ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of August 22, 2019 No. KR DSM-113

About modification and amendments in the 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"

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" I ORDER:

1. Bring in the 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" (it is registered in the Register of state registration of regulatory legal acts for No. 15473, it is published on August 17, 2017 in Reference control bank of regulatory legal acts in electronic form) the following changes and amendments:

in the Rules of rendering emergency medical service approved by the specified order:

state Item 19 in the following edition:

"19. Transportation of the patient in case of threat of his life (sharp cardiovascular and respiratory insufficiency) is performed in reception of the nearest medical organization providing the emergency stationary medical care.";

state Item 28 in the following edition:

"28. According to medical sorting, conditionally allocate 3 groups of patients:

the first group (red zone) - patients whose condition poses direct threat of life or deteriorations having high risk and requiring the emergency medical care;

the second group (yellow zone) - patients whose condition poses potential hazard for health or can progress with development of the situation, the requiring emergency medical care;

the third group (green zone) - patients whose condition does not pose direct threat for life and health and does not require hospitalization.";

38, of 39, of 40, of 41, 42 to state Items in the following edition:

"38. The structure of regional and city SSMP includes the SMP station, substations of SMP, district departments SMP and departments of sanitary aircraft.

39. As a part of SSMP of areas, the cities of republican value and the capital the Call-centers (call centers) which are provided with means of operative communication with services of law-enforcement bodies and civil protection of the population of the region, are created by substations of SMP, departments SMP in case of PHC, receptions of the medical organizations and inform the population concerning delivery of health care at pre-hospital stage.

40. SSMP of areas, the cities of republican value and the capital are equipped with automated control systems on acceptance and processing of challenges and the systems allowing message monitoring of hospital motor transport by means of navigation systems and also system of computer record of dialogues with subscribers and automatic determinant of phone number from which the challenge arrives. Storage of records of dialogues is performed at least 2 years.

41. SSMP of areas, the cities of republican value and the capital are provided with medical products and medicines according to appendix 4 to these rules.

42. In emergency mode of SSMP of areas, cities of republican value and the capital:

1) are effective within interdepartmental and intersectoral interaction, according to the order of the Government of the Republic of Kazakhstan of June 17, 2010 with No. 608 "About approval of Rules of provision, types and amount of medical care in case of emergency situations, introduction of emergency rule", to the order of the Minister of Internal Affairs of the Republic of Kazakhstan of March 3, 2015 No. 175 "About approval of Rules of implementation of the state accounting of emergency situations of natural and technogenic nature" (it is registered in the Register of state registration of regulatory legal acts for No. 10983) and to the Joint order of the Minister of Internal Affairs of the Republic of Kazakhstan of September 21, 2016 No. 919 and the Minister of health and social development of the Republic of Kazakhstan of September 21, 2016 No. 819, the Minister of investments and development of the Republic of Kazakhstan of September 28, 2016 No. 688 "About approval of Rules of rapid response and rendering the timely complex help to persons who were injured in the road accidents" (it is registered in the Register of state registration of regulatory legal acts for No. 14387);

2) are sent to zone of emergency situation of crew of SMP on liquidation of medical and sanitary effects of emergency situations;

3) hold medical and evacuation events the victim in case of liquidation of emergency situations;

4) urgently provide information on victims in case of the emergency situation of natural and technogenic nature, incidents and cases which addressed or delivered for delivery of health care and also the dead from, local state body of health care of area, the cities of republican value, the capital and the National coordination center of the emergency medicine which were traumatized in territorial subdivisions of authorized body in the field of civil protection.";

add with Items 43, of 44, of 45, of 46, of 47, of 48, of 49, of 50, of 51 following contents:

"43. In case of extraordinary incident, with number of victims of 3 and more people, SMP first crew which arrived to the place of emergency situation first of all performs medical sorting.

By results of medical sorting (триаж) the crew of SMP provides the emergency medical care by the victim with the subsequent transportation in the medical organizations for indications.

44. The emergency medical care appears the specialists who were trained according to the international acknowledged standards of rendering the ambulance and emergency aid: "Basic resuscitation" - Basic Life Support (BLS), "Expanded warmly - pulmonary resuscitation" - Advanced Cardiac Life Support (ACLS), "Expanded warmly - pulmonary resuscitation in pediatrics" - Pediatric Advanced Life Support (PALS), "Delivery of health care at pre-hospital stage in case of injuries" - Prehospital Trauma Life Support (PHTLS). For the purpose of working off of practical skills by specialists of the regional and city stations of ambulance in rendering the emergency medical care based on regional and city SSMP simulyatsionny offices will be organized.

45. For ensuring availability of services of emergency medical service to rural population, according to the decision of local authorities of public administration of health care of area in hardly accessible settlements (lack of pavings, the mountain area), the sites remote from access of medical care additional substations (departments) of regional SSMP can be created.

46. For the purpose of ensuring operational work of medical personnel, rational use of hospital motor transport and the medical equipment hospital motor transport is subdivided into the following classes:

class A: the hospital motor transport intended for holding medical actions and transportation of the patients who are presumably not the emergency patients accompanied by medical personnel;

class B: the hospital motor transport intended for holding medical actions of emergency medical service by forces of medical (medical assistant's) crew, transportation and monitoring of condition of patients at pre-hospital stage;

class C: hospital motor transport (reanimobile) intended for holding resuscitation actions and intensive therapy by forces of specialized crew, and also transportation of patients through sanitary aircraft.

47. In the absence of hospital motor transport of necessary class departure of crew is performed on the available free hospital motor transport. The mobile team continues holding medical actions before arrival of hospital motor transport of necessary class or provides transportation of the patient in the nearest medical organization giving stationary help.

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