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Automatically translated version. May contain inaccuracies compared to the original.
The minister stressed that the decision to dispatch a crew is made by the dispatcher.
Ukraine’s Health Minister Viktor Liashko urged Ukrainians to call emergency medical assistance only when a person’s life is in danger. For routine procedures, he said, patients should contact their primary care physician. He also explained how medical facilities operate during yellow and red air-threat levels. The minister spoke about this on Wednesday, 23 September, on a telethon broadcast.
“Emergency medical care is for the moment and emergency because it is the dispatcher who decides how urgently it is necessary to send an emergency medical team at that particular moment,” Liashko emphasized. Addressing Ukrainians, he explained that this is “definitely not the help that should come to give someone an IV or take a blood pressure.” In such cases, a consultation with a family doctor is needed, and “emergency medical care comes in emergencies when there is a threat to life.”
According to the Ministry of Health order No. 583, a team is dispatched, among others, when a person has lost consciousness or has seizures, suddenly stopped breathing or is choking, experiences sudden chest pain, has suddenly lost vision, speech, or limb strength. A significant bleeding, pregnancy complications, anaphylactic reaction, bites by snakes and spiders, life-threatening injuries, drowning, or foreign objects in the airways also justify dispatch.
A high fever by itself is not a reason to call. For injections, IVs, dressings, planned catheter replacements, dental care, tick removals, issuing prescriptions and certificates, the crew does not go out. It also does not respond to patients with exacerbations of chronic diseases if their condition does not require emergency care.
State Regulation No. 1271 divides calls into four categories. For a critical call (absent or ineffective breathing, massive bleeding), the crew must arrive within 10 minutes; for urgent calls (consciousness disturbance, bleeding, signs of acute coronary syndrome or stroke, breathing disorders), within 20 minutes. Non-urgent and non-specialist calls are not provided for. For a non-urgent patient, medics may be sent only if there are available crews and there is no access to a family doctor. For non-special cases, the patient is consulted by phone.
During alerts, including the red level, the ambulance operates, the minister assured. “Today all the algorithms have been worked out on how we coordinate our actions with the State Emergency Service regarding dispatches to arrivals to avoid repeated arrivals at places where there are already victims and where rescue teams are working to clear debris. We see what the threat is and where it is directed, so we can signal that emergency medical assistance can depart,” Liashko explained. The goal is to ensure there are no fatalities among medics and rescuers. Sometimes an emergency worker is directly in the State Emergency Service dispatch center.
Separately, the Ministry of Health regulated the work of medical facilities during alarms. The minister explained why this was necessary: “When an air alert was announced, clinics closed admissions, people left the buildings, and crowds gathered outside. When there were strikes near health facilities, debris could injure people standing near polyclinics.”
During the yellow level, health care facilities continue to operate. People can and should stay inside facilities that potentially shield from debris during a near-explosion. The red level is announced when there is a threat of a mass attack by “Shahed” drones or missile strikes. Then medics must descend into shelter, “but those urgent interventions that cannot be stopped at the moment of the alert, whose stoppage could lead to a loss of life, are not halted but completed.”
Operations were not halted even before, Liashko noted. New rules are needed to legally protect the heads of medical facilities: “We later had some legal collisions, whether it was necessary to stop surgical interventions, or not.”
Patients at the red level also must descend to bomb shelters. For resuscitation and bedridden patients, the Ministry of Health applies, according to the minister, “a sensible approach, where we understand how many minutes it takes to evacuate a department.” “For example, a trauma department where all inpatients occupy 50 beds, we understand that physically it is impossible to move them to a bomb shelter within three minutes. Therefore, other measures are proposed, including additional protection for the department or appropriate armor plates on windows, reducing the number of beds in the ward and spacing them as far from window openings as possible so that during explosions in the affected zone there are no patients,” Liashko gave as an example.
When speaking with the dispatcher, it is important to answer questions clearly and name the exact address. The article in ZN.UA “Emergency or Urgent?” by Olga Skrynnyk, educator, science, medicine and ecology section of DT.UA (to 2019) discusses how emergency help differs from urgent help and what a false call risks.
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