How to get an ambulance. Four million visits a year: how the metropolitan ambulance service works. Ambulance Paramedic Certificate

04.02.2021

Paramedic - medical worker having a specialized secondary education. Despite the fact that he is not a doctor, in some cases it is the paramedic who provides medical assistance to the population. First of all, this applies to work on the "Ambulance".

What are the duties of a paramedic working as part of the ambulance brigade

It depends on who is on the ambulance team.

The paramedic assists the doctor if the ambulance team includes both a doctor and a paramedic. However, such cases are quite rare. More often there are situations when the paramedic works on the road alone, and is forced to perform the functions of an ambulance doctor. In this case, the full responsibility for the treatment of the patient lies only with the paramedic.

Paramedic Skills

The functionality of an ambulance paramedic (According to the Order of the Ministry of Health of the Russian Federation dated July 23, 2010 No. 541n) is very diverse.

The list of basic skills that an ambulance paramedic should have includes:

possession of injection techniques (of all types), the ability to qualitatively install a “dropper”;

taking an electrocardiogram;

measurement of blood pressure, pulse, respiratory rate;

childbirth assistance; necessary manipulations with the newborn;

treatment of wounds and injuries;

resuscitation procedures;

organization of transportation of the patient;

organization of anti-epidemic measures, etc.

A paramedic who works independently on an ambulance should manifest himself as a generalist. In different situations, he performs the functions of a surgeon, a traumatologist, and a therapist; he must also be familiar with the basics of toxicology, pediatrics and obstetrics, be able to assess the neurological and mental state of the patient, conduct the necessary studies and draw conclusions from the data obtained.

In the case of the "Ambulance" also matter personal characteristics health worker.

A paramedic working on an ambulance must make quick and responsible decisions, often in a time pressure situation, in extreme conditions, in the absence of the necessary equipment.

Therefore, it is good if:

has a stable psyche;

confident in himself and his knowledge and capabilities;

diversified;

able to think logically;

friendly, welcoming and attentive.

The last point may seem insignificant, but it is not. Establishing contact with the patient can be extremely important not only to facilitate communication, but also to establish a more complete picture of the disease. In addition, it is important to calm the patient in time, to give him the opportunity to feel that next to him is a highly qualified specialist who can help him.

Ambulance Paramedic Training

Working in an ambulance is different from working in any other medical institution - it requires special knowledge. Therefore, in addition to the requirements that are mandatory for any paramedic, such as secondary specialized education in the specialty "General Medicine", the ambulance paramedic is required to have a certificate of a specialist in "Ambulance and emergency care"

Ambulance Paramedic Certificate

A document on the completion of training in the specialization "Ambulance and emergency care" - a certificate - can be obtained after retraining. Currently, various options for passing courses are being implemented: full-time, part-time and remote.

After the end of the course. You can work on the ambulance. only with this document.

The demand for the profession of paramedic ambulance

Paramedic "Ambulance" - a very popular profession, but, unfortunately, not very prestigious.

The need for specialists is felt almost everywhere.

However, recently the specialty of an ambulance worker has become not only responsible and difficult, but also dangerous. Increasingly, there is information about an attack on an ambulance officer by inadequate patients and their relatives. This cannot but lead to an outflow of employees.

At the moment, there is an active discussion of legislative measures aimed at protecting doctors on duty. As one of the measures, the possibility of legally equating doctors with policemen is being discussed - with all the ensuing consequences for the attackers. But this is in the future.

Average salary of paramedics

Ambulance paramedic salaries vary by region. In Moscow, they say the average figure is about 45 thousand rubles, in the regions - less, about 20-25 thousand

Benefits for paramedics

Ambulance paramedics have a number of additional payments and benefits that other categories of health workers do not have:

surcharge (currently - 3500 per month);

additional payments for understaffing of the brigade (not paid in all regions and in different amounts);

shortened working day lasting 6.5 hours (38.5 hours per week);

additional leave for those who have worked for more than 3 years - 3 calendar days extra days;

the right to early retirement.

Why do specialists go to work in the "Ambulance"?

The work of a paramedic in an ambulance is not easy and not very profitable. Therefore, the turnover in this area is very significant.

Therefore, one of the important problems for the entire ambulance service is the insufficient staffing of mobile teams. Increasingly, only one physician is working in a team on the road - as a rule, a paramedic.

But the health workers themselves admit that the salary is not the main thing for them. Here are the answers of several ambulance workers to the question of why they work there:

A person goes into medicine not for money. And to help, to save people's lives. It's an adrenaline rush when you save a person... Everyone who doesn't like this job leaves after a year. And whoever is left is not going anywhere. It's such a thrill to understand that you are needed... At work, every challenge is a surprise, an adventure, a feeling of being needed when you manage to help people... Thanks to this work, I realize my place in life. I don’t want to speak high-flown words about saving lives and the nobility of the profession, but knowing that your work brings not just joy, but the opportunity to live on is worth a lot ...

Pros and cons of being an ambulance attendant

the opportunity to provide real assistance to a person, up to saving a life;

shorter training period compared to a doctor;

high demand;

stable schedule;

benefits and social guarantees

high responsibility;

heavy work schedule;

work in stressful situations;

low salary.

Hi all! Haven't written for a long time, there were problems, business! I will slowly catch up. So, time is running out. Everything falls into place, so let's continue the doctor's notes.

Many people ask me, what is unusual about your work? What are the disadvantages in this profession? I often clarify what people are interested in, so today I will publish the cons at our work, and why you shouldn’t work for an ambulance. Everything written will be purely my personal opinion and the opinion of my colleagues, so let's go!

Why you shouldn't work in an ambulance.

1. RESPONSIBILITY

Too superficial examination of the patient, inattention, incomplete clarification of the history of the disease (i.e. anamnesis), a couple of incorrect instructions - and a person may not get better, but worse. For example, the introduction of narcotic analgesics in cardiac asthma alleviates the patient's condition, and in bronchial asthma can quickly kill him.
Each brigade is given several ampoules of narcotic and psychotropic drugs, which are subject to strict accounting. Empty ampoules are handed over. Losing or accidentally breaking ampoules (even empty ones) is an emergency. At best, you will be left without a bonus. At worst, they will open a criminal case against you for drug trafficking with all the ensuing consequences, up to a term in a colony.

2. PARONAIDAL PEDANCY

It is necessary to draw up medical documentation very clearly and carefully. Unfortunately, all people are mortal and will die sooner or later. But relatives sometimes believe that doctors are to blame for everything, and not the patient himself, who conscious life drank, smoked or lay on the couch watching TV. They can write a complaint against a health worker to high authorities and file a lawsuit, and the call card will be read more than once " interested persons". In any case, spend a lot of nerves, even if the court acquits you. All documents must be written as if they would be read by the prosecutor tomorrow.
And if you are lucky and no one wrote a complaint against you, you should not relax: medical documentation is routinely read by higher officials and inspectors. On an ambulance, almost on every shift, you have to communicate with the police, the Ministry of Emergency Situations and periodically give evidence.

I recalled an anecdote: to participate in the May Day demonstrations before 1917, one had to have courage, after 1917 - cowardice.

3.EXTEMAL MODE OF WORK.

You don't know where you'll be in 5 minutes. Working shift may start for you a few minutes earlier than expected (an emergency call at "rush hour"), and end much later. Office workers, bored from monotonous activities, in order to somehow distract themselves, jump with a parachute, play paintball, engage in digging and diving. (Although I have many hobbies))) As far as I know, ambulance workers do not suffer from this. Maybe I'm wrong?
But that's not all. In an ambulance, you have a chance to get dirty not only with blood, but also with vomit and other physiological secretions (I will not list). You try, of course, to do everything as carefully as possible, but only those who do nothing do not make mistakes. I will modestly keep silent about smells.

It was on the ambulance that I was able to get to know lice and bedbugs closely for the first time and saw unafraid cockroaches. Senior colleagues say that they have also seen live maggots in old wounds. It's okay, in the Great Patriotic War, wounds were treated like this: maggots ate dead tissue and thereby cleansed the wound.
What would you like?
Emergency doctors - attendants on call. Attitudes towards health workers have now changed significantly. If earlier it was a more respected profession, now we can be hit and beaten, especially when dealing with drunks. For the ambulance, they even planned to buy special personal protective equipment (shockers, gas sprays) But they didn’t buy it. Is it possible for a client who is always right to use a stun gun?

4. WORK ON HOLIDAYS AND WEEKENDS.

"We work where everyone rests." This is the motto of not only gynecologists, but also ambulances. There are no days off for the ambulance. On the New Year usually you have to work either on December 31 or January 1. How else, if these two days contain four 12-hour shifts?
In addition, during mass events(City Day, Victory Day, etc.) additional ambulance teams are on duty. And not always for double payment. And sometimes there are explosions.

5. STUPID ACCUSATIONS

Sometimes we are accused of stealing personal belongings. Most often, lonely grannies sin this. The most anecdotal case in my memory was when my grandmother accused the ambulance team of stealing a washcloth. Grandma later found a washcloth, but she probably left an unpleasant aftertaste.

6. CARRYING PATIENTS AND MEDICAL EQUIPMENT

If the patient is unable to walk on his own or medical indications he can’t go, we ask relatives to help or find stronger neighbors. But there are situations when there is no one to ask (lonely people in a private house, deep night, etc.). Therefore, you have to pull the stretcher mostly on yourself. The main scourge is the LAST floors!! I don’t know why, but basically, all sick people live on the top floors!!
The driver usually helps too, but our patients are often 100 kg each, and it is very difficult to get them down the narrow stairs in the “Khrushchev”, where there is not even an elevator. With a hard stretcher, you can’t turn around, but soft ones cut your hands. It is usually necessary to drag the patient in an uncomfortable and unphysiological position.

There are more and more cars on the streets. We run the risk of getting into an accident, especially when driving with flashing lights (speeds are high, and the road may not give way). We have not yet accepted to insure health workers at the expense of the employer.
Road quality is another story. Because of the constant shaking on the Gazelles, then my back often hurts.
Constant movement along busy streets forces us to breathe exhaust fumes. We have a mountainous area, so there are problems with getting to the place of the call.

8. SEASONS

This is work in a hot summer at + 35 ° C in the shade, when the car heats up, probably up to + 50 ° (air conditioners have appeared only recently, but not everywhere). And work in frost at -28 °, when in the dead of night you need to get into a completely frozen car. To go to the call in heavy rain and in a thunderstorm, when there is a danger of a lightning strike (to be honest, it was scary a couple of times).

9. DISTURBED REGULATION

The generally accepted mode of work on an ambulance (day after two or three or day, night, 2 days off) is flawed in itself. At night, you want to sleep terribly, even if you sleep during the day. To fully operate night shifts, they must be consistent. From physiology, I remember that the body adapts to the change of day and night during the week. In this way, night work in the ambulance - violence against the body.

10. INTERACTION WITH HOSPITALS.

In the emergency department of hospitals, they look at an ambulance in much the same way as Bin Laden looks at America. Some probably still believe that the ambulance is looking for patients around the city itself, having nothing to do. Hospitals, as a rule, are packed to capacity, so there is nowhere to put the sick, and it is dangerous to send them home. The reception department shows miracles of resourcefulness, sending the patient to another hospital. You have to stand your ground, pound on the table with your fist and slyly slip a referral to hospitalization: “Of course, we will go there right away, only you must write your refusal here.” Half the time the last phrase has the effect

There are probably more disadvantages in the work .. Although what am I talking about! I chose this job myself. So it's more like whining! But we are people too, so I want to talk about it. Well, that's all for now. If you have any questions, please in the comments!

It's important to know! How does first aid work?

Specialists of the Station of ambulance and emergency medical care. A.S. Puchkova is always ready to help both in word and deed. However, it is important to know in which cases it is right to call an ambulance, and in which situations you can handle it yourself.

The most common situations when an ambulance is called are associated with a high temperature during colds and flu. It should be noted that the temperature is different. So, everything that is not higher than 39-40 degrees, can often be cured on its own and, in general, is a normal protective reaction of the body to the presence of viruses in it and disappears in 2-3 days. This is the case when the local doctor of your clinic will always help, and before his visit you can apply a fairly simple and well-known therapy at home. The rest (higher temperature and a long period of exacerbation) is a good reason to call a team of doctors (paramedic) to the house.

If we are talking about an acute pathology, a sudden illness, a sharp deterioration in the condition of a chronic patient, a serious injury, of course, you should immediately call 103. If help is required for a patient suffering from one or another chronic disease without exacerbation, No the need to contact emergency medicine specialists, as this is not their prerogative.

The fact is that ambulance teams are not entitled to prescribe systemic treatment and drugs for regular use (for example, for hypertension, etc.), leave any certificates and write out prescriptions. In chronic diseases, it is important to constantly monitor patients, the ability to assess their condition in dynamics, if necessary, to correct therapy (replacement of the drug or its dosage). If there are no indications for inpatient treatment, then it is necessary for the patient to be observed by a local doctor or medical specialists from the district clinic. " Ambulance» can provide only one-time (emergency) assistance. This is not always correct for the patient. Therefore, it is not necessary once again to unnecessarily expose your body to the effects of potent drugs. As a rule, it is precisely them that ambulance workers use, since they are not faced with the task of long-term systemic treatment.

Often, after making a call, ambulance workers leave the so-called “asset to the clinic”, that is, they call the district or duty doctor from the district clinic to this patient. But you can do it yourself, without forcing the team to go to the patient only to later call and call a district police officer for him. The doctor from the polyclinic will arrive both on the day off and on the holiday. It should be noted that the doctor from the clinic comes at the actual location of the patient, regardless of where he is registered and to which clinic he is attached, whether the patient has an insurance policy or not - the doctor will come to the house in any case.

In case of a minor injury that is not associated with a threat to life, you should go to the emergency room at the place of residence on your own - they will provide assistance in full and prescribe further treatment. If the doctor of the emergency room considers it necessary to carry out further treatment in the hospital, he will write out a referral and himself will call a team to transport the patient to the hospital.

The station has emergency departments for children and adults, working around the clock to provide assistance to the population in connection with diseases that do not require emergency hospitalization (for example, fever, cough, runny nose, headache, etc.). A qualified doctor (pediatrician or internist) comes to the call and can provide emergency medical care at home and give recommendations. In cases where the doctor suspects a disease requiring inpatient treatment, he will give a referral or call an ambulance for medical evacuation of the patient.

An ambulance doctor is a representative of the only profession in medicine whose task is to provide emergency (emergency) medical care on call.

An ambulance doctor goes to the scene of an accident, catastrophe, accident or home, carries out urgent measures, saves the patient's life and transports him to the hospital. The task of the ambulance doctor is to buy time to relieve the acuteness of the problem and connect the doctor to the treatment in an operating room or intensive care unit. And during mass disasters, doctors must sort the victims, help the security forces and rescuers.

The provision of emergency emergency care is carried out at any time of the day, in any weather, under any conditions. The work schedule provides for daily duty (24 hours), for which a maximum of 15 calls are made. The health care team consists of a general practitioner or paramedic, a nurse, and a professional driver.

Ambulance teams can be linear and advisory (specialized).

Linear performs the entire scope of emergency care, regardless of profile.
Advisory deals only with narrow-profile care: cardiological, psychiatric, gynecological, obstetric, neurological, traumatological, pediatric, neonatological.

An ambulance doctor does not treat patients, he provides first aid (resuscitation) for burns, shock conditions, poisoning, angina attacks, renal and hepatic colic, conditions requiring surgical intervention, bleeding, asphyxia, hyperthermia, pre-stroke, pre-infarction, suicide attempt, accident case of drowning.

The meaning of emergency measures is the immediate arrival of ambulance doctors after the call. However, the radius of its provision is so large that it is not possible to arrive at the patient in a timely manner. In this case, doctors have to ascertain death. The lethal outcome is also confirmed by ambulance doctors in the case when the arrival is impeccable in terms of timing, but the patient, due to the severity of the condition, dies regardless of this.

The task of the doctor is to buy time to stop the dangerous condition of the patient.

Differences between an ambulance doctor and a paramedic

The difference between a doctor and a paramedic is qualifications.

Places of work

The position of an ambulance doctor (EMS) is available at any station or substation of the EMS, in polyclinics and hospitals. In addition, doctors work as part of the air ambulance and the Ministry of Emergency Situations.

History of the profession

For the first time, attempts to organize an ambulance in Russia were made by F. Rtishchev, who during the war with the Poles gathered the wounded on the battlefield and delivered them to nearby cities to care for them. In the future, the functions of emergency medical care were for a long time delegated to firefighters and policemen.

They tried to open the first official emergency hospital in 1818, but it did not receive the approval of the authorities. Only ten years later, an emergency care service for patients was organized in St. Petersburg. However, it was financed on a residual basis and eked out a miserable existence. With development industrial production the pace of life in the cities has noticeably accelerated. Transport appeared, manufactories, factories, factories opened. They were equipped with advanced technology, which created the risk of injury. Life itself dictated the conditions for the emergence of an ambulance.

The crush on Khodynka served as the reason for its final formation. More than 2,000 died, many due to the fact that there was no one to provide emergency care. The first ambulance station was opened in Russian Warsaw (1897), and then, a year later, in Moscow. But the date of birth of the ambulance is considered to be 1927, when a whole fleet of ambulances was organized. In Moscow, the position of a shift doctor, a control room, an accompanying sheet were approved, and in 1957 the first ambulance appeared in Leningrad. A year later, a brigade was created to help with heart attacks and strokes.

Ambulance emergency assistance is provided around the clock and under any conditions.

Responsibilities of an emergency physician

The main responsibilities of an emergency physician are as follows:

Monitoring the health status of the brigade, its equipment with tools and medicines.
Receiving a call from the dispatcher and within a minute sending to the route (age, address, patient complaints are preliminarily specified).
Providing emergency medical care, diagnosing the problem, making a decision on the further management of the patient.
Transportation of the patient to a specialized hospital with the provision of intensive care if necessary. If the patient refuses hospitalization, a mandatory note about this in the appointment sheet indicating the reason and the measures taken.
Providing assistance in case of an accident on the street, outside the call, if one was encountered on the route. Mandatory notification of the dispatcher in order to transfer the call to another team.
Consultation of patients and relatives in oral form without issuing prescriptions and certificates.
Declaration of death.
Maintenance of an accompanying sheet indicating the time the call was received, the mileage of the trip, the time of arrival at the place, the manipulations performed, the diagnosis and recommendations, or the point of transportation.

Requirements for an ambulance doctor

Basic requirements for an emergency doctor include:

Higher medical education, a valid accreditation sheet for emergency medical care.
Knowledge of medical ethics in dealing with patients and their relatives.
Resuscitation skills: closed heart massage, mouth-to-mouth breathing, tracheotomy, administration of drugs in various ways.
Possession of medical equipment for ECG, ultrasound, pacing.

The specialist does not treat patients, but provides first aid or resuscitation.

How to become an emergency doctor

To become an emergency physician, you must:

Graduate from a university or medical school with a degree in General Medicine or Pediatrics.
Get an accreditation sheet. To do this, you need to pass the exam and successfully pass an interview with an expert commission.
After that, you can work with patients on an outpatient basis (for example, a general practitioner or pediatrician).
To obtain a narrow specialization, you can enroll in residency (2 years of study) in the specialty "Ambulance". Paid easier, because the competition is small and for admission you need to have only 50 attestation points. Is free You can get into residency in two ways: by competition on a general basis or by the targeted referral of the head physician medical organization in which the specialist is already working.

Each year, doctors are required to score 50 certification points. To do this, you can take advanced training courses (36 points), attend scientific and practical conferences(the number of points depends on the event, but usually about 10 points), publish scientific papers, write books, defend dissertations. If enough points are scored, then you can work further. If points are not scored, then you will either have to stop medical practice, or solve this problem in “non-standard” ways.

The experience, skill and quality of the doctor's work is usually assessed qualification categories , which can be obtained by protecting research work. During the defense, the commission evaluates the doctor's skills in the field of diagnosis, treatment, prevention, as well as the relevance of his knowledge.

What are the qualification categories?

the second - over 3 years of experience;
the first - more than 7 years of experience;
higher - more than 10 years of experience.

The qualification category allows you to hold high positions in medical institutions, entitles you to a salary increase, gives you a status in a professional environment and high confidence on the part of patients. Even more respect can be achieved by speaking at conferences, symposiums and creating scientific articles and papers.

The doctor has the right not to qualify, but this will hinder his career and professional growth.

emergency doctor salary

The general income range is as follows: emergency doctors earn from 26,500 to 150,000 rubles per month. Most of all, emergency doctors are in demand in the Moscow, Leningrad, Novosibirsk regions and the Krasnodar Territory. We found the minimum salary from a doctor in the city of Bataysk (Rostov Region): 26,297 rubles per month, the maximum - in one of the St. Petersburg enterprises: 150,000 rubles per month.

The average salary of an ambulance doctor is 31,000 rubles per month.

Where to get training

Apart from higher education There are a number of short-term trainings on the market, typically lasting from a week to a year.

Medical University of Innovation and Development invites you to pass distance courses retraining or advanced training in the direction of "" with a diploma or certificate state sample. Training lasts from 16 to 2700 hours, depending on the program and your level of preparation.

Our site always presents a large number of fresh current vacancies. Use filters to quickly search by parameters.

For successful employment, it is desirable to have specialized education, and also have necessary qualities and work skills. First of all, you need to carefully study the requirements of employers in the chosen specialty, then start writing a resume.

You should not send your resume to all companies at the same time. Choose suitable vacancies based on your qualifications and work experience. We list the most significant skills for employers that you need to successfully work as an emergency doctor in Moscow:

Top 7 Key Skills You Need to Get a Job

Also quite often in vacancies there are the following requirements: to know the symptoms of conditions requiring emergency hospitalization and the use of methods of intensive care, sociability and emergency care.

When preparing for an interview, use this information as a checklist. This will help you not only to please the recruiter, but also to get the desired job!

Analysis of vacancies in Moscow

According to the results of the analysis of vacancies published on our website, the indicated starting salary, on average, is 67,400 . The average maximum income level (specified "salary to") is 100,076. Keep in mind that these figures are statistics. The actual salary during employment can vary greatly depending on many factors: