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ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of July 3, 2017 No. 450

About approval of Rules of rendering emergency medical service in the Republic of Kazakhstan

(as amended on 22-08-2019)

According to the subitem 96) Item 1 of article 7 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" PRIKAZYVAYU:

1. Approve the enclosed Rules of rendering emergency medical service in the Republic of Kazakhstan.

2. To provide to department of the organization of medical care of the Ministry of Health of the Republic of Kazakhstan in the procedure established by the legislation:

1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;

2) within ten calendar days from the date of state registration of this order the direction in one copy of its copy in paper and electronic type in the Kazakh and Russian languages in periodic printing editions and the Republican state company on the right of economic maintaining "The republican center of legal information" for official publication and inclusion in Reference control bank of regulatory legal acts of the Republic of Kazakhstan;

3) placement of this order on Internet resource of the Ministry of Health of the Republic of Kazakhstan;

4) within ten working days after state registration of this order in the Ministry of Justice of the Republic of Kazakhstan submission to Department of legal service of the Ministry of Health of the Republic of Kazakhstan of data on execution of the actions provided by subitems 1), 2), 3) of this Item.

3. Declare invalid the order of the Minister of Health of the Republic of Kazakhstan of June 26, 2013 No. 365 "About approval of standards of the organization of rendering emergency medical service and medical care in the form of sanitary aircraft in the Republic of Kazakhstan", (it is registered in the Register of state registration of regulatory legal acts for No. 8576, No. 8 is published in the Kazakhstanskaya Pravda newspaper of January 15, 2014 (27629)).

4. To impose control of execution of this order on the vice-Minister of Health of the Republic of Kazakhstan Aktayeva L. M.

5. This order becomes effective after ten calendar days after day of its first official publication.

Minister of Health of the Republic of Kazakhstan

E.Birtanov

Approved by the Order of the Minister of Health of the Republic of Kazakhstan of July 3, 2017 No. 450

Rules of rendering emergency medical service in the Republic of Kazakhstan

Chapter 1. General provisions

1. These rules of rendering emergency medical service in the Republic of Kazakhstan (further - Rules) are developed according to the subitem 96) of Item 1 of article 7 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" (further - the Code) and determine procedure for rendering emergency medical service in the Republic of Kazakhstan.

2. In these rules are used:

1) emergency medical service (further - NMP) - medical care in case of sudden sharp diseases, injuries, sharp deterioration in the state of health, exacerbation of chronic diseases, without strong indications of threat of life of the patient;

2) emergency medical service (further - SMP) - form of provision of medical care in case of the diseases and conditions at the adult and children's population requiring the emergency medical care for prevention of essential harm to health and (or) elimination of threat of life and also in need of transportation of bodies (part of bodies) and fabrics for the subsequent transplantation;

3) the emergency medical care - the medical care requiring immediate medical intervention for prevention of essential harm to health or elimination of threat of life in case of sudden sharp diseases, injuries, sharp deterioration in the state of health, exacerbation of chronic diseases.

Chapter 2. Procedure for rendering emergency medical service

3. The dispatcher of the station of emergency medical service (further - SSMP) accepts on the 103 panel all challenges from citizens in case of violation of the state of health. In case of receipt of challenge in dispatching service SSMP, the following data are fixed:

surname, name, middle name (in case of its availability), age and sex of the patient;

data on condition of the patient and circumstance of accident, injury or disease;

the address and phone, and also approximate data on journey to the location of the patient.

4. Time of processing of challenge from the moment of its receipt of SSMP by the dispatcher before transfer for servicing to crew of SMP constitutes five minutes during which sorting according to category of urgency of challenge is carried out.

5. Emergency medical service appears medical assistant's and specialized (medical) crews which structure is determined according to appendix 1 to these rules.

6. Crews of SSMP submit to the senior doctor of change of SSMP.

7. In rural settlements for servicing of challenges of SMP by the dispatcher of district substation of SSMP specialists and hospital motor transport of the nearest medical organizations are attracted.

8. The challenges accepted by the dispatcher SSMP are subdivided into 4 (four) categories of urgency according to appendix 2 to these rules:

1) challenge of 1 (first) category of urgency - the patient's condition posing direct threat of life, requiring rendering immediate medical care;

2) challenge 2 (second) categories of urgency - the patient's condition posing potential hazard of life without delivery of health care;

3) challenge 3 (third) categories of urgency - the patient's condition, a posing potential hazard for health without delivery of health care;

4) challenge 4 (fourth) categories of urgency - the patient's condition caused by acute disease or exacerbation of chronic disease without the sudden and expressed violations of bodies and systems, in the absence of direct and potential hazard of life and to health of the patient.

9. In case of receipt of challenges 1, of 2, the dispatcher of SSMP by means of automated control system transfers 3 categories of urgency challenge to medical assistant's and specialized (medical) crews of SSMP.

10. In case of receipt of challenges the dispatcher of SSMP by means of automated control system transfers 4 categories of urgency challenge to medical assistant's and specialized (medical) crews of department of emergency medical service in case of primary physician - the sanitary help (further - department SMP in case of PHC).

11. Arrival time medical assistant's and specialized (medical) to the location of the patient from the moment of receipt of challenge from the dispatcher of SSMP constitutes:

1 category of urgency - up to ten minutes;

2 category of urgency - up to fifteen minutes;

3 category of urgency - up to thirty minutes;

4 category of urgency - up to sixty minutes.

12. Medical assistant's and specialized (medical) crews of department SMP in case of PHC provide medical care to the attached population and persons which are in PHC servicing zone round the clock.

13. Challenges 4 categories of urgency are served both at the level of department SMP in case of PHC, and by transfer of this service to outsourcing to the medical organizations or (subjects of health care), having the state license for rendering the ambulance or emergency medical service, according to line 15 of appendix of 1 Law of the Republic of Kazakhstan of May 16, 2014 "About permissions and notifications".

14. In case of threat of life and to health of employees of crews of SSMP and department SMP in case of PHC servicing of challenge is performed in the presence of representatives of territorial authorities of internal affairs.

In case of absence of representatives of territorial authorities of internal affairs of crew of SSMP and department SMP in case of PHC notify dispatching service on risk of threat of life and to health by means of the radio set and (or) mobile communication. Further servicing of challenge is performed in the presence of representatives of territorial authorities of internal affairs.

15. By results of data of survey, tool diagnostics, dynamics of condition of the patient against the background of or after the held medical events, according to the preliminary diagnosis reflecting the reasons of this condition, in case of PHC one of the following decisions is accepted by the paramedic or the doctor of crew of SSMP or department SMP:

transportation of the patient in the medical organization giving stationary help (further - hospital);

the patient is left on the place of challenge;

the patient is left at home (in the place of residence).

16. In case of leaving of the patient who is not needing hospitalization on the place of challenge or at home, the crew of SSMP or department SMP in case of PHC provides medical recommendations for the further appeal to the PHC organization (at the place of residence or attachments).

17. In case of the patient and need of its visit at home by the district doctor of the paramedic or the doctor of crew of SSMP or department SMP in case of PHC fills in the alarm sheet for the patient in the form No. 110-1/u approved by the order of the acting minister of health care of the Republic of Kazakhstan of November 23, 2010 No. 907 "About approval of forms of primary medical documentation of the organizations of health care" (it is registered in the Register of state registration of regulatory legal acts for No. 6697) (further - the Order No. 907).

18. In case of decision making by crew of SSMP or department SMP in case of PHC about transportation of the patient in hospital, dispatching service SSMP informs reception of hospital on delivery of the patient.

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