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Ambulance. Photo from the site pixabay.com
Today, December 16, the Cabinet of Ministers approved the procedure for requesting an ambulance for Ukrainians. Now the speed of arrival of the brigade “103” will depend on the complaint with which the citizen applies.
In critical and emergency situations, an ambulance should arrive within 10-20 minutes. But for other calls, doctors have the right not to attend at all, and now this is enshrined at the documentary level.
“Strana” explains the government decree in which four cases Share the export of the ambulance: when should doctors arrive and when can they refuse.
The rules described will take effect on January 1, 2021 and will be a continuation of the medical reform that Ulyana Suprun initiated.
1. Critical call: arrival of the ambulance in 10 minutes
The first case of calling an ambulance is critical. This category includes treatments that require immediate response and intervention when resuscitation is needed.
The patient’s condition must be accompanied by:
- shortness of breath
- ineffective breathing
- massive blood loss.
The reasons for this condition can be:
- all kinds of injuries,
- external factors such as lightning and electric shock,
- poisoning or poisoning, including animal and insect bites.
The equipment must be in place from the moment of the call in 10 minutes.
It is true that the document contains a note: “it is allowed to exceed the specified standard, but not more than 25% of the cases”. Probably, in this way, the authorities write in plain text: for a quarter of the people on the brink of life or death, the ambulance will not arrive on time (and, most likely, will not save them).
2. Emergency call: arrival of the ambulance 20 minutes before
Emergency calls, this is the second case, refers to a potentially serious condition that requires urgent care or transportation.
These cases are accompanied by:
- impaired consciousness,
- signs of bleeding
- signs of acute coronary syndrome (heart attack),
- signs of a possible acute stroke
- respiratory disorders.
In such cases, the ambulance must arrive no later than 20 minutes. You can be late here, but no more than 15% of the time.
Please note that this column contains the two most serious diseases: heart attack and stroke. However, it is indicated that the symptoms must be “acute”. From this we can conclude that high blood pressure and tolerable pain in the heart area may not be the reason for the arrival of an ambulance in 20 minutes.
3. Non-emergency calls: to the family doctor
The third point, the most mysterious, are the calls that are not emergency. The authorities indicate that “cases are included that do not pose a threat to the life and health of the patient, but that the sick or injured require medical advice.”
In such situations, the dispatcher will recommend contacting a family doctor, transferring the request there himself or if possible Send an ambulance that does not make critical or emergency calls.
It is not clear what counts as non-emergency calls. There is a huge list that can fall into this category or refer to emergency calls.
Among them: high body temperature, malaise in pregnant women, pain in the stomach, kidneys, liver and much more. In all these cases, a person can wait for the appointment with the family doctor according to the statement tomorrow or the day after tomorrow, or die in the near future if they do not receive help. The worst thing is that ambulance dispatchers will determine it not by eye, but by ear.
4. Complementary calls
The fourth point is non-essential calls. What it is is not indicated. But it is recorded that these cases are related to the treatment of patients whose condition does not require urgent attention.
This will also be determined by the ambulance dispatcher. In this case, the citizen will be asked to receive advice by telephone.
When the ambulance stopped reaching the Ukrainians
The innovations described above are a continuation of the medical reform that was introduced under Ulyana Suprun. Then the opinion was expressed that Ukrainians were used to calling an ambulance with or without reason, and considered a rise in temperature as an urgent symptom.
With this reasoning, a protocol for dispatchers was introduced on September 1, 2018.
The new rules involved extensive questioning of Ukrainians by dispatchers calling an ambulance. The specialist received a telephone order to know if the citizen really needs urgent help or not. This work format was based on the current innovations of the Cabinet. After all, it is the dispatcher who will decide who to save and who not to send the brigade.
In the immediate aftermath of the introduction of medical reform two years ago, Ukrainians began to complain en masse about the ambulance denials to come. This was explained to them by the “frivolity of the case.”
In the words of the people, “Strana” described two specific examples: an open fracture and a high temperature that could not be reduced. In both cases, we are talking about the health of the children, but the equipment was not sent to them.
In addition, they later refused to send an ambulance based on new protocols that operated with words.
And today the Suprun case officially continued at the level of the Ukrainian government.
For comparison: according to the head of the Ministry of Health Maxim Stepanov, now the ambulance is late for calls in almost 70% of cases. After the entry into force of the protocol in four cases, it can be assumed that the brigades will be dispersed between critical and emergency. And people in very poor health, but not dying right now, will be left alone with the disease until they see a family doctor.