Medical assistance to persons serving punishment in places of imprisonment and enclosed in custody: the order of organization and rendering. Medical assistance to persons serving a sentence in places of imprisonment and imprisoned: the order of the organization and

In pursuance of the fundamentals of the legislation of the Russian Federation on the protection of the health of citizens of July 22, 1993, N 5487-1 (Vedomosti Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 33, Art. 1318; Meeting of the legislation of the Russian Federation, 1998, n 10, Art. 1143; 1999, N 51, Art. 6289; 2000, N 49, Art. 4740; 2003, N 2, Art. 167; N 9, Art. 805; N 27, Art. 2700; 2004, N 27, Art. 2711; N 35, Art. 3607; N 49, Art. 4850) We order:

Order
organization of medical care to persons serving punishment in places of imprisonment and enclosed
(approved by the order of the Ministry of Health and social Development RF and Ministry of Justice of the Russian Federation of October 17, 2005 640/190)

1. This procedure is developed in accordance with the Russian Federation on the protection of citizens' health of July 22, 1993 N 5487-1 (Vedomosti Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 33, Art. 1318), July 15 1995 N 103-FZ "On the detention of suspected and accused of committing crimes" (Meeting of the legislation of the Russian Federation, 1995, N 29, Art. 2759), the Russian Federation (meeting of the legislation of the Russian Federation, 1997, N 2, Art. 198) and regulates issues related to the organization of medical care to individuals suspected and accused of committing crimes (hereinafter - suspects and accused), held in custody in the detention facilities of the Federal Penitentiary Service, as well as persons serving sentences in prison areas (hereinafter - Convicted).

2. Medical assistance to suspects, accused and convicted person is provided by medical and preventive institutions (hereinafter referred to as LPU) and medical units of the Federal Penitial Execution Service for these purposes, or the LPU state and municipal Systems Health.

3. The organization of medical care suspects, accused, convicted, as well as quality control of its provision is carried out by the relevant federal bodies. executive powerTheir territorial bodies, including medical departments, departments, departments (hereinafter - medical services), the executive authorities of the constituent entities of the Russian Federation, local governments to belong to the LPU or medical unit.

4. Medical services of federal executive authorities ensure compliance with the patient's rights when providing medical assistance to suspect and accused, convicted, with the exception of the restrictions provided for by federal laws.

7. The organization of preventive, medical and diagnostic work is ensured in accordance with approved in installed manner regulatory legal acts.

8. The organization of medical care suspects, accused and convicts include a complex of preventive, medical and diagnostic measures aimed at ensuring their rights to health.

9. Medical assistance provided is in the amounts provided for by the program of state guarantees to citizens of the Russian Federation of free medical care.

10. Persons convicted of imprisonment, which the court determined serving a sentence in colony-settlement, other convicts, suspected and accused, not detained (protection), receive medical assistance in the LPU at the place of residence or serving the sentence on equal terms with others. Citizens of the Russian Federation.

11. State Sanitary and Epidemiological Supervision in institutions is carried out in accordance with March 30, 1999 N 52-FZ "On the Sanitary and Epidemiological Welfare of the Population" (Meeting of the Legislation of the Russian Federation, 1999, N 14, Art. 1650), other regulatory legal Acts in the field of ensuring the sanitary and epidemiological well-being of the population in the manner established by the relevant federal executive authorities.

12. Compliance with state sanitary and epidemiological, anti-epidemic rules and standards is the responsibility of employees (employees) of institutions, and the responsibility for their violation established by the legislation of the Russian Federation is distributed, including on suspects accused and convicted.

13. To provide medical assistance to the suspect, the accused and convicted in the institution a medical unit is organized, which is a structural division of the institution: the investigative insulator (hereinafter - the SIZO), a correctional institution (hereinafter - IE), including a correctional colony (hereinafter - IR), Therapeutic correctional institution (hereinafter referred to as Liu), the educational colony (hereinafter - VC), prisons or a branch of a medical and preventive institution.

(in matters and answers)

This material is not the author's text. In the form of questions and answers, adapted for perception, we set out joint rikaz of the Ministry of Health and Social Development of the Russian Federation and the Ministry of Justice of the Russian Federation of October 17, 2005 No. 640/190which establishes the basic rules of organization and the provision of medical care suspects accused and convicted. For the convenience of perception in our text, we will call these persons used in international law (see "Minimum Standard Rules for Conducting Prisoners") The term "prisoners".

1. Can medical care can be suspected, accused and convicted to be provided with not only medical and preventive institutions (hereinafter referred to as LPU) and medical units of FSIN institutions, but also by state, as well as municipal medical institutions - preventive institutions? - Yes, maybe (paragraph 2 instructions).

2. What are the basic principles of medical services of the FSIN institutions? - Provision:
a) compliance with the rights of suspects accused and convicted to protect health and state guarantees for free medical assistance;
b) the priority of preventive measures in the field of health care;
c) availability of medical care (clause 5 instructions).

Volumes of free medical care

3. In what volumes is a medical assistive suspect, accused and convicted? - in the amounts provided for by the program of state guarantees of free medical care to citizens (paragraph 9 of the Instruction). In accordance with section 2 programs approved by Decree of the Government of the Russian Federation of December 5, 2008 N 913 "On the program of state guarantees of free medical care for the Russian Federation for 2009," within the framework of this program are provided free of charge:

4. How do medical assistive persons in the colony - settlement? - They receive medical care in the LPU at the place of residence or serving the sentence on equal terms with other citizens of the Russian Federation (paragraph 10 of the Instruction).
Unlike convicts serving punishment in correctional colonies and prisons, convicted, in colonies - settlements receive medical assistance on the basis of compulsory health insurance policies. The organization of obtaining such policies in insurers is entrusted to the heads of the colonies - settlements (paragraph 2 of the order of the Ministry of Justice of the Russian Federation and the Ministry of Health of the Russian Federation of December 31, 2002 N 362/424 "On measures to improve the medical care of persons contained in the colonies of settlements, their families , workers and employees of colonial settlements "). Heads of health authorities of the subjects of the Russian Federation are obliged to ensure the provision of the necessary advisory and diagnostic, outpatient and inpatient assistance in the LPU of the subject of the Russian Federation not only to persons contained in settlement colonies, but also members of their families, workers and employees of colonial settlements in the absence of the possibility of providing the appropriate medical care in the LPU UIS Ministry of Justice of Russia. In the letter of the Federal Fund of the OMS dated June 21, 2003 N 2507 / 30-3 / and "On medical insurance of convicts contained in the colonies-settlements," is reminded that with compulsory medical insurance by the insurers for the working population are their employers, for non-working population - the executive authorities of the constituent entities of the Russian Federation, local governments (Article 2 of the Law). Norms relating to mandatory health insurance extend to working citizens from the date of conclusion with them labor contract (Article 6 of the Law), and it is proposed to organize compulsory medical insurance of convicts contained in the colonies of settlements, ensuring their insurance medical policies of the OMS and the provision medical services For compulsory health insurance, in the manner prescribed by the Federal Law, that is, by insurance by the forces of the employer.

Medical unit institutions

5. What functions are assigned to the medical unit of the institution? - Guaranteed ensuring the provision of primary medical care concluded, and depending on a) local conditions, b) of the form of institution, c) of economic feasibility, d) other circumstances of the MSH part can provide some types of specialized medical care (paragraph 14 of the Instruction). The main tasks of the medical part are: a) the provision of emergency medical care; b) the provision of outpatient and stationary medical care; c) organization and conduct of medical examinations, clinical examination; d) the organization and implementation of a set of sanitary and hygienic and anti-epidemic activities; e) hygienic learning and propaganda of a healthy lifestyle (p. 15 instructions).

6. What is the structure of the medical unit of the institution?- Possible structure Such is: an outpatientation, insulator, pharmacy, sterilization. In more detail in the instructions, the function and structure of the ambulance and insulator are painted:

Subdivision

Ambulatory

providing outpatient medical care prisoners

Cabins a) Head of the Medical Part; b) - medical reception (therapist, phthisiartra, psychiatrist, psychiatra narcologist, dentist and other cabinets); c) preference reception (paramedic, nurses); d) physiotherapy; e) procedural; e) auxiliary diagnostic, incl. functional diagnosis, radiological, fluorographic; premises g) laboratory; h) dressings; i) storage of drugs; k) waiting for admission

Medical insulator

Medical checkup

7. How is the medical examination of persons in registered corps of the SIZO, DIESO, SHISO, PKT, insulated premises of strict conditions for serving the punishment of correctional institutions? - Rooms are equipped there for an outpatient reception of suspects, accused and convicts - medical offices (p. 19 instructions).

8. What are the features of honey help provided by patients with mental disorders? - Therapeutic activities for them are carried out only in accordance with the appointments of a psychiatrist (paragraph 20 of the Instruction).

9. How is the medical examination by persons who arrived in the SIZO? - in the shortest possible time before their direction in the chamber they are carried out primary medical checkup To identify a) persons representing an epidemic hazard for others, b) patients who need emergency care. Particular attention is paid to the presence of external manifestations of skin, venereal, infectious and other diseases, an impairment of pediculose, epideaoannese is being collected. Inspection is carried out in a specially equipped medical unit of the precast separation of the SIZO, equipped with an arterial pressure measuring device, a phonenadoscope, thermometers, spatulas for inspection of the oral cavity, reflector, weights, rodomer. (P.P. 24, 25 instructions). The medical room is conducted by the Journal of Medical Inspections of the SIZO (Quarantine), where the basic data on viewed suspects, accused and convicted and disease identified in them and damage (§ 26) are recorded. For each suspect and the accused is filled with a medical card of an outpatient patient established sample (paragraph 27).

10. How is the administration of the institution when delivering a person who has bodily harm? - on the initiative of the duty assistant head of the institution (operational duty) or at the request of a person who has bodily injuries, as well as when identifying injuries When examining a medical worker (doctor, paramedic), an act of arbitrary shape is made. The specified act is compiled in two copies, one of which is attached to the medical card of an outpatient patient, the second copy is issued on the hands of a prisoner under his personal signature on the first instance of the act. The head of the institution and the supervising prosecutor is informed about the survey report. The acquisition of an act to a medical card of an outpatient patient is noted in a sheet of refined diagnoses. In coordination with the health worker, surveying, during the survey and inspection of the victim, the design of honey. Documentation or an act in order to ensure its security, other employees of the institution may be present (paragraph 28).

Act of holding medical examination

Me, honey employee of the institution _____ (name of the institution) _________ (FF. And the position of honey of an employee), ________ (date, time), when conducting medical examination _______ (FIO of the Prisoner), received from (name of the institution, from where a citizen came from ), delivered ____________ (title, positions and phids of those who gave the said person), the following injuries were identified:

Signature of the person who has accomplished: ___________
Signatures of persons present in compiling Act: ________________________
Objections of the inspected person: ________________________
Signature of a survey person for obtaining a second instance of the act: _____________

Medical mystery

11. What is a medical mystery? - Information on the fact of appealing for medical care, the health status of a citizen, the diagnosis of its disease and other information obtained during its examination and treatment, make up a medical secret (paragraph 27 of the instructions). In accordance with Art. 61 The Fundamentals of Legislation on the Protection of Citizens Information about the fact of the appeal of medical care, the state of health of the citizen, the diagnosis of its illness and other information obtained during its survey and treatment, make up a medical secret. A citizen must be confirmed by a guarantee of the confidentiality of the information transferred to them. It is not allowed to disclose the information constituting the medical mystery, the persons who they become known in the performance of professional, official and other duties, except when: 1) consent to it gave a citizen or his legal representative; 2) the examination and treatment of a citizen who is not capable of expressing their will due to its state; 3) It is necessary to prevent the threat of the spread of infectious diseases, mass poisoning and lesions; 4) Requests for the bodies of the inquiry and investigation and the court in connection with the investigation or judicial proceedings; 5) when assisting a minor under the age of 15 years (and in drug addiction - up to 16 years) to inform his parents or legal representatives; 6) there are grounds that allow us to believe that harm to the health of a citizen is caused as a result of unlawful actions; 7) for the purpose of military Medical Examination. Thus, we will not allow the refusal to provide information on the state of health under the pretext of preserving the medical mystery, both the patient himself and the person acting on the basis of a power of attorney issued by the patient.

12. Will honey issued. Documents on the hands of the patient, where these honey. Documents are stored? - Honey. Maps of an outpatient patient, sheets of destination, sheets of temporary disability in the hands of prisoners are not issued, stored in honey. Parts in cabinets under the lock, temporary disability sheets - in a metal cabinet or safe. However, the instructions noted that "the specified provision should not deprive the suspect, accused and convicted right to receive information on the state of its health. At the request of the suspect, the accused or convicted person, it is possible to directly familiarize medical documentationreflecting the state of his health carried out in the presence of a doctor "(p. 65 instructions). An important disadvantage of the instructions is that it does not provide for the patient's right - a prisoner to receive an extract from the medical record. However, the ban on the issuance of such an extract, the instruction nevertheless does not contain, since the list of documents that are not issued to the hands of the patients from the number of prisoners is exhaustive.

13. How honey is delivered. Map of an outpatient patient when sending a patient for consultation, radiological, laboratory and other research, appointed by the procedures carried out outside of the MSH? - The card is issued to a person accompanying the patient, if this person is not a medical worker, the documentation is transmitted in a prison, either in a different way that does not allow to familiarize themselves with information in it (clause 66).

Taking patients when entering the SIZO

14. How it turns out honey help to persons delivered from IVS and in need of urgent medical care in the conditions of the hospital of the LPU in the absence of the possibility of providing necessary view Treatment in the SIZO? - Such faces are not accepted in the institution, but are sent to the corresponding LPU of WIS, state and municipal health systems, where this type of assistance can be provided (p. 29).

15. How is the placement of patients enrolled in the SIZO? - Persons with suspicion of infectious disease immediately after inspection are isolated, the required disinfection of their clothing and personal belongings (paragraph 30) is made. The placement of patients is made to indicate a medical worker, and in the presence of signs of mental disorder, including a tendency to aggression and autoagression, - taking into account the recommendations of the doctor - psychiatrist and a psychologist. The quarantine term due to infectious diseases is determined by medical testimony (paragraph 31 of the instructions).

16. What is the order of an in-depth medical examination for those who came again in the SIZO? - After honey. Survey for a period of no more than three days from the moment of arrival in the SIZO, such persons, except for the following transit, pass an in-depth medical (Feldsher) inspection, as well as a x-rayofluorographic examination (paragraph 32 of the instruction). With such an examination, the doctor finds out complaints, examines anamnesis of disease and life, conducts an external inspection to detect bodily injuries, newly applied tattoos, other special, conducts a comprehensive objective examination, using generally accepted inspection methods, palpation (consistent feeling of surface tissues and driving organs) , percussions (tapping individual parts of the body and analysis of sound phenomena) and auscultation (listening to sounds formed in the parenchymal and human hollows), subject to the presence of readings appoints additional methods of examination, and the information received in the prescribed manner fixes in the medical card of an outpatient patient (p. 33 instructions).

17. What is the procedure for obtaining honey. help those who should transit? - Such persons receive treatment and examination only a) in accordance with the accompanying documents attached to the open certificate of a personal case, or b) when applying for medical help (clause 34 of the Instruction). Thus, patients following transit to obtain medical care should managing the necessary initiative.

18. How often subsequent honey are produced. Inspections of prisoners in the SIZO after their inspection upon admission?- Planned - at least 2 times a year, and unscheduled - according to the indications (clause 36 of the Instruction). So, with a deterioration in the state of health or in case of receiving suspect or accused, his medical examination, and medical care is conducted by honey. Employees of the SIZO immediately. Honey. The examination includes: a medical examination, if necessary, additional research methods and attracting specialist doctors, the results of which are fixed in the medical card of an outpatient patient and are reported to the form-seeking form (clause 37 instructions). If, with examination, data will be obtained that the harm for the health of the prisoner is caused as a result of unlawful actions, honey. An employee who conducted a medical examination, informs in writing about this head of the institution (paragraph 38).

19. How is the refusal to prisoner from examination, treatment, other medical intervention? - appropriate recording in medical records and is confirmed by his personal signature, as well as signature honey. employee after a conversation in which the prisoner explains possible consequences refusal from the proposed medical diagnostic measures. The patient's reluctance to confirm his refusal to a personal signature discussed honey. employees and recorded in medical records (clause 39 instructions). From the text of the instruction it is clear that there are several honey of workers to testify the refusal to sign

20. How is the survey for fitness for transportation at worship from the SIZO? - With all decreasing from the SIZO, a mandatory medical examination is carried out to determine suitability to the terms of transportation. Not allowed to transport:
a) patients in the acute stage of the disease; b) patients with infectious and venereal diseases; c) defeated by pediculosis, scabies who have not passed the established course of treatment; d) Non-transportable patients.
Upon completion of the inspection in the honey, the conclusion of the health status of each decreasing, under which honey. An inspection worker puts his signature with the name of the surname, positions and dates. Along with the personal case, honey map of the prisoner (p. 40) is transmitted.

Preventive inspection of convicts in IU.
Honey inspection when weaving in PKT, Schizo, Dizo

22. How often is the preventive inspection in IU? - Once a year. Preventive honey passes twice a year. The inspections are only convicted, serving the punishment in prisons and other IU in chamber content, as well as minor convicts, including serving a sentence in educational colonies. With this inspection of convicts inspect how honey. Employees of MSC colony and attracted doctors - specialists. In the inspection, the therapist, psychiatrist, dentist, and in VK and the children's houses and the pediatrician (paragraph 21 of the instructions) are participating. Unfortunately, the list of such specialists does not include an ophthalmologist, a phthisiatre and a cardiologist.

23. What is included in the passage of convicted preventive inspection? - a) collection of anamnestic data, complaints; b) anthropometric study (growth, body weight); c) an objective study by authorities and systems; d) determination of visual acuity and hearing; e) gynecological examination of women: palpator examination of the chest glands, taking a smear for cytological examination from the vagina, urethra and in the presence of a detachable - from the nipples of the chest glands, girls have a finger study through the rectum (by testimony); e) a finger study of the rectum to persons over 40 years of age; g) tuberculinidiagnosis in the prescribed manner; h) blood test; h) general analysis urine; k) ECG (from 15 years old - once every 3 years, from 30 years - annually); l) fluorography (radiography) of the chest organs - 1 time in 6 months; m) pneumotheometry, spirometry. All product reports are entered in honey. Card outpatient patient (p. 45 instructions).

24. How honey is performed inspection of the face, driven into a single chamber or a cake, in Schizo, Dizo, PKT, IPT, isolated premises of strict conditions for serving the sentence? - Honey is made to inspect such a person with the written conclusion of the doctor (paramedic) about the possibility of keeping them in the listed rooms. At the same time, the basis for making a medical conclusion about the impossibility of the content of the punished person in these premises may be a disease, injury or a different state requiring emergency care, treatment or observation in stationary conditions, incl. MSH (clause 46 instructions).

25. How is honey inspection of persons contained in Schizo, Dizo, PKT, IPT, locked rooms, as well as in car trays of the SIZO? - their honey. Inspection and honey. Help them is produced in place with daily inspection of the sanitary condition of these premises, as well as when appeals. In cases where there is a threat to the health or life of the persons contained in the specified premises, a medical worker takes measures to urgently deliver such a person to the medical unit (clause 47 instructions). By the decision of the Supreme Court of the Russian Federation of December 25, 2007 N GKPI07-1244, this item 47 is recognized as not contradictory law. In honey. The card of the outpatient patient is recorded of all the appointments and manipulations when they are conducted in Schizo, Dizo, IPT, PKT, SIZO chamber (clause 64 instructions).

26. Mandatory honey is held in relation to their prisoners under their budgeting and exemption. inspection? - Yes, it is carried out, while declining the final medical examination with the design of epicrosis (clause 48 instructions).

27. When and as prisoners in the SIZO and prisons may contact your help? - During the daily bypass of cameras, and in the case of an acute disease - to any employee. Such an employee is obliged to take measures to organize medical care. For this, a person in need of honey help is displayed in a medical office (ambulatory), where inspection is carried out and medical measures are being carried out; If necessary, the Feldsher either makes the appropriate appointments or records patients to receive a doctor (paragraph 50 instruction).

28. Can honey worker be in the cells and carcers of the SIZO, prisons, IR special regime, Shizo. Dizo, PKT without accompanying inspectors? - No, can not (paragraph 51 instructions).

29. How is the conclusion of prisoners for a doctor? - In the SIZO, IR special regime and prisons for reception or execution of procedures, patients are derived individually or groups of 3-5 people in compliance with the requirements of isolation. In other IU, convicts arrive at the outpatient reception on their own (paragraph 52). In each detachment, the head of the detachment is a pre-recording magazine for an outpatient reception. In the investigative insulator, the magazine leads on duty through the case. A pre-recording magazine before starting outpatient reception is transmitted to the medical unit. After receiving, the log is returned to the specified persons. Reception without recording in the journal is carried out only in emergency cases (clause 53 instructions).

Issuance and reception of medicines

38. How is the issuance of medicines of the patient?- Medications on the hands of prisoners are not issued, the reception of drugs is carried out in the presence of a medical worker. The exception can be drugs that are not related to narcotic, psychotropic, potent or poisonous, prescribed for diseases in need of continuous supportive treatment (ischemic heart disease with stress and rest, hypertensive disease with a resistant increase in blood pressure, diabetes, epilepsy and other similar Diseases). The decision about this (based on one day) is accepted by the head of the medical unit (health care, ambulance) in individual order In accordance with the appointment of the attending physician (paragraph 67 of the instructions). Ambulatory patients for taking drugs and performing other medical diagnostic procedures are in the medical part at the set time. The procedural card is drawn up for each such patient. Medical appointments are performed by the Feldsher (nurse), which makes marks in the procedural card, which before issuing the drug repeatedly clarifies the patient to the tolerance of each prescribed drug, and also checks the compliance of the drug output and its dosage assignment (clause 68 of the instructions).

39. How do medications acquire patients? - At the request of the patient, when agreeing with the attending physician and the head of the MSC, the patient may be allowed to acquire (obtaining) necessary for the treatment of medicines (clause 67 of the instructions).

40. How is dental assistance in the absence of a dentist doctor in the MSH? - In this case, with dental diseases (mainly on emergency testimony), the doctor (Feldsher) provides within the competence (paragraph 69 of the instructions).

41. How to store medicines in honey. parts? - All medicines for current spending, and property for emergency assistance are stored in special cabinets under the lock. Medicinal drugs, psychotropic, potent and poisonous substances are stored only in a pharmacy (equipped with a security alarm system of the administrative building) of the institution, in a metal cabinet under the lock. Their vacation honey. The parts are made strictly for medical reasons with an appropriate recording in a medical card of an outpatient patient and a book of accounting for poisonous, narcotic, psychotropic, potent, expensive medicines and ethyl alcohol in a pharmacy. Before issuing drugs, the patient is checked every time the compliance of the prescribed medication appointed and the shelf life of the drug (paragraph 82 of the instructions) is checked.

Direction and reception in the hospital.
Treatment in hospital

42. What is the order of urgent direction of patients in the hospital? - The patient with an urgent direction is sent to the nearest LPU of WIS or LPU state or municipal health systems. In the direction of urgent hospitalization, information about the state of the patient and the assistance provided to it is summoned to hospitalization (paragraph 85 of the Instruction). In the case of hospitalization of the patient in the LPU State and Municipal Health Systems Brigade of Emergency Medical Aid Medical Personnel of the sender's support for support of the patient is not attracted (paragraph 85 instructions).

43. What is the order of receiving a patient in medical hospital? - This technique is made in the presence: a) in the medical map of an outpatient patient's conclusion of a doctor about holding a stationary examination and treatment; b) directions to the hospitalization of the established sample. Data on newly enrolled in the hospital is entered into the registration journal, extracting patients and failures in hospitalization (clause 70 instructions). When entering the hospital, honey is drawn up on the patient. The map of the stationary patient (hereinafter referred to as the history of the disease, IB) with a list of appointments, in which: a) the overall state of the patient is estimated; b) complaints are written in detail and consistently; c) anamnesis of disease and life; d) an objective study data; e) detected pathology; (e) Clinical assessment of laboratory and functional research performed; g) preliminary diagnosis; h) diagnostic and therapeutic purposes; and) the written consent of the patient to carry out the necessary in the near future (taking into account the present condition of the patient) therapeutic and diagnostic measures (paragraph 71 of the instructions). All entering the hospital undergo a mandatory San. Processing, which, depending on the state of the patient, can be complete or partial. If necessary, the underwear of the patient is disinfected. Clothing and shoes are stored in a specially designated hospital room, the patient's underwear is rented and returned to him at discharge (clause 72). Patients representing the danger to others (with infectious, contagious skin, mental diseases) are contained separately, for which the MSC in the hospital is provided for chambers or boxes for separate placement of patients according to the profile of the disease (clause 73).

44. For a period of the stationary patient, a clinical diagnosis is exhibited.? - within 3 days from the date of receipt (paragraph 71 of the instructions).

45. How is the search for patients in the hospital? - Daily doctor in the morning. All those received over the past day in the hospital examines the head of the MSH, then he inspects them as needed, but at least once a week and before discharge. The results of this inspection with the diagnosis and recommendations are entered in the history of the disease and are signed by it. The diary of the disease is conducted by a doctor 1 time in 2 - 3 days in cases of easy course of the disease and daily in medium-and-heavy and severe cases. In the morning and in the evening, the body temperature (clause 74) is measured and recorded in the illness.

46. \u200b\u200bWhat actions and by whom are made with patients during hospital? -

47. What types of regime are appointed by the medical unit of the institution? -

48. In what mode are the consultations of stationary patients? - planned- on schedule, and in urgent cases - at any time of the day (clause 77 instructions).

49. In which case is an extract from the hospital? - a) when recovery; b) a resistant improvement of the condition; c) translating into another medical institution; d) violation of the routine of the day; e) refusal of treatment (in the absence of a threat to the life of a patient or health surrounding). The extract is coordinated with the head of the MSH, the corresponding epicris is issued on the proceedable epicride, which is signed by the doctor and the head of the MSH, one copy of which remains in the history of the disease, the other is introduced into the medical map (paragraph 78 of the instructions).

Emergency medical care

50. How is urgent honey help in medical institutions? - The provision of such assistance in acute diseases, poisoning, injuries and other states is one of the main functions of MSH. Its procedure is determined by the head of the MSH, depending on the schedule of the institution, which is available at its disposal of the staff and means, the features of the dislocation of the institution. Emergency medical care can be provided in the scope of first aid, prefigured, first medical and qualified medical care (in the presence of trained specialists and appropriate equipment). Urgent honey. Help must provide: a) the possibility of immediate medical care at the site of the disease, injury, poisoning or other states; b) the fast delivery of a patient in the MSC or the nearest LPU with medical care during transportation; c) the immediate provision of the patient in the MSH urgent medical or before the arrival of the doctor - a prefiguration assistance; d) an urgent medical evacuation of a patient from the medical unit in the ISIS LPU or territorial LPU in the case when an emergency qualified or specialized medical care is required (paragraph 80 of the Instruction).

51. Who is obliged to cause honey of an employee or ambulance during when there is no honey staff in the institution, as well as provide emergency evacuation of the patient with protection and supervision? - Operational duty officer or duty assistant chief of the SIZO or prison (paragraph 81 instructions).

52. What room is the provision of emergency medical care activities? - In a clean dressing or procedural office, where it should be available for this: a) kits (foreground styling) to provide emergency medical care; b) sterile surgical instruments, syringes, injection needles; c) supply of sterile dressing material; d) oxygen stock; e) a table indicating the main symptoms of the relevant diseases, guidelines for improper urgent therapy with a list of funds and activities to provide emergency care and subsequent tactics of the patient; e) drug compatibility tables and medicinal therapy complications; g) portable medical laying (bag, suitcase) with a set of tools for emergency care outside the medical unit. Each clinical state (syndromocomplex) and the corresponding drug set for it is marked with a specific sequence number (paragraph 82 instructions).

53. What are the indications for urgent and planned hospitalization in the Patient LPU? -
# 1. Urgent - surgical profile: a) disease, giving symptoms of "acute abdomen"; b) damage to blood bleeding and without it; c) internal bleeding; d) injury to damage bones, joints and nervous trunks, bone fractures; d) shaking and bruises of the brain; e) extensive damage to soft tissues; g) chest damage with suspicion of pneumothorax (accumulation of air or gases in the pleural cavity) and hemotorax (blood cluster in the pleural cavity due to internal bleeding); h An abdominal injury and pelvis with suspicion of damage to the internal organs; and) bone and tendon panaritis, deep abscesses, carbuncles of any localization, sharp osteomyelitis and arthritis; k) burns and frostbite II-IV degree; l) other diseases and damage requiring urgent surgical benefits. Also, malignant neoplasms and diseases, suspicious rebirth in malignant (including pigment tumors of leather, changing color and often bleeding when shaving, combining, may be attributed to the hospital under urgent testimony.
# 2. Urgent profile: a) acute violation of the coronary blood circulation (myocardial infarction, a prolonged attack of angina), b) hypertensive crisis that does not stop in the conditions of the medical unit; c) rheumatism (active stage); d) sharp poisoning; e) not stopped under the MSH conditions attacks of bronchial asthma; e) bruboral pneumonia; g) acute or under acute jade; h) acute heart rate disorders, incl. with blood circulation deficiency phenomena; and) comatose states; k) hemolytic states, anemias, lymphoproliferative diseases, leukemia; k) a sharp diarrhea with dehydration syndromes and electrolyte violations; l) rafts of unclear origin, as well as patients with suspicion of acute infectious disease; m) sharp and with exacerbation of chronic infectious diseases; H) sharp, under the sharp radiation disease; o) diabetes in cases requiring the correction of sugar therapy; P) Other diseases requiring emergency care.
# 3. In the Eye Department of the Hospital Patients: a) victims of eye damage from mechanical, chemical, radial effects, except for persons with foreign bodies, superficially lying in the cornea and in conjunctiva (in case of successful removal of these foreign bodies in the medical unit); patients with sharp and non-treatable chronic diseases of eye appendages; b) with diseases of the eyeball; c) with suspicion of glaucoma; d) with a rapidly progressive decrease in visual acuity or with a sudden loss of it and other pathology (paragraph 95 of the instructions).
# 4. Patients with ENT pathology: a) often recurrent nose bleeding and (or) if it is impossible to stop bleeding, a nasal injury; b) phlegmons of the oral cavity and neck, difficult to breathe, if a rapidly growing suffocation does not require emergency tracheostomy (dissection of the front wall of the trachea) in place; c) diseases requiring urgent surgical intervention (with mastoids, with suspected intracranial complications of purulent otitis); d) heavy forms of inflammation of the pharynx, larynx or trachea (acute swelling of the larynx, plug abscess); e) protracted laryngitis in the presence of Afony, the near-wing phlegmon, acute purulent medium otitis and the exacerbation of chronic purulent medium otitis; e) acute and exacerbation of chronic paranasal sinusitis (inflammation of the incomplete sinuses); g) dysphagia (inflammatory processes of the oral cavity, pharynx, esophagus, larynx); h) perichondritis (inflammation of cartilage) of ear shell, eczema of external ear, phlegmonous angina and cervical lymphadenitis (inflammation of the lymph node on one side of the neck); and) foreign bodies in the LOR - organs; K) as well as with other diseases and injuries in which a stationary examination and treatment in a specialized department is required.
# 5. Urgent - with urological pathology Patients with: a) symptoms of hematuria and pyuria; b) urolithiasis complicated by kidney colic; c) tumors and tuberculosis kidney and urinary tract; d) acute urethritis, cystitis, epididiment, prostatitis; e) piilo and glomerulonephritis; e) other inflammatory diseases of the external genital organs and enuresis; g) with closed and open damage to the urinary organs, acute urine retention, Anuria, kidney colic.
# 6. Urgent - C a) acute infectious diseases of the nervous system (meningitis, encephalitis); b) acute violations of cerebral circulation; c) injuries of the head, spinal cord and peripheral nerves; d) paroxysmal disorders of consciousness; e) other acute diseases of the nervous system.
# 7. Patients with a) venereal diseases; b) chronic furunculosis; c) furuncle face and neck; d) atypical forms of pyodermites; e) dishellic epidermofite; e) regrogue; g) tricoephyte; h) microsporia; and) favus complicated with scabies; k) common psoriasis; l) exudative erythema; n) red lupus; o) Other patients who need special methods of surveys and treatment (p. 99 instructions).
# 8. Patients with a) odontogenic inflammatory processes of the maxillofacial region (phlegmons, sharp ostteomyelitis of jaws, abscesses of soft oral cavity); b) fractures of the bones of the facial skeleton; c) extensive odontogenic cysts and benign tumors; d) diseases of the oral mucosa, d) by other diseases that require a stationary survey (paragraph 100).

54. How is hospitalized patients with mental disorders? - in acute cases on the basis of a commission of medical conclusion, and in other cases - with the written consent of the patient (.p. 98 instructions).

Transportation of patients

55. How is the conjunction of the patient with delivery to territorial LPUs? - for this there is a temporary guard; The patient surveillance is carried out by security officers (paragraph 87 instructions). In the way of following the patient must accompany honey. An employee who is provided by the necessary means to exert emergency medical care. When accompanied by an infectious patient, objects of patient care must have, in accordance with the nature of the infectious disease (bucket for collecting and disinfection of the patient's discharge, oil, - with intestinal infections, a gauze respirator in respiratory infections) and disinfection means. A physician accompanying an infectious patient conducts a briefing of temporary guard staff and security regulations for the prevention of possible infection (p. 88). Transportation of an infectious patient in the LPU is carried out by sanitary or other vehicles equipped for transportation (p. 89). Not allowed simultaneous transportation on one vehicle patients with different infections, as well as infectious and somatic patients (p. 90).

56. What actions do the doctor is obliged to carry out patients before transportation to reduce the risks of development of possible complications? -

Type of disease / injury

Actions of the doctor

1) during brain injury

possess a victim convenient position that does not make it difficult to breathe and warning aspiration of the vomit (turn the head on the side), with breathing disorders and cardiac activity to conduct relevant therapeutic measures

2) When damaged the cervical spine and spinal cord

evacuation of victims on a hard shield, careful fixation of the head, with the disorders of the activity of the cardiovascular system and respiration - the introduction of drugs, artificial ventilation of the lungs

3) in case of damage to the breast and lumbar spine and spinal cord

evacuation of victims on a hard shield, carrying out the necessary events in violations of cardiovascular activities, according to the testimony - bladder catheterization

4) when fractures of long tubular bones of limbs, damage to vessels

Immobilization, stopping bleeding, introducing painkillers before transportation and holding other anti-shock events

5) with suspected acute surgical disease of the abdominal organs

immediate evacuation by sanitary transport in LPU in the position lying accompanied by a medical worker. The use of painkillers, the delay of patients in the medical unit in order to clarify the diagnosis in the "acute abdomen" syndrome, closed abdomen injury.

Reception in the hospital

57. What is the procedure for the planned direction to the hospital? - This direction is carried out on a preliminary written request (Section 130 instructions). However, in exceptional cases, emergency testimony of the patient may be hospitalized without a prior written request as appropriate with the leadership of the hospital, but with the obligatory subsequent (within three days) the provision of documents (paragraph 131).

58. What are the features of the provision of honey help upon admission to the patient in need of emergency medical and diagnostic events? - Such events are performed before regulatory actions or simultaneously with them (clause 135 instructions).

59. What are the main tasks of the reception office of the hospital? - a) reception, medical sorting, primary clinical examination, sanitary processing and direction of patients in the appropriate hospital departments; b) the provision of emergency medical care; c) carrying out an outpatient reception of patients of individuals of economic service; d) identification, accounting of defects in the provision of medical care patients at the prehospital stage (paragraph 136).

60. What are the rules of hospitalization of patients to the hospital? - a duty officer, having studied the accompanying documentation, produces a thorough body inspection and study of the mental and somatic state of the patient, assesses the presence of medical testimony to hospitalize him to hospitalize, establishes a preliminary diagnosis of the disease, after which it makes the necessary healing appointments and directs a patient to the appropriate department ( . 138). With the hospitalization of the patient, the history of the disease is filled, where all the necessary history data is entered, including epidemiological, outdoor inspection, objective and additional research methods, its overall state is estimated (p. 139). In the absence of testimony to hospitalization, the doctor refuses to receive a hospital, and each such a case is registered in the "admission journal, extracting patients and failures in hospitalization", with subsequent notice during the day of the establishment of a patient (paragraph 18 of the Instruction). However, in hospitalization cannot be denied patients with signs of infectious diseases, which, before establishing a diagnosis, is necessarily isolated from other patients. Patients with a confirmed diagnosis of particularly dangerous infection are translated into a specialized hospital (p. 141). If the patient with the border mental state refuses hospitalization into a psychiatric department, its inpatient examination and treatment of psychiatric professionals on the basis of neurological or one of the somatic departments with the active involvement of the medical staff of the psychiatric department (p. 142) was allowed.

61. What is the procedure for honey. Workers when entering the hospital who have damage to violent nature or other origin? - The duty doctor reports to the head of the hospital or his deputy, who announces the leadership of ter. UIS organs, leading to the hospital. If these damage is detected, the doctor who has conducted a medical examination, together with the attendant assistant to the head of the hospital (operational duty) and the head of the guard (senior convoy), which delivered the suspect, accused or convicted, is an act.

62. What survey and treatment is carried out by the patient when entering the reception office? - The patient's condition is determined in the receiving department, the amount of diagnostic surveys and a preliminary diagnosis of the disease. This survey includes: a) a clinical examination by a doctor's office or duty officer; b) performing the necessary laboratory, functional, radiological and other studies; c), if necessary, consulting professionals and consultations; e) fulfillment of emergency medical events. When admission, patients are carried out: 1) the determination of body temperature; 2) arterial pressure, pulse frequency, body weight, growth (p. 147). The history of the disease is made by the results of the study of the mental and somatic state of the patient, characteristic of the disease data, preliminary diagnosis, observation data, diagnostic and therapeutic purposes (p. 148 instructions).

63. What diagnostic and laboratory studies should be carried out in the receiving department around the clock? - 1) blood test (study of the hemoglobin level, the erythrocyte sedimentation phenomenon, the amount and composition of leukocytes, the ratio of the volume of blood erythrocytes to the volume of plasma, express, the time of bleeding and blood coagulation, the sugar content, the formation of blood clot in the presence of thromboplastin and calcium salts; 2) General analysis of urine: determining the concentration of urine hydrogen ions (pH of the urine) or acid-alkaline reaction, specific weight (relative density) of urine, glucose levels in the urine, protein, bile pigments in the urine and urine precipitation study; 3) Functional research methods (p. 149). However, the chief physician of the hospital, this aspect of research can expand (paragraph 150).

Hospital UIS.

64. What tasks are entrusted to the WIS hospital? - 1) the provision of qualified and specialized inpatient care, 2) inpatient examination of persons contained in institutions (paragraph 100 of the Instruction); 3) ensuring continuity with the medical units of WIS institutions in the diagnosis, treatment and medical rehabilitation of prisoners; 4) the participation of specialists in carrying out planned preventive inspections of convicts in order to identify persons with early stages of diseases; Selection of patients for planned treatment; control over the implementation of medical institutions of recommendations, data from hospital doctors; 5) study and analysis of the causes of late hospitalization, quality control of the treatment of prisoners in the prehospital stage; Development on this basis information reviews, recommendations and proposals for medical departments (offices) of the territorial bodies of the UIS, medical units of the institutions of the WIS; 6) - conducting the examination of convicts suffering from diseases that prevent further punishment, and submission to the court of necessary materials to solve the issue of their release from serving a sentence of illness; 7) examination of patients with a long or resistant disability sent to medical and social expertise * (hereinafter - ITU), and the preparation of the necessary medical records; 8) organizational and methodological assistance to the medical parts of institutions for the diagnosis, treatment and medical rehabilitation of prisoners; 9) development and implementation of the hospital and medical units of WIS new institutions organizational forms, modern means and methods of diagnosis, treatment of diseases, medical rehabilitation of patients; 10) Raising professional qualifications medical and medium medical personnel hospital and medical units of institutions; 11) carrying out sanitary and anti-epidemic (preventive) activities on the territory of the hospital, hygienic education and training of patients; 13) Ensuring compliance with the rules for the content of prisoners in the hospital, maintaining order and discipline among them, preventing violations of the requirements of the hospital regime (clause 107 of the Instruction).

65. What legal status Hospitals? - Hospitals can be created as independent institutions of the WIS and as part of other WIS institutions (IR, VK, Liu, SIZO). Hospital as an independent institution is legal entity, acts on the basis of the Charter approved by the founder (pp 101-102 instructions). The hospital operating in the institution of the WIS is not a legal entity, it acts on the basis of the provision approved by this institution.
66. What are the authority of the hospital chief? - approval: a) spending rules for patients; b) official instructions medical workers; c) labor regulations for personnel (paragraph 109 instructions).

67. What is the functional structure of the hospital? - 1) receiving office (with diagnostic beds or insulator, sanitary bandwidth); 2) therapeutic branches for the main profiles of beds; 3) the chambers of resuscitation and intensive therapy; 4) therapeutic and diagnostic cabinets; 5) Administrative and economic part (skewers, bath laundry complex, warehouses, etc.); 6) organizational and methodical office; 7) clinical, biochemical, bacteriological and other laboratories; 8) transactory; 9) medical archive; 10) pharmacy; 11) Other divisions determined by the hospital capacity and the specialization of beds (p. 110). Equipment of the branches of the LPU with medical equipment, tools, medicines, economic equipment and equipment are determined by the regulatory documents of the Ministry of Health and Social Development and the Federal Service for Supervision of Consumer Rights Protection and Human Welfare (paragraph 111 of Instructions).

68. Who is subject to hospitalization to the hospital? - Persons: a) in need of emergency, qualified and specialized inpatient care; b) suffering from acute diseases or exacerbations of chronic diseases, the treatment of which under the conditions of the medical unit is not effective enough; c) those who need surrender to address the possibility of further serving the sentence in connection with the presence of a disease that prevents the serving of punishment; d) with a long or resistant disability in need of examination due to the direction of ITU; e) in cases requiring an in-depth clinical examination to establish a final diagnosis; e) on epidemiological indications (p. 113).

69. What are the indications for urgent and planned hospitalization in the hospital? -

Planned hospitalization

Urgent hospitalization

1) diseases requiring a large amount of operational intervention impossible in the conditions of the medical unit;

2) chronic diseases, the treatment of which in the conditions of the medical unit turned out to be ineffective;

3) hospitalization in order to clarify the diagnosis, requiring the use of special equipment or special conditions of research;

4) the provision of specialized assistance requiring special equipment or special methods and skills of the patient.

Planned hospitalization is aimed at preventing the development of acute states by timely identifying pathology requiring a retention.

1) When, when damaged or illness, the provision of urgent assistance in MSHs is not possible in full;

2) damage or diseases representing the immediate threat to the life of the patient and requiring resuscitation or intensive therapy;

3) Damage associated with high infection;

4) Acute surgical infection: in cases requiring a large amount of operational intervention; With a dubious forecast; requiring permanent observation and care for the patient;

5) acute diseases of the bodies of the chest and abdominal cavity, requiring persistent observation of patients or operational intervention;

6) damage and acute diseases of the vessels (thrombosis, phlebitis, embolism, endovasculitis and other diseases of the vessels);

7) hospitalization in order to clarify the diagnosis.

70. What are the rules of separate content in the hospital? - The convicted patients are contained taking into account their mental and somatic state (paragraph 116). Suspects and accused are contained separately from the convicts. Men, women and minors, as well as suspects and accused, passing in one criminal case, patients with various infectious diseases are contained separately (p. 117).

71. How to get acquainted with the schedule of the day of the department? - The schedule should be highlighted in a prominent place in the corridor (p. 118).

72. What is the procedure for providing dates in the hospital? - The time of dating and receiving gear is regulated by the regulations of the hospital's work schedule, approved by the head of the institution. Date can not be temporarily provided: a) during quarantine; b) on other sanitary and epidemic grounds; c) if a patient's visit can lead to a deterioration in his health or pose a threat to his life and health surrounding (including arriving for visiting). The decision of this is taken by the head of the hospital on the written conclusion of the attending physician and the head of the department (paragraph 119 of the instructions).

73. What is the procedure for considering the complaints of patients in the hospital? - Such complaints, both written and oral, are registered and are considered by the administration of the hospital, and complaints of patients for incorrect attitude towards them from the hospital personnel are checked immediately appointed by the head of the hospital by persons. If the content of the letters and statements reflects the painful (psychopathological) experience of the patient, they are registered in a special journal, and their copies are involved in the history of the disease as a clinical material, but the letters themselves are still sent to the addressee (paragraphs 20 instructions). Thus, a statement containing rudeness or rudeness may turn against the applicant itself as proof of his painful state.

74. How is the nutrition of patients? - Taking into account the requirements of dietology. The product laying is made in the presence of a dietistra or responsible person appointed by the head of the hospital. Distribution of food is allowed after removing the sample from the finished dishes by the duty doctor, the results of the sample removal are recorded in the log (clause 121 instructions).

75. What is the duration of sleep patients? - Night - at least 8 hours, afternoon recreation - at least 1 hour (paragraph 122).

76. What is the frequency of the inside of patients and shifting clothes? - Washer produced 1 time per week with change of linen, and underwear weakened patients change as needed (clause 123 instructions).

77. How is the treatment of concomitant diseases? - Simultaneously with the treatment of the underlying disease, but only in the stage of exacerbation or decompensation (clause 124 of the instructions).

78. What is the hospital regime? - This is the creation of favorable conditions for effective treatment, moral and psychological peace, the confidence of patients in the faster and complete recovery (p. 125). Such a mode must be created in each hospital.

79. Who is approved by the medical commission for holding clinical and expert work? - Head of the hospital (p. 128).

80. What are the features of the equipment and the organization of the treatment and diagnostic departments of hospitals? - Depending on the tasks, the hospital may have in its composition the following medical diagnostic departments (LGOs): surgical; therapeutic; anesthesiology and resuscitation; infectious; tuberculous; dermatovenerological; ophthalmologic; neurological; psychiatric (psychoneurological); laboratory diagnostics; functional diagnostics; X-ray; physiotherapeutic; Other medical diagnostic departments. Departments of the surgical and therapeutic profile can be specialized: a) traumatological, urological, cancer, purulent surgery, maxillofacial surgery, neurosurgery, thoracic surgery, phthisiosochurgery, vascular surgery, otolaryngological and other branches; b) cardiological, pulmonary, neurological and other branches (p. 157). The working day in LPO begins with the morning conference, which is attracted by medical personnel to work and outgoing from the change, at which the duty medical sister of the department is heard on the results of the past 24 hours and reflects the main issues: cases of emergency medical care during duty; The number of patients in the department and their condition; changing the state of patients; information about newly received patients; performing medical appointments; Performing patients of the routine of the day and the rules of the behavior of patients; the state of patients who were supervised; Sanitary state of separation and identified disadvantages (p. 159). Each medical and diagnostic department has the following premises: chambers; Cabinet Chosen Department, Ordinator; Cabinet senior medical sister, indoor nurses; One - two procedural cabinet; a handout, equipped with a stove for heating of food, titanium (boiler), washing equipment, and a dining room with a total number of seating places at least 50% of the shedding container; bathroom with souls, sanitary room, belly; Rooms for storing clean and dirty linen, cleaning equipment, Toilets with washbasins; Chambers for one or two beds for severely ill.

81. What are the features of LGO equipment depending on the specialization? - 1) In the therapeutic department - instrumental and drugs for the provision of emergency medical care with essential acute diseases and various pathological conditions: acute cardiac and vascular failure (swelling of lungs, shock, collapse), myocardial infarction and angina, hypertonic crisis, paroxysmal tachycardia, full atrioventricular blockade, pulmonary and gastric bleeding, spontaneous pneumothorax, bronchial asthma, comatose states of various etiology, acute pancreatitis, acute adrenal insufficiency, anaphylactic shock, acute infections and poisoning, terminal states of different etiology (p. 163); 2) in the surgical department - material and technical equipment to assist patients with acute surgical diseases and injuries (clause 164), including tools, dressing material and underwear, not less than two bandacing operations, reserve of canned blood, blood flowing fluids, sterile solutions and appropriate drugs for anesthesia, operations and conservative urgent measures in the department (p. 165); In non-specialized surgical departments, chambers for general mercy, traumatological patients, for patients with purulent diseases and complications (pp. 166) are distinguished.

82. How are heavier sick surgical profile place? - Such patients, as well as persons whose condition adversely affects the surrounding (abundant purulent, intestinal and urinary fistulas and other similar states) are placed separately in single and double chambers (p. 167).

83. What is the procedure for holding operations in the hospital? - Planned operations are carried out with the permission of the head of the department, and complex - with a mandatory commission discussion. In the morning on the day of operation, the patient examines the operating surgeon and anesthesiologist. Operations, with the exception of small interventions (the opening of Panaritia, the processing of superficial wounds) is carried out with the participation of a doctor-assistant. In the absence of a second surgeon, doctors are attracted to the assistance of other specialties, and if this is the impossibility of this, the absence of a assistant's doctor is justified in a preoperative epicriding (p. 169). The sequence and sequence of operations are set, starting with the most stringent rules of asepsis (on the thyroid gland, about the hernia and other "clean" operations), then the operations are followed during which it is possible to pollute the operating room (on the gastrointestinal tract, about various fistulas , purulent processes and other similar states). At the same time, major planned operations are appointed at the beginning of the week, and related to the infection of the operating room - at the end of the week before the general cleaning of the operating room (paragraph 171).

84. What is the procedure for providing the sanitary condition of operational? - Operational and dressings are at least two times a day are subjected to wet cleaning and irradiation with quartz lamps, and once a week - general cleaning with washing ceilings, walls and cabinets. Bacteriological control over the quality of cleaning, the condition of the microbial semination of air (before, during and after the end of the operation) and the objects of the external environment, for the sterility of dressing and suture, tools and other items is carried out at least once a month, and for sterility of surgeons and surgeons and The skin of the operating field is selectively once a week (paragraph 172).

85. How should intensive therapy chambers (PIT) have to work? - They are installed in them a 24-hour sister post, provided at the expense of the staffing personnel of the anesthesiology and resuscitation or relevant therapeutic and diagnostic separation. If possible, the chamber for intensive therapy is provided by a permanent medical post. If it is impossible for this during working hours, medical controls and treatment provide specialists from the branch of anesthesiology and resuscitation, and at no time - the hospital duty officer (paragraph 173). The head of the branch of anesthesiology and resuscitation together with leading experts or heads of therapeutic departments daily at the set time conducts bypassing patients with Pete. The decision to transfer the patient to the profile department (from the Chamber to the Department) adopts the head of the branch of anesthesiology and intensive care or anesthesiologist (paragraph 174).

86. How is the radiographic study of the patient organized? - To work with X-ray equipment, persons having special education - radiologists, x-ray, radiosparants (pp. 175) are allowed. The results of the survey of the patient, as well as the total dose of irradiation, the radiologist recorded in the history of the disease (paragraph 176). In urgent cases, radiological studies are carried out in accordance with the instructions of the doctor who provides medical care, regardless of the deadlines and the results of the preceding radiological studies. If the patient is in serious condition or a special x-ray study with intravascular administration of contrasting substances (intravenous urography, chopper and other complex research methods) The presence of the attending physician during the study is required (p. 177).

87. What are the rules for the appointment of physiotherapy? - Physiotherapy is appointed by the attending physician individually, taking into account the general condition of the patient, and in the history of the disease, the name of the procedures, the scope, dosage, frequency and number of procedures are indicated. In the absence of a full-time physiotherapist, his duties are fulfilled by a doctor who has passed special training. Procedural cards are stored in the physiotherapeutic department (office) and after the end of treatment are invested in the history of the disease (paragraph 190).

88. What is the procedure for placing patients in the hospital and their primary inspection? - They are placed in departments and chambers, taking into account their condition and installed in the receiving diagnosis (paragraph 181), no later than the first day of their stay in the department examined by the attending physician, and when entering the evening and night hours, weekends or holidays - on duty doctor. If the character or clinical picture of the disease is difficult to diagnose, treat or examine patients, highly qualified specialists from territorial LPUs can be involved in the hospital or by prior arrangement and with the condition for ensuring their protection, patients can be sent to specialized LPU state and municipal health systems (p. 182 ). The patient who received the medical and diagnostic department is inspected by the attending physician who finds out complaints, history of disease and life, conducts a thorough and consistent examination of the patient, organizes the fulfillment of the necessary research, establishes a preliminary diagnosis of the disease, is a plan for further surveys and appoints the necessary medical measures ( .185).

89. What frequency is the analyzes of the patient who fell into the hospital? - Clinical analysis of blood and general urine analysis - no later than the first two days after admission to the hospital, fluorographic (x-ray) study of the chest organs - in the first three days (fluorography has not been produced over the month) in the absence of contraindications for its implementation. Repeated blood tests and urine, as well as other studies are performed according to indications (p. 186).

90. For time, the clinical diagnosis is established when entering the hospital? - no later than 3 days from the date of receipt of the hospital, except in cases, complex in diagnostic relations, in this case, in the history of the disease, the reason for the diagnosis delay is indicated and additional research and advice are scheduled (p. 188).

91. How is the inspection of the patient in the hospital? - The attending physician - daily, and the branch of the department - on the day of receipt, and then - at least 1 time per week. In serious and extremely serious condition, they are examined daily, everyone else is at least once a week. The inspection results are recorded by the attending physician in the history of the disease daily on patients who are in serious and medium severity, with acute diseases, with a unclear diagnosis, with the development of a negative dynamics of the course of the disease, and on the rest - at the discretion of the attending physician, but at least 2 times in week. Data on the conduct of complex diagnostic and medical measures (operation, puncture, blood transfusion and other invasive interventions) are written in detail into the history of the disease, and their conduct is substantiated by the appropriate epicride (p. 189).

92. What is the order of filling honey card in the hospital? - in the wording of the final clinical diagnosis, the doctor reflects etiology, pathogenesis of the disease, clinical and morphological changes, the nature and degree of functional disorders, the stage of the disease, its complications, as well as related diseases. Changes in the mental and somatic state of the patient, new appointments and research are immediately reflected in the history of the disease. All records of the attending physician are bonded by his personal signature, when conducting bypass by the head of the department or consultation by medical professionals - their signatures; Joint inspections conducted by conceptuals - with signatures of all participants (paragraph 191).

93. What patients should be sent to examine at the Bureau of Medico-Social Expertise? - with a long or resistant disability after a comprehensive examination in a hospital (p. 192).

94. What is the procedure for the detection of sentences from convicts that prevent sentences? - Such convicts after a comprehensive examination in conditions of the hospital with attracting specialists of the state and municipal health systems in the necessary cases, they are examined by the Special Commission of WIS (p. 193). If the condemnation condemned due to diseases, mental state and physical disadvantages to the chosen place of residence can not independently follow, the accompanied, inclied, is released, inclined. If necessary and honey. Worker (p. 194).

95. What is the procedure for the liberation of psychiatric patients discharged under the observation of the PND? - They are transferred to relatives directly in the hospital. In the absence of relatives or the impossibility of their arrival for the patient, it is accompanied to the place of residence or treatment of honey hospital employees (p. 196).

96. Can be sent to colonies - settlements of convicts that have not passed mandatory or special treatment? - No, can not (p. 197).

97. How is the release of the convicted person who is in the hospital and needs to continue treatment? - Such a patient is sent with the discharge from the history of the disease to the medical institution in the chosen place of residence or, by agreement, in the nearest LPU state and municipal health systems (paragraph 201). If the immediate sending of the patient is dangerous for his life, then with his consent on honey. The conclusion, he may be temporarily left in a separate hospital ward, which is reported to the prosecutors and relatives.

98. On what basis and how is the extract of prisoners who are on examination, treatment or examination in the hospital? - Only due to recovery or persistent improvement in the state or by their personal application in the event that the patient's condition allows its discharge (p. 203). Systematically or maliciously disturbing hospital regimen or refusal to treatment can be discharged from the hospital at the place of serving the sentence only in the case when their mental and somatic state does not represent immediate danger for themselves or others, does not necessarify helplessness, i.e. Inability to independently satisfy the basic vital needs either the disease is not heavy and cannot lead to a significant deterioration in health after discharge from the hospital. The patient's extract is made by the attending physician with the permission of the head of the hospital or its damage (paragraph 204). The history of the illness of the patient written contains epicris, including formal data, a summary of the history, development and course of the disease, data of special research, diagnosis conducted by treatment and recommended after discharge of medical rehabilitation activities. A copy of epicrosis is made to a medical card of an outpatient patient and, together with a personal case, heads in the SIZO or IU, and when released, it is sent to the LPU at the place of translation or residence of the patient or issued to him (paragraph 205).

99. How are the causes of death of dead patients? - For this, hospital clinical and anatomical conferences are held (paragraph 208), the decision to hold a medical commission, making a conclusion that the chairman of the Commission reports the head of the hospital, at which the attending physician characterizes in detail the features of the development and course of the disease with the rationale for diagnostic and medical events. Main Freelance Specialists produce a comprehensive clinical analysis of the medical and preventive measures and evaluating their timeliness and effectiveness, noted defects of therapeutic and diagnostic measures and their causes, the pathologist reports on the basic changes detected in the opening and histological examination of the body of the corpse, the conclusion of pathogenesis The changes found and the cause of death, compares clinical and pathological analytical diagnosis. Information on cases of late diagnosis of diseases, discrepancies in clinical and pathological diagnoses, the incommodation and inadequacy of the medical measures carried out necessarily communicate to Honey. Hospital workers and honey. Pieces of SIZO and IU.

100. How should the hospital be ready to provide emergency medical care? - in the departments and cabinets of the hospital should be a) instructions and guidelines for emergency care; b) the cabinet with everything necessary to provide emergency care; c) all the necessary medicines, solutions, serums, anti-shock and impaired liquids, surgical instruments, dressings, oxygen and other equipment needed to provide emergency care (p. 211). To provide emergency medical care outside the medical case in the receiving office (as a medical sister), a special kit for emergency medical care is stored - medical laying (p. 212). To provide emergency medical care: a) in the receiving office in the procedural office - the cabinet of emergency medical care, respiratory, oxygen equipment and other equipment, card file and instructions for the provision of emergency medical care during acute diseases, injuries and poisoning, as well as medical stacking and stretcher to provide emergency medical care outside the therapeutic corps; b) in the surgical department (operating unit) - operational, prepared for the production of emergency surgical operations; c) in all therapeutic and diagnostic departments - emergency medical care closet, equipped with a branch profile (p. 213).

102. How should the hospital department should be equipped? - The sister's honey duty should be: telephone, alarm alarm button, a table lamp, a list of patients with chambers indicating the mode, diet, sheets of appointments, instructions for preparing patients to various studies, tables of higher-time and daily doses of drugs of drugs. The department must have emergency lighting - rechargeable lights, candles (p.215). The procedural office of the department is equipped with cabinets for medicines and tools, a safehouse for storing medicinal narcotic drugs, psychotropic, potent and poisonous substances equipped with alarm, couch, procedural table, sterilizer table, refrigerator, chairs, washbasin, as well as an emergency medical care closet, equipped with medical property, taking into account the branch profile, methodical instructions for the provision of emergency medical care. Medications for the current use are placed in the closet separately by groups: "internal", "outdoor", "injectable". The supply of poisonous and narcotic drugs in the hospital department should not exceed three days, and at the post office of the medical sister - one-day need, on weekends and holidays - the needs corresponding to the established number of weekends and holiday days under storage conditions that exclude the access of patients (p. 217).

Departure of doctors - specialists in the institution UIS

103. How are the treasures of medical professionals in the institutions that hospital serves?- according to the plan of the hospital or at the direction of the senior medical supervisor; The plan is agreed with the head of the Medical Department (separation) of the OSI body and communicates to all chiefs of medical parts (p. 154). Thus, every honey worker and the patient can learn about the arrival at the institution of a doctor - a specialist in advance.

104. What are the obligations of honey of workers during the departure? - a) provide organizational and methodological and advisory-diagnostic assistance to medical workers of MSH on the issues of diagnosis, treatment and medical rehabilitation; b) carry out indicative and advisory techniques, carry out dismisses with physicians of defects in the provision of medical care; c) carry out the selection of patients for the planned hospitalization in the hospital; d) check the state of the health of persons issued from the hospital and conducting it recommended treatment; e) teach medical practitioners to new methods for diagnosing and treating patients; e) report to the head of the hospital about the work done in medical units and on proposals to improve therapeutic and prophylactic support (p. 156).

Medicine in educational colony

105. What are the features of therapeutic and preventive work in educational colonies? - In the primary inspection, persons who need treatment and psycho-phylaxis are identified at a psychiatrist or psychological assistance (paragraph 220). 2 times a year, in-depth medical examinations with anthropometric measurements and laboratory studies are carried out by all convicts in the VC. 1 time in 6 months. Persons under the age of 15 years pass a tube diagnosis. Based on the health status indicators (the ratio of growth and body weight, the main indicators of the activity of cardiovascular, respiratory, nervous systems, the state of the musculoskeletal system, organs of vision, hearing, and other indicators), as well as physical fitness of convicts distribute to physical training on Groups: basic, preparatory, special and disabled. As the health status improves, they are translated from one group to another. The main group includes persons without deviations in a state of health, as well as with minor morphofunctional deviations, well-developed physically. They fulfill obligatory types of physical training in accordance with the curriculum, give control standards and participate in physical education and recreational activities, can additionally visit the sports sections. The preparatory group includes persons who have minor deviations in a state of health, not physically trained, classes under physical training are conducted under the control of medical workers. They take part in physical well-being events, can attend sports sections of general physical training. The special group includes disabled children and persons who have significant deviations in the health state of a permanent or temporary nature, admitted to study and work activities, physical training classes with which special Program Taking into account the nature and severity of the disease and are therapeutic orientation. For them, walks, mobile games, sports entertainment, subject to the control rules, are additionally organized. Individual exercise classes are held on the recommendation of the doctor (paragraph 221). Teenagers are sent to the recreation group: a) physically weakened, having weight below; b) suffering various severe diseases, injuries, surgical operations; c) Having deviations in the health state of a persistent nature, assigned to a special group of accounting and subject to constant dispensary observation. Enrollment in the recreation group is made by the head of the Honey part. The period of stay in the health group is determined by the doctor and as a rule should not exceed 30 days, but if there are medical indications, it can be extended (paragraph 222). In honey. Parts of the VC are treated with an approximate stay in the hospital of the medical part of the VC for 2 weeks, and those who require a longer period of inpatient treatment are subject to direction in the Hospital of the WIS or the nearest LPU (p. 224).

Rendering honey help women

106. What are the features of medical care for women? - Specific MSH tasks for medical support for women are: a) carrying out preventive measures aimed at preventing gynecological diseases, complications of pregnancy, childbirth and postpartum period; b) carrying out complex preventive inspections of women; c) the provision of qualified obstetric and gynecological assistance (in the medical unit of the SIZO - advisory); d) dispensary observation of gynecological patients, pregnant and maternity hospitals; e) psychoprophylactic preparation of pregnant women to childbirth; (e) Organization of the work of the "School of Mother"; g) Sanitary and educational work (including the prevention of abortion) (p. 225). The objectiveness of pregnant women in the SIZO turns out to be in the maternity branches in female IE, and in their territorial absence or impossibility of timely transportation, in the maternity homes of institutions of state and municipal health systems (p. 226). The objectiveness of pregnant groups "Risk" is carried out in the country's country houses (p. 227). With a primary examination of pregnant women, it is necessary to get acquainted with the general and special history, turning attention to family history, transferred in childhood and in the mature age of the disease (general and gynecological), operations, features of menstrual, sexual and reproductive functions, the course and outcome of previous pregnancies and childbirth; b). make a general inspection and special obstetric examination, including ultrasound; c) to produce laboratory studies: a general blood test (later - under a period of 18 and 30 weeks of pregnancy), general analysis of urine (with every visit), blood test for the Vasserman reaction (when visited, in 30 weeks of pregnancy and 2-3 Weeks to childbirth), the carrier of the hepatitis B and C virus (at the first visit and in the third trimester of pregnancy), the definition of the group and the Rh - the blood accessories, the immunological examination of the blood for HIV infection (at the first visit and in 30 weeks of pregnancy), microscopic examination separated vagina (at the first visit and in 30 weeks of pregnancy).

107. What is the frequency of examination of pregnant women? - 7 days after the first inspection (with the results of analyzes); In the first half of pregnancy - 1 time per month, - after 20 weeks of pregnancy - 2 times a month, after 30 weeks - 3 - 4 times a month. All survey and surveys, also recommendations and appointments are entered into an individual map of pregnant and herds. Maps of pregnant women are stored in the Acoucher-Gynecologist's office (p. 228.

108. What work is carried out with pregnant women? - a) sanitary and educational work on compliance with the rules of personal hygiene, labor and recreation regime; b) physical training group method on a special set of exercises; c) from 14-16 weeks of pregnancy - training at the "School of Mothers", psychoprophylactic preparation for childbirth.

109. What groups of pregnant women are subject to hospitalization and examination is subject to a survey? - at: 1) pathological course of pregnancy (early toxicosis, swelling, proteinuria, hypertensive disorders, preeclampsia; threatening miscarriage; bleeding from generic pathways; rhesus conflict pregnancy; inconsistency or suspicion of the inconsistency of the sizes of the pelvis and the fetus head; transferred pregnancy; improper position and the prevention of the fetus; insufficient or excessive growth of the fetus, hypoxia of the fetus, the antenatal death of the fetus; bubble drift and other states); 2) the kraneghenital diseases (heart defects, pyelonephritis, glomerulonephritis, hypertensive disease, hyperthyroidism, diabetes, anemia, leukemia, cystitis and other diseases); 3) The pregnancy risk factors: primible in 30 years old and older, many-member, women who gave birth to children with defects; 4) not to wear in anamnesis, multiple pregnancy, butorous preservation of the fetus, if there is a scar on the uterus, Moma of the uterus; 5) it is impossible to clarify the diagnosis of the disease in the ambulatory environment (p. 231).

110. What frequency is the inspections of women after childbirth? - the first time for 2-3 days after discharge; The second is 7 days after discharge; Final - 6-8 weeks after childbirth; After the operational delivery - under clinical indications (p. 232). At the first inspection, an outdoor inspection is performed, control blood pressure. The data of the obstetric hospital about the flow and outcome of childbirth are studied, complaints, nature and features of lactation, the condition of the mammary glands. Vaginal research is made according to the testimony. A conversation is held on the observance of the rules of personal hygiene, labor and recreation, nutrition, nutrition, about making milk glands. Advisory examinations of specialists and laboratory studies are appointed by testimony (p. 233). For the state of health of the parental, the doctor obstetrician-gynecologist is observed, and for the development of a newborn - a pediatrician. If, by the time of the end of the postpartum vacation, the Pedolina has no pathological changes in the genital organs of a woman within 8 weeks it is removed from

111. How is the identification of gynecological diseases? - Prevention of gynecological diseases and organization of timely diagnosis, treatment and dispensary observation of gynecological patients - the tasks of the medical unit of the institution of the WIS (p. 235). The identification of such diseases is carried out during the annual preventive inspections and when converting women to the doctor Akuster-Gynecologist. An inspection by the doctor an obstetrician-gynecologist is not less than 1 time per year, all women are in IU, and in the SIZO - at least 2 times a year. When identifying diseases (or suspicion of their presence), the doctor conducts: a) collecting common and special anamnesis, paying attention to heredity, transferred diseases and operations, features of the menstrual function, sexual life, course and outcome of pregnancies, the development of the present disease; b) general and gynecological examination of patients; c) inspection of the mammary glands; d) taking smears for bacteriological and cytological studies (p. 236). Are subject to dispensary gynecological patients: a) with chronic inflammatory diseases of genitals; b) with endometriosis; c) with malignant neoplasms; d) with benign tumors: tumor formations of external genital organs, with the presence of uterine misa; e) with the omitting and falling out of the walls of the vagina and the uterus; e) with before and after surgical treatment; g) with impaired menstrual function and pathological climax and other diseases (p. 237). If the planned treatment of gynecological diseases in the hospital of the medical unit, then the patient is directed to inpatient treatment to the Hospital of the WIS or in the State (Municipal) LPU.

112. How is the artificial interruption of pregnancy? - Before the direction for such an interrupt, a woman is produced: a) blood test for the Vasserman reaction; b) definition of a blood group and a ray factor; c) immunological examination of blood for HIV infection, viral hepatitis B and C; d) bacteriological examination of smears from the vagina, cervical canal and urethra (p. 240). Contraindications for artificial interruption of pregnancy are: a) sharp and under acute inflammatory processes of female genital organs, incl. sexually transmitted infections; b) acute infectious diseases; c) acute inflammatory processes of any localization (p. 241).

113. How is the work of the child's house (DR) of the institution of the WIS? "The child's houses are organized with women's IR to keep children of convicted women from birth to three years (p. 243). DrO head heads the chief of the child's house, which carries out the leadership of medical, educational and administrative and economic activities (p. 245). DR provides: a) raising children and care for them; b) the organization and conduct of preventive, medical and diagnostic and rehabilitation - wellness events; c) a comprehensive assessment of the health of the children and the effectiveness of the preventive, medical and diagnostic and rehabilitation and rehabilitation activities carried out; d) monitoring the state of health, the physical and mental development of children; e) compliance with the sanitary and hygienic regime; e) compliance with the regime of the day; g) the organization of rational nutrition and physical education, optimization of the motor regime; h) conducting sanitary and educational work with mothers and staff at home of the child; and) mastering and introducing new methods of complex rehabilitation of children; k) improving the qualifications of all categories of the child's home (p. 246). The child's houses are isolated from the residential zone of the institution (p. 247). For the passage of quarantine, a special room is organized, the number of beds in which is at least 10% of the regular number of places in the other, which has a receptacle with 2-3 semi-focus, children's maintenance rooms together with mothers, bathroom, toilet with drain, veranda and a separate platform For children's walks. Children of different ages are in the quarantine premises, the day of the day is built for each child separately, and educational work - in accordance with age and the health of the child. In the structure of DR are envisaged: a) quarantine room, b) insulator, c) group room (group): Game room, bedroom, sanitary room; d) procedural account; d) vaccination office; e) Cabins for physiotherapeutic treatment; g) Cabinet for conducting thermal procedures; h) Hall for the treatment of therapeutic physical culture (p. 248). The data of the inspection and psychophysical development of children are recorded in the "Child Medical Card, raising in the child's house" (paragraph 250). In the quarantine group hold on 21 days (paragraph 253). Sanitary and hygienic education and training, both mothers and personnel, in the form of sanitation and hygiene bulletins, seasonal prevention of diseases, "School of Mothers", lectures and conversations for medical topics (paragraph 258). When freeing women with children, a certificate of the child's birth and an extract from the history of the child's development is issued on receipt, containing information on the state of the child's health, preventive vaccinations and suffering diseases. If, when freeing a woman, a child is ill and needs hospitalization, then, with the consent of the mother, it is placed with it in the nearest children's state or municipal LPU (paragraph 259).
If the child contained in the house of the child of the correctional institution turned three years old, and the mother before the expiration of the sentence was left no more than a year, the administration of a correctional institution can extend the time of the child's stay in the child's house until the end of the sentence of the mother's sentence (h. 3 of Art. 100 PEC RF).

Patients with mental disorders

114. What are the peculiarities of providing medical care for patients with mental disorders?- If the patient represents the immediate danger to himself or others, or in the case of its helplessness, assistance to the patient is a psychiatrist of the institution at the location of the patient before transfer to a specialized psychiatric institution. Depending on the state of patients, differentiated types of observation are established for them, eliminating the possibility of attempts to suicide, autoagression, attack, run, appropriate examination and treatment (p. 261). To identify persons with mental disorders: before carrying out medical examination, the doctor will necessarily meet the materials of a personal case and medical records for the identification of persons who have had mental disorders who were sent to (held) forensic psychiatric examination; If necessary, from the LPU, which was observed (treated) about the mental illness, the prisoners are requested, discharge from medical records of an outpatient patient and (or) of a stationary patient and a copy of acts of forensic psychiatric examinations from institutions where this expertise was conducted. The determination of the presence or absence of a mental disorder of the surveyed is a psychiatrist. The conclusion about the presence of a mental disorder can only be supposed. Persons unstable in mental attitude, often appeal with neurotic complaints or with behavioral deviations (emotionally excitable, often performing externally unmotivated acts, violating the regime of detention, conflict, etc.), as well as previously treated on mental disorders, recognized by forensic psychiatric examination be charged, But having mental disorders, they are examined by a psychiatrist while complying with the principle of voluntariness. However, if, due to the severity of his mental state, the person represents the immediate danger to himself or others, is helpless either the mental disorder that has a psychiatric assistance is unrelated to him capable of causing significant harm to his health, examination can be conducted without its consent or consent legal Representative (p. 262).

115. How is psychiatric assistance to persons whom the forensic psychiatric examination (hereinafter referred to) recognized insane? - After making such a conclusion of SPE to a court decision on the recognition of a suspect or accused, therapeutic measures are carried out in the hospital of the medical unit of the SIZO with the obligatory insulation of the patient from the rest of the prisoners (p. 264). After making a court decision on non-meaningful patient prior to translation into a psychiatric hospital with a specialized type with intensive supervision, therapeutic measures are also carried out in the hospital of the medical unit of the SIZO with mandatory insulation from the rest of the prisoners.

116. How is the inspection of patients who are in the hospital of the medical part of the institution due to the presence of mental disorder? - They are examined by a psychiatrist psychiatrist (and if it is not the absence, the head of medical care or a doctor on the recommendation of the doctor's psychiatrist) at least 2 times a week. The results of the inspection are entered into a medical card of the stationary patient, and when the patient is discharged from the hospital, detailed epicrises are compiled, which is transferred to a medical card of an outpatient patient (p. 266). Persons with mental disorders requiring inpatient treatment, assistance turns out to be in conditions of honey. Parts of the institution, and in severe and long-continuous cases - in interregional psychiatric hospitals and psychiatric departments of general general hospitals of WIS (p. 267). Psychiatric examination is carried out by a medical commission consisting of the doctors of WIS institutions as part of at least 2 psychiatrous doctors. According to the results, the act of psychiatric examination of the convicted person (p. 269) is drawn up. In the event of a court decision on the application of compulsory medical measures, the patient is stapped into a specialized type psychiatric hospital with intensive observation.

Patients with alcoholism and drug addiction

117. What is the procedure for the treatment of convicts, which are assigned mandatory treatment from alcoholism and drug addiction? - Such treatment is carried out by a physician psychiatrist or a psychiatrist doctor who has appropriate training on narcology. The basis for the appointment of compulsory treatment is the commissions made by the Commission of Doctors Specialists (paragraph 272). Translation of convicts that have not completed the course of mandatory treatment of drug addiction, from a specialized medical correctional institution to another can be carried out only in case of extreme necessity (clause 273). When detected from the convicted chronic alcoholism or addiction, in cases requiring treatment, it is proposed to undergo a course of treatment from alcoholism and drug addiction in a voluntary basis. Such treatment is carried out at the place of exposure to the sentence in the establishment of narcologist doctors, and in their absence - in institutions that have the necessary base (clause 274). If you refuse a voluntary treatment with a medical commission, consisting of the head of the medical unit, two doctors of psychiatrists-narcologists or psychiatrists, a conclusion is made on the basis of which compulsory treatment is applied (clause 275). The decision on its termination is also adopted by the commission (clause 276). The exempted course of the treatment of which is not completed, further treatment from alcoholism and drug addiction is carried out in the LPU state (municipal) health care systems at the place of residence with their corresponding notice (clause 277). Information on the release of persons who passed compulsory treatment from alcoholism, addiction, Peppermaster 1 month before liberation sends to a narcological dispensary in the chosen place of residence of the exempted discharge from honey. Cards of an outpatient patient about the treatment carried out and its results (paragraph 278).

Patients with venereal diseases and contagious skin diseases

118. What is the procedure for identifying venereal or infectious skin diseases? - Each coming in the SIZO is carefully examined in order to identify signs of such diseases. Special attention is paid to the state of the skin of the scalp, the mucous membranes of the oral cavity, genitals, anal area. Shayane, submandibular, over- and connectible, axillary and inguinal lymph nodes are palpable. In suspected of a syphilis or gonoronium disease, the patient is necessarily examined by a dermatovenerologist (paragraph 279). Compulsory serological surveys on syphilis are exposed to all in the SIZO, with a control serological study after 3 months (p. 280). Clinical and laboratory survey on gonoron are subject to persons attracted to criminal responsibility under art. 121, 122, 131, 132, 134, 135 of the Criminal Code of the Russian Federation and all women, including minors (paragraph 281). In order to prevent congenital syphilis in detention facilities and IU, all pregnant women are required to be a mandatory three-time serological examination (p. 282). If, when studying anamnesis, it turns out that the examined prior to criminal responsibility has been treated on the ventenance or consisted of (serological monitoring) in the KVD, Peppermaster SIZO in a 3-day term makes a request to the KWD about the diagnosis conducted and the treatment and timing of serological monitoring. Further treatment or serological control is carried out in accordance with the responses received. With the positive results of the survey, the hidden syphilis is treated (p. 283). When identifying a venereal disease, medical care institutions sends a notice in accordance with the established form in the KVD at the place of residence of the patient to arrest (p. 285).

119. What is the procedure for the treatment of venereal diseases? - If the patient with syphilis in health facilities treatment was not completed, then the treatment of this patient is re-conducted (paragraph 286). After the end of the full-fledged specific therapy, by any method of patients with syphilis and persons who received preventive treatment are on clinical and serological control (p. 287). Preventive treatment is carried out in order to prevent syphilis to persons who are in close domestic and sexual contact with patients with early syphilis forms (p. 288). Preventive treatment is carried out by pregnant, ill or painful syphilis, and children born such women according to indications (paragraph 289). Adults and children who have received preventive treatment after sexual or close domestic contact with patients with early syphilis forms are subject to one-time clinical and serological survey 3 months after treatment, and when overflowing blood from a patient with syphilis, the control continues for 6 months. Children born without signs of congenital syphilis from mothers, patients with syphilis, are subject to clinical and serological control for 1 year (p. 290). Patients with neurosophilis, regardless of the development stage of the disease, should be supervised over 3 years with the control of treatment results using serum serum studies, as well as a mandatory liquorological examination in dynamics 1 times every 6 months before the fulfillment of the liquor (p. 291). Persons with serororentity are on clinical and serological control for 3 years (p. 292). Convicted serological surveys on syphilis are subject to convicts that have long-term dates and short-term leave, with control vasemanization after 3 months (p. 293). When identifying patients with infectious forms of syphilis, their immediate isolation is carried out. Obligatory hospitalization after diagnosis is subject to patients with a contagious form (primary, secondary syphilis) and patients with early hidden syphilis (first established) for preventive treatment (p. 294). The hospitalization of patients with sexually transmitted infections is carried out in the skin-venereological or infectious branches of the UIS hospitals into individual chambers, and if such a direction is impossible, honey part (p. 295). To identify gonorrhea and concomitant urogenital infections, the taking of clinical material for laboratory research is carried out from all foci of possible lesion (from urethra, vagina, cervical and rectakes; rotogling - according to indications), and special attention is paid to women with chronic inflammatory diseases of the genitourinary system . Laboratory verification of the diagnosis of gonorrhea is based on the results of microscopic and (or) culture studies. In persons held to criminal responsibility for violent actions of a sexual nature (Article 132 of the Criminal Code of the Russian Federation), an additional study of the material from the rectum is carried out. With the negative results of the survey on gonorrhea and the availability of anamnestic data (sexual contact with sickness of gonorads up to 60 days), preventive treatment is carried out (p. 297). After establishing the diagnosis of a venereal disease with patients, a conversation is carried out on the nature of the disease, the rules of behavior, the timing of treatment and control observation, the current legislation on venereal diseases. In accordance with Art. 121 of the Criminal Code of the Russian Federation Infection of another person by sexually illness by a person who knew about the presence of this disease, provides for responsibility in the form of a fine up to 200 thousand rubles or correctional work from 1 to 2 years, and the same infection of 2 or more persons - up to 2 years of imprisonment . At the same time, the prevention blank form is filled with a sick venereal disease, which is set to signatures of a patient and a doctor, after which the warning is attached to the medical card of an outpatient patient or a hospital patient's medical card (p. 298). After establishing the diagnosis of a venereal disease, medical institutions are sent to the center of state-poidnadzor of the OSA Emergency notice of the disease to the center of state-poidnadzor (paragraph 297). It is forbidden to send to other institutions of individuals with infectious forms of syphilis and gonorrhea (before they conduct a course of anti-silica or antigenial treatment), as well as with infectious forms of skin diseases (clause 301). After arriving in IU, patients undergoing the treatment of a venereal disease are put on dispensary accounting for further treatment and serological control (clause 302).

120. What are the peculiarities of solving the issue of conditionally - early liberation of the convicted person who has not passed the full course of compulsory treatment of a venereal disease? - Information about the treatment and prospects of recovery is sent to the court (paragraph 303). Such convicts before the end of the course of treatment are not provided and departures beyond correctional institutions (p. 304).

121. How is obliged to do honey part when identifying the fact of infected with a sentence of a venereal disease, which could happen during a long date? - The commission of the intended source of infection (paragraph 305) is sent to the survey on these diseases.

122. What are the features of the liberation of patients not filmed from the dispensary accounting, which end the term of serving the sentence? - Honey part of IU a month before liberation informs the QW in the chosen place of residence exemption with the indication of the diagnosis of the disease, the nature of the treatment, the serocontrol period (clause 306).

123. What is the procedure for the emergence of a group venereal disease in the institution? - Isolation of the fallen and their sexual partners is insulated. All those contained in the institution are targeted prophylactic inspection with mandatory conduct serological reactions. At the conclusion of the doctor's dermatovenenerologist, the target inspection is repeated after 3 months, and bodily inspections are carried out weekly within 2 months after the registration of the group disease (clause 307).

124. What is the procedure for prevention in the occurrence of minecraft skin diseases? - In this case, along with treatment, a complex of preventive measures is carried out - compliance with the hygienic regime, the improvement of production and living conditions, the exclusion of factors contributing to the development of a mineralized skin infection, constant skin care, especially after the end of work in production, use during the sanitary treatment of individual , Application in case of damage to the skin of medicines from a first-aid kit, which is stored at the manufacture of the masters, the use of individual means of protecting skin cover, protect them from pollution and irritation of mittens, protective ointments, pastes, creams (clause 308).

125. How is the prevention of copies of the stop? - Such prevention is a complex, providing for the impact on all units of the epidemiological chain, including: compliance with sanitary and hygienic standards and rules, hygienic education, timely detection, dispensary observation and treatment of patients with Mikosami. In places of undergoing sanitary treatment, in baths, shower, wooden lattices are replaced with rubber or plastic mats as more hygienic and easily disinfectable, contained in the institution are provided by disinfected by washcloths, bath shoes with mandatory subsequent disinfection. For washing feet, special labeled basins are highlighted. It is unacceptable to use an impersonal shoe. Persons suffering from foot sweating should daily wash the legs with cool water with soap, briefly cut the nails, often wash socks, (spheres); They should not wear rubber shoes and socks from synthetic materials (p. 309).

126. How is the prevention of scabies? - Sick scabies immediately is isolated in hospital honey. Parts, the chamber disinfection of the patient, linen and bedding is carried out. In the absence of a camera, the outerwear is thoroughly ventilated, and the linen - strokes the hot iron. On the day of the identification of the patient with scabies, a thorough medical examination of contact persons is carried out with subsequent sanitation (p. 210).

Sick HIV infection

127. What is the procedure for identifying and examining HIV - infected? - All identified HIV-infected persons are taken to the dispensary accounting for: a) identifying and treating existing in patients or newly emerging diseases that contribute to more rapid progression of HIV infection; b) the most early detection of signs of progression of HIV infection; c) timely appointment of specific therapy; d) the provision of all types of qualified medical care, while compliance with medical mystery (p. 312). Repeated surveys are carried out with the deterioration of the patient's condition and in a planned manner, depending on the stage of the disease. The purpose of the scheduled survey is the timely detection of the threat of disease progression. Repeated scheduled surveys are carried out on the following dates:

If a CD was first revealed when exacerbated in HIV-infected secondary diseases or the development of the terminal stage, such patients are found separately from other HIV-infected. During the remission of secondary diseases, HIV-infected convicts may be allowed walking and labor activity Given the presence of medical contraindications.
128. What indications is the hospitalization of a patient with HIV infection? - Such hospitalization can be carried out in the following testimony:
- Clinical: The emergence of signs of progression of HIV infection, manifested in the form of secondary diseases requiring inpatient treatment, or the need for planned studies that cannot be implemented in outpatient conditions;
- epidemiological: the presence of patients with bleeding or threats to the development of hemopying, secondary diseases that may be dangerous to others (open forms of tuberculosis);
- socio-psychological, which are determined with the participation of a medical specialist (psychiatrist) (p. 314).

Patients with tuberculosis

129. On what principles is being built the provision of anti-tuberculosis assistance? - on the principles: a) active prevention of tuberculosis; b) early diagnosis of tuberculosis (especially the bacillomic forms of pulmonary tuberculosis) and their effective treatment; c) the timely direction of the identified patients in anti-tuberculosis medical organizations; d) timely detection of persons in contact with the tube, their examination, preventive treatment, dispensary observation; e) insulated and separate content: patients with active tuberculosis from persons who are not in dispensary accounting about this disease; persons observed in the "0" group of dispensary accounting (hereinafter - GDU), from patients I and II GDU; patients who are registered in I GDU, from those who are registered in II GDU; patients excreasing mycobacterium tuberculosis (hereinafter - MBT), from other patients with active tuberculosis; bacteriasels with multiple drug resistance (hereinafter referred to as MDU and polyzerism from other patients excretion of MBT; (e) Conducting dispensary accounting, diagnostic measures, as well as the treatment of tuberculosis patients in the prescribed manner; g) continuity in the diagnosis, treatment and dispensary observation of patients with tuberculosis with institutions of state and municipal health systems; h) stage in carrying out anti-tuberculosis measures; and) compulsory compliance with anti-epidemic regime (clause 317).

130. How is the identification and differential diagnosis of tuberculosis in UIS institutions? - For this, it is carried out: a) a x-ray fluorographic study of prisoner breasts; b) three-time study of sputum and acid resistant mycobacteria (hereinafter - Kum) in persons: with symptoms of the disease suspicious on tuberculosis; with prolonged cough (more than 3 weeks), accompanied by the release of sputum, sputum with blood, chest pains; the presence of radiographic changes in the lungs, suspicious on tuberculosis; Incontrolled with patients with tuberculosis separating MBT (p. 319). With suspicion of tuberculosis, a medical worker immediately reports to the head of honey. Parts and takes measures to isolation of the patient (paragraph 320). Among the basic methods of diagnosing tuberculosis - microbiological research of sputum and other diagnostic material, which is carried out by methods a) direct microscopy; b) fluorescent microscopy; c) sowing the sediment of sputum (other material) to nutritional media with the definition of sensitivity isolated by MBT strains to anti-tuberculosis preparations (p. 322). Patients with the chronic flow of the tuberculosis process (constantly separating wet) are examined by the specified method periodically, but at least 1 time in 6 months (clause 323).

131. What groups are considered to be risk groups on tuberculosis? - persons who are observed: a) a hypergic reaction to tuberculin in minors; b) cough for more than 3 weeks; c) hemoptia; d) fever more than 3 weeks; e) reduction of body weight; e) individual diseases and conditions to which include: diabetes; ulcerative disease of the stomach and duodenum; transferred resection of the stomach or gastrectomy; chronic nonspecific respiratory diseases; pneumonia; diseases of urinary organs, accompanied by hematuria and pyuria; mental illness, as well as drug addiction, alcoholism; HIV infection; Long treatment medicinal preparations Corticosteroids and cytostatic groups; immunodeficiency states, g) posttuberculosis changes in the lungs; h) Finding on account in III, IV GDU.

132. What is the clinical minimum study on tuberculosis? - Such a minimum includes: a) survey and inspection; b) the X-rayOfluorographic study of the chest organs; c) microbiological studies of sputum on tuberculosis (methods of direct microscopy three-way or by fluorescent microscopy); d) overall blood test; e) general urine analysis; e) tuberculinidiagnosis according to indications (p. 330). The clinical minimum studies for tuberculosis is carried out in the presence of two and more specified risk factors, or when identifying these diseases or symptoms (p. 326).

133. Who does the diagnosis and detection of tuberculosis? - The Special Commission, created by order of the head of the institution as part of the most trained specialists, which holds meetings 1-2 times a week, and its decisions are recorded in a special magazine. This Commission confirms the diagnosis of tuberculosis, defines a group of dispensary accounting. The most difficult cases are submitted to the Central Medical Control Commission (hereinafter referred to as CVCC) of the regional (regional, republican) anti-tuberculous dispensary. The translation of patients from one group of dispensary accounting to another is carried out by solving the medical commission and is issued with epicris (p. 327).

134. What are the features of the liberation of the Tuba of the Patients? - when dismissed by active tuberculosis (with suspicion of active tuberculosis, the final diagnosis of which due to release has not yet been established), in the PTD, located at the place of intended residence, the extract from the medical card of the outpatient patient (illness history) is sent, and a copy of the statement From the medical card of an outpatient patient (history history) is issued to the patient. The accounting card of the patient with tuberculosis is directed to storage in the remand prison, located in the regional (republican, edge) center (p. 333).

135. What is the order of the direction and maintenance of persons in anti-tuberculous Liu? - After successfully completed stationary treatment and discontinuation of bacterial generation, patients are transferred to outpatient treatment into anti-tuberculous Liu (clause 335), where patients are placed and contained in accordance with the principles of separate and isolated content, prior to their translation in the III GDU (clause 336). If they are impossible to contain them in anti-tuberculous Liu, they are sent to insulated sections of the AU, specially created for the content of such patients (clause 337).

136. What is the procedure for the detection of tuberculosis reactivation in patients? - Such patients are immediately isolated and sent to inpatient treatment, and after their departure in the premises, where they were (the focus of tuberculosis infection), concluding disinfection is carried out (clause 338). Work in such a focus includes: a) timely isolation of the patient; b) determination of the source of infection; c) identifying persons in contact with patients with active tuberculosis, take them into dispensary accounting, carrying out preventive treatment; d) carrying out disinfection; e) Surprosvet work (p. 340). The final disinfection in the focus is carried out no later than 24 hours (p. 341).

137. Can the person who have 3 and 4 GDU on tuberculosis have to live together and not consisting of dispensary taking on tuberculosis? - persons having 3 GDUs, it is advisable to place separately (p. 344), and persons consistent with the IV GDU are posted in institutions on the general basis (p. 345).

138. How is the treatment of persons consisting in the III GDU and in IV GDU? -

(p. 347-348).
Preventive treatment is carried out in an outpatient basis, providing strict control over the reception of drugs (p. 350). Practice shows that for some Tuba patients are characterized by a frivolous attitude to the state of their health and evasion of honey preparations (p. 351).

139. How is the refusal of preventive treatment from tuberculosis? - appropriate recording in medical records and signed by prisoners and honey by an employee after a conversation, in which the possible consequences of refusal from the proposed treatment are explained in the patient. The patient's reluctance to confirm the refusal of treating a personal signature is recorded in the medical records commission (paragraph 351).

140. What groups of patients with diet food is prescribed? - 1) patients with tuberculosis I, II GDU and persons registered in the III GDU; 2) Persons consisting of 0, IV, V, VI GDU - for a period of trial or preventive treatment. Information about the appointed dietary nutrition is made to a medical card of an outpatient patient (paragraph 354). However, in case of refusal to receive anti-tuberculosis drugs, persons consisting of 0, IV, III GDU, dietary food is not prescribed (p. 355).

141. How does the work organize patients with tuberculosis? - Such work is carried out under the constant observation and control of medical personnel of the institution involving patients with tuberculosis, recognized in the prescribed manner able-bodied. The nature of labor and the duration of the working day is determined taking into account the clinical and expert opinion (paragraph 356).

142. Who and in what order is subject to providing free drugs due to tuberculosis? - Such provision is subject to: a) patients with tuberculosis; b) Persons under dispensary observation in connection with tuberculosis. Personal data during the entire period of dispensary observation or from the moment of detection of the disease are provided with free medicines in accordance with the appointment of a doctor or a clinical and expert commission in a federal specialized medical institution. When issuing free medicines in medical records of federal specialized honey. institutions are recorded with the name of the surname, the name and patient's patient's patient, his diagnosis, the names of medications appointed by him, their dosages with compulsory signatures of a medical worker who issued medicines, and the patient who received them (Rules for providing persons under dispensary observation in connection with tuberculosis and patients with tuberculosis free medicines for the treatment of tuberculosis on outpatient conditions in federal specialized medical institutions, approved. Decree of the Government of the Russian Federation of November 17, 2004 N 645, hereinafter - Rules . Decree of the Government of the Russian Federation № 645).

Injuries and poisoning

143. How to implement medical support production facilities Readiness to assist in injuries and poisoning? - All workshops, independent sites, workshops are equipped with first aid aid kits. Heads of workshops, sites, masters are obliged to monitor the safety and timely replenishment of the aidhechki, which is carried out honey. Employees of the institution. In each production team working on a remote area, in the workshop or group of the Brigades, one of the convicts is allocated to first aid, specially prepared for this, which honey. Part of the institution provides a sanitary bag with medicines and dressing materials. If the convicts affected in production needs urgent medical care, it is organized in the medical unit or the nearest LPU. Honey worker, providing assistance to the victim, reports the leadership of the institution about the occurrence, reflecting the nature of injury (poisoning), its severity and clarified circumstances of the incident. Each case of injury or poisoning is registered with medical workers in a special journal (paragraph 359).

144. What are the basic measures to prevent injuries and poisoning? - 1) control by the administration and honey of employees of institutions for ensuring the proper maintenance of prisoners, the right work, prevention of injuries, poisoning and accidents; 2) labor use of convicts in accordance with their qualifications and health status; 3) technical briefing and registration of admission to certain types of work; 4) systematic conduct with convicted activities to study the basic safety regulations, familiarization with the measures of personal prevention of injuries and poisoning; 5) Surprostevelopment; 6) constant monitoring of persons who have a weak physical development and chronic diseases, the definition of their work recommendations and control over their employment; 7) systematic study of the administration of institutions of the circumstances and causes injuries and poisoning with the development of specific measures to prevent them (clause 361).

Medical and social expertise to establish disability

145. Who is heading for medical and social expertise? - Persons who have a violation of health that led to restriction of livelihoods, with persistent impairments of the body functions and in need of measures social protection and medical rehabilitation. The person in need of conducting medical and social expertise in the prescribed manner in an arbitrary form is submitting a written application addressed to the head of the Bureau of Medical and Social Expertise at the location of the institution (p. 262).

146. What is the order of direction A ITU? - Before the direction to clarify the diagnosis and degree of severity of functional violations, the head of the LPU UISA takes measures to survey the face of the ISP LPU, and if necessary, in the LPU state and municipal health systems (clause 363). According to the results of the clinical and diagnostic survey, the LPU doctors decorate the Direction on ITU (clause 364). The administration of the institution forms and submits to the ITU Bureau, characteristic, honey. A card of an outpatient patient (inpatient patient), the direction of the medical and social expertise and the statement of the person contained in the institution to conduct an examination (re-examination), at the same time the issue of time and place of examination (re-examination) is solved. If a health violation is related to:
- with a professional disease to documents, the conclusion of the Center for Professional Pathology is introduced;
- industrial injuries, is an act of an accident at the production of the established form (clause 365).
Examination (re-examination) can be carried out both directly in the institution and at the ITU Bureau at the location of the institution on the general basis (clause 366). With a survey (re-examination), the Administration of the Institution ensures the delivery of a person to the ITU Bureau at the location of the institution. Mandatory the presence of a doctor's medical part or LPU UIS, also the head of the detachment or educator (hereinafter - representatives of the administration) and appropriate protection in order to curb the possible excesses from the inspected (clause 367). The certificate of the establishment of disability comes to a personal case (clause 368). Extract from the certification act on the results of determining the degree of loss of professional working capacity in percentages in need additional species assistance is issued to representatives of the administration of the institution to direct the employer (clause 369).

147. How does the decision of the Bureau of Medical and Social Expertise appealed? - Earlier, such an appeal was carried out in the order of section V Regulations on the recognition of the person with disabilities approved by the Decree of the Government of the Russian Federation of August 13, 1996 N 965 "On the procedure for recognizing citizens with disabilities." However, there is currently an appeal procedure, determined by paragraph 42-45 of the Rules for the Recognition of Persons with disabilities, approved by the Decree of the Government of the Russian Federation of February 20, 2006. N 95 as amended from 7.04.08. According to this decree, a citizen or his legal representative may appeal the decision of the Bureau to the Main Bureau within a month on the basis of a written statement submitted to the Bureau, which conducted medical and social expertise, or to the Main Bureau. The Bureau, conducted by ITU, at a 3-day period from the date of receipt of the application sends it with all the available documents to the Main Bureau, which no later than 1 month from the date of receipt of the Citizen's statement conducts its ITU and on the basis of the results obtained makes an appropriate decision. In appealing by a citizen of the decision of the Main Bureau, the main expert on ITU on the relevant subject of the Russian Federation with the consent of a citizen may entrust its ITU to another composition of the specialists of the Main Bureau. The decision of the Main Bureau may be appealed within the month of the Federal Bureau on the basis of a statement submitted by a citizen (his legal representative) to the Main Bureau, which conducted medical and social expertise or to the Federal Bureau. The Federal Bureau no later than 1 month from the date of receipt of the statement of a citizen conducts its ITU and on the basis of the results obtained makes an appropriate decision. Decisions of the Bureau, the Main Bureau, the Federal Bureau can be appealed to the court by a citizen or his legal representative.

Medical support for transportation and liberation from institutions

148. What is the procedure for the preparation of the exempted staging? - Before sending from the institution, all prisoners undergo a mandatory medical examination to determine the possibility of staging (clause 371). A) infectious patients, b) patients with syphilis, not completed treatment course, c) patients with acute gonorads before cure from the WIS institution to another, except for transfer to medical institutions (p. 372).

149. What is the procedure for the steering of patients convicted? - Infectious patients, patients with syphilis and gonorads, as well as persecuting psychos. Disorders sent to therapeutic institutions are moved separately from healthy convicts and on the conclusion of a doctor - accompanied by medical workers. Staging patients with syphilis is made only in breaks between treatment courses with the permission of the attending physician (p. 372). Transportation of women with pregnancy over 6 months. Or with children under the age of 3 years produced in special cars isolated from the rest of the convicts accompanied by honey. workers. The frequency of visits and inspections of accompanied by honey by employees is determined by the sender agency (p. 373). Honey. Personnel accompanying steps, must: attend when taking a guard convicts, control the completeness and quality of comprehensive sanitary processing before sending; When identifying infectious patients who are sick in the path and needing qualified medical care, through the head of the guard (echelon), take measures to hospitalize them in the nearest LPU of WIS or state and municipal health systems; In the following way, control the sanitary condition of the echelon, the order and conditions of storage of products and the provision of drinking water; keep the registration of all those who applied for medical care; Upon arrival at the destination to participate in the delivery of convicts, property and in the design of documentation (p. 374).

150. How to refer to trial, In the investigative authorities and in place of deprivation of freedom of convicts, refusing to eat food? - Separately from other prisoners (in a separate chamber of a special car or in a special car), accompanied by honey. employee (p. 376). If further rejection of food in the path will threaten the health and life of the prisoner, then on the written conclusion of the accompanying honey. He must be commissioned to one of the nearest agencies to provide the necessary medical care (p. 377).

Medical statistics

151. How is the statistics of diseases in the FSIN facilities of the Russian Federation? - In accordance with the form of statistics, it is taken into account:

Strings

Section 1.

The limit of places for the Tuba of patients in UIS institutions, in LPU (hospitals) - the number of standard phthisiatric and physio-spuric beds at the end of the reporting period.

the number of persons patients with active tuberculosis (I, II GDU) registered at the end of the reporting period on the basis of the journal accounting of infectious diseases (form N 060 / y), control cards of the dispensary monitoring (form N 030-4 / y), notifications with a patient with For the first time in the life of a diagnosed diagnosis of active tuberculosis, syphilis, gonorrhea, trichomoniasis, chlamydia, ureaplasmosis, garardnelez, urogenitalia candidosis, anomogenital herpes, anomogeneous-in-law-free, microspory, favus, tricochy, mikosa, scabies, trachors (form N 089 / y).

Patients with for the first time in the life of a diagnosis of tuberculosis (based on control cards of the dispensary observation (form N 030-4 / y), a patient's notifications for the first time in the life of a corresponding diagnosis

the increasing result from the beginning of the year. Filled in the column "LPU (hospital)", which indicates the total number of persons surveyed in the reporting period by medical commissions of the LPU (hospitals) in order to determine the presence or absence of a disease that impede the serving of punishment, regardless of the conclusions issued by commissions. The remaining graphs are not filled.

the total number of persons presented in the reporting period on the results of medical examination to the court for liberation due to illness.

the total number of persons liberated in the reporting period due to the disease.

the total number of exempted patients with tuberculosis, regardless of the foundation of liberation.

the number of patients with tuberculosis released in the reporting period due to the disease

information about the total number of registered diseases (acute and chronic). Filled on the basis of summary statements of diseases and injuries (forms NN 071 / y, 071-1 / y), infectious diseases magazine (form N 060 / y).

Number for the first time in the life of registered diseases. Filled on the basis of summary statements of diseases and injuries (forms NN 071 / y, 071-1 / y), infectious diseases magazine (form N 060 / y).

The number of people with disabilities contained in UIS institutions at the end of the reporting period.

The number of people who received disability for the first time in life.

The total number of dead whether (filled on the basis of a statistical map of the retired from the hospital (form N 066 / y), or protocol (maps) of the pathological and anatomical study (form N 013 / y), or forensic medical research).

The number of HIV-infected persons (at the end of the reporting period)

The number for the first time identified HIV-infected people (based on the accounting log of infectious diseases (form N 060 / y), control cards of the dispensary observation (form N 030-4 / y)

The number of HIV-infected people patients with tuberculosis at the end of the reporting period.

The number of cases for the first time identified combination of HIV infection with pulmonary tuberculosis

The number of persons consisting on the dispensary accounting is the end of the reporting period according to syphilis (based on the form N 060 / y).

the number of cases of detection of persons patients with syphilis (based on the form N 060 / y),

The number of persons patients with alcoholism at the end of the reporting period (based on the form No. 030-1 / y

Information about persons patients with alcoholism of the first group of dynamic observation undergoing mandatory treatment

Number of persons of patients addicts at the end of the reporting period (based on the form N 030-1 / y)

Information about persons patients with addicts of the first group of dynamic observation, undergoing mandatory treatment

Number of persons suffering from mental disorders (F 01-09, F 20-99, G 40-41) at the end of the reporting period according to control cards of the dispensary monitoring of mentally ill (Form N 030-1 / y)

Number of persons with weight deficit at the end of the reporting period

The number of UIS institutions at the end of the reporting period, which in its composition medical units (medical units and health parts for suspects accused of committing crimes and convicts).

Including licenses for the right to implement medical activities

Required estimated number of doctors, provisions, medium medical and pharmaceutical staff of the LPU (hospitals) and medical units of WIS institutions in accordance with typical standard standards

Including specialists at the end of the reporting period

Section 2 lines

The total amount of funds spent on the payment of medical services to institutions of state and municipal health systems, as well as medical institutions of other departments, for medical support of prisoners

Costs for medical support employees of UIS

The total amount of extrabudgetary funds attracted for procurement of medical property

The total amount of humanitarian aid attracted for procurement of medical property

Material prepared
chairman of the Committee for civil rights»

Andrei Babushkin

So, the main regulatory legal Act In the field of health in the Russian Federation, currently is the Federal Law of 21.11.2011 No. 323-FZ "On the basics of the health of citizens in the Russian Federation", as well as departmental regulatory act - Joint order of the Ministry of Health and Social Development of Russia and the Ministry of Justice of Russia dated 10/17/2005 No. 640/190 "On the procedure for organizing medical assistance to persons serving a sentence in places of imprisonment and enclosed in custody."

Article 26 of the Federal Law No. 323-FZ of 11/21/2011 No. 323-FZ established features of the provision of medical services convicted to imprisonment, as well as persons detained on charges of committing crimes. This norm of the law provides that convicted of imprisonment have the right to provide medical care, including if there is such a necessity, and in state (municipal) health care institutions.

By general rule Convicts receive medical care in departmental health care facilities of the Federal Penal Service of the Russian Federation at the place of serving the sentence, as well as in specialized medical and preventive and medical and correctional institutions of the penitentiary system on the basis of provisions

art. 101 of the Criminal Executive Code of the Russian Federation. Currently, medical assistance to the convicts in correctional institutions of the Moscow region have the relevant units of the FKUZ "MSH No. 50 of the FSIN of Russia".

At the same time, in accordance with Art. 26 of the Federal Law

21.11.2011 No. 323-ФЗ, if it is impossible to provide medical care in institutions of a criminal-executive system of persons enclosed or serving a sentence in the form of imprisonment, have the right to provide medical care in medical organizations of the State Health System and Municipal Health System, and Also for the invitation to consult medical professionals of these medical organizations in the manner prescribed by the Government of the Russian Federation, at the expense of budget allocations federal budgetstipulated by these goals of the FSIN of Russia.

Clause 3 of the Rules for persons enclosed or serving a sentence in the form of imprisonment, medical care in medical organizations of state and municipal health systems, as well as invitations to consult specialist doctors of these medical organizations with the impossibility of providing medical care in criminal institutions Systems approved by Decree of the Government of the Russian Federation 12/28/2012 No. 1466. Under the impossibility of providing medical care in institutions of the penitentiary system, the absence of an appropriate profile or qualifications, equipment or conditions for the provision of the necessary amount of medical care or The situation in which a delay in the provision of medical care is, including those associated with the expectation of the transportation of a patient to another institutional institutional institutional institution, may entail It is a deterioration of his condition, a threat to life or health. In state and municipal medical organizations, individuals deprived of their liberty are all types of medical care in compliance with the procedures for their provision and based on standards of medical care.

At the same time, according to paragraph 9 of the joint order of the Ministry of Justice of Russia

and the Ministry of Health of Russia dated 10/17/2005 No. 640/190 provided medical care provided in the amounts provided for by the program of state guarantees to citizens of the Russian Federation of free medical care, while a voluntary health insurance contract for persons serving a sentence in criminal institutions Systems are terminated.

Persons enclosed in custody serving a sentence in the form of restriction of freedom, arrest, imprisonment, have the right to provide medical care, while each patient has the right to admission to a lawyer him

The Supreme Court of the Russian Federation acknowledged the invalid of the decision on the legitimate force of paragraph of the second paragraph 119 of the procedure for organizing medical care to persons serving a sentence of imprisonment and enclosed in custody approved by the Order of the Ministry of Health and Social Development of the Russian Federation and the Ministry of Justice of the Russian Federation of October 17, 2005 . N 640/190, in terms of establishment legal regulation Data with patients serving the punishment in places of detention and enclosed in custody, with lawyers or other persons who have the right to provide legal assistance.

The court, in particular, indicated that the provisions of the paragraph of the second paragraph 119 of the Procedure were put into effect by a non-federal law, but a departmental regulatory legal act. They limit the right of persons serving the punishment in the fields of imprisonment and enclosed in custody, to receive legal assistance in quarantine, on other sanitary and epidemic grounds, and if visiting the patient can lead to a deterioration of his health or pose a threat to his life and health surrounding.

According to the Federal Law "On the Fundamentals of the Health of Citizens in the Russian Federation", persons who are serving a sentence in the form of restriction of freedom, arrest, imprisonment, have the right to provide medical care, while each patient has the right to admission to a lawyer. The named federal law, regulating relations in the protection of the health of citizens, does not establish restrictions on the admission of a lawyer, if visiting the patient can lead to a deterioration of his health or pose a threat to his life, with quarantine, according to other sanitary and epidemic grounds.

Sanitary and epidemiological requirements for the order of visiting lawyers of individuals serving a sentence in places of imprisonment and prisoners, the Federal Law of March 30, 1999 N 52-FZ "On the sanitary and epidemiological well-being of the population" does not establish.

Order 190 640.

1. — who and on the basis of which documents is responsible for the diagnosis in the SIZO. Is it possible that when entering the SIZO, the diagnostics was not conducted - whether it was carried out in this case again when admitted to Wiki
   According to the joint order Ministry of Health and Social Development of the Russian Federation and the Ministry of Justice of the Russian Federation of October 17, 2005 No. 640/190 The organization of medical care in the SIZO and colonies, as well as the quality control of its provision is carried out by the territorial bodies of the FSIN, including their medical departments together with the health authorities of the Subjects of the Russian Federation (paragraphs 3, four). The responsible for the health of the suspects accused and convicted, these provisions of the order include an uncertain circle of other bodies, in particular, the authorities of Rospotrebnadzor and local governments, which in practice generates the blurring of regulation and the uncertainty of management authority and control functions.
   In accordance with the same order as well order Ministry of Justice of October 14, 2005 No. 189 upon admission to the prisoner in the SIZO or correctional institution by a duty doctor (Feldsher) is immediately carried out by primary medical examination and the necessary survey, during which the presence of diseases representing the danger to others (to them the government decree and HIV infection), and " on a period of no more than three days from the moment of arrival in the SIZO, all received, except for the following transit, pass an in-depth medical or paramedic inspection, as well as a X-ray fluororographic examination"(Paragraph 32). Including " to identify sexually transmitted infections, HIV infections, tuberculosis and other diseases are laboratory research"(Paragraph 35).
   The order of the Ministry of Health of the Russian Federation of April 25, 1996 N 168 establishes cases of compulsory medical examination of persons in places of deprivation of liberty to identify HIV infection. These are the same cases as established by the Federal Law on HIV (blood donors and convicts involved in the work of sanitation on certain types of medical activities related to blood). For most other trended and convicted examination on HIV is not mandatory. At the same time, according to the above joint order, such a survey should be conducted "on clinical indications" ( Decision Governments of February 28, 1996 No. 221).
   The joint order provides for the right of prisoner to abandon the medical intervention, to which the survey (paragraph 39) applies. This right largely remains "paper". Refusal of examination in cases where it is recognized as mandatory (i.e., and clinical indications), it entails the responsibility provided for in the violation of the detention regime or serving the sentence.

— who and on the basis of what orders is responsible for treatment HIV, tuberculosis in the SIZO, in the stage, in the colony
At all stages, including at the stage of "Transportation", direct responsibility lies at the Medical Service of the FSIN. This follows from the aforementioned joint order No. 640/190. Also, the responsibilities of the Medical Service of the IIS institution are regulated by the orders of the Ministry of Justice of October 14, 2005 No. 189 on the approval of the rules of the internal regulation of the investigative insulators and of November 3, 2005 No. 205 On approval of the rules of the internal regulations of correctional institutions.

— what documents are to be guided by, when sending a request to the FSIN, demanding the amount of HIV and TB treatment ordered and set on the fact.
Such a request may be sent to the public observation commission in the respective region. Federal law Of June 10, 2008 "On public monitoring of human rights in the places of compulsory content and to promote persons in places of compulsory content" (editors of December 6, 2012), the Commission is endowed with the right to monitor compliance with the rights of prisoners for health protection (article 16.1).
« 1. The following public observation commissions are monitored in compliance with the requirements of the legislation of the Russian Federation on the protection of the health of citizens and the requirements provided for in Article 16 of this Federal Law, to ensure the right of persons in places of compulsory content, to protect health when they are in places of compulsory content, With temporary placement of them in medical institutions. Control over the provision of laws in places of compulsory content may also be carried out in stationary (final or intermediate) points of movement of such persons.
2. Members of public observation commissions in order to monitor the security of the right of persons in the place of compulsory content, to protect health with the consent of this person or his legal representative to get acquainted with medical records reflecting the state of his health, talk on the provision of medical care with persons who are in places of compulsory content, medical institutions«.
True, so far the public observation commissions are not created in all regions.

— whether any norms are regulated by any norms in the AIDS centers (so-called
Order Ministry of Health and Social Development of the Russian Federation of December 5, 2005 No. 757 "On urgent measures to organize drugs for drugs for HIV-infection" obliges regional health management bodies (ministries, departments, health management of the subjects of the Russian Federation) to provide an uncompressed stock of the necessary drugs. The same order should be guided in solving issues relating to the preparations of Medchways UIS.

— in what instances and on whose names send requests with the requirement to check.

Supervision of compliance with prisoners is entrusted to the Prosecutor's Office of the Russian Federation in the person of its territorial bodies (Articles 32-34 of the Federal law "On the Prosecutor's Office of the Russian Federation"). In cases of violation of the law, contact the prosecutor of the subject of the Russian Federation. Compliance with the rights of prisoners is engaged in many more bodies and officials, as well as the aforementioned public observational commissions. With such a number of defenders, prisoners would have to feel better than the will.
On issues relating to medical care prisoners should be addressed to territorial body FSIN, for the same medicinal support - to the health management authority of the subject of the Russian Federation. With the ineffectiveness of these instances, it is necessary to take higher: according to the Office of the Organization of Medical Social Security of the FSIN and Roszdravnadzor.
In cases of gross violation of prisoners, the complaint should be submitted to the Commissioner for Human Rights in the Russian Federation.

— what can be the basis for such a request, are subject to names with names, or it is possible to write on behalf of NPOs referring to information received from customers (without mentioning names)
Response measures of all of the above instances should adopt information from any source. Normal statements of the treated and convicts are required only when appealing to court.

- What documents are possible to prevent the formation of the strategic stock of drugs on the treatment of HIV, TB in the SIZO or AIDS centers serving these SIZO
The emergence of drugs with drugs of investigatively arrested has a reason for not so much the presence of any regulations, but the inconsistency of the activities of various departments.

— how is it calculated and how is the assignment of ARVT at the stage take into account?
How the presence of ARVT into the steepimated institution is taken into account (here is meant if a person is in ARVT, whether there is guarantees that this scheme has been in IC there)
According to the joint order of the Ministry of Health and Social Development of the Russian Federation and the Ministry of Justice of the Russian Federation of October 17, 2005 No. 640/190 "Suspects accused and convicted, following transit, receive necessary treatment, Examination in accordance with the accompanying documents attached to the open certificate of a personal case, or when contacting medical help "(paragraph 34).

— documents regulating the time framework of the acting, from entering the hospital to medical examination and liberation.
Exemption from the further serving of punishment on illness is carried out by the court in accordance with Article 81 of the Criminal Code of the Russian Federation. In the case of a positive decision of the court, the real liberation occurs after the entry into the judicial decree into legal force. The procedure for medical examination of convicts was established by the joint order of the Ministry of Health and the Ministry of Justice of the Russian Federation of August 9, 2001 No. 311/242.

— the presence of regulatory acts of regulatory stays in Shizo and PKT people with HIV, TB
Such an order (common for all convicts under medical supervision) is determined by the rules of the internal regulations of correctional institutions, approved by the order of the Ministry of Justice of the Russian Federation of November 3, 2005 No. 205. According to paragraphs 136, 137 "to the convicted person undergoing treatment in medical and preventive institutions, may All the measures provided for by the penal legislation are applied if their immediate execution Does not entail the threat of life and the health of the convict. Convicted, placed in penalty insulators and translated into chamber types, continue to receive the necessary treatment. "

Lev Levinson,
expert of the Institute of Human Rights
member of the Expert Council upon Commissioner
on human rights in the Russian Federation

The Ministry of Justice of the Russian Federation approved a new procedure for providing medical care to persons enclosed in custody and serving a sentence in the form of imprisonment

Ekaterina Chistyakova - Director Give Life:

"That's finally small, but the result. How many years of the work of the Council under the Government of the Russian Federation on the custody of the social sphere? Three years? Four?
This is the result, because fixed normative base, and fixed substantially, compared with those norms that acted. According to the old order of 640/190, prison medicine itself once and forever 100 years ago, it established how to treat diseases from prisoners, in which plan to examine and accompany pregnant women and women in labor. The new order establishes that medical care prisoners are based on the protocols of treatment established for the rest of society.
The result is small, because the implementation of the order, which should be expressed in normal medical care, depends on the equipment, and on the financing of prison medicine, and from high-quality control over the implementation of the order from special bodies and the public. And with security, and with the control of the case is not yet very. Yes, and in the heads there are no idea that the prisoners have the right to receive help. "

Thanks to everyone who supported, participated on trips around the country, argued, offered and worried!

Order of the Ministry of Justice of the Russian Federation of 28.12.2017 N 285
"On approval of the procedure for organizing the provision of medical assistance to persons imprisoned or serving a sentence in the form of imprisonment"
(Registered in the Ministry of Justice of the Russian Federation 09.02.2018 N 49980)

Order 190 640.

I.. On improving the procedure for providing medical care for pregnant women, women with children and women in prison places

1. Roszdravnadzor (MA Murashko) to conduct control and supervisory measures to provide medical care for pregnant women and women in the first year of 2015, serving sentences in prison and enclosed in custody in the institutions of the penitentiary system.

FSIN RUSSIA (G.A. Kornienenko) to submit to Roszdravnadzor information needed to conduct indicated control and supervisory measures.

We report on the results to the Council under the Government of the Russian Federation on the custody of the social sphere (hereinafter - the Council) until October 1, 2015.

2. The Ministry of Health of Russia (V.I.Skvortsova) together with the Ministry of Justice of Russia to work out the question of making changes to the order of the Ministry of Health and Social Development of Russia and the Ministry of Justice of Russia dated October 17, 2005 No. 640/190 "On the procedure for organizing medical care to persons serving punishment in places of imprisonment and enclosed in custody "in terms of bringing him in line with the requirements of the Federal Law of the Russian Federation of November 21, 2011 No. 323-FZ" On the basics of the health of citizens in the Russian Federation ".

3. FSIN of Russia (G. Kornienenko), Ministry of Health of Russia (V.I.Skvortsova), Ministry of Justice of Russia (A.V.Konovalov) to work out the issue of consolidation
in relevant departmental regulatory documents, official duties of medical workers of the penitentiary system
and medical organizations of municipal and state health systems of the function of mutual informing about the results of dispensary monitoring of pregnant women and children, as well as regular familiarization of mothers about the place of finding and state of health of children.

4. FSIN of Russia (G.A. Kornienenko) to conduct an analysis of the conditions for the content of pregnant women and women with children in remand insulators, premises functioning in the mode of remand insulators and children's homes with correctional colonies.

5. FSIN of Russia (G.A. Korneenko) prepare offers
on the possibility of organizing additional nutrition of pregnant women,
as well as a possible replacement of products in the diet.

II.. On the results of the analysis of the quality and timeliness of medical care during pregnancy, childbirth and after childbirth suspected, accused and convicted women who are in the institutions of the penitentiary system

1. FSIN of Russia (G. Kornienenko) to work on the conclusion of agreements (contracts) on the provision of medical care to women contained in the institutions of the penitentiary system between medical organizations Penal and executive system and state and municipal health systems in the constituent entities of the Russian Federation.

III. about the project federal Law "On Amendments to the Criminal Code of the Russian Federation, the Criminal Procedure Code of the Russian Federation and the Criminal Code of the Russian Federation"

1. The Supreme Court of the Russian Federation (V.M. Lebedev) to work on the organization in the courts of individual specialized premises to find mothers with children and pregnant women necessary equipment (changing tables, departure tools, etc.).

2. Ministry of Justice in Russia (A.V.Konovalu) together with the executive bodies and members of the Council, as well as with the involvement of independent experts, additionally work out the question:

the possibility of distributing the delay in serving the sentence at the discretion of a court on pregnant women, mothers and lonely fathers with children up to 14 years old on persons convicted of serious and especially grave crimes if the punishment does not exceed 5 and 8 years;

on the limitation of dates by convicts serving punishment for certain types of crimes.

IV. On the implementation of the instructions of the Council under the Government of the Russian Federation on the proceedings in the social sphere on the issue of health, motherhood and childhood in places of imprisonment

1. The Ministry of Justice of Russia (A.V. Bonovalov), together with the FSIN of Russia, work out the question of the possibility of leaving pregnant minor juveniles in the detention of pregnant minors after making sentence for up to 6 months, provided that during this period, their age of majority or the expiration date of the sentence occurs.

2. FSIN of Russia (G.A. Korneenko):

develop "Road Maps" of the transition of all the children's houses located on the territory of correctional institutions, to the joint residence of convicted mothers with children;

"In accordance with paragraph 4 of Article 31, paragraph 7 of Article 101, paragraphs 2, 4, [...]