Ambulance: what you need to know. Medical reform in Ukraine. Ambulance and emergency care: what is the difference and when to call whom Types of ambulance teams

Emergency is provided to citizens in conditions requiring urgent medical intervention (in case of accidents, injuries, poisoning and other conditions and diseases). It is carried out without delay by medical and preventive institutions, regardless of territorial, departmental subordination and form of ownership, medical workers, as well as persons obliged to provide it in the form of first aid. Emergency medical care is provided by a special emergency medical service of the state or municipal health care system in the manner prescribed by the Ministry of Health of the Russian Federation. Emergency medical assistance to citizens of the Russian Federation and other persons on its territory is provided free of charge at the expense of budgets of all levels. In case of a threat to the life of a citizen, medical workers have the right to use free of charge any available mode of transport to transport a citizen to the nearest medical and preventive institution. In the event that an official or the owner of a vehicle refuses to comply with the legal requirement of a medical worker to provide transport for the transportation of the victim, they bear the responsibility established by the legislation of the Russian Federation.

Ambulance is provided by emergency medical aid stations (AMS).

In rural areas, pre-medical dental emergency care is provided by the medical staff of feldsher-obstetric stations (FAPs). Medical care - dentists of local and district medical institutions. Ambulance stationis a medical and preventive institution designed to provide round-the-clock emergency medical care to adults and children both at the scene 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 of chronic diseases, accidents, injuries and poisoning, complications of pregnancy and childbirth. Ambulance stations are being set up in cities with a population of more than 50,000 people as independent medical and prophylactic institutions.

In settlements with a population of up to 50 thousand, emergency 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, sub-stations of the general ambulance station are organized as its divisions.

The ambulance station is headed by the chief physician, who is guided in his activities by the legislation of the Russian Federation, regulatory and methodological documents of the Ministry of Health of the Russian Federation, the charter of the ambulance station, orders and orders of a higher healthcare authority.

The chief doctor of the ambulance station carries out the current management of the station on the principles of unity of command on issues within his competence.

The main functional unit of the ambulance station is a mobile team (paramedical, medical, intensive care and other narrow-profile specialized teams).

Brigades are created in accordance with staff standards with the expectation of providing round-the-clock shift work.

The structure of the ambulance station includes:

- operational (dispatching) department;

— communication department;

—Department of medical statistics with an archive;

- an office for receiving outpatients;

— a room for storing medical equipment for teams and preparing medical packs for work;

— a room for storing a stock of medicines, equipped with fire and burglar alarms;

rest rooms for doctors, paramedical staff, drivers of ambulances;

— a dining area for staff on duty;

—administrative and economic and other premises;

— a garage, covered parking-boxes, a fenced area with a hard surface for parking cars, corresponding in size to the maximum number of cars working at the same time. If necessary, helipads are equipped.

Other subdivisions can be included in the structure of the station. The communication department organizes communication between all subdivisions of the ambulance station. The station should be provided with urban telephone communication at the rate of 2 inputs per 50 thousand people, radio communication with mobile teams and direct communication with medical institutions.

The ambulance station functions in the mode of daily work and in the mode of emergencies.

Station tasks in daily operation:

- organization and provision of emergency medical care to sick and injured people at the scene and during their transportation to hospitals;

—carrying out systematic work to improve professional knowledge, practical skills of medical personnel;

—development and improvement of organizational forms and methods of providing emergency medical care to the population, the introduction of modern medical technologies, improving the quality of work of medical personnel.

Station operates in emergency modeon instructions of the Territorial Center for Disaster Medicine(republican as part of the Russian Federation, regional, regional, district, city), which is guided by the documents of the headquarters (department, committee) for civil defense and emergency situations.

The main functions of the ambulance station:

1. Round-the-clock provision of timely and high-quality medical care to sick and injured people who are outside medical institutions, in case of catastrophes and natural disasters.

2. Timely transportation (as well as transportation at the request of medical workers) of patients, including infectious, injured and women in labor who need emergency hospital care.

3. Provision of medical care to the sick and injured who applied directly to the station for help.

4. Ensuring continuity in work with medical and preventive institutions of the city 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, ATC, traffic police, fire brigades and other operational services of the city.

7. Carrying out activities to prepare for work in emergency situations, ensuring a constant minimum supply of dressings and medicines.

8. Notification of the health authorities of the administrative territory and the relevant authorities about all emergencies and accidents in the service area of ​​the station.

9. Uniform staffing of field teams with medical personnel for all shifts and full provision of them in accordance with the equipment sheet.

10. Compliance with the norms and rules of sanitary-hygienic and anti-epidemic regimes.

11. Compliance with the rules of safety and labor protection.

12. Control and accounting of the work of ambulance vehicles.

Organization of the work of the ambulance station:

1. Receiving calls and transferring them to mobile teams is carried out by a paramedic (nurse) for receiving and transferring calls from the operational department (dispatch) of the ambulance station.

2. The injured (sick) delivered by the mobile teams of the ambulance station should be immediately transferred to the duty staff of the hospital reception department with a mark in the "Call Map" of the time of their arrival.

3.In order to coordinate medical and preventive work, improve continuity in servicing patients, the station administration holds regular meetings with the leadership of medical and preventive institutions located in the service area.

4. Ambulance station does not issue documents certifying temporary disability and forensic medical conclusions, does not conduct an examination of alcohol intoxication.

5. Gives verbal information in person or by telephone about the location of the sick and injured. If necessary, issues certificates of any form indicating the date, time of treatment, diagnosis, examinations, assistance provided and recommendations for further treatment.

6. For the round-the-clock provision of emergency dental care in large cities, special dental clinics and emergency departments for adults and children are allocated, providing round-the-clock outpatient services on ordinary, weekends and holidays and traveling in some cases to the patient on calls at home with portable equipment.

7. Emergency dental care is provided during the daytime in dental clinics for adults and children, in dental offices, units of medical and sanitary units and health centers, emergency medical services, dental offices in schools, higher and secondary educational institutions, reception departments of hospitals.

Emergency conditions include traumatic injuries, bleeding, acute pain, etc.

The need for emergency care is approximately 5 to 15% of the city's population.

Emergency Dental Care turns out to be in dental centers at large clinics and hospitals that work around the clock. Home service is carried out on a special ambulance transport.

Hello dear blog readers! Irina and Igor are back in touch. A lot of requests on the Internet are related specifically to an ambulance: “how to call from a mobile phone”, “how much an ambulance should travel”, “what to do if it does not arrive”, and so on.

We decided to make the task easier and make an article for you on how to call an ambulance and what to do in other situations.

Call number

Everyone knows the ambulance number - 03 . But many are lost when a call needs to be made from a mobile phone.

Let's say right away that an ambulance call can be made from any phone, even with a zero balance, and the call itself is free. Numbers to call from mobile phones:

• Beeline - 003
• Megafon - 03 or 030
• MTS - 030
• YOTA-030
• TELE 2-103

There is also a single emergency number - 112 . It is assumed that a call to it can be made even without a SIM card in the phone. However, the number has not yet been introduced in all regions of our country.

What is in the ambulance?

The so-called linear brigade is most often sent to the call. In such an ambulance, there is everything for first aid in mild cases: high blood pressure, minor injuries, minor burns, abdominal pain, etc.

But besides this, each line crew has the necessary equipment for resuscitation: portable electrocardiograph and defibrillator, devices for artificial lung ventilation and inhalation anesthesia, electric pump, oxygen cylinder, resuscitation kit.

In serious cases, a special “resuscitation vehicle” is sent to the place of the call.

How fast should the ambulance arrive?

According to the new Russian regulations, an ambulance must be at the scene of an accident 20 minutes after its call.

In large cities where several ambulances operate, this standard is met. Exceptions are any force majeure circumstances.

But in small towns, where there is often only one ambulance, such a standard may not be observed. All complaints about this should be addressed to the local health department.

Where does it take?

Whether the patient needs hospitalization, the ambulance team decides on the spot, based on the symptoms, within two to three minutes.

Where to hospitalize is decided by the hospitalization department, based on the profile of the disease and the availability of places in institutions. The patient does not have the right to choose a doctor or medical institution, since, according to the law, he needs help urgently, and the choice can take precious time.

If it still seems to you that you are being taken to the wrong place, then you should dial 03 again and ask to contact the head doctor of the station, and discuss this issue with him.

What to do if it doesn't go?

If they refused to send a brigade to you, which is unlikely, the way out is simple - call the police. According to the Criminal Code, this falls under Articles 124 "Failure to provide assistance to the sick" and 125 "Leaving in danger." Police officers will contact the medical facility and help solve the problem.

How is an ambulance different from an emergency?

Two years as ambulance and emergency care are two different services.

But even today people do not know which of them and how to call. So let's deal with this:

1. An ambulance comes to the patient only with a real threat to his life, that is, in emergency cases. She hurries to the places of car accidents, where people suffered, with heart attacks, strokes, childbirth, etc.
2. They will send an ambulance if you are sick, but there is no threat to life: with heat, pressure surges, headaches, acute respiratory infections, flu, etc.

To call an ambulance or ambulance, you need to call the numbers that we indicated at the beginning of the article. The dispatcher will take the call. You need to tell the dispatcher:

• phone number from which you are calling (suddenly the call fails, then they will call you back)
• what happened, what complaints
• gender of the patient, date of birth, address, where to go by car

If, from your words, the dispatcher decides that the patient needs emergency help, they will send an ambulance. It should be in place within 20 minutes. And, if necessary, take the patient to the hospital.

If the situation "tolerates", they will send an ambulance from the clinic. She will arrive within two hours, help the patient at home. She has no right to emergency hospitalization.

In words, everything seems to be logical. But in reality, it happens that an ambulance is sent to a person who needs to be urgently taken, for example, to intensive care. We have to issue a new ambulance call. Wasted valuable time. To prevent this from happening, clearly and in detail tell the dispatcher about the patient's condition.

Especially if the pressure is very high, there are fainting spells, difficulty breathing, pain in the sternum. These symptoms can be deadly. There is no need for emergency medical care.

We hope that neither one nor the other car you will need. And for this, of course, it is better to monitor your health and. And first of all, you should get rid of bad habits in the form of using and. The following videos will help you with this:

• "Getting rid of alcohol addiction in 12 steps"
• "Quitting smoking is easy"

Have you used ambulance services? Did the car always arrive on time? Tell us about your experiences in the comments. See you soon!

Best regards, Irina and Igor

In our country, special medical institutions have been created to provide first aid - ambulance stations and emergency centers (traumatological, dental, etc.).

The work of the ambulance station is multifaceted. It is entrusted with the duty to provide first aid for injuries and sudden illnesses, to deliver patients requiring emergency surgical and therapeutic care to the hospital, and women in labor to maternity hospitals. Ambulances are required to respond to any call without fail. Arriving at the scene of an accident, a doctor or ambulance paramedic provides first aid and provides qualified transportation of the injured or ill to the hospital.

The ambulance service is constantly developing and improving. At present, in all major cities of the Soviet Union, ambulance stations have specialized vehicles (resuscitation vehicles) equipped with modern equipment that make it possible to provide highly qualified medical first aid. Doctors and paramedics servicing these vehicles, if necessary, at the scene of the incident, in the car on the way to the hospital, they give the patient a blood transfusion or blood substitutes, perform external heart massage or artificial respiration using special devices, give anesthesia, inject antidote and other drugs . Equipping the ambulance service with such machines has significantly improved the provision of emergency care, making it highly effective.

There are units at ambulance stations that carry out only qualified transportation of patients to surgical and therapeutic hospitals, infectious diseases, psychiatric and other specialized hospitals. These cars leave on calls from doctors of polyclinics, medical units, emergency rooms to patients who are in these medical institutions.

In our country, a huge network of outpatient clinics, polyclinics, medical and sanitary units and feldsher stations has been created at enterprises that also provide emergency care to residents of the corresponding region during the daytime. Polyclinic doctors serve patients at home, in the event of a sudden serious illness or accident, they provide them with first aid, determine the need for hospitalization of the patient, its urgency and the nature of transportation.

In such medical institutions as a pharmacy, laboratory, dental clinic, sanitary and epidemiological station, an injured or suddenly ill person can seek help at any time. These institutions should have a set of equipment and medicines necessary for first aid - a first-aid kit.

The medicine cabinet must contain hydrogen peroxide, iodine tincture, ammonia, painkillers (analgin, amidopyrine), cardiovascular agents (valerian tincture, caffeine, validol, nitroglycerin, cordiamine, papazol), antipyretics (acetylsalicylic acid, phenacetin), anti-inflammatory drugs - sulfonamides and antibiotics; laxatives, hemostatic tourniquet, thermometer, individual dressing bag, sterile bandages, cotton wool, splints.

Most often for first aid go to the pharmacy. Therefore, it is natural that all pharmacists should be able to provide first aid, clearly know which medicines should be used in case of a sudden illness or accident. A first aid kit in a pharmacy should be additionally equipped with a stretcher, crutches, sterile instruments (clamps, syringes, scissors), oxygen pillows, a set of medicines in ampoules (caffeine, cordiamine, lobelia, adrenaline, atropine, glucose, corglicon, promedol, analgin , amidopyrine). It must be remembered that drugs and potent drugs are under the strictest control, so the drugs used must be registered in a special journal.

More than a hundred years ago, an ambulance service was created in our country, which has no analogues in the world and works on the principle: "do not the patient goes to the doctor, but the doctor goes to the patient."

Its main task is to provide medically qualified and specialized assistance to patients and victims as soon as possible from the moment the pathological condition occurs at the scene of the incident, during transportation, and to carry out the maximum possible amount of therapeutic measures aimed at restoring the functions of vital organs and systems. Foreign doctors call the domestic ambulance service “a subject of Russian national pride” and envy our population, which has the opportunity to receive emergency medical care at any time of the day or night without leaving a warm bed and without incurring material costs.

To our deep regret, at present this unique service, the main purpose of which is to save human lives, has been doomed to perform functions that are unusual for it and solve numerous social problems.

In no country in the world would it ever occur to anyone to call an ambulance to change the diaper of a paralyzed grandmother. “But I can’t cope alone,” her daughter declares without a shadow of embarrassment. And in the next entrance, a bedridden patient fell out of bed. And again they call an ambulance, and when they see the women's brigade, they are indignant: “We asked to send men!”

A drunken neighbor collapsed on the stairs, who did not reach his floor, and interferes with the passage. Or the HOME chose a place to sleep at your door. “We need to call an ambulance,” someone from the household says, “let them take me to the hospital.”

Who wants to mess with a dirty, lousy homeless man or a drunk lying in a puddle? What to do with homeless children found in basements and attics? You should not strain your brain convolutions to answer these questions when there is always an ambulance at hand. And what are the numerous social service officials who are called to solve these problems doing at this time?

Only a very rich and wasteful owner will allow specialized medical teams to be sent to search for and deliver homeless people to hospitals, and clinical hospitals to be used as a haven for them. The responsibility for the fate of these unfortunate and disadvantaged people should be borne by public authorities, not by health institutions.

The use of an ambulance as a free taxi deserves special mention. “Take us to a consultation with an ENT doctor (oculist, dermatologist, allergist, etc.) I will call an ambulance until they take me where I want!” immediately complain about the "bad" doctor who dared to object to her. You have to carry, where to go?

And in the admissions department of the hospital again there is indignation: “How? Are you leaving already? And who will take us home?

In the sultry summer of 2010, some individuals demanded from the ambulance crews immediate evacuation from smoky Moscow or urgent hospitalization of a healthy child "in an air-conditioned hospital." Wouldn't it be more logical, guided by the slogan "Saving the drowning - the work of the drowning themselves", take your family to a safe area or put an air conditioner in the apartment?

The child fell and broke his knee, and there is no greenery at home - they call an ambulance. The local nurse did not come to give an injection of an antibiotic (vitamin) - they call an ambulance. A patient with chronic gastritis calls an ambulance to find out if he can take an analgin pill for a headache, whether it will hurt the stomach. Mom does not know how to give an enema to a child, make a compress on an ear, remove a splinter - they call an ambulance, etc. etc. This list can be continued indefinitely. Therefore, around the clock, and especially in winter during the "rush hour", which occurs every evening from 20 o'clock to 2 o'clock in the morning, calls are transferred to teams with a significant delay, and patients are forced to wait for medical help for hours.

The main advantages of ambulance, which we were once proud of - free of charge and accessibility - have now turned against our service. Yes, and that's true: why respect her, this ambulance, is it possible to appreciate what is always at hand and does not cost a penny?

Therefore, ambulance crews walk at night along dark, filthy entrances in search of the right apartment, and none of the patient's relatives will bother to meet them. “We have a lot of hooligans in our yard, it’s scary to go out into the street,” the young dad replies to the reproach of the brigade, who came to the baby and searched for the right entrance for a long time (numbers are not indicated) in the unlit yard. It would never occur to him that it is even more terrible for women, who mainly work on children's teams, in a strange yard and a dark entrance.

When asked to prepare a clean towel, they can answer: wipe yourself with what is hanging.

To the remark that the dog must be removed before the arrival of the brigade, a vicious reaction follows and a promise to set it on the doctors.

If it becomes necessary to carry the patient to the car on a stretcher, and the help of relatives is required, indignation often arises: where are your porters?

Opening the door to the brigade, they can say in an orderly manner: take off your shoes, otherwise you will stain the floor. This order alone already testifies to the groundlessness of the call. Tell me, will you worry about the cleanliness of the floor when the baby's life is in danger?

It does not fit in my head: how can you treat people who rush to your aid at any time of the day with such disrespect and even disdain? “The outstretched hand is not bitten,” says the popular wisdom, which is forgotten when it comes to first aid. Doctors and paramedics working on ambulances make up the golden fund of our medicine and deserve high respect, and sometimes admiration for their ability to provide the necessary assistance to the victim in the most incredible conditions in a matter of minutes, often saving his life. Try getting into a vein and administering an IV to a victim in a wrecked car or crushed by the rubble of a collapsed building, performing CPR in a speeding ambulance, delivering a baby at a market stall, and convincing a mentally ill patient to put down the kitchen knife and “talk about life.” ".

Thanks to the poet Andrei Voznesensky for his kind words and sympathy for the servants of this difficult profession:

Among business scorpions,
living nearby benefits,
short hair ambulance
Lives close to misfortune.
Where are you going at midnight?
Freezing. I'd stay warm.
tortured ambulance,
Who will only help you?

To provide emergency assistance to children, special pediatric teams have been created that endure all children's suffering and try to alleviate and eliminate them as much as possible.

All calls to children arriving at "03" are sent to the children's console of the Moscow Emergency and Emergency Medical Aid Station. From here, the call is transferred to the nearest substation from the victim, and the children's team, consisting of a pediatrician and a paramedic, rushes to help. Almost every substation has one pediatric team, sometimes two, and they are never out of work. Moreover, almost half of the calls to children are made by general practitioners of line teams who do not have experience in dealing with sick children.

After all, a child is not a miniature adult. Each age has its own anatomical and physiological characteristics, which must be taken into account in the treatment, and even more so when providing emergency care.

Only a children's doctor is able to deal with a miner who cannot speak, but reports his illness with a cry or lethargy and an indifferent state. An emergency doctor, including a pediatrician, is limited in time and diagnostic capabilities, but a real professional often comes to the rescue with intuition, which helps to make a diagnosis in a matter of minutes and provide emergency assistance. According to Napoleon's definition, "intuition is a lightning-fast calculation." But such a calculation is possible only when there is knowledge and experience, multiplied by careful observation of a sick child, his behavior, the ability to identify the most subtle symptoms and analyze them. That is why special pediatric ambulance teams were created, which saved many children's lives.

“If in the middle of different things your child gets sick,
Do not appease him with a pacifier or sugar,
That should not be forgotten: there is a brigade number five
With the best pediatrician in the world.”

These words from our colleague's song give a high professional assessment to children's doctors working in the ambulance, and in the vast majority of cases they (doctors) justify this assessment.

It is all the more annoying to realize that a significant part of the calls made by pediatric teams end up with nothing more than giving advice, that is, the child did not need either emergency care or hospitalization. And this is good. But why was the ambulance necessary? And isn't it too expensive to pay for these tips that really need it?

Alas! Too many mothers think this way: while you wait for the doctor from the clinic, but while you go to the pharmacy for medicines, the ambulance will come and do everything right away.

Such parents give rise to alarming situations when a call comes in with a formidable reason (“turned blue”, “dies”, “suffocates”, “poisoned”), and there is no children's brigade either at the nearest or neighboring substations.

A child's call cannot wait, it is immediately transferred to any team, whether it be cardiology or trauma, for execution. And "adult" doctors say: "It's better to go to a complicated heart attack than to a child." And almost always they take the baby to the hospital, from where, after examining the pediatrician, he often returns home. A general practitioner can be understood: having no experience working with children, it is better to be safe than to miss a serious illness.

But how to understand parents who stubbornly refuse to call a pediatrician from a polyclinic, do not know the children's emergency telephone number in their area, but simply “wanted to consult whether to take their child to kindergarten if he vomited yesterday?”

Every mother should know the phone number by which you can call a doctor at home, and the phone number of the 24-hour medical care department (OKMP) for children in your area, so that if necessary, you can go there at any time of the day or night, on weekdays and holidays. And leave the ambulance to those who really need it.

The ambulance does not prescribe home treatment, does not inject antibiotics and vitamins, does not write out certificates and does not issue disability certificates. Otolaryngologists, ophthalmologists, surgeons, allergists and other “narrow” specialists do not work on an ambulance.

To make it easier to figure out who to call in each case, be guided by the slogan: "Ambulance" does not heal, but saves. Then real professionals will come to the baby in need of urgent medical care, provide him with qualified assistance and, if necessary, hospitalize him.

But even if your call is forwarded to the pediatric team without delay, in many cases they do not arrive at the scene as quickly as they would like. And there are objective reasons for this.

In recent years, in Moscow, perhaps the most important difficulty in the work of an ambulance has become traffic jams that occur at any time of the day and in any place, making it difficult to move both to the place of call and transport the patient to the hospital.

If there are motorists among the readers, honestly answer the question: “Do you always give way to a car with a red cross on the road?” I'm afraid there will be few positive answers. Now imagine that this car is in a hurry to call your child.

Take a look at your house and entrance through the eyes of an ambulance doctor: is the number written on the house, is there a numbering on the entrances, are the numbers of the apartments located in them indicated. Quite often, leaving the elevator, the eyes of the doctors stumble upon doors that, for some unknown reason, are devoid of identification marks. Which one would you like to call? In the daytime, this does not cause problems: you can contact any one, and the neighbors will indicate the right one. And what about at night? Do you like it if a call wakes you up late at night, and someone's voice outside the door asks for the number of your apartment?

A lot of unlit entrances and dark stairs poison the life of ambulance workers. Try to dial the code for the front door in complete darkness or find the right button in the elevator. In the course are lighters, flashlights. It's good if they (on the buttons) are marked with numbers. Otherwise, our mischievous children, with a tenacity worthy of a better use, love to have fun, erasing all the signs on intercoms and floor signs in elevators.

Do you know that not only the “two ninth cars” described by the comedian can exist on the train, but also the first two entrances in the same house? And the check-in to the house, located on one street, should be carried out from a completely different one? And on Red Dawn Street, for example, immediately after house number 37 is house number 61? And where to look for the right 55th? And on another no less mysterious street, house number 9 is located for some reason in the courtyard of the 17th. And in the area of ​​​​Kutuzovsky Prospekt there are also Kutuzovsky Proezd, and Kutuzovsky Lane, and a little further on Kutuzova Street?

Therefore, when calling an ambulance, clearly and distinctly name your address, tell me how best to drive up to the house, and where the entrance to the entrance is located: from the street or from the yard. And do not take the trouble to meet the brigade on the street, because it is your child who needs help.

Often doctors are accused of callousness, heartlessness, they are accustomed, they say, to someone else's pain. This is not true! It is impossible to get used to the pain and suffering of children, to the grief of a mother who has lost a child. This is a kind of protective reaction, the so-called emotional immunity - and this is included in the category of professional qualities of ambulance workers. In critical situations, there is no time to gasp and shed tears. It is necessary to instantly orient in the situation, “get together” in order to save the life of the patient. In some cases, sometimes you have to shout at relatives who, with their behavior, interfere with emergency measures.

An ambulance is a special world in which one constantly has to deal with negative, sometimes disgusting phenomena, the "wrong side" of life. Mothers abandon their children at stations, on trains, throw their newborns in the trash. A drunken father, plotting revenge on his ex-wife, kills two teenage sons with a kitchen knife. The killer, waiting for the businessman at the entrance, at the same time shoots his daughter, a preschooler. A sexual maniac rapes and kills children in elevators and attics. And a twelve-year-old prostitute who cannot read already has a bunch of venereal and infectious diseases. All this is also the work of a children's ambulance team and not at all the children's problems of our time. Any representative of this difficult profession has the right to say: "To love humanity and hate it, you need to work on an ambulance."

Maybe after these emotional lines you will take a different attitude to our "national pride" and with b about you will treat her servants with more respect.

An ambulance is a special form of medical care created to save the most seriously ill patients. Who works in it and what are the ambulance standards?

Emergency medical care is necessary for people when their health deteriorates sharply and this creates a real threat to their future life. Also indications for calling a brigade to an adult are various incidents accompanied by injuries, burns, bleeding, or loss of consciousness.

Among the reasons that force people to seek help from emergency doctors that are not related to trauma are acute cardiovascular accidents (stroke, heart attack), poisoning or infectious diseases accompanied by high fever, vomiting, diarrhea, of unknown origin, high or low arterial pressure, loss of consciousness or allergic reactions (urticaria, Quincke's edema), etc. Depending on the severity of the patient's state of health, ambulance specialists decide whether he needs hospitalization, or it is possible to provide assistance on the spot and transfer the asset to the local doctor for tomorrow .

Children's ambulance

Providing first aid to newborn babies

Newborns are considered children within the first 28 days of life. This is the most crucial period for the baby, during which various emergency life-threatening situations (asphyxia, convulsions, etc.) can happen to him. Especially often they occur in children born prematurely, prematurely, with congenital malformations.

Ambulance care for a newborn child is carried out by a special neonatal team, it always includes a neonatologist and two nurses (paramedics). The machine is equipped with a special device (incubator), in which it is convenient for them to carry out various manipulations (injections, artificial ventilation of the lungs, etc.). It maintains a certain temperature, which is very important for a newborn, there are devices for monitoring the most important parameters of life (pulse, pressure, oxygenation).

Ambulance for a child older than 1 month

Children's ambulance for babies of the first year and older is carried out by a pediatric team. If the child's condition is critical, then a special resuscitation team is sent to him, equipped with everything necessary for urgent measures.

Children's ambulance is usually needed for babies who have received a variety of injuries or burns, who have a complicated course of respiratory viral diseases (laryngostenosis, bronchial obstruction, febrile convulsions, etc.), an allergic reaction (urticaria, allergic swelling of the face, lips and tongue, or anaphylactic shock), vague pain in the abdomen and others.

Children's ambulance usually arrives as soon as possible, because such calls have a high category of importance and danger.

Sometimes the well-being of a sick person may require the immediate participation of health workers, otherwise he is in danger. These situations arise in case of injuries (injuries, burns, dislocations, fractures), severe fever, acute cardiovascular accidents and other conditions when the patient's health does not allow him to go to the clinic. In order to help sick people there is a special service called emergency medical care. A special car leaves for a call home or to the scene after a phone call from the patient himself, his relatives or bystanders.

An ambulance doctor is a specialist who has the skills to quickly understand the causes that led to the patient's serious condition, and as quickly as possible compensate for it with medicines, manipulations or procedures. Then he decides whether to leave the patient at home under the supervision of a local doctor, or deliver him for further treatment to a hospital if there are serious reasons for that.

Everyone should know the ambulance phone, because trouble can happen to anyone at any place and time of day.

History of the ambulance service in Russia

The ambulance service is relatively young, although medicine itself is an ancient science. The impetus for her appearance was a very strong fire in the Vienna Opera House. More than 500 people died that day, but many of them could have been saved. The victims were numerous because doctors could not properly organize their work to help them, and many of the people died from injuries sustained as a result of falls and severe burns.

After this incident, a voluntary rescue society was organized, which was the prototype of the modern ambulance. During the first year of its work, its employees saved the lives of more than 2 thousand sick people. Further, by analogy, similar services began to be organized in Berlin, London, Paris, Warsaw, Kyiv, Odessa and other cities.

In Russia, an ambulance service appeared in the capital at the end of the 19th century. However, given that they were usually financed by noble people in private, their number was very small. Only at the beginning of the 20th century did they begin to pay for the work of this service from the state treasury, which made it possible to significantly expand its volume: specialized brigades appeared. One of the first was a psychiatric emergency, which was called to pacify violent people. By the beginning of the Great Patriotic War, there were already 9 substations in Leningrad, which employed at least 200 diversified medical teams.

Interestingly, the structure of the ambulance team has remained unchanged since the formation of this service. It includes a doctor, a nurse or paramedic and junior medical staff (orderly). In addition, an important role belongs to the driver of the ambulance. help, because he must deliver a seriously ill or injured person to a hospital as soon as possible.

Ambulance: characteristics and main functions

It is difficult to imagine a modern world in which there is no such important service as emergency medical care. Every day, its employees save hundreds of thousands of human lives.

Ambulance emergency care is not only the provision of therapeutic measures at home or at the scene of an accident. Sometimes they may be needed by patients who are in a medical institution that does not deal with emergency cases (private clinic, dental office, TB dispensary, etc.).

The main characteristics of emergency honey. help:

• urgent nature,
• reliability,
• most brigades provide services under the CHI program,
• efficiency (examination, diagnosis and therapy is carried out as soon as possible).

Ambulance emergency services perform certain functions:

• The provision of emergency medical care to the sick and injured is carried out around the clock, including weekends and holidays.
• Transportation of patients and victims to a round-the-clock hospital if there are certain indications.
• Patients who turned to specialists directly in the station building should also be examined by an ambulance doctor.

City ambulance is a special type of emergency care for residents of cities. It is represented by various forms that ensure the continuity of all stages of this process.

City ambulance combines the following forms:

1. ambulance station,
2. emergency department in hospitals,
3. emergency hospital,
4. Department of emergency medical care.

All 4 forms are present only in large cities. Employees in their work are guided by certain ambulance standards approved by law, but in the event of various emergency situations, they act impromptu, but above all in the interests of patients.

Ambulance station

An ambulance station is the most important medical institution that provides emergency care to sick people both directly in the building and outside it (at home or at the scene of an accident). Depending on the size of the station, it contains various departments in its structure, the staff can also be diverse.

Usually it is headed by a chief physician, who has deputies who oversee certain areas. Operation of the ambulance station assistance is carried out in a regular (usual) mode, or in an emergency mode, which depends on certain circumstances.

Typically, a city ambulance has the following departments:

• Operations department. Provides direct emergency care to sick people, if indicated, delivers patients to the hospital. A prerequisite for the work of doctors is the observance of standards of medical care.
• Department of hospitalization of acute and somatic patients. Employees transport patients from one medical institution to another, or for a consultation with narrow specialists.
• Department of hospitalization of patients with acute gynecological pathology and women in childbirth.
• Infectious department for hospitalization of patients with various infectious diseases.
• Department of Medical Statistics. Conducts statistical processing of the work of all departments that are part of the structure of the city ambulance station.
• Communication department. Provides various technical aspects of emergency care (telephone communication). It is thanks to him that an ambulance call arrives as quickly as possible to the profile brigade.
• Inquiry Office. All certificates can be issued only upon request from law enforcement agencies or medical professionals.
• Other structural divisions. These include accounting, personnel department, pharmacy, etc.

Ambulance med. help: essential staff

The team that directly provides first aid to the sick or injured usually includes 3 employees: a doctor, a paramedic and a nurse. Various deviations from this composition are possible, which is due to the type of the brigade itself, as well as the number of employees registered for work at this station. For example, to transport a patient from the emergency room to the hospital, no assistance is required, so the presence of a doctor is not necessary, a paramedic or orderly is quite enough. However, teams that go to road accidents, to patients with heart problems or small children necessarily consist of all the necessary employees (including an ambulance doctor).

Often, due to a shortage of personnel, there are no orderlies in the brigades, so the transfer of patients on stretchers has to be carried out by doctors and paramedics themselves, sometimes drivers of special vehicles help them. Each of the employees carries out a certain type of activity within the framework of providing emergency care to the population.

The emergency doctor is the most important person in the team, who is responsible for its work. He must have a higher medical education in the specialty "ambulance", regularly undergo advanced training and confirm his professional suitability.

He examines a sick or injured person, talks with him, his relatives or witnesses of the incident. In the shortest possible time, he must determine the main diagnosis, which caused a sharp deterioration in the condition. After that, he decides what the emergency plan should be. Unlike an ambulance paramedic, the doctor makes the main decision: whether the patient or victim needs to be hospitalized in a hospital, or whether he can continue therapy at home under the supervision of a district doctor. Also, if necessary, the doctor of the linear team can call a specialized team (resuscitation, cardiological, emergency psychiatric care).

An emergency doctor is a hard and responsible job that not everyone can do. Constant night duty, the need to make vital decisions in a matter of seconds, the ability to navigate in extreme conditions and cope with various conflict situations make this specialty one of the most difficult in general, and in medicine in particular.

Paramedic ambulance

An ambulance paramedic is the chief assistant to a doctor in providing emergency care to the sick or injured. He is the "right hand" of the doctor, as he carries out all the necessary medical manipulations that he considers necessary (injections, dressings, pressure measurements, etc.). However, in some brigades, the ambulance paramedic is the only employee who makes the diagnosis himself, decides on treatment tactics and performs all the necessary manipulations. This takes place in small cities, towns and villages, as well as with a shortage of personnel among emergency doctors at stations.

The ambulance paramedic has a secondary specialized education in the relevant specialty, which gives him a special status: higher than a nurse or brother, but lower than a doctor. In the presence of the latter, he performs the functions of a nurse, and in the absence of a doctor. A paramedic, just like a doctor, must regularly improve their skills, comply with ambulance standards and improve their professional skills.

Other personnel

In addition to the doctor and paramedic, the ambulance teams also include other employees who help them in their work. These include junior medical personnel (orderlies) and drivers of special ambulances.

The orderlies help to carry out the transfer of the sick and injured, the fixation of violent patients (psychiatric emergency), maintain order in the car and perform various tasks for doctors and paramedics. Ambulance drivers should be able to deliver a seriously ill patient to a hospital as quickly as possible without creating emergency situations on the road, monitor the condition of the car, navigate the village well so as not to waste precious minutes searching for the right house or entrance. Sometimes the driver can be an orderly at the same time, which is very common.

Given the nature of the pathology, which was the reason for calling an ambulance, a brigade of a certain type is sent to it. If there are indications (if the patient's condition and the alleged diagnosis differ from the one originally assumed by the dispatcher), the doctor or paramedic can call specialists from another specialized team so that they can more adequately help the sick or injured person. For example, a general-profile team is sent to call an ambulance to a person with acute pain in the shoulder. If upon arrival this symptom turns out to be a manifestation of myocardial infarction, then the doctor calls the cardiology team, if the patient's condition requires resuscitation, then at the same time as providing assistance, they ask for reinforcements from the resuscitation team.

General ambulance

General ambulance med. assistance can be provided by both paramedical and medical teams. It depends on the size of the settlement, on the complexity of the call and the personnel situation at the station (substation).

• The paramedic general brigade contains 1-2 paramedics and a driver (who often also performs the functions of an orderly).

Usually, these teams go to patients in villages/towns where there are no doctors at all, or they do not work around the clock. They provide any kind of medical care, regardless of the severity of the disease of patients or victims.

• The general medical team contains the classic staff: a doctor, a paramedic and an orderly / driver.

She rides on all non-serious calls that are presumably the cause of an emergency call. These include high temperature, pain in the back (leg, arm, chest or abdomen), hypertensive crises, various types of injuries and burns, poisoning, etc. In a situation where the patient's condition differs from that originally intended, the doctor can call for reinforcement in the form specialized team.

Despite the fact that emergency care is provided free of charge under the compulsory medical insurance program, privately paid ambulance services are gaining popularity in large cities. Typically, the composition of such teams includes the classic trio: doctor, paramedic, orderly, and their nature is general.

Little patients always deserve special attention. Therefore, they should be assisted by specialists who have the skills to work with children, taking into account the specifics of the diseases and injuries that they experience. Ambulance care for a child is provided by a specialized pediatric team, which includes a pediatrician, a paramedic and junior staff, or a pediatrician, a nurse and junior staff.

The pediatrician must know the specifics of the most common pediatric emergencies, taking into account the specific age of the patient and, of course, the individual dosage of drugs. An ambulance is needed for a child with various injuries (fractures, burns, bruises, sprains), feverish conditions, complications of viral infections (laryngostenosis, broncho-obstructive conditions, febrile convulsions), diarrhea and vomiting, the consequences of traffic accidents, electric shocks, etc.

A special type of pediatric ambulance - neonatal resuscitation - helps the smallest patients (the first month of life) who have life-threatening conditions.

Emergency psychiatric care

Emergency psychiatric care is a special type of medical care. Employees of this brigade perform extremely important functions - they apply various measures in relation to patients suffering from mental disorders in the acute stage. Most often, these are acute psychoses with various hallucinations (auditory, visual, etc.). In this state, a person can be dangerous both for himself and for others.

In addition, the help of a psychiatric team may be required for people in a state of drug intoxication, delirium tremens, severe depression, or with active suicidal attempts. It always includes 1-2 orderlies who help fix such patients, since in a state of psychosis they can actively resist medical workers and pose a danger.

The resuscitation team provides emergency care to patients who are in an extremely serious life-threatening condition. It necessarily includes an anesthesiologist-resuscitator and 2 nurses-anesthetists (nurses), sometimes paramedics work instead of them.

For transportation, they use a special class C car (resuscitation vehicle), equipped with everything necessary for resuscitation. It is usually painted in a bright color (yellow) so that drivers of other cars can more easily notice it and give way to it. The resuscitation team arrives at the scene of the incident (or at the house of a seriously ill person) as soon as possible (within a few minutes). An ambulance for a child who is in critical condition (asphyxia, convulsions, cardiac arrest, the consequences of a serious accident) is provided by a special resuscitation pediatric team.

Aeromedical Brigade

Not always people in need of emergency medical care live in cities and towns that have ambulance stations or substations. In our country, there are many small settlements (villages, villages), which are located at a fairly large distance from the nearest medical institution. Sometimes they are separated by hundreds of kilometers, rivers and lakes through which there is no crossing. In this case, to provide assistance, there are special aeromedical teams that can transport a serious patient from the outback to the central district or regional hospital. The composition of such a team includes an anesthesiologist-resuscitator, a paramedic, a nurse anesthetist and a nurse.

Call an ambulance

An ambulance phone call is the easiest and most effective way to contact medical professionals in the event of an emergency. However, in order for the doctors to arrive at the person in need as soon as possible, you need to know what information to report to the dispatcher who receives calls.

To do this, you must provide the following important information:

• Gender, age of the patient or victim,
• Symptoms that make you seek the help of emergency physicians
• The exact address indicating the house number, entrance, intercom code, features that may make it difficult for the brigade to enter the house (special numbering, security, obstacles in the yard).

After all these parameters are specified, it is necessary to listen to information from the dispatcher. He will tell you how soon the ambulance will arrive and what urgent measures you can take on your own before the ambulance arrives.

The emergency number is a number that everyone, including teenagers and children, should know. In order to call an emergency, you need to dial 03 from a city or 03, 030 or 003 mobile number (depending on the telecom operator). The call is free and possible with a negative balance.

The alternative ambulance phone is 112, but this is a single rescue service, and after the dispatcher listens to the person, he will most likely offer him to call 103 or switch it on his own.

How is the transfer of an ambulance call

After the person has phoned, the dispatcher on duty listens attentively to him. He will determine the approximate diagnosis or profile of the patient (injured). After that, he will decide which team (general, specialized, pediatric or resuscitation) should go on this call. Depending on the urgency of the situation, the arrival time will be different: the resuscitation team arrives at the place in a few minutes, the general profile team in about 20 minutes. However, this is also affected by the number of calls, traffic conditions and other parameters that do not directly depend on medical workers.

After the dispatcher transmits the call from the ambulance phone to the team, he will give certain instructions to the caller as to what he can do for the sick or injured before the arrival of the doctors. He will also approximately orient him by the time of their arrival.

If the dispatcher considers that a call to an ambulance does not require the arrival of a brigade, he may refuse to call, give recommendations on the provision of certain measures at home, or advise calling a local doctor at home.

Private ambulance

Private ambulance is one of the modern areas of the medical business, in which the patient pays for the services of emergency doctors out of his own pocket. Any person has the right to receive free medical care under the CHI program, but not everyone is satisfied with its volume and completeness. For example, a person with a cold and a temperature of 37.5 C is unlikely to be able to count on the fact that an ambulance team will come to him, but a private ambulance gives him such an opportunity.

In addition to emergency measures, various medical procedures are carried out within the framework of private ambulance: consultations at home with various specialists, infusion and detoxification therapy, intramuscular and intravenous injections, transportation of bedridden patients for examination to polyclinics and hospitals, etc. Considering that intensive and stressful the work of free ambulance doctors does not give them the opportunity to scrupulously and thoroughly talk with patients, wealthy people often resort to the services of a private ambulance, since the work schedule of its employees is not so busy.

Paid ambulance is synonymous with private. Thus, for the services that were provided to the patient, he must pay from his wallet. In large cities, this type of activity is now developing very actively, due to demand. Before calling, you need to check the price list for certain services on the organization’s website or with the dispatcher, since paid ambulance is often not a cheap pleasure.

The main problem that arises in the provision of this service is emergency situations that require urgent hospitalization in a hospital. The cost of individual paid ambulance activities and transportation may not be as expensive as the cost of potential hospitalization. Therefore, such patients are often taken to ordinary free hospitals, where they may have certain problems with the staff of the admission department, since this disrupts continuity (usually, hospital doctors are notified in advance that a patient of a free ambulance team is being taken to them, which is not occurs in the case of private).

However, a paid ambulance is a way out for many people who need to take a seriously bedridden patient to be examined by a doctor in a clinic or hospital, and it is extremely difficult to do this in a private car.

Emergency room

An emergency department is a structural subdivision of a hospital, clinic, ambulance station or substation. Any person in need of urgent measures can apply there and he will certainly be examined by a doctor.

A number of emergency departments provide advisory support for doctors in small clinics or hospitals via telephone or Internet connection. In some large hospitals, it has a different name - the department of telemedicine or disaster medicine.

emergency hospital

An emergency hospital is a hospital that specializes in providing various types of emergency care. It has well-equipped resuscitation, cardiological, surgical, neurological and other departments. It is in emergency hospitals that patients enter after urgent events carried out by general or specialized teams for further treatment. Unlike hospitals for rehabilitation treatment, dispensaries and sanatoriums, they do not deal with issues of prevention and rehabilitation in such depth.

The ambulance hospital is usually one for a large area and is located in its center so that patients or victims can be taken to them by ambulances as quickly as possible.

The work of doctors and ambulance paramedics is carried out according to certain rules. In order to minimize the individual approach and the influence of the personal factor in the conduct of medical events, ambulance standards were introduced. For each group of diseases, a specific type of pathology or injury, there is a certain sequence of actions that medical workers must carry out when providing assistance.

Of course, an individual approach takes place in some cases, but it is the ambulance standards that are the main guideline in the work of doctors. Compliance with all points is a guarantee of protection during various quality checks and in litigation.

Emergency medical care is the most important aspect of providing emergency care to sick and injured people whose lives are at risk.