Medical Care, Emergency

the immediate medical assistance rendered to those who have been injured, accidentally poisoned, or suddenly taken seriously ill. Emergency medical care, including definitive medical management, is provided at the scene of an accident and en route to and in emergency medical care hospitals. In some cases, the service provides transportation to special medical facilities. As a preventive measure, the causes of accidents are recorded and analyzed.

Accident rates rise with the growth of cities and the development of industry and transport. The first emergency medical care station equipped with transportation and medical personnel to treat the injured at the scene of an accident was organized in Vienna in 1881. In Russia the first charitable hospital providing free emergency medical care was opened in Moscow in 1844 by the physician F. P. Gaaz. The first emergency medical care stations were established in Warsaw in 1897, in Moscow in 1898, and in St. Petersburg in 1899. Before the October Revolution of 1917 the few stations maintained by state funds and private donations did not satisfy the need for emergency medical care.

In the USSR emergency medical care services developed as part of the Soviet public health system. In 1974 there were 3,887 emergency medical care stations and divisions, including 180 medical aviation stations. Emergency medical care has become readily available as a result of the establishment of a network of specialized facilities, centralized dispatcher services with a single telephone number (03), a ramified network of substations in large cities, and hospital resuscitation centers and intensive care units. Of equal importance was the introduction of ambulances with radio communication. Specialized teams were organized in the 1950’s in Leningrad, Moscow, Kiev, and many other cities to provide immediate assistance to persons suffering from myocardial infarction, stroke, traumatic shock, acute poisoning, or other disorders. These teams have all the equipment needed to resuscitate victims at the site of an accident and to prepare them for emergency medical care in a hospital.

In areas where there are no emergency medical care stations, emergency treatment is provided during the day by hospital polyclinics and at night by medical institutions with medical personnel on around-the-clock duty. Hospitals admit those in need of immediate hospitalization regardless of whether or not there are free beds. In rural areas emergency medical care is rendered by the physicians and feldshers of rural medical institutions. Physicians on duty in municipal emergency medical care stations are not authorized to issue temporary medical certificates or make forensic medical judgments. The Sklifosovskii Scientific Research Institute of Emergency Medical Care in Moscow and the Dzhanelidze Scientific Research Institute of Emergency Medical Care in Leningrad are among the institutes studying emergency medical care.

In other socialist countries emergency medical care is organized on the same principles as in the USSR. In capitalist countries emergency medical care, which frequently requires payment, is organized by local governments, the Red Cross, insurance companies, and philanthropic societies.