The ambulance service is one of the most important links in the healthcare system in our country. The volume of medical care provided to the population by medical and paramedic teams is constantly growing. In rural areas, emergency medical departments have been established at the Central District Hospital. Calls to the population there are almost universally served by paramedic teams.
Stations have been created in cities, and major cities- also emergency medical substations. They include line medical teams serving the majority of a wide variety of calls, specialized teams ( intensive care, trauma resuscitation, pediatric intensive care, toxicology, psychiatric), as well as paramedic teams. The functions of paramedic teams in cities mainly include transporting patients from one medical institution to another, transporting patients from home to the hospital in the direction of local doctors, delivering women in labor to maternity, as well as providing assistance to patients with various injuries when the need for resuscitation care is not expected, as well as some others. For example, if the reason for the challenge is “tripped, fell, broke an arm (leg)” - this is a challenge for paramedic team, and if it is known in advance that the victim fell out of a seventh-floor window or was hit by a tram, it is more advisable to immediately send a specialized team to such a call.
But this is in cities. In rural areas, as already noted, almost all calls are carried out by a paramedic. In addition, in real work conditions, it is sometimes impossible to determine in advance what actually happened, and a paramedic working independently must be prepared for any most unexpected situations.
When working as part of a medical team, the paramedic is completely subordinate to the doctor during the call. His task is to carry out all assignments clearly and quickly. Responsibility for decisions made lies with the doctor. The paramedic must be proficient in the technique of subcutaneous, intramuscular and intravenous injections, ECG recording, be able to quickly install a system for drip fluid administration, measure blood pressure, count the pulse and number breathing movements, insert an airway, perform cardiopulmonary resuscitation. He must also be able to apply a splint and bandage, stop bleeding, and know the rules for transporting patients.
In the case of independent work, the ambulance paramedic is fully responsible for everything, so he must be fully proficient in diagnostic methods at the prehospital stage. He needs knowledge of emergency therapy, surgery, traumatology, gynecology, and pediatrics. He must know the basics of toxicology, be able to independently deliver a child, evaluate neurological and mental condition patient, not only register, but also roughly evaluate the ECG. Emergency care is the pinnacle of medical art, which is based on fundamental knowledge from various fields of medicine, combined with practical experience.
Basic orders regulating workOrder of the Ministry of Health of the Russian Federation No. 100 of March 26, 1999 “On improving the organization of emergency medical care for the population of the Russian Federation.” The main document in accordance with which the work of the ambulance service is based is the order of the Ministry of Health of the Russian Federation No. 100 dated March 26, 1999 “On improving the organization of emergency medical care for the population of the Russian Federation.” Here are some excerpts from this document. “In the Russian Federation, a system of providing emergency medical care to the population with a developed infrastructure has been created and is functioning. It includes over 3,000 stations and emergency medical departments, employing 20 thousand doctors and over 70 thousand paramedical workers... Every year, the emergency medical service makes from 46 to 48 million calls, providing medical care to more than 50 million citizens ..." It is envisaged to "gradually expand the scope of emergency medical care provided by paramedic teams, with the preservation of medical teams as intensive care teams and ... other highly specialized teams."
“An emergency medical station is a medical and preventive institution designed to provide round-the-clock emergency medical care to adults and children, both at the scene of an incident and on the way to the hospital in conditions that threaten the health or life of citizens or those around them, caused by sudden diseases , exacerbation chronic diseases, accidents, injuries and poisonings, complications of pregnancy and childbirth. Ambulance stations are created in cities with a population of over 50 thousand people as independent treatment and preventive institutions. IN populated areas with a population of up to 50 thousand, emergency medical departments are organized as part of city, central district and other hospitals.
In cities with a population of more than 100 thousand people, taking into account the length of the settlement and the terrain, emergency medical care substations are organized as divisions of stations (calculating 15-minute transport accessibility)... The main functional unit of the substation (station, department) of emergency medical care is a mobile team (paramedic, medical, intensive care and other highly specialized teams)... Teams are created in accordance with staffing standards with the expectation of ensuring round-the-clock shift work.”
Appendix No. 10 to the order of the Ministry of Health of the Russian Federation No. 100 dated March 26, 1999 “Regulations on the paramedic of the mobile ambulance team.” General provisions.
A specialist with secondary medical education in the specialty “General Medicine”, having a diploma and an appropriate certificate.
When performing emergency medical care duties as part of a paramedic team, the paramedic is the responsible performer of all work, and as part of a medical team, he acts under the direction of a doctor.
The paramedic of the mobile ambulance team is guided in his work by the legislation of the Russian Federation, regulatory and methodological documents of the Ministry of Health of the Russian Federation, the Charter of the emergency medical care station, orders and instructions of the administration of the station (substation, department), and these Regulations.
A paramedic of a mobile emergency medical team is appointed to a position and dismissed in accordance with the procedure established by law.
Responsibilities. The paramedic of the mobile ambulance team is obliged to:
Ensure the immediate departure of the brigade after receiving a call and its arrival at the scene of the incident within the established time standard for the given territory.
Provide emergency medical care to sick and injured people at the scene of an accident and during transportation to hospitals.
Administer to sick and injured people medications for medical reasons, stop bleeding, carry out resuscitation measures in accordance with approved industry norms, rules and standards for paramedic personnel in the provision of emergency medical services.
Be able to use existing medical equipment, master the technique of applying transport splints, bandages and methods of performing basic cardiopulmonary resuscitation.
Master the technique of taking electrocardiograms.
Know the location of medical institutions and station service areas.
Ensure that the patient is carried on a stretcher and, if necessary, take part in it (in the working conditions of the team, carrying a patient on a stretcher is regarded as a type of medical care). When transporting a patient, be next to him, providing the necessary medical care.
If it is necessary to transport a patient in an unconscious state or in a state of alcoholic intoxication, carry out an inspection to find documents, valuables, money indicated in the call card, hand them over to emergency department hospital with a mark in the direction for signature by the staff on duty.
When providing medical assistance in emergency situations, in cases of violent injuries, act in the prescribed manner (report to the internal affairs authorities).
Ensure infection safety (comply with the rules of sanitary and hygienic and anti-epidemic regime). If a quarantine infection is detected in a patient, provide him with the necessary medical care, observing precautions, and inform the senior shift doctor about the clinical, epidemiological and passport data of the patient.
Ensure proper storage, accounting and write-off of medications.
At the end of duty, check the condition of medical equipment, transport tires, replenish those used up during work medicines, oxygen, nitrous oxide.
Inform the administration of the ambulance station about all emergencies that occurred during the call.
At the request of internal affairs officers, stop to provide emergency medical care, regardless of the location of the patient (injured).
Maintain approved accounting and reporting documentation.
In the prescribed manner, increase your professional level and improve practical skills.
Rights. A paramedic of a mobile emergency medical team has the right to:
If necessary, call an emergency medical team for help.
Make proposals to improve the organization and provision of emergency medical care, improve working conditions for medical personnel.
Improve your qualifications in your specialty at least once every 5 years. Pass certification and recertification in accordance with the established procedure.
Take part in medical conferences, meetings, seminars held by the administration of the institution.
Responsibility. The paramedic of the mobile ambulance team is responsible in the manner prescribed by law:
For professional activities carried out in accordance with approved industry norms, rules and standards for paramedic emergency medical personnel.
For illegal actions or inaction that resulted in damage to the patient’s health or death.
In accordance with the order of the Ministry of Health of the Russian Federation No. 100, visiting teams are divided into paramedic and medical teams. The paramedic team consists of two paramedics, an orderly and a driver. The medical team includes a doctor, two paramedics (or a paramedic and a nurse anesthetist), an orderly and a driver.
However, the order further states that “the composition and structure of the team is approved by the head of the station (substation, department) of emergency medical care.” In almost real working conditions (for reasons understandable in our economic living conditions), a medical team - a doctor, a paramedic (sometimes also a paramedic) and a driver, a specialized team - a doctor, two paramedics and a driver, a paramedic team - a paramedic and a driver (maybe also and a nurse). In the case of independent work, the paramedic is the driver’s direct superior during the call, and therefore must also represent his rights and obligations.
Appendix No. 12 to the order of the Ministry of Health of the Russian Federation No. 100 dated March 26, 1999 “Regulations on the driver of an emergency medical team.” General provisions.
The driver is part of the emergency medical team and is an employee who provides driving of the ambulance service "03".
A 1-2 class vehicle driver who has special training in the program of providing first aid to victims and is trained in the rules of their transportation is appointed to the position of driver of an emergency medical team.
During a call, the driver of the emergency medical team is directly subordinate to the doctor and paramedic, and is guided in his work by their instructions, orders and these Regulations...
The appointment and dismissal of the driver is made by the head of the emergency medical service station or the chief physician of the hospital, the structure of which includes the emergency medical service unit, and when using cars on a contractual basis - by the head of the vehicle fleet.
Responsibilities.
The driver of the ambulance team is subordinate to the doctor (paramedic) and carries out his orders.
Monitors the technical condition of the ambulance and promptly refills it with fuel and lubricants. Performs wet cleaning of the vehicle interior as necessary, maintaining order and cleanliness.
Ensures that the brigade immediately responds to a call and that the vehicle moves along the shortest route.
Contains in functional condition special alarm devices (siren, flashing light), search light, portable spotlight, emergency interior lighting, entrenching tool. Performs minor repairs to equipment (locks, belts, straps, stretchers).
Together with the paramedic(s), he ensures the carrying, loading and unloading of sick and injured people during their transportation, assists the doctor and paramedic in immobilizing the limbs of the victims and applying tourniquets and bandages, transfers and connects medical equipment. Provides assistance to medical personnel accompanying mentally ill patients.
Ensures the safety of property, monitors the correct placement and securing of on-board medical devices.
It is strictly prohibited to store any items other than approved service equipment inside the vehicle.
Strictly follows the internal regulations of the emergency medical service station (substation, department), knows and observes the rules of personal hygiene.
The driver must know: the topography of the city; location of substations and healthcare facilities.
Rights. The driver of an ambulance team has the right to advanced training in the prescribed manner.
Responsibility. The ambulance driver is responsible for:
Timely and high-quality performance of functional duties in accordance with the job description.
Safety of medical equipment, instruments and sanitary property located in the ambulance vehicle.
Orders regulating work with OOI
During his work, an ambulance paramedic may meet with patients in particular dangerous infections(OOI). His actions in this case are defined by the following document:Ministry of Health of the USSR, Main Directorate of Quarantine Infections, Main Directorate of Treatment and Preventive Care. “Instructions for carrying out initial measures when identifying a patient (corpse) suspected of having plague, cholera, or contagious viral hemorrhagic fevers.” Moscow - 1985. (excerpts).
“... When establishing a preliminary diagnosis and carrying out primary measures for these diseases, be guided by the following incubation period periods: plague - 6 days; cholera - 5 days; Lassa fever, Ebola, Marburg disease - 21 days; monkeypox - 14 days.
In all cases of identification of a patient (corpse), immediate information to the authorities and healthcare institutions according to their subordination must contain the following information:
date of illness;
preliminary diagnosis, who made it (name of doctor or paramedic, position, name of institution), based on what data (clinical, epidemiological, pathological-anatomical);
date, place and time of identification of the patient (corpse);
where he is currently located (hospital, plane, train, ship);
last name, first name, patronymic, age (year of birth) of the patient (corpse);
name of the country, city, region (territory) from where the patient (corpse) arrived, what type of transport (number of train, car, plane flight, ship), time and date of arrival;
address of permanent residence, nationality of the patient (corpse);
brief epidemiological history, clinical picture and severity of the disease;
whether you took chemotherapy drugs or antibiotics in connection with this disease;
whether you received preventive vaccinations;
measures taken to localize and eliminate the outbreak of the disease (number of identified persons in contact with the patient (corpse), carrying out specific prevention, disinfection and other anti-epidemic measures;
what kind of help is needed: consultants, medicines, disinfectants, transport, protective suits;
signature under this message (full name, position held);
the name of the person who transmitted and received this message, the date and hour of the message.”
The paramedic of the emergency medical team must transfer this information to the senior doctor of the shift, and if it is impossible to do this, to the dispatcher for further transmission to the authorities.
“A health care professional should suspect plague, cholera, GVL, or monkeypox based on clinical picture diseases and epidemiological history... Often decisive factor When establishing a diagnosis, the following epidemiological history data are used:
arrival of a patient from an area unfavorable for these infections for a time equal to the incubation period;
communication of the identified patient with similar patients along the route, at the place of residence or work, as well as the presence there of any group diseases or deaths of unknown etiology;
staying in areas bordering countries unfavorable for these infections, or in exotic territory for the plague.
It should be borne in mind that these infections, especially during the initial manifestations of the disease, can give pictures similar to a number of other infectious and non-infectious diseases. So, similar symptoms can be observed:
for cholera - with acute intestinal diseases(dysentery, other acute respiratory diseases), toxic infections of various natures; poisoning with pesticides;
with plague - with various pneumonia, lymphadenitis with elevated temperature, sepsis of various etiologies, tularemia, anthrax;
for monkeypox - with chickenpox, generalized vaccine and other diseases accompanied by rashes on the skin and mucous membranes;
for Lassa fever, Ebola, Marburg disease - with typhoid fever, malaria. In the presence of hemorrhages, it is necessary to differentiate from yellow fever, Dengue, Crimean-Congo fevers.
If a sick person or a corpse suspicious for OI is detected at the scene of the call, the following measures must be taken:
The patient (corpse) is temporarily isolated in the room (apartment) where he lived or was discovered. Isolate contacts in adjacent rooms.
If you suspect a disease with plague, GVL, or monkeypox, your mouth and nose should be temporarily covered with a towel or mask before receiving protective clothing; if not, make one out of a bandage or scarf.
Transfer the information collected according to the above scheme (Scheme No. 1) to the senior shift doctor or dispatcher by phone. In his absence, without leaving the premises through a closed door or window, ask neighbors or other persons to invite your driver (do not let him into the premises), tell him the collected information and ask him to send a team of epidemiologists and protective clothing to help you. At the same time, you should prevent the spread of panic among others.
In the room where the patient and the ambulance team are located, all windows and doors are tightly closed, the air conditioning is turned off, and the ventilation holes are sealed (except in cases of cholera). The patient is not allowed to use the sewer system and the necessary containers are found on site to collect secretions, which are disinfected. The EMS brigade is equipped for this purpose with special means(diagram no. 2).
Any contact of outsiders with the patient is prohibited. When compiling lists of contacts, contacts in premises connected through ventilation ducts are taken into account (except for cases of cholera).
At the same time, the patient begins to receive the necessary medical care.
After the arrival of the epidemiological team, the paramedic and other team members put on protective suits and are at the disposal of the arriving medical specialist.
The patient and the ambulance team are hospitalized in a hospital specially designated for the isolation of patients with acute respiratory infections in accordance with the orders of local health authorities.
The procedure for putting on an anti-plague suit.
Overalls (pajamas).
Socks (stockings).
Boots (galoshes).
Hood (large headscarf).
Anti-plague robe.
Respirator (mask).
Glasses.
Gloves.
Towel (placed behind the waistband of the robe on the right side).
If it is necessary to use a phonendoscope, it is worn in front of a hood or a large scarf.
If the paramedic's own clothes are heavily contaminated with the patient's secretions, they are removed. In other cases, an anti-plague suit is worn over clothing.
The procedure for removing the anti-plague suit. They take off the suit very slowly. Wearing gloves, wash your hands in a disinfectant solution (5% carbolic acid solution, 3% chloramine solution, 5% Lysol solution) for 1–2 minutes, then:
They take out a towel from their belt.
Boots or galoshes are wiped from top to bottom with a cotton swab moistened with a disinfectant solution. A separate tampon is used for each boot.
Remove the phonendoscope (without touching the exposed parts of the skin).
They take off their glasses.
They take off the mask.
Undo the ties of the collar of the robe, belt, and sleeve ties.
Remove the robe by folding it with the outer (dirty) side inward.
Remove the scarf by rolling it from the corners to the center with the dirty side inward.
Take off gloves.
Boots (galoshes) are washed again in a disinfectant solution and removed without touching them with your hands.
All parts of the suit are immersed in a disinfectant solution. After removing the suit, wash your hands with warm water and soap.
Installation for collecting native material from a patient with suspected cholera (for non-infectious hospital institutions, emergency medical care stations, outpatient clinics, SKP, SKO) - scheme No. 2.
Sterile jars of at least 100 ml - wide-necked with lids or ground-in stoppers - 2 pcs.
Sterile spoons (sterilization period 3 months) - 2 pcs.
Plastic bags - 5 pcs.
Gauze napkins - 5 pcs.
Referral for analysis (forms) - 3 pcs.
Adhesive plaster - 1 pack.
Simple pencil - 1 pc.
Bix (metal container) - 1 pc.
Instructions for collecting material - 1 pc.
Chloramine in a bag of 300 g per 10 liters of 3% solution and dry bleach in a bag at the rate of 200 g per 1 kg of discharge.
If cholera is suspected, stool and vomit should be taken for laboratory testing immediately when the patient is identified and always before treatment with antibiotics. The secretions in a volume of 10–20 ml are transferred with spoons into sterile jars, which are closed with lids and placed in plastic bags. Samples are delivered to the laboratory in a container or in metal containers (boxes). Each test tube, jar or other container in which material from the patient is placed is tightly closed with lids, and the outside is treated with a disinfectant solution. After this, they are placed in bags and sealed with adhesive tape or tied tightly.
Job ordersIn addition to the orders, excerpts from which were given above, the emergency medical technician must be guided in his work by the following documents:
Order of the USSR Ministry of Health No. 408 dated July 12, 1989 “On measures to prevent viral hepatitis.”
OST 42–21–2–85 (from 1985) “Disinfection, pre-sterilization cleaning and sterilization of medical products.”
Order of the Ministry of Health of the Russian Federation No. 295 of 1995 - “On the implementation of the rules for conducting mandatory medical examination for HIV and the list of workers in certain professions, industries, enterprises, institutions and organizations who undergo mandatory medical examination for HIV.” This document lists the groups of people subject to mandatory HIV testing, the rules for conducting this testing, as well as a list clinical manifestations, on the basis of which AIDS can be suspected in a patient.
Order of the Ministry of Health of the Russian Federation No. 375 of December 23, 1998 “On measures to strengthen epidemiological surveillance and prevention meningococcal infection and purulent bacterial meningitis." The clinical picture of meningitis is outlined, therapeutic tactics in relation to the patient.
Order No. 171 of the USSR Ministry of Health dated April 27, 1990 “On epidemiological surveillance of malaria.”
Order of the Ministry of Health of the Russian Federation No. 330 of November 12, 1997 “On measures to improve the accounting, storage, prescribing and use of narcotic drugs.”
Order of the Ministry of Health of the Russian Federation No. 348 of November 26, 1998 “On strengthening measures to prevent epidemic typhus and combat lice.” The clinical picture of epidemic typhus and Brill's disease, the mechanism of infection, complications and treatment are described.
Certain other orders and instructions and orders and instructions from local health authorities. The significance of these documents is periodically checked at the workplace by representatives of the relevant commissions, as well as by the heads of medical institutions.
Emergency medical care to the population in large cities of the Russian Federation is provided by emergency medical care departments (rooms) of the APU. Emergency Department is structural unit APU, designed to provide round-the-clock medical care in places of permanent and temporary residence of adults and children, for acute diseases and exacerbation of chronic diseases that do not require urgent care medical intervention. Emergency medical care at home is provided on a territorial basis around the clock mobile teams emergency departments organized in one or more clinics for the population of a given administrative region. The boundaries of the service area of emergency medical care departments are approved by the health authority of the administrative region.
The main tasks of the emergency department are:
24-hour provision of timely medical care in places of permanent and temporary residence for adults and children, for acute diseases and exacerbation of chronic diseases that do not require urgent medical intervention;
Providing medical care to sick and injured people who applied directly to the department on their own (outpatients);
Making active calls to patients requiring dynamic medical supervision, ensuring continuity in work with treatment and preventive institutions of the city to provide emergency medical care to the population;
Notifying the territory's health authorities and relevant administrative bodies about all emergencies and accidents in the service area of the department;
Delivery of patients to social institutions (boarding homes, etc.) following referrals from doctors of territorial clinics;
Transportation of patients for consultations, examinations, hemodialysis in healthcare facilities, etc.
The emergency medical care department is headed by the head of the department, who is appointed and dismissed by the chief physician of the medical institution, the structural unit of which is the emergency medical care department.
The main functional unit of the emergency medical care department is the mobile team (medical, ambulance transport for transporting patients). The medical team consists of a doctor specializing in emergency medical care, a paramedic (nurse), an orderly and a driver. The paramedic team for transporting patients includes a paramedic and a driver. The number of work shifts of mobile teams, their profile, and work schedule (schedule) are determined by the higher-level organization, taking into account the number of calls from the population to the department, the density of the hourly flow of calls, the number of calls by day of the week, months of the year, the number of patients subject to emergency and planned hospitalization.
Calls are received and transferred to field teams by a paramedic ( nurse) for receiving and transmitting calls from the emergency medical dispatch department. Injured (patients) delivered by visiting teams of the emergency medical department must be immediately transferred to the duty personnel of the hospital admission department with a note in the “Call Card” of the time of their arrival.
The emergency medical care department does not issue documents certifying temporary disability and forensic medical reports, does not conduct an examination of alcohol intoxication, but provides oral information when contacting the population in person or by telephone about the location of sick and injured people. If necessary, issues certificates of any form indicating the date, time of application, diagnosis, examinations performed, medical care provided and recommendations for further treatment.
Ambulance and emergency medical care (EMS)– a medical organization aimed at providing emergency medical care, as well as specialized medical care for life-threatening accidents and acute serious illnesses both at the scene and along the way. This type assistance is organized for urgent medical care in case of accidents and sudden serious illnesses that occur at home, on the street, during work and at night, in case of mass poisoning and other threatening conditions.
The concept of “emergency conditions” defines such pathological changes in the human body, which lead to a sharp deterioration in health and can be life-threatening.
“Emergency in medical care” means the urgent elimination of all urgent pathological conditions that arose unexpectedly, which, regardless of the severity of the patient’s condition, require immediate diagnostic and therapeutic activity. It is advisable to distinguish the following main forms of pathological conditions for which emergency care is indicated:
– there is an immediate threat to life, which without timely medical attention can lead to fatal outcome
– there is no immediate threat to life, but, based on pathological condition, the threatening moment can come at any time
– there is no threat to life, but it is necessary to alleviate the patient’s suffering
– the patient is in a non-life-threatening condition, but urgent assistance is required in the interests of the team.
In the activities of emergency medical services, the preservation of the health of patients and victims depends primarily on the timely arrival of the emergency medical team at the scene of the call and the quality of pre-hospital and medical care.
Basic principles of organizing EMS:
– full accessibility
– efficiency in work, timeliness
– completeness and high quality assistance provided
– ensuring unhindered hospitalization
– maximum continuity in work.
Currently operating in the Republic of Belarus State system for organizing emergency medical services:
– pre-hospital stage: in cities, emergency medical service stations with substations and branches, trauma centers; in rural administrative areas - departments of the emergency medical service of the central district hospital, in the regions
– hospital stage: emergency hospitals, emergency departments of the general network of hospital institutions
The activities of emergency medical care stations (departments, hospitals) are regulated by the order of the Ministry of Health of the Republic of Belarus “On improving the organization of ambulance and emergency medical care.”
An emergency medical service station (department) is a healthcare facility that provides emergency and emergency medical care to adults and children in case of life-threatening conditions, accidents, acute severe diseases and exacerbation of chronic diseases both at the scene of the incident and along the route.
Tasks of the NSR station:
1. Providing, as soon as possible after receiving a call, ambulance and emergency medical care to sick and injured people who are outside health care facilities and during their transportation to hospitals.
2. Transportation of patients in need of emergency assistance, victims, women in labor, premature babies together with their mothers at the request of doctors and hospital administration.
The SMP station provides the following:
1. Emergency medical care:
A) in case of sudden diseases that threaten the patient’s life (acutely developing disorders of the cardiovascular system, central nervous system, respiratory organs, abdominal organs)
B) in case of accidents ( different kinds injuries, wounds, burns, electric shock and lightning, foreign bodies respiratory tract, frostbite, drowning, poisoning, suicide attempts)
C) during births that took place outside specialized institutions
D) in case of mass disasters and natural disasters.
2. Emergency care: during exacerbations of various chronic diseases, when the reasons for contacting do not relate to paragraph 1a) of this provision, as well as during acute illnesses of children, especially in the first year of life.
SSMP categories are established depending on the number of trips performed per year: non-category - over 100 thousand trips per year, category I - from 75 thousand to 100 thousand, category II - from 50 thousand to 75 thousand, category III - from 25 thousand to 50 thousand, IV category - from 10 thousand to 25 thousand, V category - from 5 thousand to 10 thousand. An emergency medical station is organized in cities with a population of over 50 thousand and is an independent health care facility or, according to by decision of local health authorities, it is part of the city emergency hospitals as its structural unit. In cities with smaller populations, emergency departments are organized at city, central district and other hospitals. Each city has only one emergency medical service station or department. Servicing of the rural area is carried out by the city emergency medical service or the emergency medical service department at the central district hospital. In large cities, as part of the SSMP, substations have been organized to provide 15-minute transport accessibility in a city administrative area with a population of 75-200 thousand inhabitants. In rural areas, ambulance posts operate to ensure 30-minute availability.
In accordance with the standards, one ambulance is allocated for every 10 thousand residents and 0.8 medical or paramedic teams are approved. The turnaround time for an ambulance is up to 4 minutes, for emergency care – up to 1 hour.
Documentation of emergency medical care stations (departments):
1) a log or card for recording an emergency medical call
2) card for calling ambulance and emergency medical services
3) accompanying sheet with a tear-off coupon
4) diary of the work of the ambulance station
5) station report
Call cards and emergency medical call logs are stored for 3 years. SSMP does not issue sick leave, forensic medical reports, does not conduct examinations of alcohol poisoning.
SSMP is an independent institution and is subject to the orders and instructions of higher authorities of the Zoo, and enjoys the right legal entity and has a stamp and seal indicating its name.
Emergency Hospital (EMS)– a multidisciplinary specialized medical facility for providing round-the-clock emergency inpatient medical care to the population in case of acute diseases, injuries, accidents, poisoning, as well as in case of mass casualties, catastrophes, and natural disasters.
The main tasks of the emergency hospital:
– provision of emergency specialized medical care to patients with life-threatening conditions requiring resuscitation and intensive care using means and methods of express diagnostics and treatment at the level modern achievements medical science and practice
– providing organizational, methodological and advisory assistance to medical and preventive institutions of the district in activities regarding the organization of emergency medical care
– implementation of measures to ensure the constant readiness of the hospital to work in emergency conditions during mass admissions of victims in the city (region, republic)
– ensuring effective continuity and relationship with all medical and preventive institutions of the city in providing medical care to patients in pre-hospital and hospital stages
– analysis of the quality of emergency medical care and assessment of the efficiency of the hospital and its structural divisions
– analysis of the population’s need for emergency medical care at all stages of its organization
– carrying out health education and hygiene education population by formation healthy image life, providing self- and mutual assistance in case of accidents and sudden illnesses, etc.
Emergency hospitals are organized in settlements with a population of at least 250 thousand. The hospital is managed by the chief physician.
Structural divisions of emergency hospital:
– administrative and management part
– organizational and methodological department with an office medical statistics
– hospital
– reception and diagnostic department with reference and information service
– specialized clinical departments emergency care (surgical, traumatological, neurosurgical, urological, burn, gynecological, cardiological, emergency therapy, etc.)
– Department of Anesthesiology, Resuscitation and Intensive Care
– blood transfusion department
– department of physiotherapy and exercise therapy
– pathological service with histological laboratory
– medical archive
– other departments: pharmacy, library, catering department, economic and technical department, computer center.
Emergency hospital provides:
– 24-hour provision of timely and on-time high level emergency medical care for patients with sudden illnesses, accidents
– development and improvement of organizational forms and methods of providing emergency medical care to the population
– coordination, continuity and interaction of medical and preventive institutions of the city to provide emergency medical care to the population;
– conducting examinations of temporary disability of workers and employees, issuing certificates of incapacity for work, recommendations on the transfer of discharged patients to another job for health reasons
– notification of the relevant authorities about all emergencies and accidents in accordance with special instructions and orders of the Ministry of Health of the Republic of Belarus
The emergency hospital hospitalizes patients for emergency reasons, delivered by an ambulance station, referred by outpatient clinics and other treatment and preventive institutions, as well as those who sought emergency care directly at the admission and diagnostic department. In the case of hospitalization of non-core patients, after removing them from a life-threatening condition, the hospital has the right to transfer them to other hospitals in the city according to their profile for further treatment. To ensure a 100% probability of hospitalization of emergency patients in a specialized bed, reserve beds are provided (5% of the bed capacity), which are not taken into account when drawing up the statistical plan, but are funded.
The emergency hospital is under the direct authority of the city health department. It is an independent healthcare institution and has at its disposal buildings with a designated territory, equipment, and inventory. BSMP enjoys the rights of a legal entity, has a round seal and a stamp indicating its full name.
Main tasks ambulance services at the present stage are:
1. Providing patients with pre-medical and emergency medical care.
2. Delivery to as soon as possible to a hospital to provide qualified and specialized medical care.
To the ambulance structure includes ambulance stations and substations, emergency departments within hospitals, and emergency hospitals.
Ambulance stations as independent health care facilities are created in cities with a population of over 50 thousand people.
In cities with a population of more than 100 thousand people, taking into account the length of the settlement and the terrain, emergency medical substations are organized as subdivisions of stations (within a 15-minute accessibility zone).
In settlements with a population of up to 50 thousand, emergency medical departments are organized as part of city, central, district and other hospitals.
Ambulance station - a medical and preventive institution designed to provide round-the-clock emergency medical care to adults and children in conditions that threaten the health or life of citizens or those around them, caused by sudden illnesses, exacerbation of chronic diseases, accidents, injuries and poisonings, complications of pregnancy and childbirth .
Ambulance substation is a structural subdivision of the city ambulance station, and emergency room - structural unit of the hospital (city, central district, etc.).
The work of emergency medical service stations is headed by chief doctors, and substations and departments are headed by heads. Each shift is led by a senior doctor.
In the station structure, like substations, emergency medical services are provided:
1) operational department (at the substation - control room with 1-2 round-the-clock posts); 2) communications department;
3) department of medical statistics with an archive;
4) an office for receiving outpatients;
5) a room for storing medical equipment for teams and preparing medical equipment for operation;
6) a room for storing a supply of medicines, equipped with fire and security alarms;
7) rest rooms for doctors, paramedics, drivers of ambulances; 8) premises for eating by staff on duty;
9) administrative, utility and other premises;
10) a garage, covered parking boxes, a fenced area with a hard surface for parking cars, corresponding in size to the maximum number of cars operating simultaneously;
11) if necessary, helipads are equipped.
Functions of the SMP station:
1. 24-hour provision of timely and high-quality medical care to sick and injured people who are outside medical institutions during disasters and natural disasters;
2. Timely transportation of patients, including infectious diseases, injured people and women in labor who need emergency hospital care.
3. Providing medical care to sick and injured people who sought help directly at the station;
4. Ensuring continuity in work with the city’s health care facilities to provide emergency medical care to the population;
5. Organization of methodological work, development and implementation of measures to optimize the provision of emergency medical care at all stages;
6. Interaction with authorities local authorities, department of internal affairs, traffic police, fire departments and other operational services of the city;
7. Carrying out measures to prepare for work in emergency situations, ensuring a constant, irreducible supply of dressings and medicines;
8. Notifying the health authorities of the administrative territory and relevant authorities about all emergencies and accidents in the station service area;
9. Uniform staffing of field teams medical personnel for all shifts and their full provision according to the equipment sheet;
10. Compliance with the norms and rules of sanitary-hygienic and anti-epidemic regimes;
11. Control and accounting of the work of sanitary vehicles.
The main functional unit of stations, substations and ambulance departments is mobile team (paramedic or medical).
The paramedic team includes 2 paramedics, an orderly and a driver;
Medical team - 1 doctor, 2 paramedics (or paramedic and nurse anesthetist), orderly and driver
There are: linear and specialized teams. The specialized team must include a doctor with at least 3 years of experience.
The station does not issue documents certifying temporary disability and forensic medical records. conclusions, does not conduct an examination of alcohol intoxication, but, if necessary, issues a certificate indicating the date, time of application, diagnosis, studies performed and recommendations for further treatment.
Performance indicators:
1. Provision of emergency medical services to the population = number of emergency calls/average annual population *1000 (318 calls per 1000 population);
2. Timeliness of EMS team visits = number of EMS team visits within 4 minutes from the moment the call is received/total number of EMS calls *100 (not less than 99.0%);
Main tasks ambulance services at the present stage are:
1. Providing patients with pre-medical and emergency medical care.
2. Delivery of them as soon as possible to the hospital for the provision of qualified and specialized medical care.
To the ambulance structure includes ambulance stations and substations, emergency departments within hospitals, and emergency hospitals.
Ambulance stations as independent health care facilities are created in cities with a population of over 50 thousand people.
In cities with a population of more than 100 thousand people, taking into account the length of the settlement and the terrain, emergency medical substations are organized as subdivisions of stations (within a 15-minute accessibility zone).
In settlements with a population of up to 50 thousand, emergency medical departments are organized as part of city, central, district and other hospitals.
Ambulance station - a medical and preventive institution designed to provide round-the-clock emergency medical care to adults and children in conditions that threaten the health or life of citizens or those around them, caused by sudden illnesses, exacerbation of chronic diseases, accidents, injuries and poisonings, complications of pregnancy and childbirth .
Ambulance substation is a structural subdivision of the city ambulance station, and emergency room - structural unit of the hospital (city, central district, etc.).
The work of emergency medical service stations is headed by chief doctors, and substations and departments are headed by heads. Each shift is led by a senior doctor.
In the station structure, like substations, emergency medical services are provided:
1) operational department (at the substation - control room with 1-2 round-the-clock posts); 2) communications department;
3) department of medical statistics with an archive;
4) an office for receiving outpatients;
5) a room for storing medical equipment for teams and preparing medical equipment for operation;
6) a room for storing a supply of medicines, equipped with fire and security alarms;
7) rest rooms for doctors, paramedics, drivers of ambulances; 8) premises for eating by staff on duty;
9) administrative, utility and other premises;
10) a garage, covered parking boxes, a fenced area with a hard surface for parking cars, corresponding in size to the maximum number of cars operating simultaneously;
11) if necessary, helipads are equipped.
Functions of the SMP station:
1. 24-hour provision of timely and high-quality medical care to sick and injured people who are outside medical institutions during disasters and natural disasters;
2. Timely transportation of patients, including infectious diseases, injured people and women in labor who need emergency hospital care.
3. Providing medical care to sick and injured people who sought help directly at the station;
4. Ensuring continuity in work with the city’s health care facilities to provide emergency medical care to the population;
5. Organization of methodological work, development and implementation of measures to optimize the provision of emergency medical care at all stages;
6. Interaction with local authorities, internal affairs departments, traffic police, fire departments and other operational services of the city;
7. Carrying out measures to prepare for work in emergency situations, ensuring a constant, irreducible supply of dressings and medicines;
8. Notifying the health authorities of the administrative territory and relevant authorities about all emergencies and accidents in the station service area;
9. Uniform staffing of mobile teams with medical personnel across all shifts and their full provision according to the equipment sheet;
10. Compliance with the norms and rules of sanitary-hygienic and anti-epidemic regimes;
11. Control and accounting of the work of sanitary vehicles.
The main functional unit of stations, substations and ambulance departments is mobile team (paramedic or medical).
The paramedic team includes 2 paramedics, an orderly and a driver;
Medical team - 1 doctor, 2 paramedics (or paramedic and nurse anesthetist), orderly and driver
There are: linear and specialized teams. The specialized team must include a doctor with at least 3 years of experience.
The station does not issue documents certifying temporary disability and forensic medical records. conclusions, does not conduct an examination of alcohol intoxication, but, if necessary, issues a certificate indicating the date, time of application, diagnosis, studies performed and recommendations for further treatment.
Performance indicators:
1. Provision of emergency medical services to the population = number of emergency calls/average annual population *1000 (318 calls per 1000 population);
2. Timeliness of EMS team visits = number of EMS team visits within 4 minutes from the moment the call is received/total number of EMS calls *100 (not less than 99.0%);
3. Discrepancy between EMS and hospital diagnoses = number of cases of discrepancy between EMS and hospital diagnoses/total number of hospitalized patients out of those delivered to hospitals*100 (no more than 5.0%);
4. Proportion of successful resuscitations = number of successful resuscitations performed by EMS teams / total number of resuscitations performed by EMS teams * 100 (not less than 10.0%);
5. Specific gravity deaths= number of deaths in the presence of EMS teams/total number of EMS calls *100 (no more than 0.05%).
SEE MORE:
In our country, for the provision of first medical assistance, we have created special medical facilities - Swedish medical assistance stations and emergency assistance points (traumatological, dental, etc.).
The work of the Swiss aid station is rich. She is required to provide first medical assistance for injuries and rapt diseases, to deliver sick people who require emergency surgical and therapeutic assistance, to the hospital, and to the nursery - to the canopy. The Swedish assistance machines will silently respond to any call. A doctor or a Swedish Aid paramedic arrives at the scene and provides first aid and ensures qualified transportation of the patient or sick person to the hospital.
The Swedish assistance service is constantly developing and improving. At this time, all major cities of the Radyansky Union have specialized vehicles (reanimation vehicles) at their Swedish aid stations, equipped with modern equipment that allows them to provide highly qualified first aid. Doctors and paramedics who service these machines, as necessary, on the spot, in the machine until the patient reaches the hospital, blood transfusions or blood substitutes are carried out, and external massage of the sulfur is performed. This or individual care for the use of special devices, giving anesthesia, administering antitoxin and other medicinal drugs . Equipping the Swedish emergency service with such machines has significantly improved the provision of emergency assistance and made it highly effective.
At the Swedish aid stations there are facilities that provide unqualified transportation of patients to surgical and therapeutic hospitals, infectious diseases, psychiatric and other specialists Drugs sold. These machines follow the calls of doctors, clinics, medical units, emergency aid centers and sick people who are in these medical facilities.
Our region has created a large number of outpatient clinics, clinics, medical and sanitary units and paramedic stations at enterprises, which provide uncomplicated assistance to residents of the regional region during the day. Doctors at the clinic treat patients at home, in case of serious illness or emergency, give them first medical help, indicating the need for hospitalization of the patient, and the term The news and the nature of transportation.
In such medical establishments as a pharmacy, a laboratory, a dental clinic, a sanitary-epidemiological station, they may at any moment be called upon for help from patients or victims.
Organization of emergency medical care
These settings involve a set of equipment and medications necessary for the provision of first medical assistance - a first aid kit.
The medicine cabinet contains water peroxide, tincture of iodine, ammonia, analgesics (analgin, amidopirine), cardiac medications (tincture of valerian, caffeine, validol, nitroglycerin, cordiamin , papazole), antipyretics (acetylsalicylic acid, phenacetin), anti-inflammatory drugs - sulfonamides and antibiotics; diarrhea, blood spinal tourniquet, thermometer, individual dressing bag, sterile bandages, cotton wool, splints.
Most often, they go to the pharmacy for the first help. It is natural that all pharmacists are obliged to provide first medical assistance, to clearly know which medications need to be taken in case of other raptomatic illnesses or accidents. The first aid kit in the pharmacy is to be equipped with additional stretchers, police, sterile instruments (clamps, syringes, scissors), sour pillows, a set of medicinal preparations in ampoules (caffeine, cordiamine, lobelia , adrenaline, atropine, glucose, corglicon, promedol, analgin , amidopirine). It is important to remember that drugs and potent substances are kept under strict conditions, so used medications must be registered in a special journal.
Manual:
EMERGENCY CARE SERVICE
The emergency medical service (EMS) is a division of the territorial emergency medical care system. NMP doctors must be fluent in all the necessary techniques and skills in providing care to patients before their arrival at the appropriate inpatient department. Although many aspects of the NMP's activities are not under direct medical control, clear medical direction is absolutely necessary for the reliable and effective functioning of the system.
HISTORICAL PERSPECTIVES
The impetus for the development of the modern NMP system was given in the 60s. In 1966, the National Academy of Sciences published a landmark white paper entitled "Morbidity and Disability Due to Accidents: Neglect of Morbidity in modern society"The result of this was the passage of the National Highway Safety Act of 1966, which gave the US Department of Transportation authority to equip ambulances and implement an emergency communications system, and medical service was entrusted with the development of training programs for pre-hospital care skills. Pantridge in Belfast (Northern Ireland) used a mobile unit to provide medical treatment in 1967 coronary arteries at the prehospital stage.
In 1973, a special law (93-154) defined the objectives of improving emergency medical care on a nationwide scale. In accordance with this law, the following 15 provisions related to the NMP system were identified: 1) personnel; 2) training; 2) means of communication; 4) transportation; 5) additional funds; 6) departments for assistance in critical situations; 7) public safety agencies; 8) consumer participation; 9) availability of assistance; 10) continuity of assistance; 11) standardization of patient information; 12) public information and education; 13) independent review and evaluation; 14) communication in case of disasters; 15) mutual assistance agreement.
ROLE OF THE STATE
The state legislative branch ensures the adoption of laws that regulate public safety measures, determine the level and scope of emergency medical care, requirements for training programs, necessary equipment and facilities, medical management, as well as measures of responsibility for the condition of emergency medical services. The activities of the NHC services are funded by the Department of Public Health.
ROLE OF LOCAL AUTHORITIES IN PROVIDING NMP
To implement effective activities, the NPM system must be clearly planned and organized locally. Each region, when developing and implementing the NPM system, must determine the sources of its financing and its needs, as well as the necessary and actual volume of services. The above 15 provisions regarding the NPM system can provide very valuable guidance in this activity.
Staff
Who should provide prehospital medical care? In an urban setting, this is obviously the responsibility of public safety personnel and emergency medical services personnel; in rural areas or sparsely populated areas, volunteers, forest rangers or ski guards may be involved. The population itself should not be left without attention. Public interest and public participation are the dominant components in any NPM system.
Education
Preparing citizens begins with educating them. In this regard, courses on emergency medical care, including cardiopulmonary resuscitation and other types of first aid, are important. Such training, of course, can be used to engage the wider population; These courses provide citizens with the basic skills needed to effectively participate in relief efforts. In some regions, a "dual response" system is organized, consisting of two links - first responders, followed by emergency personnel. Firefighters, police officers, forest rangers, or citizen volunteers may be the first to respond. First responder training in first aid may include training through the Red Cross or through special courses provided by the Department of Transportation. Training of emergency medical personnel is usually carried out successfully through emergency medical specialist courses (EMS). Although different states offer these courses at different levels, there are three nationally recognized levels of NSMEs: ambulance(NMSP-S), intermediate care (NMSP-P) and paramedical care (NMSP-Paramed). The NMSP-S Courses teach the necessary first aid skills, including cardiopulmonary resuscitation methods, as well as basic techniques and methods to ensure immediate prehospital care in life-threatening conditions. Other skills and abilities include gentle extrication of victims, immobilization and transport of patients to medical facilities for emergency care. Training in the NMSP-P courses also includes mastering the technique of puncture and catheterization of veins, the use of pneumatic trousers, insertion of a tube into the stomach or endotracheal intubation. NMSP-Paramed courses, in addition to everything listed above, include drug therapy emergency conditions, ECG interpretation, as well as cardioversion and defibrillation. IN Lately the study of the problem showed that training in the NMSP-S courses for ambulance crews in the operational use of defibrillators can significantly increase survival after cardiac arrest. Obviously, doctors need to be involved in education and training to ensure that the practical skills and equipment of ambulance teams can be used appropriately.
Means of communication
The universal 911 phone number for emergency calls made it universally available. Clinicians should support this system and ensure that calls are answered by knowledgeable, appropriately trained individuals who can provide appropriate (informative) first aid to the caller after receiving specific information over the phone. The public must be encouraged to use the universal telephone number 911 before calling a hospital or doctor. Once a request for assistance is made, the system must ensure that the appropriate personnel are dispatched quickly. The ambulance crew must be able to quickly communicate (directly or otherwise) with the hospital in question. It is very important that the team can have prompt communication with the doctor who corrects and directs the work performed by the team. standard procedures and interventions. Highest purpose pursued by the communication system is to take early warning measures, promptly send relevant Vehicle and personnel, recording the necessary information for the hospital and ensuring qualified medical supervision.
Transportation
To provide complex and effective medical care in those areas where mass life-saving measures must be carried out, hospitals are deployed. Federal standards provide for the use of special ambulances. Their most important feature is that the accompanying personnel are able to provide life support important functions, including airway patency and ventilation, for safe patient transport. Basic activities to maintain functions are carried out using appropriate equipment and special equipment by personnel trained at the NMSP-S level.
More complex activities are carried out by an appropriately equipped NMSP-Paramed team or other personnel skilled in administering drug therapy and more advanced medical procedures.
An aviation dispensary can be equipped either on an airplane or on a helicopter. In both options, the possibilities of providing emergency assistance to victims are good.
An ambulance plane has a higher flight speed than a helicopter, but it is not mobile enough and requires a landing strip. Its use is advisable when transporting victims over significant distances, when higher speed compensates for all time losses. A helicopter is especially suitable for short-distance transport. Such transport can be used to move people from the scene of an incident to a hospital or for inter-hospital evacuation. The helicopter allows you to provide assistance to victims in places inaccessible to other vehicles. In addition, it provides gentle transport for many patients in need. It can also be used to deliver experienced emergency medical personnel to areas where such assistance is not available. In addition, the helicopter can be used in cases where it is necessary to evacuate people concentrated in one place with various pathologies who require treatment in specialized centers (for example, delivering a large number of burned people to burn centers).
Organization of emergency medical services
Medical personnel can influence decision-making when choosing the flight route that is safest for victims; however, it is clear that strict operational safety rules must be followed and flight safety must be given priority in decision making. The medical director of a helicopter air ambulance service must exercise some care to ensure that the flight is carried out with due regard not only to commercial interests, but also to medical expediency.
Physicians involved in air transportation of patients must be aware of certain flight features related solely to its altitude characteristics. As altitude increases, the partial pressure of oxygen decreases. At high altitudes, hypoxia becomes dangerous, as it leads to a decrease in the oxygen saturation of hemoglobin. Even in an airplane cabin, the pressure corresponding to an altitude of 460-1220 m is maintained. Additional oxygen supply should be provided to each patient who may experience disturbances due to a decrease in the partial pressure of oxygen. Another effect of lowering ambient pressure atmospheric air is the expansion of balloons on catheters or endotracheal tubes filled with air on the ground. In each case, the air in them must be replaced before the aircraft takes off. saline solution. Similarly, the pressure in pneumatic trousers and in inflated cuffs (when determining blood pressure) increases with elevation, and decreases with decrease in altitude. The air in intravenous infusion bottles and intravenous catheters similarly expands and contracts, thereby affecting the amount of intravenous fluid administered. Most important, of course, has an air embolism. For this reason, it is preferable to use solutions in plastic containers for intravenous administration.
home Medical reference Medical reference book “C” EMERGENCY MEDICAL CARE
EMERGENCY
EMERGENCY MEDICAL AID is a system for organizing round-the-clock emergency medical services. assistance in case of life-threatening conditions and acute diseases at the scene of the incident and en route to medical institutions. In Russia this type of honey. medical assistance is provided. by station employees See paragraph or hospital departments. S. m. station stations are independent institutions or are part of the mountains. hospitals S. m. p. In remote and hard-to-reach areas S. p. can also be provided by emergency and planned advisory medical departments. assistance from regional (territorial) hospitals. Emergency measures at the scene include providing first aid. assistance, measures to prevent shock, thromboembolism and other life-threatening conditions of the patient and ensuring the safety of his transportation to the hospital. In the service system S. m.
ORGANIZATION OF AMBULANCE AND EMERGENCY MEDICAL CARE
The team method is used, including the use of specialized teams (intensive care, trauma, cardiology, psychiatric, etc.). Responsibilities of station personnel See paragraph. does not include examination of alcohol intoxication, issuance of certificates of incapacity for work, c.-l. written certificates for patients or their relatives, preparation of forensic medical reports. conclusions.
Under the editorship B. Borodilina
EMERGENCY MEDICAL CARE and other medical terms...
In our country, special medical institutions have been created to provide first aid - ambulance stations and emergency care centers (trauma, dental, etc.).
The work of an ambulance station is multifaceted.
99. Organization of emergency medical care for the population
She is entrusted with the responsibility of providing first aid for injuries and sudden illnesses, delivering patients requiring emergency surgery and therapeutic assistance, to the hospital, women in labor - to maternity hospitals. Ambulances are required to respond to any call without fail. A doctor or ambulance paramedic who arrives at the scene provides first aid and ensures qualified transportation of the injured or sick person to the hospital.
The ambulance service is constantly developing and improving. Currently in all major cities Soviet Union Ambulance stations have specialized vehicles (reanimobiles) equipped with modern equipment that allows them to provide highly qualified medical first aid. Doctors and paramedics serving these cars, if necessary, at the scene of the incident, in the car on the way to the hospital, give the patient a blood transfusion or blood substitutes, carry out external massage hearts or artificial respiration Using special devices, they give anesthesia, administer antidote and other medications. Equipping the ambulance service with such machines has significantly improved the provision of emergency care and made it highly effective.
At ambulance stations there are units that carry out only qualified transportation of patients to surgical and therapeutic hospitals, infectious diseases, psychiatric and other specialized hospitals. These vehicles respond to calls from doctors in clinics, medical units, and emergency rooms to visit patients in these medical institutions.
Our country has created a huge network of outpatient clinics, clinics, medical units and paramedic stations at enterprises, which provide emergency assistance to residents of the corresponding area during the daytime. Doctors at the clinic serve patients at home and provide first aid in the event of a sudden serious illness or accident. medical assistance, determine the need for hospitalization of the patient, its urgency and the nature of transportation.
An injured person or someone who suddenly falls ill can turn to medical institutions such as a pharmacy, laboratory, dental clinic, sanitary-epidemiological station for help at any time. These institutions must have a set of equipment and medications necessary to provide first aid - a first aid kit.
The first aid kit must have hydrogen peroxide, tincture of iodine, ammonia, painkillers (analgin, amidopyrine), cardiovascular drugs(valerian tincture, caffeine, validol, nitroglycerin, cordiamine, papazole), antipyretic (acetylsalicylic acid, phenacetin), anti-inflammatory - sulfonamides and antibiotics; laxatives, hemostatic tourniquet, thermometer, individual dressing bag, sterile bandages, cotton wool, splints.
Most often people turn to the pharmacy for first aid. Therefore, it is natural that all pharmacists should be able to provide first aid and clearly know what medications need to be used in case of a particular sudden illness or accident. The first aid kit in the pharmacy should be additionally equipped with a stretcher, crutches, sterile instruments (clamps, syringes, scissors), oxygen pillows, a set of medications in ampoules (caffeine, cordiamine, lobelia, adrenaline, atropine, glucose, corglycone, promedol, analgin , amidopyrine). It must be remembered that drugs and potent drugs are strictly accounted for, so used medications must be registered in a special journal.
Article 35. Ambulance, including specialized emergency medical care
1. Ambulance, including specialized emergency medical care, is provided to citizens in case of illnesses, accidents, injuries, poisoning and other conditions requiring urgent medical intervention. Ambulance, including specialized emergency medical care, is provided to citizens free of charge by medical organizations of the state and municipal healthcare systems.
2. Ambulance, including specialized emergency medical care, is provided in an emergency or emergency form outside a medical organization, as well as in outpatient and inpatient settings.
3. On the territory of the Russian Federation, for the purpose of providing emergency medical care, a system of a single number for calling emergency medical care operates in the manner established by the Government of the Russian Federation.
4. When providing emergency medical care, if necessary, medical evacuation is carried out, which is the transportation of citizens in order to save lives and preserve health (including persons being treated in medical organizations that do not have the ability to provide the necessary medical care for life-threatening conditions , women during pregnancy, childbirth, postpartum period and newborns, persons affected by emergencies and natural disasters).
Medical evacuation includes:
1) sanitary aviation evacuation carried out by aircraft;
(as amended by Federal Law dated November 25, 2013 N 317-FZ)
(see text in previous)
2) sanitary evacuation carried out by land, water and other modes of transport.
Emergency
Medical evacuation is carried out by mobile emergency medical teams, carrying out medical care measures during transportation, including the use of medical equipment.
7. Medical organizations subordinate to federal authorities executive power has the right to carry out medical evacuation in the manner and under the conditions established by the authorized federal executive body. The list of specified medical organizations subordinate to federal executive authorities is approved by the authorized federal executive authority.
(as amended by Federal Laws dated November 25, 2013 N 317-FZ, dated December 1, 2014 N 418-FZ)
(see text in previous)
Advertisement organizing necessary medical care.
