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It is registered

Ministry of Justice

Russian Federation

On March 19, 2020 No. 57786

ORDER OF THE MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

of March 19, 2020 No. 198n

About temporary procedure for the organization of work of the medical organizations for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19

(as amended on 04-02-2022)

According to the Federal Law of 21.11.2011 No. 323-FZ "About bases of protection of public health in the Russian Federation" (The Russian Federation Code, 2011, No. 48, Art. 6724; 2019, No. 52, the Art. 7836) and Item 5.2.208 of the Regulations on the Ministry of Health of the Russian Federation approved by the order of the Government of the Russian Federation of 19.06.2012 No. 608 (The Russian Federation Code, 2012, 26, of the Art. 3526) and for the purpose of fight against threat of spread of new koronavirusny infection of COVID-19 I order to No.:

1. Create:

The federal remote advisory center of anesthesiology resuscitation for adults concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - FDRKTs for adults) based on federal public autonomous educational institution of the higher education the First Moscow state medical university of name I.M. Sechenova of the Ministry of Health of the Russian Federation (Sechenovsky University);

The federal remote advisory center of anesthesiology resuscitation for children concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - FDRKTs for children) based on the isolated structural division - the Russian children's clinical hospital of federal public autonomous educational institution of the higher education "Russian national research medical university of N. I. Pirogov" of the Ministry of Health of the Russian Federation;

The federal remote advisory center of anesthesiology resuscitation for pregnant women concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - FDRKTs for pregnant women) based on federal state budgetary institution "National medical research center of obstetrics, gynecology and perinatology of name of the academician V. I. Kulakov" of the Ministry of Health of the Russian Federation;

the reserve Federal remote advisory center of anesthesiology resuscitation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia based on federal state budgetary institution "National medical and surgical center of N. I. Pirogov" of the Ministry of Health of the Russian Federation;

The federal remote advisory center for questions of clinic, pathogenesis and treatment of the heavy and complicated flu forms at adults and children based on federal state budgetary institution "Research institution of flu of name A.A. Smorodintseva" Ministries of Health of the Russian Federation.

The organizational and methodical center for creation and functioning of mobile mobile multidisciplinary teams for the purpose of delivery of health care to patients with new koronavirusny infection of COVID-19 in subjects of the Russian Federation based on federal state budgetary institution "National medical and surgical center of N. I. Pirogov" of the Ministry of Health of the Russian Federation.

2. Determine single number of call center of the federal remote resuscitation advisory centers specified in Item 1 of this order - 8-800-200-46-46.

3. To federal state budgetary institution "National Medical Research Center of Ftiziopulmonologiya and Infectious Diseases" of the Ministry of Health of the Russian Federation:

provide holding remote seminars for health workers on features of clinical current, diagnostics and treatment of new koronavirusny infection of COVID-19;

provide the round-the-clock advisory help of subjects of the Russian Federation to executive bodies in the sphere of health protection in case of identification of persons with suspicion of new koronavirusny infection of COVID-19;

create mobile multidisciplinary teams for the purpose of implementation of organizational and methodical support of subjects of the Russian Federation on the organization of delivery of health care to patients with new koronavirusny infection of COVID-19.

4. To federal state budgetary institution "Central Research and Development Institute of the Organization and Informatization of Health Care" of the Ministry of Health of the Russian Federation:

create exit with new koronavirusny multidisciplinary crews for the purpose of implementation of organizational and methodical support of subjects of the Russian Federation on the organization of delivery of health care to patients COVID-19 infection;

perform operational monitoring of incidence of extra hospital pneumonia and new koronavirusny infection of COVID-19.

4.1. To federal state budgetary institution "National Medical Research Center of Therapy and Preventive Medicine" of the Ministry of Health of the Russian Federation:

create the Federal remote advisory center for questions of vaccination against new koronavirusny infection of COVID-19;

provide holding remote seminars for health workers of the medical organizations subordinated to executive bodies of subjects of the Russian Federation in the sphere of health protection, concerning vaccination against new koronavirusny infection of COVID-19;

provide the advisory help to the medical organizations subordinated to executive bodies of subjects of the Russian Federation in the sphere of health protection, concerning vaccination against new koronavirusny infection of COVID-19;

create "the hot line" for the purpose of informing the population concerning vaccination against new koronavirusny infection of COVID-19.

5. Recommend to heads of executive bodies of subjects of the Russian Federation in the sphere of health protection:

a) create and organize functioning:

the remote advisory centers of anesthesiology resuscitation for adults concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - DRKTs for adults) based on the remote advisory centers of anesthesiology resuscitation performing activities according to the order of the Ministry of Health of the Russian Federation of 15.11.2012 No. 919n "About approval of the Procedure for delivery of health care to adult population on the "anesthesiology and resuscitation" profile (29.12.2012, registration No. 26512) with the changes made by the order of the Russian Ministry of Health of 14.09.2018 No. 625n is registered by the Ministry of Justice of the Russian Federation (31.10.2018, registration No. 52591) is registered by the Ministry of Justice of the Russian Federation;

the remote advisory centers of anesthesiology resuscitation for children concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - DRKTs for children) based on the centers of anesthesiology and resuscitation for the children performing activities according to the order of the Ministry of Health of the Russian Federation of 12.11.2012 No. 909n "About approval of the Procedure for delivery of health care to children on the "anesthesiology and resuscitation" profile (29.12.2012, registration No. 26514) is registered by the Ministry of Justice of the Russian Federation, with the change made by the order of the Russian Ministry of Health of 09.07.2013 No. 434n (it is registered by the Ministry of Justice of the Russian Federation 02.08. 2013, registration No. 29236);

the remote advisory centers of anesthesiology resuscitation for pregnant women concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - DRKTs for pregnant women) based on the obstetric remote advisory centers with mobile anesteziologo-resuscitation obstetric teams for rendering emergency and the emergency medical service of the perinatal center and maternity hospital performing activities according to the order of the Ministry of Health of the Russian Federation of 01.11.2012 No. 572n "About approval of the Procedure for delivery of health care on the "obstetrics and gynecology (except for uses of auxiliary reproductive technologies)" profile (it is registered by the Ministry of Justice of the Russian Federation 02.04. 2013, registration No. 27960) with the changes made by orders of the Russian Ministry of Health of 17.01.2014 No. 25n (it is registered by the Ministry of Justice of the Russian Federation 19.03. 2014, registration No. 31644), of 11.06.2015 No. 333n (it is registered by the Ministry of Justice of the Russian Federation 10.07. 2015, registration No. 37983), of 12.01.2016 No. 5n (it is registered by the Ministry of Justice of the Russian Federation 10.02. 2016, registration No. 41053);

directory service for ensuring interaction with service of operational medical care for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19 for single telephone number "122";

b) organize interaction of DRKTs for adults with FDRKTs and Federal state budgetary institution "National Medical Research Center of Ftiziopulmonologiya and Infectious Diseases" of the Ministry of Health of the Russian Federation;

provide the organization of carrying out laboratory researches for the purpose of establishment of the causative agent of extra hospital pneumonia, and in case of impossibility of establishment of the activator - to provide operational informing Department of the organization of the emergency medical care and risk management to health of the Russian Ministry of Health;

c) organize delivery of health care using telemedicine technologies to citizens with the confirmed diagnosis of new koronavirusny infection of COVID-19, the condition of which allows to be observed at home, and also with signs or the confirmed diagnosis of extra hospital pneumonia, acute respiratory viral infections, flu;

organize providing the medical organizations with necessary rooms, means of communication and the equipment for carrying out consultations (consultations of doctors) for implementation of remote interaction of health workers with patients. In case of implementation of consultations using telemedicine technologies by health workers in case of remote operating mode to organize providing the specified health workers with means of communication and the equipment for carrying out consultations;

provide if technically possible and taking into account requirements about information security use of modern information technologies and information systems for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19, including use of technology of artificial intelligence (including the diagnosis of new koronavirusny infection of COVID-19, based on the analysis of images natural language processing and recognition of the speech, intellectual decision support) according to the Presidential decree of the Russian Federation of October 10, 2019 to No. 490 "About development of artificial intelligence in the Russian Federation" (The Russian Federation Code, 2019, No. 41, the Art. 5700);

d) organize the out-patient centers of diagnostics and treatment of new koronavirusny infection of COVID-19 (further - the Center);

organize interaction of the Centers with the medical organizations providing emergency medical service and the medical organizations providing medical care in out-patient and stationary conditions;

provide equipment of the Centers road transport for delivery of patients, health workers, and also for transportation of biological materials for researches, delivery of medicines;

e) provide rendering in full to planned medical care to the patients with oncological and oncohematological diseases and also who are on replacement kidney therapy;

e) in case of development of adverse epidemic situation to organize delivery of health care to patients with symptoms of acute respiratory viral infections, extra hospital pneumonia, flu, new koronavirusny infection of COVID-19 in out-patient conditions, including remote method, in the place of departure of mobile medical crew, and stationary conditions, including in the reprofiled or in addition created structural divisions of medical and other organizations (except for structural divisions of the medical and other organizations providing medical care to the patients with oncological and oncohematological diseases and also who are on replacement kidney therapy); in case of reshaping of the medical organizations for treatment of patients with new koronavirusny infection of COVID-19 to provide possibility of treatment of patients with new koronavirusny infection of COVID-19 in combination with somatic pathology; to perform reshaping of the regional vascular centers and primary vascular departments on condition of preserving amounts of bed fund and availability of medical care to patients with sharp coronary syndrome and sharp violation of brain blood circulation.

6. Approve:

order of interaction of the federal remote advisory centers of anesthesiology resuscitation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia with the remote advisory centers of anesthesiology resuscitation in subjects of the Russian Federation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia according to appendix No. 1;

temporary procedure for the organization of rendering the ambulance, including fast specialized, medical care for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19 according to appendix No. 2;

temporary procedure for the organization of work of the medical organizations providing medical care in out-patient conditions for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19, according to appendix No. 3;

algorithm of actions of the health workers providing medical care in out-patient conditions, including at home, to patients with acute respiratory viral infections, flu and extra hospital pneumonia according to appendix No. 4;

the basic principles of the organization of medical care to patients with acute respiratory viral infections of medium-weight or heavy current, the heavy and (or) complicated forms of flu and extra hospital pneumonia in case of suspicion of new koronavirusny infection of COVID-19 in the medical organizations and their structural divisions providing medical care in stationary conditions according to appendix No. 5;

algorithm of actions of the health workers providing medical care in stationary conditions according to appendix No. 6;

the protocol of the events held by health workers for non-admission of intrahospital spread of new koronavirusny infection of COVID-19 in the medical organization providing medical care in stationary conditions according to appendix No. 7;

the basic principles of delivery of health care in out-patient conditions (at home) to patients with the established diagnosis of new koronavirusny infection of COVID-19 according to appendix No. 8;

procedure for the organization of additional training of health workers for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19 according to appendix No. 9;

the minimum requirements to implementation of the medical activities directed to prevention, diagnostics and treatment of new koronavirusny infection of COVID-19, according to appendix No. 10;

temporary procedure for the organization of work of the medical organizations which are carrying out works on procurement, storage, transportation and safety of donor blood and (or) its components for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19 among donors of donor blood and (or) its components according to appendix No. 11;

procedure for hospitalization in the medical organizations of patients with the established diagnosis of new koronavirusny infection of COVID-19 depending on severity of disease according to appendix No. 12;

procedure for the statement (translation) from the medical organization and criteria of recovery of patients with the established diagnosis of new koronavirusny infection of COVID-19 according to appendix No. 13;

temporary procedure for acceptance of patients by the medical organizations rendering specialized, including high-technology, medical care in planned form in the conditions of preserving risk of spread of new koronavirusny infection of COVID-19 according to appendix No. 14;

temporary procedure for acceptance of patients and accompanying persons by the medical organizations and other organizations performing sanatorium treatment in the conditions of preserving risk of spread of new koronavirusny infection of COVID-19 according to appendix No. 15;

temporary regular standard rates of the structural divisions of the medical organization providing medical care to adult population with new koronavirusny infection of COVID-19 in stationary conditions according to appendix No. 16;

temporary regular standard rates of the structural divisions of the medical organization providing medical care to children with new koronavirusny infection of COVID-19 in stationary conditions according to appendix No. 17;

temporary regulations of the organization and rendering advisory medical care using telemedicine technologies to citizens with the confirmed diagnosis of new koronavirusny infection of COVID-19, and also with signs or the confirmed diagnosis of extra hospital pneumonia, acute respiratory viral infection, flu, receiving medical care in out-patient conditions (at home), according to appendix No. 18;

regulations on the organization of work of the out-patient center of diagnostics and treatment of new koronavirusny infection of COVID-19 according to appendix No. 19;

rules of the organization of delivery of health care by mobile mobile multidisciplinary teams according to appendix No. 20;

temporary procedure for the organization of carrying out preventive inoculations against new koronavirusny infection of COVID-19, according to appendix No. 21.

7. This order is effective till January 1, 2023.

8. Subitem 1.9 of Item 1, subitems 2.19 and 2.27 of Item 2 of appendix No. 3 to this order, paragraph one of the column "Maintaining Tactics" of Item 1 of appendix No. 4 to this order, subitem 4.7 of item 4 and subitem 7.4.1 of Item 7 of appendix No. 18 to this order are effective till March 15, 2022.

Minister

M. A. Murashko

Appendix No. 1

to the Order of the Ministry of Health of the Russian Federation of March 19, 2020 No. 198n

Order of interaction of the federal remote advisory centers of anesthesiology resuscitation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia with the remote advisory centers of anesthesiology resuscitation in subjects of the Russian Federation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia

1. This Procedure determines rules of interaction of the Federal remote advisory center of anesthesiology resuscitation for adults concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia, the Federal remote advisory center of anesthesiology resuscitation for children concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia, the Federal remote advisory center of anesthesiology resuscitation for pregnant women concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia, the reserve Federal remote advisory center of anesthesiology resuscitation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - FDRKTs) with the Federal remote advisory center for questions of clinic, pathogenesis and treatment of the heavy and complicated flu forms at adults and children and the remote advisory centers of anesthesiology resuscitation concerning diagnostics and treatment of new koronavirusny infection of COVID-19, of pneumonia and the heavy and complicated flu forms in subjects of the Russian Federation (further - the regional centers) in case of delivery of health care, including carrying out consultations using telemedicine technologies (further - Pipe Metallurgic Company) in case of new koronavirusny infection of COVID-19, pneumonia, the heavy and complicated flu forms.

2. The procedure is developed for the purpose of operational receipt of the regional centers of Pipe Metallurgic Company by specialists doctors concerning delivery of health care to patients with new koronavirusny infection of COVID-19, pneumonia, the heavy and complicated flu forms (further also - patients).

3. Are carried out by Pipe Metallurgic Company of specialists doctors of the regional centers for adults with specialists doctors of FDRKTs for adults in the presence at patients of one of the following conditions:

new koronavirusny infection of COVID-19 or pneumonia of heavy current, including with respiratory and (or) polyorgan insufficiency;

severe form of flu with respiratory insufficiency.

4. Are carried out by Pipe Metallurgic Company of specialists doctors of the regional centers for children with specialists doctors of FDRKTs for children in the presence at the patient with suspicion of new koronavirusny infection of COVID-19 or with the confirmed diagnosis of new koronavirusny infection of COVID-19 or with the diagnosis pneumonia or the heavy and (or) complicated form of flu of one of the following conditions (circumstances):

the respiratory insufficiency requiring invasive ventilation of lungs;

insufficiency of blood circulation, refractory to inotropny and (or) vazopressorny medicines;

increase of syndrome of system inflammatory reaction or deterioration in assessment of pSOFA;

need of application of the methods of intensive therapy unavailable for the medical organization (for example, extracorporal membrane oxygenation, extracorporal haemo correction);

availability of serious chronic illness at the child with the confirmed diagnosis of new koronavirusny infection of COVID-19.

5. Are carried out by Pipe Metallurgic Company of specialists doctors of the regional centers for pregnant women with specialists doctors of FDRKTs for pregnant women in the presence at pregnant women, women in labor and women in childbirth of one of the following conditions:

new koronavirusny infection of COVID-19 of medium-weight or heavy current and (or) pneumonia;

respiratory insufficiency;

the heavy and (or) complicated flu form.

6. Are carried out by Pipe Metallurgic Company of specialists doctors of the medical organizations of subjects of the Russian Federation with specialists doctors of the regional centers for adults in the presence at the patient with suspicion of new koronavirusny infection of COVID-19 or the confirmed diagnosis of new koronavirusny infection of COVID-19 and (or) with extra hospital pneumonia and (or) with the heavy and (or) complicated form of the flu which is in department of anesthesiology and resuscitation, sharp respiratory insufficiency and (or) sharp respiratory distress syndrome including:

frequencies of respiratory movements more than 30 movements/min.;

blood saturations by oxygen according to pulsoksimetriya (SpO 2) 93% and less;

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