Service of medicine of catastrophes
In the last decades all over the world are intensively developing scientific-practical direction “medicine” associated with the provision of emergency medical care (EMC) at the same time a large number of affected. Emergency medicine is an integral part of emergency response in extreme situations.
The world community’s experience in the management of emergency medical forces emergency organization of the Federal and regional levels of governance and their interaction is of considerable interest.
Rapid response systems for emergencies were established in various countries after a series of major chemical accidents (Bhopal, India — 1984; G. Seveso, Italy — 1975; G. Habbestad, UK — 1984, etc.). In the United States since the second half of 80-ies. the environment Agency conducts intensive work to create rapid response systems for chemical accidents. In Europe in 1987 by the UN Commission on the protection of the environment — UNEP (United Nations Environment Programme) — began the implementation of the project APELL (Awareness and Preparedness for Emergencies at the Local Level). APELL provides guidelines for raising awareness of local public about potentially hazardous enterprises and is designed to prepare coordinated plans for responding to emergencies. It is a system of actions during industrial accidents.
In the United States at the state level for development of measures and determining overall policy for the prevention and elimination of consequences of catastrophes and natural disasters is multiple departments, reporting directly to the President. The main office, which plays a major role in disasters is FEMA (Federal Emergency Management Agency). It coordinates the activities of the civil protection authorities of the States, Federal ministries and agencies (Ministry of energy, Ministry of transport, etc.) and private sector enterprises.
FEMA also provides training, education and dissemination of information, conducting scientific research, solving problems on the fight against terrorism, control over the use of electronic media in times of emergency, cooperation with the Armed forces. FEMA is directly connected with the regional centres and centres of emergency response States. The city centre is interconnected with the following agencies and organizations: Department of public utilities, schools, military units, hospitals and other medical institutions, including the military, the American branch of the red cross, salvation Army, insurance agencies, fire agencies, the district investigation unit, the local Amateur radio societies, transport agencies. Medical aid at emergencies in the US, is part of the National system of medicine of catastrophes (National Disaster Medical System — NDMS). Responsible for NDMS are the Ministry of health and social welfare and the Ministry of defence. Material support is provided by FEMA and the veterans Committee. NDMS organizational planning, evacuation, sanitary-hygienic and health measures, the organization of units of specialized medical care and distribution of affected hospitals in the event of a disaster. In accordance with the Directive of the President, the Ministry of health and social welfare, responsible for medical support of the civilian population in the event of emergencies, manages the medical service.
In France, adopted a decentralized form of coordination of rescue operations. Each Department and major town has a special system of forces and means for liquidation of consequences of natural disasters or accidents, leading to the emergence of a large number of victims.
The signal about the accident goes to the police first, and then is transmitted to the Central Council for the organisation and assistance services of the Prefecture. In 1956, established emergency medical service Aide Medicale d’ Urgence, SAMU. Each of the 97 items on duty around the clock therapists, surgeons, anesthesiologists-Intensivists and nursing staff. In addition, SAMU with people constantly working with other institutions (medical, police, fire, transportation, etc.) and specially trained for the 400-hour program.
An important role in the provision of emergency assistance to people affected by a disaster, play the formation of voluntary rescue (secourism) — very popular in France at the present time. There is another term — sauver, which means the rescuer. Very often, these two concepts appear simultaneously. The French Association of voluntary rescuers showed its effectiveness, especially in cases where these voluntary groups were provided with the necessary equipment.
Mass movement in first aid as you think you are in France, should be developed. The creation of groups of rescuers pay great attention, to assist and support the government, government departments and cities.
Believe in France, the purpose of first aid — to take all necessary measures emergency with the threat of the vital functions of the body. A certified lifeguard must be able to bring people out of critical condition. Well-trained rescuers easily involved in rescue efforts in major disasters.
In specialized teams of emergency medical care certified lifeguards take on the role of managers of such teams, and medical personnel in them only performs its direct duties.
In Germany, the ambulance system in emergency situations includes elements of disaster medicine, USA and France.
In the event of a disaster to assist with the police involved all of the Federal and municipal services, fire stations and support services and charity unions. For example, in Bavaria there are about 7800 of voluntary fire teams, consisting of approximately 348 thousand firefighters, 6 professional and about 400 factory and industrial fire brigades. Their competence includes not only fire protection, but also technical assistance in case of catastrophes and other emergency situations. Among voluntary support services the largest organization is the Bavarian Red Cross, for regional large-scale cases comes as the Federal reserve by train using Bayern. The train provides help approximately 4,000 individuals from the medical service and maintenance. In addition, it has 19 fully equipped TEW infectious hospitals.
In Sweden, the emergency medical services in disasters, similar to the French, is administered by the fire Department of the Ministry of internal Affairs of the country.
In 1975 was formed the Swedish Association of emergency medical assistance to improve skills in the event of catastrophes. With the help of the Association is held enhanced rate for emergency services and rescuers. The purpose of training is to develop skills to provide care to the victims of the fires and the explosions, the destruction of structures, landslides, floods, and storms, road accidents, radioactive contamination, spills of oil and hazardous chemicals.
In 1986 established the National office of the emergency services, leadership in emergencies emergency rescue work of the 284 local authorities. It is responsible for the organization and training of municipal and rescue services, municipalities, provides reference and consulting support for their work in extreme situations, provides the population with all necessary information. Emergency medical institutions of Sweden transferred to the command of the civil defence of the relevant level and are ready to accept to 200 thousand affected (total population 8 million people). In addition, can be deployed 92 stationary, 90 temporary hospitals and 76 private clinics. On state, municipal warehouses and municipalities have established adequate supplies of medicines, medical equipment and other material resources.
In the UK the Central body that coordinates the actions of emergency rescue service in the country is the Ministry of the interior.
In the government, except the Ministry of internal Affairs in coordinating the preparation and conduct of rescue operations involved leading a Ministry in whose purview the area or object caught in the disaster zone. Along with the Ministry of internal Affairs it shall inform about the accident and liquidation of its consequences, the government, the Parliament and the public. In major disasters after evaluating the leading Ministry to the scale and nature of the emergency, the Cabinet of Ministers develops the necessary solutions to enhance the rescue operations and assistance to local authorities, appropriate services and population.
In Belgium the system response in the event of emergencies includes 5 centers of crisis situations, staffed by professionals. Directs the Ministry of internal Affairs of the country. The centres are equipped with necessary technical means of locating accidents and rescue people.
Management of forces and means of potentially dangerous objects, as well as crisis centres is carried out in a single information management system. Preparation of the emergency departments and specialists of enterprises in Belgium is organized on the basis of a special centre equipped with the necessary equipment and staffed with qualified teachers. It has a ground, a training space for practicing emergency.