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ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of November 30, 2020 No. KR DSM-225/2020

About approval of rules of rendering emergency medical service, including with involvement of medical aircraft

According to item 4 of article 121 of the Code of the Republic of Kazakhstan of July 7, 2020 "About health of the people and health care system" and Item 1 of article 10 of the Law of the Republic of Kazakhstan of April 15, 2013 "About the state services" PRIKAZYVAYU:

1. Approve the enclosed rules of rendering emergency medical service, including with involvement of medical aircraft.

2. Recognize invalid some orders of the Minister of Health of the Republic of Kazakhstan, according to appendix to this order.

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

3) 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.

4. To impose control of execution of this order on the vice-Minister of Health of the Republic of Kazakhstan Giniyat And.

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

Minister of Health of the Republic of Kazakhstan

A. Tsoi

"Is approved"

Ministry of Internal Affairs of the Republic of Kazakhstan

 

"Is approved"

Ministry of digital development, innovations and aerospace industry of the Republic of Kazakhstan

 

No. KR DSM-225/2020 are approved by the Order of the Minister of Health of the Republic of Kazakhstan of November 30, 2020

Rules of rendering emergency medical service, including with involvement of medical aircraft

Chapter 1. General provisions

1. These rules of rendering emergency medical service, including with involvement of medical aircraft (further - Rules) are developed according to item 4 of article 121 of the Code of the Republic of Kazakhstan of July 7, 2020 "About health of the people and health care system" (further - the Code) and determine procedure for rendering emergency medical service, including with involvement of medical aircraft.

2. In these rules are used:

1) specially prepared aircraft - the aircraft intended for accomplishment of specialized transactions through medical aircraft, equipped with the devices, devices, the equipment, complexes, systems applied separately to delivery of health care according to functional purpose and operational characteristics;

2) the aircraft (transport) - the device supported in the atmosphere due to its interaction with air excepting interaction with the air reflected from land (water) surface;

3) the commander of the aircraft (transport) - person, in accordance with the established procedure last corresponding training having the certificate of the pilot and the admission on the right of independent control of the aircraft of this type;

4) airline - the legal entity having the air operator certificate of civil aircrafts;

5) the profile specialist - the health worker with the higher medical education having the certificate in the field of health care;

6) authorized body in the field of health care (further - authorized body) - the central executive body performing management and cross-industry coordination in the field of protection of public health of the Republic of Kazakhstan, medical and pharmaceutical science, medical and pharmaceutical education, sanitary and epidemiologic wellbeing of the population, drug circulation and medical products, qualities of rendering medical services (help);

7) subjects of health care - the organizations of health care, and also the physical persons practising private medicine and pharmaceutical activities;

8) emergency medical service (further - SMP) - system of the organization of medical care in the emergency and urgent form in case of sharp diseases and conditions, life-endangering, and also for prevention of essential harm to health on the scene and (or) along the line in the medical organization;

9) emergency medical service (further - NMP) - the medical care provided in case of sudden sharp diseases and conditions, exacerbation of the chronic diseases which are not posing obvious threat of life of the patient;

10) the clinical protocol - scientifically proved recommendations about prevention, diagnostics, treatment, medical rehabilitation and palliative medical care in case of certain disease or the patient's condition;

11) consultation - research of person for the purpose of establishment of the diagnosis, determination of tactics of treatment and the forecast of disease with participation at least three doctors;

12) remote medical services - the provision of medical services for the purpose of diagnostics, treatments, medical rehabilitation and prevention of diseases and injuries, carrying out researches and estimates by means of digital technologies providing remote interaction of health workers among themselves, with physical persons and (or) their legal representatives, identification of specified persons, and also documentation of the actions made by them;

13) the airfield - the land area, ice, water surface, construction surface, including surface of floating construction intended for take-off, landing, taxing and the parking of aircrafts;

14) the specialized aircraft - the aircraft intended for accomplishment of specialized transactions through medical aircraft, equipped with the devices, devices, the equipment, complexes, systems applied in combination among themselves to delivery of health care according to functional purpose and operational characteristics;

15) medical aircraft - provision of emergency medical service in the emergency form to the population with attraction of air transport;

16) mobile crew of medical aircraft (further - MBMA) - the structurally functional unit of medical aircraft which is directly rendering one or several of following types of medical care: qualified, specialized, consulting and diagnostic medical care and high-technology medical service to patients;

17) the doctor-coordinator of medical aircraft - person having the higher medical education, the having certificate of the specialist in the corresponding specialty;

18) medical products - products of medical appointment and medical equipment;

19) the organization of medical education - the organization of education realizing educational programs for the directions of preparation "Health care";

20) medical services - the actions of subjects of health care having preventive, diagnostic, medical, rehabilitation and palliative orientation in relation to the specific person;

21) products of medical appointment - the materials, products, solutions, reagents, sets, sets used for delivery of health care according to functional purpose and the instruction of the producer;

22) medical equipment - the devices, devices, the equipment, complexes, systems applied separately or in combination among themselves to delivery of health care according to the functional purpose and operational characteristics established by the producer;

23) the medical organization - the organization of health care which main activities is delivery of health care;

24) the doctor of mobile crew of mobile aircraft - person having the higher medical education, the certificate of the specialist in "Ambulance and emergency medical service" and (or) "Anesthesiology and resuscitation (perfuziologiya, toxicology) (adult)" and (or) "Anesthesiology and resuscitation (perfuziologiya, toxicology, neonatal resuscitation) (nursery)";

25) the mobile camera - the device intended for record, storage and reproduction of audio-video information;

26) the operator - the physical person or legal entity which is engaged in operation of civil aircrafts or offering the services in this area;

27) hospital motor transport - the specialized land vehicle intended for transportation of patients, the accompanying medical personnel, also bodies (part of bodies) and fabrics for the subsequent transplantation in the relevant medical organization;

28) simulyatsionny office (center) - structural division of the organization of education in the field of health care based on which working off and delivery of practical skills by students in the conditions of imitation of clinical practice in the safe circle of training using simulyatsionny technologies are performed: dummies, exercise machines, computer simulation, technologies of virtual reality and specially trained actors trained to represent patients;

29) emergency situation - the situation in certain territory which developed as a result of accident, the fire, harmful effects of dangerous production factors, natural hazard, catastrophic crash, natural or other disaster which can entail or was entailed by the human victims, harm to human health or the environment, significant material damage and violation of conditions of activity of people;

30) emergency state - the temporary measure applied only for the benefit of safety of citizens and protection of the constitutional system of the Republic of Kazakhstan and representing the particular legal regime of activities of state bodies, organizations allowing establishment of separate restrictions of the rights and freedoms of citizens, foreigners and stateless persons, and also the rights of legal entities and assigning to them subsidiary duties;

31) transplantation - organ transplantation (part of body) and (or) fabrics (part of fabric) on other place in organism or in other organism;

32) regular flight - the flight performed according to the schedule established and published by airline;

33) the Coordinating organization - the legal entity determined according to the order of the Government of the Republic of Kazakhstan based on the subitem 5) of Item 2 of article 134 of the Law of the Republic of Kazakhstan "About state-owned property";

34) the informed consent - the procedure of written voluntary confirmation by person of the consent to receipt of medical care and (or) participation in specific research after receipt of information on all significant for adoption of the decision by it aspects of medical care and (or) research. The informed written consent is drawn up in the form approved by authorized body according to the subitem 279) of article 1 of the Code;

35) the emergency medical care - the medical care provided in case of sudden sharp diseases and conditions, exacerbation of the chronic diseases requiring immediate medical intervention for prevention of essential harm to health and (or) elimination of threat of life.

3. SMP stations (further - SSMP) areas, the cities of republican value and the capital, receptions of the medical organizations giving stationary help and the aircrafts rendering medical services are equipped with the medical equipment, uniform on design and technical characteristics.

Chapter 2. Procedure for rendering emergency medical service

4. For receipt of the state service "Challenge of Emergency Medical Service" the physical person (further - uslugopoluchatel) calls on number "103" of the subjects of health care providing emergency medical service (further - the service provider).

The main requirements to rendering the state service are provided in the standard of the state service "Challenge of Emergency Medical Service" according to appendix 1 to these rules.

The service provider enters data on stage of rendering the state service into information system of monitoring of rendering the state services according to the subitem 11) of Item 2 of article 5 of the Law of the Republic of Kazakhstan of April 15, 2013 "About the state services".

5. The dispatcher of SSMP accepts on the 103 panel challenges from citizens in case of violation of the state of health according to appendix 2 to these rules. Time of processing of challenge from the moment of its receipt of SSMP by the dispatcher constitutes five minutes during which sorting according to category of urgency of challenge is carried out.

6. Emergency medical service appears medical assistant's and specialized (medical) crews which structure is determined according to appendix 3 to these rules.

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

8. 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.

9. The challenges accepted by the dispatcher SSMP are subdivided into 4 (four) categories of urgency according to appendix 4 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.

10. 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.

11. 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 under the organization of health care giving primary health care (further - department SMP under the PHC organization).

12. Arrival time of medical assistant's and specialized (medical) crews 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.

13. Medical assistant's and specialized (medical) crews of department SMP under the PHC organization provide medical care to persons which are in zone of servicing of the PHC organization round the clock.

14. Challenges 4 categories of urgency are served at the level of department SMP under the PHC organization. In the organizations of health care rendering PHC with the attached population less than twenty thousand people, servicing of challenges 4 categories of urgency it is allowed by transfer of this service to outsourcing to the medical organizations or subjects of health care having the license for rendering 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".

15. In case of threat of life and to health of employees of crews of SSMP and department SMP under the PHC organization 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 under the PHC organization notify the dispatcher 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.

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