About the service in our hospitals and the medical field there is an a lot of talk. Including about the ambulance, although it is a separate service and "lives" it away from hospitals. About half a year ago I had the opportunity to see the work as soon as the inside. I can not say that I filmed exactly what I had imagined initially: as usual, from the inside, everything looks quite different, as it seems. But I learned a lot of new information for myself, who will try to share with you today.
Kiev ambulance station this year celebrated 110 years - this is one of the oldest medical institutions in the city and on the specifics of their work, the organizational and functional structure, methods of work - the first in Ukraine and among the top ten such facilities in Europe.
Brief Historical Background
The origin of emergency medical care in Kiev can be traced to 1881, when at the initiative of the Society of Kiev doctors' Circle doctors to doctor on duty "was organized, which in the same year opened on Khreschatyk point night duty. There are two dozen doctors participated on a voluntary basis. Activity item was largely philanthropic in nature. Assistance in case of accidents and injuries is free, and visits were paid.
Gradually, the number of complaints increased, and after a while the item was no longer able to meet the increasing needs of the people of Kiev in urgent need of assistance. In addition, some doctors refuse unprofitable calls, while others were fired.
Thus, in the city of overdue problem of organizing a full ambulance station. And June 30, 1902 (old style) on the money collected from the people at the charity event, membership fees, donations from philanthropists, the provision of the City Council, in Kiev began operating ambulance station, then called the rescue. She was placed in cramped and unsuitable areas of the house on the street. Pirogov, 6, which were equipped with reception room, duty doctors, ambulance, pharmacy, stationery and so on. D. On the opening day the station had before Austrian horse carriage, purchased with donations. station staff then consisted of a doctorate personnel (head and 8 doctors on duty), 5 nurses, 3 cabbies, street sweeper, courier and housekeeper. Daily from 9 am to 23 pm 2 doctors on duty. At night, he remained on duty 1 doctor. Constantly under any weather conditions at the ready was a horse-drawn carriage, which in 1-2 minutes after the call for help to leave on a call. Its place is immediately occupied by another coach. In case of fire with a large number of victims at the scene were sent additional medical supplies, and convened all the staff station. We rescue station:
In the first six months of the station is made of 2 thousand visits in 1903 -. 4, 5 thousand, in 1905 -. 5, 1 ths.
In 1913, the Company acquired on donations 4 vehicle and applied to the City Duma with a request to oblige all the crews in the street to free cars and ambulances (previously this was only fire brigades). During the Civil War, during street fighting health care workers stations actively provided assistance to the wounded. Despite the devastation, unemployment, hunger and lack of funding for the ambulance in Kiev continued to function. In 1919 he published a decree about nationalization of the ambulance station, but funding remained scanty. In this regard, Gubernia Executive Committee in 1923 has allowed the collection of donations among Kyiv residents and businesses in support of the ambulance, as well as provide paid transportation of patients.
The popularity of ambulances has steadily increased. If in 1924 was carried out 6, 3 thousand. Out, in 1933 there were carried out for 16, 5 thousand. Available hardware has made it impossible to further normal operation of the plant and organized a new control room in the prewar years. During these years, it is born the idea of specialization ambulances and in 1932 at the Kiev station was organized by the obstetric, and in 1934 - Pediatric teams. In the post-war years, there psychiatric, antishock, hematological, toxicological, et al, Pediatric. Specialized teams.
first aid station at the time of its placement on the street. Vladimir, 33 (1907-1912 gg.). Now this place is the SBU building.
In 1940, at the station every day traveled 18 ambulances, employs 270 people, of whom 49 were doctors. 53, 8 th. Visits were performed. During the Nazi occupation the station was not working. Equipment, property, equipment, workshops, documentation have been looted or destroyed. Survived only spaces. After the liberation of Kiev in 1943, the station has resumed its work. S 1 truck and 1 wagon was isolated. Calls serviced mainly by foot. Station staff consisted of only 9 people. About 100 people plant personnel were killed during the war. Everything had to start all over again ...
Station-house staff restored premises, workshops and garage. In 1945-46. the station received 11 trucks. Since 1948, the ambulances GAZ-AA began to arrive, and since 1953 - ZIM passenger and the ZIS. In this difficult time for the Kiev station staff headed by Natalia Andreevna Lengauer. Under her leadership, the station has evolved into an advanced medical facility not only in Kiev but also in the FSU. The station had a weight and abroad. We came here to learn and gain experience from many cities of Ukraine, the Union and other countries. Since 1960, the Kiev station ambulance becomes the Republican and in 1965 - the All-Union school of excellence.
Natalya Andreevna Lengauer:
In the meantime, Kiev and grew more acute becomes the problem of the remoteness of the new residential community to the station. This is especially felt on the Left Bank. Through perseverance NA Lengauer in 1957 on the street. Diagonal (now pr. Gagarin) for the first time in Kiev organized substation ambulance (now №2 substation on the street. Sergienko, 6). In subsequent decades, in Kiev offers more than a dozen substations, which are now in every area of the city. In 1977, the central station is divided into two sub-station: №1 and №13. Substation №1, which houses the control room, now located on the street. Bogdan Khmelnitsky, 37B, where it relocated in 1963. The new building was built on an individual project, had 42 rooms, a conference hall with 300 seats, a library, dining room, dressing room, garage, car wash and unique at the time the central control room, equipped with the latest equipment. In 1962, an ambulance has provided 47, 5 mobile teams, 323, 8 ths. Departures were carried out for the year. In 1975, it was already done 556, 4 thousand. Visits (100 times more than at the time of establishment of the station).
In the period from 1960 to 1990. annually took root from 5 to 15, new diagnostic methods and treatment, and from 8 to 25 innovations station staff. Also, the station staff are constantly engaged in scientific activities. Their development and achievements have been the subject of discussion in the city, republican, union and international conferences. In 1987 at the Kiev station for the first time in the USSR became operational consulting and information service "Health".
It would be possible to continue to lead the various historical facts of the work of the Kiev station - a lot of them and many of them are worthy of attention, but let's stop here and see "how it works" from the inside. Our journey begins in the central control room, located in the same building on the street. Bogdan Khmelnitsky, 37B, where people come to phone calls from the number 103.
Actually, dispatch. This temporary space that dispatch occupied during the recent renovation. While I was trying to force myself to finish this post, reconstruction managed to finish and now looks dispatching space. Dispatching is divided into two parts: controllers, directly receive calls, and controllers, to transfer the call to the ambulance substation, as well as working with teams.
dispatcher receiving the call, sets familiar to many a set of questions. Competent call an ambulance can significantly reduce the time of the arrival of the brigade and save the life of the victim. Do not be lazy to answer the questions of the controller and try to point out the most specific cause of the call; obvious and useless answer on the status of the patient, "Too bad!" It bears little information, because the call may need a specialized team, and the team itself better to know in advance what they will encounter. It is not recommended to entrust the children to call an ambulance, if you can call yourself. By the way, you can call an ambulance and SMS, and fax, and email. Alternative channels are used primarily to allow emergency calls for people with disabilities hearing or speech.
A call is received at the dispatcher received full answers to the questions posed. Manager must finish the conversation by repeating the complete address with the words call "The challenge is accepted, expect an ambulance."
It is understood that the ambulance station serves primarily an emergency call: loss of consciousness, sudden disturbances of breath and pain in the heart, profuse bleeding of all kinds, all kinds of injuries, electric shock, heat stroke, poisoning, damage in emergency situations , disrupt the normal course of pregnancy and so on. n. Much more, t. e. exacerbation of chronic diseases, the implementation of scheduled appointments GP, fever, cough, sore throat, headache, increased yes Lenia, lung injury (when the patient may self-refer to the emergency room), to provide dental care, removing ticks and the like. n. an emergency call is not. Manager may refuse to accept the call, advising to contact the emergency room or the proper hospital, indicating their address and telephone number.
Unfortunately, not everyone understands why they refuse to grant it an ambulance and sent to the emergency room. These are two different services, and an attempt to combine 30 years ago in Kiev ambulance with the ambulance ended in failure: greatly decreased quality of emergency and increased response time. There are people who, under the pretext of "my son's ear hurts" clamoring departure was the brigade and ambulance after the same persistent refusal to write threatening complaints. Yes, the problems of their loved ones, certainly seem more important than the problems of strangers, but the cases when due to the "ears" ambulance did not have time to come to a really special challenge, too happen. By the way, call an ambulance served, may again get into an ambulance, for example, if you want to transport the patient to a medical facility who needs emergency inpatient care and support medical staff using a stretcher (not ambulance transports patients). After filling out the cards call it is transmitted under the control of the second category of controllers that transmit on the call to the appropriate substation. They are also involved in the control to make calls and, if necessary, keeping in touch with the teams, in the case if, for example, it is necessary to clarify the whereabouts of the victim.
Call executed in the order they are received. With priority to make calls in public places, streets, businesses, educational institutions. By the way, by phone 1503 (for Kiev), you can always find out the location of patients, who were given aid ambulance (without diagnosis).
All calls that come into the control room, and recorded regularly tapped in resolving disputes or quality control receive calls. Control over the implementation challenges and teams work very hard here. When you think that ambulance had insufficient medical care, treated the patient attentively, hinted or demanded payment for their work, you are entitled to know Full name of each team member, the call number and license plate number, then file a complaint with the central ambulance station.
Then we'll go to the substation №5, which is on the street. Moscow, look at the work of ambulance crews. When I tried to imagine myself will look like shooting, then before my eyes for some reason immediately floated pictures of half-dead patients in the oxygen mask on a stretcher, broken machines in the accident, racing with lights flashing and sirens on the streets and so on. N. A dynamic thrash. But such megaaktivnost in emergency happens only in a movie and during any emergency with a large number of victims. Of all the challenges the proportion of cases where the patient's life hangs in the balance, fortunately, occupies a very small percentage, and everyday fast look very different. After spending a total of one day with three ambulance crews, I have not had a chance to get to the really difficult cases. But this does not mean that the rest of the brigade idle time and kofeok sipping on the porch near the substation. The control room is constantly receiving calls that require the participation of emergency, though such challenges are rarely ride with flashing lights. The park emergency is still full of "Gazelle" and "Photon".
All of this for a long time obsolete and out of date, and considering our roads, I just wish the patients who have to shake in a serious condition in older machines (although the "photon" problem especially in engines, and here, for example, the body is made very good). But the question of radical renewal of the car fleet as always rests against the budget (by the way, before the elections, the ambulance station has received 21 new car).
So, we leave with the substation. The first call on the street. Red Army. We need to be transported to granny very old hospital. It is not the first day of her fever, high blood pressure, she lives alone and also a neighbor, there is no one to look after her. Ambulance, which is visited in her apartment shortly before us, sent her to the hospital.
Granny moves only with the help of others and looking at it as something suddenly very clearly understand that stories about lonely elderly people who have half pension is often spent on drugs - is not out there somewhere with someone, and very often close to neighboring apartments and houses.
While this challenge is nothing special in itself does not carry - the usual routine is for emergency, however, there is also need nerves, patience, and just have something to think about when you look at it from the outside ...
The mark of a call and call back to the substation for the Notification Manager:
The next call again on Krasnoarmeyskaya.
One of the problems with the provision of ambulance - cork and culture of driving on our roads suffering. While the first part is a consequence of the second, particularly "conscious" citizens who do not want to miss open ambulance and spit on all and sundry, the brigade "love" in a special way. In principle, this problem also applies to pedestrians sometimes: he once witnessed a situation where a fire truck could not pass the intersection for pedestrians who are not paying attention to the siren and emergency lights, continued to move at a pedestrian crossing ... By the way, the allowable time an emergency call within a city is defined as 10 minutes. The increase in time depending on the weather and road conditions allowed for another 10 minutes.
A new challenge again require transport to the hospital. At this time, hip fracture, and again a person of advanced age. There is not enough without a stretcher, but the brigade only two women and drag the stretcher with the victim until it is impossible to machine. There is no place for filming, so by getting confirmation from the brigade, together with a colleague hide the camera and go upstairs to help haul the stretcher. Generally, in such cases, usually called all sorts of neighbors and passers-by until it is the desired number of volunteers. The house is in some places to turn is very hard, and the slightest wrong movements do not add joy to the patient.
Since we're talking about the conditions for the provision of first aid in our homes will not be superfluous to note that the life and health of the victim is also in the hands of calling an ambulance. Before coming teams it is important to take care of normal access to the victim. If there is a need and an opportunity, you need to remove all interfering nafig, in Vol. H. Various biting pets. This, like many other small items such as a pair of chairs, good lighting, and so on. N., Help in difficult cases to accelerate the diagnosis and to assist the patient.
But back to our call. At this time, our final destination - a military hospital.
We shift the patient to the local trolley. Alas, hospitals, and hospitals are not always looking for new applications received from the ambulance.
is such an unusual machine was seen at the hospital. To us it is time to join the second team.
In contrast to the first team, the team is exclusively male. The current call is just around the corner - near the station. Metro "Arsenal". From the first time the victim can not be found and the gang calls back to clarify the position. Just take and leave guys can not.
The victim is a citizen of no fixed abode in the tipsy and not very well maintained.
on the spot carried out the initial examination and citizen data entry, after which a team, accompanied by a friend of the victim went to the hospital, and we decide to go back to the substation and join the Third Brigade.
The next challenge and we are advancing again towards the already familiar to us repeatedly Krasnoarmeyskaya. Female, returning from the hospital by checking fundus, under the action of the drug not seen curb pecked nose in asphalt. Hospitalization is not required, the necessary assistance team is in place in the car.
Finally, our last call. Epileptic seizure, requiring hospitalization. There is a myth that the ambulances have universal keys from the intercoms. It's not as if the intercom in the apartment does not work or is incorrectly specified entrance code, the team will not waste time on the street.
A former test pilot. Looking at the numerous letters of thanks and in an apartment for himself notes that people probably lived a rich and interesting life. Recent years has washed down, which, of course, did not add health.
These are briefly turned weekdays emergency. Nothing sensational, and at the same time ordinary permanent assistance to the needy. The work of this service - especially a huge responsibility and a very difficult and emotional labor, but also on the job are fans willing to devote themselves to this hard business. However, many fans unable to stay long on such work, that is to live on the 1, 5 thousand in Kiev, to put it mildly, problematic (1, 5 thousand - a rate of nurses;.... Physicians rate, of course, a little more, but still does not correspond to the degree of responsibility that rests on these people). With all of this emergency has remained perhaps the last truly free medical service. If you do not have health insurance or you are registered in a completely different city - it can not be a reason to reject the call.