When an ambulance is called. Rules for calling emergency medical services. Reasons for calling an ambulance for urgent reasons

Emergency medical services on the territory of the Russian Federation are provided to patients who seek help directly from the state government.

gift and municipal medical organizations of emergency medical services.

The EMS call is carried out:

By telephone by dialing numbers “03”, “103”, “112” and (or) telephone numbers of a medical organization providing emergency medical services;

Via short text messages

When directly contacting a medical organization providing emergency medical services.

The patient calling the ambulance (his relatives, other persons) must:

Clearly and accurately answer all questions from the paramedic (nurse) regarding receiving EMS calls and transferring them to field EMS teams;

Give the exact address of the call (locality, city district, street, house and apartment number, floor, entrance number and front door lock code). In cases where the exact location of the patient (victim) is unknown, it is necessary to indicate the route to the address or place of the incident, and name its well-known landmarks;

State the name, gender, and age of the patient. If the calling EMS does not know the patient’s passport details, then it is necessary to indicate his gender and approximate age;

Describe the patient’s complaints, external manifestations (signs) of his condition (disease) as accurately and reliably as possible;

Provide a contact phone number;

If possible, organize a meeting of the emergency services team at the gate of the house, entrance or well-known landmarks;

Isolate pets that may complicate the provision of medical care to the patient, as well as cause harm to the health and property of medical workers of the emergency medical team;

Provide the EMS team with unhindered access (in shoes, with equipment) to the patient and create the necessary conditions for providing EMS;

Provide the EMS team with the patient’s documents (passport, insurance policy and medical documents), if available;

Assist in transporting the patient to the vehicle of the mobile ambulance team;

In cases of aggression by the patient or those around him, including those under the influence of alcohol, drugs or toxic substances, acute mental disorder, threatening the health or life of emergency medical service workers, medical care and transportation of the patient are carried out in the presence of police officers.

Persons who committed illegal actions against emergency medical services workers (insults, threats, hooliganism) that caused harm to their health or property are held accountable in accordance with the legislation of the Russian Federation.

Persons who knowingly made a false call to an EMS team to a patient who does not need EMS are brought to administrative responsibility in accordance with Art. 19.13 Code of Administrative Offenses of the Russian Federation. A deliberately false call is a call (made orally, in writing, through other persons) to the EMS team by

messages of deliberately distorted, incorrect, unreliable information to a patient who does not need emergency medical services in an emergency or urgent manner.

In cases of public appeal for reasons that cannot be fulfilled by EMS teams, the paramedic (nurse) who receives EMS calls and transfers them to field EMS teams has the right to refuse service to the caller. Refusal to service a call is recorded in the log of reception and transmission of NMS calls. The caller must be given recommendations for contacting the appropriate medical organization, indicating its address and telephone number. In case of non-standard or conflict situations, the decision on the tactics of action of EMS personnel is made by the senior (responsible) shift employee of the EMS medical organization.

Accompanying a patient to hospitals (by relatives or other persons) is carried out with the permission of the senior (responsible) employee of the emergency medical team. When transporting minor children to hospitals, it is recommended that they be accompanied by parents or legal representatives, employees of child care institutions, if they are present at the place of emergency medical care.

The responsibilities of medical organizations providing emergency medical services do not include:

Carrying out scheduled doctor's appointments (injections, intravenous infusions, dressings, recording electrocardiograms - ECG and other appointments);

Providing dental care (patients with acute dental pain are received for emergency dental care in on-duty dental medical organizations);

Removing ticks;

Conducting vaccinations;

Issuing certificates of incapacity for work, health reports, prescriptions and other medical documents, conducting any examinations or examinations;

Visiting patients under the supervision of a local doctor for chronic diseases whose condition does not require urgent medical intervention;

Transporting patients from medical organizations to their place of residence (stay);

Transportation of patients for diagnostic studies and consultations;

Delivery of medical consultants, except in cases threatening the life and health of patients;

Transportation of blood and its components, except in cases threatening the life and health of patients;

Transportation of corpses.

Call from a landline: 03 or 103.
Call from MTS, MEGAFON, TELE2 and U-tel phones: 103 or 030.

Call from BEELINE phones: 103 or 003.
Call from Sky-Link and MOTIV phones: 903.
Call from a mobile phone: 112 (in Russian and English); possible with:
- lack of funds in your account,
- blocked SIM card,
— no phone SIM card.

The criterion for a successful call is the dispatcher’s phrase “Your call has been accepted” said to the caller at the end of the conversation. The call is not accepted if the caller’s answers to the dispatcher’s questions are incomplete and inaccurate (in accordance with the call acceptance algorithm).

As a rule, the connection with the operator “03” occurs within 10-15 seconds, however, when you call the number “03” during the hours of mass calls, you can hear the answering machine information: “Ambulance. Please wait, they will definitely answer you.” Under no circumstances should you hang up and start calling again, this leads to a delay and you again end up at the end of the queue of subscribers waiting for an answer!

If the dispatcher picks up the phone, you will hear: “Ambulance, Moscow city, dispatcher 453 (for example), what happened to you?”

Remember the dispatcher's number.

The question about the phone number from which you are calling is one of the first to ask if the number is not detected automatically, so that when the call is disconnected you can contact the caller and clarify the information that you did not have time to write down (in addition to the phone number, you must provide your last name, first name, patronymic and indicate who you are calling for help - you are calling for yourself, or you are calling as a passer-by, or it is bad for your relative).

The minimum amount of information provided by a citizen (patient) calling an ambulance must contain:

last name, first name, patronymic, gender, approximate age of the person who needs help (if known); if there are several victims, first of all it is necessary to report their exact number;

what manifestations and symptoms made you call an ambulance;

what you did depending on the situation;

other information at the request of the dispatcher, necessary for quickly and correctly receiving a call and making a decision on it (in particular, remember or write down all the chronic and past illnesses of the people with whom you live).

The next step is to record the address part of the call in the following sequence: street, house, building (if any), apartment, entrance, floor, code or intercom (how to enter or will be greeted). You should indicate the access routes to your home if they are difficult (road repairs, for example). If the incident did not occur in the apartment, then the exact landmarks and access routes should be indicated! If possible, organize a meeting for the arriving brigade, indicate where and who will meet the brigade, especially at night in the private sector.

Checking the address (the dispatcher must check the Moscow district to eliminate errors).

We hang up the phone only after the dispatcher double-checks the address and hangs up with the words: “Your call has been accepted, the team will arrive now.”

Next, the dispatcher, having determined the composition (medical team or paramedic), the profile of the emergency medical team (general or specialized) and the urgency of the call, transfers it to the appropriate emergency medical team.

Ambulance assistance is divided into emergency and urgent according to urgency (emergency cases account for approximately 30% of the total number of calls). In Moscow, an ambulance team should arrive in less than 20 minutes, an emergency team - within 2 hours. In Moscow, emergency care is provided by teams of substations organized at clinics, and the ambulance dispatcher transfers the call there. In other regions, emergency teams are located in the ambulance service itself.

The person calling the ambulance must provide:

meeting the team at the gate of the house or entrance to speed up the arrival of medical personnel to the sick or injured person;

unobstructed access directly to the patient;

conditions for providing assistance (chairs; a teaspoon for examining the pharynx; a telephone for possible calls; sufficient lighting in the room; if you have an outpatient card or hospital records at home, they may be needed; a clean towel for washing hands is not needed, because now doctors use disinfectants from their beds);

isolation of pets;

assistance in transporting a sick or injured person to an ambulance (agree in advance with neighbors if the brigade’s strength is not enough).

Upon arrival of the emergency medical team, the paramedic indicates the patient’s complaints on the call card.

In accordance with Art. 32 of the “Fundamentals of Legislation on the Protection of the Health of Citizens of the Russian Federation” there must be the patient’s informed consent to medical intervention, taking into account the risk of possible complications, obtained in writing. Next, the totality of information obtained during a medical examination by interviewing the person being examined and (or) people who know him is entered. Then an objective examination of the patient (victim) is carried out: general condition, level of consciousness, skin and visible mucous membranes, peripheral lymph nodes, muscular and osteoarticular systems and other systems.

Next, the doctor or paramedic makes a decision: removal of the life-threatening condition or hospitalization of the victim (patient). The main role of the ambulance team is not to treat the patient at home, but to preserve the person’s life until he arrives at the hospital. When refusing medical intervention or hospitalization, the victim (patient) or his legal representative is explained in a form accessible to them, the possible consequences; the refusal of medical intervention or hospitalization is documented in the call card and signed by the citizen.

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Compiled on the basis of the website of the ambulance and emergency medical care service in the city of Moscow, order of the Ministry of Health of the Russian Federation dated June 20, 2013 N 388n “On approval of the Procedure for the provision of ambulance, including emergency specialized medical care”, job descriptions of ambulance workers.

Rules for calling an ambulance

The emergency medical team of the Smolevichi Central District Hospital can be called by calling 103 or by calling 59-0-62, when visiting the emergency department, via a direct line of communication with the district emergency department.

The call is received by a call-receiving paramedic.

When you receive a call, the dialogue is automatically recorded.

The paramedic registers the call on paper, determines the priority of the emergency medical team call and transfers the call to the team for service.

Calls are divided into:

emergency;

urgent;

urgent

Emergency calls include:

The patient loses consciousness;

Rash with high fever in children;

Poisoning of a patient with chemicals or drugs;

Hanging, drowning;

Extensive burn;

Deep and extensive wounds;

Convulsions;

Acute breathing disorders;

Emergency;

Road traffic accident with casualties;

Electrical injury;

Falling from a height higher than one's own height;

An emergency call is transmitted to the brigade no later than 4 minutes from the moment it is registered.

^ Urgent calls include:

Irregular heart rhythm (arrhythmia);

Heart attack;

Asthma attack;

Foreign body;

Bleeding (gastrointestinal, uterine, nasal);

Frostbite;

Sudden disturbances in motor activity

An urgent call is transferred to the brigade no later than 15 minutes from the moment it is registered.

^ Urgent calls include:

Significant change in blood pressure;

Allergy;

Headache;

Pain in the abdomen, back, chest;

Hemophilia;

Inappropriate behavior;

Renal colic;

High fever (unless the temperature is reduced by oral medications);

Acute urinary retention;

Food poisoning;

Sudden change in behavior in a child under 1 year of age;

Anesthesia;

Transporting a patient when called by a medical professional.

An emergency call is transferred by a paramedic to receive a call to an outpatient clinic (medical outpatient clinic, clinic) at the patient’s place of residence or to an emergency medical team no later than 1 hour from the moment of registration.

When an ambulance receives a call that is not related to the above, the paramedic who receives calls gives recommendations to the patient where to go for medical care.

There are situations when a large number of calls are received at the same time for an ambulance, and even if the call priority is correctly determined, there may be delays in service.

There are situations when a patient deliberately gives an unreliable reason for a call and distracts emergency medical teams, who at this time must work on emergency and urgent calls.

The ambulance service is an emergency service; an unfounded or false call to the emergency service is subject to administrative liability (fine).

Administration of the Smolevichi Central District Hospital

Ambulance assistance on the territory of the Russian Federation is provided to patients who seek help directly from state and municipal emergency medical organizations.
An emergency medical team can be called by telephone by dialing numbers “03” or “112”, by calling an emergency medical organization or by directly contacting an emergency medical organization.

Emergency medical care can also be provided in other situations that require emergency medical care (while on duty at mass events, in an emergency, when a brigade stops en route, etc.).
In regions where the structure of medical organizations has created medical care units that provide emergency care or emergency departments of outpatient medical organizations, they are assigned the functions of providing this assistance in the places where patients live (Part 7, Article 33 of the Federal Law No. 323FZ). During the opening hours of medical organizations providing medical care on an outpatient basis, this assistance is provided by local (family) doctors and general practitioners.

The patient (his relatives, other persons) calling an ambulance is obliged to:

Answer all questions from the paramedic (nurse) regarding receiving emergency medical calls and transferring them to visiting emergency medical teams;
Give the call address (locality, city district, street, house and apartment number, floor, entrance number and front door lock code). In cases where the exact location of the patient (injured) is unknown, it is necessary to indicate the route to the address or place of the incident, name its landmarks;
Provide the patient’s full name, gender, and age (if information is missing, indicate his gender and approximate age);
Describe the patient’s complaints, external manifestations (signs) of his condition (disease);
Provide a contact phone number;
If possible, arrange a meeting with the emergency medical team;
Isolate pets that may complicate the provision of medical care to the patient, as well as cause harm to the health and property of medical workers of the emergency medical team;
Provide the emergency medical team with unhindered access (in shoes, with equipment) to the patient and create the necessary conditions for providing emergency medical care;
Provide the emergency medical team with the patient’s documents (passport, insurance policy and medical documents), if available;
Assist in transporting the patient to the mobile ambulance vehicle;

In cases of aggression by the patient or those around him, including those under the influence of alcohol, drugs or toxic substances, acute mental disorder, threatening the health or life of emergency medical workers, medical care and transportation of the patient is carried out in the presence of police officers.

Persons who committed illegal actions against emergency medical workers (insults, threats, hooliganism) that caused harm to their health or property are held accountable in accordance with the legislation of the Russian Federation.
Persons who knowingly made a false call for an ambulance to a patient who does not need emergency medical care are held administratively liable in accordance with Art. 19.13 Code of Administrative Offenses of the Russian Federation. A deliberately false call is a call (made orally, in writing, through other persons) to an emergency medical team by reporting deliberately distorted, incorrect, inaccurate or incomplete information to a patient who does not need emergency medical care in an emergency or urgent manner.

In cases of public appeals for reasons not related to the provision of emergency medical care, the paramedic (nurse) who receives emergency medical calls and transfers them to mobile emergency medical teams, guided by this Procedure, has the right to refuse the caller to service the call. A refusal to service a call must be recorded in the call log, and the caller must be given recommendations for contacting the appropriate medical organization, indicating its address and telephone number.
In cases of non-standard or conflict situations, the decision on the tactics of action of emergency medical personnel is made by the senior (responsible) employee of the emergency medical service shift.
Accompanying a patient to hospitals (by relatives or other persons) is carried out with the permission of the senior (responsible) employee of the emergency medical team. When transporting minor children to hospitals, it is recommended that they be accompanied by parents or legal representatives, employees of child care institutions, if they are present at the scene of emergency medical care.

The responsibilities of mobile emergency medical teams do not include:

1. carrying out planned doctor’s appointments (injections, intravenous infusions, dressings, ECG registration and other appointments);
2. provision of dental care (patients with acute toothache receive emergency dental care in on-duty dental medical organizations);
3. removal of ticks for a patient who does not require emergency medical care;
4. vaccination;
5. issuing certificates of incapacity for work, health reports, prescriptions and other medical documents, conducting any examinations or examinations;
6. transportation of patients during planned hospitalization;
7. visiting patients under the supervision of a local doctor for chronic diseases whose condition does not require urgent medical intervention;
8. transporting patients from medical organizations to their place of residence (stay);
9. transportation of patients for diagnostic studies, consultations, hemodialysis sessions (with the exception of infectious patients who are a source of infection for others);
10. delivery of medical consultants, except for cases threatening the life and health of patients;
11. transportation of blood and its components, except for cases threatening the life and health of patients;
12. transportation of corpses.
2. Classifier of reasons for sending an emergency medical team
1.1 The reason for sending an emergency medical team to a call is a preliminary syndromic diagnosis and a brief description of the situation, formulated by a paramedic (nurse) for receiving emergency medical calls and transferring them to visiting emergency medical teams based on data received from the caller, and requiring urgent medical intervention.
2. Emergency medical care is provided in emergency and emergency forms.
1. Emergency medical care is provided for sudden acute diseases, conditions, exacerbation of chronic diseases that pose a threat to the patient’s life. The transfer of an emergency medical call for emergency indications to the visiting emergency medical teams by a paramedic (nurse) upon receiving and transferring them to the visiting team is carried out without delay.

In the event of an emergency medical call, the nearest available general emergency medical team is dispatched to the call.

Reasons for calling an ambulance in an emergency:

Sudden severe disturbances of consciousness;
Sudden severe breathing problems;
Sudden severe hemodynamic disturbances;
Sudden severe mental disorders;
Sudden severe pain syndrome;
Sudden pronounced dysfunction of any organ or system;
Injuries of any etiology - severe and moderate severity;
Chemical injury;
Sudden bleeding of any etiology;
Childbirth;
Duty in the event of an emergency or threat of emergency;

Calls to assist emergency medical personnel.

Emergency medical care is provided in case of sudden acute diseases, conditions, exacerbation of chronic diseases without obvious signs of a threat to the patient’s life. The dispatch of an emergency medical team for urgent reasons is carried out as emergency medical teams are released in the absence of calls for emergency reasons. The transfer of an emergency medical call for emergency indications to a visiting ambulance team by a paramedic (nurse) for receiving and transferring them to the visiting team is carried out within the following time frames: to the street - up to 15 minutes, to public places - up to 30 minutes, to places of residence - up to 4 -x hours.

Reasons for calling an ambulance for urgent reasons:

Sudden acute diseases (conditions) without obvious signs of a threat to life, requiring urgent medical intervention;
Sudden exacerbations of chronic diseases without obvious signs of a threat to life, requiring urgent medical intervention;
Departure to provide emergency medical care to patients who are unable to move independently for health reasons, as well as to patients suspected of having acute infectious diseases.
Confirmation of death (except for opening hours of outpatient clinics);
Sanitary transportation to hospitals on the orders of medical workers (including emergency medical teams) of patients with sudden acute diseases, conditions, exacerbations of chronic diseases without obvious signs of a threat to life, unable to move independently, as well as patients with acute infectious diseases;
Duty at public events within agreed time frames.
In cases of mass receipt of emergency calls, as well as in emergencies and natural disasters, the transfer of emergency medical calls for urgent reasons to emergency medical teams may be postponed by the decision of the responsible employee of the duty shift.

A person who knows the basics of first aid is the link between the victim and the emergency medical service. In this capacity, you must recognize that an episode of illness or injury is an emergency and then may need to provide first aid to the victim until emergency services arrive. The prompt arrival of emergency personnel increases the victim's chances of survival in a life-threatening emergency.

When to call an ambulance.

Sometimes you don’t know whether you should call an ambulance in this case; in addition, the victim may ask you not to do this because he is embarrassed to become the subject of general attention. Or sometimes you don't know whether the victim's condition is serious enough to send him to the hospital. As a general rule, an ambulance should be called in any of the following situations:

Unconscious state of the patient or changing level of consciousness;

Breathing problems (difficulty or lack of breathing);

Persistent chest pain or a feeling of pressure in the chest;

Lack of pulse;

Heavy bleeding;

Severe abdominal pain;

Vomiting blood or spotting (with urine, sputum, etc.);

Poisoning;

seizures, severe headache, or slurred speech;

Head, neck or back injuries;

Possibility of bone fracture;

Sudden onset of movement disorders.

Ambulance and the appropriate emergency services or police are also called in the following cases:

In case of fire or explosion;

Leakage of toxic substances;

Broken high-voltage electrical wires;

Industrial accidents;

Road traffic accidents;

The presence of a gunshot or knife wound.

For the rest, rely on your own intuition. If you think there's an emergency, you're probably right. Do not call or ask friends or family members for advice, thus wasting valuable time, but immediately report to the emergency services. It is better for the ambulance crew to conclude that the call was unnecessary than for the victim to not receive timely medical care when it is absolutely necessary.

How to call an ambulance.

It is preferable for someone else to call the ambulance. This will allow you to stay with the victim and not be interrupted from providing first aid.

The emergency telephone number is answered by a dispatcher located in the center. This person will decide which specialists need to be sent to the scene and may also give you first aid instructions before crews arrive.

Therefore, you or the other caller must provide the dispatcher with the correct information:

Report the exact location of the incident. Provide an address or location. Provide the name of the nearest intersecting streets (crossroads or roads), landmarks, building name, floor and apartment (office) number.
The phone number from which the call is made, who is calling “03”.
The victim's name and age.
What happened.
Number of victims.
Describe as accurately and reliably as possible the complaints of the patient or victim (chest pain, difficulty breathing, lack of pulse, bleeding, etc.).

If you are alone with the victim, shout for help. The scream will likely attract the attention of someone passing by. If no one responds to your call, then first provide first aid to the victim within a minute, and then try to call “03” yourself as quickly as possible. After this, return to the victim and continue providing first aid.

If you called an ambulance to your home, then provide the team with unhindered access to the sick or injured person and the necessary conditions for providing emergency medical care. If possible, arrange for the called ambulance to meet at the gate of your house or entrance. Isolate pets that may complicate the provision of medical care to a sick or injured person, as well as cause harm to the health and property of emergency medical workers. Provide the ambulance team with the patient's documents (passport, insurance policy and medical documents), if available.

Persons who have made insults, threats against the dispatcher, as well as hooliganism against emergency medical workers, causing harm to their health or property, are held accountable in accordance with the legislation of the Russian Federation.

Persons who knowingly made a false call to an ambulance are brought to administrative responsibility in accordance with Art. 19.13 Code of Administrative Offenses of the Russian Federation. A deliberately false call is a call (made orally, in writing, through other persons) to an emergency medical team by reporting deliberately distorted, incorrect, inaccurate or incomplete information to a patient who does not need emergency medical care in an emergency.

When not to call an ambulance.

The duties of an ambulance do not include visiting patients:

To carry out scheduled doctor’s appointments (injections, dressings, placing IVs, other appointments);

Under the supervision of a local doctor for chronic diseases, the condition of which does not require urgent medical intervention;

To provide dental care;

To remove ticks;

For issuing certificates of incapacity for work, health reports, issuing prescriptions and issuing other medical documents, as well as drawing up forensic medical examination reports;

For transportation during planned hospitalization.