DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY

DEPARTMENT OF SOCIAL MEDICINE, ECONOMICS AND ORGANIZATION OF

HEALTH CARE

METHODICAL RECOMMENDATIONS
FOR PRACTICAL CLASSES ON THE EDUCATIONAL DISCIPLINE
«SOCIAL MEDICINE, PUBLIC HEALTH»
(MODULE 2. PUBLIC HEALTH)
for the preparation of students of the second (master) level of higher education
branch of knowledge 22 «Health care»
specialty 222 «Medicine» (ІV year)

Topic № 9: ORGANIZATION AND CONTENT OF THE WORK OF

EMERGENCY MEDICAL SERVICE

Lviv-2020
 METHODOLOGICAL RECOMMENDATIONS FOR PRACTICAL CLASSES for
preparation of students of the second (master) level of higher education branch of knowledge 22
«Health care», specialty 222 «Medicine» (ІV year) elaborated at the Department of Social
Medicine, Economics and Organization of Health Care, Danylo Halytsky Lviv National Medical
University by the Head of the Department, Associate Professor GUTOR Т.H., Associate
Professor, KOVALSKA О.R., Assistant of the department BALUKH U.Y.

Reviewers: FEDORENKO V. I. – Doctor of Medical Sciences, Professor, Head of the

Department of General Hygiene and Ecology of Danylo Halytsky Lviv National Medical
University.

LUBINEC O. V. - Doctor of Medical Sciences, Professor, Head of the Department of

Public Health Faculty of Postgraduate Education of Danylo Halytsky Lviv National Medical
University.

GUTOR Т.H., KOVALSKA О.R., BALUKH U.Y. Organization and content of the
work of emergency medical service. Methodological recommendations for practical classes for
preparation of students of the second (master) level of higher education branch of knowledge 22
«Health care», specialty 222 «Medicine» (ІV year) on the educational discipline «Social medicine,
Public health» (module 2 «Public health»). Lviv, ОD КSM 2020. 25p.

Methodological recommendations discussed, approved and recommended for printing at the

meeting of the Department of Social Medicine, Economics and Organization of Health Care and at
the meeting of Cycle Methodological Commission «Preventive medicine» of Danylo Halytsky Lviv
National Medical University.
 Topic of practical lesson: ORGANIZATION AND CONTENT OF THE WORK OF
EMERGENCY MEDICAL SERVICE

І. ACTUALITY OF THE TOPIC: Provision of free, timely and effective medical care to
the population in conditions that threaten the lives of patients or victims (emergency medical care)
is one of the most important tasks of the country's healthcare sector.
Emergency medical care is one of the highest priorities in health care, since the number and
potential loss of life depends largely on the quality and effectiveness of its operation.
The need for study content of a number of legislative and regulatory documents regulating
the fulfillment by the state of its constitutional obligations to provide citizens with emergency
medical care at a modern level, reflecting the timeliness, accessibility and consistency of emergency
care makes this practical topic relevant.

ІІ. GOAL OF PRACTICAL LESSON:

Know: the basic principles of emergency medical care in Ukraine; the essence of
emergency medical care; legal principles of organization and functioning of emergency
medical care; peculiarities of functioning of the Emergency Medical Centers.
Be able to: complete accounting records related to emergency medical care; identify and
analyze activity of EMD institutions.

III. THEORETICAL PRESENTATION OF THE TOPIC

In 2012, the Law of Ukraine "On Emergency Medical Assistance" was adopted, which
defines the organizational and legal bases for providing citizens of Ukraine and other persons in its
territory with emergency medical care, including during emergencies, bases for creation,
functioning and the development of an emergency medical care system.

Law of Ukraine
“About emergency medical care”
dated 05.07.2012 No. 5081-
(Revised 07/03/2018, Ground - 2269-VIII)
(extract)
This Law defines the organizational and legal basis for providing citizens of Ukraine and
other persons in its territory with emergency medical care, including during emergencies and
elimination of their consequences, and the principles of creating, functioning and developing the
emergency medical care system.
Article 1. Definition of terms
1. In this Law, the terms are used in the following sense:
1) emergency team (ambulance) - the structural unit of the emergency (ambulance) station
or emergency and emergency medicine center, whose task is to provide emergency medical
assistance to a person in an emergency immediately at the scene and during transportation to the
medical center in accordance with this Law;
2) emergency call - notification of an emergency and the place of the event and / or
requesting emergency medical assistance by emergency telephone number 103 or by emergency
system number 112;
3) emergency medical care department - a structural unit of a multidisciplinary hospital, in
which emergency medical care is provided around the clock;
4) emergency medical care - medical assistance, which consists in the implementation of
emergency medical aid system by the employees in accordance with this Law with urgent
organizational, diagnostic and medical measures aimed at saving and preserving the life of a person
in an urgent state and minimizing the consequences for his health;
5) scene of an emergency - location of the person in an urgent state at the time of the
emergency medical emergency call;
 6) emergency condition - sudden deterioration of physical or mental health, which threatens
the life and health of the person or the surrounding people and arises due to illness, injury,
poisoning or other internal or external causes;
7) point of permanent establishment of emergency team (ambulance) - location of
emergency team and specialized transport, adapted and equipped for its operation around the
clock;
8) emergency team (ambulance) temporary stay point - temporary emergency team location
to ensure timely provision of emergency medical care, including during mass events;
9) emergency medical care system - a set of health care establishments and their structural
units defined by this Law, which provide the organization and provision of emergency medical care,
including in case of emergencies and elimination of their consequences;
10) specialized transport - transport with special light and sound signaling devices,
intended for the carriage of a person in an emergency condition and equipped for providing
emergency medical care in accordance with national standards for this type of transport.
Article 2. Legislation of Ukraine in the field of emergency medical care
1. The legislation of Ukraine in the field of emergency medical care is based on the
Constitution of Ukraine and consists of the Fundamentals of the legislation of Ukraine on health
care, other legislative acts regulating relations on health care issues, this Law and other adopted
regulations.
Article 3. Right to emergency medical care and general principles of care
1. On the territory of Ukraine, every citizen of Ukraine and any other person shall have the
right to free, accessible, timely and qualitative emergency medical care provided in accordance with
this Law. Foreigners and stateless persons temporarily residing in the territory of Ukraine, as well
as individuals taken into custody or sentenced to imprisonment, shall be provided with emergency
medical care.
2. On the territory of Ukraine, every citizen of Ukraine and any other person shall have the
right:
• Make an emergency call;
• apply for immediate medical attention to the nearest emergency department or other
healthcare facility that may provide such assistance;
• inform the physician or health care provider of the nearest health care facility, regardless of
the form of ownership and subordination, about his or her emergency or other person's emergency.
3. In case of detection of a person in urgent condition who cannot personally seek
emergency medical care and in the absence of medical workers at the scene, a citizen of Ukraine or
any other person who has identified such a person shall be obliged to:
• Make an emergency call immediately, or report an identified emergency person and the
location of a nearby healthcare provider;
• Provide assistance to the identified person in an emergency, including by transporting that
person to the nearest emergency department or other health care facility where the necessary
medical care can be provided.
Article 5. Basic principles of organization and functioning of emergency medical care
systems
The main tasks of the emergency medical care system are to organize and provide:
• providing accessible, free, timely and quality emergency medical care in accordance with
this Law, including during emergencies and elimination of their consequences;
• health support of mass events and events involving the persons subject to state protection;
• interaction with emergency departments of ministries in the event of emergencies and the
elimination of their consequences.
The basic principles of operation of the emergency medical care system are:
• ongoing readiness for emergency medical care;
• fast and round-the-clock emergency response to emergency calls;
• accessibility, free of charge, quality and priority of emergency medical care;
 • Consistency and continuity of emergency medical care;
• regional extraterritoriality.
Article 8. Operational Dispatching Service of the Emergency and medicine of disaster
center
1. The emergency and medicine of disaster center operating and dispatching service is a
structural unit of the Emergency Medical and Emergency Medicine Center, which, with the use of
telecommunication networks, software, technical and other means, provides around the clock:
• receiving, generating and transmitting information on emergency medical care calls;
• informational support and coordination of emergency (ambulance) teams and health care
providers for emergency medical care.
Article 9. Emergency (ambulance) station
1. Emergency (ambulance) health care station is a health care institution whose main task is
to ensure the constant readiness of emergency (ambulance) medical teams to provide emergency
medical care in accordance with the provisions of this Law on a 24-hour basis and coordinate them
activities with the operational-dispatching service of the center of emergency medical care and
medicine of disaster in the territory of the respective administrative unit.
2. The emergency (ambulance) station may have the status of a legal entity or a separate unit
of the center of emergency and emergency medicine.
3. The material and technical base of the emergency (ambulance) medical aid station
includes buildings, structures, medical equipment, medical devices, communication means, vehicles
and other tangible assets, transmitted by bodies authorized to manage the joint property of territorial
communities of the respective administrative and territorial area. units, in the order specified by
law.
4. The property of an emergency (ambulance) emergency medical care station, which is a
legal entity, shall be assigned to it in the operational management right and shall be used solely for
the performance of tasks stipulated by this Law.
Article 10. Emergency Department
The Emergency Department is a structural unit of a multidisciplinary hospital in which
emergency medical care is provided to patients delivered by emergency (ambulance) teams or other
persons.
Article 11. Employees of the emergency medical care system
1. Employees of the emergency medical care system in accordance with this Law are:
• medical staff at emergency and medicine of disaster centers, emergency (ambulance)
stations, emergency (emergency) units that directly provide and / or provide emergency medical
care provision under this Law;
• non-medical workers of emergency and medicine of disaster centers, emergency
(ambulance) stations, emergency (ambulance) teams, emergency units, which provide
organizational and technological support for the provision of emergency medical assistance by the
medical system emergency medical care.
2. Qualifications and other requirements for medical and other emergency medical system
workers shall be determined by the central executive authority, which shall formulate and
implement public health policy.
3. Training, retraining and advanced training of health care professionals for the needs of
the emergency medical care system shall be provided in accordance with the law by the central
executive authority.
 It is ratified
By resolution of Cabinet of ministers of Ukraine
№370 from 01.06.2009

Position
about a unified system of emergency (emergency) care
(extract)
I. General Provisions
1. A unified system of emergency (urgent) medical care (hereinafter referred to as
System) is created with the aim of implementing the state policy on providing timely and high-
quality medical care to every person who is in emergency.
2. The system operates on the principles of: availability and free of charge medical care
to every individual who is in an emergency; timeliness and quality of care; providing medical care
both in everyday and emergency situations; unity of medical science, education and practice, which
ensures the dynamic development and improvement of the System.
3. The system envisages the use of the latest standardized medical technologies,
optimization of the network of medical establishments, their reorganization on the basis of uniform
scientifically substantiated organizational principles and international standards of rendering
emergency medical care with appropriate logistical support, professional training of medical
workers in the provision of emergency medical services.
II. Systems components
1. System Management
1.1. At the central level is the Ukrainian scientific and practical center for
emergency medical services and medicine of disaster;
1.2. At the territorial level there are territorial centers of emergency medical care
and medicine of disaster
2. Pre-hospital stage
2.1. An ambulance service whose functional unit is an ambulance team;
2.2. Non-medical personnel of the system are specialists who do not have medical
education (MIA employees, rescuers and others) whose functional duties are to provide first aid.
3. Hospital phase
3.1. Multidisciplinary hospitals with round-the-clock work, including those which
have emergency departments;
3.2. Emergency hospitals;
3.3. Three-level injury centers.
4. System specialists, their training and retraining
4.1. Non-medical staff - special training centers;
4.2. Medical assistants, nurses of ambulance teams - higher educational
establishments of I-II levels of accreditation;
4.3. Doctors in the specialty "Emergency Medicine" - higher educational
establishments of III-IV levels of accreditation.
5. Communication and dispatching service
5.1. Ambulance dispatching service.
6. Vehicles (their compliance with state standards and equipment plates).
6.1. Sanitation (cars, helicopters, planes).
7. Provision of emergency medical assistance in emergency situations, catastrophe medicine
7.1. Crews of constant readiness of the first turn (ambulance crews);
7.2. Specialized ambulance teams of the second stage;
7.3. Mobile field crews;
7.4. Mobile units;
7.5. Mobile hospitals;
 7.6. Medical institutions.
8. Medical records, accounting records, statistical forms.
9. Awareness of the population of the System and emergency operations.

It is ratified
By resolution of Cabinet of ministers of Ukraine
№1116 from 21.11.2012

Typical position
about the emergency and medicine of disaster center
(extract)
1. Emergency and medicine of disaster center (hereinafter referred to as the Center) is a
health care institution providing and organizing and providing on the territory of the respective
administrative and territorial unit.
2. The main tasks of the Center are:
1) ensuring the organization and provision of:
emergency medical care in the territory of the administrative and territorial unit to patients
and victims in everyday conditions, a special period and during the elimination of the consequences
of an emergency; on-site consultative medical assistance;
2) organization:
fulfillment of the standard of arrival of emergency (ambulance) teams to the place; health
care during mass events and events with the participation of persons subject to state protection;
interaction with emergency-rescue services and subdivisions of ministries and other executive
bodies.
3) organization and implementation of:
transportation of patients and victims in need of medical support, as well as medical
evacuation of victims during emergency response;
3. In accordance with its tasks, the Center shall:
1) provides:
• Acceptance of emergency calls from the population through all means of communication;
• providing emergency medical care in accordance with approved protocols and standards;
• interaction with:
- Reception units (emergency) departments of multidisciplinary hospitals in order to ensure
continuity and consistency of emergency medical care by ambulance teams and health care
establishments;
- health care institutions of the administrative-territorial unit for creation of regional reserves
of medicines and medical products;
• developing action plans for developing an emergency medical care system;
• keeping statistical records and reporting on emergency and on-site medical advice;
2) calculate the number and determine the location of points of permanent and temporary
base of ambulance teams in order to meet the standard of arrival of such brigades to the place;
3) determine the need for:
• staffing, medicines, medical equipment and medical supplies for providing emergency
medical care;
4) provide crews with medicines, including narcotics, psychotropic substances, precursors
and potent drugs, as well as medical supplies for the provision of emergency medical care;
5) organizes and conducts training and training activities on emergency response;
7) coordinate measures to ensure the readiness of health care institutions, regardless of
subordination and ownership, communication and alert systems, specialized formations, to carry out
work on emergency response;
8) study the experience of healthcare institutions in providing emergency medical care.
 4. The Center for the execution of the main tasks shall have the right:
1) use available human resources, medicines, medical equipment, medical devices,
specialized sanitary vehicles, telecommunication and other means for the organization of effective
rendering of emergency medical care to patients and victims;
2) plan and conduct its own activities within the given powers;
3) assist health care institutions in carrying out emergency response measures;
4) submit proposals for the involvement of healthcare facilities for the provision of
emergency medical care;
5) distribute methodical, informative and other materials on the organization of emergency
medical care;

Structure
Center for emergency and medicine of disaster
1. The structure of the Center shall include:
• control unit;
• administrative and economic service;
• analytical and organizational unit;
• ambulance service;
• operational and dispatching service;
• emergency medical advisory service;
• catastrophe medicine unit with services of ensuring its constant
readiness (warehouses of normatively determined stocks of medicines, medical
equipment, tools, property);
• road transport service;
• pharmaceutical service;
• software and technical service;
• educational and methodical unit.
2. Depending on the population of the subordinate territory, the Centers are divided into the
following categories:
• Category II - Centers serving up to 2 million people;
• Category I - Centers serving more than 2 million people.

It is ratified
By resolution of Cabinet of ministers of Ukraine
№1020 from 07.12.2012

Approximate position
about the dispatching service
emergency and medicine of disaster center
(extract)
1.General provisions
1.1 The Dispatching Service (hereinafter - the DS) is a structural unit of the emergency and
medicine of disaster center (hereinafter - the Center).
1.2. The DS of the Center, using telecommunication networks, software, technical and other
means in a round-the-clock mode, provides informational support of rendering emergency medical
care in a daily mode, during the elimination of the consequences of an emergency situation and
during the special period.
1.3. The DS of the Center accepts emergency calls made by a single emergency number 103,
or by operators of the emergency system at 112.
2. Tasks
 2.1. In accordance with its tasks, the DS is obliged to:
• Accept the emergency medical care call, ensure that it is handled and responded promptly;
• during the processing of an emergency medical call, to form information about the place of
the event, the nature and features of the emergency state of the person, the type of assistance
required for such condition, and inform the subscriber who made the emergency medical care call;
• to transmit information about the emergency medical service call, the nature and features
of the emergency chief, as well as.
• identify the state-owned healthcare facility (hereinafter referred to as the health facility) to
which transport the patient in an emergency, and pass on this information to the ambulance team
and the relevant healthcare facility;
• provide information support for the provision of emergency medical care and receive
information on the outcome of its provision at the scene, during transportation and arrival of the
patient in a health care facility;
• promptly provide on-site consultative health care for health care applications;
• to transmit information on emergencies to the units of emergency rescue, emergency
services, law enforcement agencies;
3. Functions
The DS performs the following functions:
3.1. Ensuring that primary medical records are completed in the form of an electronic call
card.
3.2. Automatic location of the subscriber's location and phone number.
3.3. Automatic registration of the information (negotiations) of the subscriber with the
dispatcher.
3.4. Call transfer and e-card call to ambulance team.
3.5. Control over the work of ambulance teams.
3.6. Coordination of the work of the ambulance team and the healthcare facilities of the
administrative unit in providing emergency medical assistance to patients.
3.7. Prompt response to emergencies, coordination of ambulance team work in eliminating
their health consequences.
3.8. Acceptance of information on the need to provide on-site consultative assistance to
health care institutions of the respective administrative and territorial unit.
3.9. Formation of a bank of information on calls for emergency medical care and medical
statistics.
3.10. Provision of medical information information to the population.

It is ratified
By resolution of Cabinet of ministers of Ukraine
№1118 from 21.11.2012

Order
informing emergency / ambulance teams
about calling for emergency medical care and sending them to the scene of an emergency
(extract)
To receive call information, call center dispatchers:
answering a call;
completing primary medical records electronically;
transmission of information electronically to the direction manager.
Directions dispatchers provide:
• receiving information (electronic card) from the call manager;
• transfer of information (electronic or paper card) to the ambulance team leader;
 • receiving confirmation from the ambulance team that the call information has been
received;
• information support at all stages of emergency medical care on call;
• transfer information to hospital inpatient facilities on the need for hospitalization of
patients on call;
• receive notification of the amount of emergency medical care provided on call;
• transfer of information about the completion of the assistance provided by the call crew to
the dispatcher service of the center;

It is ratified
By resolution of Cabinet of ministers of Ukraine
№1117 from 21.11.2012

Typical position
about an emergency (ambulance) station
(extract)
1. Emergency (ambulance) station (hereinafter referred to as the station) is a health care
facility whose main task is to ensure the constant readiness of emergency (ambulance) crews
(hereinafter referred to as teams) to provide emergency medical assistance around the clock;
coordination of their activities with the operational and dispatching service of the center of
emergency medical care in the territory of the administrative-territorial unit.
2. The station is a functional component of the emergency medical aid system of the
respective administrative and territorial unit.
3. The station in its activity is guided by the legislation of Ukraine, decisions of local
executive bodies, orders of the Ministry of Health, structural divisions on health care of local
administrations, the head of the center, the chief physician of the station.
4. The station is headed by the chief physician, who reports to the head of the center, the
deputy head of the center for organization of emergency medical care.
5. The station may be a part of the territorial medical association “Center for emergency
medical care and medicine of disaster” as a legal entity and perform the functions defined by the
statute of association, or have the status of a separate unit of the center and perform the functions
assigned to it.
6. The main tasks of the station are:
1) ensuring the provision of emergency medical care to patients in accordance with the
standard of arrival of brigades to the scene of an emergency after receiving the appropriate order
from the operational-dispatching service of the center;
2) ensuring transportation of persons who are in an urgent condition and require compulsory
medical support to health care facilities, which are defined by the operative-dispatching service of
the center;
3) Participation in emergency response.
The station or its subdivisions only perform tasks related to the provision of emergency
medical care.

It is ratified
By resolution of Cabinet of ministers of Ukraine
№ 1114 from 21.11.2012

Typical position
is about the team of urgent (ambulance) medicare

1. Team of urgent (ambulance) medicare (farther is a team) is the part of center of urgent
medicare and medicine of catastrophes (farther is a center) or station of urgent (ambulance)
medicare (farther is the station), that renders urgent medicare to the man that is in the urgent state,
directly in place of event and during transportation of such man to establishment of health
protection.
2. Ambulance team in the work follows a legislation, post instructions, normative and by the
methodical documents.
3. Ambulance teams appear and liquidated in decision of leader of center in compliance with
the legislation.
4. The calculation of amount of teams is conducted in accordance with norms.
5. After the composition teams are divided into medical and medical assistant's.
6. A doctor, medical assistant, nurse, driver, enter in the complement of medical team. The
leader of team is a doctor.
7. All her workers submit the leader of team.
8. The workers must correspond qualifying requirements to position and on the state a health
to be suitable to work in extreme terms.
9. The basic tasks of ambulance team are:
1) grant of urgent medicare to the patients and injured on the prehospital stage and during
their hospitalization to profile establishments of health protection;
2) transportations of patients, that need obligatory medical accompaniment, to stationary
establishments of health protection at the direction of controller of operatively-controller's service
of center;
3) participating is in liquidation of consequences of emergency.

It is ratified
By resolution of Cabinet of ministers of Ukraine
№1119 from 21.11.2012

About the norm of arrival for team of urgent (ambulance)

medicare to the scene of an emergency
1. To set, that:
1) appeal in relation to the grant of urgent medicare after the only telephone number of
urgent medicare 103 or after the only telephone number of the system of urgent help to the
population 112 depending on the state of patient is divided into urgent and non-urgent according to
addition;
2) norms of arrival of brigades of urgent (ambulance) medicare into the scene of an
emergency after appeals that belong to the category of urgent, present in cities - 10 minutes, in
settlements out of city boundaries - 20 minutes from the moment of receipt of address.

Addition № 1.

Criteria of distribution of appeals depending on the state of patient on urgent and non-
urgent
1. To the category of urgent appeals belong in relation to a patient that is in the urgent state,
that:
1) accompanied:
consciousness; by seizures; by sudden disorder of breathing; by sudden pain in area of heart;
vomiting by blood; by sharp pain in an abdominal area; external bleeding; by the signs of acute
infectious diseases; by acute psycho disorders that threaten to life and health of patient and/or other
persons;
2) predefined:
by all types of traumas (wound, breaks, dislocations, burns); by a hit an electric current,
thermal hit, asphyxia of all kinds; by the damages of different etiology during emergencies (road
and transportation accidents, accidents on a manufacture); poisoning, by the bites of animals,
snakes, spiders and insects and others like that; by the disorders of pregnancy.
To the category of urgent the appeals of medical workers belong also in relation to
transporting of patients, that are in the state that needs obligatory medical accompaniment and
urgent hospitalization to stationary establishments of health protection.
2. To the category of non-urgent belong appeal in relation to a patient, the state of that is not
urgent and:
1) accompanied: by a sudden cough, by a headache, dizziness, weakness; by pain in back,
joints (radiculitis , osteochondrosis, arthritis, arthrosis and others like that); by a pain syndrome for
oncologic patients; by an alcoholic, narcotic, toxic abstinent syndrome;
2) predefined by intensifying of chronic diseases for patients, that are under surveillance of
FD concerning hypertensive illness, gastric and duodenum, chronic inflammation of liver, gall-
bladder, bowels, illness of kidneys, joints ulcers and others like that.
4. The controller of operatively-controller's service of center of urgent medicare and
medicine of catastrophes redirects an appeal that belongs to the category of non-urgent, to
corresponding establishment of health protection primary health care help - directs to the patient the
team of urgent (ambulance) medicare that does not execute urgent calls, during 1 hour from the
moment of receipt of appeal.

Order of Ministry of health

Ukraine
is RATIFIED
on August, 09, 2017 № 918

CHANGES
are to reference Book of qualifying descriptions of professions of workers.
1.To complement a division "SPECIALISTS" by the new point of such maintenance:

INSTRUCTOR OF PRE-HOSPITAL HELP

Task and duties. Follows Constitution of Ukraine, current legislation of Ukraine, other
normatively-legal acts that determine activity of establishments of health protection; carries out the
methodical providing and coordination of work of the accredited educational-training structural
subdivision of establishment on the base of that the studies of separate categories of non-medical
workers are conducted and all, who expressed a desire, grant of prehospital help; develops and
prepares educational materials; organizes an educational-training process, completes educational
groups; analyses results educational-training process: assists communication between listeners and
coordinator of educational center; conducts the statistical account of job of educational-training
structural subdivision, stages of preparation performances, summarizes job performances; adheres
to the personal and public safety and rules of labour protection rules; owns the receptions of
reanimation, able to give help at traumas, bleeding, cardiovascular diseases, collapse, poisoning,
warming, mechanical asphyxia, anaphylactic shock, thermal and chemical defeats, allergic states;
adheres to principles of medical deontology; the professional perfects constantly level.
Must know: Constitution of Ukraine, current legislation of Ukraine about a health protection
and other normative documents that regulate activity of establishments of health protection; rights,
duties and responsibility of instructor from a grant prehospital help; international classification of
illnesses; the clinical discipling (protocols) is from medicine of the urgent states and grant of urgent
medicare; bases of anatomy, pathoanatomy , physiology and physiopathology of human; bases of
internal medicine, pediatrics, surgery, obstetrics and gynecology, traumatology, urology,
infectiology; immunology, etiology and pathogeny of the most widespread diseases, methods of
their diagnostics and principles of treatment; basic methods of CPR children and new-born have
features of reanimation and intensive therapy; principles of grant of medicare to the victims are at
emergencies with plenty of victim, and also at the exposure of especially dangerous infections; rules
of registration of medical documentation; rules of deontology, communication are between
employees and other services; safety rules during work with a medical tool and equipment.

PARAMEDIC
Task and duties : follows Constitution of Ukraine, by the current legislation of Ukraine
about a health protection, by other normatively-legal acts, that regulate the question of health
protection, activity of establishments of health protection, organization of the first medical aid to
the adult and child's population; carries out professional activity under the direction of doctor or
independently; provides own safety; cooperates with other urgent by services; inspects patients in
the presence of the urgent states, executes the medical sorting; makes decision about the volume of
help and hospitalization; at a necessity consults by a doctor; renders urgent medicare at traumas or
diseases of respiratory, cardiovascular, endocrine, immune, nervous systems, system of digestion
and urogenital system, at psycho diseases, at the damages of musculosceletal system , at the action
of external factors; carries out treatments and manipulations: inhalations, injections; a intra bones
provides and peripheral intravenous accesses; sets urinary catheters, stomach-pumps, provides
communicating of overhead standard, decompression punction of pleura cavity, sets air-channels,
carries out the intubation of trachea, surgical renewal of communicating of respiratory ways; stops
bleeding direct pressure, tamponing; at traumas conducts stabilizing and immobilization of
musculosceletal system, lays on bandages; writes down and interprets the results of
electrocardiogram; executes vehicle researches and urgent procedures and carries out preparation of
patient to other researches; analyses a working process with the aim of upgrading of work; conducts
medical documentation; passes to the separation of urgent medicare information about the process
of grant of medicare to the patient in place of event and during transporting to the separation;
manages the specialized ambulance of urgent medicare; conducts replacement of expense materials,
checks up a good condition and readiness of equipment; helps at transporting of patients, executes
transportation of patients to establishments of health protection; adheres to principles of medical
deontology; provides maintenance of medical secret; constantly perfects the professional level.
Must know: Constitution of Ukraine, current legislation of Ukraine about a health protection
and other normative documents that regulate activity of establishments of health protection; rights,
duties and responsibility of paramedic; a current legislation of Ukraine is about information and her
defence; principles of organization and functioning of the system of urgent medicare; general
principles of organization of work and operating normatively-legal acts, that regulate work of center
of urgent medicare and medicine of catastrophes, station of urgent medicare, separation of urgent
medicare; operating normatively-legal acts, that regulate work, right and duties workers of the
system urgent medical help; pharmacodynamics of medicinal facilities and their co-operation,
testimony and ways of introduction, dosage, complication at their application; international
classification of illnesses; the clinical discipling (protocols) is from medicine of the urgent states
and grant of urgent medicare; anatomy, pathoanatomy, physiology and physiopathology of man,
internal medicine, pediatrics, surgery, obstetrics and gynecology, orthopedy and traumatology,
urology, otorhinolaryngologist, ophthalmology, neurology; immunology, oncology, etiology and
pathogeny of the urgent states, methods of their diagnostics and principles treatment; children and
new-born have methods of CPR, feature of reanimation and intensive therapy; principles of conduct
of physiology luing-ins and recognition of pathological; principles of work are with an anesthesia-
respiratory and other apparatus that is used in urgent medicare; rules of deontology, communication
are between employees and other services; rules of the medical sorting; safety rules are during work
with a medical tool and equipment; requirements are in relation to the conduct of primary medical
registration documentation; tables of rigging of establishments of health protection, that enter in the
complement of the system of urgent medicare; an order of work is at emergencies with plenty of
victim, and also at the exposure of especially dangerous infections; rules of travel motion; rules,
order and terms of transportation of patients.

URGENT MEDICAL TECHNICIAN

Task and duties : follows Constitution of Ukraine, by the current legislation of Ukraine about
a health protection, by other normatively-legal acts, that regulate the question of health protection,
activity of establishments of health protection, organization of the first aid to the adult and child's
population; carries out professional activity under the direction of doctor or paramedic; estimates
the place of event in the presence of threats to own life and life of other people, factors that
influence on the state and health of patients; provides own safety; keeps inviolability of place of
event and material proofs, co-operates with other urgent services; estimates the state of patient,
inspects patients in the presence of the urgent states, participates in medical sorting; renders
medicare in composition the brigade of urgent medicare; looks after and gives help at by-reactions
on medicinal facilities; executes reanimation measures; helps the personnel of separation of urgent
medicare; helps in the conduct of medical documentation; gives medical accompaniment during
mass measures, sporting events and other measures; helps at transporting of patients and executes
transportation of patients to establishments of health protection; manages the specialized ambulance
of urgent medicare; supports the specialized ambulance of urgent medicare cocked, works with the
present specialized equipment; conducts replacement of expense materials; checks up a good
condition and readiness of all equipment; adheres to principles of medical deontology; provides
maintenance of medical secret; constantly perfects the professional level.
Must know: Constitution of Ukraine, current legislation of Ukraine about a health protection,
information and its defence, other normative documents that regulate activity of establishments of
health protection; rights, duties and responsibility of urgent medical technician; a current legislation
is about a motor transport and travel motion; rules of travel motion; bases of anatomy,
pathoanatomy, physiology and physiopathology of human, pediatrics, surgery, obstetrics and
gynecology, orthopedy and traumatology, urology, otorhinolaryngologist, ophthalmology; etiology
and pathogeny of the most widespread urgent states, methods of their diagnostics and principles of
treatment; basic methods of CPR; children and new-born have features of reanimation; principles of
conduct of physiology luing-ins and recognition of pathological; testimony and ways of
introduction of the most widespread medicinal substances, their compatibility, dosage; rules of
registration of corresponding documentation; rules of deontology, communication are between
employees and other services; safety rules during work with a medical tool and equipment.

IV. REGISTRATION-CURRENT DOCUMENTATION

WHAT CERTIFIES ACTIVITY OF CENTER OF URGENT MEDICARE

it is Ratified
By the order of MoH of Ukraine
№ 999 from 17.11.2010

1) "Card of call of emergency help" (form N 109/о) and Instruction are in relation to filling.
2) "Card of departure of ambulance team" (form N 110/о) and Instruction are in relation to filling.
3) "Accompanying sheet" (form N of 114/о) and Instruction are in relation to filling.
4) "Journal of registration of appeals about the emergency help" ( form N 115/о) and Instruction are
in relation to filling.
5) "Diary of work of the station (unit) of emergency help" ( form N of 115-1/о) and Instruction are
in relation to filling.
6) "Report of the station of emergency help (form N 22) and Instruction are in relation to filling.
 V. CONTROL QUESTIONS FOR EXAMINATION OF THE THEORETICAL
KNOWLEDGE

1. What Law of Ukraine regulate activity of emergency care. Shortly expose maintenance.
2. Give definition to the basic terms that are used in the article of a Law of Ukraine "About
emergency medical care».
3. Generalize essence of resolution of Cabinet of Ministers of Ukraine № 1116 from 21.11.2012.
4. Shortly expose maintenance of resolution of Cabinet of Ministers of Ukraine №1119 from
21.11.2012 in part of norms of arrival of emergency team to the scene of an emergency. Criteria of
urgency of distribution of appeals are depending on the state of patient.
5. Explain maintenance of order №1020 from 07.12.2012.
6. Expose shortly maintenance of resolution of Cabinet of Ministers of Ukraine №1117 from
21.11.2012 that regulates work of the station of urgent/ ambulance of medicare. List its basic tasks.
7. Outline general principles of work of ambulance team in obedience to typical position about the
team of urgent medicare, Cabinet of Ministers of Ukraine №1114 from 21.11.2012.
8. Describe tasks and duties of instructor of pre-hospital help.
9. Describe tasks and duties of paramedic.
10. Describe tasks and duties of urgent medical technician.
11. Give the list of basic registration documentation that certifies activity of urgent medicare in
obedience to the order of MoH of Ukraine №999 from 17.11.2010.
12. List of basic statistical indexes to characterize activity of emergency medical services.
13. Expose maintenance of instruction to primary medical record N 109/o "Emergency call card".
14. Expose maintenance of instruction to primary medical registration documentation "Map of
departure of emergency team (ambulance)" (form № 110/о).

VІ. LIST OF BASIC STATISTICAL INDEXES:

1) Part of the patients hospitalized on results appeals to EMS (emergency medical services):
Number of patients that is hospitalized
Common amount of calls of emergency medical aid × 100 %

2) Index of level of appeals to medical first – aid

Number of all appeals to emergency aid for a year

× 1000
Average annual quantity of population

3) A structure of appeals is for nosologies

Number of illnesses of this pathology (groups)

× 100 %
Incurrence of appeals
4) Index of structure of appeals by sex / by age:
Number of patients applied for help by sex and by age

(_ ?№ ШМД × 100 %
Number of all appeals for emergency aid

5) Part of calls by the separate types of ambulance teams

Amount of calls by the separate type of the specialized ambulance team

× 100 %
Common amount of calls of emergency aid

6) Index of seasonality of calls for emergency help

Amount of patients that called emergency aid in set time of year
Common amount of appeals in emergency aid × 100 %

VII. SITUATION TASKS FOR PRACTICAL SKILLS FORMATION

Situational Task No 1
Amount of emergency provided medical care in the city of K in the analyzed years
List of measures what were Years
conducted C-year N-year R-year
1. Calls that were conducted 4989 4817 5268
2. Consultations that were held 3692 3462 3570
Invasive manipulations that where
3. 180 252 333
done
Delivered to medical institutions in
4. 1117 1103 1365
the city of K
According to the situational task you need to:
1) Calculate the indicators (%) of the implemented measures on the amount of the
emergency medical care (EMC) in the city K by years;
2) Graph the pie charts for obtained indicator of the R-year.

Situational Task No 2
In Region K, where the population is 1 million 757 thousand people, for the reporting
year, 561 450 calls to ambulance stations were recorded, 557 383 departures were made and
4067 rejections of emergency calls due to their unreasonableness.
According to the situational task you need to:
1) Calculate indexes:
 - the level of calls to ambulance in the K region (per 100 thousand population);
- Proportion (%) of reasonable and unreasonable ambulance calls in K region
2) To show graphically a pie chart with obtained indexes of the proportion of reasonable
and unreasonable calls to ambulance in area K.

Situational Task No 3
Age of persons, who received emergency medical care in city D
Age of persons,who received an Years
emergency medical care
C-year N-year R-year
0-14 years 1337 1100 2015
15-17 years 47 70 74
>17 years 2308 2292 1481
Total 3692 3462 3570
According to the situational task you need to:
1) Calculate the indexes (%) of the age structure of persons who received
emergency aid in city D by years;
2) Graphically show indexes of the age structure of persons who received
emergency aid in city D in R-year by sectoral diagram.

Situational Task No 4
Amount of departures of ambulance reams to inhabitans of cities of the region W and to
inhabitants of contrysides of region W and beyond the boundaries of the region
Years
Calls to EMS С-year N-year
Absolute numbers Absolute numbers
1. In cities of regin W 931 991
2. In countrysides 2080 1793
3. beyond the boundaries 14 19
Total 3025 2803
According to the situational task you need to:
1) Calculate the indexes of departures (%) of ambulance teams to inhabitans of cities in
the region W, countrysides and beyond the boundaries of region;
2) Graphically show obtained indexes of the departures of the ambulance teams to the
inhabitants of the cities of region W and countrysides in C-year by sectoral diagram.

Situational Task No 5
In region B, with a population of 1 million 757 thousand people, 561 450 calls to EMC
stations were recorded during the reporting year, at the same time 557 383 departures were
made and 4067 refusals of ambulance aid due to calls unreasonableness. In the structure of
the departures, what was made, 39,948 was made due to accidents and 384 674 due to acute
diseases, 2 673 childbirth and pathology of pregnancy and 62 008 departures for other
diseases. In addition, 28,821 patients were transported and 39,259 unreasonable departures
were made.
 According to the situational task you need to:
1)Calculate indexes:
- the level of departures made by ambulance teams to the population of region B (per 100
thousand population);
- the structure of the departures what was performed by the ambulance crews for various
reasons to the population of the region B.
2) To show graphically the obtained indexes of the structure of departures made by
ambulance teams for various reasons to the population of the region B by sectoral diagram.

Situational Task No 6
Number of ambulance teams and the number of people who received emergency
medical aid during the reporting year in Region X.
Number

Types of People who received emergency

ambulance teams Ambulance teams medical care

(Absolute value) (Absolute value)

General 46 198 511
Specialized 20 21 866
Paramedics 60 167 564
Total 126 387 941
In the region of X there are 1 million 386 thousand people.
According to the situational task you need to:
1) Calculate the indexes of work of ambulance teams.
2) To show graphically indicators of the level of work provided by one ambulance team (per
100 thousand) population of the region X for the reporting year by linear diagram.

Situational Task No 7
In region B, where the population is 1 million 695 thousand people, 16 ambulance
stations are organized and 1 emergency hospital function. In total, there are 1,657 posts in
Emergency Center of Category II staff, including 322 physicians and 727 secondary medical
workers. It is known that 270 physicians work in full-time medical positions, and 715
secondary medical staff members. There are 45 general ambulances (42 - for adults and 3 -
for children), 10 specialized and 50 paramedical teams.
According to the situational task you need to:
1) Calculate indexes:
- staffing (%) with physicians and secondary medical workers of the Emergency Center of category
II of the region
- structure (%) of functioning of ambulance team types of Emergency Center of category II of
region B.;
2) Show graphically indicators of staffing positions of doctors and secondary medical
workers of the Emergency Center of category II of region B.
 Situational Task No 8
Reasons of departures of the anbulance crews in the city of H in G-year
All departures
Reasons of calls
Absolute value
1 Medical transportation 1081
2 Consultation 105
3 Road accidents 451
4 Acute conditions 828
5 Training 39
6 Event service 210
7 Accompaniment 10
8 Technological departures 153
9 Fires 136
10 Ineffectual 12
Total 3025
According to the situational task you need to:
1) Calculate the structure indexes (%) of the reasons for the departure of ambulance teams
in the city H in year G and to re-evaluate the obtained results;
2) Show graphically obtained indexes of the reasons for the departure of ambulance teams
in the city of H in G-year by pie chart.

Situational Task No 9
Age distribution of population, who received emergency care from ambulance teams in
F during the last three years
Number of
А-year В-year С-year
people, who
received
emergency Absolute value Absolute value Absolute value
aid
1 All 876 2129 2295
2 - children 60 251 270
3 - adult 816 1878 2025
According to the situational task you need to:
1) Calculate indexess (%) of medical care provided by ambulance teams in the city of F
during the last three years;
2) Show graphically the obtained indexes of medical care provided by the ambulance teams
in the city F in C-year by sectoral diagram.

Situational Task No 10
In Region K, where the population is 1 million 757 thousand people, during the
reporting year 561 450 calls to EM stations were recorded, 557 383 departures were made and
4067 refusals were recorded due to unreasonableness. At the same time, 146 343 departures
of ambulance crews to countrysides were made. Therefore, the timely departures (up to 10
minutes and 20 minutes) were 473 773. Among them, 36 127 were due to accidents, 331 722
due to acute diseases, 2 441 childbirth and pathology of pregnancy and 52 658 departures due
to other diseases. At the same time, 19 720 timely arrivals were recorded regarding
transportation of patients and 31 105 due to unresonable calls. 106 210 timely departures
were made to the countryside.
According to the situational task you need to:
1) Calculate indexes:
- the levels of departures made by ambulance teams for various reasons to the
population of the K region (per 100 thousand people);
- part of departures what were made by ambulance teams (%) to countrysides.
2) Show graphically obtained indexes of the levels of departures what was made by
ambulance for various reasons to the population of the K region (per 100,000
population) by linear diagram

Situational Task No 11
Number of the departures what were made ambulance crews by months in the year G in the
city H
Months All
Reason of calls during
І ІІ ІІІ ІV V VI VII VIII IX X XI X year
Medical
1081
transportation 91 99 87 105 67 77 99 100 69 97 84 106
Consultation 24 15 9 6 13 5 18 2 1 3 4 5 105
Road accidents 38 39 18 40 36 29 38 51 46 31 35 50 451
Acute conditions 84 91 51 65 73 61 98 62 74 65 64 40 828
Training 3 3 2 11 10 2 0 0 3 1 4 0 39
Event service 9 2 14 23 20 44 16 30 5 27 4 7 210
Accompaniment 0 2 0 1 0 0 0 0 0 0 7 0 10
Technological
153
departures 16 12 10 15 23 10 12 15 8 6 14 12
Fires 10 19 19 17 17 4 8 9 17 10 0 6 136
Ineffectual 0 0 0 0 0 8 0 2 0 1 2 0 12
Total 275 282 218 283 259 240 289 271 223 241 218 226 3025
According to the situational task you need to:
1) Calculate the monthly indexes (%) of calls to ambulance brigade in city H in G-year for
traffic accidents;
2) show graphically using radial diagram the obtained indexes (%) of ambulance teams
departures in the city H in G-year due to traffic accidents.
 Situational Task No 12
Departures made by EM teams to medical institutions of cities of regional subordination for
consulting of patients
Count of calls to ambulance by years
Cyties F-year S-year G-year
(Absolute value) (Absolute value) (Absolute value)
1 Lviv 1757 1665 1686
2 Drohobych 126 79 137
3 Stryy 101 110 67
4 Chervonograd 54 69 46
5 Boryslav 33 28 15
6 Truskavets 7 11 15
Total 2078 1962 1966
According to the situational task you need to:
1) Calculate indexers (%) of consultative calls made by ambulance teams to patients of
medical institutions of cities of regional subordination during three years;
2) Show graphically the consultative calls made by the ambulance teams to the patients of
the medical institutions of the cities of regional subordination in G-year by the pie chart

Situational Task No 13
The total number of calls to ambulance in N city by months in G-year
Number of months
calls to
ambulance І ІІ ІІІ ІV V VI VII VIII IX X XI XII Total

Number of
275 282 218 283 259 240 289 271 223 241 218 226 3025
calls
According to the situational takk you need to:
1) Calculate monthly indexes (%) of calls to EMS in city H in G-year;
2) Show graphically with the a radial chart the obtained indexes (%) of calls to EMS in
city N. in G-year.

Situational Task No 14
Number of specialized ambulance teams and the number of people who received emergency
medical care during the reporting year in region X
Numbers
Types of
specialized People, who received emergency
Number of specialized medical aid
ambulance teams ambulance teamd
(Absolute value) (Absolute value)
 Spesialized : 36 69 213
-cardiology 12 24 312
- intensive care 15 25 020
- neurological 1 3 310
- psychiatric 4 8 320
- other specialized 4 8 251
In the region X there are 2 million 813 thousand people.
According to the situational task you need to:
1) Calculate the indexes of work of ambulance teams;
2) Show graphically obtained indicators of the level of providing medical care by one
specialized team in region X (per 100 thousand population) by bar chart.

VIII. RECOMMENDED REFERENCES

1. Social medicine and organization of health care/under the Ed. Yu. V. Voronenka, V.F.
Moskenko. Ternopil: Ukrmedbook. 2000.
2. Public health: textbook for students of higher medical education institutions/[B.F.Moskalenko,
O.P.Gulchii, T.S.Gruzieva]; ed. by V.F.Moskalenko – 3rd reissue: Nova knyha, 2013.-560p.
3. Fundamentals of Ukrainian legislation on health care. Law of Ukraine № 2801-XII від
19.11.1992 р. with the redaction from 01.01.2019. URL:
https://zakon.rada.gov.ua/laws/show/2801-12.
4. On approval of the concept of public health system development. Decree of the Cabinet of
Ministers of Ukraine of 30 November 2016 р. № 1002-р URL:
https://www.kmu.gov.ua/ua/npas/249618799
5. Legislation of Ukraine. URL: zakon.rada.gov.ua/
6. Statistical data of Ukraine. URL: https://www.lv.ukrstat.gov.ua/
7. Statistical data of Lviv region. URL: http://www.ukrstat.gov.ua/

Instruction
for filling the form of primary medical records N 109 / o"Emergency call card"
1. This Instruction defines the order of filling in the form of primary medical records N 109 /
o "Emergency medical card" (hereinafter - the card).
2. The Card is the primary medical document for reporting calls of people.
3. The card should be filled in by a medical assistant, dispatcher.
4. The right column of the card:
4.1.To fill in the date and order number of call to the emergency medical service.
Numbering of cards is made in advance for each day.
4.2. The "Dispatcher N" line indicates the number of the manager who answered the call,
workplace number.
4.3. The line "reason for the call" records data from the words of the person calling the
ambulance: the reason for recieving treatment, the number of victims, if possible - the condition of
the sick or injured person, etc.
4.4. The "Call Address" line fully specifies (if available) the call address, where the
ambulance team should arrive, the telephone number of the person who need medical help, their
surname, age and gender, the name of the person calling the ambulance.
4.5. The line "Additional information, reason for rejection" contains additional information
regarding the call: about the facility, institution, where the ambulance team need to arrive, the best
way to get to the place of the accident, place where the ambulance team will meet, the door code
number, etc.
4.6. The "Departure and return time" line specifies the time of departure of the ambulance
team for the call and the time of the return of the ambulance team to the station.
5. The left column of the card:
5.1. The "Time" line specifies the time of receiving the call (hours and minutes),
transmitting it to the ambulance team, leaving, arriving at the call, ending the call and returning the
ambulance team to the station.
5.2. The "Transferred" line contains information about the place of call transfer: substation
number, ambulance team number, to which the call was referred, the emergency room indicating
the telephone number, registration number and surname of the ambulance station dispatcher, who
referred the call, dispatcher of emergency station who answered the call.
5.3. In the "Direction dispatcher" line is the number of the dispatcher on ambulance station
who controls the execution of the call.
5.4. The term of storage of a card in a medical institution is three years.
5.5. A-5 card format

Instruction
on filling in the form of primary medical records 110/o
«Ambulance Departure Card»
1.This Instruction specifies the order of filling of the primary registration form 110/o
"Ambulance departure card" (hereinafter - the card).
2. The card shall be filled in by the head of the ambulance team on national language, as
well as for each patient who received medical care.
3. The card is filled with a ballpoint pen of blue or black.
4. Corrections are not allowed in the card.
5. The paras in which coding is provided are encoded in Arabic numerals.
6. The paras with making the choice of the proposed variant in blank are indicated by .
7. The passport part of the card shall indicate the number by which an appeal to the
ambulance station is registered and the date of receipt of the call by the dispatcher of the ambulance
station, which must coincide with the details of the card.
8. In the case of providing medical assistance by the ambulance team on one call to several
persons, the cards are numbered by one call number.
The same numbering is carried out in cases of passing calls directly to the team.
9. The number, month and year are indicated only in Arabic numerals.
10. The address and the reason for the call are indicated as they were registered when the
call was received.
11. The name, surname and patronymic of the patient should be written in legible letters as
they are recorded in the identity document (passport, etc.), in the absence of any document - from
the words of the person or witness.
12. The item "Patient's address" shall indicate the place of residence of the person according
to the information entered in the passport document or address, location; in the absence of any
document confirming identity, the place of residence is indicated from the words of the person or
witnesses.
13. Items "Place of work", "kind of activity" shall indicate (if available) the name of the
institution, organization where the person works and the position he occupies (profession), or
indicate the name of the educational institution where the person study (faculty, course, class).
If the person does not work (does not study), the line indicates: does not work.
14. In case of violation of the person's consciousness, passport and other data are recorded
from the available documents or from the words of witnesses.
15. In case it is impossible to establish the passport data of the person, the item "Surname,
first name, patronymic" is not filled and remains free, and on the back of the card the items
"Complaints" and "History of disease" indicate the approximate height, the figure of the person
(deceased), color her hair and eyes, special features, describes clothes, shoes etc.
16. If the person is insured, the items "Insurance policy N" and "Insurance company" shall
indicate the number of the insurance policy and the name of the insurance company.
17. Item 1 "Age" indicates the full age of the person in the line named "years". If it is
impossible to determine the age of the person, it is determined approximately by median age with
the sign "~".
The age of children up to one year is encoded in line named "month" in which the number of
months is affixed.
The age of children up to one month is encoded in line named"days", which indicate the
number of days.
The full date of birth (number, month and year) should be entered (at the top above the
"Age" point) in cases of departure for children under three years of age, as well as in patients
diagnosed with "acute myocardial infarction" and "acute cerebral circulation".
18. In item 2, "Gender", digit 1 is coded as male and digit 2 is female.
19. In item 3 "Resident" the information is indicated according to the data of the place of
residence registration.
20. In the absence of registration information shall be indicated at the place of call. Foreign
nationals are encoded with the number 3.
21. Item 4 "Social status" encodes the relevant social status of the individual.
22. In item 5 "Further patient stay" the information as to the subsequent stay of a person
after the provision of medical care is encoded:
figure 1 is affixed if the person remains on the place of the call;
figure 2 - if the person is brought home to the place of residence after providing medical
care;
figure 3 - if the person is taken to another place, what must be indicated (to the apartment
to relatives, acquaintances, etc.);
figure 4 - if the person is delivered at the direction on the basis of form N 114 / o "Cover
letter. Coupon to the cover letter" (hereinafter - cover letter).
The hospital outfit number is displayed in the appropriate line.
Cover number - in the appropriate line;
figure 5 - in the case of transportation of a person solely to the direction of another medical-
preventive inctitute (the name of the institution is indicated);
figure 6 - if the person is taken to medical-preventive institute (trauma center, medical
center, polyclinic, etc.) without registration of a cover letter.
In the case of transportation of a person to a medical-preventive institute, name of institute
is indicated.
The time of arrival at the medical-preventive institute and the time of departure are specified
in item 5 "Further stay of the person" by the team chief upon fact.
The doctor of the emergency department of the medical and preventive hospital, who
accepts the person or refuses to hospitalize him, makes the appropriate entry (diagnosis or
justification of the refusal) in item 5 "Further stay of the patient", states his name and signs it.
If a person has been examined in the emergency department of a medical-preventive
institution by several specialists, the return time and the diagnosis made after examination of the
person by each specialist shall be indicated on the back of the card in free space.

In item 10 "Medical care according to diagnosis":

figure 1 is affixed after the physician's assessment of the person's condition in cases where
the person really needs emergency medical care from the ambulance team:
• accidents and all kinds of injuries (injuries, fractures, burns, severe injuries, head injuries,
other injuries, etc.) that have caused disability and require medical support; electric shock;
heatstroke; asphyxia of all kinds; severe bleeding of all kinds; damage during emergencies;
 • sudden worsening of the condition (loss of consciousness, acute disorders of
cardiovascular, respiratory, central nervous system, allergic reactions of immediate type, acute
abdominal pain, etc.), which caused a limitation of capacity and required medical support during
transportation;
•labor, complications of pregnancy;
• transportation of persons after calling of a medical professional (except for planned
hospitalization) in the presence of medical indications for emergency hospitalization to a medical-
preventive institution.
figure 2 - in cases where the person does not require emergency medical care.

The card is not issued in the case when medical worker provide medical aid without the
involvement of the ambulance team, and the information on the provision of medical care and the
use of medicines is entered by the medical worker who provided this aid in the "Register of
outpatients" (Form N 074/o).

In item "Injury", the relevant figure encodes the types of injury.

figure 1 - injuries resulting from unforeseen factors in everyday life;
figure 2 - street injuries - those that occurred on the street and do not belong to another type
of injury;
figure 3 - injury caused by another person;
figure 4 - injuries resulting from an accident;
figure 5 - injuries, poisonings and illnesses caused by external factors in the workplace
while performing professional duties.
Injury caused to another person in the course of his / her professional duties is coded as
industrial;
figure 6 - injuries sustained during sports;
figure 7 - suicide injuries;
figure 8 - injuries resulting from icing.

The accuracy of the information entered in the card, the head of the team certifies with a
signature.
The card must be filled in and immediately handed over to the dispatcher after the
ambulance team returns to the station.
Card retention in a hospital is one year after the reporting period.
Card format - A 4.

Instruction
on filling in the form of primary medical records N 115/o
"Emergency medical records journal"
1. This Instruction specifies the order of filling in the form of primary accounting records
N 115/o "Emergency medical records journal ".
2. The journal is a medical document of the departments of emergency medical care, which
are organized at outpatient establishments for providing emergency medical care to adults and
children at home.
3. The journal is filled by a medical worker – paramedic, a nurse of a medical center
(department) of emergency medical care according to the established model.
4. All journal columns must be filled in.
5. The journal must be numbered, lined and stamped by the health care institution.
6. The period of storage of the journal in a medical institution is three years after the
reporting period.
7. The format of the journal - A4, pages stitched, stamped and signed by the head of the
institution.