ФЕДЕРАЛЬНОЕ ГОСУДАРСТВЕННОЕ БЮДЖЕТНОЕ УЧРЕЖДЕНИЕ
Всероссийский центр медицины катастроф "Защита" 
Министерства здравоохранения Российской Федерации 

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123182, Москва, ул. Щукинская, д.5 Полная информация и схема проезда 


Medical evacuation

For medical evacuation the following transport is used:

     – air vehicle (special airplanes equipped with medical modules- planes, helicopters, regular and charter air flights)
     – ground vehicle (cars, railway transport)

     – water transport (ferries, etc)

Medical evacuation is implemented by different types of air transport (medical aviation), ground, water and other types of transport in the Russian Federation and from abroad. Medical evacuation is implemented according to the warrants of the Ministry of Public Health of the Russian Federation in pursuance to the State Task and as extra budgetary activity on a fee basis according to the price list.
During medical evacuation, if necessary, telemedicine and on-site consultations are hold, the Team’s physicians identify risks and conditions of transportation, appropriate teams and equipment for medical transportation of each patient is approved. Experienced specialists of the Team prepare the injured and patients to the forthcoming transportation, they conduct medical escort, resuscitation, intensive care, monitoring and life support en route.

Stages of medical evacuation: 

1. Collection of information about the patient

        According to the official request to the hospital where the patient is staying specialists of the Team receive all necessary information, including medical documents with epicrisis concerning possibilities, risks and conditions of transportation, appropriate specialists, equipment and medicines for medical escort.
When a Russian citizen is repatriated because of medical reasons from abroad, necessary information is received by applying to the consular institution of Russia in the host country. When international insurance policy is available, the Team interacts with insurance and assistance companies. 
List of documents and information necessary for medical evacuation of the RF citizen from abroad is given on the official site of Russian Ministry of Health by reference

2. Telephone and telemedicine consultations 
        On the grounds of received medical documents doctors of the team estimate the patient’s state and risks of his transportation, they organize telephone and telemedicine consultations. As appropriate specialists of the leading medical institutions and chief non-staff experts of Ministry of Health are enlisted to telemedicine consultations. The decision on medical evacuation is taken considering the results of the consultations. 
Russian citizens can be medically evacuated from a foreign country on receiving special “fit to fly” permission from the foreign hospital. 

3. Face-to-face consultations 
        Medical specialists of the Team hold face-to- face consultations in medical institutions to identify risks for a patient’s transportation, preparation and stabilization. During these consultations they evaluate advisability of the patient’s transportation, possibilities to provide safe evacuation and therapy continuity en route, possible influence of hazard evacuation factors. 

4. Medical escort 
        The Team’s medical personnel has a great practical experience of evacuation patients by different vehicles, including in emergencies with big amount of the injured. Escort is implemented by specialized teams consisting of a physician-resuscitator and a nurse. If necessary, other specialists are enlisted (neurosurgeons, neonatologists, traumatologists etc.) from different medical institutions including federal medical institutions and medical institutions of Moscow Health Department. Medical equipment and medicines used during transportation are registered in the Russian Federation and meet requirements of legal acts of the Federal Service for Surveillance in Healthcare. 

5. Hospitalization to the appropriate medical institution 
        Escorting medical team delivers the patient to the appropriate medical institution where secondary medical care is given

  

Air Medical Evacuation in the Airplane Equipped with Medical Modules

Airplanes equipped with medical modules transport patients with different injuries and severe somatic pathology around Russia and from abroad. Airplanes in medical version are equipped with special modules providing a comfort position of patients in the saloon and include a medical and oxygen equipment for monitoring, maintenance of patients’ stable state (vital functions) and resuscitation during transport.

Taking into account the large distances, geographic location of Russia, for repatriation of Russian citizens from foreign countries at the Federal level the following medium- and long haul airplanes are used: Russia EMERCOM airplanes – AN-148, Sukhoi Superjet, IL-76, as well as charter aviation transport of different air companies.

The flight range of AN-148, Sukhoi Superjet is approx. 3500-4000 km, IL-76 – 4000-5000 km. AN-148 and Sukhoi Superjet are equipped with six modules, each for one person (for a comfort position – 4 modules), IL -76 is equipped with five modules, each for four persons, maximum capacity is up to 20 persons.

The airplane medical module comprises a modern equipment meeting the norms of legislation, including air norms:

– apparatus for artificial lung ventilation;
– monitoring and defibrillation system;
– electric medical aspiration-suction device;
– injection pumps;
– pulse oximeter;
– medical items for a patient’s immobilization, vacuum mattress;
– medical oxygen balloons;
– other equipment (heaters, a set of cervical splints for adults and children, vacuum mattress, plastic shield with harness, etc.).

When transporting newborns and premature babies, special neonatal systems (converses) are used maintaining optimal for a baby temperature with oxygen supply; these systems also include a neonatal apparatus for artificial lung ventilation 


                                                                          Medical modules for aircraft


Airplane Medical Modules
Air Medical Evacuation in Scheduled Passenger Airplanes

      When transporting patients in scheduled passenger airplanes, an air company coordinates installation of a special place for a “lying patient” and carriage of medical and other equipment, medications, as well as oxygen supply provision and energy for a normal work of electric devices. The measures concerning boarding the airplane of the medical team with the patient, for example, using the ambulift – are coordinated with airport and customs services.


      Medical evacuation of little children, including those up to one year, is performed on condition that the air company gives its consent, adjusts the conditions of evacuation, and, if necessary – provides “an aviation cradle” (flight baby bassinet).


                                                                               Place for a lying patient aboard



                                                 Ambulift (to take a patient aboard from outside-in)



                                                             Ambulift (to carry a patient inside a plane)


Medical evacuation by resuscitation ambulance (reanimobile)

Medical transport of ARCDM “Zaschita” is presented by “C” class reanimobiles on “Mercedes” and “Fiat” basis. Reanimobiles are equipped with modern medical and other necessary equipment in accord with the Russian Federation legislation. Patients are transported in Moscow and outside.


Medical support in mass gathering events

        Team’s specialists are on duty during mass cultural, social, sport and other events at the request of Ministry of Health of the Russian Federation and as extra budgetary activity on a fee basis according to the price list.


Interaction

–  Territorial centres for disaster medicine, emergency consultative departments of the regions of the Russian Federation.

         –  Regional executive bodies of the regions of the Russian Federation in the field of health care
         –  Federal medical institutions of Ministry of Health of the Russian Federation and Federal Medical-Biological Agency
         –  Regional medical institutions
         –  EMERCOM of the Russian Federation
         –  Ministry of Foreign Affairs
         –  Customs and border services
         –  Foreign hospitals
         –  Insurance and assistance companies
         –  Consular and diplomatic missions of RF abroad
         –  Air flight companies
         –  First aid stations
–  Ministry of Internal Affairs
–  Social project #SvoikhNeBrosaem


How to apply for medical evacuation

Who can apply: citizens of the Russian Federation, regional executive bodies, other individuals and organizations.
Where to apply: Ministry of Health of the Russian Federation, other authorized departments.
Contact information of Ministry of Health of the Russian Federation

Information phone: +7 (495) 628-44-53, +7 (495) 627-29-44

Multichannel phone: +8 (495) 627-24-00

Phone for registration information: +8 (495) 627-29-93

«Hot line» of Ministry of Health of the Russian Federation 8 800 200 03 89

e-mail: info@rosminzdrav.ru

Address: 3, Rakhmanovsky per., 127994,ГСП-4, Moscow

Procedure of Appeal to the Ministry of Public Health of the Russian Federation: official site of the Ministry: https://www.rosminzdrav.ru/reception/appeals/new“Hot line” of the Ministry of Health of the Russian Federation; per post; reception of appeals during personal visits. 
Procedure of the reception and treatment of the public appeals is given at: https://www.rosminzdrav.ru/reception/order
Federal law dated May 02, 2016 # 59-FL “On the procedure of the public appeals in the Russian Federation”.


Legal regulations and norms

Federal law dated November 21, 2011 # 323-FL “On the fundamentals of public health support in the Russian Federation”

Warrant of the Ministry of Public Health of Russia dated June 20, 2013 # 388н “On the approval of the Procedure of emergency medical care delivery, secondary medical care included”

Federal law dated November 29, 2010 # 326-FL “On public compulsory medical insurance in the Russian Federation”

Federal law dated May 04, 2011 # 99-FL “On licensing of separate types of activity”

Warrant of the Ministry of Public Health of Russia dated January 22, 2016 # 36н “On approval of requirements for supply of medications and medical items, and emergency kits”

Warrant of the Ministry of Public Health of Russia dated May 02, 2012 # 500н “On the approval of the list of the State facilities providing medical evacuation”

Federal law dated October 06, 1999 # 184 “On general principles of the organization of the legislative (representative) and executive bodies of the State power in the subjects of the Russian Federation”

Warrant of the Ministry of Public Health and Social Development of the Russian Federation dated May 04, 2012 # 477н “On approval of the list of the human states requiring medical care, and the list of measures on medical care delivery”

Recommendations of the Russian aviation dated December 09, 2013 “Medications and medical items support of the air plains of the civil aviation”

Order of the RF Government dated September 20, 2012 # 950 “On approval of the rules for determination of the moment of the human death, including criteria and procedures of determination of the human death, Regulations for cessation of resuscitation and forms of the protocol for determination of the human death”

Federal law dated August 15, 1996 # 114-FL “On the procedure for exit from the Russian Federation and for entry in the Russian Federation”

Federal law dated November 24, 1996 # 132-FL “On the fundamentals of the tourism activity in the Russian Federation”

“Air Code of the Russian Federation” dated March 19, 1997 # 60-FL

Norms of the international organizations “ICAO”, “IATA”


Long-Term Trends of Activity of the Medical Evacuation Team

– development of the legal norms and standards for delivery of the emergency care, including secondary, medical care and air medical evacuation;

– development of the legal norms and standards providing rules of operation for medical personnel on board the air planes in compliance with the air legislation and customs code; 

– development of the legal norms and standards realized by the Russian aviation and other authoritative bodies concerning rules for medical equipment and medications carriage and application on board the air planes regarding the requirements of the aviation safety service;

– elaboration of interdepartmental ways for cooperation concerning air medical evacuation of the patients, from abroad included;

– regulation of consultative care, telemedicine technology included;

– problems concerning involvement of modern air planes, medical planes included;

– problems of acquiring medical aviation services within the framework of budget grants and contract system.

Paid medical services realized by the specialists of the Centre for Medical Evacuation and Emergency Medical Care

(reference to the types of services and price-list is necessary) – a separate block


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