhgdv bde

Be|bdfkikduv

G}hikusx hv dgu b fgip`kuk ikbv{sk gl skvphsbugsxv{llhfhkdfx$ B pbuhkdu v{llkshdn lsgimxpg|kduh`buhgd -pggs nbv k}fmbdnk hd umk `{dnv(nh|kd 2??+ g}xnkd fbd mb|k k}fk``kdu c`ggeg}xnkd `k|k`v ~mh`k vuh`` v{llkshdn lsgi skvphsbugsxbfhegvhv e{k ug k}fkvvh|k fbscgd ehg}hek$

G}hikusx hv dgu b fgip`kuk ikbv{sk gl skvphsbugsxv{llhfhkdfx$ B pbuhkdu v{llkshdn lsgimxpg|kduh`buhgd -pggs nbv k}fmbdnk hd umk `{dnv(nh|kd 2??+ g}xnkd fbd mb|k k}fk``kdu c`ggeg}xnkd `k|k`v ~mh`k vuh`` v{llkshdn lsgi skvphsbugsxbfhegvhv e{k ug k}fkvvh|k fbscgd ehg}hek$


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V{fuhgd{vke ug f`kbs umk bhs~bx gl c`gge, vb`h|b,

|gihu, gs gumks vkfskuhgdv vg umbu bpbuhkdu ibx cskbumk$

psk|kdu p{`igdbsx bvphsbuhgd, ~mhfmfbd `kbe ug `{dn hdlkfuhgdv

{vke ug skig|k l`{hev lsgi umkbhs~bxv lbfh`hubuk cskbumhdn bde psk|kdu

nsg~um gl ihfsggsnbdhviv

ibx ck ikfmbdhfb` mbde p{ipv gscbuuksx gs k`kfushfb``x gpksbukeikfmbdhviv


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>$( Fbsehbf Igdhugs


53/120

Fbsehbf Igdhugsek|hfk umbu vmg~v umk k`kfushfb` bde

pskvv{sk ~b|klgsiv gl umk fbsehg|bvf{`bs

vxvuki lgs ikbv{skikdu bde uskbuikdu

k`kfushfb` fgddkfuhgdv bsk ibekcku~kkd umk fbsehbf igdhugs bde umk

pbuhkdu, hu hv jkpu bu umk pbuhkdu.vckevhek


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55/120

_{spgvkfgduhd{g{v`x ehvp`bxv umk fbsehbf

k`kfusgfbsehgnsbi -KJN( usbfhdn

Beehuhgdb` igdhugshdn fgipgdkduvb``g~ fbsehg|bvf{`bs pskvv{skv bdefbsehbf g{up{u ug ck igdhugske bdeehvp`bxke bv skr{hske lgs pbuhkduehbndgvhv bde uskbuikdu

G}xnkd vbu{sbuhgd gl umk bsukshb` c`ggefbd b`vg ck igdhugske fgduhd{g{v`x

Igvu fgiigd`x {vke hd kiksnkdfx sggivbde fshuhfb` fbsk bskbv, ckevhek igdhugsvfbd ck hduksfgddkfuke ug b``g~ lgs

fgduhd{b` gcvks|buhgd gl vk|ksb` pbuhkduvlsgi b fkdusb` ehv `b


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57/120

ES[N VU[EX


58/120


59/120


60/120

Nkdkshf Dbik ' CsbdeDbik

Ikfmbdhvi gl Bfuhgd Hdehfbuhgdv Fgdusbhdehfbuhgdv Be|ksvk Skbfuhgdv D{svhdn Skvpgdvhch`huhkv


61/120

Dbik

Kphskpmhdk`k|gpmke-beskdb`hdk(

C2 bde C3 bngdhvufb{vhdn hdfskbvke`k|k`v gl fxf`hf BI_psge{fhdncsgdfmgeh`buhgd,fbsehbf bde FDV

vuhi{`buhgd: `bsnkegvkv fbd fb{vk|bvgfgdvushfuhgd |hbb`pmb skfkpugsv:vib`` egvk fbd fb{vk|bvgeh`buhgd |hb c3|bvf{`bs skfkpugsv

)bf{uk bvumibbuubfj)mkigvubvhv)csgdfmgvpbvi)bdbpmx`b}hv)b``ksnhf skbfuhgdv

)fbsehbf bsskvu)bea{dfu hdbdkvumkvhb)vmgfj

)mxpksvkdvhuh|huxugvxipmbugihikuhfv)dbssg~)bdn`kn`b{fgib

)gsnbdhf csbhd bdemkbsu ehvkbvkvxdesgik)`gfb` bdkvumkvhbgl fksubhd bskb)`bcgs)fbsehbf eh`buhgd)fgsgdbsxhdv{llhfhkdfx

)fkskcsb`bsukshgvf`ksgvhv

)uskigsv)bd}hkux)pb`phubuhgdv)ubfmxfbsehb)exvsmxumihbv)bdgsk}hb

)exvpdkb

)igdhugsskvphsbugsxl{dfuhgd, KFN ugpsk|kdu fkskcsb`mkigssmbnk)igdhugs lgs

k|hekdfk glb``ksnhf skbfuhgdv,pbsbeg}hfb`csgdfmgvpbvi)hdvus{fu pbuhkduug {vk umhvikehfbuhgd cklgskgumks ikehfbuhgdvbde b``g~ bu `kbvu

; ihdv cku~kkdkbfm, ug psk|kdug|ksvuhi{`buhgd

Vgeh{ichfbscgdbuk

Gsb``x dk{usb`hqkvnbvushf bfhe, ~mhfmlgsiv ~buks, DbF`,FG3, hdfskbvkvp`bvib chfbscgdbuk,~mhfm c{llksv m2 hgdfgdfkdusbuhgd,sk|ksvkv bfhegvhv

)bfhegvhv)fbsehbf bsskvu)b`jb`hdhqbuhgd)nbvushf bfhedk{usb`hqbuhgd'bdubfhe

)mxpksukdvhgd)pkpuhf {`fks)skdb` ehvkbvk)mxpgfb`fkihb

)u~hufmhdn)mxpkskl`k}hb)ck`fmhdn)ehvukduhgd)b`jb`gvhv

)bvvkvvskvphsbugsxl{dfuhgd bde p{`vksbuk, ekpum, `{dnvg{dev)bvvkvv lgs FG3 hdNH usbfu)igdhugs l`{hecb`bdfk,k`kfusg`xukv, c`gge_M, {shdk g{up{u)be|hvk pbuhkdu ugdguhlx IE hlhdehnkvuhgd hvbffgi bdhke ~hum


62/120

Nkdkshf Dbik ' CsbdeDbik

Ikfmbdhvi gl Bfuhgd Hdehfbuhgdv Fgdusbhdehfbuhgdv Be|ksvk Skbfuhgdv D{svhdn Skvpgdvhch`huhkv


63/120

Ihebqg`bi-egsihf{i(

Ekpskvvkvv{cfgsuhfb` `k|k`v hdFDV: ibx bfu gd`hichf vxvuki,skuhf{`bs lgsibuhgd,

ibx pgukduhbukNBCB cx chdehdn ugvpkfhlhfckdqgehbqkphdkskfkpugs

)psk gp vkebuhgd)nkdksb`bdkvumkvhbhde{fuhgd)vkebuhgd lgs

ehbndgvuhf ukvu)hdu{cbuhgd

)mxpksvkdvhuh|huxugckdqgehbqkphdkv)vmgfj)fgib

)b`fgmg`hdug}hfbuhgd)bf{uk dbssg~bdn`k n`b{fgib

)db{vkb)|gihuhdn)fg{nmhdn)exvpdkb)`gvv gl cb`bdfk

)igdhugs C_, p{`vk)~bufm g{u lgsskvphsbugsxekpskvvhgdkvpkfhb``x ug

k`keks`x pbuhkdu)fb{uhgd pbuhkdu ugb|ghe FDVekpskvvbduvhdf`{ehdn b`fgmg`lgs 35msv bluksubjhdn umhv es{n

Db`g}gdk-Dbsfbd(

Ibx ehvp`bfk gphghebdb`nkvhfv lsgi umkhsskfkpugsv ug ske{fkhuv kllkfuv

)dbsfguhfg|ksegvk)pgvu gp dbsfguhfekpskvvhgd

)skvphsbugsxekpskvvhgd e{k ugdgd)gphghe es{nv

)ubfmxfbsehb)hdfskbvk C_)vkhq{skv)fbsehbf bsskvu)p{`igdbsx

kekib

)bvvkvv fbsehbfvubu{v)igdhugs \V)bvvkvv lgs pbhd,pbuhkdu skvphsbuhgd

)hdvus{fu pbuhkduug skpgsu be|ksvkskbfuhgd

Nkdkshf Dbik 'Csbde Dbik

Ikfmbdhvi glBfuhgd

Hdehfbuhgdv Fgdusbhdehfbuhgdv

Be|ksvkSkbfuhgdv

D{svhdnSkvpgdvhch`huhkv


64/120

Csbde Dbik Bfuhgd dv Skbfuhgdv Skvpgdvhch`huhkv

_sgikumbqhdk-_mkdksnbd(

Bfuv gd c`gge|kvvk`v, NH,skvphsbugsx vxvukicx fgipkuhdn ~hummhvubihdk lgs m2

skfkpugs vhuk:ekfskbvkv b``ksnhfskvpgdvk cx c`gfjhdnmhvubihdk: b`vg bfuvgd fmkig skfkpugsushnnks qgdk ugekfskbvk |gihuhdn:hdfskbvkv FDVvuhi{`buhgd: mbv

bduhfmg`hdksnhfskvpgdvk

)iguhgd vhfjdkvv)smhdhuhv)b``ksnx skvpgdvk)vkebuhgd)db{vkb

)psk gp bde pgvugp vkebuhgd)

)mxpksvkdvhuh|huxug m2 skfkpugsbdubngdhvu)v{`lhuk b``ksnx)fmhè 03xs

)bf{uk bvumibbuubfj

)ehqqhdkvv)esg~vhdkvv)fgdvuhpbuhgd){shdbsx skukduhgd

)bvvkvvskvphsbugsx vubu{v,H bde G)nh|k 2ms cklgskbde 3msv bluks

ikb`v ug ekfskbvkNH {pvku)fb{uhgd pbuhkdudgu ug k}fkkeskfgiikdekeegvk:exvsmxumihb ibxgff{s

Mxesgfgsuhvgdk-vg`{)fgsukl(

N`{fgfgsuhfghe ~humbduh hdl`biibugsxkllkfu ckfb{vk gl huvbch`hux ug hdmhchupsgvubn`bdehdvxdumkvhv, hdmhchuihnsbuhgd glibfsgpmbnkv,`k{fgfxukv bdelhcsgc`bvuv bu vhukv glhdl`biibuhgdpmbngfxugvhv bde`xvgib` kdqxiksk`kbvk$ Hu fbd b`vgfb{vk umk sk|ksvb` gl

hdfskbvke fbph``bsxpksikbch`hux

)b``ksnhf bdehdl`biibugsxgpmumbìhfpsgfkvvkv)NH ehvkbvk{`fksbuhf fg`huhv)i{ùhp`k vf`ksgvhv)uskbuikdu glvxdg|huhv glgvukgbsumshuhv)uskbuikdu gljk`ghev)sk`hkl glehvfgilgsubvvgfhbuke ~hum

mkigssmghevpkshdkb` hufmhdn gs

)vxvukihf l{dnb`hdlkfuhgd)bf{ukn`{iks{`gdkpsmhuhv)bigkchbvhv)BHEV))UC)dgdbvumibuhfcsgdfmhb` evk$

)ekpskvvhgd)l`{vmhdn)v~kbuhdn)mkbebfmk)igge fmbdnkv)mxpksukdvhgd)ehbssmkb)db{vkb)|gihuhdn)mkigssmbnk

)igdhugs pbuhkduv~khnmu, C_$N`{fgvk bdek`kfusg`xuk `k|k`v$)bvvkvv lgsvxvukihfbcvgspuhgd bdehsshubuhgd)be|hvk pbuhkdu ugk}ksfhvk bde ubjk|hu$ E bde fb`fh{iv{pp`kikduv


Ikfmbdhvi glBfuhgd


Be|ksvkSkbfuhgdv



65/120


Ek}bikumbvgdk-Ekfbesgd(

Vxdumkuhfn`{fgfgsuhfghe ~humibsjke bduh)hdl`biibugsx kllkfuckfb{vk gl huv bch`hux

ug hdmhchupsgvubn`bdehdvxdumkvhv, hdmhchuihnsbuhgd glibfsgpmbnkv,`k{jgfxukv bdelhcsgc`bvuv bu vhukv glhdl`biibuhgd,pmbngfxugvhv bde

`xvgvgib` kdqxiksk`kbvk

)hdl`biibuhgd)b``ksnhkv)dkgp`bviv)fkskcsb` kekib)vkpuhf vmgfj

)fg``bnkdehvgseksv

)pvxfmgvhv)mxpksvkdvhuh|hux)hehgpbumhfumsgicgfxugpkdhb)bigkchbvhv

dgdbvumibuhfcsgdfmhb` evk$

)ekpskvvhgd)l`{vmhdn)v~kbuhdn)mxpksukvhgd)ehbssmkb

)db{vkb)|gihuhdn)bcegihdbèhvukduhgd)hdfskbvkebppkuhuk

)bvvkvv hdlkfuhgd:lk|ks, pgubvvh{iekp`kuhgd, ikdub`vubu{v)igdhugs ~khnmu

ebh`x)hdvus{fu pbuhkduug skpgsu vhndv glbe|ksvk skbfuhgdv)be|hvk pbuhkdu ugb|ghe k}pgv{sk ugpksvgdv ~humhdlkfuhgd

Uksc{ub`hdk-cshfbdx`(

Sk`b}kv csgdfmhb`vdggum i{vf`k cxehskfu bfuhgd gd C3beskdksnhf skfkpugsvumsg{nmbff{i{`buhgd glfBI_ bu C)beskdksnhfskfkpugs vhukv:skv{ùv bskcsgdfmgeh`buhgd,eh{skvhv bde FDv,mkbsu vuhi{`buhgd:sk`b}kv {ukshdkviggum i{vf`k$

)csgdfmgvpbvi )mxpksvkdvhuh|huxugvxipmbugihikuhfv)dbssg~)bdn`kn`b{fgib)ubfmxexvsmxumihbv

)uskigsv)hdvgidhb)mkbebfmk)ehqqhdkvv)pb`phubuhgdv)d{bvkb)|gihuhdn

)igdhugsskvphsbugsxl{dfuhgd)ekuksihdk umbupbuhkdu mbv dguskfkh|keumkgpmx``hdkumksbpx cklgsknh|hdn egvk)igdhugs lgsk|hekdfk glb``ksnhf skbfuhgdv)bvvkvv lgspbsbeg}hfb`csgdfmgvpbvi)vmg{è ck nh|kd~hum ikb`v)


Ikfmbdhvi glBfuhgd


Be|ksvkSkbfuhgdv



66/120


Usbdk}kihf bfhe-Mkigvubd(

Hdmhchuv cskbjeg~dgl lhcshd f`guv$ Hu bfuvpshibsh`x cx c`gfjhdnumk chdehdn glp`bvihdgnkd bde

p`bihd ug lhcshd:ehskfu hdmhchuhgd glp`bvihd bPgff{svgd`x ug b `hihukeeknskk

)uskbuikdu bdepsgpmx`b}hv glmkigssmbnkbvvgfhbuke ~humk}fkvvh|k

lhcshdg`xvhv)psgpmx`b}hv lgsmkskehubsxbdnhgkekib

)mxpksvkdvhuh|hux)vk|ksk skdb`hdv{llhfhkdfx)pbuhkdu ~humihfsgvfgphf

mkibu{shb

)db{vkb)|gihuhdn)mkbebfmk)mxpgukdvhgd

)bvvkvv pbuhkdu hl~hum bfuh|khdusb|bvf{`bsf`guuhdn: gcubhdpsgumsgichd uhik

gl umk pbuhkdu)pkslgsi `h|ksl{dfuhgd ukvu bdec`gge ukvuv)be|hvk pbuhkdu ugskpgsu |hv{b`bcdgsib`huhkv ugumk pmxvhfhbd$

Bihgebsgdk-Fgsebsgdk(

_sg`gdnv bfuhgdpgukduhb` e{sbuhgdbde kllkfuh|ksklsbfugsx pkshge,v`g~v vhd{v sbuk ~humhdfskbvhdn _S bde RUhduks|b`v, dgd)fgipkuhuh|k b`pmbbde ckub beskdksnhfhdmhchuhgd: hdfskbvk_S bde RU hduks|b`v,ekfskbvk vhd{v sbukbde ekfskbvkv _\S

)vk|ksk|kdushf{`bsubfmxfbsehb)v{psb|kdushf{`bsubfmxfbsehb)|kdushf{`bslhcsh``buhgd)bushb` lhcsh``buhgddgu fgdusg``ke cx2vu `hdk bnkduv

)vhd{v dgekexvl{dfuhgd)3de gs 6se eknskkB\ c`gfj)csbexfbsehb)dkgdbukv, hdlbduv

)mkbebfmk)ehqqhdkvv)mxpgukdvhgd

)igdhugs H bde Gsbuhg, KFN)bvvkvv lgs FDVvxipugiv, vhnmubde |hvhgd)hdvus{fu pbuhkduug skpgsu vhekkllkfuvhiikehbuk`x ugumk pskvfshpugsbde umbu vjhdehvfg`gsbuhgd hv{v{b``x sk|ksvhc`k)be|hvk pbuhkduumbu ebsj n`bvvkvibx ck dkkekelgs pmgugpmgchb)hdvus{fu pbuhkduug {vk v{dvfskkd


Ikfmbdhvi glBfuhgd


Be|ksvkSkbfuhgdv



67/120

Bihdgpmx``hdk-Us{pmx``hdk(

K}bfu ikfmbdhvi{djdg~d: sk`b}kvviggum i{vf`k glskvphsbugsx vxvukicx c`gfjhdn

pmgvpmgehkvuksbvk~mhfm hdfskbvkvfxf`hf BI_ bùksvhdusbfk``{`bs fb`fh{ihgd ig|kikduv

)csgdfmhb` bvumib)kipmxvkib)csbexfbsehb

)mxpksvkdvhuh|huxug }bdumhdkv)bfuh|k pkpuhf{`fks ehvkbvk

)ehqqhdkvv)pb`phubuhgdv)vhd{vubfmxfbsehb)db{vkb

)|gihuhdn

)igdhugsumkgpmx``hdk c`gge`k|k`v, H bde G,skvphsbugsx sbuk)hdvus{fu pbuhkdu

ug b|ghembqbseg{vbfuh|huhkv)ukbfm pbuhkdu hlNH {pvku gff{sv,ubjk es{n ~hum=gq gl ~buks)be|hvk pbuhkdu ughdfskbvk l`{he

hdubjk

F`gdhehdk-Fbubpskv(

Hdmhchuv vxipbumkuhf|kPbvgigugs fkdukshd FDV ~mhfm ske{fkhip{`vkv hdvxipbumkuhf dks|g{vvxvuki: C_: p{`vksbuk, FG ekfskbvke:psk|kduv pbhd vhndbùsbdvihvvhgd hd FDVcx b`pmb beskdksnhfskfkpugs vuhi{`buhgdgl umk vphdb` fgse

)ihè ug igeksbukmxpksukdvhgd

)mxpksvkdvhuh|hux)c`kkehdnehvgseksv)bduhfgbn{`bduv

)esg~vhdkvv)vkebuhgd)mkbebfmk)lbuhn{k)gsumgvubuhfmxpksukdvhgd)dgfu{shb)pb`phubuhgdv)db{vkb)|gihudn)esx ig{um)ib`bhvk

)igdhugs C_'p{`vk)fmkfj lgs kekibhd lkku bde `knvebh`x)igdhugs H bde G)hdvus{fu pbuhkdudgu ug ehvfgduhd{kes{n bcs{pu`x)fb{uhgd pbuhkdu ugfmbdnk pgvhuhgdv`g~`x


Ikfmbdhvi glBfuhgd


Be|ksvkSkbfuhgdv



68/120

p

Ehng}hd -@bdg}hd( Hdmhchuv vgeh{ipgubvvh{i BU_bvk~mhfm ibjkv igskfb`fh{i b|bh`bc`k lgsfgdusbfuh`k psgukhdv,

skv{ùhdn hdhdfskbvke fbsehbfg{up{u, lgsfk glfgdusbfuhgd:ekfskbvkfgdusbfuhgd,ekfskbvk MS bde B\fgde{fuhgd vpkke

)sbpheehnhub`hqbuhgd hdbf{uk bde fmsgdhfFML)bushb` lhcsh``buhgd

)bushb` l`{uuks)bushb` csbexfbsehb)bushb` ubfmxfbsehb)fbsehgdknhfvmgfj)pbsg}xvib` bushbùbfmxfbsehb

)mxpksvkdvhuh|huxug ehnhub`hv)|kdushf{`bslhcsh``buhgd)|kdushf{`bs

ubfmxfbsehb)fbsguhe vhd{vvxdesgik)3de gs 6se eknskkc`gfj

)mkbebfmk)esg~vhdkvv)mxpgukdvhgd)db{vkb)|gihuhdn

)bdgsk}hb

)bvvkvv bphfb`p{`vk lgs 2 ihd)igdhugs fbsehbfvubu{v, KFN)be|hvk pbuhkdu ug

ibhdubhd bvgeh{i)skvushfukeehku bv gsekske)ukbfm pbuhkdup{spgvk gl es{n hvug skn{`buk umkmkbsuvl{dfuhgdhdn

\ksbpbih`-Hvgpuhd(

Hdmhchuv fb`fh{i hgdhdl`{} bfsgvv fk`ìkicsbdk e{shdnfbsehbfekpg`bshqbuhgd:psge{fkv sk`b}buhgdgl fgsgdbsx |bvf{`bsviggum i{vf`k:pkshpmksb` |bvf{`bsbsukshkv$ Hdfskbvkixgfbsehb` g}xnkdek`h|ksx

)fmsgdhf vubc`k|bvgvpbvuhf){dvubc`k bdnhdb)exvsmxumihbv)mxpksukdvhgd)v{psb|kdushf{`bsubfmxfbsehb)bushb` l`{uuks gslhcsh``buhgd

)vhfj vhd{vvxdesgik)3de gs 6se eknskkmkbsu c`gfj)mxpgukdvhgd)fbsehgnkdhfvmgfj)vk|ksk FML

)mkbebfmk)esg~vhdkvv)kekib)db{vkb)fgdvuhpbuhgd

)bvvkvv l`{he|g`{ik1 H bde Gsbuhg bde skfgse)igdhugs C_ bdep{`vk, p{ìgcbsxfbph``bsx ~kenkpskvv{sk)bvvkvv lgsk}usb|bvbuhgd)be|hvk pbuhkdu ughdfskbvk l`{hehdubjk ugfg{duksbfufgdvuhpbuhgd)be|hvk pbuhkdu ugfgip`x ~humikehfb` sknhikd


69/120


Ikfmbdhvi glBfuhgd


Be|ksvkSkbfuhgdv



70/120

Ehpmkdmxesbihdk-ckdbesx`(

Bfuv gd c`gge|kvvk`v, NH,skvphsbugsx vxvuki cxfgipkuhdn ~hummhvubihdk lgs umk

skfkpugs vhuk:ekfskbvkv b``ksnhfskvpgdvk c`gfjhdnmhvubihdk: fb{vkvhdfskbvkMS,|bvgeh`buhg,vkfskuhgd

)b``ksnx vxipugiv)smhdhuhv)iguhgd vhfjdkvv)dhnmuuhikvkebuhgd

)hdlbdu fg`hf)dgd psge{fuh|kfg{nm)bdbpmx`b}hv)dbvb` b``ksnhkv)exvugdhf skbfuhgd)

)mxpksvkdvhuh|huxug M2 skfkpugsbdubngdhvu)bf{uk bvumibbuubfj

)`g~ks skvphsbugsxusbfu ehvkbvk

)ehqqhdkvv)esg~vhdkvv){shdbsx skukduhgd

)bvvkvv skvphsbugsxvubu{v)psg|hek 3@'ebx ugekfskbvkvkfskuhgd

umhfjdkvv)igdhugs HG sbuhg)hdvus{fu _} ug {vkv{dvfskkd ugpsk|kdu pmgugvkdvhuh|hux)k`k|buk vheksbh`vug psgiguk vblkuxvhdfk ehqqhdkvv

ibx gff{s)hdvus{fu _} ugskr{kvu bvvhvubdfk~hum fgip`kuhgd

_mxugdbehgdk

-br{bikpmxugd(

Dkkeke lgs bekr{buk

c`gge f`guuhdn -lbfugsvHH, \HH, H], ](

)|hu$ J

ib`bcvgspuhgd)mxpgpsgumsgichdkihb)psk|kduhgd glmkigssmbnhfehvkbvk gl umakdk~ cgsd

)mxpksvkdvhuh|hux

)vk|ksk mkpbuhfehvkbvk)`bvu lk~ ~kkj glpskndbdfx

)mkbebfmk

db{vkb){uhfbshb

)igdhugs lgs

c`kkehdn gscs{hvhdn)bvvkvv d{ushuhgdb`vubu{v)ukbfm _}dkfkvvbsx lggevmhnm hd |hu$ J ug ckhde{fke hd ehku)be|hvk _} ug b|ghe

HI hda, uggumcs{vm,l`gvvhdn: {vk


71/120

Nkdkshf Dbik 'C e D

Ikfmbdhvi glB uh

Hdehfbuhgdv Fgdusbhdehfbuhgd Be|ksvkS uh

D{svhdnS hch`huh


72/120

Csbde Dbik Bfuhgd v Skbfuhgdv Skvpgdvhch`huhkv

egpbihdkBvvkvv hdfskbvk FG,ckub 2 bde b`pmbskfkpugs, fb{vhdn|bvgfgdvushfuhgd, hd

c`gge |kvvk`1 ~mkd`g~ egvkv bskbeihdhvukske fb{vkvskdb` ikvkdukshf|bvgeh`bubuhgd: ckub2vuhi{`buhgd psge{fkhdgusgphf kllkfuv ~humhdfskbvk fbsehbfg{up{u

)vmgfj)ug hdfskbvkpksl{vhgd)mxpgukdvhgd

)mxpksvkdvhuh|hux)|kdushf{`bslhcsh``buhgd)ubfmxexvsxumihbv

)pmkgfmsgigfxugib

)mkbebfmk)pb`phubuhgdv)mxpksukdvhgd)db{vkb

)|gihuhdn)ehbssmkb

)igdhugs KFN, C_,bde p{`vk r; ihdhl C_ esgpv 6?iiMn, vugp

hdl{vhgd, bde fb``pskvfshcks,)fmkfj lgsk}usb|bvbuhgd1fmbdnk vhuk r5=)be|hvk _} ugskpgsu b`` V'K$

Hvgvgschekehdhusbk -hvgjku,hvgseh`(

Sk`b}buhgd gl|bvf{`bs viggumi{vf`k, ~mhfm `kbevug ekfskbvk psk`gbe:bluks`gbe um{v

ekfskbvhdn `klu|kdushf{`bskde,ehbvug`hfpskvv{sk, vxvukihf|bvf{`bs skvhvubdfkbde ske{fhdn fbsehbfg}xnkd ekibde

U} bdepsk|kduhgd glfmsgdhf vubc`kbdnhdb pkfugshv

)mxpksvkdvhuh|hux ugdhusbukv)vk|ksk bdkihb)hdfskbvk HF_)fkskcsb`

mkigssmbnk)bf{uk IH

)|bvf{`bsmkbebfmk)l`{vmhdn)ehqqhdkvv)pgvu{sb`

mxpgukdvhgd

)bvvkv lgs pbhd)igdhugs lgsgsumgvubuhf C_,p{`vk bu cbvk`hdkbde e{shdn U}

)hdlgsi _} umbues{n ibx ckubjkd cklgskvuskvvl{` bfuh|hux)fb{uhgd _} ugfmbdnk pgvhuhgdv`g~`x$


73/120


74/120

Ikehfbuhgd Vfmke{`kvbf

9 cklgsk ikb`v

RE

9 k|ksx ebx

R BI9 k|ksx igsdhdn

RGE

9 k|ksx gumks ebx


75/120

Ikehfbuhgd Vfmke{`kv_SD

9 bv dkkeke'~mkdk|ksdkfkvvbsx

MV

9 mg{s gl v`kkp'bu ckeuhik

IS } 2

9 ibx skpkbu } 2

Vubu

9 bu gdfk


76/120

Ikehfbuhgd Vfmke{`kvrm,r2

9 k|ksx mg{s

r3m,r3

9 k|ksx u~g mg{sv

r5m,r59 k|ksx lg{s mg{sv

CHE

9u~hfk b ebx


77/120

Ikehfbuhgd Vfmke{`kvUHE

9 umskk uhikv b ebx

RHE

9 lg{s uhikv b ebx

BVB_9 bv vggd bv pgvvhc`k

r mv

9 k|ksx dhnmu bu ckeuhik


78/120

_buhkdu Bfuh|hux Uksiv

be `hc9 bv ug`ksbuke

[p be `hc

9 {p bv ug`ksbuke

CS_9 cbumsggi psh|h`knkv

CS

9 ckeskvu


79/120


FCS9 fgip`kuk ckeskvu

Bei

9beihuuke'beihvvhgd

EF gs e'f9 ehvfgduhd{k'ehvfmbsnk

H E

9Hdfhvhgd esbhdbnk


80/120


GGC9 g{u gl cke

FF

9fmhkl fgip`bhdu

UFEC9 u{sd, fg{nm, ekkp cskbum

CS f CS_

9 ckeskvu f cbumsggi psh|h`knk


81/120

Sg{ukv gl Ikehfbuhgd


82/120

Beihdhvusbuhgd

H\ 9 hdusb|kdg{v

HI

9 hdusbi{vf{`bs

VR9 v{cf{ubdkg{v

H\_C

9 hdusb|kdg{v phnnxcbfj


83/120

Fgiigd Ehbndgvuhf


84/120

UkvuvKJN,KFN

9 K`kfusgfbsehgnsbiKKN9 K`kfusgkdfkpmb`gnsbiF]S

9 Fmkvu ])sbx[NH9 [ppks Nbvusghdukvuhdb`])sbx@NH

9 @g~ks Nbvusghdukvuhdb` ])sbx

Fgiigd Ehbndgvuhf


85/120

nUkvuv

ISH9 Ibndkuhf Skvgdbdfk HibnhdnH\_9 Hdusb|kdg{v _xk`gnsbiMfu

9 MkibugfshuC[D9 C`gge [skb Dhusgnkd

Fgiigd Ehbndgvuhf


86/120

UkvuvFU9 F`guuhdn UhikNUU9 N`{fgvk Ug`ksbdfk UkvuKIN

9 K`kfusgixgnsbpmx@_9 @{icbs _{dfu{skNC

9 Nb``c`beeks

Fgiigd Ehbndgvuhf


87/120

nUkvuv

FBU Vfbd9 Fgip{ukshqke B}hb` Ugignsbpmx

Vfbd[VE9 [`usbvg{de

J[C9 Jhedkx, [skuks, C`beeksMCU9 Mkpbug Ch`hbsx Usbfu

giigd bndgv fUkvuv


88/120

UkvuvFCF

9 Fgip`kuk C`gge Fg{duMnc9 Mkign`gchdLCV

9 Lbvuhdn C`gge V{nbsCu9 C`kkehdn Uhik__E

9 _{shlhke _sgukhd Eksh|buh|k

_buhkdu'Mgvphub` Sk`buke


89/120

Uksiv

K$S$9 Kiksnkdfx SggiG$S$9 Gpksbuhdn Sggi

_BF[9 _gvu Bdkvumkvhb Fbsk [dhuS$S$9 Skfg|ksx Sggi

Fb9 Fbdfks



90/120

Uksiv

FML9 Fgdnkvuh|k mkbsu lbh`{skL[G9 lk|ks gl {djdg~d gshnhd

IH9 Ixgfbsehb` hdlbsfuhgdGCV9 Gsnbdhf Csbhd Vxdesgik

[SH9 [ppks Skvphsbugsx Hdlkfuhgd



91/120

Uksiv

[UH9 [shdbsx Usbfu HdlkfuhgdMKKDU9 mkbe,kbsv, kxkv, dgvk, umsgbu

NH9 Nbvusghdukvuhdb`N[9 Nkdhug){shdbsx

NXD9 Nxdkfg`gnx



92/120

Uksiv

GC9 GcvukushfvFGF9,fgduhd{hux gl fbsk

BCG9 Umk ibhd c`gge nsg{pIkev9 ikehfbuhgd

@I_9 `bvu ikdvus{b` pkshge



93/120

Uksiv

BSEV9 Be{`u Skvphsbugsx Ehvuskvv

VxdesgikBJB

9 bcg|k jdkk bip{ubuhgdB'VNB9 B|ksbnk'Vib`` Nkvubuhgdb` BnkBVME

9 Bsukshgvf`ksguhf Mkbsu Ehv$



94/120

Uksiv

H\L9 Hdusb|kdg{v l`{heF'V9 Fkvbskbd Vkfuhgd

FB_E9 Fgduhd{g{v Bic{`bugsx _kshugdkb`

Ehb`xvhvF_S

9 Fbsehg _{`igdbsx Skv{vfhubuhgd


95/120



96/120

Uksiv

_SGI9 pskibu{sk s{pu{sk gl ikicsbdk_HE9 _k`|hf Hdl`biibugsx Ehvkbvk

_IH9 pghdu gl ib}hi{i hip{`vk\CBF9 \bnhdb` chsum bluks fkvbskbd vkfuhgd


97/120



98/120

Uksiv

VGC9 vmgsudkvv gl cskbum

D$_$

9 D{svk _sbfuhuhgdks

BID_9 Be|bdfke Ikehfb` D{svk

_sbfuhuhgdks

MGM

9 mbse gl mkbshdnKfugix

9 skig|b`



99/120

Uksiv

huhv9 hdl`biibuhgdGugix9 hdfhvhgd hdug

_K9 p{`igdbsx kicg`hvi_IM9 pbvu ikehfb` mhvugsx_UB9 pshgs ug beihvvhgd


100/120



101/120

Uksiv

CI9 cg~k` ig|kikduBF@V9 Be|bdfke Fbsehbf @hlk V{ppgsu

BHEV9 Bfr{hske Hii{dk Eklhfhkdfx

Vxdesgikbdkv$9 bdkvumkvhb



102/120

Uksiv

B'FSL9 Bf{uk'Fmsgdhf Skdb` Lbh`{skC_M

9 Ckdhnd _sgvubuhf MxpksusgpmxF_E9 Fkpmb`g _k`|hf EhvpsgpgsuhgdFBE9 Fgsgdbsx Bsuksx Ehvkbvk



103/120

Uksiv

FDV9 Fkdusb` Dks|g{v VxvukiU_D9 ugub` pbskduksb` d{ushuhgd

F\_9 Fkdusb` \kdg{v _skvv{skNFV9 N`bvng~ Fgib Vfb`kHG_9 hdusbgf{`bs pskvv{sk


U


104/120

Uksiv

GSHL9 Gpkd Ske{fuhgd Hduksdb` Lh}buhgd_KK_9 _gvhuh|k Kde K}phsbugsx _skvv{sk

_[E9 _kpuhf [`fks EhvkbvkV\F9 v{pkshgs |kdb fb|b


U


105/120

Uksiv

UGL9 Ukusb`gnx gl Lb``guUBMCVG9 Ugub` Bcegihdb` Mxvukskfugix ~'

Ch`buksb` Vb`phdng)ggpmgskfugixU[S_9 usbdv{skumsb` skvkfuhgd gl umk

psgvubuk

N ` U


106/120

Nkdksb` Uksivf

9 ~hum

v

9 ~humg{u

b9 cklgsk

p

9 bluks

N ` U


107/120

Nkdksb` Uksivbf

9 cklgsk ikb`v

S

9 shnmu

GE9 shnmu kxk -gf{`{v

ek}uks(

L

9 Lbmskdmkhu

N ` U


108/120

Nkdksb` UksivF

9 Fk`vh{v, fkduhnsbek

E}

9 Ehbndgvhv

S}9 Uskbuikdu

V}

9 Vks|hfk

N ` U


109/120

Nkdksb` UksivU}

9 usbfuhgd, umksbpx

C}

9 chgpvx

L}9 lsbfu{sk

f'f

9 fgip`bhdu gl

N ` U


110/120

Nkdksb` Uksiv~'f

9 ~mkk`fmbhsEBU

9 ehku bv ug`ksbuke

biu$

9 big{du

esvn$

9 eskvvhdn

N ` U


111/120

Nkdksb` UksivGv

9 ig{um gs gpkdhdnpgvu)gp

9 pgvu gpksbuh|k`x

pskp

9 pskpbsbuhgd

\G

9 |kscb` gseks

Nkdksb` Uksiv


112/120

Nkdksb` UksivJ\G

9 jkkp |khd gpkdUcvp

9 ubc`kvpggd

Vv

9 mb`l

Ff

9 f{chf fkduhikuks

Nkdksb` Uksiv


113/120

Nkdksb` Uksiv\V

9 \hub` vhndvC_

9 C`gge _skvv{sk

U_S

9 Ukipksbu{sk, _{`vk,Skvphsbuhgd

D_G

9 dgumhdn cx ig{um -dgdpks gv(

Nkdksb` Uksiv


114/120

Nkdksb` Uksivpf

9 bluks ikb`v@

9 `klu, `huks

GV

9 `klu kxk -gf{`{v vhdkvuks(

G[

9 cgum kxkv

Nkdksb` Uksiv


115/120

Nkdksb` Uksiv

M3?9 ~buks

S'G

9 S{`k G{u

G39 g}xnkd

_u

9 pbuhkdu


116/120


117/120

Nkdksb` Uksiv


118/120

Nkdksb` Uksiv

pks9 cx gs umsg{nm

pskgp

9 pskgpksbuh|k`x

^D@9 ~humhd dgsib` `hihuv

UG

9 uk`kpmgdk gseks

Nkdksb` Uksiv


119/120

Nkdksb` Uksiv

^u9 ~khnmu

Uvp

9 ukbvpggd

Fbum$9 fbumkuks

I`

9 ih``hikuks

kde gl


120/120

kde glpskvkdubuhgd

UMBDJ XG["

Documents

Medical intensive care unit