1. 1. Organization of emergency and acute care Prepared by: C.m.s., assistant professor of outpatient therapy and emergency medical emergency KSMU A. R. Alpyssova

2. The purpose of the lecture After completing the lecture, students should be guided in the organization of emergency and urgent care After completing the lecture, students should be guided in the organization of emergency and urgent care

3. The concepts of LUTS Medical emergency – it is suddenly emerged pathological change in the functions of the human body, threatening to his life, health or those around him. Medical emergency – it is suddenly emerged pathological change in the functions of the human body, threatening to his life, health or those around him.

4. Urgent states are classified as follows: Life-threatening conditions - a pathological condition characterized by impaired vital main functions (blood circulation and respiration). State, threatening the health - this pathological condition with a high risk of disorders of vital functions or can cause persistent health problems that may occur in the absence of medical care in the near future. Conditions requiring urgent medical intervention in the interests of others persons in connection with the behavior of the patient. A special type of emergency conditions considered labor. In fact, the birth - a physiological act, they can be resolved without emergency medical intervention. However, due to certain risk of complications, including life-threatening, you must include the delivery of medical emergencies, and to include within the scope of the provision of UMC. Life-threatening conditions - a pathological condition characterized by impaired vital main functions (blood circulation and respiration). State, threatening the health - this pathological condition with a high risk of disorders of vital functions or can cause persistent health problems that may occur in the absence of medical care in the near future. Conditions requiring urgent medical intervention in the interests of others persons in connection with the behavior of the patient. A special type of emergency conditions considered labor. In fact, the birth - a physiological act, they can be resolved without emergency medical intervention. However, due to certain risk of complications, including life-threatening, you must include the delivery of medical emergencies, and to include within the scope of the provision of UMC.

5. The main reasons for urgent conditions acute diseases acute diseases Exacerbation of chronic diseases Exacerbation of chronic diseases Injuries Injuries poisoning poisoning

6. The concept of UMC UMC (syn. emergency medical care), as a form of care - a set of implemented without delay treatment and diagnostic and tactical measures aimed at elimination of sudden pathological condition that threatens human life and health (medical emergency), or surrounding persons at all stages of treatment. UMC (syn. emergency medical care), as a form of care - a set of implemented without delay treatment and diagnostic and tactical measures aimed at elimination of sudden pathological condition that threatens human life and health (medical emergency), or surrounding persons at all stages of treatment. UMC, as a system - a set of standards, structures and mechanisms of interaction, to provide UMC, its scientific and methodological support and training. The term “UMC system" means also emergency medical assistance at all stages, and scientific-methodological support and training, respectively, includes, along with the services of UMC (stations, offices) and hospitals UMC, specialized research institutes and centers UMC training centers and disaster medicine. UMC, as a system - a set of standards, structures and mechanisms of interaction, to provide UMC, its scientific and methodological support and training. The term “UMC system" means also emergency medical assistance at all stages, and scientific-methodological support and training, respectively, includes, along with the services of UMC (stations, offices) and hospitals UMC, specialized research institutes and centers UMC training centers and disaster medicine.

7. Hospital UMC - health care setting of a stationary type, having a branch in the structure of the UMC. The service UMC interacts with the hospitals of various types, providing emergency medical care. Patients can be delivered to teams of UMC in municipal, district, regional (territorial, republican) hospitals, institutions, ambulances and specialized scientific-practical institution. Hospital UMC - health care setting of a stationary type, having a branch in the structure of the UMC. The service UMC interacts with the hospitals of various types, providing emergency medical care. Patients can be delivered to teams of UMC in municipal, district, regional (territorial, republican) hospitals, institutions, ambulances and specialized scientific-practical institution. The Prehospital stage of UMC - emergency medical care outside of hospitals. The Prehospital stage of UMC - emergency medical care outside of hospitals.

8. Basic principles for UMC The urgency of providing UMC, due to a violation of the vital functions of the patient (victim) or a high risk of development due to the rapid progression of the pathological state in the absence of adequate medical benefits. The urgency of providing UMC, due to a violation of the vital functions of the patient (victim) or a high risk of development due to the rapid progression of the pathological state in the absence of adequate medical benefits. Trouble-free nature of the UMC provision in urgent situations. Trouble-free nature of the UMC provision in urgent situations. Every citizen regardless of social, ethnic, cultural-religious and other features by contacting UMC and in need of urgent medical intervention is entitled to receive free emergency medical care in accordance with the standards of care. Every citizen regardless of social, ethnic, cultural-religious and other features by contacting UMC and in need of urgent medical intervention is entitled to receive free emergency medical care in accordance with the standards of care. Free nature of the assistance patients (victims) in urgent situations. Free nature of the assistance patients (victims) in urgent situations. State regulation requires executive agencies responsible for organizing the uninterrupted provision of UMC. State regulation requires executive agencies responsible for organizing the uninterrupted provision of UMC.

9. The volume of UMC - a set of urgent medical-diagnostic measures to address urgent condition. The volume of UMC - a set of urgent medical-diagnostic measures to address urgent condition. Depending on the condition of the assistance due to stage of care, availability of special medical equipment and training, assistance can be provided in the following amounts: Depending on the condition of the assistance due to stage of care, availability of special medical equipment and training, assistance can be provided in the following amounts: First aid for the sick and injured First aid for the sick and injured before doctor care before doctor care First medical aid First medical aid Skilled care Skilled care Specialized medical care Specialized medical care The list of minimum required diagnostic-treatment activities regulated by the relevant standards (protocols).

10. Algorithm of emergency medical care - a sequence of necessary diagnostic-treatment activities in a typical clinical situations, the appropriate phase and the volume of supporting emergency medical care. Algorithm of emergency medical care - a sequence of necessary diagnostic-treatment activities in a typical clinical situations, the appropriate phase and the volume of supporting emergency medical care. The tactics of emergency medical services - tools and methods used to ensure timely and effective emergency medical care at all stages. The tactics of emergency medical services - tools and methods used to ensure timely and effective emergency medical care at all stages. The tactics of the UMC should include a preventive component - a warning of possible life-threatening conditions and other emergencies, to provide security for both the patient and for the surrounding people and medical staff. The tactics of the UMC should include a preventive component - a warning of possible life-threatening conditions and other emergencies, to provide security for both the patient and for the surrounding people and medical staff.

11. The service UMC is operates: daily work - Emergency The service UMC is operates: daily work - Emergency Two interrelated stages of organization and delivery of the UMC: prehospital (station UMC); prehospital (station UMC); hospital (hospitals at various levels) hospital (hospitals at various levels) 3 levels in the organization of the UMC: 3 levels in the organization of the UMC: One-level (paramedic) in rural areas. One-level (paramedic) in rural areas. 2-level (mixed) in medium-sized cities (medical crew and paramedic team). 2-level (mixed) in medium-sized cities (medical crew and paramedic team). 3-level (mixed) in the major cities (medical team, a specialized medical team paramedic and team). 3-level (mixed) in the major cities (medical team, a specialized medical team paramedic and team).

12. 2 principles of the separation of functions between the stations of the UMC and clinics: 2 principles of the separation of functions between the stations of the UMC and clinics: On the basis of determining the severity of a reason to call (a life-threatening, unlife-threatening disease). On the basis of determining the severity of a reason to call (a life-threatening, unlife-threatening disease). On the basing of determining of place of crime scene. (street, apartment). On the basing of determining of place of crime scene. (street, apartment). Taking into account the principle of determining the severity of the organization of medical care for patients with acute and chronic, but unlife-threatening disease are the responsibility of the clinic. Taking into account the principle of determining the severity of the organization of medical care for patients with acute and chronic, but unlife-threatening disease are the responsibility of the clinic.

13. Service UMC can be organized on the following principles: Service UMC can be organized on the following principles: By geography sign By geography sign By the principle of relationships with hospitals and the type of administration (and funding) By the principle of relationships with hospitals and the type of administration (and funding) By the principle of giving first aid "on the scene" with the organization of parallel emergency medical services at clinics: Street - UMC, apartment - a medical emergency. By the principle of giving first aid "on the scene" with the organization of parallel emergency medical services at clinics: Street - UMC, apartment - a medical emergency. By the principle of giving first aid to "the severity of reason“, independently of the scene (without the creation of emergency medical services) with forces and means only the UMC. By the principle of giving first aid to "the severity of reason“, independently of the scene (without the creation of emergency medical services) with forces and means only the UMC. By the principle of affiliation and funding, and (or) by dividing by the state and non-governmental services of the UMC. By the principle of affiliation and funding, and (or) by dividing by the state and non-governmental services of the UMC.

14. Station UMC - state or municipal health care facility that is designed to assist UMC in the prehospital outreach and has the necessary forces and means it. As part of the station should be provided for UMC: operational department (office) (for receiving calls), the department of communication (for the interaction between the station and outreach UMC), Department of Medical Statistics from the archive office for receiving out-patient room for storage of medical equipment UMC and teams prepare for the work of medical pilings, storage space for stock drugs, equipped with fire and burglar alarm, rest rooms for the doctors, the average

15. medical personnel, ambulances drivers, room for meal duty personnel, administrative and other buildings, garages, covered parking boxes, enclosed area with a paved parking lot, corresponding to the size of the maximum number of vehicles operating simultaneously. Operations Division (office) station UMC provides non-stop centralized receiving calls (calls) of the population, timely referral outreach MSP, operational management and control over their work, the organization of the UMC, depending on the current operational situation. medical personnel, ambulances drivers, room for meal duty personnel, administrative and other buildings, garages, covered parking boxes, enclosed area with a paved parking lot, corresponding to the size of the maximum number of vehicles operating simultaneously. Operations Division (office) station UMC provides non-stop centralized receiving calls (calls) of the population, timely referral outreach MSP, operational management and control over their work, the organization of the UMC, depending on the current operational situation.

16. The main functions of the operative department: Receiving calls from the public. Receiving calls from the public. Transferring calls for execution. Transferring calls for execution. Operative management of outreach. Operative management of outreach. Sharing information with substations on operational work. Sharing information with substations on operational work. Interaction with the duty of the city services (rural area), the police, traffic police, fire protection, emergency, etc. Interaction with the duty of the city services (rural area), the police, traffic police, fire protection, emergency, etc. Emergency information management station of emergency and conflict situations. Emergency information management station of emergency and conflict situations. Information on emergency instances, certain public health authorities. Information on emergency instances, certain public health authorities. Issuance of the population reference information. Issuance of the population reference information.

17. Basic steps of a call manager when receiving phone call: Basic steps of a call manager when receiving phone call: Listen to the citizen who applied for the "03". Listen to the citizen who applied for the "03". Address the issue of receiving a call in accordance with the instructions. Address the issue of receiving a call in accordance with the instructions. When the complexity of the decision - to switch the telephone line to a senior doctor. When the complexity of the decision - to switch the telephone line to a senior doctor. If a decision on receiving a call, record data: If a decision on receiving a call, record data: address and telephone number; address and telephone number; surname, first name, age of the patient surname, first name, age of the patient name and phone calling, relationship to the patient; name and phone calling, relationship to the patient; What happened? What happened? Based on the response to formulate a reason to call (when working by hand). When operating an automated call processing system cause the call is formed by a computer program. Based on the response to formulate a reason to call (when working by hand). When operating an automated call processing system cause the call is formed by a computer program.

18. Depending on the capabilities of UMC processing station calls can be conducted manually or through an automated system. Depending on the capabilities of UMC processing station calls can be conducted manually or through an automated system. All jobs in the operations department (dispatch) must be computerized, equipped to record conversations and Automatic Number Identification telephone. All jobs in the operations department (dispatch) must be computerized, equipped to record conversations and Automatic Number Identification telephone. In the operations department (dispatch) should be form a single personalized database of patients who applied for the provision of UMC. In the operations department (dispatch) should be form a single personalized database of patients who applied for the provision of UMC. Receiving calls and sending their outreach carried out by nurse (the nurse) to receive and transfer calls to the operations department (dispatch) station of the UMC. Receiving calls and sending their outreach carried out by nurse (the nurse) to receive and transfer calls to the operations department (dispatch) station of the UMC.

19. Away team UMC - UMC staff service workers, providing emergency medical care for the sick and injured to the point of call and in the ambulances in the way to following in health care setting. Away team UMC - UMC staff service workers, providing emergency medical care for the sick and injured to the point of call and in the ambulances in the way to following in health care setting. Depending on the composition, equipment and tasks are the following types of outreach: Depending on the composition, equipment and tasks are the following types of outreach: Away linear (medical) team UMC - UMC visiting team, led by a physician with a special "emergency ambulance service." Medical outreach UMC includes in its membership a doctor, two paramedics, paramedic and the driver and provides medical care in accordance with the standards of the UMC and is working on schedule. In his spare time, call staff on-site team UMC must be present at the station (substation), office of the UMC. Away linear (medical) team UMC - UMC visiting team, led by a physician with a special "emergency ambulance service." Medical outreach UMC includes in its membership a doctor, two paramedics, paramedic and the driver and provides medical care in accordance with the standards of the UMC and is working on schedule. In his spare time, call staff on-site team UMC must be present at the station (substation), office of the UMC.

20. Away specialized team of UMC - outreach activities designed to provide emergency medical assistance in the amount of pre- hospital specialist care, which has as part of a doctor who owns a specialty basic "ambulance" and additional specialty (specialties) along the profile of a specialized team and has the necessary specialist equipment. Away specialized team of UMC - outreach activities designed to provide emergency medical assistance in the amount of pre- hospital specialist care, which has as part of a doctor who owns a specialty basic "ambulance" and additional specialty (specialties) along the profile of a specialized team and has the necessary specialist equipment. The main types of specialized brigade: The main types of specialized brigade: Reanimation anesthetic (resuscitative-surgical, cardiac, neurological, multidisciplinary intensive care, intensive care) brigade. Reanimation anesthetic (resuscitative-surgical, cardiac, neurological, multidisciplinary intensive care, intensive care) brigade. Mental health brigade. Mental health brigade. Pediatric and other brigade. Pediatric and other brigade.

21. Away paramedic brigade of UMC – brigade of UMC, led by a medical assistant, designed to assist UMC in the amount of pre-hospital with the elements of skilled care. Away paramedic brigade of UMC – brigade of UMC, led by a medical assistant, designed to assist UMC in the amount of pre-hospital with the elements of skilled care. Away paramedic team UMC includes in its membership two paramedics, paramedic and the driver and provides medical care in accordance with the functional responsibilities of assistant: Away paramedic team UMC includes in its membership two paramedics, paramedic and the driver and provides medical care in accordance with the functional responsibilities of assistant: -at transport of patients (when the nurse works as an independent unit in accordance with established medical diagnosis and assistance to women in childbirth); -help the doctor in the team, as the acting physician. Paramedics can be used as a doctor acting in desperate situations [when not enough or not physicians (rural area)]. Obstetric brigade.

22. Ambulance service - a special vehicle equipped with medical stretchers and medical equipment and designed to provide emergency medical care and transportation of the patient. The main types of ambulance - road, air and water. Ambulance service - a special vehicle equipped with medical stretchers and medical equipment and designed to provide emergency medical care and transportation of the patient. The main types of ambulance - road, air and water. Selecting a profile brigades depends on the following circumstances: Selecting a profile brigades depends on the following circumstances: living conditions and the magnitude of the population (rural, small towns, medium and large cities; living conditions and the magnitude of the population (rural, small towns, medium and large cities; availability of appropriate patient population (uptake and structure of the calls). availability of appropriate patient population (uptake and structure of the calls). It is necessary to take into account the fundamental aspects: It is necessary to take into account the fundamental aspects: Medical care on the quality is higher from medical assistant. Medical care on the quality is higher from medical assistant. If the medical team makes calls that do not require medical attention, it quickly leads to loss of qualification. If the medical team makes calls that do not require medical attention, it quickly leads to loss of qualification. Paramedical teams work in any circumstances, require medical supervision. Paramedical teams work in any circumstances, require medical supervision.

23. Away brigade of UMC undertaking the following activities: Away brigade of UMC undertaking the following activities: Immediate departure and arrival to the patient (the scene) within the time limits set for the administrative area. Immediate departure and arrival to the patient (the scene) within the time limits set for the administrative area. The diagnosis, implement activities that promote stabilization or improvement of the patient, and, in the presence of medical indications, transporting it to the clinic The diagnosis, implement activities that promote stabilization or improvement of the patient, and, in the presence of medical indications, transporting it to the clinic Transfer of patients to appropriate medical documentation to the duty doctor (the assistant), a hospital health-care setting. Transfer of patients to appropriate medical documentation to the duty doctor (the assistant), a hospital health-care setting. Conduct triage (the victims) and the sequencing of health care for those diseases, poisoning, injuries and other emergencies. Conduct triage (the victims) and the sequencing of health care for those diseases, poisoning, injuries and other emergencies. Software and holding the necessary hygienic and anti- epidemic measures in due course. Software and holding the necessary hygienic and anti- epidemic measures in due course.

24. Basic requirements for exit brigades of ambulance to work Efficiency of work exit brigades. Efficiency of work exit brigades. After receiving the call, the brigade going out in during 4 minutes. After receiving the call, the brigade going out in during 4 minutes. Brigade UMC arrives to the place of call on the optimal route and report about arrival in the operational department. Brigade UMC arrives to the place of call on the optimal route and report about arrival in the operational department. Brigade UMC spends the minimum time for quality assistance in full (the volume of medical care may be reduced only in an emergency). Brigade UMC spends the minimum time for quality assistance in full (the volume of medical care may be reduced only in an emergency). The brigade UMC immediately report about execution of call. The brigade UMC immediately report about execution of call.

25. The quality of medical care controls these persons: Head of sub-stations (departments) of medical documents (call card, returnable coupons accompanying sheet) and in the control exits. Head of sub-stations (departments) of medical documents (call card, returnable coupons accompanying sheet) and in the control exits. Senior doctors of operative department (tactical decisions of exit brigades). Senior doctors of operative department (tactical decisions of exit brigades). Doctors of bureau hospitalization (tactical decisions of exit brigade). Doctors of bureau hospitalization (tactical decisions of exit brigade). Senior doctors-specialists of station (by medical documents). Senior doctors-specialists of station (by medical documents). Assistant of Chief doctor of medical field (of medical documents). Assistant of Chief doctor of medical field (of medical documents). Medical-control commission of the station assigned to the order of the chief physician. Medical-control commission of the station assigned to the order of the chief physician.

26. Quality of registration of medical documents checked below listed individuals and committees: Quality of registration of medical documents checked below listed individuals and committees: Heads of sub-stations (departments). Heads of sub-stations (departments). Doctors of bureau hospital (accompanying sheet). Doctors of bureau hospital (accompanying sheet). Assistant of chief physician at the medical field (selective). Assistant of chief physician at the medical field (selective). Commission on the audit of the departments appointed by the Chief. Commission on the audit of the departments appointed by the Chief.

27. Ensuring health care quality in the service NSR Quality of care (ILC) - a set of features satisfying the needs of citizens in the effective prevention and treatment of diseases, improving the quality of life and increase its duration. Quality of care (ILC) - a set of features satisfying the needs of citizens in the effective prevention and treatment of diseases, improving the quality of life and increase its duration. Health Care Quality Assurance is aimed at obtaining the maximum possible given the current level of knowledge of the results for the improvement of public health with a minimum (optimal) expenditure of funds. Health Care Quality Assurance is aimed at obtaining the maximum possible given the current level of knowledge of the results for the improvement of public health with a minimum (optimal) expenditure of funds.

28. Commission's evaluation criteria are: Commission's evaluation criteria are: accessibility; accessibility; adequacy; adequacy; continuity; continuity; effectiveness; effectiveness; efficiency; efficiency; focus on the patient; focus on the patient; security; security; timeliness. timeliness.

29. Indicators of quality of care - — A numerical indicators used to assess medical care, indirectly reflect the quality of its basic components: the structure, processes and outcomes. The value of quality indicators expressed as a percentage of the threshold (target or acceptable) values. Development and implementation of quality indicators is a methodologically complicated process, but their use can identify problems and irregularities of technology at different levels in the activities of physicians, institutions and industry in general. Analysis of these indicators can help you develop ways to improve the quality of care. We are currently performing the development of quality indicators for service SMEs and explores the possibility of their implementation. We are currently performing the development of quality indicators for service SMEs and explores the possibility of their implementation.

30. Clinical practice guidelines of professional societies, standards and plans for patient management as the basis of the medical process Clinical guidelines - a systematically developed a document containing information on prevention, diagnosis, treatment of specific diseases and syndromes and helps your doctor make good clinical decisions. Clinical guidelines - a systematically developed a document containing information on prevention, diagnosis, treatment of specific diseases and syndromes and helps your doctor make good clinical decisions. Clinical guidelines developed by professional international and national health NGOs. Clinical guidelines developed by professional international and national health NGOs.

31. Standards of care applicable to the RK and approved by health authorities, determine the recommended minimum amount of care and treatment time. These documents are used for economic calculations, but not as guidelines for the management of patients. Standards of care applicable to the RK and approved by health authorities, determine the recommended minimum amount of care and treatment time. These documents are used for economic calculations, but not as guidelines for the management of patients. Based on CD and in accordance with its human and material capacity of health institutions at various levels can make plans (protocols) of patients with established disease. Their implementation allows to reduce the cost of treatment due to cost optimization, improve patient safety, reduce the incidence of complications and reduce treatment time. Based on CD and in accordance with its human and material capacity of health institutions at various levels can make plans (protocols) of patients with established disease. Their implementation allows to reduce the cost of treatment due to cost optimization, improve patient safety, reduce the incidence of complications and reduce treatment time.

32. The regulation of service SMEs State regulation of relations arising in the provision of UMC, by authority of executive power, with responsibility for implementing the licensing service UMC, state control of quality of care. State regulation of relations arising in the provision of UMC, by authority of executive power, with responsibility for implementing the licensing service UMC, state control of quality of care. Organizational-methodical management of the service provided by the Ministry of Health and Social Development of the RK, health authorities. Organizational-methodical management of the service provided by the Ministry of Health and Social Development of the RK, health authorities. In order to improve UaEMC (Urgent and emergency medical care) and improve the quality of services to the population of the RK, strengthening its regulatory framework, published by Order № 756 of 16.08.2001 "On measures to improve emergency medical care to the population of the RK" Agency for Health Affairs, which approved the Rules of station (department In order to improve UaEMC (Urgent and emergency medical care) and improve the quality of services to the population of the RK, strengthening its regulatory framework, published by Order № 756 of 16.08.2001 "On measures to improve emergency medical care to the population of the RK" Agency for Health Affairs, which approved the Rules of station (department

33. NSR, Rules of call an ambulance, Regulations and Instructions. NSR, Rules of call an ambulance, Regulations and Instructions. SMP station operates its activity according to the Order № 511 of Ministry of Health ot17.08.2007 "The activities of organizations that provide emergency medical care to the population of the RK." SMP station operates its activity according to the Order № 511 of Ministry of Health ot17.08.2007 "The activities of organizations that provide emergency medical care to the population of the RK." Annex to the Order № 511 - "Regulations on the activities of health care organizations that provide emergency medical care." Annex to the Order № 511 - "Regulations on the activities of health care organizations that provide emergency medical care."

34. The most important regulatory documents of stations are include: The job descriptions of employees stations (offices) The job descriptions of employees stations (offices) The position of station units, approved by the director (chief physician) The position of station units, approved by the director (chief physician) Orders, regulations governing the forms of plant Orders, regulations governing the forms of plant House rules House rules The collective agreement between management and trade union committee of the station on the main directions of socio- economic protection of workers The collective agreement between management and trade union committee of the station on the main directions of socio- economic protection of workers

35. Documentation of Ambulance Service Map of the call - № 220u, approved by Order № 332 from 2005. Map of the call - № 220u, approved by Order № 332 from 2005. Accompanying sheet - № 110u Accompanying sheet - № 110u Signal list №110 1 / y Signal list №110 1 / y Journal of incoming calls - № 109 / e Journal of incoming calls - № 109 / e Notice - approved ATS №193 / y Notice - approved ATS №193 / y The report of the death The report of the death Journal of the senior doctor on duty Journal of the senior doctor on duty journal of emergency journal of emergency Journal of the comments on the cards calls Journal of the comments on the cards calls Register of infectious diseases № 13-10 Register of infectious diseases № 13-10 Record Book of narcotic and psychotropic substances Record Book of narcotic and psychotropic substances Journal of "hot line" Journal of "hot line" The log of complaints and suggestions The log of complaints and suggestions

36. RULES of station (department) emergency medical care Station emergency medical care is a medical organization providing free round the clock ambulance and emergency medical assistance to adults and children with life-threatening conditions, accidents, acute serious diseases, like at the scene and in route. Station emergency medical care is a medical organization providing free round the clock ambulance and emergency medical assistance to adults and children with life-threatening conditions, accidents, acute serious diseases, like at the scene and in route. The main principles are: The main principles are: full availability to the public; full availability to the public; efficiency in work and timeliness of care; efficiency in work and timeliness of care; completeness of the volume and the high qualification; completeness of the volume and the high qualification; ensuring smooth admission to the appropriate medical organizations. ensuring smooth admission to the appropriate medical organizations.

37. The concept of "emergency" medical care includes emergency removal of all pathological conditions of emergency arising unexpectedly due to external and internal factors that are independent of severity of the condition requiring immediate diagnosis and treatment activities. The concept of "emergency state" shall establish the pathological changes in the human body that lead to a sharp deterioration in health and can be life threatening. At their treatment is required an aggregate of emergency medical interventions that can not be postponed. Schedule time out teams: by ambulance, to 4 minutes; by ambulance, to 4 minutes; for emergency traffic - up to 30 minutes; for emergency traffic - up to 30 minutes; on the planned traffic - in during 90 minutes. on the planned traffic - in during 90 minutes.

38. Station emergency medical care is organized in cities, district centers with populations over 30 thousand people. Station emergency medical care is organized in cities, district centers with populations over 30 thousand people. In cities with smaller populations organized emergency department and urgent medical care in urban and central district and other hospitals. In cities with smaller populations organized emergency department and urgent medical care in urban and central district and other hospitals. In big cities and district centers in the emergency stations and emergency care are organized substation with a 15-minute calculation of accessibility. In big cities and district centers in the emergency stations and emergency care are organized substation with a 15-minute calculation of accessibility. In the cities and district centers with populations of more than 70 thousand inhabitants should be allocated a team to provide medical care for children's population, over 100 thousand - the brigade is organized to provide emergency care to patients with severe mental disorders. In the cities and district centers with populations of more than 70 thousand inhabitants should be allocated a team to provide medical care for children's population, over 100 thousand - the brigade is organized to provide emergency care to patients with severe mental disorders.

39. Station (Department) emergency medical assistance should be provided by local telephone connection from the input rate of 2 per 100 thousand people, but not less than 2 inputs, with radio and direct outreach - from medical institutions, agencies of the Ministry of Interior, divisions Agency for Emergency Situations. Station (Department) emergency medical assistance should be provided by local telephone connection from the input rate of 2 per 100 thousand people, but not less than 2 inputs, with radio and direct outreach - from medical institutions, agencies of the Ministry of Interior, divisions Agency for Emergency Situations. The residence time of emergency teams and emergency care in a hospital emergency room less than 10 minutes (time to transfer a sick or injured on duty doctor-patient). The residence time of emergency teams and emergency care in a hospital emergency room less than 10 minutes (time to transfer a sick or injured on duty doctor-patient). For the station (office) emergency medical assistance is allocated an ambulance with a stretcher for every 10,000 people. For the station (office) emergency medical assistance is allocated an ambulance with a stretcher for every 10,000 people.

40. RULES of call emergency medical care Brigade Station (Branch) emergency medical aid is sent for emergency treatment: Brigade Station (Branch) emergency medical aid is sent for emergency treatment: accidents; accidents; Sudden life-threatening diseases. Sudden life-threatening diseases. Assists and makes transportation to specialized health care organizations: Assists and makes transportation to specialized health care organizations: childbirth and complications of pregnancy; childbirth and complications of pregnancy; children under 1 year; children under 1 year; acute exacerbation and various chronic diseases associated with rapidly deteriorating health; acute exacerbation and various chronic diseases associated with rapidly deteriorating health; patients, on call doctors, in need of medical care in transit and transport stretcher, at health issues, needing to transport medical transportation. patients, on call doctors, in need of medical care in transit and transport stretcher, at health issues, needing to transport medical transportation.

41. Ambulance does not accept the call and not leave in the following cases: Ambulance does not accept the call and not leave in the following cases: to patients at home, not in need of emergency medical aid in time of polyclinics and family doctors' clinics; to patients at home, not in need of emergency medical aid in time of polyclinics and family doctors' clinics; for the examination and making the act of death; for the examination and making the act of death; for doctors and prescriptions of the planned treatment; for doctors and prescriptions of the planned treatment; of providing advisory services to healthcare organizations; of providing advisory services to healthcare organizations; for the delivery of patients home from hospitals. for the delivery of patients home from hospitals. Information on hospitalization of patients affected and provides round the clock help desk station. Information on hospitalization of patients affected and provides round the clock help desk station.

42. POSITION of performance of the stations ( offices) of emergency medical care To improve accounting and reporting forms and simplify them without reducing the information content introduced key performance indicators for single stations (department), urgent and emergency care in the Republic of Kazakhstan: To improve accounting and reporting forms and simplify them without reducing the information content introduced key performance indicators for single stations (department), urgent and emergency care in the Republic of Kazakhstan: Total hits: Total hits: the absolute number - the absolute number - per 1000 population – from them to children under 14 years: per 1000 population – from them to children under 14 years: the absolute number - the absolute number - per 1000 population - per 1000 population - Unsuccessful (in%); Unsuccessful (in%); rejected as ungrounded - (in%): rejected as ungrounded - (in%):

43. Rendered medical assistance, including in connection with: In accidents: In accidents: the absolute number - the absolute number - Percentage - Percentage - 1,000 calls – 1,000 calls – Sudden illness: Sudden illness: the absolute number - the absolute number - Percentage – Percentage – 1,000 calls – 1,000 calls – Emergency transportation: Emergency transportation: the absolute number - the absolute number - Percentage – Percentage – 1,000 calls – 1,000 calls – Childbirth and disorders of pregnancy: Childbirth and disorders of pregnancy: the absolute number - the absolute number - Percentage - Percentage - 1,000 calls – 1,000 calls –

44. Served an outpatient basis: the absolute number - the absolute number - in% of patients who were assisted. in% of patients who were assisted. The number of calls which performed ​​ late: The number of calls which performed ​​ late: the absolute number - the absolute number - in % in % 1,000 calls – 1,000 calls – Of these, "first aid": absolute number- absolute number- percentage percentage 1,000 calls 1,000 calls Referral to hospital: Referral to hospital: the absolute number - the absolute number - in% of patients who were assisted. in% of patients who were assisted. 1,000 calls 1,000 calls Hospitalized: Hospitalized: the absolute number - the absolute number - in% of the number delivered in a hospital in% of the number delivered in a hospital 1,000 calls 1,000 calls Coincidence with diagnoses stations: Coincidence with diagnoses stations: in % in % 1,000 calls 1,000 calls

45. To day mortality in a hospital: the absolute number of the absolute number of in% of total admissions in% of total admissions 1000 Call 1000 Call Repeated calls because of fault of medical staff: the absolute number of the absolute number of in % in % 1000 call 1000 call Challenges in working hours of health clinics: the absolute number the absolute number 100 call 100 call

46. Qualifying feature specialist physician of emergency medical care General knowledge: basic legislation on public health and policy documents defining the activities and health care; basic legislation on public health and policy documents defining the activities and health care; basis for the organization of emergency assistance, the basic documents governing its work, the rights and duties of staff Brigade of First Aid Station, the structure of morbidity in the ambulance service, basics of labor rights and health; basis for the organization of emergency assistance, the basic documents governing its work, the rights and duties of staff Brigade of First Aid Station, the structure of morbidity in the ambulance service, basics of labor rights and health; basis resuscitation: basic techniques for resuscitation at sudden cardiac arrest, acute respiratory failure, allergic, comatose states, with hanging, drowning, electric shock, especially intensive care in children and infants; basis resuscitation: basic techniques for resuscitation at sudden cardiac arrest, acute respiratory failure, allergic, comatose states, with hanging, drowning, electric shock, especially intensive care in children and infants;

47. basis of general anesthesia, used for pre-hospital; basis of general anesthesia, used for pre-hospital; basics of diagnosis and emergency care in urgent situations in the clinic of Internal Medicine (for cardiovascular diseases, diseases of the respiratory tract, diseases of abdominal organs, endocrine diseases, blood diseases, allergic diseases); basics of diagnosis and emergency care in urgent situations in the clinic of Internal Medicine (for cardiovascular diseases, diseases of the respiratory tract, diseases of abdominal organs, endocrine diseases, blood diseases, allergic diseases); basics of diagnosis and emergency care for acute diseases and injuries of the abdominal cavity; basics of diagnosis and emergency care for acute diseases and injuries of the abdominal cavity; basics of diagnosis and emergency care for injuries of the musculoskeletal system; basics of diagnosis and emergency care for injuries of the musculoskeletal system; basis of emergency at acute diseases and injuries of ear, nose and throat; basis of emergency at acute diseases and injuries of ear, nose and throat; basis of emergency at acute injuries and diseases of the nervous system; basis of emergency at acute injuries and diseases of the nervous system; Basis of emergency at acute eye diseases and injuries; Basis of emergency at acute eye diseases and injuries;

48. general principles of emergency care for obstetric and gynecological pathology; general principles of emergency care for obstetric and gynecological pathology; general principles of emergency care for mental illnesses; general principles of emergency care for mental illnesses; basis of emergency for acute exogenous poisoning; basis of emergency for acute exogenous poisoning; basis of emergency under the thermal lesions; basis of emergency under the thermal lesions; basis of emergency with infectious diseases; basis of emergency with infectious diseases; basis of emergency for acute diseases and injuries in urology; basis of emergency for acute diseases and injuries in urology;

49. General Skills: obtain information about the disease; obtain information about the disease; to apply objective methods of examination of the patient, to identify common and specific symptoms of the disease; to apply objective methods of examination of the patient, to identify common and specific symptoms of the disease; assess the severity of the patient, the cause of this condition; assess the severity of the patient, the cause of this condition; define the scope and sequence of resuscitation, provide necessary medical care; define the scope and sequence of resuscitation, provide necessary medical care; determine the needing of application of special methods of investigation (electrocardiography), to perform and to interpret; determine the needing of application of special methods of investigation (electrocardiography), to perform and to interpret; justify the serial diagnosis, plan and tactics of the patient, evidence of hospitalizations, provide transportation to the hospital; justify the serial diagnosis, plan and tactics of the patient, evidence of hospitalizations, provide transportation to the hospital; arrange medical documentation provided by the legislation on health care. arrange medical documentation provided by the legislation on health care.

50. Special skills: In the intensive care ambulance, surgeon should know and be able to: clinical and pharmacological study of the use of the mediator (M- and H-cholinomimetics and holinilitics, alpha and beta - agonists and blockers), antiarrhythmics, narcotic analgesics, devices used for infusion therapy; clinical and pharmacological study of the use of the mediator (M- and H-cholinomimetics and holinilitics, alpha and beta - agonists and blockers), antiarrhythmics, narcotic analgesics, devices used for infusion therapy; indications and methods of resuscitation, the conditions out of it, features of resuscitation in children and infants; indications and methods of resuscitation, the conditions out of it, features of resuscitation in children and infants; reasons for the development, classification and treatment of allergic and comatose states; reasons for the development, classification and treatment of allergic and comatose states; features of reanimation and intensive care units in drowning, hanging in; features of reanimation and intensive care units in drowning, hanging in; major components of general anesthesia, used in the prehospital phase, the mechanism of action and methods of use of nitrous oxide, Trillo, ftorotana, barbiturates, hydroxybutyrate, sodium, ketamine, drugs major components of general anesthesia, used in the prehospital phase, the mechanism of action and methods of use of nitrous oxide, Trillo, ftorotana, barbiturates, hydroxybutyrate, sodium, ketamine, drugs

51. neyroleptoanalgesia, pharmacodynamics, and ways to use local anesthetics; neyroleptoanalgesia, pharmacodynamics, and ways to use local anesthetics; Inhalation of anesthesia equipment and its characteristics and operation; Inhalation of anesthesia equipment and its characteristics and operation; equipment for ventilation, its characteristics and operation. equipment for ventilation, its characteristics and operation. In the emergency state in the internal medicine clinic, in emergency room physician needs to know: diagnosis and emergency care in coronary artery disease, its modern classification, diagnosis of angina, myocardial infarction and its complications, the principles of intensive therapy; diagnosis and emergency care in coronary artery disease, its modern classification, diagnosis of angina, myocardial infarction and its complications, the principles of intensive therapy; diagnosis and treatment of emergency conditions in the inflammatory, degenerative lesions, heart defects and cardiomyopathy; diagnosis and treatment of emergency conditions in the inflammatory, degenerative lesions, heart defects and cardiomyopathy; diagnosis and emergency treatment for arrhythmia and heart block; diagnosis and emergency treatment for arrhythmia and heart block; diagnosis and emergency treatment for arterial hypertension; diagnosis and emergency treatment for arterial hypertension;

52. methods of recording and transcript of the electrocardiogram and its patterns of myocardial infarction, rhythm disturbances and reducibility; methods of recording and transcript of the electrocardiogram and its patterns of myocardial infarction, rhythm disturbances and reducibility; diagnosis and emergency treatment at pneumonia, acute obstructive laryngotracheitis, pulmonary embolism, bronchial asthma and asthmaticus status; diagnosis and emergency treatment at pneumonia, acute obstructive laryngotracheitis, pulmonary embolism, bronchial asthma and asthmaticus status; diagnosis and emergency care with spontaneous pneumothorax and pulmonary hemorrhage; diagnosis and emergency care with spontaneous pneumothorax and pulmonary hemorrhage; diagnosis and emergency care for peptic ulcer and its complications, diseases of the esophagus (hiatal hernia, changes in varicose veins); diagnosis and emergency care for peptic ulcer and its complications, diseases of the esophagus (hiatal hernia, changes in varicose veins); epidemiology of hepatitis A and B, Approach to the Patient with their diagnosis, acute care in hepatic coma; epidemiology of hepatitis A and B, Approach to the Patient with their diagnosis, acute care in hepatic coma; diagnosis and emergency care for gallstone disease, acute pancreatitis, indications for hospitalization; diagnosis and emergency care for gallstone disease, acute pancreatitis, indications for hospitalization;

53. diagnosis and emergency care for acute pyelonephritis, urolithiasis, uremic coma; diagnosis and emergency care for acute pyelonephritis, urolithiasis, uremic coma; medical diagnosis and tactics in aneurysm of the abdominal aorta; medical diagnosis and tactics in aneurysm of the abdominal aorta; diagnosis and emergency care for patients with diabetes (hypoglycemic condition, diabetic acidosis); diagnosis and emergency care for patients with diabetes (hypoglycemic condition, diabetic acidosis); diagnosis and emergency care in pheochromocytoma, adrenal insufficiency; diagnosis and emergency care in pheochromocytoma, adrenal insufficiency; diagnosis and emergency care in hypothyroid coma, and thyrotoxicosis; diagnosis and emergency care in hypothyroid coma, and thyrotoxicosis; urgent status at hematocytoblastdoses and hemorrhagic diathesis. urgent status at hematocytoblastdoses and hemorrhagic diathesis.

54. I n the field of emergency conditions in acute diseases and injuries of abdominal and thoracic, physician joint ventures must know: I n the field of emergency conditions in acute diseases and injuries of abdominal and thoracic, physician joint ventures must know: diagnosis and tactics in acute appendicitis, especially in pregnancy diagnosis, childhood and old age; diagnosis and tactics in acute appendicitis, especially in pregnancy diagnosis, childhood and old age; diagnosis and tactics in strangulated hernia, the most common complications; diagnosis and tactics in strangulated hernia, the most common complications; diagnosis and tactics in acute intestinal obstruction, disorders of homeostasis and methods of their correction; diagnosis and tactics in acute intestinal obstruction, disorders of homeostasis and methods of their correction; diagnosis and tactics in damage to the stomach, hospital injuries of parenchymatous and hollow organs, especially in the diagnosis of closed injuries of the abdomen; diagnosis and tactics in damage to the stomach, hospital injuries of parenchymatous and hollow organs, especially in the diagnosis of closed injuries of the abdomen; diagnosis and emergency care for injuries of the chest, the mechanisms of ODN, the principles of treatment of various types of pneumothorax, hemothorax in tactics, emergency on pre-hospital. diagnosis and emergency care for injuries of the chest, the mechanisms of ODN, the principles of treatment of various types of pneumothorax, hemothorax in tactics, emergency on pre-hospital.

55. In the field of traumatology emergency doctor needs to know: In the field of traumatology emergency doctor needs to know: structure damage due to injuries of the musculoskeletal system, the value of pain and anti-shock; structure damage due to injuries of the musculoskeletal system, the value of pain and anti-shock; diagnosis and emergency care for soft tissue injuries, fractures and dislocations; diagnosis and emergency care for soft tissue injuries, fractures and dislocations; diagnosis and features of emergency care at injuries of the pelvis and spine; diagnosis and features of emergency care at injuries of the pelvis and spine; classification of open lesions, classification of wounds and their treatment methods and ways of preventing; classification of open lesions, classification of wounds and their treatment methods and ways of preventing; infection; infection; Features of diagnosis, principles of travmatogenez with combined injuries, medical events on pre-hospital; Features of diagnosis, principles of travmatogenez with combined injuries, medical events on pre-hospital; features of injuries of locomotor apparatus in children. features of injuries of locomotor apparatus in children.

56. In the field of emergency conditions in diseases and injuries of the ear, nose and throat, physician of joint ventures must know: In the field of emergency conditions in diseases and injuries of the ear, nose and throat, physician of joint ventures must know: principles of diagnosis and treatment of wounds and foreign bodies; principles of diagnosis and treatment of wounds and foreign bodies; diagnosis and emergency care for fractures of the nasal bones, nasal bleeding, intracranial complications of diseases of the nose and paranasal sinuses (meningitis, brain abscess); diagnosis and emergency care for fractures of the nasal bones, nasal bleeding, intracranial complications of diseases of the nose and paranasal sinuses (meningitis, brain abscess); diagnosis and emergency care for injuries of the pharynx, larynx and esophagus, suppurative processes and foreign bodies. diagnosis and emergency care for injuries of the pharynx, larynx and esophagus, suppurative processes and foreign bodies. In the field of emergency conditions in injuries and diseases of the nervous system, physician joint ventures must know: classification and diagnosis of traumatic brain injury. The clinical course of different types of komotsionno-contusion syndrome, general principles of treatment in pre-hospital ; classification and diagnosis of traumatic brain injury. The clinical course of different types of komotsionno-contusion syndrome, general principles of treatment in pre-hospital ; classification and diagnosis of spinal cord injury, treatment guidelines, particularly transportation; classification and diagnosis of spinal cord injury, treatment guidelines, particularly transportation;

57. classification, diagnosis and treatment of convulsive states, peculiarities of development in children; classification, diagnosis and treatment of convulsive states, peculiarities of development in children; classification, diagnosis and emergency care in acute disorders of cerebral circulation; classification, diagnosis and emergency care in acute disorders of cerebral circulation; diagnosis and emergency care for acute inflammatory diseases of the brain and spinal cord and its membranes. diagnosis and emergency care for acute inflammatory diseases of the brain and spinal cord and its membranes. In the field of emergency conditions in diseases and injuries of the eye, emergency doctor needs to know: symptoms and emergency care in an acute attack of glaucoma; symptoms and emergency care in an acute attack of glaucoma; characterization of wounds and burns of eyes, the principles of emergency care, indications for hospitalization. characterization of wounds and burns of eyes, the principles of emergency care, indications for hospitalization.

58. In the field of urgent conditions in obstetric-gynecology, physician joint ventures must know: In the field of urgent conditions in obstetric-gynecology, physician joint ventures must know: etiology, pathogenesis and clinic abortion pregnant, emergency care for eclampsia; etiology, pathogenesis and clinic abortion pregnant, emergency care for eclampsia; diagnosis and emergency care in abortion and premature delivery, the pathogenesis of hemorrhage in preterm labor; diagnosis and emergency care in abortion and premature delivery, the pathogenesis of hemorrhage in preterm labor; general principles of management of labor outside the hospital; general principles of management of labor outside the hospital; diagnosis of bleeding in late pregnancy, childbirth and the postpartum period; diagnosis of bleeding in late pregnancy, childbirth and the postpartum period; pathogenesis of hemorrhagic shock in obstetrics, the principles of intensive therapy; pathogenesis of hemorrhagic shock in obstetrics, the principles of intensive therapy; clinical manifestations of septic disease (metroendometritis, peritonitis), and emergency care for them; clinical manifestations of septic disease (metroendometritis, peritonitis), and emergency care for them; diagnosis and emergency care for an ectopic pregnancy, ovarian apoplexy and dysfunctional uterine bleeding; diagnosis and emergency care for an ectopic pregnancy, ovarian apoplexy and dysfunctional uterine bleeding; diagnosis and tactics in acute inflammatory diseases of female genital mutilation. diagnosis and tactics in acute inflammatory diseases of female genital mutilation.

59. In the emergency conditions of mental illness, JV doctor needs to know: In the emergency conditions of mental illness, JV doctor needs to know: clinical psychiatric syndromes, their classification, principles of emergency care; clinical psychiatric syndromes, their classification, principles of emergency care; clinical manifestations of schizophrenia and acute care in the prehospital phase in its aggravations; clinical manifestations of schizophrenia and acute care in the prehospital phase in its aggravations; diagnosis and emergency care for alcohol psychosis, manic- depressive psychosis; diagnosis and emergency care for alcohol psychosis, manic- depressive psychosis; arreactive states arreactive states In the field of toxicology physician joint ventures must know: classification of poisons on toxicity, the main factors determining the severity of poisoning; classification of poisons on toxicity, the main factors determining the severity of poisoning; classification of acute poisoning, pathological syndromes in acute poisoning, current treatment guidelines; classification of acute poisoning, pathological syndromes in acute poisoning, current treatment guidelines; Toxicology especially in childhood, clinical features of acute poisoning in elderly and senile age. Toxicology especially in childhood, clinical features of acute poisoning in elderly and senile age.

60. In the field of emergency at thermal lesions physician of SP needs to know: In the field of emergency at thermal lesions physician of SP needs to know: general information on burns, their classification, the periods of burn disease, pathogenesis and clinic of burn shock; general information on burns, their classification, the periods of burn disease, pathogenesis and clinic of burn shock; methods of intensive therapy; methods of intensive therapy; diagnosis and emergency care when the sun and heat stroke, the general cooling and frostbite. diagnosis and emergency care when the sun and heat stroke, the general cooling and frostbite. In the field of emergency conditions in infectious diseases physician joint ventures must know: In the field of emergency conditions in infectious diseases physician joint ventures must know: etiology and epidemiology, diagnosis and emergency care at tifoparatifoz diseases; etiology and epidemiology, diagnosis and emergency care at tifoparatifoz diseases; salmonellosis, nutritional diseases, botulism, influenza and its complications, and diphtheria; salmonellosis, nutritional diseases, botulism, influenza and its complications, and diphtheria; diagnosis and emergency care with meningococcal infection, meningitis, encephalitis, tetanus; diagnosis and emergency care with meningococcal infection, meningitis, encephalitis, tetanus;

61. medical tactics, self-protection measures in particularly dangerous and quarantine infections (cholera, medical tactics, self-protection measures in particularly dangerous and quarantine infections (cholera, plague, anthrax, AIDS); plague, anthrax, AIDS); features of the course and first aid for infectious diseases in newborns. features of the course and first aid for infectious diseases in newborns. In the field of emergency conditions in acute diseases and injuries in urology should know: semiotics of urological diseases, urgent care, in acute urinary retention; semiotics of urological diseases, urgent care, in acute urinary retention; basics of diagnosis and emergency care in inflammatory diseases of genital organs in men; basics of diagnosis and emergency care in inflammatory diseases of genital organs in men; basics of diagnosis and emergency care for injuries of urinary tract. basics of diagnosis and emergency care for injuries of urinary tract.

62. Manipulation: Manipulation: endotracheal intubation; endotracheal intubation; aspiration of fluid from the respiratory tract; aspiration of fluid from the respiratory tract; ventilation without devices and machines with a "Lada", "Pneumatic", AN-8, DN-10; ventilation without devices and machines with a "Lada", "Pneumatic", AN-8, DN-10; closed cardiac massage; closed cardiac massage; puncture of peripheral veins; puncture of peripheral veins; venesection; venesection; inhalation of oxygen; inhalation of oxygen; nitrous oxide anesthesia, analgesia trilen; nitrous oxide anesthesia, analgesia trilen; gastric lavage; gastric lavage; tracheostomy and konikotomiya; tracheostomy and konikotomiya; technique of recordings and transcriptions of the electrocardiogram; technique of recordings and transcriptions of the electrocardiogram; technology cardioversion (defibrillation of the heart) techniques to temporarily stop bleeding; technology cardioversion (defibrillation of the heart) techniques to temporarily stop bleeding; puncture of pleural cavity with air-and hemothorax; puncture of pleural cavity with air-and hemothorax;

63. Transport immobilization; Transport immobilization; implementation of closure: vagosimpatic, paravertebral, sakrospinal by Shkolnikov, blockade of the femoral and sciatic nerve; implementation of closure: vagosimpatic, paravertebral, sakrospinal by Shkolnikov, blockade of the femoral and sciatic nerve; execution of case anesthesia; execution of case anesthesia; imposition of bandage turbans, anterior and posterior tamponade in nasal hemorrhages. imposition of bandage turbans, anterior and posterior tamponade in nasal hemorrhages.

64. INSTRUCTIONS equipping specialized mobile teams (teams of intensive care) station (office) NSR Stretcher Stretcher A set of transport buses A set of transport buses Chance collar, hard headholder Chance collar, hard headholder bus Dieterichs bus Dieterichs bus Cramer bus Cramer bus Yelanskaya bus Yelanskaya Shield for patients with damage to the spine and pelvis Shield for patients with damage to the spine and pelvis A set of sanitary equipment: A set of sanitary equipment: pillow pillow pillowcase pillowcase sheets sheets sterile sheets sterile sheets towels towels blanket blanket scarves medical scarves medical capacity to collect vomit capacity to collect vomit probe for gastric lavage probe for gastric lavage

65. Sterile generic package (set) Sterile generic package (set) including: including: Kocher's forceps Kocher's forceps scissors scissors pupochnics pupochnics wipes wipes ligature ligature diaper diaper pear rubber pear rubber portable electrocardiograph portable electrocardiograph Electric current converter Electric current converter Apparatus for feeding anesthetic nitrous oxide Apparatus for feeding anesthetic nitrous oxide Breathing apparatus manual Breathing apparatus manual pneumo-oxygenator pneumo-oxygenator Set for intubation: laryngoscope laryngoscope replacement Blades replacement Blades tracheal tubes of different sizes tracheal tubes of different sizes adapters adapters

66. conductors - mandrin conductors - mandrin gag gag glossotilt glossotilt ducts ducts Device for transferring liquids in the machine Device for transferring liquids in the machine Apparatus for measuring blood pressure Apparatus for measuring blood pressure Set for an ambulance in the box - installation: Set for an ambulance in the box - installation: medicines medicines strophanthin 0.05% to 1.0 ml in amp. strophanthin 0.05% to 1.0 ml in amp. Korglikon 0.06% to 1.0 ml in amp. Korglikon 0.06% to 1.0 ml in amp. adrenaline g / x 0.1% 1.0 lm in amp. adrenaline g / x 0.1% 1.0 lm in amp. norepinephrine 0.2% 1.0 ml in amp norepinephrine 0.2% 1.0 ml in amp naloxone in 2.0 ml in amp. naloxone in 2.0 ml in amp. Lasix 20 mg 2.0 ml Lasix 20 mg 2.0 ml atropine 0.1% 1.0 ml in amp. atropine 0.1% 1.0 ml in amp. dipiroksim 15% in 1.0 ml in amp. dipiroksim 15% in 1.0 ml in amp. pentamin 5% to 1.0 ml in amp. pentamin 5% to 1.0 ml in amp. benzogeksony 2.5% 1.0 ml in amp. benzogeksony 2.5% 1.0 ml in amp. chlorpromazine 2.5% 2.0 ml in amp. chlorpromazine 2.5% 2.0 ml in amp. vikasol 1% to 1.0 ml in amp. vikasol 1% to 1.0 ml in amp. diphenhydramine 1% 1.0 ml in amp diphenhydramine 1% 1.0 ml in amp pipolfen 2.5% 2.0 ml in amp pipolfen 2.5% 2.0 ml in amp

67. ascorbic acid 5% in 1.0 ml ampoules promedol 2% 1.0 ml Panangin 10.0 ml in amp. lidocaine 2% 2.0 ml in amp. Mannitol 30.0 vials fentanyl 0.005% to 2.0 ml in amp. Droperidol 25 mg of 10.0 ml vial Relanium (seduksen) 0.5% ml in amp. sodium chloride 0.9% 5.0 ml in amp. Water for injection to 10.0 ml in amp. Glucose 40% 10.0 amp. ascorbic acid 5% in 1.0 ml ampoules promedol 2% 1.0 ml Panangin 10.0 ml in amp. lidocaine 2% 2.0 ml in amp. Mannitol 30.0 vials fentanyl 0.005% to 2.0 ml in amp. Droperidol 25 mg of 10.0 ml vial Relanium (seduksen) 0.5% ml in amp. sodium chloride 0.9% 5.0 ml in amp. Water for injection to 10.0 ml in amp. Glucose 40% 10.0 amp. maprocaine 2% 5.0 ml in amp. procaine 0.5% 5.0 ml in amp. aminophylline 2.4% in 10 ml ampoules. calcium chloride 10% 10.0 ml in amp. sodium gluconate 10% 10.0 ml in amp. novokainamid 10% in 5.0 ml in amp. verapamil (fenoptin) in 2.0 ml ampoules obzidan 0.1% PA5 ml in amp. maprocaine 2% 5.0 ml in amp. procaine 0.5% 5.0 ml in amp. aminophylline 2.4% in 10 ml ampoules. calcium chloride 10% 10.0 ml in amp. sodium gluconate 10% 10.0 ml in amp. novokainamid 10% in 5.0 ml in amp. verapamil (fenoptin) in 2.0 ml ampoules obzidan 0.1% PA5 ml in amp.

68. unitiol 5% to 5.0 ml in amp. bemegrit 0.5% 5 ml amp. penicillin 1 million vials heparin (5000 ed.v 1.0 ml) 5.0 ml vials prednisolone 30 ml in amp. chloramphenicol 0.5 vials Nitroglycerin 1% 10 ml vial 1 glucose 5% 400.0 ml vial "Disol" to 400.0 ml vial "Atsesol" to 400.0 ml vial unitiol 5% to 5.0 ml in amp. bemegrit 0.5% 5 ml amp. penicillin 1 million vials heparin (5000 ed.v 1.0 ml) 5.0 ml vials prednisolone 30 ml in amp. chloramphenicol 0.5 vials Nitroglycerin 1% 10 ml vial 1 glucose 5% 400.0 ml vial "Disol" to 400.0 ml vial "Atsesol" to 400.0 ml vial ethyl alcohol 33% 10.0 in the bottle ethyl alcohol 96% 30.0 ml vial ethyl alcohol 70% 10.0 ml vial Hydrogen peroxide 3% 50.0 ml vial iodine 5% alcoholic solution of 30.0 ml vial ammonia 10% solution of 30.0 ml in vial polyglukin to 400.0 ml vial sodium chloride 0.9% to 400.0 ml vial ethyl alcohol 33% 10.0 in the bottle ethyl alcohol 96% 30.0 ml vial ethyl alcohol 70% 10.0 ml vial Hydrogen peroxide 3% 50.0 ml vial iodine 5% alcoholic solution of 30.0 ml vial ammonia 10% solution of 30.0 ml in vial polyglukin to 400.0 ml vial sodium chloride 0.9% to 400.0 ml vial Rehydron to 28 grams. packaged nifedipine 10 mg in the Table. izoket (aerosol) dopamine 0.5% 5.0 ml in amp. Rehydron to 28 grams. packaged nifedipine 10 mg in the Table. izoket (aerosol) dopamine 0.5% 5.0 ml in amp.

69. b) dressing Bandage 14cm x 7m 5m x 10cm Bandage Bandage 5m x 7 cm cotton-gauze pads Band-Aid 4cm x 5m Absorbent cotton wool in the gr. c) tools, health products, etc. - stethoscope syringes for single use 20-gram syringes for single use 10-gram Disposable syringes 5 gram syringes for single use 2-gram scissors tweezers clamp probe for tamponade of the nose stall metal metal spatula silk surgical ampoules medical thermometer beaker clamp probe for tamponade of the nose stall metal metal spatula silk surgical ampoules medical thermometer beaker

70. rubber band for venipuncture pipette system for blood transfusions and blood products (disposable) medical rubber gloves (pair) g) sterile sets rubber band for venipuncture pipette system for blood transfusions and blood products (disposable) medical rubber gloves (pair) g) sterile sets  Tracheotomy set (in sterile packaging), including:  Scalpels  hooks tracheotomy  surgical tweezers  anatomic forceps  needle holder  fluted tube surgery  medical scissors with sharp point  medical scissors blunt curved  tracheotomy tube number 2  tracheotomy tube number 5  dilator tracheotomy  haemostatic clamps  surgical silk number 3 (in amps).

71. Kit arteriovenosektsii in sterile packaging, including: scalpel surgical tweezers haemostatic clamps surgical needle Surgical gloves (pair) needle for intracardiac injection (in sterile packaging) set of flexible catheters for children Kit arteriovenosektsii in sterile packaging, including: scalpel surgical tweezers haemostatic clamps surgical needle Surgical gloves (pair) needle for intracardiac injection (in sterile packaging) set of flexible catheters for children A set of test strips to detect glucose in urine A set of test strips to detect glucose in urine

72. This equipment is recommended for visiting medical emergency teams and emergency medical care is minimal. This equipment is recommended for visiting medical emergency teams and emergency medical care is minimal. At the discretion of management stations can be replaced by types of anesthesia-respiratory and electronic equipment, if necessary, extended range and increased the number of drugs, dressings, etc. At the discretion of management stations can be replaced by types of anesthesia-respiratory and electronic equipment, if necessary, extended range and increased the number of drugs, dressings, etc. Interior design should provide for car seats and brackets for additional equipment in case of using the machine as a dedicated ambulance crews. Interior design should provide for car seats and brackets for additional equipment in case of using the machine as a dedicated ambulance crews. Brigade to provide medical care for children equipped with a linear view of a set of tires, tools, catheters, probes, anesthesia masks, etc., designed for children age. Brigade to provide medical care for children equipped with a linear view of a set of tires, tools, catheters, probes, anesthesia masks, etc., designed for children age.

73. Thank you for attention!!!