The procedure for providing medical care to the population. Equipment standard for the beauty parlor. Treatments in cosmetology

ORDER

PROVIDING MEDICAL ASSISTANCE TO THE ADULT POPULATION

BY PROFILE "SURGERY"

1. This Procedure establishes the rules for the provision of medical care to the adult population on the "surgery" profile in medical organizations.

2. Medical assistance in the "surgery" profile (hereinafter referred to as medical assistance) is provided in the form of:

primary health care;

ambulance, including specialized ambulance, medical care;

specialized, including high-tech, medical care.

3. Medical assistance can be provided under the following conditions:

on an outpatient basis (in conditions that do not provide for round-the-clock medical supervision and treatment);

in a day hospital (in conditions providing for medical supervision and treatment in the daytime, not requiring round-the-clock medical supervision and treatment);

stationary (in conditions providing round-the-clock medical supervision and treatment).

4. Primary health care provides measures for the prevention, diagnosis, treatment of surgical diseases and conditions, medical rehabilitation, education healthy way life of the population.

5. Primary health care includes:

primary pre-medical health care;

primary medical health care;

primary specialized health care.

Primary health care is provided on an outpatient basis and in a day hospital.

Primary pre-medical health care is provided by medical workers with an average medical education.

Primary medical health care is provided by a district general practitioner, a doctor general practice(family doctor).

In the presence of medical indications for the provision of medical care that does not require its provision in inpatient conditions, a local general practitioner, general practitioner (family doctor), medical worker with a secondary medical education or a general practitioner refer a patient to a surgeon's office of a medical organization to provide primary specialized health care.

Primary specialized health care is provided by a surgeon.

If it is impossible to provide medical care within the framework of primary health care and there are medical indications, the patient is sent to a medical organization that provides specialized medical care in the "surgery" profile.

6. Ambulance, including specialized ambulance, medical care for patients requiring urgent medical intervention is provided by paramedic ambulance teams, medical mobile ambulance teams, specialized mobile ambulance teams in accordance with the order of the Ministry of Health and social development Of the Russian Federation of November 1, 2004 N 179 "On approval of the procedure for the provision of emergency medical care" (registered by the Ministry of Justice of the Russian Federation on November 23, 2004, registration N 6136), as amended by orders of the Ministry of Health and Social Development of the Russian Federation of 2 August 2010 N 586n (registered by the Ministry of Justice of the Russian Federation on August 30, 2010, registration N 18289), dated March 15, 2011 N 202n (registered by the Ministry of Justice of the Russian Federation on April 4, 2011, registration N 20390) and dated 30 January 2012 N 65n (registered by the Ministry of Justice of the Russian Federation on March 14, 2012, registration N 23472).

7. When providing emergency medical assistance, if necessary, medical evacuation is carried out, which includes sanitary-aviation and sanitary evacuation.

8. Ambulance, including specialized ambulance, medical care is provided in an emergency and urgent form, as well as in outpatient and inpatient conditions.

9. The ambulance team delivers patients with life-threatening conditions to medical organizations that provide round-the-clock medical care in the profile of "anesthesiology and resuscitation" and "surgery".

10. In the presence of medical indications, after the elimination of life-threatening conditions, patients are transferred to surgery department medical organization for the provision of specialized medical care.

11. Specialized, including high-tech, medical care is provided by surgeons in inpatient and day hospital conditions and includes prevention, diagnosis, treatment of diseases and conditions requiring the use of special methods and sophisticated medical technologies, as well as medical rehabilitation.

12. In the presence of medical indications, treatment is carried out with the involvement of specialist doctors in the specialties provided for by the Nomenclature of Specialties of Specialists with Higher and Postgraduate Medical and Pharmaceutical Education in the Healthcare Sector of the Russian Federation, approved by order of the Ministry of Health and Social Development of the Russian Federation No. 210n (registered by the Ministry of Justice of the Russian Federation on June 5, 2009, registration N 14032), as amended by order of the Ministry of Health and Social Development of the Russian Federation dated February 9, 2011 N 94n (registered by the Ministry of Justice of the Russian Federation on March 16, 2011, registration N 20144).

13. Routine medical care is provided when carrying out preventive measures, for diseases and conditions that are not accompanied by a threat to life, do not require emergency and urgent care, the delay of which is certain time will not entail a deterioration in the condition, a threat to the life and health of the patient.

14. The provision of medical care in a medical organization that provides specialized medical care is carried out according to medical indications with the patient's independent treatment or together with his legal representative, in the direction of a medical worker with secondary medical education, a district general practitioner, general practitioner (family doctor) , a general practitioner, a surgeon of a medical organization providing primary health care, as well as when a patient is delivered by an ambulance team.

15. The provision of specialized, with the exception of high-tech, medical care is carried out in federal medical organizations under the jurisdiction of the Ministry of Health of the Russian Federation, if it is necessary to establish a final diagnosis due to the atypical course of the disease, the lack of effect of the therapy and (or) repeated courses of treatment in the likely effectiveness of other treatments, high risk surgical treatment in connection with a complicated course of the underlying disease or the presence of concomitant diseases, the need for additional examination in diagnostically difficult cases and (or) complex preoperative preparation in patients with complicated forms of the disease, concomitant diseases, if necessary, re-hospitalization on the recommendation of the indicated federal medical organizations in accordance with The procedure for sending citizens of the Russian Federation to federal state institutions, under the jurisdiction of the Ministry of Health and Social Development of the Russian Federation, for the provision of specialized medical care, given in the annex to the Procedure for organizing the provision of specialized medical care, approved by order of the Ministry of Health and Social Development of the Russian Federation of April 16, 2010 N 243n (registered by the Ministry of Justice Of the Russian Federation on May 12, 2010, registration N 17175), as well as if the patient has medical indications - in federal medical organizations providing specialized medical care, in accordance with the Procedure for sending citizens by the authorities executive power subjects of the Russian Federation in the field of health care to the place of treatment in the presence of medical indications, approved by order of the Ministry of Health and Social Development of the Russian Federation dated October 5, 2005 N 617 (registered by the Ministry of Justice of the Russian Federation on October 27, 2005, registration N 7115).

Pursuant to article 37 Federal law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724) I order:

To approve the Procedure for the provision of medical care in the "cosmetology" profile according to the appendix.

Minister T.A. GOLIKOVA

Application

to the order of the Ministry

PROCEDURE FOR PROVIDING MEDICAL CARE FOR THE PROFILE "COSMETOLOGY"

1. This Procedure regulates the provision of medical care in the field of "cosmetology" to the population of the Russian Federation in organizations of state and other forms of ownership (hereinafter - organizations).

2. Medical care in the field of "cosmetology" includes a complex of medical, diagnostic and rehabilitation measures aimed at maintaining or restoring the structural integrity and functional activity of the integumentary tissues of the human body (skin and its appendages, subcutaneous adipose tissue and superficial muscles).

3. Provision of medical care in the field of "cosmetology" includes:

diagnostics and correction of congenital and acquired morphological and functional disorders of the integumentary tissues of the human body, including those arising from injuries and surgical interventions, chemotherapeutic, radiation and drug exposure and past diseases;

informing the population about hygienic recommendations for the prevention of diseases, prevention of premature aging and involutionary degradation of the skin and its appendages, subcutaneous adipose tissue and muscular apparatus.

4. Medical assistance in the profile of "cosmetology" is provided by a cosmetologist in organizations, structural divisions, carrying out their activities in accordance with Appendices No. 1 - 18 to this Procedure. Nursing staff can provide medical services and manipulations as prescribed by a cosmetologist.

5. At the first visit of the patient, the cosmetologist:

evaluates patient complaints, structural integrity and functional activity of integumentary tissues, identifies specific defects and disorders that require cosmetic correction;
informs the patient about the procedures for self-fulfillment; gives recommendations for the care of the integumentary tissues of the body, including training in the necessary hygiene skills;
fills out medical documentation in the prescribed manner;
draws up a plan for the necessary examination and treatment;
prescribes medical procedures to be performed by nurses;
performs medical procedures necessary to correct the identified violations and defects.

6. In case of repeated visits of the patient, the cosmetologist:

assesses the dynamics of the state of the integumentary tissue complex in the process of medical manipulations and cosmetic correction;
assesses the clinical effectiveness of medical interventions and the patient's compliance with medical recommendations and prescriptions and, if there are medical indications, makes adjustments to the treatment;
performs medical procedures and manipulations to correct identified violations and defects;
controls the performance of prescribed medical procedures by nurses;
in medical records makes notes about the patient's condition and the dynamics of the clinical picture.

7. In the event that a cosmetologist detects a benign neoplasm of the skin and (or) its appendages, its removal is carried out followed by a pathomorphological examination.

8. If the cosmetologist suspects or detects malignant neoplasms of the skin and (or) its appendages, the patient is sent to the primary oncological office (department), after which the specialist of the primary oncological office sends the patient to the oncological dispensary or oncological hospital to clarify the diagnosis and determine the subsequent patient management tactics in accordance with the Procedure for providing medical care to the population in case of oncological diseases, approved by order of the Ministry of Health and Social Development of Russia dated December 3, 2009 N 944n (registered by the Ministry of Justice of Russia on December 15, 2009 N 15605).

9. When a cosmetologist detects conditions requiring medical care using the methods of plastic and maxillofacial surgery, the patient is sent to medical organizations that provide medical care of the appropriate profile.

10. When a cosmetologist detects clinical manifestations of skin diseases, sexually transmitted infections, infectious diseases, HIV infection, tuberculosis, the patient is sent to medical organizations that provide medical care of the appropriate profile.

11. When providing medical care in the "cosmetology" profile, cosmetologists and paramedical personnel conduct medical records, including primary, accounting and reporting.

Appendix N 1

to the Procedure for the provision

by order of the Ministry

health and social

development of the Russian Federation

REGULATIONS ON THE ORGANIZATION OF THE COSMETOLOGY CABINET

1. This Regulation determines the organization of the cosmetology office (hereinafter - the Cabinet), which may be a structural unit of organizations.

4. The structure of the Cabinet may include:

doctor's office;
manipulation room;
treatment room.

5. In the Office of a medical appointment, the following is carried out:

patient counseling;
examination of patients (with dermatoscopy; measuring the amount of superficial fat and the activity of the sebaceous glands - sebumetry; studies of desquamation, pigmentation, transdermal fluid loss, skin elasticity; pH-metry of the skin; profilography, ultrasound examination of the epidermis, dermis, hypodermis, blood vessels of the skin and subcutaneous tissue , superficial muscles).

6. In the manipulation room, non-invasive procedures are performed (depilation; darsonvalization; cosmetological face cleansing; cryomassage; cryo-irrigation; manual medical massage of the face, neck and décolleté; hardware skin peeling; superficial peeling).

7. In the procedural room, invasive procedures are carried out (injection of tissue fillers; injection of botulism toxin preparations; injection correction of scar tissue; mesotherapy; biorevitalization; median peeling; injection drugs).

8. The office is equipped with medical equipment in accordance with the equipment standard set forth in Appendix No. 2 to the Procedure approved by this order.

9. The staffing of medical and other personnel of the Cabinet is established by the head of the medical organization, taking into account the recommended staffing standards set forth in Appendix No. 3 to the Procedure approved by this order.

Appendix N 2

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

COSMETOLOGY CABINET EQUIPMENT STANDARD

		Required quantity, pcs.
	Medical furniture	1 set



	including mobile	1 for mobile - 1 for 2 rooms
	UV
	Facial steamer

3. The standard of equipment for the treatment room

	Equipment name (equipment)	Required quantity, pcs.
	Medical furniture	1 set
	Shadowless lamp with magnifying glass
	Ultrasonic cleaning and disinfection device tools and products (bath)
	Air sterilizer, dry air *
	including mobile	1 for mobile - 1 for 2 rooms
	Irradiator - air recirculator UV
	Refrigerator for storing medicines
	IV stand

Note:

Appendix N 3

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

MEDICAL AND OTHER STAFF OF THE COSMETOLOGY CABINET

Appendix N 4

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

POSITION

ON THE ORGANIZATION OF THE CABINET OF HARDWARE METHODS

TREATMENT IN COSMETOLOGY

1. This Regulation determines the organization of the activity of the cabinet of apparatus methods of treatment in cosmetology (hereinafter - the Cabinet), which may be a structural unit of organizations.

2. A specialist is appointed to the post of a cosmetologist in the Cabinet. Qualification requirements to specialists with higher and postgraduate medical and pharmaceutical education in the field of health care, approved by the order of the Ministry of Health and Social Development of Russia dated July 7, 2009 N 415n (registered by the Ministry of Justice of Russia on July 9, 2009 N 14292), specializing in cosmetology.

3. Specialists who have received additional professional education in the specialty "Nursing in cosmetology".

4. In the Cabinet, procedures are carried out using hardware methods of treatment (darsonvalization, treatment with broadband pulsed light, laser exposure to integumentary tissues, magnetotherapy, microcurrent therapy, radio frequency exposure, phonophoresis, electromyostimulation, electrophoresis, ultraviolet irradiation of tissues).

5. The office is equipped with medical equipment in accordance with the equipment standard set forth in Appendix No. 5 to the Procedure for the provision of medical care in the "cosmetology" profile, approved by this order.

6. The staffing of medical and other personnel of the Cabinet is established by the head of the medical organization, taking into account the recommended staffing standards set forth in Appendix No. 6 to the Procedure approved by this order.

Appendix N 5

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

STANDARD

EQUIPMENT OF THE CABINET OF APPARATUS TREATMENT METHODS

IN COSMETOLOGY

	Equipment name (equipment)	Required quantity, pcs.
	Medical furniture	1 set
	Ultraviolet (quartz) sterilizer, including mobile	1 for mobile - 1 for 2 rooms
	Irradiator - air recirculator UV
	Laser therapy apparatus
	Phonophoresis apparatus
	Apparatus for electromyostimulation
	Microcurrent therapy apparatus
	RF exposure apparatus
	Device for ultraviolet irradiation of tissues
	Darsonvalization apparatus
	Broadband pulse treatment apparatus light
	Magnetic therapy apparatus

Appendix N 6

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

MEDICAL AND OTHER STAFF OF THE CABINET OF HARDWARE METHODS

TREATMENT IN COSMETOLOGY

Appendix N 7

to the Procedure for the provision

medical care by profile

"cosmetology" approved

health and social

development of the Russian Federation

POSITION

1. This Regulation determines the organization of the cabinet's activities for destruction in the human integumentary tissues (hereinafter - the Cabinet), which may be a structural subdivision of organizations.

2. A specialist is appointed to the position of a cosmetologist in the Cabinet who meets the Qualification Requirements for Specialists with Higher and Postgraduate Medical and Pharmaceutical Education in Healthcare, approved by Order of the Ministry of Health and Social Development of Russia dated July 7, 2009 N 415n (registered by the Ministry of Justice of Russia on July 9, 2009 N 14292), specializing in cosmetology.

3. Specialists who have received additional professional education in the specialty "Nursing in cosmetology" are appointed to the posts of nursing staff in the Cabinet.

4. Specialists who have received additional professional education in the specialty "Nursing in cosmetology" are appointed to the posts of nursing staff in the Cabinet.

5. The office is equipped with medical equipment in accordance with the equipment standard set forth in Appendix No. 8 to the Procedure for the provision of medical care in the "cosmetology" profile, approved by this order.

Appendix N 8

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

STANDARD

EQUIPMENT OF THE CABINET FOR CONDUCTING DESTRUCTIONS IN THE COMPOSITION

COVER TISSUE

	Equipment name (equipment)	Required quantity, pcs.
	Medical furniture	1 set
	Shadowless lamp with magnifying glass
	Surgical electrocoagulator (coagulator)
	Ultrasonic cleaning device and disinfection of instruments and products (bath)
	Air sterilizer, dry air *
	Ultraviolet (quartz) sterilizer, including mobile	1 for mobile - 1 for 2 rooms
	Irradiator - air recirculator UV
	Ceiling lighting
	Equipment for cryodestruction

Note:

The appendix contains the minimum range and the minimum amount of equipment for organizations. Equipping with equipment marked with "*" is carried out in the absence of a central sterilization department in the organization.

Appendix N 9

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

DESTRUCTION IN COVER TISSUE COMPOSITION

Appendix N 10

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

POSITION

ABOUT THE ORGANIZATION OF THE HAIR TREATMENT CABINET

1. This Regulation determines the organization of the activity of the hair treatment room (hereinafter referred to as the Cabinet), which may be a structural unit of organizations.

3. Specialists who have received additional professional education in the specialty "Nursing in cosmetology" are appointed to the posts of nursing staff in the Cabinet.

4. The structure of the Cabinet may include: a doctor's office, a manipulation room for hair treatment.

5. In the office of a doctor's appointment, the following is carried out:

patient counseling;
study of the condition of the integumentary tissues of the scalp;
carrying out diagnostic procedures (measuring the amount of superficial fat and the activity of the sebaceous glands - sebumetry, trichoscopy, ultrasound examination of integumentary tissues (epidermis, dermis, hypodermis, vessels of the skin and subcutaneous tissue, superficial muscles).

6. In the manipulation room of hair treatment, hair treatment procedures are carried out (vacuum massage, cryomassage, manual massage of the scalp, darsonvalization, rubbing medicines in the scalp, medical masks).

7. The office is equipped with medical equipment in accordance with the equipment standard set forth in Appendix No. 11 to the Procedure for the provision of medical care in the "cosmetology" profile, approved by this order.

8. The staffing of medical and other personnel of the Cabinet is established by the head of the medical organization, taking into account the recommended staffing standards set forth in Appendix No. 12 to the Procedure approved by this order.

Appendix N 11

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

HAIR TREATMENT ROOM EQUIPMENT STANDARD

1. The standard of equipping the office of a doctor's appointment

2. Equipment standard for the manipulation room

hair treatments

Note:

Appendix N 12

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

MEDICAL AND OTHER STAFF OF THE HAIR TREATMENT CABINET

Appendix N 13

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

POSITION

ABOUT THE ORGANIZATION OF THE TREATMENT CABINET

DISEASES OF NAILS

1. This Regulation determines the organization of the activities of the office for the treatment of nail diseases of a non-infectious nature (hereinafter - the Cabinet), which may be part of the structural divisions of organizations.

2. Specialists who have received additional professional education in the specialty "Nursing in cosmetology" are appointed to the posts of nursing staff in the Cabinet.

3. In the Office, procedures for processing nail plates are carried out (hardware processing of nail plates for pathological changes of non-infectious etiology).

4. The office is equipped with medical equipment in accordance with the equipment standard set forth in Appendix No. 14 to the Procedure for the provision of medical care in the "cosmetology" profile, approved by this order.

5. The staffing of medical and other personnel of the Cabinet is established by the head of the medical organization, taking into account the recommended staffing standards set forth in Appendix No. 15 to the Procedure approved by this order.

Appendix N 14

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

EQUIPMENT STANDARD FOR NAIL DISEASES TREATMENT ROOM

	Equipment name (equipment)	Required quantity, pcs.
	Workplace for the control room treatment of nail plates	1 set
	Shadowless lamp with magnifier
	Device for processing nail plates (scaler with a set of cutters)
	Ultrasonic cleaning and disinfection device tools and products (bath)
	Air sterilizer, dry air *
	Ultraviolet (quartz) sterilizer, including mobile	1 for mobile - 1 for 2 rooms
	Irradiator - air recirculator UV
	Medical furniture	1 set

Note:

Appendix N 15

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

MEDICAL AND OTHER STAFF OF THE TREATMENT CABINET

DISEASES OF NAILS

Appendix N 16

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

POSITION

ABOUT THE ORGANIZATION OF THE CABINET'S ACTIVITIES FOR CARRYING OUT

1. This Regulation determines the organization of the office for medical massage of the face and body (hereinafter - the Office), which may be a structural unit of organizations.

2. Specialists who have received additional professional education in the specialty "Nursing in cosmetology" or "Medical massage" are appointed to the posts of nursing staff in the Cabinet.

3. Massage procedures (medical massage of the face, neck and décolleté; manual medical massage of the body; vacuum massage; mechanotherapy (automated massage); medical lymphatic drainage massage) are carried out in the Cabinet on the appointment of a cosmetologist.

4. The office is equipped with medical equipment in accordance with the equipment standard set forth in Appendix No. 17 to the Procedure for the provision of medical care in the "cosmetology" profile, approved by this order.

Appendix N 17

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

STANDARD

CABINET EQUIPMENT FOR CARRYING OUT MEDICAL MASSAGE

FACES AND BODIES

Appendix N 18

to the Procedure for the provision

medical care by profile

"cosmetology" approved

by order of the Ministry

health and social

development of the Russian Federation

MEDICAL AND OTHER STAFF OF THE CABINET FOR CARRYING OUT

MEDICAL FACE AND BODY MASSAGE

About approval

The procedure for the provision of medical care in the profile of "radiology"

In accordance with article 37 of the Federal Law of November 21, 2011 No. 323-FZ "On the protection of the health of citizens in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, No. 48, Art. 6724; 2012, No. 26, Art. 3442, Art. 3446) of the order:

To approve the attached Procedure for the provision of medical care in the profile of "radiology".

Minister V.I. Skvortsova
Structure

The procedure for the provision of medical care in the profile "Radiology" 3

Appendix 1. Rules for organizing the activities of the X-ray diagnostics department 10

Appendix 2. Rules for organizing the activities of the Department of Radiation Diagnostics 14

Appendix 3. Rules for organizing the activities of the X-ray diagnostics room 17

Appendix 4. Rules for organizing the activities of the X-ray fluorographic office 21

Appendix 5. Rules for organizing the activities of the X-ray mammography room 24

Appendix 6.Computed tomography room 28

Appendix 7. Rules for organizing activities magnetic resonance imaging room 31

Appendix 8. Rules for organizing activities office of X-ray surgical methods of diagnosis and treatment 33

Appendix 9. Rules for organizing activities to osteodensitometry abinet 37

Appendix 11. Rules for organizing the activities of the center (department) of radiation diagnostics 46

Appendix 13. Rules for organizing activities tomography departments of a medical organization 62

Appendix 14. Organization rules regional X-ray and radiological department at the center (department) of radiation diagnostics of a medical organization of a constituent entity of the Russian Federation 65

Appendix 15. Rules for organizing the activities of the archive of the X-ray diagnostics department, the center (department) of radiation diagnostics 68

Appendix 16. Rules for organizing activities topometry cabinet 72

Appendix 17. Approximate time standards for X-ray examinations

The procedure for the provision of medical care

in the profile "radiology"
1. This Procedure regulates the provision of medical care in the profile of "radiology" in medical and other organizations of the state, municipal and private health systems, including individual entrepreneurs who have a license for medical activity, obtained in the manner prescribed by the legislation of the Russian Federation.

2. Medical care in the profile of "radiology" includes a set of medical measures, the purpose of which is:

organization and conduct of X-ray studies for the diagnosis of diseases and injuries, including X-ray diagnostic, computed tomography, magnetic resonance studies;
ensuring the implementation of preventive X-ray examinations in order to timely identify socially significant diseases;
organization and implementation of minimally invasive X-ray surgical diagnostic and medical procedures performed under X-ray and other types of radiation control;
implementation of measures to control radiation safety and limit the exposure of patients and personnel during X-ray examinations.

3. Medical assistance on the profile of "pathological anatomy" is provided:

3.1. on an outpatient basis (in conditions that do not provide for round-the-clock medical supervision and treatment), except for cases of calling a medical worker at home;

3.2. in a day hospital (in conditions providing for medical supervision and treatment during the day, but not requiring round-the-clock medical supervision and treatment);

3.3. in a hospital (in conditions providing round-the-clock medical supervision and treatment).

4. X-ray diagnostic studies and treatment procedures can be carried out in a hospital, day hospital, on an outpatient basis, as well as outside a medical organization with portable and mobile X-ray machines.

5. Medical organizations provide medical care in the profile of "radiology" in accordance with Appendices N1-17 to this Procedure.

6. Medical care in the profile of "pathological anatomy" is provided in the provision of primary health care, specialized, including high-tech, medical care, ambulance, including specialized emergency, medical care and palliative care.

7. To carry out X-ray examinations and medical and diagnostic procedures under X-ray (radiation) control, medical organizations create specially equipped X-ray diagnostic rooms and rooms for X-ray surgical methods of diagnosis and treatment, which can be included in the X-ray diagnostic departments, departments (centers, departments) of radiation diagnostics.

8. In medical organizations that provide ambulance, including emergency specialized medical care, X-ray rooms, X-ray departments or departments (centers, departments) of radiation diagnostics are created to provide medical care in the field of radiology.

9.In medical organizations providing primary health care, it is planned to create X-ray diagnostic rooms, including an X-ray diagnostic room and, if there is a justified need for preventive examinations, an X-ray fluorographic room.

10. In medical organizations providing specialized medical care, an X-ray diagnostics department is created, which includes rooms for general X-ray diagnostics, computed tomography, magnetic resonance imaging, X-ray surgical methods of diagnosis and treatment (Appendix No. 2 to this Procedure). When combining X-ray diagnostic rooms with rooms ultrasound diagnostics, endoscopic diagnostics and other rooms of radiation and instrumental diagnostics into a single structural subdivision, the department of X-ray diagnostics is transformed into a department of radiation diagnostics. (Appendix No. 3 to this Procedure).

11.In the presence of two or more departments in a medical organization providing specialized, including high-tech medical care, which use methods of radiation and instrumental diagnostics (X-ray diagnostics, ultrasound diagnostics, radionuclide diagnostics, X-ray surgical methods of diagnostics and treatment), a center (department ) radiation diagnostics (Appendix No. 11 to this Procedure).

12.As part of the center (department) of radiation diagnostics of one of the medical organizations of the constituent entity of the Russian Federation, a regional X-ray and radiological department is created with the functions of an organizational and methodological department in the profile of radiology, in accordance with Appendix No. 15 of this Procedure, taking into account the recommended staff standards (Appendix No. 10 to this Procedure) and standards for equipping departments (centers) of radiation diagnostics (Appendix No. 12 to this Procedure).

13. X-ray examinations are performed for prophylactic or diagnostic purposes. Preventive (verification) X-ray examinations are an integral part of preventive, preliminary and periodic medical examinations population in order to timely identify socially significant diseases of an infectious and non-infectious nature. Preventive examinations are carried out in accordance with this Procedure and in accordance with current regulations about the prophylactic medical examination of the population and certain types medical examinations of the population.

14. X-ray examinations in medical organizations are carried out in accordance with the approved procedures for the provision of medical care and standards for the treatment of certain nosological forms of diseases and injuries, in specially equipped X-ray diagnostic rooms equipped with devices for performing the corresponding types of X-ray examinations and medical and diagnostic procedures. If there is a justified need, devices for other types of diagnostic instrumental examinations, in particular ultrasound, endoscopic, functional diagnostics and others, are installed in the X-ray diagnostic rooms. When conducting these studies independently, the radiologist must have special training in the relevant specialty, confirmed by state documents of the established form.

15. X-ray examinations and diagnostic and treatment procedures under radiation control, during which ionizing radiation is used, are performed in accordance with the requirements of the legislation of the Russian Federation, current radiation safety standards, basic sanitary rules for ensuring radiation safety and this Regulation.

16. X-ray examinations and medical and diagnostic procedures are carried out in a planned, emergency and urgent manner. The working hours of the X-ray diagnostics rooms and the duty service of the X-ray diagnostics department (the X-ray diagnostics department) are determined by the head medical institution in agreement with the head of the department (department) of radiation diagnostics in accordance with the current regulatory documents and this Regulation.

17. X-ray examinations are carried out in the direction of a doctor, which can be issued on a separate form, in an outpatient's card, in the medical history of an inpatient or in the history of a child's development. In the direction of the study, the patient's passport data, clinical or preliminary diagnosis, the proposed method of radiation examination, the anatomical region or organ (organs) to be examined and the specific purpose of the prescribed study are indicated. A referral to an X-ray examination of an inpatient can be stated in the medical history in the form of a justification (epicrisis). X-ray examinations without a doctor's referral with justification for its need are not allowed.

18.When choosing a method of X-ray examination, the advisability of reducing the patient's radiation dose should be taken into account, provided that the volume of diagnostic information is preserved. The final decision on the possibility of conducting a radiation study using ionizing radiation is made by the radiologist conducting this study, taking into account the justification of the direction, the presence or absence of contraindications, the technical feasibility of conducting the study in this medical institution, the degree of risk of the planned study, as well as other factors that may affect the patient and staff.

19. If it is impossible or inexpedient to carry out the prescribed study, the radiologist is obliged to substantiate in writing the refusal to conduct the study. An entry is made in the medical record of an inpatient, outpatient or in the history of the child's development, indicating the specific reasons that served as the basis for refusing to conduct the study, as well as specific recommendations for choosing other, alternative, types of radiation and instrumental studies.

20. Scheduled X-ray examination, if there is a referral and justification of the need for its implementation, can be carried out directly when the patient applies to the diagnostic room or by appointment. Pre-registration is required in cases where X-ray examination requires special training patient or diagnostic room.

21. In the absence of contraindications, the radiologist conducts a diagnostic study in accordance with the current technological standards, guidelines and directions. If it is impossible to conduct a study in compliance with the accepted technological standards, recommendations and instructions, the conclusion indicates the specific reason and possible consequences of deviation from the established research methodology.

22. If it is necessary to carry out invasive medical interventions during an X-ray examination or a diagnostic and diagnostic procedure under X-ray control, the administration of drugs, including contrast agents, the radiologist is obliged to explain to the patient the content and necessity of these actions before the start of the study, as well as possible risks related to the conduct of the study. Based on the results of the interview, the patient's informed consent is drawn up to perform this type of radiation examination or diagnostic and treatment procedure under radiation control.

23. A doctor who sends a patient for an X-ray examination, in which it is planned to carry out invasive procedures, the administration of drugs, including contrast agents, must first find out whether the patient has contraindications to such a study and indicate this in the direction of the study.

24. Based on the results of the study, the radiologist draws up a study protocol, which is provided to the patient or the doctor who sent the patient for the study, no later than 24 hours after the end of the study. The X-ray examination protocol should reflect the patient's passport data, the most important technological characteristics of the performed radiation examination, detailed description identified pathological changes and development options. The protocol ends with a conclusion, which determines or assumes the nature of the identified changes, indicates specific diseases or pathological processes that may cause the identified changes, as well as recommendations for additional research methods in cases where the nature of the detected changes remains unclear.

25. When ionizing radiation is used in the study process, the study protocol indicates the effective dose of radiation to the patient, which is entered into an outpatient medical record insert or the history of a child's development and is recorded in the daily X-ray examinations log. When the patient is discharged from the hospital, the results of the studies carried out using ionizing radiation are entered into an extract with an indication of the dose load, which is then transferred to the list of dose loads of the outpatient's medical record. Data on the radiation dose of patients examined in specialized medical organizations are transferred to the polyclinic at the place of residence for entering into the insert of the outpatient's medical record.

26.Diagnostic images obtained during the this study... Analog images are created on X-ray film, thermal paper, or other special media used in medical devices to produce hard copies of diagnostic images. The procedure for handling hard copies of analog images is given in Appendix No. 16 of this Procedure.

27.Digital images obtained during X-ray, computed tomography and magnetic resonance, radionuclide and other radiation studies are provided in digital form on electronic storage media (preferably on a laser disk) in DICOM format, together with a program that allows you to view images on personal computer. Paper copies of digital images printed on household printers are not diagnostic images and cannot be analyzed or interpreted. In a medical organization using digital X-ray machines, it should be possible to obtain a hard copy of a digital medical image.

28. In the absence of technical or organizational capabilities for the necessary X-ray examination (X-ray surgical procedure), the patient should be referred to a medical organization of a constituent entity of the Russian Federation or a medical organization of federal subordination that has necessary conditions to perform this type of research or medical and diagnostic procedure, in accordance with the procedure for providing medical care in this profile. Based on the results of the study, a conclusion is drawn up, which, together with the diagnostic images performed, is transferred to the medical organization from which the patient was referred.

29. The organization of emergency and urgent X-ray examinations is carried out in accordance with the procedures and standards for the provision of medical care in medical organizations located at a minimum distance to the patient's location, provided they have specialists on duty in X-ray diagnostics and the necessary diagnostic equipment.

30. Urgent X-ray examinations and medical and diagnostic procedures under X-ray (radiation) control are carried out by staff members of the X-ray diagnostic rooms during their working hours, either by the radiologist on duty, or by the radiologist on duty in the direction of the responsible (duty) doctor. Emergency X-ray examinations are carried out in specially designated diagnostic rooms with necessary equipment for urgent studies, or outside diagnostic rooms, using mobile or portable devices for X-ray diagnostic studies.

31.When performing X-ray diagnostic studies outside the X-ray room, the staff of the X-ray diagnostic department must take all necessary measures to protect patients and staff of the medical department from the effects of ionizing radiation in accordance with the requirements of the current sanitary regulations and norms.

32. The staff of the department in which it is planned to perform an urgent X-ray examination and, if possible, the patient's relatives, should provide the necessary assistance to the staff of the X-ray diagnostic room in organizing and conducting the examination of patients and victims, subject to the radiation safety rules provided for by the current sanitary norms and rules. ...

33.The protocol of urgent X-ray examination is drawn up in the medical history of an inpatient or an outpatient card immediately after the end of the examination and immediately transmitted to the doctor who sent the patient for examination. If the radiation examination is carried out by an average medical worker, the results of the performed X-ray examination are analyzed by the doctor who prescribed this X-ray diagnostic examination, about which a corresponding entry is made in the medical history (outpatient card). The radiologist draws up a protocol describing the results of the emergency radiation examination performed on the next working shift after the examination.

34. In the event of complications or emergencies during the X-ray examination, the staff of the office is obliged to take all necessary measures to eliminate them in accordance with the current instructions approved by the head of the medical institution in agreement with the head of the department of radiation diagnostics.

35. Responsible for ensuring radiation safety, safety and industrial sanitation during the operation of X-ray machines and rooms is the administration of the institution in accordance with the current sanitary rules and regulations.

36. At all stages of X-ray studies and diagnostic and treatment procedures under X-ray (radiation) control, proper quality control of the work performed must be ensured in the form of a system of organizational measures, technical means and workflows for quantifying, monitoring, and maintaining optimal performance of diagnostic instrumentation and diagnostic test modes. Methodological guidance for the coordination of activities and quality control in the departments of radiation diagnostics is assigned to the X-ray and radiological department of the constituent entity of the Russian Federation.

It is a type of medical services that includes a set of standard procedures aimed at the preliminary elimination of sources that threaten the victim's life. These assistance are carried out at the site of the lesion by the patient (self-help) or other persons (mutual assistance) who are nearby. Today, there are certain procedures for the provision of medical care to the population of the Russian Federation.

General requirements for the provision of first aid and its types

The main task in providing the necessary services is, first of all, the ability to provide assistance to a patient who has been injured or suffered from a sharp attack of illness, until a qualified ambulance team appears.

To date, the procedures for the provision of specialized medical care by profile include 3 types:

basic medical;
pre-medical;
initial treatment.

The first medical assistance is considered to be the combination of measures taken by the residents themselves at the site of injury, by means of self and mutual assistance, as well as by participants in emergency rescue operations using improvised and service tools. First aid services are provided by a paramedic.

The first medical aid is a complex of medical and prophylactic procedures performed by specialists and aimed at eliminating the results of the lesion. Thus, the person providing the necessary medical assistance may be an absolutely outsider who is skilled in providing such assistance.

General procedure

The procedures for the provision of specialized medical care by profile are:

providing the patient with qualified doctors;
calling an ambulance;
giving the victim first curative care before the arrival of the medical team.

In what situations do you need to call an ambulance

The patient is in
If the victim has heavy breathing, or it does not exist at all.
The patient has incessant pain in the sternum.
Profuse bleeding.
Acute abdominal cramps.
Intoxication or other urgent circumstances.

In other situations, when it is impossible to resort to, you should trust your instinct.

Treatment Service Standards

The procedures for the provision of medical care to children and adults are created in accordance with the list of medical assistance and include the average coefficients of the frequency of use and the frequency of supply:

medical services;
varieties of medical food, as well as special products for patients;
medicines registered in Russia (with the setting of medium dosages), according to the instructions for their use and the pharmacotherapeutic composition according to the anatomical-therapeutic-chemical specification, certified The World Organization health care;
blood components;
medical products transplanted into the human body;
other services based on the specificities of the disease (condition).

The use and appointment of medical devices, tools and specialized food products that are not included in the relevant standard of medical services are permitted due to the presence of medical indications for the patient by the decision of the medical board. And here additional procedures for the provision of medical care are already provided.

Healing assistance for bleeding

External blood flow occurs as a result of trauma to the blood vessels with the appearance of blood on the surface of the skin. The severity of bleeding is determined by the type of wound in the blood vessel. With small cuts, insignificant blood flow appears, and if large blood vessels (veins, arteries) are damaged, blood flows out instantly, and bleeding can be life-threatening.

Arterial blood flow is usually strong and rapid, with sharp pain in the damaged area of the body, with a bright red tint of blood that flows from the wound in a stream.

For venous bleeding, more uniform blood flow from the site of injury is characteristic. The blood is dark red or burgundy and flows constantly. To eliminate such blood flows, there are certain procedures for the provision of medical care.

If you faint

This phenomenon is considered unexpected, which is accompanied by a weakening of the work of breathing and heart. Fainting appears with rapidly developing anemia of the brain, it lasts from a few seconds to 3-10 minutes or even more. Indicators of fainting are:

loss of consciousness;
nausea;
lethargy;
pallor and coolness of the skin;
dizziness;
slow breathing;
rare and weak pulse (up to 40 beats per minute).

The first thing to do in such a situation is to put the patient on his back so that the legs are raised and the head is lowered. In order to improve the condition of the victim, there are certain procedures for the provision of medical care.

Free chest and neck from tight clothing to facilitate breathing.
Cover the patient with something warm and apply a heating pad to the legs.
Smell ammonia and rub it into whiskey.
Spray your face with cool water.
If fainting is prolonged, artificial respiration is required.
As the patient comes out of a fainting state, you need to immediately give him strong coffee.

Help for minor injuries

If there is a deep cut or puncture with any object, you should do the following:

wash the wound with soapy water or an antiseptic solution - a medicinal agent that has antimicrobial efficacy (for example, hydrogen peroxide, iodine) and is used to treat scratches and cuts;
to cleanse dirty abrasions, it is necessary to use a sterile swab or napkin, starting from the center of the wound and heading towards its edges;
apply a small tourniquet.

The services of a specialist will be needed only in a situation if there is a danger of infection getting into the cut.

Procedures for the provision of medical care in surgery

There are some rules for providing people with surgical assistance.

The legal order approves the requirements for the provision of medical services to an adult in the specialty "surgery" in medical clinics.
Surgical care is provided in the form of the first medical-sanitary, specialized, high-tech assistance.
The procedures for the provision of medical care can be carried out on an outpatient basis (there is no round-the-clock medical supervision and therapy), on (treatment and medical supervision during the day, there is no constant observation), stationary (by agreement, which provides round-the-clock supervision and therapy).
Primary health care services involve procedures for the treatment of surgical conditions and ailments, as well as diagnostics, medical recovery, prevention, and maintaining a healthy way of life for people.

At the present time, it is very important for every person to know the procedures and standards for the provision of medical care in any situation. After all, you can always find yourself in the place where you will need to help the victim. And if you do it right, you can save the patient's life before the ambulance arrives.