DEPARTMENT OF CIVIL DEFENSE
I approve
Head of the Department
O. Babenko
"____" ____________ 2008
LECTURE
for students of medical, dental and preventive medicine faculties
Theme:
Discussed at a meeting of the Department of Civil Defense
"____" ____________ 2008
Protocol No.
Moscow 2008
Study questions:
Sl. 2
Organizational structure and main tasks of the civil defense medical service management bodies.
Federal Civil Defense Medical Service executive power and departmental institutions and their interaction with the medical service of civil defense health.
Formation of MSGS; tasks and organizational and staff structure, opportunities to provide medical care amazed.
Preparation and staffing of MSGD units. Training of specialists in scarce specialties.
Sl. 3
Literature:
Federal Law of February 12, 1998 No. 28-FZ "On Civil Defense" (as amended on October 9, 2002, June 19, August 22, 2004) Adopted by the State Duma on December 26, 1997
Avetisov P.V., Apollonova L.A., Gogolev M.I. and other Organization of the medical service of Civil Defense. Moscow, 2002
Altunin A. T. Formation of civil defense in the fight against natural disasters. Moscow, 1999
Vinnichuk N.N., Novitskiy S.N., Zaitsev G.I. and other Organization of medical support of the population in emergency situations. Moscow, 2003
Vinnichuk N.N., Davydova V.V. The basics of organizing medical support for the population in emergency situations. Saint Petersburg, 2003
Mikhailov V.I. Fundamentals of the organization and tactics of the medical service of civil defense. Moscow, 1981
Sakhno V.I., Zakharov G.I., Karlin N.E., Pilnik N.M. Organization of medical assistance to the population in emergency situations. Saint Petersburg, 2003
Life Safety: Textbook / Under. Ed. Prof. E. Arustamova. - M. 2000.
Know and be able to. Memo for the population. Moscow, 1999
Educational and material support:
Technical training aids:
Video equipment
Projector
Organizational structure and main tasks of the civil defense medical service management bodies.
Losses among the population in past wars reached great proportions. So, of the 50 million people who died in the Second World War 1939-1945, almost half were civilians. The need for human reserves and material resources of modern armies and the national economy of the country is even higher than it was in the last World War II. Therefore, in the conditions of modern war, accompanied by massive human losses at the front and in the rear of the country, the fulfillment of this task is of major state importance.
Consequently, in the conditions of war, there is an urgent need for measures aimed not only at saving the lives of the victims, but also at the fastest restoration of their working capacity, at reducing disability among them. As you know, Soviet military medicine during the Great Patriotic War had great achievements in this respect. During the years of the Great Patriotic War, the medical and sanitary service of the Ministry of Defense provided medical assistance to 140 thousand victims of the Nazi aviation and returned 80% of them to work (V.A. Rybasov, 1970).
Sl. 4
Health care activities in modern warfare will proceed in conditions that are sharply different from the practice of medical care for the population in peacetime. The most important of them are:
Mass character, simultaneous occurrence (in a short period of time) of the occurrence of losses among the population, varied nature and high severity of the lesion;
Disruption of health care institutions in areas of massive population loss;
The possible presence of contamination (contamination) of the area, food and water with radioactive, toxic substances and bacterial agents;
The complexity of the sanitary-epidemic situation in the centers of mass destruction and in areas where large "numbers of the population are concentrated during civil defense evacuation measures;
A sharp discrepancy between the need for manpower and health care facilities and their availability;
The complexity of managing the forces and means of health care in eliminating the consequences of an enemy attack.
It is extremely difficult to organize medical support for the population in such a very difficult situation, using the existing network of medical healthcare institutions in peacetime, and sometimes it is simply impossible. These institutions do not have the proper mobility to move into areas of mass casualties and, as a rule, do not have the appropriate equipment, functional departments are not adapted to serve large, let alone massive streams of the affected.
The experience of public health services in the period of past wars and in eliminating the consequences in areas of natural disasters and major accidents has confirmed the need to create special forces and means in the health care system, to develop appropriate forms and methods of their work that meet the specific requirements of a modern war situation, natural disasters and major accidents.
Since the 1930s, such an organization in our country has been the local air defense medical service (MS MPVO), which in 1962 was reorganized into the civil defense medical service (MS GO).
In accordance with the Government Decree Russian Federation dated November 18, 1999 No. 1266 "On Federal Civil Defense Services" in accordance with Article 14 of the Federal Law "On Civil Defense", order of the Ministry of Health of the Russian Federation dated July 3, 2000 No. 242, the federal medical civil defense service was created.
Sl. five
Civil Defense Medical Service (hereinafter MS GO) is a special organization in the health care system of the Russian Federation, organizationally consisting of a system of governing bodies, institutions and formations intended for medical support of the population affected by hostilities or as a result of these actions, as well as in the event of emergency situations of natural and technogenic character
MS GO is a nationwide service, which is created on the basis of the bodies and institutions of health care of the Russian Federation, regardless of their departmental affiliation and ownership.
Methodical guidance the creation and activities of the MS GO are carried out by the Ministry of Social Development and Health of the Russian Federation, Orders, directives and instructions, as well as regulatory documents issued by the Ministry of Social Development and Health of the Russian Federation on medical provision of the population in wartime, are mandatory for all organizations and executive authorities
Sl. 6
By the governing bodies of the medical service civil defense are the regular health management bodies and the headquarters of the civil defense medical service of the constituent entities of the Russian Federation, cities, urban areas and rural districts. The headquarters of the MS GO are created under the corresponding heads of the MS GO for the operational management of the forces and means of the service.
Medical support includes a set of medical and evacuation, sanitary and anti-epidemic (preventive) measures aimed at preserving the life and health of the affected population, as well as measures for the medical supply of units and institutions of the MS GO and medical protection of the population from damaging factors modern means of destruction.
Sl. 7
According to the significance of the tasks being solved, MS GO is rightly considered one of the leading services of GO. It is responsible for the following main goals:
- the fastest restoration of health of the affected population, its return to work, reduction of disability and mortality;
- prevention of the emergence and spread of mass infectious diseases;
- ensuring the sanitary well-being of the population, eliminating the unfavorable sanitary consequences of the enemy's use of weapons of mass destruction and protecting the health of personnel of non-military formations and civil defense institutions.
The fulfillment of the tasks facing the MS GO is of great national importance and is carried out in constant interaction with the EMERCOM of Russia and its territorial bodies, the medical service of the Ministry of Internal Affairs of Russia, and other civil defense services.
Sl. eight
MS GO is created according to the territorial production principle and has four levels:
federal - includes the forces and means of MS GO on the territory of the entire Russian Federation;
territorial - includes the forces and means of MS GO on the territory of a constituent entity of the Russian Federation (region, territory, republic within the Russian Federation);
local - includes the forces and means of MS GO on the territory of the city, urban area, rural district;
object - represented by the forces and means of MS GO organizations (objects of the economy).
At each level, the civil defense medical service includes: leadership, governing bodies, institutions, formations, (civil civil defense organizations).
At each level, the civil defense medical service includes: leadership, governing bodies, institutions, formations (civil civil defense organizations). A schematic diagram of the organization of the MS GO is shown in Fig. 2.
The leadership includes the heads of the civil defense medical service. The head of the civil defense medical service of the Russian Federation is the First Deputy Minister of Health of the Russian Federation.
The heads of the MS GOs of the constituent entities of the Russian Federation, cities, urban areas are the corresponding heads of health management bodies of regions, territories, republics within the Russian Federation, cities, urban areas. Heads of MS GOs in rural districts are chief doctors of Central regional hospitals (chief doctors of districts).
Sl. nine
Governing bodies of the civil defense medical service are the regular health management bodies and the headquarters of the civil defense medical service of the constituent entities of the Russian Federation, cities, urban areas and rural districts. The headquarters of the MS GO are created under the corresponding heads of the MS GO for the operational management of the forces and means of the service.
Sl. 10, 11
Legend:
BSMP - teams of specialized medical care
SEO - sanitary and epidemiological unit
SEB - sanitary-epidemiological brigade
SPEB - specialized anti-epidemic brigade
GER - Epidemiological Intelligence Group
MO - medical unit
CPG - Surgical Mobile Hospital
TSH1G - toxic therapeutic mobile hospital
IPG - Infectious Mobile Hospital
AL - pharmacy meeting
GB - head hospital
BCH - multidisciplinary hospital
PB - profiled hospital
Fig. 2. Organizational structure of MS GO (diagram).
The composition of the headquarters of the civil defense medical service is determined by the order of the relevant head of the health management body.
Sl. 12
The chief of staff is the deputy head of the health management body. The deputy chief of staff of the MS GO is the head of the second department (department, sector) of the health management body. Members of the MS GO headquarters are:
heads of structural units of the relevant health management body
chief state sanitary doctor of the administrative territory;
chief medical specialists;
chief physician of the blood transfusion station;
director of the territorial center for disaster medicine (at federal level Director of the All-Russian Center for Disaster Medicine "Zashchita" is the deputy chief of staff of the MS GO);
representatives of the committees of the Russian Red Cross Society;
head of the production association "Pharmacy;
head of the production association "Medtekhnika".
representatives of other state, public and private organizations involved in medical provision of the population in wartime.
The headquarters of the MS GO of the constituent entity of the Russian Federation has urban and suburban control points, as well as a backup. As a rule, the headquarters of the Ministry of Defense of one of the rural districts is a backup.
To solve urgent problems of organizing the management of the forces and means of the service in a special period, operational groups are created in advance from among the employees of the health management apparatus and the center of disaster medicine. The inclusion of heads and specialists of territorial disaster medicine centers in the headquarters of the MS GO allows, even at the planning stage, to determine the tasks and place of the governing bodies, forces and means of the disaster medicine service in the system of medical support for the population in wartime.
The organizational structure of the MS GO is in constant development, taking into account the changes in the military doctrine of the Russian Federation and the military threats to the security of our state, the economic state of Russia, the military-political situation in the country and the world, the improvement of medical science and practice, the strategy and tactics of civil defense and other factors.
The successful fulfillment of the main task of the MS GO on the fastest restoration of health of the population affected by the enemy's weapons, his return to work, reduction of disability and mortality will contribute to the restoration of the human, and, consequently, the economic and military potential of the country.
For the successful implementation of the first main task of the MS GO, measures aimed at reducing mortality and disability are important. Mortality (an indicator of the frequency of deaths among those treated), for example, among the population of Hiroshima and Nagasaki, who suffered from the atomic bombing in 1945, reached 25%, with about 70% falling on the first day. The main reason for the death of the wounded and sick in the first day after defeat in a modern war will be, as in previous wars, shock, bleeding, asphyxia and other severe consequences of the direct action of the damaging factors of weapons.
In this regard, there will be a need for a complex scientifically grounded complex of therapeutic and prophylactic measures. A special place among them will be occupied by timely and high-quality medical care and subsequent treatment of the affected. The organization and implementation of measures to prepare the population, civil defense units for the provision of medical care to those affected by various injuries, burns, OS lesions and poisoning are gaining in importance. This becomes one of the decisive conditions for the salvation and early recovery of the wounded and sick, and the restoration of their working capacity.
Sl. 13
Prevention of the emergence and spread of mass infectious diseases in the conditions of modern war, the medical service has been set as one of the main tasks not only in connection with the possible occurrence of infectious diseases among the population due to unfavorable sanitary consequences caused by the use of nuclear and chemical weapons by the enemy, but primarily in connection with the possible deliberate spread of pathogenic microorganisms by the enemy to defeat the population in large areas of the area.
Successful implementation of this task will require the following, also a very wide range of measures: antibacterial protection of the population (bacteriological reconnaissance, emergency and specific prevention of those infected with bacterial agents, indication of bacterial agents, organization of observation and quarantine); organization of treatment and prophylactic care in foci of bacteriological damage (identification of cases, their isolation and hospitalization); strengthening control over the conduct of sanitary and hygienic and anti-epidemic measures among the population; organizing and conducting disinfection measures in the bacteriological focus, as well as preparing the forces and means of the MS GO for carrying out the listed activities, etc.
Sl. fourteen
Ensuring sanitary well-being population, the elimination of the unfavorable sanitary consequences of the use of mass destruction weapons by the enemy acquire special significance in the context of the use of nuclear weapons by the enemy, when huge masses of the population are deprived of public utilities, housing, are accommodated in temporary tents and other types of towns, or are forced to live in territory contaminated with radioactive products of a nuclear explosion, and in other adverse conditions.
In solving this problem, an important place is occupied by laboratory control and monitoring of radioactive contamination and contamination of OM and BS of the external environment, food and drinking water, sanitary and hygienic control over the conditions of housing the population, over the burial and cleaning of corpses of people and animals, etc.
The fulfillment of this task is complicated by the need to carry out measures for the medical support of personnel of civil defense formations (institutions) involved in the elimination of the consequences of the use of weapons of mass destruction by the enemy (carrying out measures for medical protection, providing medical assistance to the injured and sick, carrying out sanitary and hygienic and anti-epidemic measures on the routes entering the hearth and when working in the hearth, etc.).
Thus, the implementation of the main tasks of the civil defense system will require a complex complex of medical and evacuation, anti-epidemic and sanitary and hygienic measures, measures for the medical protection of the population and personnel of civil defense formations (institutions), medical supplies, training of personnel and means of the civil defense organization to work in modern warfare. These activities constitute the content of the concept of "medical provision of the population" They are carried out taking into account the readiness of civil defense, local and other conditions of the situation.
Forces and means of the federal medical service of civil defense.
To fulfill the main tasks, the medical service of the civil defense has in its forces and means non-military medical units, institutions, management bodies and leadership.
Civil defense organizations and institutions of the Civil Defense Ministry, which are intended for medical support of the population affected by hostilities or as a result of these actions, belong to the forces of the civil defense service.
Civil organizations MS GO (hereinafter formation of MS GO ) are mobile forces of the service, created on a territorial-production basis on the basis of health care institutions, regardless of their organizational and legal form, not part of the Armed Forces of the Russian Federation, appropriately equipped and prepared for medical support of the population affected by hostilities or as a result these actions.
Non-militarized medical units of civil defense include: sanitary posts (SP); sanitary squads (SD); units of sanitary squads (OSD); first aid teams (OPM (MMO)); detachments (brigades) of specialized medical care (OSMP, BSMP); specialized anti-epidemic brigades (SPEB) (SEO, SPEB); mobile anti-epidemic squads (PPEO); epidemiological reconnaissance teams (GER) and etc.
A common characteristic feature for medical units is their purpose for working directly in the outbreaks of mass destruction (with the exception of part of the sanitary squads intended for work in medical institutions in the suburban area), and each unit performs a specific list of medical and preventive or anti-epidemic measures established for it. After completing their tasks in the outbreak, they return to the areas where the establishment-forming institution is located to work in it, being its mobile part.
Sl. fifteen
Formations of the medical service of civil defense are intended to conduct medical and biological reconnaissance, to provide medical assistance to the affected, to carry out sanitary and anti-epidemic (preventive) measures, as well as to care for the injured, and can act as part of a grouping of civil defense forces as independently (OPM, IPG, TTPG, SEO, etc.), and as part of general-purpose civil defense units or services (SD).
Depending on the subordination of the formation, MS GO are subdivided into object and territorial.
Object medical units include: sanitary posts and sanitary squads.
Territorial formations include: medical teams (hereinafter first aid teams), mobile hospitals, teams of specialized medical care, sanitary and epidemiological teams, sanitary and epidemiological teams, specialized anti-epidemic teams, epidemiological reconnaissance groups.
If necessary, by decisions of executive authorities and heads of organizations, other formations of the MS GO can be created.
Object formations of MS GO. Sanitary posts (SP) and sanitary brigades (SD) are created at economic facilities, in institutions, higher educational institutions. They do not include persons with a medical education, reserve nurses, students of medical institutes and students of medical schools.
Sl. sixteen
Sanitary post consists of 4 people - the head of the joint venture and 3 sanitary posts.
In peacetime, joint ventures are intended to provide first aid in case of industrial injuries, to carry out recreational activities among workers and employees of their economic facility.
In wartime, they participate in providing first aid to the affected and conducting sanitary and anti-epidemic measures.
The joint venture is equipped with service property as a link in the sanitary squad (instead of a sanitary bag, the joint venture has a first-aid kit from the sanitary post). For 10 hours of work in the lesions, the joint venture can provide first aid to 100 affected people (without tracing and taking out).
Sl. 17
Sanitary squad consists of 23 people, including a commander, a liaison officer (he also performs the functions of a supply manager), a driver and 5 links, each of which consists of a commander and 3 female officers. SD are intended to work as part of the formations and institutions of MS GO, and are also included in the composition of general-purpose civil defense formations (consolidated and rescue teams).
In wartime, SD are involved in searching for the affected, conducting primary triage and providing first aid, to work in medical institutions of the hospital base and formations of the MS GO, as well as to carry out sanitary and hygienic and anti-epidemic measures.
The equipment of the SD with medical and special equipment is carried out in accordance with the equipment sheet. For the transportation of personnel, the SD is assigned from the economic object freight car (bus).
One DM for 10 hours of work in the lesion focus can provide first aid to 500 affected people. In the focus of biological contamination, one SD is assigned a territory with a population of 1500 people for the entire period of work in the outbreak.
Sl. 18
Territorial formations of MS GO according to their purpose, they are divided into the following groups:
1. Formations intended for the provision of first medical aid: first aid units (OPM);
2. Formations intended for the provision of specialized medical care: toxic-therapeutic mobile hospitals (TTPG), infectious mobile hospitals (IPG), surgical mobile hospitals (KhPG), specialized medical care teams (BPS);
3. Formations intended for carrying out sanitary and anti-epidemic (preventive) measures: sanitary-epidemiological units (SEA); sanitary and epidemiological brigades (SEB): epidemiological, radiological, sanitary and hygienic (toxicological); specialized anti-epidemic brigades (SPEB); Epidemiological Intelligence Groups (EPG).
Sl. nineteen
To the formations of the MS GO, intended for the provision of first medical aid the population in the lesions include medical units (first aid units). They are created by local health authorities on the basis of medical institutions in cities and rural areas, regardless of their departmental affiliation.
Number personnel of the OPM 143 people, including:
doctors - 9 people;
nursing staff - 63 people.
The OPM includes the following departments: reception and sorting, surgical and dressing, hospital, evacuation, partial sanitization and decontamination of clothes and shoes, medical supplies (pharmacies), laboratory and household. Of the equipment, the following are attributed to the OPM: 13 trucks, 1 passenger car, 1 motorcycle, a mobile power plant, a radio station R-105 (R-109).
OPMfully staffed and equipped with personnel assets of the mobilization reserve, refers to the formations of high readiness. For 24 hours of operation, the OPM can provide first aid to 1000 affected.
A major drawback of OPM is their cumbersomeness, low material and technical readiness for action in a modern war. Therefore, at present, a promising model has been developed for a new mobile medical detachment MS GO (MMO) - a brigade structure designed to provide medical care to the affected. MMO is compact and has higher mobility than OPM.
Sl. 20
To the formations intended for the provision of specialized medical care , include toxic-therapeutic, infectious and surgical mobile hospitals, as well as teams and teams of specialized medical care.
Toxic Therapy Mobile Hospital (TTPH) MS GO is created on the basis of toxicological centers or multidisciplinary hospitals, which include therapeutic departments. It is intended for the provision of specialized medical care and treatment of the affected OS and AHOV.
The TTPG is deployed near the focus of chemical damage in a non-contaminated area by the decision of the head of the Ministry of Defense of the region and is subordinate to him. The personnel of TTPG is 171 people, including: doctors - 18, of whom 11 are toxicologists, anesthesiologists-resuscitators - 2, nurses - 47.
The TTPG has a management, a medical unit, an MTO department and deploys the following departments and divisions: reception and evacuation, two therapeutic departments, a neuropsychiatric department, as well as auxiliary departments: an X-ray room, a laboratory, a pharmacy, a dental and physiotherapy department, a morgue, an economic branch and power plant.
TPG has 19 vehicles, including: 2 cars, 11 trucks, 1 ambulance bus. The hospital is deploying 300 regular beds in tents. Readiness to receive the injured in 2 hours after arrival at the deployment site, the time of full readiness - 3 hours.
The staffing of the TPPG with medical personnel, sanitary-economic and special property is carried out at the expense of the forming institution.
Other personnel, transport, clothing, food are attributed by the decision of the administrative bodies of the corresponding territory.
Infectious mobile hospital (IPG) MS GO created by the order of the head of the healthcare management body of the constituent entity of the Russian Federation on the basis of one of the medical institutions of an infectious profile (hospital) according to the standard staff.
IPG is intended for the provision of specialized medical care and treatment of infectious patients, the provision of qualified advisory assistance to medical personnel working in the centers of especially dangerous infections.
In peacetime, IPG is used to work in foci of infectious diseases, in wartime - in foci of mass destruction (biological and combined).
The numerical composition of the IPG is 138 people, including 17 doctors, 42 paramedical workers.
The recruitment of IPG personnel is carried out at the expense of the forming institution. IPG is able to provide specialized treatment for 200 infectious patients within a month. When IPG is deployed in a focus of especially dangerous infections, its capacity is reduced to 100 beds without changing the staff structure. The IPG includes: treatment and diagnostic departments (reception and diagnostic, medical), as well as a clinical diagnostic and bacteriological laboratory. The IPG also includes a pharmacy and the following divisions: transport, household, washing and disinfection, canteen.
IPG ceases its activity after the discharge of recovered infectious patients, final disinfection, observation and complete sanitization of the medical and service personnel.
Surgical mobile hospital (CPH) MS GO is intended for the provision of surgical care and treatment of the affected population in conditions of the use of modern weapons by a likely enemy.
The hospital is created in peacetime by order of the head of public health of the constituent entity of the Russian Federation on the basis of a multidisciplinary hospital, which has surgical departments. KhPG MS GO has 300 regular beds, is deployed in tents, must be ready to receive the injured in 3 hours after arriving at the deployment site and fully ready to work in 6-8 hours.
With a massive admission of affected CPH, MS GO provides surgical assistance, mainly for health reasons.
The main departments of the hospital are: an emergency room, the first surgical department with an operating and dressing unit, an intensive care unit and an intensive care unit, a second surgery unit with an intensive care unit, and a third surgery unit with an intensive care unit. Auxiliary units are: X-ray room, laboratory, physiotherapy room, pharmacy, morgue.
Specialized Medical Aid Brigades (BSMP) are created on the basis of medical institutes, institutes for advanced training of doctors, clinical city, regional, regional and republican hospitals.
The main purpose of the emergency medical care is to provide specialized medical care to those affected in medical institutions in the suburban area. In some cases, emergency medical aid can be attached to first aid units.
In MS GO bSMP 17 profiles are created: general surgical, neurosurgical, ophthalmic, maxillofacial, traumatological, thoracoabdominal, toxicotherapy, burns, neuropsychiatric, urological, radiological, radiological, anesthesiological, obstetric-gynecological, otorhinolaryngological, infectious, blood transfusions.
Equipping the emergency medical care unit with medical equipment is carried out according to the equipment sheet at the expense of the forming institution. All the equipment of the emergency medical care unit is stored in special boxes in readiness for immediate use for medical assistance.
If necessary, units of specialized medical care (OSMP) can be formed. Organizationally, the OSMP consists of a department and eight teams of specialized medical care.
Sl. 21
To formations intended for carrying out sanitary and anti-epidemic (preventive) measures, include sanitary-epidemiological teams (SEO) and sanitary-epidemiological brigades (SEB), specialized anti-epidemic brigades (SPEB), as well as epidemiological reconnaissance groups (GER).
Sanitary-epidemiological units are high-readiness civil defense units. They are created on the basis of the centers of state sanitary and epidemiological surveillance (TsGSES), institutes of epidemiology, microbiology and hygiene, and are intended to organize and conduct sanitary and anti-epidemic (preventive) measures in the lesions.
SEA is formed due to the functional association of radiological, sanitary and hygienic (toxicological) and epidemiological teams of rapid response of the centers of state sanitary and epidemiological surveillance. TsGSEN, which do not have the capacity to create SEA, form sanitary-epidemiological brigades (SEB).
Sl. 22
Specialized anti-epidemic brigades are created on the basis of anti-plague institutes, stations. They are designed to work in foci of biological infection (especially dangerous infections) and other infectious diseases and diseases of unknown etiology that are dangerous in emergency situations. SPEB participate in organizing and carrying out a complex of emergency anti-epidemic measures to identify, localize and eliminate foci of especially dangerous and other infectious diseases, diagnose diseases of unclear etiology and indicate pathogens of infectious diseases in the environment.
Sl. 23
Epidemiological reconnaissance teams (EPGs) are created on the basis of the centers of state sanitary and epidemiological surveillance. GER are intended for conducting epidemiological examination of infectious foci, conducting epidemiological reconnaissance and sampling from objects of the external environment. The ERT consists of 3 people: the commander is a doctor-epidemiologist, an assistant epidemiologist is a paramedic (laboratory assistant) and an orderly driver. The GER is equipped with sampling pads and anti-plague suits at the expense of the property of the TsGSEN - the shaper of this group. GER within 1 hour can survey an area of \u200b\u200b2 km2 with the selection of 8 samples from environmental objects.
In the interests of the federal medical service of civil defense for evacuation affected from the lesions, as well as the removal of personnel, patients and medical property of healthcare institutions from categorized cities during evacuation measures sanitary transport units are being created :
autoanitary columns and detachments created on the basis of motor transport enterprises;
evacuation trains MS GO and evacuation rooms of GO, created on the basis of the Ministry of Railways of the Russian Federation;
airborne squadrons.
For the evacuation of the injured to the medical institutions of the suburban area, it is also planned to use the vessels of the river and sea fleets.
The institutions of the MS GO include health care institutions, having a mobilization task for the additional deployment of hospital beds or for the creation of medical units of the civil defense, as well as newly created hospital institutions according to wartime plans.
Institutions of the MS GO are also the centers of state sanitary and epidemiological supervision, included in the network of observation and laboratory control of civil defense (SNLK), stations and departments of ambulance and emergency medical care, forensic laboratories, pharmacies, medical property warehouses, blood transfusion stations and others medical institutions, intended for medical support of the population affected by hostilities or as a result of these actions.
Sl. 24, 25
In order to provide the affected with qualified and specialized medical care and their inpatient treatment in the territory of the Russian Federation, it is planned to deploy head, multidisciplinary, specialized (trauma, burn, therapeutic, neuropsychiatric, infectious diseases) hospitals, as well as children's hospitals and departments. If necessary and possible, it is allowed to deploy hospitals for lightly affected people. The total bed capacity of all medical institutions of the MS GO is determined by the development of the health care of the constituent entity of the Russian Federation in peacetime and the task received from the Ministry of Health of Russia for the additional deployment of the bed network in wartime.
It is planned to create multidisciplinary hospitals on the basis of central regional hospitals, as well as large regional and city hospitals, which have at least two surgical departments. Profiled hospitals - on the basis of specialized medical institutions or hospitals with departments of the corresponding profile. The deployment of MS GO institutions in the suburban area is planned to be carried out on the basis of year-round public buildings.
In order to ensure an organized and rational medical evacuation of the affected from the outbreaks to the hospitals of the MS GO, in the suburban area of \u200b\u200bthe constituent entities of the Russian Federation, medical and evacuation directions (LEN), which are the territory of several rural districts with a network of medical institutions of MS GO deployed on them, united by evacuation routes.
Management of the organization and provision of medical care the affected in medical institutions of each treatment and evacuation direction are carried out by head hospitals, which are appointed from among the most powerful central district hospitals (CRH) located on the main evacuation routes of the affected.
Deployment of additional hospital beds for MS GO in the suburban area provided by the plan for medical support of the population in wartime in two main options:
1) in the conditions of the systematic implementation of civil defense measures, when medical and preventive institutions of categorized cities are evacuated to the suburban area and together with the existing medical facilities there, medical institutions of the MS GO are deployed;
2) in the event of a surprise attack by the enemy, without the possibility of using hospitals in categorized cities, when additional hospital beds for healthcare are deployed only by the forces of healthcare institutions in the suburban area.
The number and profile of additionally deployed hospital beds of MS GO are determined by the scale and intensity of hostilities, the type of weapons used by the enemy, the structure of losses among the population, as well as the capabilities and specialization of the existing medical and preventive healthcare institutions. In accordance with the recommendations of the Ministry of Health of the Russian Federation, additionally deployed hospital beds should roughly have the following specialization:
Surgical profile - 70-75%, incl. neurosurgical - 10-11%, thoracoabdominal - 11-12%, traumatological - 18-19%, burns - 7-8%, general surgical - 17%, gynecological -1-1.5%, for lightly wounded - 7-8%.
Therapeutic profile - 25-30%, incl. therapeutic - 13-14%, neuropsychiatric - 5-6%, infectious - 4-6%, tuberculosis -1-1.5% and skin-venereal -1%.
At the same time, children's beds should be at least 20% of the total number of additionally deployed hospital beds of MS GO;
Medical supply institutions (medical warehouses, etc.) carry out the supply of medical and other property to the formations and institutions of the MS GO, and the population - with individual first aid equipment and medical protection equipment. To replenish medical equipment in the formations working in the outbreak of mass destruction, pharmacy rooms are created on vehicles (one pharmacy meeting by car can deliver medical equipment for 3000 injured people).
Blood service institutions intended for procurement, processing and supply of blood and blood products to hospitals. They are created on the basis of institutes and blood transfusion stations existing in peacetime. In the hospital base, a blood preparation and transfusion station is being created as part of the sorting and evacuation hospital, and blood transfusion (preparation) departments in hospitals of the MS GO. In addition, the capabilities of mobile teams to collect blood are widely used. The organization of the collection and transfusion of blood, its components and blood replacement fluids in the hospital base is supervised by the senior inspector for the blood service of the Hospital Base Directorate.
The operational management of the deployment and operation of medical institutions of the MS GO is carried out by the headquarters of the MS GO of the constituent entity of the Russian Federation and its operational groups.
Medical forces and means of various ministries and departments in the provision of medical care to the population in the lesions should be used jointly.
The means of MS GO include service medical, sanitary and economic, special property.
If necessary, in the event of outbreaks of massive sanitary losses and a significant shortage of forces and means of MS GO, all human and material resources of health care can be involved in the provision of medical care to the affected population, regardless of their forms of ownership and departmental affiliation, incl. not included in the MS GO.
In turn, in order to more efficiently use the human and material resources of health care, it is necessary to provide for the possibility of medical care in medical institutions of MS GO patients from the local population and evacuated residents. Experience shows that in the event of the destruction of large cities by the enemy, the residence of significant contingents of the evacuated population in the suburban area (mainly old people, women and children) can take on a long-term character.
In addition, it should be borne in mind that, in addition to the "organized" evacuation, in the suburban area it is possible to form large groups of forced migrants who arrive as a result of spontaneous migration and do not have shelter, food, and basic necessities.
In the first period after the completion of the evacuation, the medical support of this contingent may be in the nature of emergency medical measures provided for by the federal law of the Russian Federation "On Civil Defense" for the primary life support of the population affected by the hostilities - first aid to patients, if necessary, with their subsequent evacuation to medical institutions , provision of the simplest medicines, implementation of sanitary-hygienic and anti-epidemic measures in places of settlement.
In the future, medical care for the evacuated population (including refugees) should be built on a long-term basis in accordance with the local principle of medical care at the place of residence adopted in our country.
Civil Defense Medical Service (MSDS) – it is a special organization in the health care system, designed to provide medical support to the population in wartime, as well as to eliminate the medical and sanitary consequences of natural disasters, accidents and disasters in peacetime.
MSGS is one of the leading civil defense services. It carries out its activities in cooperation with the Ministry of Emergencies, other civil defense services, the medical service of the Armed Forces and other troops in the prescribed manner.
MSGS was created and operates on the basis of the following regulatory documents: ФЗ № 28 - 1998. " About civil defense", Resolution of the Government of the Russian Federation No. 1266 - 1999. " ABOUT federal services GO", Order of the Minister of Health No. 242 - 2000. " Regulations on the federal MSGO».
MSGS is responsible for the following main goals:
1. timely provision of all types of medical care to the affected and sick, the organization of their treatment in order to quickly restore health and working capacity, reduce disability and mortality;
2. prevention of the emergence and spread of mass infectious diseases among the population, and in case of their occurrence, the fastest localization and elimination;
3. elimination of unfavorable sanitary consequences of the enemy's use of modern means of destruction or exposure to damaging emergency factors;
4. health protection of personnel of civil defense units and institutions.
To fulfill these tasks, the MSGD in peacetime carries out following activities:
1. planning of measures for medical protection of the population.
2. preparation of service management bodies.
3. creation and equipping of service units, personnel training.
4. preparation of medical institutions for work in wartime and in emergency situations.
5. working out interaction with other civil defense services and the medical service of the RF Armed Forces.
6. participation in educating the population on techniques, rules and methods of providing medical care for injuries and injuries;
Principles of organization of MSGS:
1. territorial production principle: MSGD is organized on the basis of existing government bodies and health institutions. MSGS has 4 levels: federal, territorial, local and object.
2. principle of universalism: MSHO creates formations capable of working in any lesion focus without significant restructuring.
3. functional principle: each formation, institution is designed to perform a specific list of activities or functions in the MSGD system inherent to it.
4. to provide first aid to the affected and sick, the population itself is involved, by educating the population on the rules and methods of providing medical care.
MSGO operates in the same three modes as the entire civil defense system (see above).
For the activities of the MSGD in wartime may be influenced by the following factors:
1.the type of the disaster and the size of the lesion focus;
2. mass character and simultaneous occurrence of losses among the population;
3. the varied nature of the pathology, the appearance of a large number of those affected with combined and multiple lesions;
4. disruption of the work of medical institutions, losses among medical workers;
5. destruction of buildings and structures in settlements, which complicates the deployment and operation of medical units;
6. Possible contamination of territories, water sources and foodstuffs with radioactive substances, hazardous substances, BS;
7. complication of the sanitary and epidemiological situation in the affected areas and areas of population evacuation;
IN organizational structure MSGS distinguish:
1. MSGD management. These are the heads of the MSGS, who are the heads of the relevant health authorities (ministers, heads of departments (departments) of health of territories, regions, cities, districts). They are subordinate to the relevant heads of civil defense and to the superior MSGD. Thus, the MSGD in the region is headed by the head of the regional health department.
2. Governing bodies -these include:
A) Headquarters of MSGS. They are created under the heads of the MSGD for the daily management of the forces and means of the service. Allocate the following types headquarters:
Headquarters of the Federal MSGS;
Headquarters of MSGS of the constituent entity of the Russian Federation:
Headquarters of MSGD cities, districts.
B) Administration of hospital bases (BB). They are created for the operational management of BB hospitals deployed in a suburban area during a threat of enemy attack. The department is headed by the Deputy Minister of Health, Deputy Head of Health of the Territory, Region. It organizes the deployment and filling of BB hospitals.
3. Forces of MSGD.These include
A) Non-standard emergency rescue teams (NASF), designed to work in the lesion focus... These formations by subordinationdivided into
1. facility: sanitary posts (SP) and sanitary squads (SD), which are created at economic facilities, in institutions, secondary and higher educational institutions;
2. territorial: first aid squad (OPM), mobile hospitals (PG), specialized medical aid teams (BSMP), specialized anti-epidemiological brigades (SPEB), sanitary-epidemiological teams (SEO), etc.
B) Institutions of MSGS:
1. Therapeutic: multidisciplinary, profiled, head hospitals),
2. Antiepidemiological: state centers for sanitary and epidemiological surveillance (TsGSEN), anti-plague institutions
3. Medical supply institutions: warehouses, bases, pharmacies, blood transfusion stations, etc.)
The Medical Service of Civil Defense (MSHO) is a special organization in the health care system designed to provide medical support to the affected population in wartime, as well as in the elimination of the consequences of natural disasters, major industrial accidents and disasters in peacetime.
The main tasks of the medical service of civil defense :
· Provision of all types of medical care to the affected population in the outbreaks of mass destruction with the aim of the quickest return of the affected to work, the maximum reduction in disability and mortality;
· Carrying out sanitary and hygienic and anti-epidemic measures aimed at preventing the emergence and spread of mass infectious diseases;
· Carrying out comprehensive measures to protect the population and personnel of the MSGD from the impact of damaging factors of modern military weapons and man-made disasters.
To solve these problems in peacetime and wartime emergencies, the MSGD has an appropriate organizational structure. The composition of the MSGD includes: leadership, management bodies, forces and means.
The management includes the heads of the MSGS. They are the heads of the relevant health authorities at all levels.
The governing bodies are represented by the headquarters of the MSHO and the management of the hospital base (UBB).
The forces of MSGD include: medical non-military formations and institutions.
The basis organization the forces and means of MSGS are laid down as follows principles :
· territorial production (created mainly on the basis of existing institutions and health authorities);
· universalization training (i.e. designed to work in any focus of mass destruction);
· functional purpose (i.e., a priority functional assignment is determined for each formation and institution).
The GO medical service includes the following medical units :
· Sanitary post;
· Sanitary squad;
· First aid unit;
· Teams of specialized medical care;
· Detachment of specialized medical care;
· Toxic-therapeutic mobile hospital;
· Specialized anti-epidemic brigades;
· Group of epidemiological reconnaissance.
Sanitary post (SP) consists of four people - the head of the post and three sanitary posts. In peacetime and wartime, joint ventures are designed to provide first aid, sanitary and hygienic and anti-epidemic measures. They also take care of the injured and sick at medical points along the evacuation route. A sanitary post for 10 hours of work in the outbreaks of mass destruction can provide first aid to 100 affected people (without search and removal).
To the state sanitary squad (SD) includes: the commander of the squad, his deputy, a liaison (he is also the manager) and five units of 4 people each; each of them is headed by a flight commander appointed from among its members. In total, there are 23 people in the sanitary squad. In addition, a truck with a driver can be attached to the sanitary squad. They are equipped with SD according to uniform timesheets at the expense of the institutions on the basis of which they are created. For 5 hours of work, the SD can provide assistance to up to 250 injured in a nuclear focus or up to 200 injured in a chemical focus. Sanitary squads are intended for independent work in lesions, as well as in the formations and institutions of MSGD and general-purpose civil defense units (consolidated detachment, rescue detachment).
First aid squad (OPM) is intended to provide first aid to those affected in the outbreaks (at the border) of massive sanitary losses. The detachment is formed on the basis of one medical and preventive institution. The detachment enrolls men aged 16-60 and women (16-55 years old), with the exception of unbooked military personnel, invalids of the first and second groups, pregnant women and women with children under 8 years of age, as well as women with middle and higher medical education with children under 2 years of age.
By the decision of the district administration, sanitary squads (two), a mobile feeding point (PPP), a mobile clothing supply point (PPVS), motor vehicles with drivers, as well as buildings for deployment are assigned to the detachment. It is also provided for the placement of PKOs in tents. The state provides for: 146 personnel, including: 8 doctors, 38 nurses and paramedics, 2 sanitary squads and 52 service personnel.
To work in the outbreak, the detachment deploys: a department, a sorting and evacuation department, a department for partial sanitization and decontamination of clothes and shoes, an operating and dressing department, a hospital department with isolators for infectious patients (for two infections) and for those affected with acute mental disorders, a department medical supplies (pharmacy), laboratory department, economic department, morgue.
For 12 hours of work, the OPM can receive, conduct a medical triage, provide first aid and prepare 500 injured people for evacuation.
Specialized medical care teams (BSMP) are designed to provide specialized medical care to the affected and sick of the corresponding profile in the hospitals of the MSGO in the suburban area, which they strengthen. The team consists of 2 doctors, 2 nurses and a driver.
Detachment of specialized medical care (OSMP) consists of 8 teams of specialized medical care and management (head of the detachment, his deputy, driver-liaison).
Toxic Therapy Mobile Hospital (TTPG): intended for the provision of qualified and specialized medical care and treatment of those affected by ADE. Deployed near the focus of chemical damage.
Infectious mobile hospital (IPG) is intended to provide qualified and specialized medical care and treatment of infectious patients, to provide advice to medical personnel working in foci of dangerous infections, to conduct laboratory identification of bacterial agents.
Specialized anti-epidemic brigades (SPEB) are designed to carry out anti-epidemic measures in foci of dangerous infections and areas of large-scale disasters.
Epidemiological Intelligence Unit (GER) is designed to conduct an epidemiological survey of infectious foci, conduct epidemiological reconnaissance and sample objects from environmental objects.
The institutions of the MSHE include: medical institutions (MSHO hospitals in the suburban area), blood transfusion stations, centers of the State Sanitary and Epidemiological Service, medical supply warehouses, pharmacies, educational institutions for initial and postgraduate training of medical workers in MSHE, etc.
Medical institutions of MSHI are designed to provide the affected with qualified and specialized medical care and treatment until their final outcome. Medical institutions that exist in peacetime do not fully correspond to the conditions for changing work with the mass admission of those affected with specific pathologies. Therefore, they will need to be prepared in advance: expanding the bed capacity, deploying subdivisions characteristic of a given pathology, training personnel for work in new conditions, taking the medical facility to the suburban area.
Simultaneously with this restructuring, some of the beds in these hospitals are retained for servicing transportable patients removed from the city by the hospital and non-transportable patients left in the city (about 10% of all patients in the city). In addition, infectious, neuropsychiatric, pediatric and maternity beds remain. Some of the personnel leave to work in medical units. And, nevertheless, in all cases, it is necessary to preserve the functional and administrative integrity of the hospital and expand its bed capacity at least 2 times, using its own area and additionally assigned public buildings calculated within 3 m 2 per bed. It is possible to distribute the affected among the local population (2 affected per family).
Hospitals MSGS can be multidisciplinary (head hospitals, multidisciplinary hospitals) and single-profile (profiled hospitals): traumatological (TPB), therapeutic (TerPB), infectious (IPB), neuropsychiatric (PNB).
The set of medical and prophylactic institutions of the MSHO of the suburban area, united by a single governing body and intended to provide the full volume of medical care to the affected population, was called the hospital base (BB). Organizationally, the hospital base consists of treatment and evacuation areas (LEN).
The head hospital (GB) is the body organizing work in medical and evacuation areas. It accepts those affected on the main route of their removal from the outbreak of mass sanitary losses, sorts them out, provides emergency assistance to the most severe, and distributes the rest to the specialized hospitals of this LEN. The head hospital, before entering the hospital base, sets up a medical distribution post (MRP) on the main evacuation route. Here, the affected are examined in transport and the transport can be immediately sent to a specialized hospital, bypassing the head hospital (in the case of a single-profile of the affected). At the entrance to the main hospital, an auxiliary distribution post (VDU) is set up.
Considering that the formations and institutions of the MSGS and the QMS are practically created on the same basis, as well as the uniformity of their tasks in peacetime and wartime, it seems appropriate to organize their work in the elimination of the consequences in the centers of mass losses under a single management body - the headquarters of the medical services of civil protection.
Study questions:
- Definition, objectives, principles of organization and maintenance of civil defense.
- Organizational structure of civil defense, its forces and means.
- Main tasks, organizational structure of MSGS.
- Organization of training of personnel of the medical service of civil defense.
- Characteristics of the formations and institutions of the MS GO. Their tasks, organizational and staff structure.
Introduction
Assessing the military-political situation in the modern world, it is necessary to note positive shifts in the international arena, but at the same time, one cannot fail to take into account that sufficiently reliable guarantees of the irreversibility of these changes have not yet been created and the prospect of creating such guarantees is, unfortunately, quite ghostly character. This is confirmed by the fact that there are still huge arsenals of weapons, more modern means of destruction are being created, and there are real sources of military danger. They are manifested, in particular, in the ongoing expansion of NATO to the East.
National and religious extremism, separatist tendencies have a negative impact on the country's security. The danger of internal armed conflicts has not been eliminated, which in case of a negative outcome and protraction can be used for military intervention by other states.
This explains the need to maintain the country's readiness to ensure the protection of the population, material and cultural values \u200b\u200bof the country at a level adequate to real threats. The main place in solving this problem is given to civil defense.
Question number 1
Definition, tasks, principles of organization and maintenance of civil defense.
In the Soviet Union in 1961. local air defense is transformed into civil defense, which becomes an integral part of the system of national defense measures. The territorial-production principle was adopted as the basis for its construction, the post of the head of the Civil Defense of the USSR was introduced.
Historically, there are three stages in the development of GO.
At the first stage (1961-1972), the idea of \u200b\u200bcarrying out a mass evacuation of the population in the case of a possible massive nuclear attack by the enemy, when several thousand strikes were expected on all the largest cities and the most important objects of the national economy, was taken as the basis for protecting the population. a suburban area of \u200b\u200bcities - likely targets of an attack. Shelters were built to ensure the protection of personnel who remained to work at the factories of these cities. In addition, there was an active preparation for the conduct of large-scale rescue and urgent emergency recovery work in numerous foci of destruction. For this, civil defense troops are created, massive non-military rescue and emergency recovery formations.
At the second stage (1972 - 1992), new aspects appeared in the preparation of civil defense. The main emphasis was placed on the fastest accumulation of means of protecting the population from weapons of mass destruction. During this period, shelters with a total capacity of 1.0 million people and anti-radiation shelters for 3.0-4.0 million people were built annually in the country. Adaptation for protective structures of subways and underground mine workings was actively carried out. A stock of personal protective equipment was created for the entire population of the country.
The problem of ensuring the stable functioning of the economy, the country in wartime, acquired particular relevance in these years, the solution of which was also entrusted to the civil defense.
Since 1992 the third stage of civil defense development began.
Civil defense troops in January 1992 removed from the structure of the Russian Ministry of Defense and transferred to the established in December 1991. State Committee for Emergency Situations (GKES) of Russia. Governing bodies and civil defense troops are reassigned to solving problems of protecting the population and territories from natural and man-made emergencies.
In 1994. Emergencies Ministry of Russia is created and GO troops are transferred to the Ministry of Emergencies.
Federal Law No. 28, which came into force in February 1998. "On Civil Defense" defines civil defense .
GO is a system of measures to prepare for the protection and to protect the population, material and cultural values \u200b\u200bfrom the dangers arising from the conduct of hostilities or, as a result of these actions, as well as in the event of emergencies natural and technogenic character.
This law determined:
Civil defense tasks,
Legal aspects of their implementation,
Powers, duties and rights of public authorities, bodies local government and organizations, chiefs of civil defense at all levels, civil defense governing bodies,
The composition of the forces and means of civil defense, the principles of its organization and conduct.
The organization and conduct of civil defense, in accordance with the law, is one of the most important functions of the state, an integral part of defense construction and ensuring the security of the state.
Organization principles of civil defense
- The principle of legal conditionality.Civil Defense is carried out in strict accordance with international treaties and agreements, current legislation and other regulations RF, foreign and domestic policy of the country, the concept of national security and the military doctrine of the state.
- Territorial production principle.
Territorial principle - consists in organizing civil defense in the territories of all republics, territories, regions, cities, districts, villages according to the administrative division of the Russian Federation.
Production principle is the organization of civil defense in each ministry, department, institution, at the facility.
These two principles are interconnected and inseparable.
- The principle of universal duty... Civil Defense, in accordance with the Constitution of the country, is an obligatory function of all state authorities, local authorities, enterprises, institutions and organizations, regardless of departmental affiliation and forms of ownership, the duty and obligation of every citizen of the Russian Federation.
- State character GO - is enshrined in the relevant laws and government regulations.
- Differentiated approach to the organization of civil defense . GO is organized throughout the territory of the Russian Federation, taking into account the characteristics of regions, districts, settlements, enterprises, institutions and organizations, in economic, political, strategic, military and other respects.
There is such a concept as, "territory assigned to the group for civil defense"
Under the territory assigned to the GO groupthis refers to the territory on which a city or other settlement is located, which has an important defense and economic significance, with facilities located in it, representing a high degree of danger of emergencies in war and peacetime.
By Decree of the Government of the Russian Federation No. 1149 of 1998, the entire territory of the country is divided into 4 groups: special territories of federal significance, territories of the 1st, 2nd and 3rd groups.
The special territory includes federal cities: Moscow and St. Petersburg.
To the first group - includes territories with a population of more than 1 million people. Or with a number of 500,000 to 1 million, but having at least 3 organizations of special importance for civil defense or more than 50 organizations of the 1st (2nd) category for civil defense, as well as a territory where more than 50% of the population or area falls in the area of \u200b\u200bpossible dangerous chemical contamination, radiation pollution or catastrophic flooding.
To the second group territories for civil defense include cities with a population of 500,000 to 1 million people or with a population of 250,000 to 500,000 but having at least 2 organizations of particular importance for civil defense or more than 20 organizations of the 1st (2nd) category for civil defense, and also territories in which more than 30% of the population or more than 30% of the area falls into the zone of possible dangerous chemical contamination, contamination or catastrophic flooding
To the third group territories for civil defense include cities with a population of 250,000 to 500,000 or with a population of 50,000 to 250,000, but having 1 organization of special importance for civil defense or more than 2 organizations of the 1st (2nd) category for civil defense, as well as territories with less than 30 % of the population or less than 30% of the area falls into the zone of possible hazardous chemical contamination, radiation pollution or catastrophic flooding.
During the conduct of hostilities, dangers arise that can lead to:
To the mass death of people
Loss of health and livelihood,
Violation of the habitat,
Significant material damage.
The transfer of civil defense from peaceful to martial law is carried out, as a rule, in advance - during the threatened period.
This period characterized by: 1. the growing threat of aggression of a potential adversary 2. the emergence of armed conflicts 3. the beginning of hostilities and war in general.
Depending on the situation, civil defense can be transferred to martial law throughout the territory of the Russian Federation or in some of its localities.
The transfer of civil defense from peaceful to martial law is in the consistent build-up of measures and capabilities of the civil defense to solve wartime tasks assigned to it.
To this end:
- civil defense governing bodies and forces are alerted,
- population protection systems are being deployed,
- accelerated preparation is carried out for the maintenance of the ASiDNR in possible lesions.
Conducting civil defense in the Russian Federation as a whole or in some of its localities begins from the moment:
Declarations of a state of war
The actual start of hostilities,
With the introduction of martial law by the President of the Russian Federation.
Maintenance of GO consists of:
In the practical implementation of measures to protect the population, material and cultural values \u200b\u200bfrom the dangers arising from the conduct of hostilities or as a result of these actions;
Rescue and other urgent work;
On the priority provision of the affected population in the conduct of military operations;
Ensuring the actions of the forces and measures of civil defense;
To restore and maintain order in areas affected by hostilities or as a result of them.
In wartime, civil defense has the same main goal as the Armed Forces - to protect the rear of the country, reduce human and material losses.
It should be noted that the GO is aimed at protecting the rear of the Armed Forces, primarily mob. resources and production capacity. Therefore, if the GO does not fulfill the tasks of preserving them in the initial period of the war, then the Armed Forces will be doomed to defeat.
The main tasks (directions) of civil society activities
- 1. Protection of the population from weapons of mass destruction, other modern means of warfare, security forces, accidents and disasters.
- Creation of warning systems and warning the population about the dangers during the conduct of hostilities or as a result of these actions.
- Educating the population on how to protect themselves from the dangers arising from the conduct of hostilities.
- Accumulation and provision of shelters and PPE to the population.
- Carrying out activities for light and other types of camouflage.
- Evacuation of the population, material and cultural values \u200b\u200bto safe areas.
2. Implementation of measures aimed at increasing the stability of the operation of objects and sectors of the economy in wartime and emergency situations.
This direction includes the implementation of the following activities:
- Shift shelter construction.
- Protection of machine tools and equipment from the damaging factors of weapons of mass destruction.
- Creation of reliable systems for the supply of electricity and automatic gas shutdown systems.
- Changing the technological process taking into account wartime.
- Development and implementation of measures aimed at preserving objects necessary for the survival of the population in wartime
- Ensuring constant readiness of civil defense forces and means.
3. Carrying out NPP and DPR in the centers of destruction, areas of security, accidents, disasters.
Emergency rescue (AS) work includes:
- Detection and designation of areas affected by Radiation, Chemical, Biological or other contamination.
- Fighting fires in the course of hostilities.
- Opening of destroyed and buried shelters.
- Removal of people to safe areas.
- Providing medical assistance.
Other urgent work (DPR) include:
- Arrangement of driveways in the rubble.
- Building bridges and crossings.
- Strengthening or collapse of structures.
- Priority provision of the population affected by the conduct of hostilities with housing, medical care, food, etc.
- Urgent restoration of the functioning of the necessary utilities.
- Restoring and maintaining order in areas affected by the conduct of hostilities.
- Disinfection of the population, equipment, buildings, territories and other necessary measures.
- Urgent burial of corpses in wartime.
Question number 2 "The organizational structure of civil defense, its forces and means"
The structure of civil defense corresponds to the system of organization of economic and military management adopted in the Russian Federation.
In the organizational structure of GO, the following elements are distinguished:
1. Leadership.
These are chiefs of civil defense of all degrees. The government of the Russian Federation carries out the management of the Civil Defense of the Russian Federation. Civil defense management in the executive authorities of the constituent entities of the Russian Federation, municipalities and organizations are carried out by their leaders, who are, by virtue of their position, the heads of the civil defense of the specified management bodies and organizations. (In our YAGMA, the head of the GO Academy is the rector, who is subordinate to the head of the GO Kirovsky district and the head of the GO FOIV, i.e. the Minister of Health).
2. For the day-to-day management of civil defense, governing bodies or civil defense headquarters (created under the heads of civil defense of all levels). The general management of civil defense is carried out by the Russian Emergencies Ministry.
3. Evacuation authorities.
These include: 1. Evacuation commissions. They are created at sites, institutions and administrations. They are headed by one of the deputies. the head of the institution, object, head of administration. 2. SEP 3. PEC 4. PEP 5. Administration of points of embarkation and disembarkation and some others.
4. Service.
In world time, there are 5 Federal Civil Defense Services:
Public Order Protection Service, Fire-fighting Service, Medical Service, Protection of Animals and Plants, Protection of Cultural Property.
In wartime, up to 20 services can be organized, for example, such as: Communications, Engineering, Utilities, Transport, Logistics, Food and clothing supply, etc.
5. GO forces.
The GO forces include:
I. Rescue military formations (Civil Defense Troops). They are organizationally combined into rescue centers, rescue and training brigades, separate mechanized regiments, helicopter detachments and other types of units and subunits. Troops are commanded by the Minister of the Russian Emergencies Ministry.
II. Non-standard rescue teams (NASF) is the most massive part of the civil defense forces , are being created now on the territorial-production principle. They enroll citizens who do not have mobilization instructions, men aged 18-60 years and women 18-55 years old, except for the disabled, pregnant women and women with children under 8 years of age (women with secondary and higher medical education, having children under 3 years of age), as well as machinery, equipment and property that are not subject to supply in wartime to the Armed Forces.
Formations are created on the basis of organizations that own special equipment, property and are prepared to protect the population, material and cultural values \u200b\u200bfrom the dangers arising from the conduct of hostilities or as a result of these actions.
They are intended to carry out the bulk of emergency rescue operations, the primary life support of the population in wartime and other civil defense measures.(participation in fire fighting, detection and designation of contaminated areas, etc.).
Organizations can create rescue, medical, fire-fighting, engineering, emergency-technical, automobile formations, as well as reconnaissance, radiation and chemical observation, radiation and chemical protection, communications, mechanization of work, protection of public order, food, trade and other types of formations.
Formation based on subordination are subdivided into:
AND) Object - are created on the basis of organizations and are intended for the AU and DPR in those organizations on the basis of which they are created.
B) Territorial - are used to carry out civil defense measures in the interests of the region, city, building up the civil defense forces during the AU and DPR.
Based destinationsformations are divided into:
AND) general purpose formation, which independently lead the AU and DNR in the lesions. These include: consolidated and rescue teams, teams and groups, teams of work mechanization, etc.
B) formation of civil defense services,those. created by civil defense services and intended for performing special work in the lesion focus, strengthening general purpose formations.
These include: teams, groups, intelligence units, communications; medical detachments, medical teams, mobile hospitals, sanitary posts; emergency technical teams and groups; car and auto-sanitary columns; teams and groups of public order protection, etc.
III. Civil Society Institutions (city, regional GO courses).
IV. To solve problems in the field of civil defense in accordance with the legislation of the Russian Federation the RF Armed Forces, other troops and military formations, as well as the AU service and AU formation can be involved.
Periods of GO activity
* Period of peacetime (planning of civil defense activities is being carried out; creation, equipment and preparation of the created civil defense forces, preparatory measures that increase the stability of the operation of objects in a special period, etc.)
* The period of the threat of an enemy attack (accelerated preparation for the implementation of civil defense measures).
* The period of elimination of the consequences of an enemy attack (carrying out ASDNR).
Civil defense readiness
In the Russian Federation, the following degrees of readiness are established for GO:
- "Casual"
- "Priority civil defense activities of the first group"
- "Priority activities of the second group of civil defense"
- "General readiness of civil defense"
Bringing GO to readiness to one degree or another can be carried out either sequentially, or, depending on the situation, immediately to the highest degree of readiness, with the obligatory implementation of measures provided for by lower levels of readiness.
Organization of civil defense in a medical institution
A GO is created in health care institutions. It is a special organization in the structure of a medical facility. Created by order of its leader. On the basis of structural divisions of the object in accordance with the assignment of the higher authorities of the healthcare administration.
Designed to perform the following tasks:
- Advance preparation of health care facilities for the protection of personnel, patients, material assets from the impact of damaging factors.
- Carrying out measures to increase the stability of the work of health care facilities in emergencies.
- Carrying out ASIDND in health care institutions and participating in their conduct on the scale of certain territories.
Diagram of the organization of civil defense in a medical institution
Question number 3
"Basics of the task and organizational structure of MSGS"
MSGS is a special organization in the health care system designed to provide medical support to the population in wartime, as well as to eliminate the health consequences of natural disasters, accidents and disasters in peacetime.
MSGS is one of the leading types of civil defense services. It carries out its activities in cooperation with the Ministry of Emergencies, other civil defense services, honey. service of the Armed Forces and other troops in the prescribed manner.
This service was created and operates on the basis of the following regulatory documents: Federal Law No. 28 - 98g. "On GO", RF government decree No. 1266 -99. “On federal civil defense services”, order of the Minister of Health No. 242-2000. "Regulations on the Federal MSGS".
MSGS is responsible for the following main goals:
- Timely provision of all types of medical care to the affected and sick, the organization of their treatment with the aim of the fastest restoration of health and working capacity, reducing disability and mortality.
- Prevention of the emergence and spread of mass infectious diseases among the population, and in case of their occurrence, the fastest localization and elimination.
- Elimination of unfavorable sanitary consequences of the use of modern weapons by the enemy or during an emergency.
- Health protection of personnel of civil defense formations and institutions.
In order to fulfill the assigned tasks, MSGS in peacetime conducts a number of activities, such as:
- Planning measures for medical protection of the population.
- Conducts training of service management bodies.
- Creates, equips and trains personnel of the service units.
- Prepares medical institutions for work in wartime and in emergency situations.
- Works out interaction with other civil defense services and the military medical service of the Ministry of Defense.
- Participates in teaching the population the techniques, rules and methods of providing medical care for injuries and injuries.
Principles of organization of MSGS
- MSGS is organized on the basis of existing management bodies and health care institutions on a territorial-production basis.
- MSHO creates formations capable of working in any lesion focus without significant restructuring (the principle of universalism).
- Each formation, institution is designed to perform a specific list of activities or functions inherent in it in the MSGS system (the principle of the main functional purpose).
- The population itself is involved in providing first aid to the injured and sick, by teaching the population the rules and methods of providing medical care.
MSGO, like the entire civil defense system, can operate in three modes.
Peacetime mode (daily readiness).
Enemy attack threat mode (high alert).
The mode of eliminating the consequences of an attack by the enemy (emergency mode).
The organizational structure of MSGS is distinguished by:
I. Manual
These are the heads of the MSGS, who are the heads of the relevant health authorities (ministers, heads of departments (departments) of health of territories, regions, cities, districts, health facilities). They are subordinate to the relevant heads of civil defense and the superior head of MSGS.
Thus, the MSGD in the region (region) is headed by the head of the department (ministry) of health of the constituent entity of the Russian Federation.
II. Governing bodies -these include;
- Headquarters of MSGS.
They are created under the heads of the MSGD for the daily management of the forces and means of the service.
The following types of headquarters are distinguished:
Headquarters of the Federal MSGD
Headquarters of MSGD of a constituent entity of the Russian Federation
Headquarters of MSGD cities, districts.
Let's analyze the structure of the MSHO headquarters using the example of the region.
It is headed by the chief of staff - deputy. head of the regional health department.
The headquarters includes:
- deputy Chief of Staff - Head of the 2nd Division;
- heads of structural divisions of the regional health management body (department);
- chief specialists of the field (chief surgeon, therapist, radiologist, toxicologist, infectious disease specialist, pediatrician),
- chief sanitary doctor of the region,
- chief physician of the blood transfusion station,
- ambulance stations,
- head of the Territorial Administration "Pharmacy",
- head of the territorial production department "Medtekhnika";
- head of the TCMK;
- task force and other persons.
The headquarters of the MSGS of the urban and rural areas are organized in approximately the same way. Only in the structure of these headquarters there are no chief specialists, but there are assistants to the head of the MSGD district: for mass formations, for evacuation, for medical supplies.
The headquarters organize and conduct combat and special training of service personnel, and develop a plan for medical support of the population.
- BB management. Created for the operational management of medical institutions BB deployed in a suburban area during the threat of enemy attack. It is headed by the Deputy Minister of Health, Deputy Head of Health of the Territory, Region. It organizes the deployment and filling of BB hospitals.
III. Forces of MSGO.
A. Non-standard MSGS rescue teams... Designed to work in the very focus of the lesion. After completing the task at the hearth, they return to their shaper institutions.
These formations by subordination are divided
1.to object (sanitary posts - joint ventures and sanitary squads - SD) that are created at economic facilities, institutions, secondary and higher educational institutions,
2.territorial formations
Territorials are subdivided into:
For the provision of first aid, OPM, IMO
To provide qualified and specialized medical care: mobile hospitals, emergency medical care
For carrying out sanitary-hygienic and anti-epidemiological measures: SEB, SPEB, SEO, GER.
B. Institutions of ICGS
A) Medical (multidisciplinary, profiled, head hospitals),
B) Anti-epidemiological institutions (TsGSEN),
C) Medical supply institutions (warehouses, bases, pharmacies, blood transfusion stations, etc.)
Question number 4
"Organization of training of personnel of MSGS"
Upon arrival at a health care facility, after graduation from an educational institution, you will be obligatorily recruited, in accordance with the law, to work in the headquarters of medical institutions, as well as object and territorial formations of MSGS.
One of the main indicators of the readiness of a health management body, a health care institution to perform tasks in wartime is the level of training of medical and pharmaceutical workers to perform duties both in their positions in peacetime and for purposes of wartime.
Special training is carried out with the personnel of the MSGD, which is an integral part of the preparation of health care institutions for work in wartime conditions.
Special training is planned and carried out in a differentiated manner, taking into account the category of trainees, institution or formation, in the course of planned classes and exercises, at training camps.
The topic of classes with the personnel of the headquarters, institutions and formations of the MSGD is determined based on the purpose and level of training of the trainees.
The main form of training the headquarters of the MSGD for the performance of tasks is command-staff exercises and command-staff (staff) training.
Complex object exercises are conducted with the institutions of the MSGS, with formations - tactical-special classes and tactical-special exercises.
The frequency and duration of exercises with headquarters, institutions and formations of the MSGD are established in accordance with the organizational and methodological instructions of the Ministry of Health of Russia for the training of health authorities and health care institutions in the field of civil defense.
Classes and exercises with the personnel of the headquarters, institutions and formations of the MSGD are held at the hours established by the heads of the health authorities and health institutions.
Improvement of the heads of healthcare authorities and healthcare institutions, medical specialists on the organization of medical and sanitary provision of the population in wartime is carried out at the cycles of thematic improvement in medical higher educational institutions (FUV of our academy), at local educational bases ( GO courses), at training camps in the prescribed manner.
Question number 5
“Characteristics of the formations and institutions of MSGS. Their tasks are organizational and staff structure "
Object medical units:
Sanitary posts (SP).Created at enterprises, institutions, universities, etc.
Consists of 4 people - the head of the post and 3 female officers. In peacetime and wartime, joint ventures are designed to provide first aid, sanitary and hygienic and anti-epidemic measures. They also take care of the injured and sick in medical centers at the SES, PEP, along the route during evacuation. Equipped with: first-aid kit, stretcher, shoulder straps, PPE, Red Cross armband. A joint venture for 10 hours of work in the outbreaks of mass destruction can provide 1 aid to 100 affected (without tracing and removal)
Sanitary squads (SD).
Designed to participate in the search for the injured, the removal and removal of the injured from the lesion focus, participation in the loading of the injured on vehicles, and first aid.
The staff of the SD includes: the commander of the squad, his deputy, a liaison (he is also the manager) and 5 units of 4 people each; each of them is headed by a flight commander appointed from among its members. There are 23 people in the SD in total. In addition, a lorry with a driver can be attached to the SD.
They are equipped with SDs according to uniform timesheets (medical bags, stretchers, shoulder straps, PPE, flasks with water, armbands, uniform uniforms) at the expense of enterprises, institutions on the basis of which they are created.
For 1 hour of work, the SD can provide assistance to up to 50 injured (in a nuclear focus) or up to 40 in a chemical focus. SD are intended for independent work in lesions, as well as in the formations and institutions of MSGD and general purpose civil defense units (consolidated detachment, rescue detachment). In the OBZ, 1,500 people are assigned to the squad for observation.
Responsibility for equipping and equipping facility medical units is borne by the heads of the organizations where they are created.
First aid squad (OPM). This is a territorial unit. The detachment is intended to provide 1st medical care to those affected in the outbreaks (at the border) of massive sanitary losses, medical trials, temporary accommodation and preparation for further evacuation of the affected (b). The detachments are formed on the basis of treatment-and-prophylactic institutions (hospitals) according to the plans of the headquarters of the MSGD region, city. By the decision of the district administration, sanitary squads (two), a mobile feeding point (PPP), a mobile clothing supply point (PPVS), motor vehicles with drivers, as well as buildings for deployment are assigned to the detachment.
It is envisaged to place the PKO in tents, but the detachment does not have a tent fund.
Full readiness of the OPM to receive the affected - 2 hours after arrival at the outbreak. The OPM's ability to receive the injured, provide first medical aid and prepare for evacuation is up to 500 people in 10 hours of work.
According to the staff, the detachment provides for: 146 personnel, incl. 8 doctors, 38 nurses and paramedics, 2 sanitary squads and 52 service personnel.
To work in the outbreak, the detachment deploys as part of:
Directorates (squad leader, deputy for mass formations, communications link),
Sorting and evacuation department with SD,
Departments of ChSO and decontamination of clothes and shoes,
Operational dressing department,
Hospital ward with isolators for infectious patients (for two infections) and for those affected with acute psychosis. disorders with diabetes,
Departments of honey. supplies (pharmacy),
Laboratory department,
Household department.
Organizational and staff structure of the PKO
Mobile Medical Squad (MMO) (created to replace the OPM) : is a territorial formation of the MSGD and is designed to provide PVP to the affected population in wartime or large man-made accidents and disasters.
The tasks of the detachment are: conducting medical reconnaissance along the route of movement and in the area of \u200b\u200bdeployment; medical triage; preparation of the affected for evacuation; temporary isolation of infectious patients and persons with mental disorders; conducting medical records and reporting.
The detachment is formed in a health care facility, which is entrusted with the corresponding task, with the assistance of the local OIV and the health authority of the constituent entity of the Russian Federation.
The detachment is manned in accordance with the staff approved by the Ministry of Health of the Russian Federation, at the expense of the personnel of the forming institution (some of the personnel can be assigned at the expense of other LUs or at the expense of the resources of military commissariats).
The accumulation and storage of all types of property and equipment for IMO is carried out in the warehouses of the medical mobilization reserve in accordance with the equipment sheet. Automotive and special equipment is not laid down, but is attributed to the decision of the local executive authorities. Pharmacy and other supporting organizations and institutions are also credited with it. For replenishment with medical equipment, a pharmacy meeting is created (one for 4 squads).
The organizational unit consists of:
- Directorate (head of the detachment, deputy for the medical department, assistant for logistics) - only 7 people.
- The admission and triage department - a total of 27 people, including 2 general practitioners and a pediatrician.
- The dressing department - 44 people in total, including 6 general practitioners and 2 pediatricians. Equipped with 6 AP - 2.
- Evacuation department - only 14 people, including 1 general practitioner.
- Pharmacy - headed by a pharmacist. Only 3 people.
The full composition of the detachment is represented by 108 people, of which 14 doctors, of which three are pediatricians, paramedical workers - 22. junior medical personnel - 41 people and other personnel.
The personnel of the detachment per day of work can provide first medical aid to 400 injured and sick.
To deploy the detachment, an area of \u200b\u200b200 X 300m is required. The detachment begins to receive the injured in 15 minutes. after arriving at the place, it is completely ready in 1.5-2 hours.
In autonomous mode, it can work up to 3 days due to transportable stocks.
Toxicotherapy mobile hospital (TTPH):A nabaza of toxicological centers and multidisciplinary hospitals with therapeutic departments is being created. Designed to provide qualified and specialized medical care and treatment of those affected by AOHV; is deployed near the focus of chemical damage in the composition of: reception and evacuation department, two therapeutic, neuropsychiatric department. and other medical-diagnostic and auxiliary departments, has a tent fund.
Infectious mobile hospital (IPH): - formed on the basis of infectious diseases hospitals. Designed for hospitalization and treatment of infectious patients, providing medical advice. to personnel working in the centers of dangerous infections, laboratory identification of bacterial agents. Designed for 200 beds (for especially dangerous infections per 100 patients). Organizationally it consists of: Administration (chief, chief medical officer, deputy for educational work, help for MTO), reception and diagnostic department, 2 treatment departments, laboratory (clinical diagnostic and bacteriological), washing and disinfection department. pharmacies, auxiliary departments.
Surgical mobile hospital (CPH).
It is created on the basis of multidisciplinary hospitals with surgical departments. Designed to provide emergency surgical care and treatment of the affected. Deployed to 300 regular beds, deployed in tents. The time of readiness to start receiving the affected is 3 hours.
The main departments of the hospital are: reception and evacuation, three surgical departments, an X-ray room, a physiotherapy room. The first surgical department includes an operating and dressing unit, an intensive care unit and an intensive care unit. Intensive care wards are being deployed as part of other surgical departments. In addition, a morgue and other support departments are being deployed.
Specialized medical care brigades (BSMP) - are mobile units of MSGS, formed by health authorities, created on the basis of honey. universities, clinical research institutes, specialized medical centers, large hospitals. Check-out time is no later than 6 hours. Opening hours 12 hours. Designed to provide specialized honey. care for the affected and sick of the corresponding profile in the hospitals of the MSHO in the suburban area, which they strengthen. The team consists of 2 doctors, 2 nurses and a driver. Crew profiles of Khr. Nx. Tr. Ozh. Ps. Of. Trasfouz. Aksh.-gynek. childish. etc .. The main purpose is to strengthen medical institutions of the ZZ, the organization of emergency medical services for the affected.
Medical institutions MSHO.
Hospitals ZZ (head, multidisciplinary, profiled, etc.)
Designed to provide qualified and specialized medical care to the affected and (b) C go to the hospital base of the ZZ.
Under suburban area understand the territory between the outer border of the zone of possible destruction of the affected city and the administrative border of the region (edge). It houses a grouping of civil defense forces, the evacuated population, evacuated health care institutions and creates hospital bases.
Hospital base (BB) — a set of medical institutions existing in rural areas and additionally deployed in a suburban area in the interests of a large city (regional center), designed to provide qualified and specialized medical care, treatment of the affected until the final outcome.
The hospital base is the second and final stage of medical evacuation in the system of medical and evacuation support for the injured. The organization of the BB is entrusted to the health authorities of the region (region).
The BB includes several treatment and evacuation directions (LEN), at least 2 directions.
Organizational structure of the hospital base (BB)
As part of each LEN, the following are deployed:
1. Head hospital (GB) deployed, as a rule, on the basis of the Central District Hospital, located on the main routes of evacuation of the affected. She supervises the evacuation of the affected from the first stage to the second and the distribution of the flow of the affected in the districts, and as a multidisciplinary institution provides qualified and specialized medical care to the contingent of the injured, with a deterioration in their condition during evacuation, to women in childbirth, state-nourish the non-transportable.
The following units are deployed as part of GB:
- management;
- receiving and sorting department with sorting area;
- Surgical department with an operating and dressing unit and wards (for those affected with injuries of the head, neck, spine; thoracoabdominal profile; with combined injury; with injuries to the hip and large joints; intensive care and for children);
- therapeutic department;
-maternity ward; a department for the provision of inpatient medical care to the population with wards (therapeutic, children's, maternity, neurological, gynecological, etc.)
- anaerobic department.
2. Multidisciplinary hospitals deployed in a suburban area on the basis of the Central Regional Hospital, regional hospitals, as well as on the basis of medical institutions evacuated from cities, having in their structure at least two departments of the surgical profile ... The main purpose of these hospitals is to provide fully qualified and specialized surgical care to those affected with injuries of the head, chest, abdomen, pelvis, as well as in cases of combined and concomitant injuries.
The main branches of the BCH are:
reception and diagnostic;
an emergency department (with separate clean and purulent operating rooms) for those affected with injuries to the head, chest, abdomen and pelvis, resuscitation, anesthesia and anti-shock wards, as well as clean and purulent dressings;
the hospital department, which deploys a ward for intensive care and beds for neurosurgical, ophthalmological and otolaryngological, maxillofacial, thoracoabdominal, urological, burn and traumatic profiles;
anaerobic department;
maternity ward;
wards for the injured with combined radiation injuries;
wards for children.
It is advisable to have a therapeutic department in the BCH.
3. Profiled hospitals are intended to provide the affected with qualified and specialized medical care, in accordance with the profile of the lesion and their treatment until the final outcome.
- Trauma hospitals (Tr ) are deployed on the basis of the Central Regional Hospital, rural district and city hospitals, which in their structure they have departments of a surgical profile or a specialized trauma department. It is designed to provide qualified and specialized assistance to those affected with mechanical injuries of the musculoskeletal system and burns and their combinations. The hospital has two departments: trauma (50% of beds) and burns (50% of beds).
- Therapeutic hospitals (T) are deployed (mainly) on the basis of rural district hospitals that do not have surgical departments in their structure, as well as on the basis of urban therapeutic hospitals and departments evacuated to the suburban area. Hospitals are intended for the treatment of patients with acute radiation sickness (II, III, IV degrees), toxic substances and toxins and somatic patients, in need of urgent therapeutic assistance.
- Psychoneurological hospitals (PNB ) are deployed on the basis of existing psychiatric hospitals, neuropsychiatric dispensaries with hospitals, as well as rural district hospitals with a therapeutic profile, with the obligatory reinforcement of them by psychiatrists. These hospitals are intended for the provision of C and EMC, the treatment of shell-shocked and injured people with mental and nervous disorders. The specialists of this hospital carry out an examination (B) with disorders of neuropsychic functions.
- Infectious disease hospitals (and ) are deployed on the basis of similar rural and urban LUs (infectious wards). The creation of these hospitals is also possible on the basis of rural district hospitals of a therapeutic profile with their reinforcement by infectious disease doctors and paramedical personnel. Infectious hospitals are designed to receive and treat infectious patients, including patients with AOI (plague, cholera, natural smallpox), and the departments will be redesigned accordingly.
With a large number of easily affected, it is possible to deploy profiled hospitals for Lightly affected ... A prerequisite for the deployment of such hospitals is the presence of a surgical department in the structure of the institution.
Burns, children's and other specialized hospitals can also be deployed.
Conclusion
Thus, MSGS is an integral part of civil defense, a special organization in the health care system, designed to provide medical support to the affected population in wartime, as well as in the elimination of the consequences of security, control and emergency situations in peacetime, which is entrusted with one of the main tasks of civil defense, saving the lives of the victims during the conduct of hostilities, the return of victims to work, reduction of disability among them. In order to fulfill the tasks assigned to the MSGD, it must already in peacetime plan measures for the medical protection of the population, take measures to increase the stability of the work of its institutions in wartime.
Art. Lecturer of the Department of MPZ and MK
Study questions:
- Definition, objectives, principles of organization and maintenance of civil defense.
- Organizational structure of civil defense, its forces and means.
- Main tasks, organizational structure of MSGS.
- Organization of training of personnel of the medical service of civil defense.
- Characteristics of the formations and institutions of the MS GO. Their tasks, organizational and staff structure.
Introduction
Assessing the military-political situation in the modern world, it is necessary to note positive shifts in the international arena, but at the same time, one cannot fail to take into account that sufficiently reliable guarantees of the irreversibility of these changes have not yet been created and the prospect of creating such guarantees is, unfortunately, quite ghostly character. This is confirmed by the fact that there are still huge arsenals of weapons, more modern means of destruction are being created, and there are real sources of military danger. They are manifested, in particular, in the ongoing expansion of NATO to the East.
National and religious extremism, separatist tendencies have a negative impact on the country's security. The danger of internal armed conflicts has not been eliminated, which in case of a negative outcome and protraction can be used for military intervention by other states.
This explains the need to maintain the country's readiness to ensure the protection of the population, material and cultural values \u200b\u200bof the country at a level adequate to real threats. The main place in solving this problem is given to civil defense.
Question number 1
Definition, tasks, principles of organization and maintenance of civil defense.
In the Soviet Union in 1961. local air defense is transformed into civil defense, which becomes an integral part of the system of national defense measures. The territorial-production principle was adopted as the basis for its construction, the post of the head of the Civil Defense of the USSR was introduced.
Historically, there are three stages in the development of GO.
At the first stage (1961-1972), the idea of \u200b\u200bcarrying out a mass evacuation of the population in the case of a possible massive nuclear attack by the enemy, when several thousand strikes were expected on all the largest cities and the most important objects of the national economy, was taken as the basis for protecting the population. a suburban area of \u200b\u200bcities - likely targets of an attack. Shelters were built to ensure the protection of personnel who remained to work at the factories of these cities. In addition, there was an active preparation for the conduct of large-scale rescue and urgent emergency recovery work in numerous foci of destruction. For this, civil defense troops are created, massive non-military rescue and emergency recovery formations.
At the second stage (1972 - 1992), new aspects appeared in the preparation of civil defense. The main emphasis was placed on the fastest accumulation of means of protecting the population from weapons of mass destruction. During this period, shelters with a total capacity of 1.0 million people and anti-radiation shelters for 3.0-4.0 million people were built annually in the country. Adaptation for protective structures of subways and underground mine workings was actively carried out. A stock of personal protective equipment was created for the entire population of the country.
The problem of ensuring the stable functioning of the economy, the country in wartime, acquired particular relevance in these years, the solution of which was also entrusted to the civil defense.
Since 1992 the third stage of civil defense development began.
Civil defense troops in January 1992 removed from the structure of the Russian Ministry of Defense and transferred to the established in December 1991. State Committee for Emergency Situations (GKES) of Russia. Governing bodies and civil defense troops are reassigned to solving problems of protecting the population and territories from natural and man-made emergencies.
In 1994. Emergencies Ministry of Russia is created and GO troops are transferred to the Ministry of Emergencies.
Federal Law No. 28, which came into force in February 1998. "On Civil Defense" defines civil defense .
GO is a system of measures to prepare for the protection and to protect the population, material and cultural values \u200b\u200bfrom the dangers arising from the conduct of hostilities or, as a consequence of these actions, as well as in the event of natural and man-made emergencies.
This law determined:
Civil defense tasks,
Legal aspects of their implementation,
Powers, duties and rights of state authorities, local authorities and organizations, heads of civil defense at all levels, governing bodies of civil defense,
The composition of the forces and means of civil defense, the principles of its organization and conduct.
The organization and conduct of civil defense, in accordance with the law, is one of the most important functions of the state, an integral part of defense construction and ensuring the security of the state.
Organization principles of civil defense
- The principle of legal conditionality.Civil defense is carried out in strict accordance with international treaties and agreements, current legislation and other regulations of the Russian Federation, foreign and domestic policy of the country, the concept of national security and the military doctrine of the state.
- Territorial production principle.
Territorial principle - consists in organizing civil defense in the territories of all republics, territories, regions, cities, districts, villages according to the administrative division of the Russian Federation.
Production principle is the organization of civil defense in each ministry, department, institution, at the facility.
These two principles are interconnected and inseparable.
- The principle of universal duty... Civil Defense, in accordance with the Constitution of the country, is an obligatory function of all state authorities, local authorities, enterprises, institutions and organizations, regardless of departmental affiliation and forms of ownership, the duty and obligation of every citizen of the Russian Federation.
- State character GO - is enshrined in the relevant laws and government regulations.
- Differentiated approach to the organization of civil defense . GO is organized throughout the territory of the Russian Federation, taking into account the characteristics of regions, districts, settlements, enterprises, institutions and organizations, in economic, political, strategic, military and other respects.
There is such a concept as, "territory assigned to the group for civil defense"
Under the territory assigned to the GO groupthis refers to the territory on which a city or other settlement is located, which has an important defense and economic significance, with facilities located in it, representing a high degree of danger of emergencies in war and peacetime.
By Decree of the Government of the Russian Federation No. 1149 of 1998, the entire territory of the country is divided into 4 groups: special territories of federal significance, territories of the 1st, 2nd and 3rd groups.
The special territory includes federal cities: Moscow and St. Petersburg.
To the first group - includes territories with a population of more than 1 million people. Or with a number of 500,000 to 1 million, but having at least 3 organizations of special importance for civil defense or more than 50 organizations of the 1st (2nd) category for civil defense, as well as a territory where more than 50% of the population or area falls in the area of \u200b\u200bpossible dangerous chemical contamination, radiation pollution or catastrophic flooding.
To the second group territories for civil defense include cities with a population of 500,000 to 1 million people or with a population of 250,000 to 500,000 but having at least 2 organizations of particular importance for civil defense or more than 20 organizations of the 1st (2nd) category for civil defense, and also territories in which more than 30% of the population or more than 30% of the area falls into the zone of possible dangerous chemical contamination, contamination or catastrophic flooding
To the third group territories for civil defense include cities with a population of 250,000 to 500,000 or with a population of 50,000 to 250,000, but having 1 organization of special importance for civil defense or more than 2 organizations of the 1st (2nd) category for civil defense, as well as territories with less than 30 % of the population or less than 30% of the area falls into the zone of possible hazardous chemical contamination, radiation pollution or catastrophic flooding.
During the conduct of hostilities, dangers arise that can lead to:
To the mass death of people
Loss of health and livelihood,
Violation of the habitat,
Significant material damage.
The transfer of civil defense from peaceful to martial law is carried out, as a rule, in advance - during the threatened period.
This period characterized by: 1. the growing threat of aggression of a potential adversary 2. the emergence of armed conflicts 3. the beginning of hostilities and war in general.
Depending on the situation, civil defense can be transferred to martial law throughout the territory of the Russian Federation or in some of its localities.
The transfer of civil defense from peaceful to martial law is in the consistent build-up of measures and capabilities of the civil defense to solve wartime tasks assigned to it.
To this end:
- civil defense governing bodies and forces are alerted,
- population protection systems are being deployed,
- accelerated preparation is carried out for the maintenance of the ASiDNR in possible lesions.
Conducting civil defense in the Russian Federation as a whole or in some of its localities begins from the moment:
Declarations of a state of war
The actual start of hostilities,
With the introduction of martial law by the President of the Russian Federation.
Maintenance of GO consists of:
In the practical implementation of measures to protect the population, material and cultural values \u200b\u200bfrom the dangers arising from the conduct of hostilities or as a result of these actions;
Rescue and other urgent work;
On the priority provision of the affected population in the conduct of military operations;
Ensuring the actions of the forces and measures of civil defense;
To restore and maintain order in areas affected by hostilities or as a result of them.
In wartime, civil defense has the same main goal as the Armed Forces - to protect the rear of the country, reduce human and material losses.
It should be noted that the GO is aimed at protecting the rear of the Armed Forces, primarily mob. resources and production capacity. Therefore, if the GO does not fulfill the tasks of preserving them in the initial period of the war, then the Armed Forces will be doomed to defeat.
The main tasks (directions) of civil society activities
- 1. Protection of the population from weapons of mass destruction, other modern means of warfare, security forces, accidents and disasters.
- Creation of warning systems and warning the population about the dangers during the conduct of hostilities or as a result of these actions.
- Educating the population on how to protect themselves from the dangers arising from the conduct of hostilities.
- Accumulation and provision of shelters and PPE to the population.
- Carrying out activities for light and other types of camouflage.
- Evacuation of the population, material and cultural values \u200b\u200bto safe areas.
2. Implementation of measures aimed at increasing the stability of the operation of objects and sectors of the economy in wartime and emergency situations.
This direction includes the implementation of the following activities:
- Shift shelter construction.
- Protection of machine tools and equipment from the damaging factors of weapons of mass destruction.
- Creation of reliable systems for the supply of electricity and automatic gas shutdown systems.
- Changing the technological process taking into account wartime.
- Development and implementation of measures aimed at preserving objects necessary for the survival of the population in wartime
- Ensuring constant readiness of civil defense forces and means.
3. Carrying out NPP and DPR in the centers of destruction, areas of security, accidents, disasters.
Emergency rescue (AS) work includes:
- Detection and designation of areas affected by Radiation, Chemical, Biological or other contamination.
- Fighting fires in the course of hostilities.
- Opening of destroyed and buried shelters.
- Removal of people to safe areas.
- Providing medical assistance.
Other urgent work (DPR) include:
- Arrangement of driveways in the rubble.
- Building bridges and crossings.
- Strengthening or collapse of structures.
- Priority provision of the population affected by the conduct of hostilities with housing, medical care, food, etc.
- Urgent restoration of the functioning of the necessary utilities.
- Restoring and maintaining order in areas affected by the conduct of hostilities.
- Disinfection of the population, equipment, buildings, territories and other necessary measures.
- Urgent burial of corpses in wartime.
Question number 2 "The organizational structure of civil defense, its forces and means"
The structure of civil defense corresponds to the system of organization of economic and military management adopted in the Russian Federation.
In the organizational structure of GO, the following elements are distinguished:
1. Leadership.
These are chiefs of civil defense of all degrees. The government of the Russian Federation carries out the management of the Civil Defense of the Russian Federation. The management of civil defense in the executive authorities of the constituent entities of the Russian Federation, municipalities and organizations is carried out by their leaders, who are, by virtue of their positions, the heads of civil defense of the indicated control bodies and organizations. (In our YAGMA, the head of the GO Academy is the rector, who is subordinate to the head of the GO Kirovsky district and the head of the GO FOIV, i.e. the Minister of Health).
2. For the day-to-day management of civil defense, governing bodies or civil defense headquarters (created under the heads of civil defense of all levels). The general management of civil defense is carried out by the Russian Emergencies Ministry.
3. Evacuation authorities.
These include: 1. Evacuation commissions. They are created at sites, institutions and administrations. They are headed by one of the deputies. the head of the institution, object, head of administration. 2. SEP 3. PEC 4. PEP 5. Administration of points of embarkation and disembarkation and some others.
4. Service.
In world time, there are 5 Federal Civil Defense Services:
Public Order Protection Service, Fire-fighting Service, Medical Service, Protection of Animals and Plants, Protection of Cultural Property.
In wartime, up to 20 services can be organized, for example, such as: Communications, Engineering, Utilities, Transport, Logistics, Food and clothing supply, etc.
5. GO forces.
The GO forces include:
I. Rescue military formations (Civil Defense Troops). They are organizationally combined into rescue centers, rescue and training brigades, separate mechanized regiments, helicopter detachments and other types of units and subunits. Troops are commanded by the Minister of the Russian Emergencies Ministry.
II. Non-standard rescue teams (NASF) is the most massive part of the civil defense forces , are being created now on the territorial-production principle. They enroll citizens who do not have mobilization instructions, men aged 18-60 years and women 18-55 years old, except for the disabled, pregnant women and women with children under 8 years of age (women with secondary and higher medical education, having children under 3 years of age), as well as machinery, equipment and property that are not subject to supply in wartime to the Armed Forces.
Formations are created on the basis of organizations that own special equipment, property and are prepared to protect the population, material and cultural values \u200b\u200bfrom the dangers arising from the conduct of hostilities or as a result of these actions.
They are intended to carry out the bulk of emergency rescue operations, the primary life support of the population in wartime and other civil defense measures.(participation in fire fighting, detection and designation of contaminated areas, etc.).
Organizations can create rescue, medical, fire-fighting, engineering, emergency-technical, automobile formations, as well as the formation of reconnaissance, radiation and chemical monitoring, radiation and chemical protection, communications, mechanization of work, public order protection, food, trade and other types of formations.
Formation based on subordination are subdivided into:
AND) Object - are created on the basis of organizations and are intended for the AU and DPR in those organizations on the basis of which they are created.
B) Territorial - are used to carry out civil defense measures in the interests of the region, city, building up the civil defense forces during the AU and DPR.
Based destinationsformations are divided into:
AND) general purpose formation, which independently lead the AU and DNR in the lesions. These include: consolidated and rescue teams, teams and groups, teams of work mechanization, etc.
B) formation of civil defense services,those. created by civil defense services and intended for performing special work in the lesion focus, strengthening general purpose formations.
These include: teams, groups, intelligence units, communications; medical detachments, medical teams, mobile hospitals, sanitary posts; emergency technical teams and groups; car and auto-sanitary columns; teams and groups of public order protection, etc.
III. Civil Society Institutions (city, regional GO courses).
IV. To solve problems in the field of civil defense in accordance with the legislation of the Russian Federation the RF Armed Forces, other troops and military formations, as well as the AU service and AU formation can be involved.
Periods of GO activity
* Period of peacetime (planning of civil defense activities is being carried out; creation, equipment and preparation of the created civil defense forces, preparatory measures that increase the stability of the operation of objects in a special period, etc.)
* The period of the threat of an enemy attack (accelerated preparation for the implementation of civil defense measures).
* The period of elimination of the consequences of an enemy attack (carrying out ASDNR).
Civil defense readiness
In the Russian Federation, the following degrees of readiness are established for GO:
- "Casual"
- "Priority civil defense activities of the first group"
- "Priority activities of the second group of civil defense"
- "General readiness of civil defense"
Bringing GO to readiness to one degree or another can be carried out either sequentially, or, depending on the situation, immediately to the highest degree of readiness, with the obligatory implementation of measures provided for by lower levels of readiness.
Organization of civil defense in a medical institution
A GO is created in health care institutions. It is a special organization in the structure of a medical facility. Created by order of its leader. On the basis of structural divisions of the object in accordance with the assignment of the higher authorities of the healthcare administration.
Designed to perform the following tasks:
- Advance preparation of health care facilities for the protection of personnel, patients, material assets from the impact of damaging factors.
- Carrying out measures to increase the stability of the work of health care facilities in emergencies.
- Carrying out ASIDND in health care institutions and participating in their conduct on the scale of certain territories.
Diagram of the organization of civil defense in a medical institution
Question number 3
"Basics of the task and organizational structure of MSGS"
MSGS is a special organization in the health care system designed to provide medical support to the population in wartime, as well as to eliminate the health consequences of natural disasters, accidents and disasters in peacetime.
MSGS is one of the leading types of civil defense services. It carries out its activities in cooperation with the Ministry of Emergencies, other civil defense services, honey. service of the Armed Forces and other troops in the prescribed manner.
This service was created and operates on the basis of the following regulatory documents: Federal Law No. 28 - 98g. "On GO", RF government decree No. 1266 -99. “On federal civil defense services”, order of the Minister of Health No. 242-2000. "Regulations on the Federal MSGS".
MSGS is responsible for the following main goals:
- Timely provision of all types of medical care to the affected and sick, the organization of their treatment with the aim of the fastest restoration of health and working capacity, reducing disability and mortality.
- Prevention of the emergence and spread of mass infectious diseases among the population, and in case of their occurrence, the fastest localization and elimination.
- Elimination of unfavorable sanitary consequences of the use of modern weapons by the enemy or during an emergency.
- Health protection of personnel of civil defense formations and institutions.
In order to fulfill the assigned tasks, MSGS in peacetime conducts a number of activities, such as:
- Planning measures for medical protection of the population.
- Conducts training of service management bodies.
- Creates, equips and trains personnel of the service units.
- Prepares medical institutions for work in wartime and in emergency situations.
- Works out interaction with other civil defense services and the military medical service of the Ministry of Defense.
- Participates in teaching the population the techniques, rules and methods of providing medical care for injuries and injuries.
Principles of organization of MSGS
- MSGS is organized on the basis of existing management bodies and health care institutions on a territorial-production basis.
- MSHO creates formations capable of working in any lesion focus without significant restructuring (the principle of universalism).
- Each formation, institution is designed to perform a specific list of activities or functions inherent in it in the MSGS system (the principle of the main functional purpose).
- The population itself is involved in providing first aid to the injured and sick, by teaching the population the rules and methods of providing medical care.
MSGO, like the entire civil defense system, can operate in three modes.
Peacetime mode (daily readiness).
Enemy attack threat mode (high alert).
The mode of eliminating the consequences of an attack by the enemy (emergency mode).
The organizational structure of MSGS is distinguished by:
I. Manual
These are the heads of the MSGS, who are the heads of the relevant health authorities (ministers, heads of departments (departments) of health of territories, regions, cities, districts, health facilities). They are subordinate to the relevant heads of civil defense and the superior head of MSGS.
Thus, the MSGD in the region (region) is headed by the head of the department (ministry) of health of the constituent entity of the Russian Federation.
II. Governing bodies -these include;
- Headquarters of MSGS.
They are created under the heads of the MSGD for the daily management of the forces and means of the service.
The following types of headquarters are distinguished:
Headquarters of the Federal MSGD
Headquarters of MSGD of a constituent entity of the Russian Federation
Headquarters of MSGD cities, districts.
Let's analyze the structure of the MSHO headquarters using the example of the region.
It is headed by the chief of staff - deputy. head of the regional health department.
The headquarters includes:
- deputy Chief of Staff - Head of the 2nd Division;
- heads of structural divisions of the regional health management body (department);
- chief specialists of the field (chief surgeon, therapist, radiologist, toxicologist, infectious disease specialist, pediatrician),
- chief sanitary doctor of the region,
- chief physician of the blood transfusion station,
- ambulance stations,
- head of the Territorial Administration "Pharmacy",
- head of the territorial production department "Medtekhnika";
- head of the TCMK;
- task force and other persons.
The headquarters of the MSGS of the urban and rural areas are organized in approximately the same way. Only in the structure of these headquarters there are no chief specialists, but there are assistants to the head of the MSGD district: for mass formations, for evacuation, for medical supplies.
The headquarters organize and conduct combat and special training of service personnel, and develop a plan for medical support of the population.
- BB management. Created for the operational management of medical institutions BB deployed in a suburban area during the threat of enemy attack. It is headed by the Deputy Minister of Health, Deputy Head of Health of the Territory, Region. It organizes the deployment and filling of BB hospitals.
III. Forces of MSGO.
A. Non-standard MSGS rescue teams... Designed to work in the very focus of the lesion. After completing the task at the hearth, they return to their shaper institutions.
These formations by subordination are divided
1.to object (sanitary posts - joint ventures and sanitary squads - SD) that are created at economic facilities, institutions, secondary and higher educational institutions,
2.territorial formations
Territorials are subdivided into:
For the provision of first aid, OPM, IMO
To provide qualified and specialized medical care: mobile hospitals, emergency medical care
For carrying out sanitary-hygienic and anti-epidemiological measures: SEB, SPEB, SEO, GER.
B. Institutions of ICGS
A) Medical (multidisciplinary, profiled, head hospitals),
B) Anti-epidemiological institutions (TsGSEN),
C) Medical supply institutions (warehouses, bases, pharmacies, blood transfusion stations, etc.)
Question number 4
"Organization of training of personnel of MSGS"
Upon arrival at a health care facility, after graduation from an educational institution, you will be obligatorily recruited, in accordance with the law, to work in the headquarters of medical institutions, as well as object and territorial formations of MSGS.
One of the main indicators of the readiness of a health management body, a health care institution to perform tasks in wartime is the level of training of medical and pharmaceutical workers to perform duties both in their positions in peacetime and for purposes of wartime.
Special training is carried out with the personnel of the MSGD, which is an integral part of the preparation of health care institutions for work in wartime conditions.
Special training is planned and carried out in a differentiated manner, taking into account the category of trainees, institution or formation, in the course of planned classes and exercises, at training camps.
The topic of classes with the personnel of the headquarters, institutions and formations of the MSGD is determined based on the purpose and level of training of the trainees.
The main form of training the headquarters of the MSGD for the performance of tasks is command-staff exercises and command-staff (staff) training.
Complex object exercises are conducted with the institutions of the MSGS, with formations - tactical-special classes and tactical-special exercises.
The frequency and duration of exercises with headquarters, institutions and formations of the MSGD are established in accordance with the organizational and methodological instructions of the Ministry of Health of Russia for the training of health authorities and health care institutions in the field of civil defense.
Classes and exercises with the personnel of the headquarters, institutions and formations of the MSGD are held at the hours established by the heads of the health authorities and health institutions.
Improvement of the heads of healthcare authorities and healthcare institutions, medical specialists on the organization of medical and sanitary provision of the population in wartime is carried out at the cycles of thematic improvement in medical higher educational institutions (FUV of our academy), at local educational bases ( GO courses), at training camps in the prescribed manner.
Question number 5
“Characteristics of the formations and institutions of MSGS. Their tasks are organizational and staff structure "
Object medical units:
Sanitary posts (SP).Created at enterprises, institutions, universities, etc.
Consists of 4 people - the head of the post and 3 female officers. In peacetime and wartime, joint ventures are designed to provide first aid, sanitary and hygienic and anti-epidemic measures. They also take care of the injured and sick in medical centers at the SES, PEP, along the route during evacuation. Equipped with: first-aid kit, stretcher, shoulder straps, PPE, Red Cross armband. A joint venture for 10 hours of work in the outbreaks of mass destruction can provide 1 aid to 100 affected (without tracing and removal)
Sanitary squads (SD).
Designed to participate in the search for the injured, the removal and removal of the injured from the lesion focus, participation in the loading of the injured on vehicles, and first aid.
The staff of the SD includes: the commander of the squad, his deputy, a liaison (he is also the manager) and 5 units of 4 people each; each of them is headed by a flight commander appointed from among its members. There are 23 people in the SD in total. In addition, a lorry with a driver can be attached to the SD.
They are equipped with SDs according to uniform timesheets (medical bags, stretchers, shoulder straps, PPE, flasks with water, armbands, uniform uniforms) at the expense of enterprises, institutions on the basis of which they are created.
For 1 hour of work, the SD can provide assistance to up to 50 injured (in a nuclear focus) or up to 40 in a chemical focus. SD are intended for independent work in lesions, as well as in the formations and institutions of MSGD and general purpose civil defense units (consolidated detachment, rescue detachment). In the OBZ, 1,500 people are assigned to the squad for observation.
Responsibility for equipping and equipping facility medical units is borne by the heads of the organizations where they are created.
First aid squad (OPM). This is a territorial unit. The detachment is intended to provide 1st medical care to those affected in the outbreaks (at the border) of massive sanitary losses, medical trials, temporary accommodation and preparation for further evacuation of the affected (b). The detachments are formed on the basis of treatment-and-prophylactic institutions (hospitals) according to the plans of the headquarters of the MSGD region, city. By the decision of the district administration, sanitary squads (two), a mobile feeding point (PPP), a mobile clothing supply point (PPVS), motor vehicles with drivers, as well as buildings for deployment are assigned to the detachment.
It is envisaged to place the PKO in tents, but the detachment does not have a tent fund.
Full readiness of the OPM to receive the affected - 2 hours after arrival at the outbreak. The OPM's ability to receive the injured, provide first medical aid and prepare for evacuation is up to 500 people in 10 hours of work.
According to the staff, the detachment provides for: 146 personnel, incl. 8 doctors, 38 nurses and paramedics, 2 sanitary squads and 52 service personnel.
To work in the outbreak, the detachment deploys as part of:
Directorates (squad leader, deputy for mass formations, communications link),
Sorting and evacuation department with SD,
Departments of ChSO and decontamination of clothes and shoes,
Operational dressing department,
Hospital ward with isolators for infectious patients (for two infections) and for those affected with acute psychosis. disorders with diabetes,
Departments of honey. supplies (pharmacy),
Laboratory department,
Household department.
Organizational and staff structure of the PKO
Mobile Medical Squad (MMO) (created to replace the OPM) : is a territorial formation of MSGS and is designed to provide PVP to the affected population in wartime or major man-made accidents and disasters.
The tasks of the detachment are: conducting medical reconnaissance along the route of movement and in the area of \u200b\u200bdeployment; medical triage; preparation of the affected for evacuation; temporary isolation of infectious patients and persons with mental disorders; medical records and reporting.
The detachment is formed in a health care facility, which is entrusted with the corresponding task, with the assistance of the local OIV and the health authority of the constituent entity of the Russian Federation.
The detachment is manned in accordance with the staff approved by the Ministry of Health of the Russian Federation, at the expense of the personnel of the forming institution (some of the personnel can be assigned at the expense of other LUs or at the expense of the resources of military commissariats).
The accumulation and storage of all types of property and equipment for IMO is carried out in the warehouses of the medical mobilization reserve in accordance with the equipment sheet. Automotive and special equipment is not laid down, but is attributed to the decision of the local executive authorities. Pharmacy and other supporting organizations and institutions are also credited with it. For replenishment with medical equipment, a pharmacy meeting is created (one for 4 squads).
The organizational unit consists of:
- Directorate (head of the detachment, deputy for the medical department, assistant for logistics) - only 7 people.
- The admission and triage department - a total of 27 people, including 2 general practitioners and a pediatrician.
- The dressing department - 44 people in total, including 6 general practitioners and 2 pediatricians. Equipped with 6 AP - 2.
- Evacuation department - only 14 people, including 1 general practitioner.
- Pharmacy - headed by a pharmacist. Only 3 people.
The full composition of the detachment is represented by 108 people, of which 14 doctors, of which three are pediatricians, paramedical workers - 22. junior medical personnel - 41 people and other personnel.
The personnel of the detachment per day of work can provide first medical aid to 400 injured and sick.
To deploy the detachment, an area of \u200b\u200b200 X 300m is required. The detachment begins to receive the injured in 15 minutes. after arriving at the place, it is completely ready in 1.5-2 hours.
In autonomous mode, it can work up to 3 days due to transportable stocks.
Toxicotherapy mobile hospital (TTPH):A nabaza of toxicological centers and multidisciplinary hospitals with therapeutic departments is being created. Designed to provide qualified and specialized medical care and treatment of those affected by AOHV; is deployed near the focus of chemical damage in the composition of: reception and evacuation department, two therapeutic, neuropsychiatric department. and other medical-diagnostic and auxiliary departments, has a tent fund.
Infectious mobile hospital (IPH): - formed on the basis of infectious diseases hospitals. Designed for hospitalization and treatment of infectious patients, providing medical advice. to personnel working in the centers of dangerous infections, laboratory identification of bacterial agents. Designed for 200 beds (for especially dangerous infections per 100 patients). Organizationally it consists of: Administration (chief, chief medical officer, deputy for educational work, help for MTO), reception and diagnostic department, 2 treatment departments, laboratory (clinical diagnostic and bacteriological), washing and disinfection department. pharmacies, auxiliary departments.
Surgical mobile hospital (CPH).
It is created on the basis of multidisciplinary hospitals with surgical departments. Designed to provide emergency surgical care and treatment of the affected. Deployed to 300 regular beds, deployed in tents. The time of readiness to start receiving the affected is 3 hours.
The main departments of the hospital are: reception and evacuation, three surgical departments, an X-ray room, a physiotherapy room. The first surgical department includes an operating and dressing unit, an intensive care unit and an intensive care unit. Intensive care wards are being deployed as part of other surgical departments. In addition, a morgue and other support departments are being deployed.
Specialized medical care brigades (BSMP) - are mobile units of MSGS, formed by health authorities, created on the basis of honey. universities, clinical research institutes, specialized medical centers, large hospitals. Check-out time is no later than 6 hours. Opening hours 12 hours. Designed to provide specialized honey. care for the affected and sick of the corresponding profile in the hospitals of the MSHO in the suburban area, which they strengthen. The team consists of 2 doctors, 2 nurses and a driver. Crew profiles of Khr. Nx. Tr. Ozh. Ps. Of. Trasfouz. Aksh.-gynek. childish. etc .. The main purpose is to strengthen medical institutions of the ZZ, the organization of emergency medical services for the affected.
Medical institutions MSHO.
Hospitals ZZ (head, multidisciplinary, profiled, etc.)
Designed to provide qualified and specialized medical care to the affected and (b) C go to the hospital base of the ZZ.
Under suburban area understand the territory between the outer border of the zone of possible destruction of the affected city and the administrative border of the region (edge). It houses a grouping of civil defense forces, the evacuated population, evacuated health care institutions and creates hospital bases.
Hospital base (BB) — a set of medical institutions existing in rural areas and additionally deployed in a suburban area in the interests of a large city (regional center), designed to provide qualified and specialized medical care, treatment of the affected until the final outcome.
The hospital base is the second and final stage of medical evacuation in the system of medical and evacuation support for the injured. The organization of the BB is entrusted to the health authorities of the region (region).
The BB includes several treatment and evacuation directions (LEN), at least 2 directions.
Organizational structure of the hospital base (BB)
As part of each LEN, the following are deployed:
1. Head hospital (GB) deployed, as a rule, on the basis of the Central District Hospital, located on the main routes of evacuation of the affected. She supervises the evacuation of the affected from the first stage to the second and the distribution of the flow of the affected in the districts, and as a multidisciplinary institution provides qualified and specialized medical care to the contingent of the injured, with a deterioration in their condition during evacuation, to women in childbirth, state-nourish the non-transportable.
The following units are deployed as part of GB:
- management;
- receiving and sorting department with sorting area;
- Surgical department with an operating and dressing unit and wards (for those affected with injuries of the head, neck, spine; thoracoabdominal profile; with combined injury; with injuries to the hip and large joints; intensive care and for children);
- therapeutic department;
-maternity ward; a department for the provision of inpatient medical care to the population with wards (therapeutic, children's, maternity, neurological, gynecological, etc.)
- anaerobic department.
2. Multidisciplinary hospitals deployed in a suburban area on the basis of the Central Regional Hospital, regional hospitals, as well as on the basis of medical institutions evacuated from cities, having in their structure at least two departments of the surgical profile ... The main purpose of these hospitals is to provide fully qualified and specialized surgical care to those affected with injuries of the head, chest, abdomen, pelvis, as well as in cases of combined and concomitant injuries.
The main branches of the BCH are:
reception and diagnostic;
an emergency department (with separate clean and purulent operating rooms) for those affected with injuries to the head, chest, abdomen and pelvis, resuscitation, anesthesia and anti-shock wards, as well as clean and purulent dressings;
the hospital department, which deploys a ward for intensive care and beds for neurosurgical, ophthalmological and otolaryngological, maxillofacial, thoracoabdominal, urological, burn and traumatic profiles;
anaerobic department;
maternity ward;
wards for the injured with combined radiation injuries;
wards for children.
It is advisable to have a therapeutic department in the BCH.
3. Profiled hospitals are intended to provide the affected with qualified and specialized medical care, in accordance with the profile of the lesion and their treatment until the final outcome.
- Trauma hospitals (Tr ) are deployed on the basis of the Central Regional Hospital, rural district and city hospitals, which in their structure they have departments of a surgical profile or a specialized trauma department. It is designed to provide qualified and specialized assistance to those affected with mechanical injuries of the musculoskeletal system and burns and their combinations. The hospital has two departments: trauma (50% of beds) and burns (50% of beds).
- Therapeutic hospitals (T) are deployed (mainly) on the basis of rural district hospitals that do not have surgical departments in their structure, as well as on the basis of urban therapeutic hospitals and departments evacuated to the suburban area. Hospitals are intended for the treatment of patients with acute radiation sickness (II, III, IV degrees), toxic substances and toxins and somatic patients, in need of urgent therapeutic assistance.
- Psychoneurological hospitals (PNB ) are deployed on the basis of existing psychiatric hospitals, neuropsychiatric dispensaries with hospitals, as well as rural district hospitals with a therapeutic profile, with the obligatory reinforcement of them by psychiatrists. These hospitals are intended for the provision of C and EMC, the treatment of shell-shocked and injured people with mental and nervous disorders. The specialists of this hospital carry out an examination (B) with disorders of neuropsychic functions.
- Infectious disease hospitals (and ) are deployed on the basis of similar rural and urban LUs (infectious wards). The creation of these hospitals is also possible on the basis of rural district hospitals of a therapeutic profile with their reinforcement by infectious disease doctors and paramedical personnel. Infectious hospitals are designed to receive and treat infectious patients, including patients with AOI (plague, cholera, natural smallpox), and the departments will be redesigned accordingly.
With a large number of easily affected, it is possible to deploy profiled hospitals for Lightly affected ... A prerequisite for the deployment of such hospitals is the presence of a surgical department in the structure of the institution.
Burns, children's and other specialized hospitals can also be deployed.
Conclusion
Thus, MSGS is an integral part of civil defense, a special organization in the health care system, designed to provide medical support to the affected population in wartime, as well as in the elimination of the consequences of security, control and emergency situations in peacetime, which is entrusted with one of the main tasks of civil defense, saving the lives of the victims during the conduct of hostilities, the return of victims to work, reduction of disability among them. In order to fulfill the tasks assigned to the MSGD, it must already in peacetime plan measures for the medical protection of the population, take measures to increase the stability of the work of its institutions in wartime.
Art. Lecturer of the Department of MPZ and MK