JOINT ORDER OF THE MINISTER OF JUSTICE OF THE REPUBLIC OF KAZAKHSTAN, MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of May 25, 2004 No. 145, on May 7, 2004 No. 405

About approval of the regulatory legal acts regulating treatment-and-prophylactic providing and sanitary and epidemiologic wellbeing of persons containing in correctional facilities and pre-trial detention centers of judicial authorities of the Republic of Kazakhstan

List of amending documents

 

It is approved Attorney-General Republic of Kazakhstan May 21, 2004.

Minister of work and social protection of the population Republic of Kazakhstan May 17, 2004.

According to Article 97 of the Penitentiary code of the Republic of Kazakhstan, article 23 of the Law of the Republic of Kazakhstan "About procedure and conditions of detention of suspects and the crimes accused of making", the legislation in the field of health protection and sanitary wellbeing of citizens of the Republic of Kazakhstan we ORDER:

1. Approve enclosed:

Rules of treatment-and-prophylactic providing persons containing in correctional facilities and pre-trial detention centers of judicial authorities of the Republic of Kazakhstan (appendix 1);

Rules of ensuring sanitary and epidemiologic wellbeing of persons containing in correctional facilities and pre-trial detention centers of judicial authorities of the Republic of Kazakhstan (appendix 2);

The instruction on the organization of treatment-and-prophylactic actions concerning persons having separate diseases (appendix 3).

2. To impose control of execution of this order on the vice-Minister of Justice of the Republic of Kazakhstan Bekbosunov S. M., the vice-Minister of Health of the Republic of Kazakhstan Dikanbayevu S.A.

3. This order becomes effective from the moment of its state registration in the Ministry of Justice of the Republic of Kazakhstan and extends to legal relationship since January 1, 2004.

 

Minister of Justice Republic of Kazakhstan O. Zhumabekov

Minister of Health Republic of Kazakhstan E. Dosayev

Appendix 1

Approved by the joint order of the Minister of Justice of the Republic of Kazakhstan of May 25, 2004 No. 145 and the Minister of Health of the Republic of Kazakhstan of May 7, 2004 No. 405 "About approval of the regulatory legal acts regulating treatment-and-prophylactic providing and sanitary and epidemiologic wellbeing of persons containing in correctional facilities and pre-trial detention centers of judicial authorities of the Republic of Kazakhstan"

Rules of treatment-and-prophylactic providing persons containing in correctional facilities and pre-trial detention centers of judicial authorities of the Republic of Kazakhstan

1. Organization of work of medical part, its equipment and equipment

1. Medical part is structural division of correctional facility, the pre-trial detention center (further organizations) which will organize and exercises medical control over the implementation of sanitary and hygienic regulations and rules, anti-epidemic providing and hygienic education, medical care to persons containing in organizations (further special squads).

2. In medical part there are job descriptions on each health worker, and also work plans of medical part, the working schedule of medical personnel, the schedule of work of medical part, regulations for the patients who are in hospital.

3. In the cases requiring rendering the emergency specialized stationary aid, the direction of patients can be performed in hospitals of bodies of health care.

4. Application in organizations of new medicines for the purpose of their clinical testing (experiments) is forbidden.

5. Food of patients will be organized according to the regulations approved by the Government of the Republic of Kazakhstan taking into account requirements of dietology.

6. As a part of medical part will be organized: out-patient clinic, hospital, chambers for the isolated content of patients with infectious forms of diseases and mental disturbances, drugstore.

In regime cases of organizations rooms for performing outpatient appointment of special squads are equipped.

Medical part is equipped with tools, the equipment and stock.

2. Treatment-and-prophylactic providing in medical part

1. Medical control of condition of persons containing in organizations

7. Medical control is exercised in the way:

physical examination in case of receipt of special squads in organizations for the purpose of detection of infectious, parasitic and other sharp diseases;

preliminary and periodic physical examination in case of job placement, for the purpose of prevention of infectious and parasitic diseases;

performing medical examinations: annual preventive, target, in case of departure from organization, for the purpose of timely active identification of patients, persons with pathological and prepathological conditions and developments concerning their medical and improving actions;

dispensary observation of persons having diseases;

sanitary inspection behind working conditions, placement and food of special squads;

systematic check of accomplishment of recommendations of the medical and advisory commissions (further - VKK) on the correct trudoispolzovaniye of disabled people and persons with limited working capacity, and also recommendations of medical institutions about holding treatment-and-prophylactic actions among chronic patients.

8. On arrival in the pre-trial detention center everything arrived (including the following transit) performs primary medical examination for the purpose of identification of persons constituting epidemic danger to people around, and the patients needing emergency aid. The doctor or the paramedic in specially equipped medical office of combined department of organizations examines. Persons with infectious diseases or with suspicion on them right after survey are isolated from healthy. Primary sanitary processing of these persons is performed in the last queue with obligatory disinfection of clothes and personal belongings then they go to specially allocated cameras where it conducts the corresponding examination and treatment.

9. In time no more than three days from the moment of arrival in the pre-trial detention center all arrived have medical examination (in medical assistant's health centers - medical assistant's), and also rentgenflyuorografichesky inspection. On everyone containing in the pre-trial detention center, the medical out-patient record is filled.

10. All decreasing from the pre-trial detention center (including transit) medical examination is carried out final (medical or medical assistant's). Patients in sharp stage of disease, sick infectious (except tuberculosis) and venereal diseases, the struck with pediculosis, mange, not completed the established course of treatment, nontransportable patients are not allowed to transportation.

On completion of survey the conclusion with mark in the medical out-patient record about the state of health everyone decreasing, possibilities of its following is drawn.

The health worker performing inspection appends the signature with indication of surname and initials under the conclusion.

11. On arrival in correctional facility all convicts have medical examination for the purpose of detection of infectious and parasitic diseases.

12. In the first two weeks on arrival in correctional facility convicts have medical examination for the purpose of detection of the available diseases, estimates of physical condition, preliminary determination of category of working capacity. During his doctors make collection of anamnestic data on the postponed diseases, injuries, transactions which are registered in the medical out-patient record, if necessary additional inspections are appointed.

Further medical control of the state of health of convicts is exercised during routine medical examinations, and also out-patient addresses to medical part.

13. For the purpose of health protection of convicts, prevention of infectious and parasitic diseases it is necessary to conduct obligatory preliminary and periodic physical examinations of persons directed for work to objects of food, water supply system in medical parts, hospitals, delivery rooms, children's homes. Physical examinations are conducted by specialists doctors.

Examinations are conducted by forces of medical parts of organizations if necessary with involvement of specialists doctors both treatment and prevention facilities of criminal executive system, and organizations of bodies of health care on places (under approval).

Physical examinations include: survey by the therapist, dermatovenerologist, inspection on tuberculosis, carriage of causative agents of intestinal infections, helminthoses, venereal and infectious skin diseases, in some cases the stomatologist and the otolaryngologist according to frequency rate and amount of carrying out obligatory preliminary in case of revenues to work and periodic medical examinations according to the order of the Minister of Health of the Republic of Kazakhstan of October 20, 2003 N 766 "About approval of Rules of performing obligatory medical examinations of dekretirovanny national groups". It is registered in the Ministry of Justice of the Republic of Kazakhstan on November 12, 2003 N 2556.

When carrying out physical examinations:

1) the therapist shall:

collect the anamnesis, especially concerning the postponed infectious diseases;

conduct examination of condition of internals;

issue the direction on all-clinical laboratory analyses and fluorographic inspection. In the presence in the anamnesis of the postponed intestinal diseases to specify about it in the accompanying document for carrying out control laboratory research.

2) the dermatovenereologist shall:

to inspect carefully skin, the indumenta, nail plates visible mucous, including in genitals by means of mirrors (at women);

propalpirovat regional lymph nodes;

take material from urethra (at men scraping), the cervical channel and the back code of vagina, and according to indications - and from rectum on availability of gonokokk, trichomonad and other pathogenic microorganisms;

blood test on syphilis (microreactions);

according to indications - research on availability of fungal diseases of smooth skin, hair, nail plates, and also itch.

3) the dentist shall:

to carefully inspect condition of red border of lips, oral cavities, parodont on availability of caries, unextracted roots, fistular courses, periodontal disease and periodontosis.

4) the otolaryngologist shall:

carry out rinoskopiya, faringoskopiya, laringoskopiya, having paid special attention on condition of mucous membranes and availability of inflammatory processes.

Laboratory researches on bacteriocarrier are conducted in laboratories of sanitary and epidemiologic stations, on availability of helminthoses - in kliniko-diagnostic laboratories of medical preventive institutions. Laboratory researches on syphilis availability (express method), gonorrhoeas, trichomoniasis and diseases of urinogenital bodies (dabs), on fungal diseases, mange (native medicines) are conducted in laboratories of polyclinics, hospitals.

Upon termination of all necessary types of physical examination and in the absence of contraindications specialists doctors draw the conclusion and give mark in the personal medical book about the admission to work. In case of diagnosing of the diseases listed in the stated below paragraph and the bacteriocarriers interfering work on objects of organizations they shall report about it in divisions of the state sanitary and epidemiological surveillance of Committee of criminal executive system of the Ministry of Justice (further - PGSEN) and to send the patient for treatment to the relevant treatment and prevention facility.

Are not allowed to work of person in the presence at them the following diseases and bacteriocarrier:

typhoid, paratyphus, salmonellosis, dysentery;

gimenolepidoza, enterobioza;

syphilis (all forms);

gonorrhoeas (all forms);

leprosies;

infectious skin diseases: itches, cutting depriving (trichophytosis and microsporias of hairy part of the head, smooth skin and nails), scabs, actinomycosis with ulceration or fistulas on open parts of body;

infectious and destructive forms of tuberculosis of lungs, extra pulmonary tuberculosis with availability of fistulas, bakteriouriya, tubercular lupus of person and hands.

The admission to work of patients with noncontagious skin diseases (psoriasis, eczema, allergic dermatitis) decides the doctors performing medical examinations depending on the state of health and sore point.

Persons having pustulous diseases are not allowed to the work in obstetric and surgical hospitals, departments of newborns and also connected with preparation and realization of foodstuff. Also persons with inactive focal changes in lungs of tubercular nature are not allowed to work with newborn children, children of early and preschool age.

The administration of organization shall:

provide timely passing by workers of obligatory periodic physical examinations according to the scheduled plan which affirms management of organization in coordination with PGSEN;

supply each worker who is to be surveyed with the personal medical book.

Personal medical books of workers on passing of survey are stored in medical part of organization.

Persons which did not undergo physical examinations at the scheduled time are not allowed to work.

Responsibility for acceptance and stay at work of the persons which did not undergo physical examinations, and also skirting deadlines, procedure for their passing is assigned to the chief of organization.

After carrying out physical examinations medical part of organizations sends to PGSEN lists of the persons which passed and did not undergo physical examination in the terms established by the scheduled plan.

Control of carrying out physical examinations is imposed on PGSEN.

The convicts occupied on harmful productions are subject preliminary and to periodic professional surveys.

For serological inspections on syphilis, typhoid blood sampling is carried out from finger of hands, blood sampling from vein is forbidden. In case of inspection on gonorrhea the bacterioscopy of 2 dabs taken from urethra (at men according to indications) and necks of uterus, the back code of vagina and rectum and painted methylene blue or diamond green and if necessary on Gram is carried out.

The list of professions, frequency rate of inspection if necessary can be added with health services of criminal executive system in the presence of epidemic indications.

14. Routine medical examination is performed once a year. The convicts containing in correctional facilities of the particular or prison treatment (in case of chamber content), and minors in educational colonies are subject to survey two times a year.

The schedule of performing medical examinations affirms the chief of organizations. According to the schedule the chief of medical part will organize survey of special squads by forces of doctors of medical part, in correctional facilities if necessary doctors specialists of hospitals of criminal executive system are attracted. The therapist, the phthisiatrician, the psychiatrist, the stomatologist (dentist), and also doctors of local authorities of health care under approval surely take part in survey. Arrival of special squads in medical part is provided by the chief of group (the senior on the case).

During medical examinations it is carried out:

collection of anamnestic data;

anthropometrical research (growth, body weight);

gynecologic survey of women with capture of dab for cytologic research, girls have manual research through rectum (according to indications);

determination of visual acuity and hearing;

blood test (determination of speed of sedimentation of erythrocytes (далееСОЭ), hemoglobin, leukocytes, blood sugar according to indications);

research of the general analysis of urine;

electrocardiography (further - the ECG) (since 15 years - 1 times in 3 years, since 30 years - annually);

fluorography (X-ray analysis) of bodies of thorax - 2 times a year; to women - palpatorny research of mammary glands;

manual research of rectum;

pneumotachometry;

survey by the therapist, phthisiatrician, psychiatrist, stomatologist (dentist);

survey by doctors of other specialties (according to indications).

Results of routine inspection are brought in the medical out-patient record.

15. Before the placement of special squads to the penal isolation center (далееШИЗО), the room of chamber type (further - PKT), the disciplinary insulator (further - DIZO), the solitary confinement is made medical examination for determination of possibility of its content in the listed rooms. The written conclusion of the doctor (paramedic) about opportunity or impossibility of its settlement is for health reasons fixed in the resolution on settlement of the convict, investigative arrested. In case of impossibility of carrying out survey the special squads, and also if it has no visible signs of dangerous disease, poisoning, injury, are located in ShIZO, PKT, DIZO, the solitary confinement with subsequent within a day from the moment of settlement with obligatory medical examination.

16. In case of departure from correctional facilities (transfer, release, the direction into treatment, departure to the main place of serving sentence and other) convicts have final medical examination.

2. Organization of outpatient appointment

17. Out-patient medical care to special squads is performed by treatment and prevention facilities of criminal executive system.

18. Outpatient appointment in medical part is carried out in the hours established by the order on organization. In correctional facilities for each group, change or several groups time of outpatient appointment is allocated. In pre-trial detention centers, prisons and correctional facilities of particular treatment outpatient appointment is carried out by doctors (paramedics) in regime cases in specially equipped rooms by appointment, made by the paramedic (in exceptional cases - the senior on the case).

19. In each group of correctional facility there shall be magazine of preliminary record on outpatient appointment (any form) which is conducted by the chief of group. In the pre-trial detention center the magazine is kept by the paramedic of the case. The magazine of preliminary record before outpatient appointment is transferred to medical part. After acceptance the magazine returns to specified persons.

Acceptance without log entry is carried out only in case of emergency.

20. In pre-trial detention centers, prisons and correctional facilities of particular treatment the paramedic jointly with the senior on the case daily checks sanitary condition of cameras by their bypass after special squads conclusion to walk or sanitary processing.

For rendering emergency medical service person needing it is removed in case out-patient clinic. The paramedic does the corresponding appointments in the amount established for him or makes record of patients on appointment. About the patients needing emergency aid, medical part is informed through duty controllers.

And also medical care is provided to persons containing in ShIZO, DIZO, PKT in solitary confinements of pre-trial detention centers, prisons and correctional facilities of particular treatment on site by medics in case of daily check of sanitary condition of these rooms. In cases when there is health hazard or lives of persons containing in the specified rooms, the health worker takes measures to urgent transfer of such persons in medical part.

21. In premises of medical divisions where there is direct contact of health workers with special squads there shall be button of the alarming alarm system.

22. Doctors, paramedics, nurses are forbidden to be in cameras of pre-trial detention centers, prisons, correctional facilities of particular treatment, ShIZO, DIZO, PKT without controllers.

23. In pre-trial detention centers, prisons and correctional facilities of particular treatment patients are removed on appointment (paramedic) or performing procedures pokamerno individually or groups on 3-5 people.

The organized appearance on outpatient appointment of convicts in correctional facilities is provided by chiefs of groups.

24. The paramedic (nurse) prior to outpatient appointment selects medical out-patient records on written down in the magazine of preliminary record on outpatient appointment, briefly interviews patients for clarification of their claims, takes body temperature at patients and determines priority of their direction to the doctor.

25. After survey of the patient the doctor it is short and legible brings in the medical out-patient record date of acceptance, the claim, data of objective inspection, the diagnosis, appointments, does the conclusion about need of release from work and it is signed with indication of surname and initials.

26. In the magazine of preliminary record on outpatient appointment the doctor or the paramedic writes down the diagnosis, the conclusion about release from work or job specifications, date of repeated appearance to the doctor. On each case of release the coupon of registration of the reasons of temporary disability is filled in.

27. The conclusion on partial or full relief from job specifications and work is given by the doctor, and in case of absence of the doctor - the paramedic no more than for three days. In case of need release can be prolonged.

28. Medical part transfers lists of on an outpatient basis exempted special squads to the duty assistant to the chief of organization.

29. In the out-patient card are made entry about all surveys by health workers, appointments and manipulations.

30. Medical out-patient records, certificates of release from work, recipes, other medical documents to special squads are not handed out. Are stored in alphabetical order or on divisions in medical part, in cases under the lock. Together with medical out-patient records magazines of registration of outpatients are stored.

31. Medicines to special squads are not handed out, acceptance of medicines is made in the presence of the health worker.

The exception is constituted by the diseases requiring permanent availability of medical medicines: nitroglycerine for persons with coronary heart disease, pocket inhalers for patients with bronchial asthma, insulin with the insulin syringe for patients with diabetes of the first type and others. On this category of patients with the chief of medical part the special permission approved by the chief of organization is drawn up.

Medical procedures the outpatient are carried out by medical part during the day in the established hours.

32. In case of the direction of the patient on radiological, laboratory and other research, on acceptance to the specialist, and also on procedures which cannot be executed in medical part, the medical out-patient record issue to person accompanying the patient.

In the medical record data of the examinations conducted in medical part, the expected diagnosis and the reasons of the direction shall be specified.

In complex or not clear cases when the doctor of medical part cannot independently make the diagnosis of disease, patients shall go for consultation to specialists which is performed in medical part or in other medical institution.

In correctional facilities for consultation specialists doctors of hospitals of criminal executive system, and also territorial authorities of health care are attracted.

3. Organization of emergency medical service

33. Emergency medical service is provided to special squads in accordance with the established procedure.

Responsibility for timeliness of challenge of the medic or emergency medical service in hours when the schedule of work does not provide stay in organization of medical personnel, and also for ensuring the emergency evacuation of the patient with transport and convoy is born by the duty assistant to the chief of organization.

34. The out-patient clinic shall be ready for rendering emergency medical service at any time. For this purpose in procedural and dressing (operating room) it is necessary to have in permanent readiness sets (posindromny stackings) for rendering emergency aid in case of sharp conditions, sterile surgical tools, syringes, injection needles, inventory of oxygen, sterile dressing, the table with indication of the main symptoms of the corresponding diseases, the list of medicines for rendering emergency aid, according to the Standard list of posindromny stackings and the medicines and tools entering them for rendering emergency medical service (appendix 1).

In permanent readiness there shall be portable stacking (bag, suitcase) with set of means, for rendering emergency aid out of medical part.

35. All medicines intended for the current expenditure and property for rendering emergency aid shall be stored in special cases under the lock.

Store medicines and other account property in out-patient clinic it is allowed in the quantity which is not exceeding five-day requirement. Before issue of medicines to the patient, every time check compliance of the issued medicine appointed and the term of its validity.

Narcotic medicines are stored only in the special room of the office building of organization equipped with the security alarm system, in the metal safe under the lock, according to the order of the Government of the Republic of Kazakhstan of November 10, 2000 N 1693 "About approval of rules of implementation of the state control over drug trafficking, psychotropic substances and precursors of the Republic of Kazakhstan". Their leave is made strictly on medical indications with the corresponding record.

4. Amount of medical care in medical part

36. In case of inspection of patients for establishment of the diagnosis of disease the doctor of medical part uses data of the anamnesis, medical documents, results of survey yielded laboratory, radiological and functional methods of research. In necessary cases about the being available diseases data from medical institutions of bodies of health care on the residence before their arrest and condemnation are requested.

In the field of surgery the doctor of medical part shall:

determine blood type;

make local novokainovy infiltration anesthesia, novokainovy blockade; primary surgical processing of small wounds of soft fabrics; transport immobilization; stop of outside bleeding tamponade, bandaging of vessels or imposing of clip on the bleeding vessel; kateterization and puncture of bladder; trakheostomiya; puncture of pleural cavity or introduction of drainage with the valve in case of intense pheumothorax;

give help in case of burns, freezing injuries and electric traumas;

treat limited burns and freezing injuries of I and II degrees.

In the field of surgery the paramedic shall:

timely and correctly to give pre-medical help and to direct immediately to the doctor of the patients needing medical assistance;

determine blood type;

make temporary stop of bleeding;

perform transport immobilization;

enter antitetanic serum in case of all wounds, freezing injuries, burns and electric traumas;

make artificial respiration by different methods, indirect massage of heart, oxygen inhalation;

do subcutaneous and intramuscular injections, enter medicines intravenously, make drop and jet injections of krovezameshchayushchy and antishock liquids;

know symptomatology of the most widespread and especially sharp surgical diseases, distinguish colorable actions of investigative arrested and convicts;

sterilize tools, ware, linen and other.

37. Indications for hospitalization, including urgent, are the conditions requiring treatment in the conditions of hospital.

38. Taking into account transportability of the patient it is hospitalized in the nearest hospital of the corresponding profile.

In need of holding along the line actions of medical nature, and also in case of possibility of such need of sick (victim) the health worker having in case of himself stacking with medicines and tools shall accompany. In the direction on the emergency hospitalization shall be briefly stated the data on condition evacuated and the given help.

39. The patients who are not requiring on nature of disease (injury) of difficult methods of diagnostics and treatment are subject to out-patient treatment lasting no more than 14-15 days (bruises, distorziya, abscesses superficial and other). The amount of diagnostic actions concerning surgical patients is determined by opportunity to provide in the conditions of medical part laboratory, radiological and other ad hoc methods of research.

The doctor of medical part shall:

provide emergency medical service in case of sharp poisonings, unconscious condition, heatstroke, drowning, defeat with electric current, pulmonary, gastric and intestinal bleedings, attacks of bronchial asthma, spontaneous pheumothorax, sharp heart and vascular failure, renal and hepatic gripes and other sharp conditions;

perform treatment of persons with sharp and viral upper respiratory tract infections, acute and chronic bronchitis, quinsy, functional frustration of cardiovascular system, malaria, helminthoses, chronic gastritis, uncomplicated forms of stomach ulcer of stomach and duodenum, cholecystitis and hypovitaminoses;

exercise control of the patients who are written out from hospitals which condition requires further observation;

know symptomatology of sharp defeats (including ionizing radiation, toxic agents, bacterial means) and to give the first medical assistance in case of these defeats;

remove the ECG and know electrocardiographical signs of stenocardia, sharp myocardial infarction, the "menacing" violations of rhythm of heart.

In case of diseases of internals the paramedic shall:

distinguish and treat the most often found diseases of internals, give emergency aid in case of suddenly arising sharp diseases and poisonings;

organize and perform patient care;

wash out stomach, do medicinal and cleaning enemas;

remove the ECG;

make the elementary laboratory researches (calculation of quantity of leukocytes, determination of hemoglobin of blood, SOE, specific weight of urine, high-quality reactions to sugar and protein in urine);

put tuberkulinovy test (Manta), it is correct to estimate it and to own the revaccination equipment against tuberculosis vaccine BTsZh by intracutaneous method, in the presence of the corresponding certificate.

In case of diseases and injuries of eyes and their appendages the doctor of medical part shall:

determine visual acuity by Sivtsev's tables and color sensation according to Rabkin's tables;

remove foreign matters from conjunctiva century and from cornea blankets, using focal lighting;

distinguish mechanical injuries, thermal and chemical burns of eyes and their appendages;

give the first medical assistance in case of these types of injury;

distinguish barley and meybomita century, neosystem inflammation of edges century and conjunctivas, night blindness;

organize treatment of this category of patients, and in case of other diseases of eyes timely to resolve issue of need of consultation or hospitalization of the patient in hospital.

In case of diseases and injuries of eyes and their appendages the paramedic (nurse) shall:

carry out medical appointments: dig in eye drops, pledge ointment for eyelids, twist upper eyelid, wash out conjunctival cavity, apply bandage one or both eyes;

distinguish injuries of eyes and their appendages and give pre-medical help;

delete foreign matters from conjunctiva century and cornea blankets;

distinguish inflammatory diseases century and conjunctivas and to give pre-medical help in case of them.

40. Are subject to the direction in eye department of hospital:

all victims with injuries of eyes of mechanical, chemical, beam impacts, except persons with the foreign matters which are superficially lying in cornea and on conjunctiva (in case of successful removal of these foreign matters in medical part);

patients with the sharp and not giving in to treatment chronic diseases of appendages of eyes;

all patients with eyeball diseases;

persons with suspicion of glaucoma;

persons with the gradual progressing deterioration in sight or with its sudden loss.

41. In case of diseases of ear, throat and nose the doctor of medical part shall:

give emergency aid in case of injuries and diseases of the ENT organs which are followed by complications, life-threatening (suffocation because of throat stenosis, bleeding from ENT organs);

distinguish and treat in medical part of patients with outside diseases of ear: dermatitis, furunkulezy, sulfuric stopper, the foreign matter of outside acoustical pass which is at entrance well visible and the ear syringe which is easily deleted by careful washing; nasal bleedings, diseases of outside nose (follikulita, dermatitis), sharp rhinitises;

treat patients with the chronic pharyngitises, laryngitis and tonsillitis which are not requiring surgical intervention, chronic purulent and sharp catarral average otitises (on specifying of the specialist - the otolaryngologist), freezing injuries and burns of the I-II degree of nose and ear, to make blowing off of ears cylinder, nose cavity tamponade in case of bleedings.

In case of diseases of ear, throat, nose the paramedic (nurse) shall:

distinguish the sharp diseases of ear, throat, nose requiring urgent medical assistance;

give pre-medical help in case of diseases and injuries of ear, throat, nose, to do toilet of acoustical passes in case of diseases of ears, to delete (washing) sulfuric traffic jams;

carry out appointments of the specialist doctor.

42. In case of diseases of urinogenital system:

the doctor of medical part shall:

provide emergency medical service in case of damages of bodies of urinogenital system, renal colic, sharp delay of urine, parafimoza;

diagnose the most characteristic diseases (small egg edema, cryptorchism, seed cyst, expansion of veins of seed cord, epididymite, фимоз).

the paramedic (nurse) shall:

give emergency pre-medical aid in case of damages of bodies of urinogenital system.

43. In case of dental diseases the help, in case of absence in medical part of the dentist (dentist), the doctor generally according to urgent indications renders. At the same time the doctor shall:

distinguish sharp pulpitis, sharp odontogenny osteomyelitis of jaw and phlegmon, and also aftozny and ulcer stomatitis and to give emergency aid in case of these diseases;

diagnose fracture of the lower (upper) jaw, dislocation of the lower jaw and to give first aid in case of wounds and damages of maxillofacial area.

44. In case of mental diseases and diseases of nervous system the doctor shall:

reveal the main forms of diseases of nervous system and give emergency aid to patients with sharp violations of brain blood circulation, meningitis, encephalitis, with injuries of head and spinal cord, epileptic and fits of hysteria;

distinguish the main forms of mental diseases, give emergency aid to patients with sharp psychotic reactive conditions, take measures for their isolation, and also evacuation in psychiatric hospitals, to own technique of fixation of restless patients;

diagnose and treat in the conditions of medical part of disease of peripheral nervous system (sharp lumbar and sacral radiculitis, lumbago, neuralgia of separate nerves), neurotic and asthenic conditions.

The doctor shall hold treatment-and-prophylactic events for occasion of psychological diseases in close contact with regular and non-staff specialists.

the paramedic shall:

distinguish sharp violations of brain blood circulation, injury of the central nervous system, neuroinfection (meningitis and encephalitis), to give to patients emergency aid;

know symptoms of the main mental diseases, and in case of identification of such patients timely to report on them on the doctor;

take measures to their isolation, stop psychomotor excitement, participate in evacuation of patients in mental health facilities (departments), own technique of fixation of restless patients.

45. In case of skin and venereal diseases the doctor of medical part shall:

distinguish the main skin and venereal diseases, give medical help in case of these diseases and hold necessary preventive events;

own technology of washing of urethra, autogemoterapiya, capture and transfer of blood for serological research; captures of dab on availability of gonokokk in allocated from urethra, secret of prostate gland and uric ways; researches of scales and hair from the centers of damage of skin on fungi.

the paramedic (nurse) shall:

to independently distinguish the most often found skin and venereal diseases;

apply the main forms of medicines and delete them from the surface of skin;

carry out autogemoterapiya;

enter soft catheter into urethra, take blood on Wasserman's reaction, own technique of express diagnosis of syphilis;

take and send material for laboratory research to gonokokk and fungal diseases;

make washing of urethra.

46. The chief of medical part (health center) of organization bears responsibility for training of medical personnel for rendering the medical help in the amount stated above. The job description of the chief of medical part is developed and affirms according to the Standard job description of the chief of medical part of organization (appendix 2).

3. Organization of the stationary help in medical parts of organizations

inspections and treatments of the patients needing bed rest with treatment term to 14-15 days;

necessary stationary aftercare of the patients who are written out from hospitals;

temporary isolation of patients, infectious or suspicious on infectious disease, to the direction them in hospital;

hospitalization of nontransportable patients before improvement of their condition and the direction in hospital;

rooms of the faces which are subject to hospitalization according to the plan of dispensary observation or carried to improving group;

rooms of the patients who are subject to release from serving sentence in connection with disease in case of impossibility of stay them in the hostel and lack of indications for the direction in hospitals of criminal executive system.

48. The chief of organization provides expansion of the beds put on the state and their effective use.

49. Acceptance of patients in hospital of medical part is performed in the presence in the medical out-patient record of the conclusion of the doctor about need of carrying out stationary inspection and treatment.

Data about again arrived in hospital are entered in register of acceptance, the statement of patients and refusals in hospitalization.

On each patient the medical record of the inpatient is kept.

In hospital, and also statements from it medical part informs the chief of group on all cases of the emergency or planned hospitalization (the senior on the case).

50. In the presence the patients constituting danger to people around (infectious, infectious skin, mental diseases) contain in hospital of several chambers separately.

51. All patients arriving in hospital undergo obligatory sanitary processing. Depending on the patient's condition sanitary processing can be complete or partial. If necessary linen of the patient is exposed to disinfection. Clothes and footwear are stored in specially allocated room of hospital, underwear of the patient is given in washing, and in case of the statement returns to it.

During stay in hospital of the patient shall undergo inspection. If necessary on consultation specialists doctors of medical institutions of bodies of health care are attracted (under approval). Planned consultations are performed according to the schedule, and in urgent cases - at any time.

Doctors of medical part make bypass of patients daily. Diary entries are made by the patient 1 time in 3 days in cases of easy course of disease and daily in medium-weight and hard cases. The chief of medical part inspects the patient at least once a week and without fail - in the first day of arrival of the patient and before the statement.

Medical appointments, measurement of body temperature, anthropometrical researches are made by the paramedic (nurse) duty; also observation of accomplishment of regulations for patients is assigned to it.

52. The amount of medical care in hospital is determined by availability of the specialists doctors working in medical part and the equipment according to the Standard sheet of equipment by medical tools, the equipment and stock of medical parts of organizations (appendix 3).

53. As a part of hospital the chamber for the isolated content of patients with infectious forms of diseases and mental disturbances is equipped. The chamber intends for temporary isolation (to the direction in hospital) infectious patients (including TB patients) and patients with diseases, suspicious on infectious, rendering to them the first medical assistance, leaving and observation of patients and capture of the materials necessary for diagnosis of disease. In chamber timely shall the current and final disinfection is carried out. The medical personnel in chamber use specially allocated dressing gowns and strictly follow all rules of personal hygiene.

54. In hospital of medical part round the clock there shall be duty hospital attendant. The number of personnel on duty is established by the chief of medical part.

55. In hospital job descriptions of workers, work plans, and also regulations of hospitals of medical parts and hospitals of criminal executive system shall be developed and approved (appendix 4).

The job description of the chief of hospital of criminal executive system shall be developed and approved according to the Standard job description of the chief of hospital of criminal executive system (appendix 5).

Disclaimer! This text was translated by AI translator and is not a valid juridical document. No warranty. No claim. More info