The procedure for providing emergency medical care. Changes in the procedure for providing emergency, including specialized emergency medical care
1. Ambulance, including specialized emergency medical care, is provided to citizens in case of illnesses, accidents, injuries, poisoning and other conditions requiring urgent medical intervention. Ambulance, including specialized emergency medical care, is provided to citizens free of charge by medical organizations of the state and municipal healthcare systems.
2. Ambulance, including specialized emergency medical care is provided in an emergency or emergency form outside medical organization, as well as in outpatient and inpatient settings.
3. On the territory Russian Federation in order to provide emergency medical care There is a system of a single number for calling emergency medical care in the manner established by the Government of the Russian Federation.
4. When providing emergency medical care, if necessary, medical evacuation is carried out, which is the transportation of citizens in order to save lives and preserve health (including persons being treated in medical organizations that do not have the ability to provide the necessary medical care for life-threatening conditions , women during pregnancy, childbirth, the postpartum period and newborns, persons injured as a result emergency situations And natural Disasters).
5. Medical evacuation includes:
1) sanitary aviation evacuation carried out by aircraft;
2) sanitary evacuation carried out by land, water and other modes of transport.
6. Medical evacuation is carried out by mobile emergency medical teams, carrying out measures to provide medical care during transportation, including the use of medical equipment.
7. Medical organizations subordinate to federal authorities executive power has the right to exercise medical evacuation in the manner and on the terms established by the authorized federal body executive power. The list of specified medical organizations subordinate to federal executive authorities is approved by the authorized federal executive authority.
Advertisement organizing necessary medical care.
The emergency medical service in the Ulyanovsk region is represented by an emergency medical service station and emergency departments at central regional hospitals.
In dispatch services, number 03 inputs are installed and operate around the clock. The ambulance station is equipped with an automated control system for receiving and processing calls, recording is kept telephone conversations, which helps in resolving conflict situations. Cars and emergency medical stations were radioed, which led to more efficient work services by reducing vehicle mileage, travel time to the patient and time spent on calls.
Since 2012, a software and hardware complex for satellite navigation has been installed, which determines the location and speed of NSR vehicles. The software and hardware complex for satellite navigation is installed on 169 vehicles, and 33 automated workstations are equipped.
In total, the service has 186 ambulance vehicles (including the city of Dimitrovgrad), of which class “A” - 102 (54.8%), class “B” - 76 (40.9%), class “C” » – 8 (4.3%).
Class “C” cars are available in the city of Dimitrovgrad, Terengulsky, Novospassky and Nikolaevsky districts, which received cars as part of the program to reduce injuries on the roads.
The ambulance station and departments are provided with medicines, disposable instruments, consumables V in full and according to established standards.
In the Ulyanovsk region in 2012, 26 medical teams were formed, of which 9 teams to provide care to children, 102 paramedic teams,
1 intensive care team, 1 psychiatric team, 6 specialized teams, of which 4 are cardiological, 2 resuscitation teams.
Between the emergency medical service and other medical organizations of the Ulyanovsk region, continuity of work is carried out through hospitalization with accompanying sheets in hospitals and transfer of calls to the clinic.
In 2012, 418,548 visits were made, which is 3,770 less than in 2011, including 63,537 visits to children versus 61,355 in 2011 (+ 2,182),
to rural settlements – 56503, in 2011 – 54853 (+ 1650).
Assistance was provided to 359,939 patients with sudden illnesses, which
9944 more than in 2011, 42525 patients in accidents, which is 3304 more than in 2011.
65,744 people were hospitalized (+2522), 19,159 patients (- 13,559) were transported by emergency medical teams at the request of doctors from various medical institutions.
In 2012, there was a decrease in the total number of ambulance visits in the region by 3,770, and a decrease in the total number of calls was also noted by 3,364. The number of calls per 1,000 population decreased accordingly and amounted to 329.8 (in 2011 - 331). The decrease in the total number of calls is associated with a decrease in the number of unsuccessful calls, which has a positive effect on the work of emergency medical services.
In 2012, paramedic teams carried out 18,951 transports (2011 – 32,728). Number of persons who received outpatient care, amounted to 36,108, which is 1,426 more than last year.
The timeliness of EMS teams reaching the place of call within 20 minutes was 92.7% (387,994) of the total number of trips.
The air ambulance system in the Ulyanovsk region is represented by emergency and planned advisory medical care departments created on the basis of the Ulyanovsk Regional Clinical Hospital and the Ulyanovsk Regional Children's Clinical Hospital named after the political and public figure Yu.F. Goryachev using ground transport.
The departments have organized a 24-hour dispatch service for telephone emergency calls from health care facilities in the region.
In order to increase the efficiency and quality of work of the emergency medical service in the Ulyanovsk region, it is planned to:
retrofit and provide field teams with modern medical equipment;
to create a unified emergency medical service dispatch service in the Ulyanovsk region by consolidating and creating inter-district emergency medical service dispatch centers with the provision of information to field teams;
organize substations (two points of temporary stay of teams) of emergency medical care in the Zasviyazhsky and Leninsky districts of Ulyanovsk to serve a designated territory, which will significantly improve the availability and quality of emergency medical care to residents of the Zasviyazhsky and Leninsky districts of the city and achieve the indicative travel time of up to 20 minutes ;
continue to equip stations, substations and emergency departments with new ambulance transport;
purchase specialized EMS vehicles based on all-wheel drive vehicles with the ability to deploy a field triage point to provide assistance to a larger number of victims in various major incidents and emergencies.
Registered with the Ministry of Justice of Russia on August 16, 2013 N 29422
MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION
ORDER
MEDICAL CARE
In accordance with Part 2 of Article 37 Federal Law dated November 21, 2011 N 323-FZ “On the protection of the health of citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724; 2012, N 26, Art. 3442, 3446) I order:
1. Approve the attached Procedure for the provision of emergency, including specialized emergency medical care.
2. To recognize as invalid:
Order of the Ministry of Health and Social Development of the Russian Federation dated November 1, 2004 N 179 “On approval of the Procedure for the provision of emergency medical care” (registered by the Ministry of Justice of the Russian Federation on November 23, 2004, registration N 6136);
order of the Ministry of Health and Social Development of the Russian Federation dated August 2, 2010 N 586n "On amendments to the Procedure for the provision of emergency medical care, approved by order of the Ministry of Health and Social Development of the Russian Federation dated November 1, 2004 N 179" (registered by the Ministry of Justice of the Russian Federation August 30, 2010, registration N 18289);
order of the Ministry of Health and Social Development of the Russian Federation dated March 15, 2011 N 202n “On amending Appendix No. 3 to the Procedure for the provision of emergency medical care, approved by order of the Ministry of Health and Social Development of the Russian Federation dated November 1, 2004 N 179” ( registered by the Ministry of Justice of the Russian Federation on April 4, 2011, registration N 20390);
order of the Ministry of Health and Social Development of the Russian Federation dated January 30, 2012 N 65n "On introducing changes to the Procedure for providing emergency medical care, approved by order of the Ministry of Health and Social Development of the Russian Federation dated November 1, 2004 N 179" (registered by the Ministry of Justice of the Russian Federation March 14, 2012, registration N 23472).
V.I.SKVORTSOVA
Approved
by order of the Ministry of Health
Russian Federation
AMBULANCE SERVICES, INCLUDING EMERGENCY SPECIALIZED,
MEDICAL CARE
1. Present Order establishes the rules for the provision of emergency, including specialized emergency medical care on the territory of the Russian Federation.
2. Ambulance, including specialized emergency medical care, is provided in case of illnesses, accidents, injuries, poisoning and other conditions requiring urgent medical intervention.
3. Ambulance, including specialized emergency medical care, is provided on the basis of medical care standards.
4. Ambulance, including specialized emergency medical care, is provided in the following conditions:
a) outside a medical organization - at the place where the ambulance team is called, including specialized emergency medical care, as well as in vehicle during medical evacuation;
b) outpatient (in conditions that do not provide round-the-clock medical supervision and treatment);
c) stationary (in conditions that provide round-the-clock medical supervision and treatment).
5. Ambulance, including specialized emergency medical care, is provided in the following forms:
a) emergency - in case of sudden acute diseases, conditions, exacerbation chronic diseases posing a threat to the patient’s life;
b) urgent - in case of sudden acute diseases, conditions, exacerbation of chronic diseases without obvious signs of a threat to the patient’s life.
6. Ambulance, including specialized ambulance, medical care outside a medical organization is provided by medical workers of mobile ambulance teams.
7. Mobile emergency medical teams are dispatched to a call by a paramedic to receive emergency medical calls and transfer them to mobile emergency medical teams or by a nurse to receive emergency medical calls and transfer them to mobile emergency medical teams, taking into account the profile visiting team emergency medical care and forms of medical care.
8. Ambulance, including specialized emergency medical care in outpatient and inpatient settings is provided by medical workers of medical organizations providing medical care in outpatient and inpatient settings.
9. Emergency medical assistance is called:
a) by telephone by dialing numbers “03”, “103”, “112” and (or) telephone numbers of a medical organization providing emergency medical care;
b) using short text messages (SMS);
c) when directly contacting a medical organization providing emergency medical care.
10. If an emergency medical call is received, the nearest available general-purpose mobile ambulance team or specialized mobile ambulance team is dispatched to the call.
11. The reasons for calling an ambulance in an emergency are:
a) disturbances of consciousness that pose a threat to life;
b) breathing problems that pose a threat to life;
c) disorders of the circulatory system that pose a threat to life;
G) mental disorders, accompanied by the patient’s actions that pose an immediate danger to him or other persons;
e) sudden pain syndrome that poses a threat to life;
f) sudden dysfunction of any organ or organ system that poses a threat to life;
g) injuries of any etiology that pose a threat to life;
h) thermal and chemical burns that pose a threat to life;
i) sudden bleeding that poses a threat to life;
j) childbirth, threat of termination of pregnancy;
k) duty in the event of a threat of emergency, provision of emergency medical care and medical evacuation during liquidation health consequences emergency situation.
12. In the event of an urgent medical emergency call, the nearest available general-profile mobile ambulance team is dispatched to the call in the absence of emergency emergency medical calls.
13. The reasons for calling an ambulance in an emergency are:
a) sudden acute diseases(conditions) without obvious signs of a threat to life, requiring urgent medical intervention;
b) sudden exacerbations of chronic diseases without obvious signs of a threat to life, requiring urgent medical intervention;
c) declaration of death (except for the opening hours of medical organizations providing medical care on an outpatient basis).
14. When providing emergency, including specialized emergency medical care, medical evacuation is carried out if necessary.
15. Ambulance, including specialized emergency, medical care in inpatient conditions is provided by medical workers of the inpatient emergency department.
16. When a patient enters a medical organization to provide emergency medical care in a hospital setting, the diagnosis is clarified, diagnostics, dynamic observation and therapeutic and diagnostic measures are carried out in emergency medical care beds for a daily stay and, if there are medical indications, short-term treatment lasting no more than three days in short-stay emergency medical beds.
17. If there are medical indications, patients are sent from the inpatient emergency department to the specialized departments of the medical organization within which the inpatient emergency department has been created, or to other medical organizations to provide specialized, including high-tech, medical care.
18. In remote or hard-to-reach settlements (areas settlements), along highways To provide emergency, including emergency specialized medical care, branches (posts, route points) of emergency medical care can be organized, which are structural divisions a medical organization providing emergency medical care outside a medical organization.
19. Ambulance, including specialized emergency medical care, is provided in accordance with Appendices No. 1 - 15 to this Procedure.
Appendix No. 1
to the Procedure for providing
ambulance, including
emergency specialized
medical care,
approved by order
Ministry of Health
Russian Federation
IMPLEMENTATION OF MEDICAL EVACUATION WHEN PROVIDING AN AMBULANCE
MEDICAL CARE
1. These Rules determine the procedure for carrying out medical evacuation when providing emergency medical care (hereinafter referred to as medical evacuation).
2. These Rules do not apply to relations involving medical evacuation by federal government agencies.
3. Medical evacuation includes:
a) sanitary aviation evacuation carried out by air transport;
b) sanitary evacuation carried out by land, water and other modes of transport.
4. Medical evacuation is carried out by mobile emergency medical teams.
5. Medical evacuation can be carried out from the scene of the incident or the location of the patient (outside the medical organization), as well as from a medical organization that does not have the ability to provide the necessary medical care for life-threatening conditions, women during pregnancy, childbirth, the postpartum period and newborns, persons affected by emergencies and natural disasters (hereinafter referred to as a medical organization that does not have the ability to provide the necessary medical care).
6. The choice of a medical organization to deliver a patient during medical evacuation is made based on the severity of the patient’s condition, minimum transport accessibility to the location of the medical organization and the profile of the medical organization where the patient will be delivered.
7. The decision on the need for medical evacuation is made by:
a) from the scene of the incident or the location of the patient (outside the medical organization) - medical worker mobile emergency medical team, appointed by the head of the specified team;
b) from a medical organization in which there is no possibility of providing the necessary medical care - the head (deputy head for medical work) or the doctor on duty (except for the working hours of the head (deputy head for medical work)) of a medical organization in which there is no possibility of providing the necessary medical care assistance, upon the recommendation of the attending physician and the head of the department or the responsible medical worker of the shift (except for the working hours of the attending physician and the head of the department).
8. Preparation of a patient being treated in a medical organization that does not have the ability to provide the necessary medical care for medical evacuation is carried out by medical workers of the specified medical organization and includes all the necessary measures to ensure the stable condition of the patient during medical evacuation in accordance with the profile and severity disease (condition), expected duration of medical evacuation.
During medical evacuation, medical workers of the mobile ambulance team monitor the state of the patient’s body functions and provide him with the necessary medical care.
9. Upon completion of the medical evacuation, the medical worker of the mobile emergency medical team, appointed by the head of the specified team, transfers the patient and the corresponding medical documentation to the doctor of the reception department of the medical organization and informs the paramedic on receiving emergency medical calls and transferring them to visiting emergency medical teams or nurse for receiving emergency medical calls and transferring them to visiting emergency medical teams about the completion of medical evacuation of the patient, indicating the last name, first name and patronymic of the doctor of the admission department of the medical organization.
10. Medical evacuation in case of road traffic accidents is carried out to medical organizations that provide medical care to victims with combined, multiple and isolated injuries accompanied by shock.
11. Sanitary aviation evacuation is carried out in the following cases:
a) the severity of the patient’s condition, requiring his prompt delivery to a medical organization, if available technical feasibility the use of air transport and the inability to provide sanitary evacuation in the optimal time frame by other modes of transport;
b) the presence of contraindications to medical evacuation of the victim by ground transport;
c) the location of the incident is remote from the nearest medical organization at a distance that does not allow the patient to be delivered to the medical organization as quickly as possible;
d) climatic and geographical features the location of the incident and lack of transport accessibility;
e) the scale of the incident does not allow mobile emergency medical teams to carry out medical evacuation by other means of transport.
Appendix No. 2
to the Procedure for providing
ambulance, including
emergency specialized
medical care,
approved by order
Ministry of Health
Russian Federation
ORGANIZATION OF THE ACTIVITIES OF THE AMBULANCE Crew
MEDICAL CARE
1. These Rules determine the procedure for organizing the activities of a mobile ambulance team.
2. The main purpose of the mobile ambulance team is to provide emergency medical care, including at the scene of an emergency call during medical evacuation.
3. Based on their profile, mobile emergency medical teams are divided into general, specialized, emergency advisory, obstetric, and aeromedical.
4. Based on their composition, mobile emergency medical teams are divided into medical and paramedic teams.
5. Specialized mobile emergency medical teams are divided into anesthesiology-resuscitation, pediatric, pediatric anesthesiology-resuscitation, psychiatric, and obstetrics-gynecology teams.
6. Mobile emergency medical teams include medical workers from medical organizations providing emergency medical care.
7. Mobile emergency medical teams are created taking into account the need to ensure round-the-clock shift work, the population size, the average radius of the service area, the average load per ambulance team per day, and the load factor of emergency medical teams.
8. A paramedic general-profile mobile ambulance team includes either one emergency medical paramedic and one paramedic-driver of an ambulance, or two paramedics of an emergency medical service and one paramedic-driver, or two paramedics of an emergency medical service and one driver, or two paramedics - ambulance drivers (using a class "A" or "B" ambulance).
9. A medical general-profile mobile emergency medical team includes either one emergency medical technician and one paramedic-emergency medical driver, or one emergency medical technician, one emergency medical assistant and one paramedic-driver, or one emergency medical technician, one emergency medical technician and one driver (using a class "B" ambulance).
10. A specialized mobile emergency medical team of anesthesiology-resuscitation, a pediatric specialized mobile emergency medical team of anesthesiology-resuscitation includes either one emergency medical doctor (a specialist doctor in a specialty corresponding to the profile of the mobile emergency medical team), two specialists with secondary medical education (emergency medical assistant or nurse anesthetist) and one orderly-driver, or one emergency medical doctor (specialist doctor in a specialty corresponding to the profile of the mobile emergency medical team), two specialists with secondary medical education (emergency medical assistant aid or nurse anesthetist) and one driver, or one emergency medical technician (specialist doctor in a specialty corresponding to the profile of the mobile emergency medical team), one specialist with secondary medical education (emergency medical assistant or nurse anesthetist) and one paramedic-driver of an ambulance (using a class "C" ambulance of the appropriate profile).
11. A psychiatric specialized mobile emergency medical team, a pediatric specialized mobile emergency medical team, an obstetric-gynecological specialized mobile emergency medical team include either one emergency medical doctor (a specialist doctor in a specialty corresponding to the profile of the mobile emergency medical team), two emergency medical assistants and one paramedic-driver, or one emergency medical doctor (specialist doctor in a specialty corresponding to the profile of the mobile emergency medical team), two emergency medical assistants and one driver, or one emergency medical doctor (doctor - a specialist in a specialty corresponding to the profile of the mobile emergency medical team), one emergency medical assistant and one emergency medical assistant driver (using a class "C" ambulance of the appropriate profile).
12. An obstetric emergency medical team includes either one obstetrician and one nurse-driver, or one obstetrician and one driver (using a class “A” or “B” ambulance).
13. A traveling emergency advisory ambulance team includes either a specialist doctor (consultant) of the emergency advisory emergency medical care department of a medical organization, two specialists with secondary medical education (an emergency medical assistant or a nurse anesthetist) and one orderly driver, or a specialist doctor (consultant) of the emergency advisory ambulance department of a medical organization, two specialists with secondary medical education (an emergency medical assistant or nurse anesthetist) and one driver, or a specialist doctor (consultant) of the emergency advisory ambulance department of a medical organization organization, one specialist with secondary medical education (emergency medical assistant or nurse anesthetist) and one paramedic-emergency medical driver (using a class "C" ambulance of the appropriate profile).
14. The aeromedical emergency medical team includes at least one emergency medical technician or anesthesiologist-resuscitator and at least one specialist with secondary medical education (emergency medical assistant or nurse anesthetist).
15. The mobile ambulance team is operationally subordinate to the senior doctor (senior paramedic) of the operational department of the medical organization providing emergency medical care, the shift supervisor of the medical organization providing emergency medical care, the paramedic for receiving emergency medical calls and transferring them to mobile ambulance teams medical assistance (a nurse who receives emergency medical calls and transfers them to visiting emergency medical teams).
16. The mobile emergency medical team performs the following functions:
a) carries out immediate departure (departure, departure) to the place where emergency medical assistance is called;
b) provides emergency medical care based on the standards of medical care, including establishing the leading syndrome and preliminary diagnosis of the disease (condition), taking measures to help stabilize or improve the patient’s condition;
c) determines the medical organization to provide medical care to the patient;
d) carries out medical evacuation of the patient if there are medical indications;
e) immediately transfers the patient and the corresponding medical documentation to the doctor of the admission department of the medical organization with a note in the emergency medical care call card of the time and date of admission, the name and signature of the person receiving it;
f) immediately informs the paramedic for receiving emergency medical calls and transferring them to emergency medical teams (the nurse for receiving emergency calls and transferring them to emergency medical teams) about the end of the call and its result;
g) ensures the triage of patients (victims) and establishes the sequence of medical care in case of mass diseases, injuries or other conditions.
17. The mobile ambulance team calls a specialized mobile ambulance team (if they are available in the service area) in cases where the patient’s condition requires the use of special methods and complex medical technologies, performing the maximum possible amount of medical care on site before its arrival using its own resources and resources.
Appendix No. 3
to the Procedure for providing
ambulance, including
emergency specialized
medical care,
approved by order
Ministry of Health
Russian Federation
2. Ambulance, including specialized emergency medical care, is provided in case of illnesses, accidents, injuries, poisoning and other conditions requiring urgent medical intervention.
3. Emergency, including specialized emergency medical care is provided on the basis of standards of medical care and taking into account clinical recommendations (treatment protocols).
4. Ambulance, including specialized emergency medical care, is provided in the following conditions:
A) outside a medical organization - at the place where the ambulance team is called, including specialized emergency medical care, as well as in a vehicle during medical evacuation;
B) outpatient (in conditions that do not provide round-the-clock medical supervision and treatment);
C) inpatient (in conditions that provide round-the-clock medical supervision and treatment).
5. Ambulance, including specialized emergency medical care, is provided in the following forms:
A) emergency - in case of sudden acute diseases, conditions, exacerbation of chronic diseases that pose a threat to the patient’s life;
B) emergency - in case of sudden acute diseases, conditions, exacerbation of chronic diseases without obvious signs of a threat to the patient’s life.
6. Ambulance, including specialized ambulance, medical care outside a medical organization is provided by medical workers of mobile ambulance teams.
7. Mobile emergency medical teams are dispatched to a call by a paramedic to receive emergency medical calls and transfer them to mobile emergency medical teams or by a nurse to receive emergency medical calls and transfer them to mobile emergency medical teams, taking into account the profile of the mobile emergency medical team and forms of medical care.
8. Ambulance, including specialized emergency medical care in outpatient and inpatient settings is provided by medical workers of medical organizations providing medical care in outpatient and inpatient settings.
9. Emergency medical assistance is called:
A) by telephone by dialing numbers “03”, “103”, “112” and (or) telephone numbers of a medical organization providing emergency medical care;
B) using short text messages (SMS) if technically possible;
C) when directly contacting a medical organization providing emergency medical care;
D) upon admission to a medical organization providing emergency medical care, filled in in electronic format emergency medical emergency call cards from information systems emergency services.
10. If an emergency medical call is received, the nearest available general-purpose mobile ambulance team or specialized mobile ambulance team is dispatched to the call.
11. The reasons for calling an ambulance in an emergency are sudden acute diseases, conditions, exacerbations of chronic diseases that pose a threat to the patient’s life, including:
A) disturbances of consciousness;
B) breathing problems;
B) disorders of the circulatory system;
D) mental disorders accompanied by the patient’s actions that pose an immediate danger to him or other persons;
D) pain syndrome;
E) injuries of any etiology, poisoning, wounds (accompanied by life-threatening bleeding or damage to internal organs);
G) thermal and chemical burns;
H) bleeding of any etiology;
I) childbirth, threat of termination of pregnancy.
12. In the event of an urgent medical emergency call, the nearest available general-profile mobile ambulance team is dispatched to the call in the absence of emergency emergency medical calls.
13. The reasons for calling an ambulance in an emergency are:
A) sudden acute diseases, conditions, exacerbations of chronic diseases requiring urgent medical intervention, without obvious signs of a threat to life specified in paragraph 11 of this Procedure;
B) declaration of death (except for the opening hours of medical organizations providing medical care on an outpatient basis).
14. When providing emergency, including specialized emergency medical care, medical evacuation is carried out if necessary.
15. When a death is ascertained in an ambulance, the visiting ambulance team is obliged to immediately notify the paramedic for receiving emergency medical calls and transferring them to visiting ambulance teams or the nurse for receiving emergency medical calls and transferring them to visiting ambulance teams. medical assistance to call employees of the territorial bodies of the Ministry of Internal Affairs of the Russian Federation or obtain permission to transport the body of a deceased patient to a medical organization performing a forensic medical examination.
If signs of violent death are detected in a deceased (deceased) patient or if it is suspected, as well as if it is impossible to identify the identity of the deceased (deceased), when making an emergency medical call, the medical worker of the mobile emergency medical team, appointed by the senior, is obliged to notify about this a paramedic to receive emergency medical calls and transfer them to mobile emergency medical teams or a nurse to receive emergency medical calls and transfer them to mobile emergency medical teams for immediate notification territorial body Ministry of Internal Affairs of the Russian Federation.
16 - 17. Lost power. - Order of the Ministry of Health of Russia dated January 22, 2016 N 33n.
18. In remote or hard-to-reach settlements (sections of settlements), along highways, to provide emergency, including specialized emergency medical care, branches (posts, route points) of emergency medical care can be organized, which are structural divisions of a medical organization providing ambulance , including emergency specialized medical care.
In the event of a threat of emergency situations, including in places of mass events, mobile ambulance teams are on duty.
19. Ambulance, including specialized emergency medical care, is provided in accordance with Appendices No. 1 to this Procedure.