a system of forces and means for providing medical assistance to victims in emergency situations. The All-Russian Disaster Medicine Service (VSMK) is organized at 5 levels: federal, regional, territorial, local and facility. The federal level (on the scale of the Russian Federation) is represented by: the All-Russian Center for Disaster Medicine "Protection" (VTsMK), with its headquarters of the VSMK, branches of the VTsMK "Protection" (in seven federal districts and in special occasions may temporarily be created in certain subjects of the Russian Federation), a clinic for disaster medicine with a field multidisciplinary hospital (PMH), the Institute for Problems of Disaster Medicine, the Center for Medical Expertise and Rehabilitation, the Research Department of Medical and Technical Problems of Extreme Medicine, the Department of Medical Care in Radiation Accidents, the Department medical supply (reserve warehouse for emergencies); specialized formations and institutions of the State Sanitary and Epidemiological Service and the Federal Office "Medbioekstrem"; All-Army Center for Emergency Medical Care and medical units and institutions of central subordination of the Russian Ministry of Defense; institutions of central subordination of the Ministry of Internal Affairs of Russia, other ministries and departments intended to participate in the elimination of the medical and sanitary consequences of emergency situations. In addition, non-staff formations, clinical bases of federal executive bodies, as well as scientific bases designed to eliminate the medical and sanitary consequences of emergencies, provide emergency and advisory, emergency and emergency medical care to the population are used in the interests of the VSMK. The regional level (on a regional scale) is represented by: branches of the VTsMK Zashchita (RCMK) with their staff units and institutions in the federal districts (North-Western, Central, Southern, Volga, Ural, Siberian and Far Eastern); interregional centers for emergency situations of the State Sanitary and Epidemiological Service in Moscow and Novosibirsk and centers of the State Sanitary and Epidemiological Surveillance at the regional level with their constituent units; formations at the regional level of the Ministry of Defense of Russia, the Ministry of Internal Affairs of Russia, other ministries and departments intended to participate in the elimination of the medical and sanitary consequences of emergencies, as well as clinical and scientific bases. The territorial level (on the scale of the constituent entities of the Russian Federation - republics, territories, regions, national districts, the cities of Moscow and St. Petersburg) is represented by: territorial centers of disaster medicine with their staff units; centers of the State Sanitary and Epidemiological Surveillance at the territorial level with their constituent units; non-standard formations of the VSMK; formations of the Ministry of Defense of Russia, the Ministry of Internal Affairs of Russia, and other departments located in this territory and intended to participate in the elimination of the medical and sanitary consequences of emergency situations; clinical bases designed to eliminate the medical and sanitary consequences of emergencies and provide emergency and advisory medical care to the population. The local level (on the scale of individual districts, cities, urban areas) is represented by: centers of disaster medicine (where they are created) or ambulance stations (substations) with their constituent units that perform the functions of management bodies of the disaster medicine service; centers of the State Sanitary and Epidemiological Surveillance in cities and districts that form brigades and groups of epidemic intelligence; formations of constant readiness of military medical institutions, formations of the bodies of the Ministry of Internal Affairs of Russia, other federal executive bodies participating in accordance with their duties in the elimination of emergency situations; medical and preventive institutions intended for medical and sanitary support of the population in emergency situations. The facility level (at facility scale) is represented by: emergency health officials; medical formations; subdivisions of sanitary and epidemiological supervision; medical and preventive institutions intended for medical and sanitary support of the population in emergency situations.

Emergency Medicine is a branch of medicine and is a system scientific knowledge and the scope of practical activities aimed at saving lives and preserving the health of the population in case of accidents, catastrophes, natural disasters and epidemics, preventing and treating lesions (diseases) resulting from emergencies, maintaining and restoring the health of participants in the liquidation of emergencies.

All-Russian Service for Disaster Medicine (VSMK)- functional subsystem of the Unified state system prevention and liquidation of emergency situations, functionally uniting the services of disaster medicine of the Ministry of Health of Russia, the Ministry of Defense of Russia, as well as the forces and means of the Ministry of Railways, the Ministry of Internal Affairs of Russia and other federal bodies executive power designed to eliminate the medical and sanitary consequences of emergencies.

The basis of the VSMK is the Disaster Medicine Service of the Ministry of Health Russian Federation.

Disaster Medicine Service of the Russian Ministry of Health- organizational and functional branch of the healthcare system of the Russian Federation, designed to organize and implement medical and sanitary support during the liquidation of emergency situations in peacetime; it performs its tasks in direct interaction with the governing bodies of other branches of this system (treatment and prevention, sanitary and hygienic and anti-epidemic, maternal and child health, personnel training, etc.).

The main tasks of the VSMS are:

Organization and implementation of medical and sanitary support for the population during the elimination of the consequences of emergencies, including in local armed conflicts and terrorist acts;

Creation, preparation, readiness and improvement of management bodies, formations and institutions of the service for actions in emergency situations;

Creation and rational use of reserves of medical property, financial and material and technical resources, ensuring emergency supplies of medicines in the aftermath of emergencies;

Training and advanced training of specialists VSMK, their certification; development of methodological foundations for training and participation of the population and rescuers in preparing for the provision of first aid in emergencies;

Given that the basis of the VSMK is the Disaster Medicine Service of the Ministry of Health of Russia, these tasks equally apply to it.

VSMK formations - medical units (groups, brigades, etc.) and mobile medical units (hospitals, detachments, etc.) designed to move into the emergency zone (region) and perform their regular tasks there; VSMK institutions are medical institutions that perform their regular tasks in the VSMK system in places of permanent deployment.

Research work and international cooperation in the field of disaster medicine.

In addition, VSMK takes part in identifying sources of emergencies that may be the causes of adverse health consequences, and in organizing constant health care control over them; carrying out a set of measures to prevent or reduce the severity of possible emergencies; implementation state expertise, supervision and control in the field of protection of the population and territories in emergency situations; development and implementation of measures for social protection of the population; carrying out humanitarian actions; providing conditions for citizens to exercise their rights and obligations in the field of protection from emergencies.

The All-Russian Service for Disaster Medicine is organized on the basis of accepted in our country general principles health protection and provision of medical care to the population. The main ones are the following.

State and priority character. It is provided by the relevant decrees of the President of Russia, decrees of the Government of the Russian Federation and the creation in the country of the Unified State System for the Prevention and Elimination of Emergency Situations. The above documents defined the protection of the population and its medical and sanitary provision in emergency situations as the most important state task.

Territorial production principle. The disaster medicine service is organized according to the territorial-production principle, taking into account the economic, medical-geographical and other features of the region or administrative territory. Formations, institutions and management bodies of the VSMC are created on the basis of existing and newly organized medical and preventive, sanitary and epidemiological institutions of territorial and departmental health care, central, clinical, research and other institutions using their human and material resources.

Centralization and decentralization of management. The centralization of management is ensured by the creation of a service management system (information and control automated system), capable of providing information to all levels and subsystems involved in the elimination of the consequences of emergencies.

The centralization of management during the period of liquidation of the medical and sanitary consequences of emergencies implies a unified management of all the forces and means of the VSMK, regardless of their departmental affiliation, at any level of its functioning.

Decentralization of management provides for the leading role of this level of management in the preparation and implementation of medical and sanitary support in emergencies that have arisen in a certain territory.

planned character provides for the advance preparation of forces and means of the VSMK, forecasting options for their use in various regions, planning interaction with other services, special training and advanced training of service personnel (managers, medical personnel, engineering and technical specialists, etc.). The principle of universalism involves the creation of formations and institutions ready to work in any emergency without significant reorganization.

The principle of the main functional purpose of the forces and means of the VSMK means that the formations of the service and the means attached to them can be used to solve the corresponding tasks and have a certain functional purpose - to provide pre-medical, first medical, qualified and specialized medical care; implementation of anti-epidemic and sanitary-hygienic measures; supply of medical supplies. Taking into account the peculiarities of certain emergency situations, the service should have different formations.

Medical and evacuation support when eliminating medical and sanitary consequences, an emergency is organized on the basis of a system of staged treatment of the affected with their evacuation according to their destination.

The provision of medical care to the injured and sick, their evacuation and treatment in emergency situations, accompanied by small sanitary losses, can be organized in the same way as in normal conditions.

The principle of material interest and responsibility of the personnel of the formations and institutions of the service involved in the elimination of the medical and sanitary consequences of emergencies. The implementation of this principle can be carried out by various incentive measures.

Mobility, efficiency and constant readiness of formations and educational institutions to work in emergency situations are achieved by the presence of mobile medical formations that are in constant readiness and are able to work autonomously; regular training of their personnel and its high professionalism; the use of modern high-speed vehicles for the delivery of forces and means of service to the areas of emergency situations and the evacuation of the affected modern high-speed vehicles; the creation of stocks of property and medicines; improving the communication and warning system, which ensures the timeliness of obtaining information about the occurrence of emergencies, the current situation and the efficiency of using the forces and means of the disaster medicine service.

Legal and social protection of medical and other service specialists. This principle is implemented in accordance with the Federal Law "On emergency rescue services and the status of rescuers", adopted by the State Duma on 14.07.95. The personnel of the disaster medicine service participate in the elimination of the medical and sanitary consequences of interethnic conflicts only on a voluntary basis (under contract).

General training of the population, including persons with high-risk professions, for actions, first aid for the injured, the rules of adequate behavior in various emergencies. This principle is implemented by the creation and precise implementation of a coherent system of training the population, as well as the creation of an educational and methodological base.

Consider the organization of the All-Russian Service for Disaster Medicine. It was created taking into account the tasks assigned to it, the structure of the RSChS and the requirements of the "Regulations on the All-Russian Service for Disaster Medicine".

As seen from rice. 2, 3, VSMK unites the services of disaster medicine of the Ministry of Health, the Ministry of Defense of Russia, as well as the forces and means of the Ministry of Internal Affairs and the Ministry of Railways of Russia and other federal executive bodies intended to eliminate the medical and sanitary consequences of emergencies. The service is organized at the federal, regional, territorial, local and facility levels. At each level, the service has governing bodies, formations and institutions.

Federal level VSMK(on the scale of the Russian Federation) includes: the All-Russian Center for Disaster Medicine "Protection" of the Ministry of Health of Russia (VTsMK "Zashchita") with its staff units and institutions, the Department for Sanitary and Epidemiological Surveillance of the Ministry of Health of Russia, federal center state sanitary and epidemiological supervision with specialized formations and institutions of the State Sanitary and Epidemiological Service and the Federal Directorate "Medbioekstrem", the All-Army Center for Disaster Medicine and medical units and institutions of central subordination of the Russian Ministry of Defense; institutions and formations of central subordination of the Ministry of Internal Affairs of Russia, the Ministry of Railways of Russia, other ministries and departments intended to participate in the elimination of the medical and sanitary consequences of emergencies. In addition, non-staff units, clinical bases of the Ministry of Health of Russia, other ministries and departments, as well as scientific bases designed to eliminate the medical and sanitary consequences of emergencies, provide emergency and advisory, emergency and emergency medical care are used in the interests of the VSMK. population.

The regional level of the VSMK (on a regional scale) is represented by:

Branches of the VTsMK "Protection" (RTsMK) with their staff formations and institutions in the federal districts (North-Western, Central 7 , Southern, Volga, Ural, Siberian, Far Eastern);

Interregional centers for emergency situations of the State Sanitary and Epidemiological Service in Moscow and Novosibirsk and centers of the State Sanitary and Epidemiological Surveillance at the regional level with their constituent units;

Formations at the regional level of the Ministry of Defense, the Ministry of Internal Affairs and the Ministry of Railways of Russia, other ministries and departments intended to participate in the elimination of the medical and sanitary consequences of emergencies, as well as clinical and scientific bases.

The territorial level of the VSMK (on the scale of the constituent entities of the Russian Federation - republics, territories, regions, national districts, the cities of Moscow and St. Petersburg) is represented by:

Territorial centers of disaster medicine with their staff units;

Centers of the State Sanitary and Epidemiological Surveillance of the territorial level with their constituent units;

Freelance formations of the VSMK;

Formations of the Ministry of Defense, the Ministry of Internal Affairs and the Ministry of Railways of Russia, and other departments located in this territory and intended to participate in the elimination of the medical and sanitary consequences of emergencies;

Clinical bases designed to eliminate the medical and sanitary consequences of emergencies and provide emergency and advisory medical care to the population.

Non-staff formations of the VSMK are medical units (groups, brigades, etc.) formed on the basis of hospitals, polyclinics, ambulance stations, sanitary and epidemiological surveillance centers that are not part of the staff of disaster medicine centers and perform tasks in the VSMK system.

The functions of the branch are performed by VTsMK Zashchita.

Local level VSMK(on the scale of individual districts, cities, urban areas) includes: disaster medicine centers (where they are created) or ambulance stations (substations) (with units included in them and formed in other healthcare facilities) that perform the functions management bodies of the disaster medicine service; centers of the State Sanitary and Epidemiological Surveillance in cities and districts, forming sanitary and epidemiological teams and epidemiological intelligence groups; formation of constant readiness of military medical institutions, formation of bodies of the Ministry of Internal Affairs, Ministry of Railways of Russia, institutions of the Federal Department of Biomedical and Extreme Problems under the Ministry of Health of Russia, other federal executive bodies participating in accordance with their duties in the elimination of emergencies; medical and preventive institutions intended for medical and sanitary support in emergencies.

Object level VSMK(on the scale of the facility) includes: officials for medical and sanitary support of the facility in an emergency; medical formations; subdivisions of sanitary and epidemiological supervision; medical and preventive institutions intended for medical and sanitary support in emergencies.

When creating and improving the HCMC, special attention is paid to the territorial, local and facility levels of service, since the effectiveness of medical and sanitary support for the population in various emergencies depends on the readiness and success of these levels. It should be noted that this trend takes place throughout the RSChS.

The head of the VSMK at the federal level is the chairman of the federal interdepartmental coordinating commission of the VSMK, at the regional, territorial and local levels - the chairmen of the relevant interdepartmental coordinating commissions of the VSMK.

Disaster Medicine Service of the Russian Ministry of Health, as mentioned, it is the basis of the VSMC and the organizational and functional branch of the healthcare system of the Russian Federation. It performs its tasks together with the Department of State Sanitary and Epidemiological Surveillance in cooperation with the Federal Directorate "Medbioex-trem", authorities and institutions of other healthcare sectors (therapeutic and prophylactic, provision of medicines and medical equipment, training, MSGO, etc.).

The head of the disaster medicine service of the Ministry of Health of Russia is the Minister of Health of the Russian Federation. The direct management of the service is carried out by the First Deputy Minister of Health of the Russian Federation. The head of the disaster medicine service at the regional level is the representative of the Minister of Health in the federal district. The heads of the disaster medicine services at the territorial and local levels are the heads of the health management bodies of the relevant executive authorities, and at the facility - the heads of the facility health care institutions.

Disaster Medicine Service of the Ministry of Defense of Russia is a powerful departmental service, which is part of the VSMK; She is well prepared to work in various emergency situations. The service is mainly focused on the elimination of the medical and sanitary consequences of emergencies in the areas of deployment of troops and military-strategic facilities.

In the future, these officials also referred to as: "Head of the VSMK" of the corresponding level. However, as experience shows, the formations of the disaster medicine service of the Ministry of Defense of Russia are also involved in the work in the event of emergencies in other areas. The organization and management of the activities of the service is carried out by the Main Military Medical Directorate of the Russian Ministry of Defense.

The Disaster Medicine Service of the Ministry of Defense of Russia includes: military authorities; officials; special purpose medical units; formations, forces and means of medical military units and institutions of the Ministry of Defense of Russia, medical military educational institutions and research organizations intended to participate in the elimination of the medical and sanitary consequences of emergencies.

To perform similar functions and participate in solving the general tasks of the VSMK, there are also special management bodies, formations and institutions in the system of the Ministry of Internal Affairs and the Ministry of Railways of Russia.

Coordination of the preparation and interaction of governing bodies, as well as the use of units and institutions that are part of the VSMC, is entrusted to the disaster medicine service of the Ministry of Health of Russia, which provides:

Development of scientific and methodological principles of the activities of the VSMK;

Training, advanced training and certification of VSMK specialists;

Development of methodological bases for preparing the population for the provision of first aid in emergencies;

Management of forces and means involved in the elimination of the medical and sanitary consequences of emergencies.

In the Decree of the Government of the Russian Federation of 03.05.94. 420 "On the protection of life and health of the population of the Russian Federation in the event of the occurrence and elimination of the consequences of emergencies caused by natural disasters, accidents and catastrophes" the preservation of life and health of the population of Russia in emergency situations is recognized as the most important state task of the federal executive authorities, executive authorities of the constituent entities of the Russian Federation Federation and local government. In solving this problem, much attention is paid to the preparation of the population, the further improvement of the disaster medicine service, and the creation of conditions for its successful operation. This ordinance regulated creation of a unified All-Russian Service for Disaster Medicine (VSMK), functionally uniting the services of disaster medicine of the Ministry of Health of Russia, the Ministry of Defense of Russia, as well as the medical forces and means of the Ministry of Transport (in particular JSC Russian Railways), the Ministry of Internal Affairs of Russia, other ministries and departments involved in the elimination of the medical and sanitary consequences of emergencies. In the development of this resolution, the Regulations on the All-Russian Service for Disaster Medicine were developed, which was approved by the Decree of the Government of the Russian Federation dated February 28, 1996. No. 195.

The Government of the Russian Federation confirmed the priority importance of the disaster medicine service in solving the problem of preserving the life and health of the population in emergencies. Thus, at present in medical science and in the system health care in our country, there are three independent areas dealing with the problems of medical (medical and sanitary) support in emergencies.

Issues of medical support for the Armed Forces of the Russian Federation in wartime are developed by military medicine, and a set of practical measures is carried out by the medical service of the Russian Ministry of Defense.

The development of the scientific foundations of medical support for the population of the country in wartime and the implementation of a set of relevant practical measures are entrusted to MSHO.

The "youngest" section of medical science and a branch of the health care system are disaster medicine and the service of disaster medicine, respectively - the theory and practice of medical and sanitary provision of the country's population in peacetime emergencies.

Recently, opinions have been rather persistently expressed about the expediency of creating a single service on the basis of MSHO and the disaster medicine service, designed to provide medical and sanitary support to the population in peacetime and wartime emergencies. This is due to the fact that both of these services are created and headed by the Ministry of Health of Russia, have a similar purpose and solve largely the same tasks. Basically, the bases for their creation, the conditions of activity and the organizational forms of medical and sanitary support used are similar. Currently, this problem is being studied, but a practical solution has not yet been found.

Emergency Medicine is a branch of medicine and is a system of scientific knowledge and a field of practice aimed at saving lives and preserving the health of the population in case of accidents, catastrophes, natural disasters and epidemics, preventing and treating injuries (diseases) resulting from emergencies, maintaining and restoring the health of participants elimination of emergencies.

All-Russian Service for Disaster Medicine (VSMK)- a functional subsystem of the Unified State System for the Prevention and Elimination of Emergency Situations, which functionally unites the services of disaster medicine of the Ministry of Health of Russia, the Ministry of Defense of Russia, as well as the forces and means of the Ministry of Transport, the Ministry of Internal Affairs of Russia and other federal executive authorities, designed to eliminate the medical and sanitary consequences of emergencies.

The basis of the VSMC is the disaster medicine service of the Ministry of Health of the Russian Federation.

Disaster Medicine Service of the Russian Ministry of Health- organizational and functional branch of the healthcare system of the Russian Federation, designed to organize and implement medical and sanitary support during the liquidation of emergency situations in peacetime; it performs its tasks in direct interaction with the governing bodies of other branches of this system (therapeutic and prophylactic, sanitary and hygienic and anti-epidemic, maternal and child health, personnel training, etc.).

The main tasks of the VSMK are:

organization and implementation of medical and sanitary support for the population during the elimination of the consequences of emergencies, including in local armed conflicts and terrorist acts;

creation, preparation, readiness and improvement of management bodies, formations and institutions of the 5th service for actions in emergency situations;

creation and rational use of reserves of medical property, financial and material and technical resources, ensuring emergency supplies of medicines in the aftermath of emergencies;

training and advanced training of VSMK specialists, their certification; development of methodological foundations for training and participation of the population and rescuers in preparing for the provision of first aid in emergencies;

Research work and international cooperation in the field of disaster medicine.

In addition, VSMK takes part in identifying sources of emergencies that may be the cause of adverse health consequences, and in organizing ongoing health care control over them; carrying out a set of measures to prevent or reduce the severity of possible emergencies; implementation of state expertise, supervision and control in the field of protection of the population and territories in emergency situations; development and implementation of measures for social protection of the population; carrying out humanitarian actions; providing conditions for citizens to exercise their rights and obligations in the field of protection from emergencies.

The All-Russian Disaster Medicine Service is organized on the basis of the general principles of health care and the provision of medical care to the population adopted in our country. The main ones are the following:

State and priority character. It is ensured by the relevant decrees of the President of Russia, decrees of the Government of the Russian Federation and the creation in the country of the Unified State System for the Prevention and Liquidation of Emergency Situations. The above documents have identified the protection of the population and its medical and sanitary provision in emergency situations as the most important state task.

Territorial production principle. The service of disaster medicine is organized according to the territorial-production principle, taking into account the economic, medical-geographical and other features of the region or administrative territory. Formations, institutions and management bodies of the VSMK are created on the basis of existing and newly organized medical and preventive, sanitary and epidemiological institutions of territorial and departmental health care, central, clinical, research and other institutions using their human and material resources.

Centralization and decentralization of management. The centralization of management is ensured by the creation of a service management system (information and control automated system), capable of providing information to all levels and subsystems involved in the elimination of the consequences of emergencies.

Centralization of management during the period of liquidation of medical and sanitary consequences of emergency situations, it assumes the unified management of all the forces and means of the VSMK, regardless of their departmental affiliation, at any level of its functioning.

Decentralization of management provides for the leading role of this level of management in the preparation and implementation of medical and sanitary support in emergencies that have arisen in a certain territory.

planned character provides for the advance preparation of forces and means of the VSMK, forecasting options for their use in various regions, planning interaction with other services, special training and advanced training of service personnel (managers, medical personnel, engineering and technical specialists, etc.).

The principle of universalism involves the creation of formations and institutions ready to work in any emergency without significant reorganization.

The principle of the main functional purpose of the forces and means of the VSMK means that the formation of the service and the funds attached to them can be used to solve the relevant tasks and have a certain functional purpose - to provide pre-medical, first medical, qualified and specialized medical care; implementation of anti-epidemic and sanitary-hygienic measures; supply of medical supplies. Taking into account the peculiarities of certain emergency situations, the service should have different formations.

Medical and evacuation support when eliminating medical and sanitary consequences, emergencies are organized on the basis of a system of staged treatment of the affected with their evacuation according to their destination.

Providing medical care to the injured and sick, their evacuation and treatment in emergency situations, accompanied by small sanitary losses, can be organized in the same way as in normal conditions.

The principle of material interest and responsibility of the personnel of the formations and institutions of the service involved in the elimination of the medical and sanitary consequences of emergencies. The implementation of this principle can be carried out by various incentive measures.

Mobility, efficiency and constant readiness of formations and institutions to work in emergency situations are achieved by the presence of mobile medical units that are in constant readiness and are able to work autonomously; regular training of their personnel and its high professionalism; use for the delivery of forces and means of service to the areas of emergency situations and the evacuation of the affected modern high-speed vehicles; the creation of stocks of property and medicines; improvement of the communication and warning system, ensuring the timely receipt of information about the occurrence of emergencies , the current situation and the efficiency of using the forces and means of the disaster medicine service.

Legal and social protection of medical and other service specialists. This principle is implemented in accordance with the Federal Law "On emergency rescue services and the status of rescuers", adopted by the State Duma on 14.07.95. The personnel of the disaster medicine service participate in the elimination of the medical and sanitary consequences of interethnic conflicts only on a voluntary basis (under contract).

General training of the population, including persons with high-risk professions, for actions, first aid for the injured, the rules of adequate behavior in various emergencies. This principle is implemented by the creation and precise implementation of a coherent system of training the population, as well as the creation of an educational and methodological base.

2. Organization of the VSMK (federal, regional, territorial, local and facility levels). Management of the service of disaster medicine (definition, the management system of the VSMC and the principles of organizing interaction, the management of the VSMC during the liquidation of emergencies).

VSMK unites the services of disaster medicine of the Ministry of Health, the Ministry of Defense of Russia, as well as the forces and means of the Ministry of Internal Affairs and the Ministry of Transport of Russia and other federal executive bodies intended to eliminate the medical and sanitary consequences of emergencies. The service is organized at the federal, regional, territorial, local and facility levels. At each level, the service has governing bodies, formations and institutions.

Federal level VSMK(on the scale of the Russian Federation) includes: the All-Russian Center for Disaster Medicine Zashchita of the Ministry of Health of Russia (VTsMK Zashchita) with its staff units and institutions, the Department for Sanitary and Epidemiological Surveillance of the Ministry of Health of Russia, the Federal Center for State Sanitary and Epidemiological Surveillance with specialized formations and institutions of the State Sanitary and Epidemiological Service and the Federal Directorate "Medbioekstrem", the All-Army Center for Disaster Medicine and medical units and institutions of central subordination of the Ministry of Defense of Russia; institutions and formations of central subordination of the Ministry of Internal Affairs of Russia, the Ministry of Transport of Russia, other ministries and departments intended to participate in the elimination of the medical and sanitary consequences of emergencies. In addition, non-staff formations, clinical bases of the Ministry of Health of Russia, other ministries and departments, as well as scientific bases designed to eliminate the medical and sanitary consequences of emergencies, provide emergency and advisory, emergency and emergency medical care to the population are used in the interests of the VSMC.

Regional level VSMK(on a regional scale) is represented by:

branches of the VTsMK "Protection" (RCMK) with their staff units and institutions in the federal districts (North-Western, Central, Southern, Volga, Ural, Siberian, Far Eastern);

interregional centers for emergency situations of the State Sanitary and Epidemiological Service in Moscow and Novosibirsk and centers of the State Sanitary and Epidemiological Surveillance at the regional level with their constituent units;

formations at the regional level of the Ministry of Defense, the Ministry of Internal Affairs and the Ministry of Transport of Russia, other ministries and departments intended to participate in the elimination of the medical and sanitary consequences of emergencies, as well as clinical and scientific bases.

Territorial level VSMK(on the scale of the subjects of the Russian Federation - republics, territories, regions, national districts, cities of Moscow and St. Petersburg) is represented by:

territorial centers of disaster medicine with their staff units;

centers of the State Sanitary and Epidemiological Surveillance at the territorial level with their constituent units;

non-standard formations of the VSMK;

formations of the Ministry of Defense, the Ministry of Internal Affairs and the Ministry of Transport of Russia, other departments located in this territory and intended to participate in the elimination of the medical and sanitary consequences of emergencies;

clinical bases designed to eliminate the medical and sanitary consequences of emergencies and provide emergency and advisory medical care to the population.

Local level VSMK(on the scale of individual districts, cities, urban areas) includes: disaster medicine centers (where they are created) or ambulance stations (substations) (with units included in them and formed in other healthcare facilities), performing the functions of medical service management bodies disasters; centers of the State Sanitary and Epidemiological Surveillance in cities and districts that form sanitary and epidemiological teams and epidemiological intelligence groups; formation of constant readiness of military medical institutions, formation of bodies of the Ministry of Internal Affairs, the Ministry of Transport of Russia, institutions of the Federal Department of Biomedical and Extreme Problems under the Ministry of Health of Russia, other federal executive bodies participating in accordance with their duties in the elimination of emergencies; medical and preventive institutions intended for medical and sanitary support in emergencies.

Object level VSMK(on the scale of the facility) includes: officials for medical and sanitary support of the facility in an emergency; medical formations; subdivisions of sanitary and epidemiological supervision; medical and preventive institutions intended for medical and sanitary support in emergencies.

When creating and improving the HCMC, special attention is paid to the territorial, local and facility levels of service, since the effectiveness of medical and sanitary support for the population in various emergencies depends on the readiness and success of these levels. It should be noted that this trend takes place throughout the RSChS.

The head of the VSMK at the federal level is the chairman of the federal interdepartmental coordination commission of the VSMK, at the regional, territorial and local levels - the chairmen of the relevant interdepartmental coordination commissions of the VSMK.

Disaster Medicine Service of the Russian Ministry of Health, as mentioned, it is the basis of the HSMC and the organizational and functional branch of the health care system of the Russian Federation. It performs its tasks jointly with the Department of State Sanitary and Epidemiological Surveillance in cooperation with the Federal Directorate "Medbioekstrem", authorities and institutions of other healthcare sectors (treatment and prevention, provision of medicines and medical equipment, training, MSGO, etc.).

The head of the disaster medicine service of the Ministry of Health of Russia is the Minister of Health of the Russian Federation. The direct management of the service is carried out by the First Deputy Minister of Health of the Russian Federation. The head of the disaster medicine service at the regional level is the representative of the Minister of Health in the federal district. The heads of disaster medicine services at the territorial and local levels are the heads of the healthcare management bodies of the relevant executive authorities, and at the facility - the heads of the facility healthcare institutions.

Management of the All-Russian Service for Disaster Medicine - purposeful activity of the chiefs (heads) of the service management bodies, heads (heads) of formations and institutions to maintain the readiness of the service, prepare it to solve the assigned tasks and guide subordinate authorities, formations and institutions in the course of their implementation.

Basic principles of management are: unity of command, centralization of management with the provision of initiative to subordinates in determining ways to perform tasks; the ability to analyze the situation, draw the right conclusions from its assessment and foresee the course of events; efficiency, creativity and high organization in work; firmness and perseverance in the implementation of decisions and plans; personal responsibility of the heads of the disaster medicine service for the decisions made and the results of the fulfillment of the assigned tasks.

A number of requirements are imposed on the management of the VSMC. It should be sustainable,continuous, prompt, qualified and efficient.

Stability and continuity of management are achieved by: knowledge of the actual situation; correct understanding of the tasks set by senior commanders; timely decision-making and clear assignment of tasks to subordinates; the presence of constant, stable communication with subordinates, as well as senior bosses; ensuring the reliability of the disaster medicine service.

Efficiency of management consists in knowing the situation and quickly responding to all changes; timely clarification of the decision made and tasks assigned to subordinates; the ability to apply the most appropriate methods of work and to complete the assigned tasks in a timely manner. However, the speed as the most important indicator efficiency should not be at the expense of the quality of management. High quality of management is the second side of efficiency.

Management qualification is achieved by the fact that the chiefs (heads) of the governing bodies should lead their subordinates on the basis of a deep knowledge of the theory and practice of medical and sanitary provision of the population, rely on the advice and assistance of various specialists - surgeons and therapists, epidemiologists and hygienists, medical supply organizers, etc. should not be in conflict with the need to centralize management in the hands of the leader. Only he has the right to make the final decision, for which he bears full responsibility.

Management efficiency largely provided by subjective factors - the personality and style of work of the respective superiors, as well as the high morale and psychological state of all personnel, their readiness to perform the tasks of medical and sanitary support at any time and in any conditions.

Management is an information process, which includes the following operations (functions):

obtaining (obtaining) the necessary information (status and command information) about the control objects and the environment;

processing the received (obtained) information and making appropriate decisions on the basis of this;

setting tasks for control objects (transfer of command information) and monitoring the implementation of decisions made (orders given).

Management system of the All-Russian Service for Disaster Medicine.

It is natural that the control system of the VSMK corresponds to the control system of the RSChS.

The governing bodies of the Service at the federal, regional and territorial levels are the relevant interdepartmental coordination commissions, the All-Russian Center for Disaster Medicine "Protection" of the Ministry of Health of the Russian Federation and its branches (regional centers for disaster medicine), territorial centers for disaster medicine, which simultaneously perform the functions of headquarters of the Service. At the local level, the functions of the headquarters of the Service are assigned to the centers of disaster medicine (where they are created) or the management of ambulance stations (substations), and at the facility level - to specially appointed officials for civil defense and emergency situations. Headquarters of the Service are subordinate to the heads of the relevant healthcare unit.

Decree of the Government of the Russian Federation dated February 28, 1996 No. 195 approved the Regulations on the interdepartmental coordination commissions of the HSMC (coordinating bodies of the service), according to which these commissions are the governing bodies of the HSMC of this level.

The main tasks of the interdepartmental coordination commissions (ICC) are:

participation in the development and implementation of agreed measures to prevent emergencies and reduce the severity of health consequences;

development of draft legislative and other regulatory legal acts on issues within the competence of the service;

participation in the development and implementation of scientific and technical programs to improve the organization and activities of the service;

solving the most important issues of improving the organization and activities of the service, including determining the list, quantity, place of creation, procedure for providing units and institutions of the service;

ensuring the constant readiness of the governing bodies, formations and institutions of the service to fulfill the tasks assigned to them;

solution of fundamental issues of the integrated use of formations and institutions that are part of the service, executive authorities of the appropriate level in the elimination of the medical and sanitary consequences of emergencies;

participation in the development of a plan for the medical and sanitary provision of the population in emergencies;

implementation of a unified system for training forces and means of service;

coordination of the creation and use of reserves of financial, medical and material and technical resources;

definition of scientific and clinical bases of the service;

development of proposals for the economic and legal support of the work of the personnel of the governing bodies, formations and institutions of the service;

determination of the main directions of international cooperation in the field of disaster medicine.

The regulation defines the typical composition of the IWC. Yes, in the composition federal commissions include by position: Minister of Health of the Russian Federation (Chairman of the Commission); First Deputy Minister of Health of the Russian Federation - Chief State Sanitary Doctor of the Russian Federation (Deputy Chairman); Deputy Minister of Health of the Russian Federation (Deputy Chairman); President of the Russian Academy of Medical Sciences (Deputy Chairman); Director of the All-Russian Center for Disaster Medicine "Protection"; Head of the Federal Department of Biomedical and Extreme Problems under the Ministry of Health of the Russian Federation; heads of medical (medical and sanitary) services of the Ministry of Defense, the Ministry of Internal Affairs, the Ministry of Transport of Russia, the Federal Service of Border Troops; Chairman of the Central Committee of the Russian Red Cross Society, etc.

Compound regional commissions is determined by the federal ICC service in agreement with the executive authorities of the relevant constituent entities of the Russian Federation, the representative offices of the President of the Russian Federation in the Federal Districts, the command of military districts, federal executive authorities participating in accordance with their duties in the elimination of emergencies at the regional level.

Compound territorial commissions determined by the executive authorities of the constituent entities of the Russian Federation, and local commissions - executive authorities and local self-government bodies of districts and cities (settlements).

These ICCs include the heads of all medical, medical and sanitary, sanitary and preventive services, emergency medical facilities, blood services, medical property and medical equipment supply agencies; director of disaster medicine centers located in the respective territory.

Organizational and technical support for the work of the ICC is carried out by the relevant centers for disaster medicine.

The commission carries out its activities in accordance with the work plan adopted at the meeting of the commission and approved by its chairman.

Commission meetings are held as needed, at least once a quarter.

Decisions taken by the ICC in accordance with its competence are drawn up in a protocol and are binding on all bodies represented in the commission, as well as on organizations operating under the jurisdiction of these bodies.

The Commission may establish working groups on major issues related to its activities and determine the procedure for their work.

At all levels, the chairpersons of the ICC are the heads of the disaster medicine service of the Ministry of Health of Russia (heads of the healthcare management body at this level).

The headquarters of the BCMK are the permanent governing bodies of the VSMK. They carry out their work on the basis of the Regulations on the HCMC, decisions of the relevant coordinating commissions. The headquarters of the VSMK, staffed with personnel, means of communication and automation, having the necessary equipment, a set of reference, accounting and reporting documents and other means, are control points. In the control system, the headquarters of the VSMK solve the corresponding tasks, depending on the mode of operation of the RSChS.

The organizational structure of any governing body is determined mainly by the tasks assigned to it and the content of the work. Considering that the headquarters of the VSMC at the regional, territorial and local levels are functional subdivisions of the disaster medicine centers (affiliates of the VTsMK Zashchita), their structure may be different.

The VTsMK "Protection" has a full-time headquarters of the VSMK . Organizationally, it includes: management, operational management, management of the organization of medical and sanitary support in emergencies, the department for working with regions, the department for organizing interaction, the accounting and analytical department, the logistics department, etc.

The headquarters of the branch of the VTsMK "Protection" and the territorial center, in addition to full-time employees, include representatives of the health management bodies of other ministries and departments participating in accordance with their duties in the elimination of the consequences of emergencies.

Organization of interaction of the All-Russian service of disaster medicine.

An important element in the management of the disaster medicine service in various periods of its activity is the organization of interaction.

The All-Russian Disaster Medicine Service, on the one hand, is a subsystem of the RSChS, and on the other hand, functionally unites the disaster medicine services of the Ministry of Health, the Ministry of Defense of Russia, the forces and means of other ministries and departments participating in accordance with their duties in the elimination of medical and sanitary consequences of the emergency. This means that the successful fulfillment of the tasks of the service is possible only if there is close operational and effective interaction with other subsystems of the RSChS and between the governing bodies, institutions and formations that are part of the VSMK.

VSMK interaction is a system of coordinated and interconnected in terms of goals, objectives, place, time, methods and scope of measures to prepare government bodies, formations and institutions of service of various subordination for forecasting and assessing the situation in an emergency; reducing the severity of health consequences of emergencies; planning and implementation of medical and sanitary provision of the population in emergency situations; management of forces and means during the liquidation of the consequences of emergencies.

Interaction is carried out on the basis of the following principles:

unity of state policy in the field of prevention and elimination of emergencies, public health protection and disease prevention;

the priority of preserving the life and health of the population in the event of the occurrence and elimination of emergencies caused by natural disasters, accidents, catastrophes, epidemics;

unified approaches and criteria in predicting and assessing the health situation in various situations, taking into account the capabilities of emergency rescue and medical units, formations and institutions.

The main participants (parties) of the interaction of the VSMK are its governing bodies, formations and institutions at the federal, regional, territorial, local and facility levels. The goals and principles of interaction between the VSMK and the RSChS and between the governing bodies, formations and institutions of the VSMK are practically the same. However, specific activities for interaction in these two areas differ.

The following organizations participate in the organization of interaction between governing bodies, formations and institutions of the VSMK:

from the Ministry of Health of Russia

at the federal level - Ministry of Health of Russia, VTsMK "Zashchita", Center of Rspotrebnadzor, Federal Office "Medbioekstrem";

at the regional level - representatives of the Ministry of Health of Russia in the Federal District, branches of the VTsMK "Protection" (RTsMK);

at the territorial level - heads of health authorities of the constituent entities of the Russian Federation, territorial centers for disaster medicine;

at the local (object) level - heads of health authorities, local governments (health care institutions), headquarters (where they are created); management of ambulance stations (substations); specially appointed persons for civil defense affairs;

from the Russian Ministry of Defense

at the federal level - Main Military Medical Directorate of the Russian Ministry of Defense, All-Army Disaster Medicine Center;

at the regional level - medical services (governing body) of military districts (fleets);

at the territorial level - medical services (governing body) of military districts (fleets) at the place of their deployment and heads of medical services of garrisons;

at the local level - chiefs of medical services of garrisons;

from the Ministry of Internal Affairs of Russia

at the federal level - Medical Department of the Ministry of Internal Affairs of Russia;

at the regional level - departments of the medical service of the districts of the Ministry of Internal Affairs of Russia;

at the territorial level - management of the medical service at the place of their deployment;

in other subjects of the Russian Federation and at the local level - medical services of departments (departments) of the Ministry of Internal Affairs of Russia;

from the Ministry of Transport of Russia

at the federal level - Health Department of the Ministry of Transport of Russia;

at the regional, territorial, local and facility levels – the relevant governing bodies of the medical and sanitary service and healthcare institutions of the Ministry of Transport of Russia;

from the Russian Academy of Medical Sciences

at the federal, state and local levels - its relevant governing bodies and institutions (organizations);

from the Russian Red Cross Society

on the federal level - Central Committee of the Red Cross;

at the regional, territorial, local and facility levels – relevant committees of the Red Cross (Crescent).

At all levels, the relevant authorities organize interaction with institutions and enterprises supplying medical equipment and equipment.

The interaction of the governing bodies, formations and institutions of the HCMC is organized and carried out at each level in accordance with the Plan for the medical and sanitary provision of the population in emergencies.

The coordination of the preparation and interaction of the governing bodies, as well as the use of units and institutions of the VSMK, is entrusted to the disaster medicine service of the Ministry of Health of Russia.

The joint efforts of the interacting parties are aimed at solving the following tasks:

organization of constant medical and sanitary monitoring of objects potentially dangerous in terms of the occurrence of emergencies, carrying out a set of measures to prevent or reduce the severity of the medical and sanitary consequences of possible emergencies;

timely and accurate planning of medical and sanitary support during the liquidation of the consequences of emergencies;

operational provision of information on the occurrence of emergencies, their health consequences, changes in the medical and sanitary and epidemiological situation, the presence and creation of management bodies, formations and institutions of the VSMK;

maintaining the high readiness of the governing bodies, formations and institutions of the VSMK;

ensuring constant, stable communication between the governing bodies, formations and institutions of the VSMK;

timely adoption and prompt implementation of optimal decisions on the deployment of formations of the interacting parties to the emergency zone, their effective use in the conduct of medical evacuation, sanitary-hygienic and anti-epidemic measures, as well as on the provision of medical equipment;

creation and accurate maintenance of unified accounting and reporting documents;

resolving issues of financial and logistical support;

maintaining the health of the personnel of emergency rescue units, formations and institutions, as well as the population participating in the elimination of the consequences of emergencies.

The interaction of the parties in the field of prevention and elimination of the medical and sanitary consequences of emergencies includes the following activities:

development and implementation in healthcare practice of a unified doctrine for the preparation and use of forces and means of healthcare, organization and implementation of a complex of medical-evacuation, sanitary-hygienic and anti-epidemic measures in emergencies;

a clear definition of the specific tasks of all interacting management bodies, formations and institutions and the organization of their solution at a given level of the VSMK and in specific emergencies;

joint participation in the development of legal and regulatory documents;

preparation of groups of forces and means for carrying out medical evacuation measures, as well as specialized formations of Rospotrebnadzor for carrying out sanitary-hygienic and anti-epidemic measures in emergency zones;

exchange of information on the emerging medical and sanitary-epidemiological situation;

organization of measures to maintain the sanitary and epidemiological well-being of the population in the emergency zone;

additional staffing of the units involved in the elimination of the medical and sanitary consequences of emergencies;

creation of a management system, organization of notification and comprehensive support of the governing bodies, formations and institutions of the VSMK;

conducting joint drills (exercises) to test the reality of plans, prepare management bodies, formations and institutions of the VSMK;

joint development and constant refinement of issues of interaction between plans for medical and sanitary provision of the population in emergencies;

mutual exchange of information on the prevention and elimination of health consequences of emergencies, which is within the competence of the interacting parties;

joint development of the content and methods of special training of personnel of the governing bodies, formations and institutions of the VSMK;

participation in the preparation of the population for the provision of first aid in emergencies;

coordination of scientific research on the organization of the VSMK, its preparation and activities, improving the interaction of the parties, issues of medical protection of the population and personnel of emergency rescue units, improving the equipment of units and service institutions;

exchange of experience, participation in conferences, seminars on the problems of prevention and elimination of medical and sanitary consequences of emergencies.

The interaction of the governing bodies, formations and institutions of the VSMK is organized at the federal, regional and territorial levels by the interdepartmental coordination commissions of the VSMK, at the local level - by the head of the health authority, at the facility level - by the head of the healthcare institution.

Proposals for the organization of interaction, as a rule, are included in orders on planning the medical and sanitary provision of the population, developing a plan of work (actions) of the formation (institution) in the event of an emergency. They should contain: brief conclusions on the assessment of the situation, reflecting the conditions of medical and sanitary support in probable emergencies (the content, volume and organization of activities to be performed, the need for forces and means); a list of governing bodies, formations and institutions with which interaction should be organized; the tasks of each of the participants in the interaction (the content and scope of the activities assigned to them, the timing and fundamental recommendations for their implementation); organization of control.

The main provisions on the organization of interaction between the governing bodies, formations and institutions of the HCMC involved in the prevention and elimination of the medical and sanitary consequences of emergencies are reflected in the relevant sections of the plan for the medical and sanitary provision of the population in emergencies, developed at the federal, regional, territorial, local and facility levels. If necessary, separate plans for interaction are developed.

Interaction tables are being developed in individual formations and institutions of the VSMK. Extracts from the plan (table) relating to the participants in the interaction and ensuring the successful fulfillment of the tasks assigned to them are communicated in writing to all participants in the interaction.

Management of the All-Russian Service for Disaster Medicine in the course of emergency response

The organization of the management of the VSMK during the liquidation of emergencies depends mainly on the scale and nature of the emergency, the current organization of medical and sanitary support and the general management system during the liquidation of emergencies.

Depending on the situation that has developed in an emergency, two typical options should be considered in the management of the VSMC in the elimination of health consequences. In the first of them, which takes place in emergencies, accompanied by small sanitary losses and relatively favorable conditions for medical and sanitary support, the management of forces and means involved in the elimination of the consequences of an emergency is provided by a control system operating in the mode of constant readiness. Its main characteristics have been discussed in the previous sections. When large-scale emergencies occur, a situation usually develops that requires a significant improvement in the existing HSMC control system or the creation of a special system that provides the solution of new tasks. This is due to a number of factors specific to this situation:

the involvement of a significant number of units for medical and sanitary support, often having different departmental affiliations and arriving in the emergency zone (district) at different times;

as a rule, the significant size of the zone (region) of emergency situations;

ambiguity of the situation in the zone (region) of the emergency situation, obtaining indicative actual data on the consequences of the emergency situation only after its occurrence, the possibility of significant changes in the assessment of the situation in the course of emergency rescue operations;

the urgency of making and implementing most decisions on the organization of medical and sanitary support in the aftermath of emergencies and the possibility of making many decisions only directly in the zone (district) of the emergency:

organization of rescue and other urgent work to eliminate emergencies in separate, often isolated sectors (areas);

organization of medical and evacuation support in several isolated areas.

In connection with the above, the organization of the management of the VSMK according to the second option provides for the need for close interaction with the authorities, forces and means of the RSChS involved in the elimination of emergencies. At the same time, special attention should be paid to constant contact with the management (the head of the emergency response work). , operational and mobile control groups, etc.) Representatives of all departments whose forces and means are involved in the elimination of the medical and sanitary consequences of emergencies should be at the control points of the VSMK.

In general, the management system of the VSMC during the liquidation of the medical and sanitary consequences of emergencies should include:

headquarters of the VSMK, which have constant close contact with the corresponding command posts (headquarters) of the RSChS of the corresponding level;

operational groups of the headquarters of the service at the control points of the RSChS, which manage the work on the elimination of local emergencies; they should work with local health authorities;

operational groups at the command posts of units and divisions (formations) of the RSChS, which manage work at the facilities (sites) of emergency rescue operations;

control points of formations and institutions of the VSMK participating in the elimination of the consequences of emergencies;

means of communication and automation with pre-developed programs and sets of formalized documents.

The experience of liquidation of the consequences of the earthquake in Armenia (1988) showed the need for advancing (before the arrival of the main forces) the creation of a control system in the area of ​​a natural disaster, major accident or catastrophe to ensure reconnaissance, receive arriving units and formations, make informed decisions, set tasks in a timely manner and organized the beginning of rescue operations, and subsequently - a firm unified leadership of them. Based on this, it is advisable at the territorial and local levels, in case of the likelihood of catastrophic emergencies, to have pre-prepared management bodies (operational groups), which, upon arrival at the centers of destruction (damage), should take over the management (leadership) of emergency rescue operations.

3. Disaster Medicine Service of the Ministry of Health of Russia (formations of the QMS of the Ministry of Health of Russia, a field multidisciplinary hospital, specialized medical care teams (BSMP), medical and nursing teams (VSB), medical mobile ambulance teams, first aid teams and paramedic mobile ambulance teams ).

Formation of the disaster medicine service of the Ministry of Health of Russia represented by mobile hospitals, detachments, brigades, groups. They are created in accordance with the approved states and are provided with special equipment and equipment according to the time sheets. Formations are intended for work in zones (regions) of emergency situations. They can work autonomously or as part of other formations and institutions involved in the elimination of the medical and sanitary consequences of emergencies. Disaster medicine service formations are organized at all levels and may be regular or non-standard.

Regular are formations, continuously funded at the expense of funds allocated to the service of disaster medicine this level.

On the basis of medical educational, research, medical and preventive and sanitary institutions through their staff at all levels of the disaster medicine service emergency formations are created(detachments, brigades, groups). Ensuring their readiness for work is entrusted to the heads of the relevant institutions. In the event of an emergency, these formations come under the operational subordination of the management bodies of the disaster medicine service of the corresponding level.

The means of the QMS are medical, sanitary and special property and equipment, consisting of equipping the governing bodies, formations and institutions of the service and designed to ensure the fulfillment of their tasks.

The main mobile medical and diagnostic formation of the disaster medicine service is Field multidisciplinary hospital (PMH) VTsMK "Protection" . It is designed to advance to the emergency zone, receive the injured, sort them, provide qualified medical care with elements of specialized medical care to the injured, prepare them for evacuation, temporary hospitalization of non-transportable, as well as outpatient care for the population. With full deployment, the hospital can take up to 250 patients per day. For the hospitalization of non-transportable affected, the hospital can deploy up to 150 beds. The staff units of the hospital include: management, main departments (reception and diagnostic, surgical, resuscitation and anesthesia, hospital, evacuation), support units (pharmacy, engineering department, logistics department). The emergency departments of the hospital are 17 brigades (sorting, diagnostic, emergency response duty, general surgical, surgical children's, traumatology, neurosurgery, burns, ophthalmology, resuscitation, extracorporeal detoxification, therapeutic, psychiatric, infectious, radiological, toxicological and evacuation). Teams are formed from highly qualified specialists of basic medical institutions.

The hospital can move to the emergency zone in whole or in part. Depending on the nature of the emergency, the hospital is equipped with teams of various profiles and is deployed as a surgical, toxicological, radiological, therapeutic, pediatric, tuberculosis or multidisciplinary hospital.

Specialized Medical Teams may be regular or non-standard. They are mobile formations of the disaster medicine service and are designed to specialize or strengthen medical institutions involved in the elimination of the consequences of emergencies.

The main tasks of the BSMP are: medical triage of the affected, in need of specialized medical care; provision of specialized medical care to the injured and treatment of non-transportable injured; preparation of the injured for evacuation to specialized medical facilities; provision of advisory and methodological assistance to those affected in medical facilities.

The states and tables of equipment of the emergency medical service are determined on the basis of the Model Regulations on the teams of specialized medical care of the disaster medicine service, approved by the Ministry of Health of the Russian Federation on December 29, 1995.

Teams are formed by health authorities on the basis of republican, regional (territorial), city multidisciplinary and specialized hospitals, central district hospitals, emergency hospitals, clinics of medical universities, research institutes and specialized medical centers and are recruited from highly qualified specialists on a voluntary basis .

The appointment and change of the main composition and backup personnel of the BSMP are carried out by orders of the head of the institution-former.

In the modes of daily activities and high alert, the BSMP are subordinate to the head of the forming institution and are operationally subordinate to the head of the corresponding center for disaster medicine.

In the high alert mode, specialists of regular teams on holidays and weekends are on duty at home - according to a schedule approved by the head of the shaping institution in agreement with the center for disaster medicine. In emergency situations, the management of the brigade is assigned to the head of the disaster medicine center.

The terms of departure (departure) of the ambulance with property to the emergency area are determined based on local conditions, but no later than 6 hours after receiving the order. The mode of operation of the brigade in emergency situations is an average of 12 hours a day.

The BSMP is supplied with medical, sanitary and special equipment by the forming institution on the principle of priority provision according to the equipment list. The property of the brigade is completed and stored in the institution-former in special packing, ready for quick release.

Delivery of emergency ambulance to the place of work in the event of an emergency is carried out on a priority basis by the decision of the relevant commission for emergency situations.

Remuneration of labor and social protection of BSMP specialists is carried out in accordance with the Federal Law on Emergency Rescue Services and the Status of Rescuers (adopted by the State Duma on 14.07.95).

The head of the forming institution is directly responsible for the formation of the BSMP and their readiness to perform the tasks assigned to them. He is obliged:

staff the BSMP with specialists;

provide the BSMP with standard equipment and organize its safety, timely renewal and the possibility of quick issuance;

upon receipt of an instruction from the disaster medicine center, ensure the notification of the emergency ambulance service personnel and their collection, timely delivery of the brigade to the collection point for dispatch to the emergency zone (district);

organize special training for BSMP specialists and their certification;

to finance the duty and work of the emergency ambulance service in the zone (center) of emergency situations, to comply with the norms of social protection of the emergency hospital specialists established by law.

The head of the brigade is appointed by order of the head of the institution-former from among the most qualified specialists and is responsible for the state of readiness of the brigade to work in emergency situations and the fulfillment of the tasks assigned to it.

There are 21 types of teams in accordance with the Model Regulations on Specialized Medical Care Teams of the Disaster Medicine Service. Surgical, traumatological, neurosurgical, burn, children's surgical, obstetric-gynecological, transfusiological, toxic-therapeutic, psychiatric and infectious emergency hospitals are most often involved in emergency situations.

Surgical EMS designed to provide qualified and specialized medical care to the affected surgical profile.

The composition of the brigade: 3 surgeons (one head), an anesthesiologist-resuscitator, 2 operating nurses, an anesthetist nurse and a dressing nurse (gypsum) - total 8 people.

For 12 hours of work, the team can perform up to 10 surgical interventions.

Traumatological emergency hospital designed to provide qualified and specialized medical care to those affected with mechanical damage, mainly of the musculoskeletal system, and their treatment.

The composition of the brigade: 2 traumatologists (one head), an anesthesiologist-resuscitator, 2 operating nurses, an anesthetist nurse and a dressing nurse (gypsum) - total 7 people.

For 12 hours of work, the team can perform up to 10 surgical interventions.

Neurosurgical BSMP It is designed to provide qualified and specialized medical care to those affected with skull injuries, brain and spinal contusions, who need surgical care.

The composition of the brigade: 2 neurosurgeons (one head), an anesthesiologist-resuscitator, 2 operating nurses and an anesthetist nurse - total 6 people.

Within 12 hours of work, the team performs up to 6 surgical interventions.

Burn BSMP It is designed to provide qualified and specialized medical care to those affected with thermal injuries.

The composition of the brigade: 2 surgeons-combustiologists (one head), an anesthesiologist-resuscitator, 2 operating nurses and an anesthetist nurse - total 6 people.

.

Children's surgical BSMP It is designed to provide qualified and specialized surgical care to children and their treatment. These teams are created on the basis of children's clinics of medical universities, research institutes, advanced training institutes for doctors, regional and city children's hospitals with surgical departments.

The need to have such emergency hospitals in the disaster medicine service is due to the fact that among those affected in emergencies, on average, 25% are children.

The composition of the brigade: head (surgeon for children), surgeon-tramatologist-orthopedist for children, anesthesiologist-resuscitator, 2 operating nurses, 2 nurses-anesthetists and a dressing nurse (gypsum) - only 8 people

For 12 hours of work, the team can carry out up to 10 surgical interventions.

Obstetrics and Gynecology BSMP is designed to organize and provide qualified and specialized obstetric and gynecological care to the affected and patients in need of it, and their treatment.

The composition of the brigade: 2 obstetrician-gynecologists (one head), an anesthesiologist-resuscitator, midwife, senior operating nurse, 2 nurses (anesthetist and nursery) - only 7 people.

.

Transfusiological BSMP is intended for infusion-transfusion intensive therapy, therapeutic plasmapheresis, hemodialysis and hemosorption of the affected. The brigade is created on the basis of institutes (stations) of blood transfusion, hematological centers.

The composition of the brigade: head (reanimatologist), surgeon-transfusiologist, therapist-organizer of donor blood collection, nephrologist, laboratory assistant, senior nurse (hemodialysis, blood collection, plasmapheresis), anesthetist nurse and paramedic -lab assistant - only 8 people

For 12 hours of work, the brigade can provide assistance to 50 injured.

Toxic-therapeutic BSMP is designed to organize and provide qualified and specialized medical care and treatment of those affected by hazardous chemicals and poisonous substances. Created on the basis of toxicological centers, toxicological departments and intensive care units of hospitals.

Medical institutions assigned to chemically hazardous facilities and having a toxicological department or an intensive care unit in their composition form teams from their composition. In the absence of such departments, BSMPs are assigned to the relevant facilities by the decision of the territorial or local health authorities.

The composition of the brigade: head (anaesthesiologist-resuscitator-toxicologist), general practitioner-toxicologist, nurse (anesthetist) and paramedic (nurse) - only 4 people

For 12 hours of work, the brigade can provide assistance to 30 injured.

Psychiatric Emergency is designed to organize and provide qualified and specialized medical care to those affected with acute reactive psychoses and other mental disorders in emergency situations. It is created on the basis psychiatric hospitals and dispensaries.

The composition of the brigade: head (psychiatrist), 2 doctors (psychiatrist and psychophysiologist), 2 nurses - only 5 people

For 12 hours of work, the brigade can provide assistance to 50-100 injured.

Infectious BSMP designed to provide specialized medical care and treatment of infectious patients. It is created on the basis of infectious diseases hospitals and healthcare facilities with infectious diseases departments.

The composition of the brigade: head (infectionist), 2 doctors (infectionist and pediatrician), 3 nurses - only 6 people.

For 12 hours of work, the team can provide assistance to 50-100 patients.

Medical institutions involved in the elimination of the consequences of emergencies, if necessary, can be strengthened by other emergency hospitals: anesthesiology, resuscitation, ophthalmology, otorhinolaryngology, maxillofacial surgery, therapeutic, pediatric, laboratory and diagnostic. All these teams are headed by doctors of the relevant specialties, have 2-3 more doctors and 3-5 paramedical workers.

Part sanitary and toxicological BSMP includes: head (hygienist), toxicologist, 2 analytical chemists, electronics engineer - 5 people in total.

Radiological BSMP includes: a manager (hygienist), 2 radiation medicine specialists, a laboratory assistant-hematologist, 2 physicists-dosimetrists, a physicist-spectrometer - 7 people in total.

The formations of the disaster medicine service, intended to provide first aid to the injured, include medical mobile ambulance teams and medical and nursing teams.

Medical ambulance teams are created on the basis of stations, substations, emergency departments. The main tasks of the brigade are: medical triage of the injured, the provision of first aid in the prescribed volume and the evacuation of the injured from the focus (zone) of emergency situations.

The composition of the brigade: head - a doctor, 2 paramedics (or a paramedic and a nurse anesthetist), an orderly and a driver - only 4 people

Medical and nursing teams are non-staff mobile units of the disaster medicine service, designed to provide first aid, organize and conduct medical triage and prepare for the evacuation of the affected from the outbreak. They are created on the basis of city, central district, inter-district, district hospitals, as well as polyclinic institutions and health centers.

The composition of the brigade: head - doctor, senior nurse, 2 nurses, orderly, driver-orderly - only 6 people.

Staffing with medical property of medical and nursing teams is carried out by the establishments-formers according to the report card . The property, ready for work, is stored in the forming institution in special stowage. The staffing of vehicles with drivers is carried out by order of the head of the forming institution or by the decision of the administration of the city (district).

For 6 hours of work, the brigade provides medical assistance to 50 injured.

The main formations intended for the provision of first aid are the first aid teams and paramedical ambulance line teams.

First aid teams assistance are mobile medical units of health care, designed to triage the injured, provide them with first aid and prepare for evacuation.

They are created and staffed according to the report card on the basis of the decision of the territorial health authorities on the basis of city, central, district and district hospitals, as well as polyclinics, health centers and are used to work in the outbreak (on the border of the outbreak).

At the facilities, teams can be created by decision of the head of the facility at the expense of the personnel of the medical and sanitary unit (health center).

The composition of the brigade: head - paramedic (nurse), 1-2 nurses, driver-orderly - only 3-4 people.

For 6 hours of work in emergency situations, the brigade can provide assistance to 50 injured.

Paramedic ambulance teams are created on the basis of stations (substations, departments) of emergency medical care.

The composition of the brigade: 2 paramedics (one of them is the head), an orderly and a driver - only 4 people On equipment, the brigade has special stacks, completed according to the report card.

For 6 hours of work in emergency situations, the brigade can provide assistance to 50 injured.

The institutions of the disaster medicine service of the Ministry of Health of Russia are the centers of disaster medicine, hospitals and supply bases that perform their tasks at the places of permanent deployment.

4. Tasks and organizational structure of the sanitary and epidemiological service in emergency situations (organization of the sanitary and epidemiological service in emergency situations, tasks and organization of specialized units of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, sanitary and epidemiological teams ( SEA), sanitary and epidemiological brigades (SEB), specialized anti-epidemic brigades (SPEB), epidemiological reconnaissance teams).

In accordance with Decree of the Government of the Russian Federation No. 924 dated August 3, 1996 “On the Forces and Means of the Unified State System for the Prevention and Elimination of Emergencies”, the establishment and formation of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare of Russia in the Unified State System for the Prevention and Elimination emergency situations, carry out state sanitary and epidemiological supervision as part of the forces and means of monitoring and controlling the state of the environment, the situation at socially hazardous facilities and adjacent territories and analyze the impact of harmful factors on public health, and are also included in the monitoring and laboratory control network ( SNLC). The Regulations on the VSMK and QMS of the Ministry of Health of Russia define the tasks for these formations for organizing and carrying out sanitary-hygienic (preventive) and anti-epidemic measures.

The list of permanent readiness forces of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare of Russia at the regional and territorial level includes 89 centers of Rospotrebnadzor in the territories of the constituent entities of the Russian Federation, 5 anti-plague institutes, an anti-plague Center in Moscow and 11 anti-plague stations. All these institutions can form 70 sanitary and epidemiological teams and 19 sanitary and epidemiological teams, as well as 15 specialized anti-epidemic brigades (SPEB) based on anti-plague institutions to work in the emergency zone.

Head centers of Rospotrebnadzor at the federal level- Federal Center of Rospotrebnadzor, Anti-Plague Center, Central Research Institute of Epidemiology, St. Petersburg Research Institute of Radiation Hygiene.

Head and regional centers of federal and regional level solve the following tasks:

anti-plague institutes perform the functions of head (by indication) and regional centers for especially dangerous infections; form and maintain in a state of readiness specialized anti-epidemic teams and expert groups; carry out the indication and identification of bacteria and viruses;

research institutes of a hygienic profile provide practical assistance to Rospotebnadzor centers in assessing the levels of pollution and environmental contamination that are dangerous for the life of the population; carry out hygienic examination, expert evaluation and laboratory research of food raw materials, foodstuffs and environmental objects, formation of expert groups.

Interregional centers for emergency situations and hygienic expertise of the European part, Siberia and the Far East of the Russian Federation - scientific and practical centers for emergency situations and hygienic expertise in the cities. Moscow and Novosibirsk - provide: providing practical assistance to the centers of Rospotrebnadzor during the hygienic examination, the formation of expert groups, the development of guidelines for planning and conducting hygiene measures in emergencies.

Regional level centers solve the following tasks:

research institutes of epidemiology and microbiology provide practical assistance to the centers of Rospotrebnadzor in the investigation of epidemic situations, in the indication and identification of pathogens of infectious diseases; training of specialists of the Rospotrebnadzor service to work in an epidemic focus; formation of expert groups;

research institutes of hygiene provide practical assistance to the centers of Rospotrebnadzor in matters of prevention and diagnosis of AOHV lesions.

The focal points of the Rospotrebnadzor service at the regional level are the Rospotrebnadzor centers in the cities. Moscow and St. Petersburg, in the Krasnoyarsk and Khabarovsk Territories, Rostov, Samara, Sverdlovsk, Novosibirsk, Chita Regions - coordinate and organize the interaction of Rospotrebnadzor centers with the corresponding centers of the Russian Emergencies Ministry and other governing bodies, formations and institutions of the VSMK.

Centers of regional and territorial level (anti-plague stations) perform the functions of regional and territorial centers for especially dangerous infections and provide: the formation and maintenance of specialized anti-epidemic teams in a state of readiness to work in the foci of infectious diseases of various etiologies; indication and identification of causative agents of plague, cholera and other dangerous infections.

Centers of Rospotebdnadzor on transport carry out: sanitary and epidemiological supervision of the state of vehicles, water and aircraft, coastal facilities and airports; supervising the implementation of quarantine and observational measures; examination and laboratory control, and also take part in identifying the sources of infection (contamination), its extent and causes, the formation of teams (groups).

Territorial level centers- centers of Rospotrebnadzor in the republics, autonomous formations, territories, regions and cities (including the listed centers of the regional level located in this territory) - must carry out:

state sanitary and epidemiological supervision of hygienically and epidemiologically significant objects from " at-risk groups”, for the sanitary condition of environmental objects, food raw materials and food products;

epidemiological control over nutrition, water supply, living conditions of the affected (affected) population;

carrying out anti-epidemic measures in the epidemic focus;

formation of sanitary and epidemiological teams of constant readiness, and, if necessary, sanitary and epidemiological teams;

sampling and delivery of samples for testing for pathogens of groups I-II (plague, cholera, anthrax, hemorrhagic fevers of Lass, Marburg, Ebola and a number of other contagious infections), for toxic substances;

indication of pathogens of infectious diseases of III-IV groups (tetanus, shigellosis, diphtheria and a number of other infections);

training of specialists, conducting exercises and drills;

determination of toxic substances, indication of pathogens, determination of radioactive contamination.

Local Level Centers- Rospotebnadzor centers in the districts - should carry out:

state sanitary and epidemiological supervision of epidemiologically significant objects from the "risk group";

control over food, water supply;

carrying out quarantine and observational measures in the epidemic focus;

formation of epidemiological intelligence groups.

Specialized (non-standard) formations of the Rospotrebnadzor service are designed to organize and carry out sanitary-hygienic and anti-epidemic measures to prevent and eliminate emergencies in peacetime and wartime.

Formations are created on the basis of the centers of Rospotrebnadzor, anti-plague institutions, research institutes of epidemiological and hygienic profile according to the relevant orders of the Ministry of Health of Russia.

The creation of the following types of specialized formations is envisaged: sanitary and epidemiological detachments (SEO); sanitary and epidemiological teams (SEB) - epidemiological, radiological, sanitary and hygienic (toxicological); specialized anti-epidemic brigades (SPEB); Epidemiological Intelligence Groups (ERGs).

The specific tasks of formations in various emergencies are determined by the Regulations on specialized formations of the State Sanitary and Epidemiological Service of Russia.

Sanitary and epidemiological teams are formed by the centers of Rospotrebnadzor in the constituent entities of the Russian Federation from employees of the institutions of the state sanitary and epidemiological service, as well as through the functional integration of radiological, sanitary-hygienic (toxicological) and epidemiological rapid response teams. Rospotrebnadzor centers that do not have the ability to form SEA, create SEB. SEA is a mobile formation of constant readiness, capable of working both in in full force, and as part of individual units (brigades). The composition of the SEA, the number and size of the brigades are determined by the leadership of the shaping institution. In order to implement special measures, mixed brigades may be created with the participation of experts for a preliminary assessment of the situation and to determine the completeness of the deployment of brigades or detachments.

Responsibility for the readiness of the SEA for action in an emergency rests with the chief doctor of the center of Rospotrebnadzor, who forms the detachment.

The readiness of the SEA for work in emergency situations in isolation from the formation base - 24 hours (teams - 12 hours). For teams to work on the spot, this period should not exceed 2-4 hours. The SEA (typical) includes only 21 people.

The composition of the sanitary and epidemiological teams - only 5 people.

epidemiological - head (doctor), epidemiologist, assistant epidemiologist (paramedic), instructor-disinfector, vehicle driver - 5 people in total;

radiological - chief (doctor), radiation hygiene doctor, assistant sanitary doctor (paramedic), dosimetrist technician, vehicle driver - 5 people in total;

Sanitary-hygienic (toxicological) - head (doctor), sanitary doctor-toxicologist, assistant sanitary doctor (medical assistant-laboratory assistant), laboratory assistant-chemist (medium qualification), driver of vehicles - 5 people in total.

Tasks of SEA in the mode of daily activities :

participation of SEA personnel in the organization and implementation of basic measures to prevent the occurrence of epidemic outbreaks in emergency situations;

maintaining the constant readiness of the detachment management, other forces and means, ensuring readiness for sampling, carrying out an indication of pathogens of infectious diseases; accumulation, storage and updating of equipment of the formation;

creation of stocks of medical immunobiological preparations for the diagnosis of especially dangerous infectious diseases;

training of specialists of the detachment on the prevention of especially dangerous infections, prevention and elimination of the sanitary and epidemiological consequences of emergencies;

training of personnel of the detachment in modern methods of detection and indication of pathogens, laboratory control of food products, food raw materials and drinking water for contamination with bacterial agents (BS),

AOKhV and radioactive substances (RS);

conducting training sessions personnel of the detachment for the organization of sanitary-hygienic and anti-epidemic measures in the event of an emergency;

checking the readiness of the detachment for its practical deployment on time with the involvement of all forces and means and setting tasks to eliminate the medical and sanitary consequences of emergency situations;

verification of the effectiveness of the notification scheme and the collection of personnel, clarification of the need for personnel, transport, property; determination of real terms of alerting; clarification of the sequence and order of deployment; clarification of the possibilities of conducting biological reconnaissance in wartime and sanitary and epidemiological reconnaissance, laboratory monitoring of contamination with RS, AOC and contamination of food products, food raw materials and drinking water with BS; determination of the volume of sanitary-hygienic and anti-epidemic measures in the event of an emergency.

Tasks of SEA on high alert :

increasing the readiness of SEA units designed to eliminate possible emergencies, clarifying their plans and actions depending on the forecast for the development of the sanitary and epidemiological situation;

bringing the SEA to a state of high alert (promotion of the SER and SEA to the area of ​​proposed actions).

Tasks of SEA in the state of emergency in peacetime :

deployment and implementation of measures of a sanitary and epidemiological nature, carried out in the event of an emergency;

advancement of operational groups (GER) and formations to the emergency area;

organization and implementation of anti-epidemic measures;

sampling, delivery of samples and laboratory research;

assessment of the sanitary and epidemiological situation and forecast of its development;

determination of the volume and implementation of sanitary-hygienic and anti-epidemic measures during the elimination of emergencies;

ensuring the sanitary and epidemiological well-being of the population and personnel of emergency rescue teams participating in the elimination of emergencies;

examination of food, drinking water, water supply sources, air and soil for contamination with RV, AOC, BS infection and issuing conclusions on the possibility of their use for the needs of the population;

sanitary and epidemiological urgent measures for the life support of the population and personnel of other formations participating in the elimination of emergencies;

informing the population about the degree of risk to health and life as a result of emergencies; systematic informing the management of the emergency zone about changes in the sanitary and epidemic situation and measures to stabilize the situation;

operational work with the media.

Specialized anti-epidemic brigade is a mobile autonomous formation of constant readiness, designed to carry out anti-epidemic and preventive measures in emergency sanitary-epidemic situations or in case of a threat of their occurrence.

They report directly to the Federal Center of Rospotrebnadzor of the Ministry of Health of Russia and are its representatives in the areas of activity.

Brigades are formed on the basis of anti-plague institutions. The number of SPES, forming their basic institutions and organizational staffing structure is determined by the Federal Center of Rospotrebnadzor.

The staffing of the main and backup staff of the SPES is made from among the personnel of anti-plague institutions with the involvement (if necessary) by order of the Federal Center for Rospotrebnadzor of the Ministry of Health of Russia, specialists from other institutions of Rospotrebnadzor.

The head of the SPES is appointed by order of the head of the institution on the basis of which it is formed.

The equipment of the SPEB is carried out in accordance with the “Table of equipment for a specialized anti-epidemic brigade” at the expense of the federal budget. Consumables and property must be designed for the operation of the SPES within two weeks (minimum period). Replenishment of the SPES with standard equipment and materials is carried out by the forming institution at the expense of targeted funding from the federal budget.

The main tasks of the SPES are :

participation in the organization and implementation of a complex of emergency anti-epidemic measures to identify, localize and eliminate quarantine and other infectious diseases, including in cases of their importation from abroad;

participation in the organization and implementation of a set of preventive and anti-epidemic measures in emergency zones aimed at preventing and reducing the infectious morbidity of the population, as well as assessing and forecasting the sanitary and epidemic situation;

participation in the organization and implementation of a complex of emergency anti-epidemic measures in case of activation of natural foci of infectious diseases;

diagnostics of diseases of unknown etiology and indication of pathogens of infectious diseases of bacterial nature in environmental objects.

Readiness of the SPES to work in emergency situations in isolation from the base of formation - 12 hours, for work at the place of formation - 2-4 hours.

The organization of the work of the SPES in the emergency zone is carried out in cooperation with the institutions of the Ministry of Health, the Ministry of Emergency Situations of Russia, and other ministries and departments.

When deploying the SPES, its management organizes interaction with the administration on whose territory the SPES operates, resolves the issues of providing the SPES with premises for the deployment of its units; protection; meeting household, technical, energy and transport needs; allocation of additional staff if necessary.

The supply of the SPES with consumables as they are used is carried out by the management of the anti-plague institution and (or) the center of Rospotrebnadzor, on the territory of which the SPES operates, at the expense of targeted funding from the federal budget.

The SPEB consists of 40 people in total.

Epidemiological Intelligence Groups are created on the basis of regional (regional), city and district centers of Rospotrebnadzor. The SERs may be part of the SEA. The group consists of three people: the leader is an epidemiologist, an epidemiologist assistant (paramedic), and a driver. If necessary, other specialists can be included in the group. The group takes samples in the environment and conducts a sanitary and epidemiological survey of the emergency focus. It is equipped with a sampling kit and has a car. The tasks of the GER include the determination of the type of pathogen in laboratories by the express method, the examination of food, and the control of water quality.

State Budgetary Educational Institution of Higher Professional Education of the Ministry social development and healthcare of the Russian Federation

"Samara State Medical University"

Department of Life Safety and Disaster Medicine

Abstract on the topic:

"All-Russian Service for Disaster Medicine of Russia"

Performed:

Aidumova O.Yu.

SAMARA, 2012

Introduction

The main tasks of the VSMK of the Ministry of Health of the Russian Federation

Organizational structure of the VSMK of the Ministry of Health of the Russian Federation

Organization of activities of the VSMC of the Ministry of Health of the Russian Federation

Conclusion

Bibliography

Introduction

The Service for Disaster Medicine of the Ministry of Health of the Russian Federation (hereinafter referred to as the Service) is part of the All-Russian Service for Disaster Medicine (VSMK) and performs its tasks in direct interaction with the Department for State Sanitary and Epidemiological Surveillance of the Ministry of Health of Russia, the Federal Directorate "Medbioekstrem", health authorities of the subjects Russian Federation and healthcare institutions.

The service is intended to carry out a set of measures to prevent health consequences and provide health care to the population in case of natural disasters, accidents, catastrophes, epidemics, local armed conflicts, terrorist attacks and other emergencies, as well as to organize and provide emergency and advisory medical care. population.

The service carries out its activities in cooperation with federal executive authorities, formations and institutions of ministries and departments involved in the elimination of the medical and sanitary consequences of emergency situations (ES).

The Service is guided in its activities by the Constitution of the Russian Federation, the Federal Law “On the Protection of the Population and Territories from Natural and Technogenic Emergencies”, and others. federal laws, decrees and orders of the President of the Russian Federation, orders and orders of the Government of the Russian Federation, orders and orders of the Ministry of Health of the Russian Federation, decisions of the federal interdepartmental coordination commission of the VSMK, other regulatory legal acts as well as these Regulations.

1. The main tasks of the VSMK of the Ministry of Health of the Russian Federation

To provide emergency medical care in the first minutes, hours in case of disasters with mass casualties of the population, by Decree of the Government of the Russian Federation No. 195 of February 28, 1996, the Disaster Medicine Service of the Ministry of Health and Social Development was established.

Medical support for the population in emergency situations is organized by federal, regional and territorial interdepartmental coordination commissions, heads (directors) of regional and territorial centers for disaster medicine. The commissions are chaired by health officials at the appropriate level. The commissions include heads of medical services and heads of state sanitary and epidemiological surveillance.

To provide emergency medical care to those affected by nuclear, chemical and bacteriological weapons, to carry out sanitary and hygienic and anti-epidemic measures, medical measures to protect against weapons of mass destruction in wartime, the civil defense medical service is intended - a special healthcare organization, which is one of the structures of the Civil Defense (GO ) Russian Federation. Civil defense formations and institutions participate in the elimination of the consequences of major natural disasters and catastrophes in peacetime.

The main tasks of the All-Russian Service for Disaster Medicine are:

Organization and implementation of medical and sanitary support during the liquidation of emergency situations;

Creation, preparation and ensuring the readiness of the management bodies of formations and institutions of the Service for actions in emergency situations;

Ensuring the constant readiness and efficient operation of units of emergency and planned advisory assistance to the population (air ambulance);

Participation in the preparation and readiness of government bodies, sanitary and preventive and other institutions of the Ministry of Health and Social Development to work in emergency situations;

Identification of sources of emergency situations that may be accompanied by adverse health consequences, carrying out a set of measures to prevent or reduce such consequences;

Forecasting and assessment of the health consequences of natural disasters, accidents and catastrophes;

Creation and organization of work of interdepartmental coordinating commissions of disaster medicine;

Collection and processing of information of a medical and sanitary nature in the field of protection of the population and territories on the medical and sanitary consequences of emergency situations and their elimination, exchange and presentation of such information to interested organizations (institutions);

Organization of measures to maintain the sanitary and epidemiological well-being of the population in the emergency zone;

Organization of interaction between governing bodies, formations and institutions involved in the elimination of the medical and sanitary consequences of emergency situations, regardless of their affiliation, coordination of their activities;

Development of the bases for the preparation of the Service, principles and organization of work in the liquidation of the medical and sanitary consequences of emergency situations;

Development, implementation and improvement of methods and means of providing emergency and planned advisory medical care to the population;

Development, implementation and improvement of methods and means of providing medical care and treatment of the affected population, taking into account the nature of emergencies;

Continuous improvement of the organizational structure of the Service and the system of medical and sanitary support for the population in case of emergencies, the system of emergency and planned advisory medical care to the population;

Maintenance in constant readiness and improvement of the management system of the Service;

Development of scientific and practical foundations for the training and advanced training of specialists of the Service and the organization of their certification;

Training and advanced training of specialists of the Service;

Development of methodological foundations and participation in the preparation of the population and rescuers to provide first aid in emergency situations;

Participation in the implementation of state expertise, supervision and control in the field of protection of the population and territories in emergency situations;

Participation (in the area of ​​responsibility of health authorities) in the development and implementation of measures for the social protection of the population, carrying out humanitarian actions, providing conditions for citizens to exercise their rights and obligations in the field of protection from emergencies;

Creation and rational use of reserves of financial and material and technical resources to ensure the activities of the Service;

International cooperation in the field of disaster medicine.

2. Organizational structure of the VSMK of the Ministry of Health of the Russian Federation

In accordance with the structure of the Unified State System for the Prevention and Elimination of Emergencies and the assigned tasks, the Service is being created at the federal, regional, territorial, local and facility levels.

At the federal level, the Service is represented by:

All-Russian Center for Disaster Medicine "Protection" of the Ministry of Health of Russia (VTsMK "Protection").

VTsMK "Zashchita" is a state multidisciplinary head institution of the disaster medicine service of the Ministry of Health of the Russian Federation of a special type, performing the functions of the governing body of the VSMC and the disaster medicine service of the Ministry of Health of Russia at the federal and regional levels, an educational, research and medical institution.

VTsMK "Protection" has the status of a WHO Collaborating Center and performs the functions of the Eurasian Regional Center for Disaster Medicine in the CIS.

The organizational structure of the VTsMK "Protection" and its branches is approved by the Ministry of Health of Russia, and the staffing table is approved by the director of the VTsMK "Protection" in agreement with the Ministry of Health of Russia.

VTsMK "Protection" consists of management, main divisions and support divisions. Management includes: management, office, departments - financial and economic, accounting and reporting, personnel, regime, international relations and organizational planning, as well as a group of advisers and consultants. The management consists of the director of the VTsMK "Protection", the first deputy director, deputy directors for scientific, medical work and other areas of the Center's activities.

The main subdivisions of the VTsMK "Protection" are: the headquarters of the VTsMK "Protection" (in seven federal districts and in special cases, by decision of the Ministry of Health of the Russian Federation, they can temporarily be created in certain constituent entities of the Russian Federation), a clinic for disaster medicine with a field multidisciplinary hospital (PMG ), Institute of Problems of Disaster Medicine and Additional Professional Education for Specialists of the Disaster Medicine Service, Center for Medical Expertise and Rehabilitation, Research Department of Medical and Technical Problems of Extreme Medicine; department of organization of medical care in case of radiation accidents, department of medical supply (reserve warehouse of the Ministry of Health of Russia for emergencies).

The Headquarters of the All-Russian Service for Disaster Medicine (hereinafter referred to as the Headquarters) operates as part of the All-Russian Central Medical Center "Protection" of the Ministry of Health of Russia, is the working body of the federal interdepartmental coordination commission of the All-Russian Higher Medical Commission. It performs the functions of operational management of the activities of the disaster medicine service of the Ministry of Health of the Russian Federation, the Ministry of Defense of the Russian Federation, as well as the forces and means of the Ministry of Internal Affairs, the Ministry of Railways of the Russian Federation, and other federal executive bodies intended to eliminate the medical and sanitary consequences of emergencies. The Headquarters carries out its work on the basis of the decisions of the federal interdepartmental coordination commission of the VSMK, orders and instructions of the Ministry of Health of Russia and the Ministry of Emergency Situations of Russia, as well as decisions of the Chief of Staff taken within his competence.

The headquarters coordinates the preparation and interaction of government bodies, as well as the use of units and institutions that are part of the All-Russian Disaster Medicine Service at the federal, regional and territorial levels.

The transfer of the Headquarters from the mode of daily activities to the modes of high alert and emergency is carried out by decision of the Ministry of Health of Russia, the Ministry of Emergency Situations of Russia, as well as the chief of staff of the VSMK.

The organizational structure and staffing of the Headquarters is determined by the Chief of Staff and approved by the Minister of Health of the Russian Federation.

The main divisions of the headquarters are: management - operational, organization of medical support in emergencies, for work with the regions, as well as departments - general, organization of interaction, information and logistics.

Branches of VTsMK "Protection" ensure the fulfillment of the tasks of VTsMK "Protection" at the regional and territorial levels, measures in the field of protecting the life and health of the population, its medical and sanitary support in the aftermath of emergency situations.

Within the limits of the assigned tasks, the branches of the VTsMK "Zashchita" are guided by the documents of the representative of the Minister of Health of the Russian Federation in the federal districts, the regional centers of the Russian Emergencies Ministry and the regional interdepartmental coordination commission of the All-Russian Service for Disaster Medicine and other regulatory legal acts, as well as the Regulations on the branches of the VTsMK "Protection".

The branches of VTsMK Zashchita do not have the status of a legal entity.

The disaster medicine clinic includes a field multidisciplinary hospital, profiled (specialized) clinical departments, dispatching units and support units.

The clinic is designed to provide qualified and specialized medical care and treatment of the sick and wounded with pathologies characteristic of emergency situations (possible injuries, burns, diseases, chemical and radiation injuries, etc.); practical training of specialists intended to work in the SGP; ensuring constant readiness for work in case of emergencies of a field multidisciplinary hospital. The Disaster Medicine Clinic operates within the compulsory health insurance system.

The Institute of Problems of Disaster Medicine and Additional Professional Education includes the departments of disaster medicine, emergency conditions and expert medical care, sanitary and anti-epidemic support in emergencies, restorative medicine with relevant specialized scientific laboratories; department of scientific and technical information with a library.

The Institute of Problems of Disaster Medicine and Additional Professional Education for Specialists of the Disaster Medicine Service is intended mainly to improve the management of the Service, to develop (together with other divisions of the All-Russian Center for the Protection of Children and public policy in the field of disaster medicine, for the prevention and elimination of the medical and sanitary consequences of emergencies, the development of federal targeted and research programs to improve and increase the readiness of the VSMC.

The Center for Medical Expertise and Rehabilitation is designed to develop and implement an organizational and functional system of medical expertise and rehabilitation of participants in the aftermath of emergencies and a regulatory framework that ensures the implementation of the system at the federal, regional and territorial levels. In addition, on the basis of the center, medical rehabilitation of professional contingents involved in the elimination of the consequences of emergencies is carried out, development, testing and implementation of promising means and methods of medical examination and rehabilitation are carried out.

The Center for Medical Expertise and Rehabilitation has a rehabilitation practical complex and three scientific laboratories - promising tools and methods for prenosological diagnostics and health screening, clinical testing of modern rehabilitation technologies, and pharmacological problems of rehabilitation.

Specialized formations and institutions of the State Sanitary and Epidemiological Service of the Russian Federation, directly subordinate to the Ministry of Health of Russia. The organizational and methodological function of organizing sanitary and anti-epidemic support is performed by the Department for State Sanitary and Epidemiological Surveillance of the Ministry of Health of Russia.

At the regional level, the Service is represented by:

.Branches of VTsMK "Protection" in the federal districts:

.The main subdivisions of the regional branches of the VTsMK "Protection" are: headquarters, a mobile medical detachment with teams of specialized medical care, a medical supply department, a logistics and transport support department.

.Centers for State Sanitary and Epidemiological Surveillance at the regional level with their constituent units.

.Clinical bases designed in accordance with their duties to eliminate the medical and sanitary consequences of emergencies.

At the territorial level, the Service is represented by:

.Territorial centers of disaster medicine of the constituent entities of the Russian Federation - health care institutions of the Russian Federation of a special type and branches of the All-Russian Center for Medical Treatment "Protection" (Chechen Republic, Ingush Republic, Republic of Dagestan), performing the functions of the management body of the disaster medicine service at the territorial level. The Territorial Center for Disaster Medicine has the status of a legal entity, its main divisions are: administration, operational dispatch department, organizational and methodological department, specialized medical care teams, department of emergency and planned advisory medical care to the population (sanitation), department of medical supply, department of material -technical support.

.Centers for State Sanitary and Epidemiological Surveillance in the constituent entities of the Russian Federation and cities of federal significance, which create forces and means for monitoring, controlling and eliminating emergency situations on the territory of the corresponding constituent entity of the Russian Federation, and their activities are coordinated by the health authorities of the constituent entities of the Russian Federation (sanitary and anti-epidemic commissions ).

.Clinical bases designed, in accordance with their duties, to eliminate the medical and sanitary consequences of emergency situations and provide emergency and planned advisory medical care to the population.

At the local level, the Service is represented by:

.Disaster medicine centers at the local level (where they are created) or ambulance stations (substations) that act as the management body of the disaster medicine service with their constituent units.

.Centers for state sanitary and epidemiological surveillance in cities and districts, forming sanitary and epidemiological teams and epidemiological intelligence groups.

.Medical and preventive institutions designed in accordance with their duties to eliminate the medical and sanitary consequences of emergency situations.

At the object level, the Service is represented by:

.Officials for medical and sanitary support of the facility in emergency situations.

.Medical contingencies.

.Medical and preventive institutions (medical units, polyclinics, etc.), designed in accordance with their duties to eliminate the medical and sanitary consequences of emergency situations.

.Structural divisions of the sanitary and epidemiological supervision of the facility.

To participate in the elimination of the medical and sanitary consequences of emergencies at the federal, regional, territorial, local and facility levels, at the expense of the existing medical and preventive and sanitary and epidemiological institutions of the Ministry of Health of Russia, non-staff formations of the Service are created (attracted). The main ones are:

At the federal and regional levels:

· teams of specialized medical care (surgical, traumatological, neurosurgical, burn, obstetric-gynecological, transfusiological, toxicological, psychotherapeutic, infectious diseases, children's surgical, radiological, etc.);

·

· sanitary and epidemiological teams (epidemiological, radiological, sanitary and hygienic (toxicological) teams);

· specialized anti-epidemic teams.

At the territorial, local and facility levels:

· ambulance teams (medical, feldsher);

· specialized ambulance teams (intensive care, toxicological, radiological, psychiatric, pediatric, etc.);

· teams of specialized medical care;

· first aid teams (medical and nursing teams);

· first aid teams;

· sanitary posts;

· sanitary and epidemiological teams;

· sanitary and epidemiological teams;

· epidemiological intelligence teams.

The profile, number, readiness terms of non-staff formations of the Service, as well as medical and preventive and sanitary and epidemiological institutions on the basis of which they are created, are determined by the heads of the Service, based on the medical and sanitary situation in case of possible emergencies.

Ensuring the readiness of non-staff formations for work is assigned to the head of the forming institution; in the event of emergencies, they come under the operational subordination of the governing bodies of the Service of the corresponding level.

To create units of the Service, train its personnel and solve scientific problems at all levels, medical centers located on the territory are used. educational establishments and research institutes, medical and preventive and sanitary institutions.

Organization of activities of the VSMC of the Ministry of Health of the Russian Federation

Depending on the situation, the activities of the Service are carried out in the modes of daily activities, high alert and emergency.

The decision to introduce high alert and emergency regimes is made by federal executive authorities, executive authorities of the constituent entities of the Russian Federation, local governments, facility managers.

Depending on the mode of activity, the Service performs the following main activities.

During daily activities:

current planning and organization of work in daily activities;

participation in the organization and implementation of monitoring the habitat of the population and the situation at potentially hazardous facilities, in zones (regions) of possible emergencies in terms of preventing or reducing their health consequences;

creation of units of the Service, ensuring their constant readiness for work in emergency situations;

planning measures to reduce the health consequences of emergencies, participation in improving the level of protection of the population and in its training in the rules of first aid;

planning of medical and sanitary provision of the population in case of emergencies;

organizing and ensuring the continuous effective functioning of the duty dispatch service;

organization and provision of emergency and advisory medical care to the population;

organization and implementation of sanitary and hygienic and anti-epidemic measures in order to maintain the sanitary and epidemiological well-being of the population;

maintaining the readiness of the governing bodies, formations and institutions of the Service, improving the training of its personnel;

checking the readiness of the disaster medicine service of lower levels;

maintaining interaction between the management bodies, formations and institutions that are part of the disaster medicine service of this level;

creation, accumulation, refreshment, control over the storage and proper use of reserves of medical property;

development and implementation of a set of measures for the timely logistics of the Service;

creation, maintenance, control over the use of financial and material and technical resources intended to ensure the operation of the Service;

participation in the medical training of personnel of the rescue teams of the RSChS;

summarizing the experience of the Service for the Elimination of Medical and Sanitary Consequences of Emergencies.

On high alert:

notifying the personnel of the governing bodies, formations and institutions of the Service about the introduction of a high alert regime;

strengthening the duty dispatch service, transferring, if necessary, round-the-clock work (partially or completely) of the personnel of disaster medicine centers, creating operational groups, providing them with vehicles and communications;

analysis of the reasons that led to the introduction of the high alert mode, forecasting the possible development of the situation and developing proposals for organizing the work of the Service;

clarification of the plan for medical and sanitary provision of the population in case of an emergency;

organization of the implementation by the governing bodies, formations and institutions of the Service of the relevant measures of the high alert regime, the plan for medical and sanitary support of the population in emergency situations, verification of their implementation and provision of assistance;

creation and direction, if necessary, of operational groups of the disaster medicine center (health management body) to the management bodies of the RSChS and to the place of a possible emergency;

participation in carrying out measures to protect the population and prepare it for action in case of emergency;

verification of readiness for the use of financial, material and technical resources and reserves of medical property and their replenishment;

organization of an extraordinary meeting of the interdepartmental coordination commission of the disaster medicine service;

clarification of plans for interaction with government bodies, institutions and organizations of other ministries and departments involved in the elimination of an emergency;

In emergency mode:

notification of the personnel of the governing bodies, formations and institutions of the Service about the introduction of an emergency regime;

active collection of information about the situation in the emergency zone, its assessment and development of proposals for the organization of medical and sanitary support during the liquidation of the emergency;

putting into effect, at the direction of the chairman of the interdepartmental coordinating commission for disaster medicine, a plan for medical and sanitary provision of the population in emergency situations;

advancement to the emergency zone of the operational groups of the disaster medicine center (health management bodies), formations and institutions of the Service;

creation of a communication system of the Service, its coordination with the communication system of the RSChS;

participation (together with emergency rescue and other formations of the RSChS) in providing first aid to the injured and their evacuation from the zone (center) of the emergency;

organization and implementation of medical and evacuation support for the population affected by an emergency;

organization of medical and sanitary support for the personnel of formations and institutions participating in the liquidation of an emergency;

organization of medical and sanitary support for the population evacuated from the zone (district) of the emergency;

organizing and conducting a forensic medical examination of the dead and a forensic medical examination of the injured (including in cooperation with the bodies of the Ministry of Internal Affairs of Russia);

organization and implementation of sanitary and epidemiological support for the population in the emergency zone;

organization of sanitary and hygienic measures to protect the population, personnel of emergency facilities and participants in the elimination of emergency situations;

medical control over the state of health of the personnel of formations and institutions participating in the liquidation of emergency situations, providing them with special clothing, protective equipment and their correct use;

ensuring continuous and operational management of the formations and institutions of the Service involved in the elimination of the medical and sanitary consequences of an emergency, their financial, logistical support and supply of medical equipment;

maintaining and timely submission of accounting and reporting documents.

Measures of high alert and emergency regimes are organized and conducted taking into account the location, scale, nature of a possible or emerging emergency and may relate to the entire Service of a given level or to part of it (at the territorial level - to a specific city, district; at the local level - to district of the city, object of economy).

disaster medicine healthcare anti-epidemic

Conclusion

Elimination of the medical and sanitary consequences of emergency situations is a priority task of the Unified State System for the Prevention and Elimination of Emergency Situations. To solve this problem in the interests of the Service, plans for its interaction with the authorities, units, subdivisions and formations of the RSChS at all levels must provide for:

continuous assistance to the Service in increasing its readiness to work in case of emergencies;

immediate informing the management bodies of the Service about the introduction of high-alert and emergency regimes, about the situation in the emergency zone, the results of reconnaissance and decisions taken on its liquidation;

ensuring the priority deployment of forces and means of the Service to the emergency zone;

creation of favorable conditions for the work of the forces and means of the Service in the emergency zone; in this case, the main attention should be paid to: organizing a quick search for the injured, extracting them from the rubble, removing them from the fires, from the area contaminated with radioactive and potent poisonous substances; providing first aid at the site of injury; removal (export) to the point of collection of the affected or places of provision of pre-medical (first medical) aid to them; allocation of premises for the deployment of medical units and expansion of the bed network of medical institutions; rendering assistance to medical formations and institutions involved in the elimination of the medical and sanitary consequences of emergency situations, in providing them with transport, food, water, electricity, and fuel.

Bibliography

1. Decree of the Government of the Russian Federation of February 28, 1996 No. 195 "Issues of the All-Russian Service for Disaster Medicine".

Goncharov M.V. Emergency Medicine. Lecture course: [ tutorial for medical universities] - M.,: GEOTAR - Media, 2012. - P.345

Levchuk I.P., Tretyakov N.V. Emergency Medicine. Course of lectures: [textbook for medical universities] - M.,: GEOTAR - Media, 2011. - S. 224-238

4. Mastryukov B.S. Dangerous situations of technogenic nature and protection against them. Textbook for universities / B.S. Mastryukov. - M.: Academy, 2009. - 320 p.